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European Heart Journal Supplements: Journal of the European Society of Cardiology

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https://read.qxmd.com/read/30837806/potassium-binders-for-the-prevention-of-hyperkalaemia-in-heart-failure-patients-implementation-issues-and-future-developments
#1
Faiez Zannad, João Pedro Ferreira, Bertram Pitt
New therapeutic options to treat hyperkalaemia, such as potassium binders, have been suggested as potentially beneficial by allowing the maintenance (or increase) of the dose of medications that improve outcomes in several cardiovascular conditions, but which have in common the propensity for raising serum potassium. However, potassium binding drugs have yet to prove their causal association with improvements in patients' prognosis before their widespread use can be recommended. In this review we provided an up-to-dare appraisal on potassium binders, their potential clinical applications and directions for future research...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837805/a-new-area-for-the-management-of-hyperkalaemia-with-potassium-binders-clinical-use-in-nephrology
#2
Patrick Rossignol
Chronic kidney disease (CKD) patients and more so CKD patients treated with renin-angiotensin-aldosterone system inhibitors (RAASi) are prone to experience hyperkalaemia, a condition associated with an increased risk of death. This represents a true dilemma in daily practice since RAASi are the cornerstones of nephroprotective and cardioprotective strategies in CKD patients, as well as in hypertensive patients with or without CKD. The recent availability in the USA and EU of the potassium-binding resin Patiromer, together with sodium zirconium cyclosilicate (SZC), which was more recently approved in the EU and the US, may lead to a paradigm shift both in the treatment of hyperkalaemia and in enabling RAASi maintenance...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837804/new-treatments-for-hyperkalaemia-clinical-use-in-cardiology
#3
Shilpa Vijayakumar, Javed Butler, Stefan D Anker
Hyperkalaemia causes significant burden, and even mild hyperkalaemia has been independently associated with increased morbidity and mortality. Patients with chronic disease states, such as heart failure, hypertension, chronic kidney disease and diabetes mellitus, are increasingly susceptible to the development of hyperkalaemia. Options for management of hyperkalaemia had mainly been limited to short-term, temporizing methods with focus on rapid achievement of normokalaemia. Until recently, there was a lack of safe, efficacious and well-tolerated therapies for long-term management...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837803/new-frontiers-for-management-of-hyperkalaemia-the-emergence-of-novel-agents
#4
Michael E Nassif, Mikhail Kosiborod
Hyperkalaemia is a common electrolyte abnormality, associated with higher risk of morbid events, and increasing in prevalence-in part, due to increasing rates of comorbidities such as heart failure, chronic kidney disease, diabetes mellitus, and the use of renin-angiotensin-aldosterone system inhibitors (RAASi). In spite of this growing problem, the existing treatments for chronic hyperkalaemia have been limited, and are typically confined to dietary potassium restrictions and cessation or modification of RAASi, with latter option being potentially problematic given the known morbidity and mortality benefit of RAASi therapy in certain disease states, such as heart failure...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837802/pharmacology-of-new-treatments-for-hyperkalaemia-patiromer-and-sodium-zirconium-cyclosilicate
#5
Giuseppe M C Rosano, Ilaria Spoletini, Stefan Agewall
Hyperkalaemia is a life-threatening condition, resulting from decreased renal function or dysfunctional homoeostatic mechanisms, often affecting patients with cardiovascular (CV) disease. Drugs such as renin-angiotensin-aldosterone system inhibitors (RAASi) are known to improve outcomes in CV patients but can also cause drug-induced hyperkalaemia. New therapeutic options exist to enhance potassium excretion in these patients. To this aim, we reviewed pharmacological properties and available data on patiromer and sodium zirconium cyclosilicate for the treatment of hyperkalaemia...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837801/barriers-to-guideline-mandated-renin-angiotensin-inhibitor-use-focus-on-hyperkalaemia
#6
Shilpa Vijayakumar, Javed Butler, George L Bakris
