<i>Background.</i> Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin. <i>Methods.</i> This study was a retrospective cohort study. One hundred seventy-two confirmed COVID-19 patients were included in this study, hospitalized at Babol University of Medical Sciences hospitals between <i>March 5, 2020</i>, and <i>April 3, 2020</i>. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment. <i>Results.</i> 83.1% of patients received hydroxychloroquine plus azithromycin vs. 16.9% of patients who received only hydroxychloroquine. The mean age of patients was <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="32.222pt" style="vertical-align:-0.3499298pt" id="M1" height="8.69875pt" version="1.1" viewBox="-0.0498162 -8.34882 32.222 8.69875"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 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transform="matrix(.013,0,0,-0.013,35.127,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,41.367,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,47.608,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.572,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g></svg>.</span></span>The mean of posttreatment QTc interval in the monotherapy group was shorter than the mean of posttreatment QTc interval in the combination therapy group, but it had no significant statistical difference (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="38.461pt" style="vertical-align:-0.3499298pt" id="M2" height="8.69875pt" version="1.1" viewBox="-0.0498162 -8.34882 38.461 8.69875"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g><g transform="matrix(.013,0,0,-0.013,12.48,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,18.72,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,21.684,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,30.83,0)"><use xlink:href="#g117-37"/></g></svg><span class="ibiop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.997pt" style="vertical-align:-0.3499298pt" height="8.69875pt" version="1.1" viewBox="41.317183799999995 -8.34882 21.997 8.69875"><g transform="matrix(.013,0,0,-0.013,41.367,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.013,0,0,-0.013,47.607,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.013,0,0,-0.013,53.847,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,56.811,0)"><use xlink:href="#g113-50"/></g></svg></span> milliseconds vs. <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="38.461pt" style="vertical-align:-0.3499298pt" id="M3" height="8.69875pt" version="1.1" viewBox="-0.0498162 -8.34882 38.461 8.69875"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><use xlink:href="#g113-55"/></g><g transform="matrix(.013,0,0,-0.013,12.48,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.013,0,0,-0.013,18.721,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,21.685,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,30.83,0)"><use xlink:href="#g117-37"/></g></svg><span class="ibiop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.997pt" style="vertical-align:-0.3499298pt" height="8.69875pt" version="1.1" viewBox="41.317183799999995 -8.34882 21.997 8.69875"><g transform="matrix(.013,0,0,-0.013,41.367,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,47.607,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,53.848,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,56.812,0)"><use xlink:href="#g113-50"/></g></svg></span> milliseconds; <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M4" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 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252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><use xlink:href="#g113-57"/></g></svg>).</span></span> Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="33.198pt" style="vertical-align:-2.15716pt" id="M5" height="10.9105pt" version="1.1" viewBox="-0.0498162 -8.75334 33.198 10.9105"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-82" d="M720 -138C627 -96 538 -41 476 2C594 39 703 153 703 331C703 532 552 665 384 665C170 665 44 499 44 315C44 215 87 129 147 73C211 11 298 -11 355 -14C476 -99 554 -136 584 -144S664 -160 712 -159L720 -138ZM348 25C231 49 146 172 146 342C146 533 249 629 360 629C497 629 601 510 601 302C601 142 523 51 443 28C434 34 425 41 416 47L348 25Z"/></g><g transform="matrix(.013,0,0,-0.013,9.607,0)"><path id="g190-85" d="M592 498C586 556 582 629 581 675H560C545 656 537 650 510 650H115C87 650 74 652 60 675H40C38 620 33 555 28 495H57C69 539 77 568 89 585C102 607 122 616 205 616H267V123C267 44 259 34 168 28V0H454V28C360 34 352 44 352 123V616H422C498 616 514 608 531 584C542 568 552 543 562 495L592 498Z"/></g><g transform="matrix(.013,0,0,-0.013,16.349,0)"><path id="g190-100" d="M390 111C344 68 312 56 269 56C212 56 118 102 118 241C118 346 175 401 241 401C277 401 312 388 342 360C350 352 355 349 361 349C372 349 394 371 394 392C394 403 391 411 378 422C362 436 329 449 288 449H287C250 449 190 432 138 392C71 341 37 274 37 197C37 90 112 -12 238 -12C297 -12 363 32 407 90L390 111Z"/></g><g transform="matrix(.013,0,0,-0.013,25.567,0)"><path id="g117-94" d="M531 285V335L57 550V494L473 310L57 127V71L531 285ZM531 -40V10H57V-40H531Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.918pt" style="vertical-align:-2.15716pt" height="10.9105pt" version="1.1" viewBox="36.780183799999996 -8.75334 18.918 10.9105"><g transform="matrix(.013,0,0,-0.013,36.83,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.013,0,0,-0.013,43.07,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,49.31,0)"><use xlink:href="#g113-49"/></g></svg></span> milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, fourteen patients did not continue therapy after four days. <i>Conclusions.</i> Hospitalized patients treated by hydroxychloroquine with or without azithromycin had no significant difference in prolongation of QT interval and outcome. The numbers of patients with prolonged QT intervals in this study emphasize careful cardiac monitoring during therapy, especially in high-risk patients.

