Category: Cardiovascular Disease

Categories : Ageing Cardiovascular DiseaseTags :

Screening for AF in the Elderly Using Thumb ECGs Reduces Stroke Risk

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Screening for atrial fibrillation in 75- and 76-year-olds using thumb ECGS could reduce the risk of stroke, severe bleeding and death, according to a large-scale Swedish study.

Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke, and the symptoms are often deleterious since large blood clots can form in the heart, breaking free and posing a stroke risk. Still, countries do not screen the general population for atrial fibrillation, but rather treat those patients who are discovered during routine care. This study by the Karolinska Institutet in Sweden and published in The Lancet, investigated the effectiveness of screening for AF.

“There has never really been a study that examines if it would be beneficial to screen for atrial fibrillation, which is why we wanted to investigate it,” said Emma Svennberg, cardiologist at the Karolinska University Hospital, Huddinge, and researcher at the Department of Medicine, Huddinge, Karolinska Institutet.

The study included almost 28 000 participants aged 75 or 76, randomised to be invited either to screening or to a control group, who received standard care. Of those invited to screening, more than half choose to participate. They completed a health questionnaire and performed a so-called thumb ECG (electrocardiogram), which involves placing one’s thumbs on an ECG device that measures the heart’s electrical activity.

Those without atrial fibrillation were asked to record their heart rhythm twice daily for two weeks using the ECG device which they took home. If the device registered irregular heart rhythms, the participants were referred to a cardiologist for a standardised work-up and, if there were no contra-indications, initiation of oral anticoagulant therapy.

The study’s 28 000 participants were then followed for at least five years. More detections of atrial fibrillation were recorded in the screening group, which also had a slightly lower incidence of death, stroke and severe bleeding than the control group.

“In total, 31.9 percent of those in the screening group experienced a negative event compared to 33 percent in the control group,” said Johan Engdahl, adjunct lecturer at the Department of Clinical Sciences, Danderyds Hospital, at Karolinska Institutet. “Now, that may sound like a small difference, but you must bear in mind that only about half of those invited to screening participated and it’s possible we would have seen a more pronounced difference had more people turned up for screening. Those who participated in the screening had significantly fewer negative events.”

Based on the findings, the researchers estimated that at least 2300 cases of stroke or death could be avoided per year in Sweden if a national screening of atrial fibrillation in the elderly was introduced.

Source: Karolinska Institute

Categories : Cardiovascular DiseaseTags :

Heart Attack Survivors can Extend Healthy Lifespan

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If patients follow lifestyle advice and medications after a heart attack, it could add seven healthy years of life, according to a new study.

“Most heart attack patients remain at high risk of a second attack one year later,” explained study author Dr Tinka Van Trier of Amsterdam University Medical Centre. “Our study suggests that improving both lifestyles and medication use could lower this risk, with a gain in many years of life without a cardiovascular event.”

A previous study showed that 80–90% of the risk of a heart attack can be modified by managing factors such as smoking, unhealthy diet, abdominal obesity, inadequate physical activity, hypertension, diabetes and raised blood lipid levels. Two main strategies are used: lifestyle change and medication.

However, risk factors are rarely reduced sufficiently after a heart attack, even in programmes aiming to help patients improve their lifestyles and optimise their medication. Therefore, residual risk is high to very high in a large number of patients. Dr Van Trier said: “This study was conducted to quantify this residual risk and estimate the extent to which it could be lowered with optimal management.”

The study pooled data from 3230 patients, average age 61 and 24% women, that had a heart attack or received a stent or bypass surgery. At an average of one year after the cardiac event, 30% continued smoking, 79% were overweight, and 45% reported insufficient physical activity. Only 2% of attained treatment targets for blood pressure, LDL cholesterol, and glucose levels with 40% having hypertension and 65% having high LDL cholesterol. Preventative medication use was common: 87% used antithrombotic medications, 85% took lipid lowering drugs and 86% were on blood pressure lowering drugs.

The researchers calculated the lifetime risk of a heart attack, stroke, or death from cardiovascular disease and estimated changes in healthy years when lifestyle or medication was changed or optimised. 

The estimated average residual lifetime risk for cardiovascular disease mortality was 54%. If all targets in the model were met, this risk would drop to 21%.