Hyperkalaemia in patients with chronic disease states can be caused by both abnormalities of potassium homeostasis as well as extrinsic factors such as medication use and potassium intake. In patients with heart failure (HF), chronic kidney disease (CKD), diabetes mellitus (DM), and in those who use renin-angiotensin-aldosterone system inhibitors (RAASi), there is particularly increased risk of chronic or recurrent hyperkalaemia. Hyperkalaemia is often a reason for the suboptimal dosing or complete discontinuation of RAASi...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837800/current-treatment-and-unmet-needs-of-hyperkalaemia-in-the-emergency-department
#7
Zubaid Rafique, Tahar Chouihed, Alexandre Mebazaa, W Frank Peacock
Hyperkalaemia is a common electrolyte abnormality and can cause life-threatening cardiac arrhythmia. Even though it is common in patients with diabetes, heart failure, and kidney disease, there is poor consensus over its definition and wide variability in its treatment. Medications used to treat hyperkalaemia in the emergent setting do not have robust efficacy and safety data to guide treatment leading to mismanagement due to poor choice of some agents or inappropriate dosing of others. Moreover, the medications used in the emergent setting are at best temporizing measures, with dialysis being the definitive treatment...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837799/hyperkalaemia-aetiology-epidemiology-and-clinical-significance
#8
Jasper Tromp, Peter van der Meer
Disturbances in the potassium homeostasis are common among patients with heart failure (HF) and negatively affect clinical outcome. Patients with HF have a higher prevalence of common risk factors related to hyperkalaemia, including diabetes mellitus, hypertension, and chronic kidney disease. Furthermore, the use of renin-angiotensin-aldosterone system (RAAS) inhibitors, is an important risk factor for developing hyperkalaemia. The association between hyperkalaemia and mortality is not unequivocal, depends on the study type (trial vs...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30837798/potassium-homoeostasis-and-pathophysiology-of-hyperkalaemia
#9
Keld Per Kjeldsen, Thomas Andersen Schmidt
Determination of potassium level is one of the most frequent laboratory tests in clinical medicine. Hyperkalaemia is defined as a potassium level >5.0 mmol/L and is one of the most clinically important electrolyte abnormalities, because it may cause dangerous cardiac arrhythmia and sudden cardiac death. Here, we review methodological challenges in the determination of potassium levels, important clinical aspects of the potassium homoeostasis as well as of the pathophysiology of hyperkalaemia.
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30555280/repetitive-levosimendan-treatment-in-the-management-of-advanced-heart-failure
#10
Fabrizio Oliva, Josep Comin-Colet, Francesco Fedele, Friedrich Fruhwald, Finn Gustafsson, Matti Kivikko, Attila Borbély, Gerhard Pölzl, Carsten Tschöpe
Inotropes may be an appropriate treatment for patients with advanced heart failure (AdHF) who remain highly symptomatic despite optimized standard therapies. Objectives for inotrope use in these situations include relief of symptoms and improvement of quality of life, and reduction in unplanned hospitalizations and the costs associated with such episodes. All of these goals must be attained without compromising survival. Encouraging findings with intermittent cycles of intravenous levosimendan have emerged from a range of exploratory studies and from three larger controlled trials (LevoRep, LION-HEART, and LAICA) which offered some evidence of clinical advantage...
December 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30555279/use-of-levosimendan-in-acute-heart-failure
#11
Veli-Pekka Harjola, George Giannakoulas, Dirk von Lewinski, Simon Matskeplishvili, Alexandre Mebazaa, Zoltan Papp, Robert H G Schwinger, Piero Pollesello, John T Parissis
As a calcium sensitizer and inodilator that augments cardiac contractility without increasing myocardial oxygen demand or exacerbating ischaemia, levosimendan may be well configured to deliver inotropic support in cases of acute heart failure (AHF). Other factors favouring levosimendan in this setting include its extended duration of action due to the formation of an active metabolite and the lack of any attenuation of effect in patients treated with beta-blockers. Effects of levosimendan on systemic haemodynamics include its significant, dose-dependent increases in cardiac output, stroke volume and heart rate, and decreases in right and left ventricular filling and total peripheral resistance...
December 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30555278/levosimendan-in-acute-and-advanced-heart-failure-still-some-chapters-to-be-written
#12
EDITORIAL
Gerhard Pölzl
No abstract text is available yet for this article.
