nach oben

Journal of Thrombosis and Thrombolysis

Erschienen in:

28.01.2024

Different drugs in drug-eluting stents for peripheral artery disease: a systematic evaluation and Bayesian meta-analysis

verfasst von: Keqin Chen, Lei Xu, Xiehong Liu

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 3/2024

Einloggen, um Zugang zu erhalten

Abstract

Drug-eluting stents (DESs) have become the first-line treatment for symptomatic peripheral arterial disease (PAD). Currently, there are many types of DESs on the market. The same type of DESs has different concentrations, and various drugs in them show uneven efficacy. The selection of DESs remains controversial. This study was aimed at comparing the long-term real-world outcomes of different DESs in the treatment of peripheral arterial occlusive disease (PAOD). The databases including Cochrane Library, Embase, and PubMed were searched with a time frame until March 25, 2023. The primary patency (PP) and target lesion revascularization (TLR) at 6 months were used as the primary endpoints. A total of 32 studies (5467 patients) were eligible. At the six-month follow-up, DES-Evero 1 ug/mm2 ranked first in terms of PP, with a significant difference from BMSs (RR [95% CI] = 1.6). DES-Siro 0.9 ug/mm2, DES-Siro 1.4 ug/mm2, DES-Siro 1.95 ug/mm2, DES-PTX 0.167 ug/mm2, DES-PTX 1 ug/mm2 and covered stents (CSs) showed significantly better PPs than BMSs. In terms of TLR, DES-Siro 0.9 ug/mm2 (0.31) ranked first, and DES-Evero 1 ug/mm2 ranked last. Among the treatment modalities for PAD, different DESs showed overall encouraging results in improving PP and TLR compared with BMSs. DES-Evero 1 ug/mm2 showed the best PP, but it had the highest reintervention rate at 6 months. Sirolimus-eluting stents were not always more effective with higher concentrations of sirolimus. Among various DESs, sirolimus-eluting stents and everolimus-eluting stents were superior to paclitaxel-eluting stents.

Nur mit Berechtigung zugänglich

Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T et al (2018) 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): document covering atherosclerotic Disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)the Task Force for the diagnosis and treatment of peripheral arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 39(9):763–816PubMedCrossRef

Song P, Rudan D, Wang M, Chang X, Rudan I (2019) National and subnational estimation of the prevalence of peripheral artery Disease (PAD) in China: a systematic review and meta-analysis. J Glob Health 9(1):010601PubMedPubMedCentralCrossRef

Parikh RB, Victor V, Levy MS (2021) Catheter based interventions for lower extremity peripheral artery Disease. Prog Cardiovasc Dis 69:62–72PubMedCrossRef

Gerhard-Herman M, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE et al (2017) 2016 AHA/ACC Guideline on the management of patients with Lower Extremity Peripheral Artery Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice guidelines. Circulation 135(12):e686–e725PubMed

Abdullah K, Bou Dargham B, Steinbrecher M, Sun B, Huiqiang Z, Khalili H et al (2018) Drug-eluting stents for treatment of Peripheral Artery Disease. Am J Cardiovasc Drugs 18(3):175–180PubMedCrossRef

Romiti M, Albers M, Brochado-Neto FC, Durazzo A, Pereira C, Luccia ND (2008) Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia. J Vasc Surg 47(5):975–981PubMedCrossRef

Siablis D, Karnabatidis D, Katsanos K, Diamantopoulos A, Spiliopoulos S, Kagadis GC et al (2009) Infrapopliteal application of sirolimus-eluting versus bare metal stents for critical limb ischemia: analysis of long-term angiographic and clinical outcome. J Vasc Interv Radiol 20(9):1141–1150PubMedCrossRef

Bosiers M, Scheinert D, Peeters P, Torsello G, Zeller T, Deloose K et al (2012) Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive Disease. J Vasc Surg 55(2):390–398PubMedCrossRef

Truijers M, Reijnen MMPJ (2015) Commentary: treatment of in-stent restenosis in the superficial femoral artery: at the crossroads of using either covered stents or paclitaxel-based modalities. J Endovasc Ther 22(1):11–13PubMedCrossRef

10.

Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R et al (2019) Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg 58(1s):S1–S109e33PubMedPubMedCentralCrossRef

11.

Taneva GT, Pitoulias GA, Abu Bakr N, Kazemtash M, Muñoz Castellanos J, Donas KP (2022) Assessment of Sirolimus- vs. paCLitaxEl-coated balloon angioPlasty in atherosclerotic femoropopliteal lesiOnS (ASCLEPIOS Study): preliminary results. J Cardiovasc Surg (Torino) 63(1):8–12PubMed

12.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71PubMedPubMedCentralCrossRef

13.

Duda SH, Pusich B, Richter G, Landwehr P, Oliva VL, Tielbeek A et al (2002) Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery Disease: six-month results. Circulation 106(12):1505–1509PubMedCrossRef

14.

Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Tielbeek A et al (2005) Sirolimus-eluting versus bare nitinol stent for obstructive superficial femoral artery Disease: the SIROCCO II trial. J Vasc Interv Radiol 16(3):331–338PubMedCrossRef

15.

Siablis D, Kraniotis P, Karnabatidis D, Kagadis GC, Katsanos K, Tsolakis J (2005) Sirolimus-eluting versus bare stents for bailout after suboptimal infrapopliteal angioplasty for critical limb ischemia: 6-Month angiographic results from a nonrandomized prospective single-center study. J Endovas Ther 12(6):685–695CrossRef

16.

Falkowski A, Poncyljusz W, Wilk G, Szczerbo-Trojanowska M (2009) The evaluation of primary stenting of sirolimus-eluting versus bare-metal stents in the treatment of atherosclerotic lesions of crural arteries. Eur Radiol 19(4):966–974PubMedCrossRef

17.

Rastan A, Tepe G, Krankenberg H, Zahorsky R, Beschorner U, Noory E et al (2011) Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial. EUR HEART J 32(18):2274–2281PubMedCrossRef

18.

Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB et al (2013) Sustained safety and effectiveness of paclitaxel-eluting stents for femoropopliteal lesions: 2-year follow-up from the zilver PTX randomized and single-arm clinical studies. J Am Coll Cardiol 61(24):2417–2427PubMedCrossRef

19.

Spreen MI, Martens JM, Hansen BE, Knippenberg B, Verhey E, van Dijk LC et al (2016) Percutaneous transluminal angioplasty and drug-eluting stents for Infrapopliteal Lesions in critical limb ischemia (PADI) trial. Circ Cardiovasc Interv 9(2):e002376PubMedPubMedCentralCrossRef

20.

Mori S, Hirano K, Yamauchi Y, Hayashi E, Doijiri T, Takamura T et al (2017) Penetration rate of the placement of a drug-eluting stent for the treatment of superficial femoral artery lesions in Japan. Heart Vessels 32(9):1093–1098PubMedCrossRef

21.

Vent PA, Kaladji A, Davaine JM, Guyomarch B, Chaillou P, Costargent A et al (2017) Bare Metal Versus Paclitaxel-Eluting Stents for Long Femoropopliteal Lesions: Prospective Cohorts Comparison Using a Propensity Score-Matched Analysis. Ann Vasc Surg 43:166–75PubMedCrossRef

22.

Björkman P, Auvinen T, Hakovirta H, Romsi P, Turtiainen J, Manninen H et al (2018) Drug-Eluting Stent Shows Similar Patency Results as Prosthetic Bypass in Patients with Femoropopliteal Occlusion in a Randomized Trial. Ann Vasc Surg 53:165–170PubMedCrossRef

23.

