Pulmonary veno-occlusive disease as a cause of pulmonary arterial hypertension.

Pulmonary veno-occlusive disease (PVOD) represents a rare form of precapillary pulmonary arterial hypertension. We present a young patient hospitalized with progressive dyspnea, with initial workup suggestive of pulmonary hypertension and unexplained noncardiogenic pulmonary edema. His subsequent clinical course was consistent with the diagnosis of PVOD.

Glucose levels and depression in Hispanic patients admitted to the cardiovascular intensive care unit: a cross-sectional study.

Depression is frequently associated with diabetes mellitus (DM) and may worsen DM-related morbidity and mortality. We determined the potential association of glucose levels with depression in Hispanic patients admitted to the Cardiovascular Intensive Care Unit. Patients were given the Center for Epidemiologic Studies-Depression scale survey within 24 hours of admission. Glycated hemoglobin and fasting blood glucose levels within 30 days of admission were extracted. The HbA1c levels remained significantly associated with both presence of depression and depression levels. Histories of DM, myocardial infarction, and percutaneous coronary intervention as well as baseline brain natriuretic peptide levels were also significantly associated with depression levels. The presence of a significant association between glucose levels and depression in Hispanic patients indicates that there is a need for optimal management of glycemic levels. This may then lead to better health outcomes in Hispanics with cardiovascular disease.

Depression as a predictor of length of stay in patients admitted to the cardiovascular intensive care unit at a university medical center.

Depression is a predictor of length of stay (LOS) and adverse outcomes in patients with cardiac disease. Our objective was to assess the impact of depression on LOS in a Hispanic population admitted to a cardiovascular intensive care unit (CVICU). This was a prospective study of 151 consecutive patients admitted to the CVICU. Patients were administered the Center for Epidemiologic Studies Depression (CES-D) scale survey within 24 hours of admission. Patients were followed until discharge to determine LOS and adverse outcomes. Depression was more prevalent in Hispanic patients than in nonHispanic patients based on the CES-D scores (41% vs 14%). Using multivariate analysis, the presence of depression was a significant predictor of increased LOS (P = .001). Depression has a significant impact on LOS in a Hispanic population. Appropriate treatment of depression may decrease LOS and has the potential to be cost effective in the current health care environment.

Cardiovascular safety profile of currently available diabetic drugs.

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality among patients with diabetes, underscoring the importance of choosing drugs that do not increase cardiovascular risk and reduce the risk of cardiovascular events. Since 2008, the US Food and Drug Administration has recommended that new drugs for type 2 diabetes undergo clinical trials to demonstrate cardiovascular safety in addition to glycemic benefit. In 2012, the European Medicines Agency issued a similar recommendation. METHODS: We searched the PubMed, Cochrane CENTRAL, EMBASE, and CINAHL databases from inception through August 2013 and compiled and reviewed the existing data on the cardiovascular safety profiles of currently available diabetic drugs. RESULTS: While intensive glycemic control in diabetics has been consistently shown to reduce the risk of microvascular complications, the data on macrovascular risk reduction have not been as clear, and questions have been raised about possible increases in cardiovascular morbidity and mortality. CONCLUSION: Careful selection of drug therapy-paying particular attention to cardiovascular safety-is important in optimizing diabetic therapy.