Statin therapy is associated with improved survival in patients with ventricular tachyarrhythmias

Objectives: The study sought to assess the impact of statin therapy on survival in patients presenting with ventricular tachyarrhythmias. Background: Data regarding the outcome of patients with statin therapy presenting with ventricular tachyarrhythmias is limited. Methods: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with statin were compared to patients without statin therapy (non-statin). The primary prognostic endpoint was long-term all-cause death at 3 years. Uni- and multivariable Cox regression analyses were applied in propensity-score matched cohorts. Results: A total of 424 matched patients was included. The rates of VT and VF were similar in both groups (VT: statin 71% vs. non-statin 68%; VF: statin 29% vs. 32%; p = 0.460). Statin therapy was associated with lower all-cause mortality at long-term follow-up (mortality rates 16% versus 33%; log rank, p = 0.001; HR = 0.438; 95% CI 0.290–0.663; p = 0.001), irrespective of the underlying type of ventricular tachyarrhythmia (VT/VF), left ventricular ejection fraction (LVEF) > 35%, presence of an activated implantable cardioverter defibrillator (ICD), cardiogenic shock or cardiopulmonary resuscitation (CPR). Conclusion: Statin therapy is independently associated with lower long-term mortality in patients presenting with ventricular tachyarrhythmias on admission. Trial registration: Clinicaltrials.gov, NCT02982473 , 11/29/2016, Retrospectively registered

Intracoronary Application of Super-Saturated Oxygen to Reduce Infarct Size Following Myocardial Infarction

Optimal medical therapy for secondary prevention following acute myocardial infarction reduces non-fatal ischaemic events. Intensive antithrombotic or lipid-lowering approaches have failed to significantly lower mortality. In the past, reduction of infarct size in patients undergoing primary percutaneous revascularisation for acute myocardial infarction had been considered as a surrogate outcome marker. However, infarct size measured by magnetic resonance imaging or SPECT is strongly associated with all-cause mortality and hospitalization for heart failure within the first year after an acute myocardial infarction. Intracoronary administration of super-saturated oxygen (SSO2) immediately after revascularisation is an approach that can be used to reduce infarct size and, therefore, improve cardiovascular outcome in patients with acute myocardial infarction. In this article, we describe the modulation of pathophysiology by SSO2, review the existing trial data and present our first impressions with the technique in real clinical practice

Antimicrobial Resistance of Urinary Escherichia coli Isolates

Purpose: To investigate the antimicrobial resistance rate of 110 Escherichia coli strains, isolated from UTIs in Etlik Lokman Hekim Hospital, Etlik, Ankara, Turkey. Methods: API-20E System (bioMerieux, France) was used to identify E. coli isolates. Antimicrobial susceptibility testing was conducted on Mueller-Hinton Agar plates (Merck, Germany) using agar disc diffusion method and the results were expressed as susceptible or resistant according to the criteria recommended by the Clinical and Laboratory Standarts Institute (CLSI). Results: The resistance rates detected were 56 % to ampicillin, 24 % to ampicillin sulbactam, 9 % to gentamicin, 15 % to ciprofloxacin, 36 % to trimethoprim sulfamethoxazole, 12 % to cefazolin, and 7 % to cefuroxime. All isolates tested were susceptible to fosfomycin and nitrofurantoin. Conclusion: When the high resistance rates in Turkey are taken into consideration, antimicrobial agent usage policies and empirical therapies should be based on antimicrobial resistance surveillance studies