Miura T, Miyashita Y, Soga Y, Hozawa K, Doijiri T, Ikeda U et al (2018) Drug-eluting Versus Bare-Metal Stent Implantation with or without Cilostazol in the treatment of the superficial femoral artery. Circ Cardiovasc Interv 11(8):e006564PubMedCrossRef

24.

Kibrik P, Victory J, Patel R, Chait J, Alsheekh A, Aurshina A et al (2019) A real-world experience of drug eluting and non-drug eluting stents in lower extremity peripheral arterial Disease. Vascular 27(6):648–652PubMedCrossRef

25.

Falkowski A, Bogacki H, Szemitko M (2020) Assessment of Mortality and factors affecting outcome of Use of Paclitaxel-Coated stents and Bare Metal stents in Femoropopliteal PAD. J Clin Med 9(7):2221PubMedPubMedCentralCrossRef

26.

Iida O, Fujihara M, Kawasaki D, Mori S, Yokoi H, Miyamoto A et al (2021) 24-Month Efficacy and Safety results from Japanese patients in the IMPERIAL Randomized Study of the Eluvia Drug-Eluting Stent and the Zilver PTX Drug-Coated Stent. Cardiovasc Intervent Radiol 44(9):1367–1374PubMedPubMedCentralCrossRef

27.

Müller-Hülsbeck S, Benko A, Soga Y, Fujihara M, Iida O, Babaev A et al (2021) Two-year efficacy and safety results from the IMPERIAL Randomized Study of the Eluvia polymer-coated drug-eluting stent and the Zilver PTX polymer-free drug-coated stent. Cardiovasc Intervent Radiol 44(3):368–375PubMedCrossRef

28.

Marples R, Binks M, Spina R, Wright M, Huilgol R (2022) Prophylactic paclitaxel-eluting stent placement does not improve covered femoropopliteal stent patency. Surg Open Science 7:18–21CrossRef

29.

Tomoi Y, Soga Y, Iida O, Shiraki T, Kobayashi Y, Hiramori S et al (2016) Impact of drug-eluting stent implantation for Femoropopliteal In-Stent occlusion. J Endovasc Ther 23(3):461–467PubMedCrossRef

30.

Ansel GM, Jaff MR, Popma JJ, Battisti AJ, Lottes AE, Harnish P et al (2017) A Quantitative Angiographic Comparison of Restenotic Tissue Following Placement of Drug-Eluting Stents and Bare Metal stents in symptomatic patients with Femoropopliteal Disease. J Endovasc Ther 24(4):499–503PubMedCrossRef

31.

Spreen MI, Martens JM, Knippenberg B, van Dijk LC, de Vries JPM, Vos JA et al (2017) Long-term follow-up of the PADI Trial: Percutaneous Transluminal Angioplasty Versus Drug-Eluting stents for Infrapopliteal Lesions in critical limb ischemia. J Am Heart Assoc 6(4):e004877PubMedPubMedCentralCrossRef

32.

Gray WA, Keirse K, Soga Y, Benko A, Babaev A, Yokoi Y et al (2018) A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomised, non-inferiority trial. Lancet 392(10157):1541–1551PubMedCrossRef

33.

Meng FC, Chen PL, Lee CY, Shih CC, Chen IM (2018) Real-world comparison of drug-eluting and Bare-Metal stents in superficial femoral artery Occlusive Disease with Trans-Atlantic Intersociety Consensus B lesions: a 2-Year, single-Institute study. Acta Cardiol Sin 34(2):130–136PubMedPubMedCentral

34.

Haine A, Schmid MJ, Schindewolf M, Lenz A, Bernhard SM, Drexel H et al (2019) Comparison between interwoven Nitinol and Drug Eluting stents for Endovascular Treatment of Femoropopliteal Artery Disease. Eur J Vasc Endovasc Surg 58(6):865–873PubMedCrossRef

35.

