RESUMO
BACKGROUND: There are no meta-analyses evaluating the efficacy and safety of colchicine in the treatment of acute myocardial infarction (AMI). Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. METHODS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this meta-analysis. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases for all English-language cohort studies published up to April, 2021. The cohort studies focusing on assess the efficacy and safety of colchicine in the treatment of AMI will be included in our meta-analysis. At least one of the following outcomes should have been measured: reduced infarct size, C-reactive protein (CRP) level, adverse events, death and major cardiovascular events. Review Manager software will be used for the meta-analysis. All outcomes are pooled on random-effect model. A P value of <.05 is considered to be statistically significant. RESULTS: Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. REGISTRATION NUMBER: 10.17605/OSF.IO/NTU5F.
Assuntos
Anti-Inflamatórios/uso terapêutico , Colchicina/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Protocolos Clínicos , Humanos , Modelos Estatísticos , Resultado do Tratamento , Metanálise como AssuntoRESUMO
BACKGROUND: The survival benefit and safety of Impella support versus intra-aortic balloon counterpulsation (IABP) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock were investigated in several observational trials that revealed mixed results. Thus, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a meta-analysis to assess the efficacy and safety of Impella versus IABP in AMI complicated by cardiogenic shock. METHODS: We will search the EMBASE, Web of Knowledge, PubMed, ClinicalTrials.gov, and Cochrane Library from inception to Mar 2021 to retrieve relevant studies. Two independent authors will extract the information from the selected studies. Disagreements will be resolved through a discussion with a third review author. The outcomes include mortality and complications. The quality of randomized trials will be assessed by Cochrane risk of bias tool for randomized controlled trials and the risk of bias in non-randomized studies - of Interventions for non-randomized, observational studies. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. RESULTS: The present meta-analysis will compare the efficacy and safety of Impella versus IABP in AMI complicated by cardiogenic shock. CONCLUSIONS: The results of our review will be reported strictly following the PRISMA criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/SKEQ7. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.
Assuntos
Coração Auxiliar , Balão Intra-Aórtico , Metanálise como Assunto , Infarto do Miocárdio/complicações , Infarto do Miocárdio/cirurgia , Choque Cardiogênico/etiologia , Revisões Sistemáticas como Assunto , Coração Auxiliar/efeitos adversos , Humanos , Balão Intra-Aórtico/efeitos adversos , Projetos de PesquisaRESUMO
Over 1 000 000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 9 days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living-related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.