Dr Van Trier said: “The findings show that despite current efforts to reduce the likelihood of new events after a heart attack, there is considerable room for improvement. Our analysis suggests that the risk of another cardiovascular event could, on average, be halved if therapies were applied or intensified. For individual patients, this would translate into gaining an average of 7.5 event-free years.”

Source: European Society of Cardiology

Categories : Cardiovascular Disease Medical Research & TechnologyTags :

Drone-delivered Defibs Beat Ambulances to Cardiac Arrests

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Photo by David Bartus from Pexels

In a unique pilot project in Sweden, drones were used to deliver defibrillators to real-life alerts of suspected cardiac arrest. The drones were dispatched in more than a fifth of the emergencies and arrived on target and ahead of the ambulance in most cases. 

”This is the first time in the world that a research group can report results from a study where drones flew defibrillators to location of real-life alerts of suspected cardiac arrest,” says lead researcher Andreas Claesson, associate professor at the Center for Resuscitation Science at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet.

With sudden cardiac arrest, every minute counts. Currently, the odds of surviving an out-of-hospital cardiac arrest are 10 percent. However, with early CPR and a shock from an automated external defibrillator (AED), the chances of survival could reach 50-70 percent but response time needs to improve. In 2019 the median response time from alert to ambulance arrival for out-of-hospital cardiac arrest (OHCA) in Sweden was 11 minutes.  
To try and reach cardiac arrest victims sooner, researchers investigated using the rapid dispatch of drone-carried defibrillators in parallel with ambulances. Drones are already used in some countries to dispatch medicines and medical supplies to remote rural regions, The study, conducted in mid-2020 in western Sweden, describes an integrated method where emergency operators, drone pilots and air traffic control worked together to facilitate the dual response.

The drones took off in response to 12 out of 53 alerts of suspected cardiac arrest over a four-month period, successfully delivering an AED to the site in 11 of those cases. In seven of those cases, the drones arrived before the ambulance, with a median time benefit of 1 minute and 52 seconds. However, no drone-delivered defibrillators were attached to the patients before ambulances arrived.

“Even if none of the AEDs were used this time, our study shows that it is possible to use drones to transport defibrillators in a safe way and with target precision during real-life emergencies,” said first-author Sofia Schierbeck, PhD student at the Center for Resuscitation Science at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet. “A precondition for their future use is that the dispatcher takes initiative and instructs people on site to quickly collect and attach the AED in order to help the person with cardiac arrest.”

More work is needed to increase the dispatch rate and time benefits. For instance, in 2020 the drones were grounded if it was dark, rainy or the winds were too strong. The software system was also configured to avoid routes above densely populated areas, meaning that some alerts were too far out of range.

“Since this study was completed, we have identified several areas of improvement,” Andreas Claesson said. “In April this year, we began a follow-up study with a more optimised system. In that study, we want to test if we can use the drones in more alerts and reduce the response time further and thereby increase the time benefit as compared to the ambulance. Every minute without treatment in the early stages reduces the chance of survival by around 10 percent, and that is why we believe this new method of delivery has the potential to save lives.”

The results are published in the European Heart Journal.

Source: Karolinska Institute

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Periodontitis Linked to Risk of Cardiovascular Disease

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A new study has found that periodontitis is associated with an increased risk of cardiovascular disease: the more severe the periodontitis, the higher the risk. Those who had a previous heart attack showed an even stronger association.

Study author Dr Giulia Ferrannini of the Karolinska Institute said: “Our study suggests that dental screening programmes including regular check-ups and education on proper dental hygiene may help to prevent first and subsequent heart events.”

Periodontitis, a disease of the tissue surrounding the tooth structure, has been associated with a number of diseases. The Swedish PAROKRANK (Periodontitis and its Relation to Coronary Artery Disease) study previously demonstrated that there was a significantly higher prevalence of periodontitis in first time heart attack patients compared to their healthy peers.

In this long-term follow-up of PAROKRANK, participants investigated whether the periodontitis, both in heart attack patients and their healthy peers, was related to an increased risk of new cardiovascular events over time.

The analysis included 1587 participants aged an average of 62 years. Participants underwent a dental examination between 2010 and 2014: 985 were classified as healthy, 489 had moderate periodontitis, and 113 had severe periodontitis. Participants were followed up for the occurrence of cardiovascular events and death. The primary endpoint was a composite of all-cause death, non-fatal heart attack or stroke, or severe heart failure. Follow-up data were collected until the end of 2018 from Swedish national death and patient registries.