Saratzis A, Rudarakanchana N, Patel S, Diamantopoulos A, Lea T, Corbo B et al (2019) Interwoven Nitinol stents versus Drug Eluting stents in the Femoro-Popliteal segment: a propensity matched analysis. Eur J Vasc Endovasc Surg 58(5):719–727PubMedCrossRef

36.

Gouëffic Y, Sauguet A, Desgranges P, Feugier P, Rosset E, Ducasse E et al (2020) A polymer-free paclitaxel-eluting Stent Versus a Bare-Metal Stent for De Novo Femoropopliteal lesions: the BATTLE trial. JACC Cardiovasc Interv 13(4):447–457PubMedCrossRef

37.

Soga Y, Fujihara M, Iida O, Kawasaki D, Hirano K, Yokoi H et al (2020) Japanese patients treated in the IMPERIAL Randomized Trial comparing Eluvia and Zilver PTX stents. Cardiovasc Intervent Radiol 43(2):215–222PubMedCrossRef

38.

Tsujimura T, Ishihara T, Iida O, Hata Y, Kurata N, Asai M et al (2020) Angioscopic assessments at 3 months after Fluoropolymer-based paclitaxel-eluting stent implantation for Femoropopliteal Endovascular intervention. Circ J 84(11):1999–2005PubMedCrossRef

39.

Zamani N, Sharath SE, Browder RC, Barshes NR, Braun JD, Mills JL Sr et al (2021) Outcomes after Endovascular Stent Placement for Long-Segment superficial femoral artery lesions. Ann Vasc Surg 71:298–307PubMedCrossRef

40.

Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Oliva V et al (2006) Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial. J Endovasc Ther 13(6):701–710PubMedCrossRef

41.

Siablis D, Karnabatidis D, Katsanos K, Kagadis GC, Kraniotis P, Diamantopoulos A et al (2007) Sirolimus-eluting versus bare stents after suboptimal infrapopliteal angioplasty for critical limb ischemia: enduring 1-year angiographic and clinical benefit. J Endovasc Ther 14(2):241–250PubMedCrossRef

42.

Mathlouthi A, Yei KS, Naazie I, Bertges DJ, Malas MB (2021) Increased mortality with paclitaxel-eluting stents is driven by lesion length. J Vasc Surg 73(2):548–53e2PubMedCrossRef

43.

Fong KY, Xin L, Ng J, Loh SEK, Ng JJ, Choong A (2022) A systematic review and meta-analysis of sirolimus-eluting stents for treatment of below-the-knee arterial Disease. J Vasc Surg 77(4):1264–1273PubMedCrossRef

44.

Schiff PB, Fant J, Horwitz SB (1979) Promotion of microtubule assembly in vitro by taxol. Nature 277(5698):665–667PubMedCrossRef

45.

Axel DI, Kunert W, Goggelmann C, Oberhoff M, Herdeg C, Kuttner A et al (1997) Paclitaxel inhibits arterial smooth muscle cell proliferation and migration in vitro and in vivo using local drug delivery. Circulation 96(2):636–645PubMedCrossRef

46.

Heldman AW, Cheng L, Jenkins GM, Heller PF, Kim DW, Ware M Jr. et al (2001) Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis. Circulation 103(18):2289–2295PubMedCrossRef

47.

Gupta R, Al-Ali F, Thomas AJ, Horowitz MB, Barrow T, Vora NA et al (2006) Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation. Stroke 37(10):2562–2566PubMedCrossRef

48.

Feldman DN, Armstrong EJ, Aronow HD, Gigliotti OS, Jaff MR, Klein AJ et al (2018) SCAI consensus guidelines for device selection in femoral-popliteal arterial interventions. Catheter Cardiovasc Interv 92(1):124–140PubMedCrossRef

49.

Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB et al (2016) Durable clinical effectiveness with paclitaxel-eluting stents in the Femoropopliteal artery: 5-Year results of the Zilver PTX Randomized Trial. Circulation 133(15):1472–1483PubMedPubMedCentralCrossRef

50.

