Most Read Articles
Jairia Dela Cruz, 10 Sep 2019
Use of aspirin in the primary prevention of cardiovascular disease (CVD) in patients with no prior CVD history yields protection against the risks of acute myocardial infarction (AMI) and ischaemic stroke, but at the expense of an increase of similar magnitude in the incidence of major bleeding, according to the results of a recent meta-analysis presented at the European Society of Cardiology (ESC) Congress 2019 in Paris, France.
Dr Margaret Shi, 6 days ago

A comprehensive model of care delivered by nonphysician health workers (NPHWs), involving primary care physicians and families that was informed by local context, substantially improved blood pressure (BP) control and cardiovascular disease (CVD) risk, according to results of the HOPE 4 trial reported at the European Society of Cardiology (ESC) Congress 2019 and World Congress of Cardiology (WCC) 2019.

Prophylactic methylprednisolone may benefit some neonates undergoing cardiac surgery

11 Aug 2019

Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.

However, patients undergoing palliative procedures seem to benefit from corticosteroid therapy. In addition, a significant interaction exists between treatment effect and centre, suggesting the possibility of centre or patient characteristics that make prophylactic methylprednisolone helpful.

This double-blind randomized controlled trial determined whether intraoperative methylprednisolone improved postoperative recovery in neonate undergoing cardiac surgery. The investigators enrolled 190 neonates undergoing cardiopulmonary bypass at two centres after the induction of anaesthesia, among whom 176 (n=81 methylprednisolone 30 mg/kg; n=95 placebo) were included in the analysis.

The primary endpoint was a previously validated morbidity-mortality composite of any of the following events after surgery before discharge: death, cardiac arrest, hepatic injury, renal injury, mechanical circulatory support or rising lactate level (>5 mmol/l).

These outcomes occurred in 27 (33 percent) neonates in the methylprednisolone group and 40 (42 percent) in the placebo group (odds ratio [OR], 0.63, 95 percent CI, 0.31–1.3; p=0.21). However, methylprednisolone led to decreases in vasoactive inotropic requirement and in the incidence of the composite endpoint in patients undergoing palliative operations (OR, 0.38, 0.15–0.99; p=0.048).

Furthermore, a significant interaction was observed between treatment effect and centre in this analysis. Corticosteroid therapy conferred a protective benefit at one centre (OR, 0.35, 0.15–0.84; p=0.02) but not at the other (OR, 5.13, 0.85–30.90; p=0.07).

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 10 Sep 2019
Use of aspirin in the primary prevention of cardiovascular disease (CVD) in patients with no prior CVD history yields protection against the risks of acute myocardial infarction (AMI) and ischaemic stroke, but at the expense of an increase of similar magnitude in the incidence of major bleeding, according to the results of a recent meta-analysis presented at the European Society of Cardiology (ESC) Congress 2019 in Paris, France.
Dr Margaret Shi, 6 days ago

A comprehensive model of care delivered by nonphysician health workers (NPHWs), involving primary care physicians and families that was informed by local context, substantially improved blood pressure (BP) control and cardiovascular disease (CVD) risk, according to results of the HOPE 4 trial reported at the European Society of Cardiology (ESC) Congress 2019 and World Congress of Cardiology (WCC) 2019.