December 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29977165/betrixaban-for-prevention-of-venous-thromboembolism-in-acute-medically-ill-patients
#13
Jan Beyer-Westendorf, Peter Verhamme, Rupert Bauersachs
Venous thromboembolism (VTE) is a common, potentially preventable cause of morbidity and mortality among acute medically ill patients. More than half of VTE events in this population occur after hospital discharge. Thus, providing extended-duration VTE prophylaxis from in-hospital through the post-discharge continuum may improve the quality of care in patients at risk of VTE. Betrixaban is a new oral, once-daily factor Xa inhibitor approved by the United States (US) Food and Drug Administration (FDA) for extended-duration prophylaxis of VTE in acute medically ill patients...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29977164/pharmacological-properties-of-betrixaban
#14
Menno V Huisman, Frederikus A Klok
Venous thromboembolism (VTE) in acute medically ill patients is a leading cause of in-hospital morbidity and mortality. A majority of these VTE events occur post-discharge, and patients remain at increased VTE risk for up to 3 months post-discharge. Recent clinical trials of extended-duration thromboprophylaxis with enoxaparin, rivaroxaban, and apixaban in acute medically ill patients did not demonstrate a net clinical benefit compared with in-hospital thromboprophylaxis, and were shown to be associated with higher risks of major bleeding...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29977163/reducing-the-burden-of-venous-thromboembolism-in-the-acute-medically-ill-population-with-extended-duration-thromboprophylaxis
#15
Walter Ageno, Beverley J Hunt
Hospitalized acute medically ill patients are vulnerable to venous thromboembolism (VTE), known as hospital-acquired thrombosis (HAT). The elevated risk of HAT is usually due to a combination of factors, with immobility and a prothrombotic state due to acute illness being the most frequent. The HAT risk persists well after hospital discharge, with more than half of events occurring after patient release. These HAT events may be fatal, and patients who survive the initial event may be subject to VTE recurrence, chronic discomfort from post-thrombotic syndrome and, although rare, may develop chronic thrombo-embolic pulmonary hypertension, which is often debilitating...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29977162/highlights-burden-of-venous-thromboembolism-and-role-of-extended-duration-thromboprophylaxis-in-acute-medically-ill-patients
#16
(no author information available yet)
No abstract text is available yet for this article.
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29977161/extended-thromboprophylaxis-with-betrixaban-a-new-standard-for-acute-medically-ill-patients
#17
EDITORIAL
Alexander T Cohen
No abstract text is available yet for this article.
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/29867293/consensus-document-anmco-ance-arca-gicr-iacpr-gise-sicoa-long-term-antiplatelet-therapy-in-patients-with-coronary-artery-disease
#18
Michele Massimo Gulizia, Furio Colivicchi, Maurizio Giuseppe Abrignani, Marco Ambrosetti, Nadia Aspromonte, Gabriella Barile, Roberto Caporale, Giancarlo Casolo, Emilia Chiuini, Andrea Di Lenarda, Pompilio Faggiano, Domenico Gabrielli, Giovanna Geraci, Alessio Gaetano La Manna, Aldo Pietro Maggioni, Alfredo Marchese, Ferdinando Maria Massari, Gian Francesco Mureddu, Giuseppe Musumeci, Federico Nardi, Antonio Vittorio Panno, Roberto Franco Enrico Pedretti, Massimo Piredda, Enrico Pusineri, Carmine Riccio, Roberta Rossini, Fortunato Scotto di Uccio, Stefano Urbinati, Ferdinando Varbella, Giovanni Battista Zito, Leonardo De Luca
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor is the cornerstone of pharmacologic management of patients with acute coronary syndrome (ACS) and/or those receiving coronary stents. Long-term (>1 year) DAPT may further reduce the risk of stent thrombosis after a percutaneous coronary intervention (PCI) and may decrease the occurrence of non-stent-related ischaemic events in patients with ACS. Nevertheless, compared with aspirin alone, extended use of aspirin plus a P2Y12 receptor inhibitor may increase the risk of bleeding events that have been strongly linked to adverse outcomes including recurrent ischaemia, repeat hospitalisation and death...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30188961/landiolol-for-managing-atrial-fibrillation-in-post-cardiac-surgery
#19
Jean-Luc Fellahi, Matthias Heringlake, Johann Knotzer, William Fornier, Laure Cazenave, Fabio Guarracino
Landiolol is an intravenous ultra-short acting beta-blocker which has been used in Japan for many years to prevent and/or to treat post-operative atrial fibrillation following cardiac surgery. The drug is now available in Europe. This article is a systematic review of literature regarding the use of landiolol in that specific surgical setting.
January 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://read.qxmd.com/read/30188960/landiolol-for-managing-atrial-fibrillation-in-intensive-care
#20
Sebastian Rehberg, Michael Joannidis, Tony Whitehouse, Andrea Morelli
Landiolol is an injectable ultrashort acting beta-blocker with high beta1 selectivity indicated for heart rate control of atrial fibrillation in the emergency and critical care setting. Accordingly, landiolol is associated with a significantly reduced risk of arterial hypotension and negative inotropic effects. Based on this particular profile along with the clinical experience in Japan for more than a decade landiolol represents a promising agent for the management of elevated heart rate and atrial fibrillation in intensive care patients even with catecholamine requirements...
January 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
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