Tepe G, Schnorr B, Albrecht T, Brechtel K, Claussen CD, Scheller B et al (2015) Angioplasty of femoral-popliteal arteries with drug-coated balloons: 5-year follow-up of the THUNDER trial. JACC Cardiovasc Interv 8(1 Pt A):102–108PubMedCrossRef

51.

Schneider PA, Laird JR, Tepe G, Brodmann M, Zeller T, Scheinert D et al (2018) Treatment effect of drug-coated balloons is durable to 3 years in the femoropopliteal arteries: long-term results of the IN.PACT SFA Randomized Trial. Circ Cardiovasc Interv 11(1):e005891PubMedPubMedCentralCrossRef

52.

Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB et al (2011) Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal Disease: twelve-month Zilver PTX randomized study results. Circ Cardiovasc Interv 4(5):495–504PubMedCrossRef

53.

Mills JL, Conte MS, Murad MH (2019) Critical review and evidence implications of paclitaxel drug-eluting balloons and stents in peripheral artery Disease. J Vasc Surg 70(1):3–7PubMedCrossRef

54.

Toutouzas K, Di Mario C, Falotico R, Takagi T, Stankovic G, Albiero R et al (2002) Sirolimus-eluting stents: a review of experimental and clinical findings. Z Kardiol 91 Suppl 3:49–57CrossRef

55.

Zhang Q, Lu L, Pu L, Zhang R, Shen J, Zhu Z et al (2007) Neointimal hyperplasia persists at six months after sirolimus-eluting stent implantation in diabetic porcine. Cardiovasc Diabetol 6:16PubMedPubMedCentralCrossRef

56.

Skalsky I, Filova E, Szarszoi O, Parizek M, Lytvynets A, Maluskova J et al (2011) A periadventitial sirolimus-releasing mesh decreased intimal hyperplasia in a rabbit model. Physiol Res 60(3):585–588PubMedCrossRef

57.

Lammer J, Bosiers M, Zeller T, Schillinger M, Boone E, Zaugg MJ et al (2011) First clinical trial of Nitinol self-expanding everolimus-eluting stent implantation for peripheral arterial occlusive Disease. J Vasc Surg 54(2):394–401PubMedCrossRef

58.

Oberhoff M, Herdeg C, Baumbach A, Karsch KR (2002) Stent-based antirestenotic coatings (sirolimus/paclitaxel). Catheter Cardiovasc Interv 55(3):404–408PubMedCrossRef

59.

Wessely R, Schomig A, Kastrati A (2006) Sirolimus and Paclitaxel on Polymer-based drug-eluting stents: similar but different. J Am Coll Cardiol 47(4):708–714PubMedCrossRef

60.

Im E, Hong MK (2015) Drug-eluting stents to prevent stent Thrombosis and restenosis. Expert Rev Cardiovasc Ther 14(1):87–104PubMedCrossRef

61.

Zhao HQ, Nikanorov A, Virmani R, Schwartz LB (2012) Inhibition of experimental neointimal hyperplasia and neoatherosclerosis by local, stent-mediated delivery of everolimus. J Vasc Surg 56(6):1680–1688PubMedCrossRef

62.

Wang X et al (2013) Oral everolimus inhibits intimal proliferation in injured carotid artery in rats. Chin Med J 126:1906–1912PubMedCrossRef

63.

Jensen LO, Thayssen P, Hansen HS, Christiansen EH, Tilsted HH, Krusell LR et al (2012) Randomized comparison of everolimus-eluting and sirolimus-eluting stents in patients treated with percutaneous coronary intervention: the Scandinavian Organization for Randomized trials with clinical outcome IV (SORT OUT IV). Circulation 125(10):1246–1255PubMedCrossRef

64.

Shiomi H, Kozuma K, Morimoto T, Igarashi K, Kadota K, Tanabe K et al (2014) Long-term clinical outcomes after everolimus- and sirolimus-eluting coronary stent implantation: final 3-year follow-up of the Randomized evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial. Circ Cardiovasc Interv 7(3):343–354PubMedCrossRef

65.