Seyed Parsa Eftekhar

Sohrab Kazemi

Mohammad Barary

Mostafa Javanian

Soheil Ebrahimpour

Naghmeh Ziaei

Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients

Hye-Ran Jun

Hyunah Kim

Seung-Hwan Lee

Jae Hyoung Cho

Hyunyong Lee

Hyeon Woo Yim

Kun-Ho Yoon

Hun-Sung Kim

Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker

<i>Background</i>. Pulmonary complications of systemic sclerosis (SSc), including pulmonary arterial hypertension (PAH), are the leading causes of patient death. However, the precise molecular mechanisms of its etiology are unclear. This study’s objective was to identify the candidate genes involved in the progression of SSc-PAH and investigate the genes' function. <i>Methods</i>. The gene expression profiles of GSE33463 were obtained from the Gene Expression Omnibus (GEO) database. A free-scale gene coexpression network was constructed using the weighted gene coexpression network analysis (WGCNA) to explore the association between gene sets and clinical features and identify candidate biomarkers. Then, gene ontology analysis was performed. A second dataset was used, GSE19617, to validate the hub genes. The verified hub genes’ potential function was further explored using gene set enrichment analysis (GSEA). <i>Results</i>. Through average link-level clustering, a total of seven modules were classified. A total of 938 hub genes were identified in the key module, and the key module’s function mainly enriched was related to chemokine activities. Subsequently, four candidate genes, BTG3, CCR2, RAB10, and TMEM60, were filtered. The expression levels of these four hub genes were consistent in the GSE19617 and GSE33463 datasets. We plotted the ROC curve of the hub genes (all <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.804pt" style="vertical-align:-0.6370001pt" id="M1" height="9.39034pt" version="1.1" viewBox="-0.0498162 -8.75334 37.804 9.39034"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.226,0)"><path id="g190-86" d="M716 650H478V622C549 617 570 605 575 566C579 535 582 493 582 401V326C582 161 537 40 393 40C269 40 205 133 205 294V521C205 611 213 617 291 622V650H33V622C111 615 120 611 120 521V272C120 154 148 80 208 34C252 0 309 -14 368 -14C434 -14 501 7 548 55C605 116 623 201 623 319V401C623 493 626 536 629 563C633 605 656 618 716 622V650Z"/></g><g transform="matrix(.013,0,0,-0.013,17.794,0)"><path id="g190-68" d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"/></g><g transform="matrix(.013,0,0,-0.013,30.173,0)"><path id="g117-92" d="M512 230V281L75 514V456L453 256V254L75 55V-3L512 230Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.893pt" style="vertical-align:-0.6370001pt" height="9.39034pt" version="1.1" viewBox="41.3861838 -8.75334 21.893 9.39034"><g transform="matrix(.013,0,0,-0.013,41.436,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,47.676,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,50.64,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g><g transform="matrix(.013,0,0,-0.013,56.882,0)"><use xlink:href="#g113-49"/></g></svg>).</span></span> Furthermore, the results of the GSEA for hub genes were correlated with complement and inflammatory responses. <i>Conclusions</i>. The hub genes (BTG3, CCR2, RAB10, and TMEM60) performed well in distinguishing the SSc-PAH patients from controls, and some biological functions, related to immunity, inflammation, and cytokines, might pave the way for follow-up studies on the diagnosis and treatment of SSc-PAH.

Zhixiao Xu

Jiaxing Ruan

Lingyun Pan

Chengshui Chen

Candidate Genes Identified in Systemic Sclerosis-Related Pulmonary Arterial Hypertension Were Associated with Immunity, Inflammation, and Cytokines

Afshin Amirpour

Mehrbod Vakhshoori

Reihaneh Zavar

Hadi Zarei

Masoumeh Sadeghi

Behzad Yavari

The Effect of 3-Month Growth Hormone Administration and 12-Month Follow-Up Duration among Heart Failure Patients Four Weeks after Myocardial Infarction: A Randomized Double-Blinded Clinical Trial

