The result is increased morbidity and mortality. Our aims were to investigate this phenomenon, known as therapeutic inertia, in patients with dyslipidemia and ischemic heart disease, and to determine its possible causes.
Methods. Design: national, Emricasan research buy multicenter, observational study of data obtained from physicians by questionnaire and from the clinical records of patients with ischemic heart disease. Main variable: therapeutic inertia during a consultation, defined as treatment remaining the same despite a change being indicated
(e.g. low-density lipoprotein cholesterol >100 mg/dl or >70 mg/dl in diabetics). Covariates: physician, patient and consultation characteristics. Statistical analysis:
multivariate logistic regression analysis of factors associated with therapeutic inertia during a consultation.
Results. Overall, 43% of consultations involved therapeutic inertia, and an CBL0137 association with coronary risk factors, including diabetes, did not result in a change in treatment. Therapeutic inertia occurred more frequently when there was a long time between the diagnosis and treatment of dyslipidemia and that of ischemic heart disease. Undertreatment was particularly common in women despite a greater overall risk. The more experienced physicians treated BI 2536 purchase younger patients more appropriately. Clinical practice was improved by educational sessions at conferences.
Conclusions.
Therapeutic inertia was common in patients with chronic ischemic heart disease and dyslipidemia, irrespective of overall cardiovascular risk. Factors associated with the patient, disease and physician had an influence.”
“To confirm the central role of antenatal echocardiography and necropsy in the prenatal diagnosis of rare congenital heart defects.
A 33-year-old woman undergoing second trimester scan using 2D transabdominal and Doppler sonography.
The echocardiographic examination showed, at the level of the four-chamber view, a predominant left ventricle with a rudimental right ventricle and a single artery emerging with failed visualization of the pulmonary trunk: a diagnosis of truncus arteriosus communis associated with tricuspid atresia and hypoplastic right heart was made. No other ultrasound-associated anomalies were seen. Fetal karyotype and 22q11.2 microdeletion for Di George syndrome were sought using cordocentesis performed at 21 weeks and both the results were normal. After extensive counselling, the couple opted for termination of pregnancy at 22 weeks gestation. Necroscopy confirmed the prenatal ultrasound diagnosis.