Abstract:
BACKGROUND:Acute pericarditis is common, yet uncertainty persists on its treatment. We thus aimed to conduct a comprehensive systematic review on pharmacologic treatments for acute or recurrent pericarditis. METHODS:Controlled clinical studies were searched in several databases and were included provided they focused on pharmacologic agents for acute pericarditis or its recurrences. Random-effect odds ratios (ORs) were computed for long-term treatment failure, pericarditis recurrence, rehospitalization, and adverse drug effects. RESULTS:From 2,078 citations, 7 studies were finally included (451 patients); but only 3 were randomized trials. Treatment comparisons were as follows: colchicine versus standard therapy (3 studies, 265 patients), steroids versus standard therapy (2 studies, 31 patients), low-dose versus high-dose steroids (1 study, 100 patients), and statins versus standard therapy (1 study, 55 patients). Colchicine was associated with a reduced risk of treatment failure (OR = 0.23 [0.11-0.49]) and recurrent pericarditis (OR = 0.39 [0.20-0.77]), but with a trend toward more adverse effects (OR = 5.27 [0.86-32.16]). Overall, steroids were associated with a trend toward increased risk of recurrent pericarditis (OR = 7.50 [0.62-90.65]). Conversely, low-dose steroids proved superior to high-dose steroids for treatment failure or recurrent pericarditis (OR = 0.29 [0.13-0.66]), rehospitalizations (OR = 0.19 [0.06-0.63]), and adverse effects (OR = 0.07 [0.01-0.54]). Data on statins were inconclusive. CONCLUSIONS:Clinical evidence informing decision-making for the management of acute pericarditis and its recurrences is still limited to few, small, and/or low-quality clinical studies. Notwithstanding such major caveats, available studies routinely using nonsteroidal anti-inflammatory agents in both experimental and control groups suggest a beneficial risk-benefit profile for colchicine and a detrimental one for steroids, especially when used at high dosages.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Lotrionte M,Biondi-Zoccai G,Imazio M,Castagno D,Moretti C,Abbate A,Agostoni P,Brucato AL,Di Pasquale P,Raatikka M,Sangiorgi G,Laudito A,Sheiban I,Gaita Fdoi
10.1016/j.ahj.2010.06.015subject
Has Abstractpub_date
2010-10-01 00:00:00pages
662-70issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00509-0journal_volume
160pub_type
杂志文章,评审abstract::To determine whether mitral valve annulus displacement (MVAD) can be used to assess septal contractility in patients with paradoxical septal motion, we assessed four atrioventricular regions (septum, lateral wall, anterior wall, and inferior wall) by MVAD in 80 consecutive patients. The patients were divided into five...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90062-9
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:This study investigates whether pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with metabolic syndrome (MS) using intravascular ultrasound (IVUS). Pioglitazone, a novel insulin-sensitizing thiazolidinedione, has been shown to reduce neointimal hyperplasia after co...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.022
更新日期:2007-05-01 00:00:00
abstract::Current evidence suggests that the pathogenesis of atrial fibrillation (AF) is multifactorial. The observation that AF, once present, alters the electrophysiologic properties of the atrial myocardium causing self-perpetuation of the arrhythmia raised the importance of electrical remodeling in its pathogenesis. Althoug...
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pub_type: 杂志文章,评审
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abstract:BACKGROUND:Long-term treatment with beta-blockers reduces mortality after acute myocardial infarction (AMI). Whether beta-blockers exert a class effect is unknown. METHODS:We analyzed mortality after AMI in Canadian patients 65 years or older who were discharged from hospital with a diagnosis of AMI from April 1996 to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.11.008
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90982-2
更新日期:1992-10-01 00:00:00
abstract::Women with coronary artery disease are less likely to undergo percutaneous transluminal coronary angioplasty (PTCA) because of the potential referral bias in favor of men with coronary artery disease in the use of invasive diagnostic procedures and interventions. This difference may represent a sex bias in the deliver...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70056-5
更新日期:1997-10-01 00:00:00
abstract::This study correlates the anatomic pathologic coronary anatomy found by arteriography in each of three groups of symptomatic patients, all with coronary artery disease, divided according to the magnitude of ST-segment depression after an adequate submaximal treadmill exercise test. Group I consists of 45 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90080-0
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-8703(98)70024-9
更新日期:1998-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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journal_title:American heart journal
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2003.12.011
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90577-5
更新日期:1991-11-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.08.019
更新日期:2009-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:2003-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90837-8
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:American heart journal
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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