Over an average 6.2 years of follow-up, there were 205 primary endpoint events. In the overall cohort, participants with periodontitis at baseline had 49% higher odds of the primary endpoint compared to those with healthy gums, increasing with periodontitis severity.
Assessing heart attack patients and healthy controls separately, graded relationship between gum disease severity and the primary endpoint was significant only for the patients group.

Dr Ferrannini said: “The risk of experiencing a cardiovascular event during follow-up was higher in participants with periodontitis, increasing in parallel with the severity. This was particularly apparent in patients who had already experienced a myocardial infarction.”

She added: “We postulate that the damage of periodontal tissues in people with gum disease may facilitate the transfer of germs into the bloodstream. This could accelerate harmful changes to the blood vessels and/or enhance systemic inflammation that is harmful to the vessels.”

“It is important to underline that the quality of care in Sweden is high, as confirmed by the overall low number of total events during follow-up. Despite this, gum disease was linked with an elevated likelihood of cardiovascular disease or death,” Dr Ferrannini concluded.

Source: European Society of Cardiology

Categories : Cardiovascular Disease Diet and NutritionTags :

Gut Microbiome Moderates BP Benefits of Flavonoids

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Flavonoid-rich foods, such as berries, apples, pears and wine, seem to reduce hypertension due in part to characteristics of the gut microbiome, according to a new study published in Hypertension.

“Our gut microbiome plays a key role in metabolising flavonoids to enhance their cardioprotective effects, and this study provides evidence to suggest these blood pressure-lowering effects are achievable with simple changes to the daily diet,” said lead researcher Aedín Cassidy, PhD, chair and professor in nutrition and preventive medicine at the Institute for Global Food Security at Queen’s University.

Flavonoids are compounds found naturally in fruits, vegetables and plant-based foods such as tea, chocolate and wine. They have miscellaneous favourable biochemical and antioxidant effects associated with various diseases such as cancer, Alzheimer’s disease, atherosclerosis, etc. Flavonoids are broken down by the body’s gut microbiome. Recent studies found a link between gut microbiota, the microorganisms in the human digestive tract, and cardiovascular disease (CVD). Gut microbiota are highly individual, and seem to be associated with CVD.

With studies suggesting flavonoids may reduce heart disease risk, the researchers investigaged the role of the gut microbiome in this. 
Researchers drew on a group of 904 adults between the ages of 25 and 82, 57% men from Germany’s PopGen biobank. Researchers evaluated the participants’ food intake, gut microbiome and blood pressure levels together with other clinical and molecular phenotyping at regular follow-up examinations.

Participants’ intake of flavonoid-rich foods during the previous year was calculated from a self-reported food questionnaire detailing the frequency and quantity eaten of 112 foods.

Participants’ gut microbiomes were assessed by faecal bacterial DNA in stool samples. After an overnight fast, participants’ blood pressure levels were measured. Researchers also collected participants’ lifestyle information, and measured BMI and other physical characteristics,

The analysis found that:

  • Study participants with the highest intake of flavonoid-rich foods, including berries, red wine, apples and pears, had lower systolic blood pressure levels, as well as greater gut microbiome diversity than the participants with the lowest levels of flavonoid-rich food intake.
  • Up to 15.2% of the association between flavonoid-rich foods and systolic blood pressure could be explained by the diversity found in participants’ gut microbiome.
  • Eating 1.6 servings of berries per day (one serving = 80 grams, or 1 cup) was associated with an average reduction in systolic blood pressure levels of 4.1 mm Hg. 12% of the association was explained by gut microbiome factors.
  • Drinking 2.8 glasses (125 ml of wine per glass) of red wine a week was associated with an average of 3.7 mm Hg lower systolic blood pressure level, of which 15% could be explained by the gut microbiome.

“Our findings indicate future trials should look at participants according to metabolic profile in order to more accurately study the roles of metabolism and the gut microbiome in regulating the effects of flavonoids on blood pressure,” said Cassidy. “A better understanding of the highly individual variability of flavonoid metabolism could very well explain why some people have greater cardiovascular protection benefits from flavonoid-rich foods than others.”

While this study suggests potential benefits to consuming red wine, the American Heart Association suggests that if you don’t drink alcohol already, you shouldn’t start.

Study limitations include not being able to account for all factors, such as genetics and lifestyle. The authors noted the focus of this study was on specific foods rich in flavonoids, not all food and beverages with flavonoids.

