Most Read Articles
29 Mar 2020
Targeting a low-density lipoprotein cholesterol level <70 mg/dL following an ischaemic stroke of atherosclerotic origin helps to avoid one in four subsequent major vascular events without increasing the risk of intracranial haemorrhage over about 5 years of follow-up, according to data from the Treat Stroke to Target trial.
Pearl Toh, 12 Sep 2020
Early initiation of rhythm-control therapy led to a significantly reduced risk of major adverse cardiovascular (CV) outcomes compared with usual care (typically rate control) in patients with newly diagnosed atrial fibrillation (AF) at risk of stroke, reveals the EAST-AFNET 4* trial presented at ESC 2020.
Audrey Abella, 16 Sep 2020
The final results of EVAPORATE* reinforce the plaque-regressing potential of icosapent ethyl (IPE) in patients on statins for elevated triglycerides.
01 Feb 2020
High-intensity statin therapy appears to be seeing increased use in patients with acute coronary syndrome and leads to better lipid control, according to a recent Thailand study.

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).

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Most Read Articles
29 Mar 2020
Targeting a low-density lipoprotein cholesterol level <70 mg/dL following an ischaemic stroke of atherosclerotic origin helps to avoid one in four subsequent major vascular events without increasing the risk of intracranial haemorrhage over about 5 years of follow-up, according to data from the Treat Stroke to Target trial.
Pearl Toh, 12 Sep 2020
Early initiation of rhythm-control therapy led to a significantly reduced risk of major adverse cardiovascular (CV) outcomes compared with usual care (typically rate control) in patients with newly diagnosed atrial fibrillation (AF) at risk of stroke, reveals the EAST-AFNET 4* trial presented at ESC 2020.
Audrey Abella, 16 Sep 2020
The final results of EVAPORATE* reinforce the plaque-regressing potential of icosapent ethyl (IPE) in patients on statins for elevated triglycerides.
01 Feb 2020
High-intensity statin therapy appears to be seeing increased use in patients with acute coronary syndrome and leads to better lipid control, according to a recent Thailand study.