Anesthesiology and Intensive Care

NSAIDs can exacerbate HF by promoting sodium and water retention, higher intravascular resistance, and reduced response to diuretics. Whenever possible, NSAIDs should be avoided among patients with HF. Thiazolidinediones can exacerbate existing HF and promote new HF. The risk for HF complications appears to be stronger with rosiglitazone vs pioglitazone. The dipeptidyl peptidase-4 (DPP-4) inhibitors are also associated with an increased risk for HF exacerbation, with an odds ratio of 1.19 in one meta-analysis. In contrast, metformin has been associated with reduced mortality risk among patients with HF in recent studies. However, metformin still should be avoided among patients with moderate or severe chronic kidney disease. Treatment with doxazosin was associated with a 2-fold increase in incident HF compared with treatment with chlorthalidone in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Amlodipine does not reduce mortality r...

Cardiac protection with phosphocreatine: a meta-analysis Giovanni Landonia, Alberto Zangrilloa, Vladimir V. Lomivorotovc , Valery Likhvantsevd , Jun Mae , Francesco De Simonea and Evgeny Fominskiya Phosphocreatine (PCr) plays an important role in the energy metabolism of the heart and a decrease in its intracellular concentration results in alteration of myocardium energetics and work. We conducted a meta-analysis of all randomized and matched trials that compared PCr with placebo or standard treatment in patients with coronary artery disease or chronic heart failure or in those undergoing cardiac surgery. We systematically searched PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials and Google Scholar up to 1 November 2015, for pertinent trials. The primary outcome was all-cause mortality. Secondary outcomes included inotrope use, ejection fraction (EF), peak creatinine kinase-myocardial band (CK-MB) release and the incidence of major arrhythmias, as well ...