Source: Medical Xpress

Categories : Cardiovascular DiseaseTags :

Parental History Not The Only Premature Heart Attack Risk

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A new study has shown that, while parental history is a contributing factor, young heart attack victims are more likely to be smokers, obese, and have high blood pressure or diabetes compared to their peers.

“The findings underline the importance of preventing smoking and overweight in children and adolescents in order to reduce the likelihood of heart disease later in life,” said study author Professor Harm Wienbergen of the Bremen Institute for Heart and Circulation Research.

“Understanding the reasons for heart attacks in young adults is important from a societal perspective due to their employment and family responsibilities,” he continued. “However, there are limited data on the predictors of heart events in this group.”

The researchers compared the clinical characteristics of consecutive patients admitted to hospital with acute myocardial infarction at 45 years of age or younger against randomly selected individuals from the German population. Cases and controls were matched according to age and gender. The case-control study enrolled a total of 522 patients with 1191 matched controls from a national database.

The researchers found that the proportion of active smokers was more than three-fold higher in the young heart attack group compared to the general population (82.4% vs 24.1%). Patients were more likely to have high blood pressure (25.1% vs 0.5%), diabetes (11.7% vs 1.7%) and a parental history of premature heart attack (27.6% vs 8.1%) compared to their peers. Patients were more often obese, with a median body mass index (BMI) of 28.4 kg/m2 compared to 25.5 kg/m2 for controls. In contrast, the proportion consuming alcohol at least four times a week was higher in the general population (11.2%) compared to heart patients (7.1%).

The researchers analysed the independent risk factors for the occurrence of acute myocardial infarction at 45 years of age or younger. The analysis was adjusted for age, sex, high blood pressure, diabetes, active smoking, body mass index, alcohol consumption, years of school education, and birth in Germany.

Hypertension was associated with an 85-fold odds of a heart attack aged 45 or under. The corresponding odds of a premature heart attack associated with active smoking, diabetes mellitus, parental history and obesity (BMI 30 kg/m2 or above) were 12, 5, 3 and 2. Alcohol consumption was associated with a lower odds of heart attack at a young age with an odds ratio of 0.3.

Prof Wienbergen said: “Our study shows that smoking and metabolic factors, such as hypertension, diabetes and obesity, are strongly associated with an increased likelihood of premature acute myocardial infarction. A protective effect of moderate alcohol consumption has been described by other studies and is confirmed in the present analysis of young patients.”

He concluded: “Our study suggests that family history is not the only predisposing factor for early heart attacks. The findings add impetus to the argument that young people should be educated about why it is important to avoid smoking and have a healthy body weight.”

Source: European Society of Cardiology

Categories : Cardiovascular DiseaseTags :

Stress Signal From Fat Cells Induces Protective Effect in Heart

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A stress signal sent from fat cells to the heart could be protective against obesity-induced cardiac damage, according to new research. 

This might help explain the ‘obesity paradox’, where obese individuals have better short- and medium-term cardiovascular disease prognoses compared with those who are normal weight, but have worse long-term outcomes.

“The mechanism we have identified here could be one of many that protects the heart in obesity,” said study leader Philipp E. Scherer, PhD, Professor of Internal Medicine and Cell Biology at UTSW who has long studied fat metabolism.

Study co-leader Clair Crewe, PhD, Assistant Instructor of Internal Medicine at UTSW, explained that the metabolic stress of obesity gradually makes fat tissue dysfunctional, causing shrinkage and death of its mitochondria. This unhealthy fat loses the ability to store lipids generated by excess calories in food, causing lipotoxicity and poisoning other organs. However some organs, including the heart, preemptively defend against lipotoxicity. How the heart actually senses fat’s dysfunctional state has been unknown so far.

The researchers used a genetic technique to speed the loss of mitochondrial mass and function in mice. The mice were fed a high-fat diet and became obese, and their fat cells began sending out extracellular vesicles filled with small pieces of dying mitochondria. Some of these mitochondrial snippets travelled through the bloodstream to the heart and triggered oxidative stress.

Cardiaccells produce a flood of protective antioxidant molecules to counteract this stress, and this protective backlash was so strong that when the scientists injected mice with extracellular vesicles filled with mitochondrial snippets and then induced a heart attack, the animals had significantly less damage to their hearts compared with mice that didn’t receive an injection.

