Comparison between provisional and dual systematic stenting approach for left main bifurcation disease: A systematic review and meta-analysis.

Despite recent advancements, challenges persist in determining the optimal stenting strategy for LM bifurcation disease. Hence, this systematic review aims to compare single provisional and systematic dual stenting for managing LM bifurcation disease. A systematic search was performed until January 14, 2024. For the effect measure, risk ratios (RRs) was calculated. This study included 22 studies with 10776 participants. The all-cause mortality and cardiovascular mortality revealed comparable outcomes between provisional and dual-systematic stenting (RR 1.13, CI95 %: 0.87-1.47, p 0.36, I2 59 %; RR 1.16, CI95 %: 0.73-1.84, p 0.63, I2 80 %). In addition, MACE, MI, TLR, TVR, and in stent thrombosis also showed similar findings. Subgroup analysis revealed that cohort studies was the source of heterogeneity in all-cause mortality, stent thrombosis, and TLR. This meta-analysis suggests comparable outcomes between provisional and dual-systematic stenting in managing LM bifurcation disease. Further study is needed to validate the outcomes of novel techniques.

The roles of thyroidectomy in patients with amiodarone-induced thyrotoxicosis: A systematic review.

The principal management of Amiodarone-induced-thyrotoxicosis (AIT) is balancing cardiac-thyroid conditions. However, the role of thyroidectomy is still contentious. This systematic review aims to provide insights into the roles of thyroidectomy in the management of AIT. This systematic review encompasses 303 AIT patients who underwent thyroidectomy from 14 studies. The indication of thyroidectomy can be due to cardiac factors, thyrotoxicosis conditions, and patient-physician considerations. Thyroidectomy is more effective in improving thyroid hormone status, cardiac function, and mortality compared to optimal medical therapy, especially in those with left ventricular ejection fraction < 40 %. Thyroidectomy is effective in improving cardiac function and mortality due to shorter duration for achieving euthyroid. Thyroidectomy and medical therapy have comparable side effects. However, the identification of high-risk patients may reduce thyroidectomy complications. Thus, thyroidectomy should not be viewed as the last resource and should be performed immediately when indicated.

Appropriateness of Fluid Therapy in Cardiogenic Shock Management: A Systematic Review of Current Evidence.

Fluid therapy plays a pivotal role in maintaining tissue perfusion during the management of cardiogenic shock. Nevertheless, its application in this context is contentious, necessitating a balance between achieving adequate volume and avoiding fluid overload. This systematic review aimed to assess the outcomes of fluid therapy in cardiogenic shock. This review encompasses 11 studies involving 406 participants. Although some studies reported hemodynamic improvements following fluid administration, others presented contrasting findings. Studies that did not highlight the benefits of fluid therapy typically involved patients with unique comorbidities requiring specific etiology-based medical treatments. The most prevalent cause of cardiogenic shock, acute coronary syndrome, exhibited varying responses to fluid therapy based on the infarct location. In conclusion, fluid therapy plays a crucial role in cardiogenic shock management but necessitates integration into an appropriate treatment strategy, accounting for individual circumstances, comorbidities, and etiology. Further research is imperative to amass additional evidence regarding this issue.

Cardioprotective properties of glucagon-like peptide-1 receptor agonists in type 2 diabetes mellitus patients: A systematic review.

BACKGROUND AND AIMS: Cardiovascular disease is one of the main contributors for the mortality in type 2 diabetes mellitus (T2DM) patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) had shown cardiovascular benefits which may be advantageous to reduce mortality in T2DM patients. This systematic review focused on analyzing the effects of GLP-1 RAs on cardiovascular outcomes. METHODS: We conducted an extensive search through JSTOR, PubMed, Scopus, EBSCohost, and CENTRAL. All related studies assessing the use of GLP-1 RAs in T2DM patients from inception up to October 2020 were screened. Any cardioprotective properties as the outcomes were obtained. RESULTS: A total of six studies (4 randomized, 2 observational) with a total of 182.205 patients were included in this review. The GLP-1 RAs used were either liraglutide or exenatide in combination with antihypertensive or antilipidemic drugs. All studies showed that GLP-1 RA significantly caused weight loss and improved cardiac functional capacity by increasing left ventricular ejection fraction and reducing end-systolic and end-diastolic left ventricle volume. GLP-1 RA also improved myocardial blood flow without affecting myocardial glucose uptake. However, GLP-1 RA failed to show its effect in reducing blood pressure and improving lipid profiles. CONCLUSIONS: Despite the limited number of studies, consistent data showed that GLP-1 RA has several cardioprotective properties.