<i>Background</i>. Thrombocytopenia was intuitively considered to be associated with higher risk of bleeding and multiple comorbidities after percutaneous coronary intervention (PCI). However, controversial results exist, and the real-world clinical impact of thrombocytopenia in patients undergoing PCI is largely unknown. The aim of this study was to evaluate the influence of baseline thrombocytopenia on the prognosis of patients undergoing PCI. <i>Methods</i>. Using the West China Hospital Inpatient Sample database, patients who underwent PCI were identified from August 2012 to January 2019. Baseline thrombocytopenia was defined as a preprocedural platelet count of <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="29.257pt" style="vertical-align:-2.1507pt" id="M1" height="13.7421pt" version="1.1" viewBox="-0.0498162 -11.5914 29.257 13.7421"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,12.48,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,21.626,0)"><path id="g117-42" d="M528 54L331 254L528 455L492 493L294 291L96 493L60 455L257 254L60 54L96 16L294 217L492 16L528 54Z"/></g></svg><span class="ibiop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="22.829pt" style="vertical-align:-2.1507pt" height="13.7421pt" version="1.1" viewBox="32.1121838 -11.5914 22.829 13.7421"><g transform="matrix(.013,0,0,-0.013,32.162,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,38.402,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0091,0,0,-0.0091,44.689,-5.741)"><path id="g50-58" d="M247 635C116 635 39 518 39 421C39 315 113 237 221 237C239 237 258 241 281 253L349 289C315 140 204 42 60 19L66 -15C90 -15 153 -5 207 16C344 70 447 199 447 385C447 521 373 635 247 635ZM231 598C329 598 356 478 356 390C356 371 355 347 352 325C330 309 297 297 262 297C179 297 127 369 127 456C127 515 156 598 231 598Z"/></g><g transform="matrix(.013,0,0,-0.013,49.635,0)"><path id="g113-48" d="M368 703H309L44 -163H104L368 703Z"/></g></svg><span class="isep"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="7.234pt" style="vertical-align:-2.1507pt" height="13.7421pt" version="1.1" viewBox="54.9461838 -11.5914 7.234 13.7421"><g transform="matrix(.013,0,0,-0.013,54.996,0)"><path id="g190-77" d="M495 163C480 117 462 85 444 65C421 39 387 34 332 34C290 34 256 36 236 47C218 57 213 77 213 131V526C213 612 222 616 301 622V650H40V622C122 616 128 611 128 526V126C128 41 120 34 36 28V0H489C498 31 519 126 525 157L495 163Z"/></g></svg></span> or less obtained from a routine blood sample taken within 48 hours before coronary PCI. The clinical effect of the advanced thrombocytopenia group (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="34.28pt" style="vertical-align:-2.1507pt" id="M2" height="13.7421pt" version="1.1" viewBox="-0.0498162 -11.5914 34.28 13.7421"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g117-93" d="M531 71V127L115 310L531 494V550L57 335V285L531 71ZM531 -40V10H57V-40H531Z"/></g><g transform="matrix(.013,0,0,-0.013,11.263,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,17.503,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g><g transform="matrix(.013,0,0,-0.013,26.649,0)"><use xlink:href="#g117-42"/></g></svg><span class="ibiop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="22.829pt" style="vertical-align:-2.1507pt" height="13.7421pt" version="1.1" viewBox="37.1351838 -11.5914 22.829 13.7421"><g transform="matrix(.013,0,0,-0.013,37.185,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,43.425,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0091,0,0,-0.0091,49.712,-5.741)"><use xlink:href="#g50-58"/></g><g transform="matrix(.013,0,0,-0.013,54.658,0)"><use xlink:href="#g113-48"/></g></svg><span class="isep"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="7.239pt" style="vertical-align:-2.1507pt" height="13.7421pt" version="1.1" viewBox="59.969183799999996 -11.5914 7.239 13.7421"><g transform="matrix(.013,0,0,-0.013,60.019,0)"><use xlink:href="#g190-77"/></g></svg>),</span></span> according to the median value of platelet count in the thrombocytopenia cohort, was further assessed. The primary outcome was a composite of in-hospital death, bleeding events, and post-PCI transfusion. <i>Results</i>. Of 9531 patients enrolled in our study, 936 had baseline thrombocytopenia and 8595 patients did not have. There were no significant differences in the primary outcome between the two groups. However, advanced thrombocytopenia was independently associated with higher risk of primary outcome (OR 1.67, 95% CI 1.06 to 2.65, <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M3" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 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transform="matrix(.013,0,0,-0.013,44.289,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 369 124 458C124 517 152 602 228 602Z"/></g></svg>).</span></span> Acute coronary syndrome (ACS) patients with thrombocytopenia were associated with higher odds of major bleeding (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="44.315pt" style="vertical-align:-1.11981pt" id="M4" height="9.87315pt" version="1.1" viewBox="-0.0498162 -8.75334 44.315 9.87315"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-67" d="M372 352C427 368 507 407 507 502C507 548 486 592 451 616C420 638 376 650 301 650H44V622C124 616 128 610 128 527V123C128 40 122 34 36 28V0H257C336 0 402 12 453 40C512 72 548 124 548 191C548 291 471 335 372 350V352ZM213 362V558C213 591 216 602 226 608C235 614 258 618 282 618C377 618 415 558 415 490C415 406 369 362 260 362H213ZM213 328H258C380 328 450 283 450 181C450 76 377 35 296 34C231 34 213 53 213 125V328Z"/></g><g transform="matrix(.013,0,0,-0.013,7.331,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,16.314,0)"><path id="g190-83" d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z"/></g><g transform="matrix(.013,0,0,-0.013,24.282,0)"><path id="g190-68" d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"/></g><g transform="matrix(.013,0,0,-0.013,36.684,0)"><path id="g117-94" d="M531 285V335L57 550V494L473 310L57 127V71L531 285ZM531 -40V10H57V-40H531Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="6.392pt" style="vertical-align:-1.11981pt" height="9.87315pt" version="1.1" viewBox="47.8971838 -8.75334 6.392 9.87315"><g transform="matrix(.013,0,0,-0.013,47.947,0)"><use xlink:href="#g113-51"/></g></svg>)</span></span> (OR 2.56, 95% CI 1.24 to 5.44, <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M5" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-113"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.184pt" style="vertical-align:-3.42938pt" height="11.7782pt" version="1.1" viewBox="22.555183800000002 -8.34882 28.184 11.7782"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><use xlink:href="#g113-50"/></g></svg>).</span></span> Compared with the nonthrombocytopenia group, the thrombocytopenia group with ticagrelor use had higher odds of major bleeding (OR 9.7, 95% CI 1.57 to 60.4 versus OR 0.22, 95% CI 0.03 to 1.69, interaction <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M6" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-113"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.184pt" style="vertical-align:-3.42938pt" height="11.7782pt" version="1.1" viewBox="22.555183800000002 -8.34882 28.184 11.7782"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><use xlink:href="#g113-54"/></g></svg>).</span></span> <i>Conclusions</i>. It seems feasible for patients with thrombocytopenia to receive PCI, but close attention should be paid to advanced thrombocytopenia, the risk of postprocedure bleeding in ACS patients, and the use of more potent P2Y<sub>12</sub> inhibitor.