Fat tissue from obese human patients showed that these cells also release mitochondria-filled extracellular vesicles.

The heart and other organs in obese individuals are eventually overwhelmed by lipotoxic effects, resulting in a number of obesity’s comorbidities. If the protective mechanism identified in this study could be artificially generated, it could result in new ways of treating obesity’s negative consequences. This might even be adapted to treat normal weight individuals.

“By better understanding the distress signal from fat,” Dr Crewe said, “we may be able to harness the mechanism to improve heart health in obese and non-obese individuals alike.”

The team’s findings were published in Cell Metabolism.

Source: UT Southwestern Medical Center

Categories : Cardiovascular DiseaseTags :

Eight Factors Predict Gastrointestinal Bleeding Risk after Heart Attack

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Using machine learning, researchers at Karolinska Institutet have identified eight primary factors that increase the risk of a common bleeding complication after heart attack.

Some of these factors had been known already, however, the researchers have found additional predictors, such as smoking, blood pressure and blood glucose. The study was published in the European Heart Journal – Cardiovascular Pharmacotherapy.

“If we can identify patients at high risk of upper gastrointestinal bleeding following heart attack, doctors will be able to take prophylactic measures to mitigate this risk,” said the study’s corresponding author Moa Simonsson, deputy consultant at Karolinska University Hospital and doctoral student. “There are, for instance, drugs that combat bleeding complications, gut bacteria tests that can be used on risk groups and other possibilities for personalised treatment for heart attack patients at high risk of bleeding complications.”

Upper gastrointestinal (GI) tract bleeding is one of the most common bleeding complications following acute myocardial infarction. The condition requires a lot of resources to treat, causes considerable suffering and increases mortality risk. Bleeding complications also limit antithrombotic use, which in turn can worsen the cardiovascular prognosis.

Over the past 20 years, a close focus on bleeding has resulted in several strategies for reducing the risk of upper gastrointestinal tract bleeding. However, few studies on this complication include a diverse population of heart attack patients.

For the current study, the researchers sourced data from the national SWEDEHEART registry on almost 150 000 patients with acute myocardial infarction between 2007 and 2016. Approximately 1.5 percent of these patients suffered GI bleeding within a year of their heart attack, and they also had an increased risk of death and stroke.
Several known factors that increase the risk of upper GI tract bleeding were confirmed by the analysis, including low levels of haemoglobin, previous upper GI tract bleeding, age and intensive antithrombotic treatment.

Using an algorithm, the researchers also identified additional risk factors, including smoking, blood pressure, blood glucose and previous treatment for stomach disorders, such as ulcers and acid reflux.

“If you combine traditional statistical models with machine learning methods, you can create unique opportunities to find key risk factors for previously unknown cardiovascular events,” explained co-author Philip Sarajlic, doctoral student at Karolinska Institutet. “This makes it possible for us to make effective use of valuable data from the medical quality registry by taking account of complex relationships between risk factors and outcomes in order to further optimise the current recommendations for patient care.”

The researchers will soon begin a major clinical study to explore the significance of diagnosis and treatment of a common infection in the upper GI tract.

“A pilot study last year showed a two-fold increase in the presence of Helicobacter Pylori in heart attack patients,” said last author Robin Hofmann, researcher and consultant at Karolinska Institutet. “We will now proceed with a large randomized study to ascertain whether a systematic screening of heart attack patients for Hp infection and, where relevant, its treatment, can reduce bleeding complications and improve prognosis after heart attack.”

Source: Karolinska Institute

Categories : Cardiovascular Disease General InterestTags :

One Woman’s Journey of Recovery from Cardiac Arrest

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Photo from Olivier Collett on Unsplash
Photo from Olivier Collett on Unsplash

At age 37, Mary Gordon was fit and healthy but could not explain the fatigue she began experiencing. Shortly before Christmas 2019, she woke up feeling out of sorts. During Christmas shopping, she nearly passed out at one point.

“Everything went blank,” Gordon recalled. “But it was so quick that I questioned if it really happened.”

Gordon put it down to dehydration and tiredness. But over the next week, she nearly passed out three more times, once while driving. Just before flying home, she managed to get a last-minute appointment on New Year’s Eve with her doctor’s physician assistant. By this point, she half expected to be admitted to hospital.
The physician assistant performed a test on her heart, which looked normal. But her blood pressure was through the roof. She advised Gordon to cancel her flight and to start wearing a heart monitor so the medical team could gather more information.

