Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 6 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.

Connective tissue diseases increase complication risk after PCI

05 Apr 2020

Percutaneous coronary intervention (PCI) appears to come with more complications in patients with connective tissue disease (CTD), leading to excess rates of acute kidney injury (AKI) and access site complications (ASC), a recent study has found.

Accessing the National Inpatient Database, researchers identified 17,422 CTD patients (mean age, 63.0±12.1 years; 63.2 percent female) who had undergone PCI between the years 2007 and 2015. Aside from AKI and ASC, other study outcomes included ventricular fibrillation, cardiogenic shock, stroke, in-hospital mortality and hospital length of stay (LOS). Patients were propensity-matched with 52,566 no-CTD controls.

AKI occurred significantly more frequently in the CTD arm than in controls (8.3 percent vs 6.6 percent; p<0.001), as did ASC (3.2 percent vs 2.7 percent; p=0.01). Mean hospital LOS was likewise significantly longer in patients with CTD (4.2±4.8 vs 3.8±5.2 days; p<0.001).

This was confirmed in multivariate analyses, which found that AKI was 18-percent more likely to occur in CTD patients (odds ratio [OR], 1.18, 95 percent confidence interval [CI], 1.01–1.27; p<0.001), while ASC was 14-percent more likely (OR, 1.14, 95 percent CI, 1.02–1.27; p=0.01). No such effect was found for the other endpoints.

Subgroup analyses yielded generally consistent results. AKI, ASC and hospital LOS were all significantly greater in patients with rheumatoid arthritis and systemic lupus erythematosus. In those with scleroderma, only AKI risk and LOS were elevated, while in patients with Sjögren’s syndrome, all three correlations were attenuated.

“Awareness of CTD diagnosis in patients before PCI could help operators apply caution in the volume of contrast used and make decisions about the duration and volume of hydration to decrease AKI. Also, such information may guide operators on the choice of vascular access and choice of vascular closure following PCI,” the researchers said.

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Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 6 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.