Zhongxiu Chen

Zheng Liu

Nan Li

Ran Liu

Miye Wang

Duolao Wang

Chen Li

Kai Li

Fangbo Luo

Yong He

Impact of Thrombocytopenia on In-Hospital Outcome in Patients Undergoing Percutaneous Coronary Intervention

Direct oral anticoagulants (DOACs) are widely used for the prevention of stroke in nonvalvular atrial fibrillation, treatment of deep venous thrombosis and pulmonary embolism, and as prophylaxis after hip and knee surgery after approval by the Food and Drug Administration. In the last decade, DOACs were studied for various indications; this review is focused on rivaroxaban, a factor Xa inhibitor, which is used in an expanded evidence-based fashion for coronary artery disease, peripheral artery disease, heart failure, malignancy, and prophylaxis of deep venous thrombosis in acute medical illnesses.

Muhammad Ajmal

Jacob Friedman

Qurat Ul Ain Riaz Sipra

Tom Lassar

Rivaroxaban: Expanded Role in Cardiovascular Disease Management&#x2014;A Literature Review

Ventricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classified quickly and accurately. The aim of this study was to present a new clinical classification for FWR. Seventy-eight patients with FWR after STEMI were enrolled in the study. We classified FWR, according to clinical situations after onset, into the cardiac arrest type, unstable type, and stable type. The cardiac arrest type was the most common type, accounting for about 83.3&#x0025;. 90.8&#x0025; of patients of this type were complicated with electromechanical dissociation at the time of FWR onset, and 100&#x0025; of patients of this type died in the hospital. The unstable type was characterized by sudden clinical condition changes with moderate/massive pericardial effusion. In this study, 9.0&#x0025; of patients were diagnosed as the unstable type. The average time from onset to death was 4.5 hours. This period was the &#x201C;golden time&#x201D; to rescue such patients. The stable types usually have stable hemodynamics, but may worsen, requiring rigorous detection of pericardial effusion and vital signs. In this study, 7.7&#x0025; of patients were diagnosed as the stable type, and 83.5&#x0025; of them survived in the hospital. The new clinical classification provides a basis for clinical diagnosis and treatment of FWR. The clinical application of the new classification is expected to improve the prognosis of FWR patients.

Wei Gong

Shaoping Nie

New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction

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<p><em>Cardiovascular Therapeutics</em> publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of novel cardiovascular therapies.</p>


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Cardiovascular Therapeutics - Table of contents 2021

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Cardiovascular Therapeutics publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of novel cardiovascular therapies.

Cardiovascular Therapeutics