Gordon was familiar with the heart monitor because in university, her doctor detected a heart murmur and diagnosed her with mitral valve prolapse: extra tissue caused the mitral valve leaflets to expand into the left atrium when her heart contracted. In the severe cases, it can lead to blood leaking back through the valve, potentially resulting in arrhythmia. However, when the doctor reviewed the data, he told her to not worry about it. And an electrocardiogram years later seemed to confirm the diagnosis.

But now, leaving the visit with the physician assistant, Gordon collapsed near the elevator, in cardiac arrest. Fortunately a receptionist found her. For six minutes, the physician assistant and a doctor performed CPR , and also used an automated external defibrillator. The first thing she remembered was being in the emergency room, with her boyfriend, Matt Costakis, and several doctors at the foot of her bed.
She was confused for the first few days.

“My brain was not retaining information,” she said. “It took a few days before things were sinking in. Everything was a blur.”

An implantable cardioverter defibrillator was implanted in her chest, followed by a minimally invasive surgery the week after to repair her mitral valve.

“It wasn’t until the surgery that it was fully recognized she has something that’s particularly rare called mitral annular disjunction,” said Dr. Paula Pinell-Salles, Gordon’s cardiologist at Virginia Heart in Falls Church. “That variant is the most prone to significant prolapse and may be more closely associated with the kind of arrhythmia she presented with.”

Gordon was discharged after a two-week hospital stay. Though fatigued, she eagerly started her cardiac rehab, relishing the supportive environment. 

“The thought of raising my heart rate or being able to ever run again was so foreign,” she said. “It was awesome to know there’s a way to slowly ease back into that with the safety of people watching you.”

When COVID ended in-person rehab, she continued to push herself walking long distances but she still feared exercising alone.

“It was a weird transition and very emotional,” she said, pointing to the emergency ID tag she now wears. “But I got to the point where I could go off by myself.”

Eight months after the cardiac arrest, she was running again. And on the one-year anniversary, Gordon and Costakis, along with her dog, hiked her favourite trail to the top of a mountain, where Costakis proposed to her. 

Now happily engaged and largely recovered, Gordon promotes CPR training and wants to raise awareness about the difference between heart attacks and cardiac arrest.

As defined by the American Heart Association and the American College of Cardiology, “(sudden) cardiac arrest is the sudden cessation of cardiac activity so that the victim becomes unresponsive, with no normal breathing and no signs of circulation. If corrective measures are not taken rapidly, this condition progresses to sudden death. Cardiac arrest should be used to signify an event as described above, that is reversed, usually by CPR and/or defibrillation or cardioversion, or cardiac pacing. Sudden cardiac death should not be used to describe events that are not fatal.”

“It doesn’t hurt to learn it again, or watch the video and just build your confidence,” she said. “If I can do something to help the next person, that’s all I can ask for.”

Source: American Heart Association

Categories : Cardiovascular DiseaseTags :

Study Evaluates Efficacy and Tolerability of Ultrafiltration

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A new study evaluates the efficacy and renal tolerability of ultrafiltration in acute decompensated heart failure.

Acute decompensated heart failure (ADHF) is a life-threatening and costly disease. Controversy remains regarding the efficacy and renal tolerability of ultrafiltration for treating ADHF. This article by Yajie Liu and Xin Yuan from the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China, and published in Cardiovascular Innovations and Applications, evaluated this clinical issue.

After searching databases for relevant trials, their quality and outcomes were evaluated with the use of the risk of the bias assessment tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, respectively. Risk ratio and the standardised or weighted mean differences were computed and pooled with fixed-effects or random-effects models.

The 19-study meta-analysis, involving 1281 patients, found that ultrafiltration was superior to control for weight loss (1.24kg) and fluid removal (1.55L) and was associated with a significant increase in serum creatinine level compared with the control treatments (0.15 mg/dL).
No significant effects were found for serum N-terminal prohormone of brain natriuretic peptide level, length of hospital stay, all-cause mortality, or all-cause rehospitalisation in the ultrafiltration group.

Overall, the meta-analysis found that use of ultrafiltration in patients with ADHF is superior to control treatments for weight loss and fluid removal but has adverse renal effects and lacks significant effects on long-term prognosis.

Source: News-Medical.Net