Smits PC, Vlachojannis GJ, McFadden EP, Royaards KJ, Wassing J, Joesoef KS et al (2015) Final 5-Year Follow-Up of a Randomized Controlled Trial of Everolimus- and paclitaxel-eluting stents for coronary revascularization in Daily Practice: the COMPARE trial (a trial of Everolimus-Eluting stents and Paclitaxel stents for Coronary Revascularization in Daily Practice). JACC Cardiovasc Interv 8(9):1157–1165PubMedCrossRef

66.

Bangalore S, Kumar S, Fusaro M, Amoroso N, Attubato MJ, Feit F et al (2012) Short- and long-term outcomes with drug-eluting and bare-metal coronary stents: a mixed-treatment comparison analysis of 117 762 patient-years of follow-up from randomized trials. Circulation 125(23):2873–2891PubMedCrossRef

67.

Parry TJ, Brosius R, Thyagarajan R, Carter D, Argentieri D, Falotico R et al (2005) Drug-eluting stents: sirolimus and paclitaxel differentially affect cultured cells and injured arteries. Eur J Pharmacol 524(1–3):19–29PubMedCrossRef

68.

Levin AD, Vukmirovic N, Hwang C-W, Edelman ER (2004) Specific binding to intracellular proteins determines arterial transport properties for rapamycin and paclitaxel. Proc Natl Acad Sci U S A 101(25):9463–9467PubMedPubMedCentralCrossRef

69.

Schwartz SM (1997) Smooth muscle migration in Atherosclerosis and restenosis. J Clin Invest 100(11 Suppl):S87–S89PubMed

70.

Chen Y, Zeng Y, Zhu X, Miao L, Liang X, Duan J et al (2021) Significant difference between sirolimus and paclitaxel nanoparticles in anti-proliferation effect in normoxia and hypoxia: the basis of better selection of Atherosclerosis treatment. Bioact Mater 6(3):880–889PubMed

71.

Farb A, Burke AP, Kolodgie FD, Virmani R (2003) Pathological mechanisms of fatal late coronary stent Thrombosis in humans. Circulation 108(14):1701–1706PubMedCrossRef

72.

Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T et al (2004) Localized hypersensitivity and late Coronary Thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation 109(6):701–705PubMedCrossRef

73.

Nebeker JR, Virmani R, Bennett CL, Hoffman JM, Samore MH, Alvarez J et al (2006) Hypersensitivity cases associated with drug-eluting coronary stents: a review of available cases from the research on adverse drug events and reports (RADAR) project. J Am Coll Cardiol 47(1):175–181PubMedCrossRef

Titel: Different drugs in drug-eluting stents for peripheral artery disease: a systematic evaluation and Bayesian meta-analysis
verfasst von: Keqin Chen
Lei Xu
Xiehong Liu
Publikationsdatum: 28.01.2024
Verlag: Springer US
Erschienen in: Journal of Thrombosis and Thrombolysis / Ausgabe 3/2024
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-023-02932-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Bei Herzinsuffizienz muss „Eisenmangel“ neu definiert werden!

16.05.2024 Herzinsuffizienz Nachrichten

Bei chronischer Herzinsuffizienz macht es einem internationalen Expertenteam zufolge wenig Sinn, die Diagnose „Eisenmangel“ am Serumferritin festzumachen. Das Team schlägt vor, sich lieber an die Transferrinsättigung zu halten.

Herzinfarkt mit 85 – trotzdem noch intensive Lipidsenkung?

16.05.2024 Hypercholesterinämie Nachrichten

Profitieren nach einem akuten Myokardinfarkt auch Betroffene über 80 Jahre noch von einer intensiven Lipidsenkung zur Sekundärprävention? Um diese Frage zu beantworten, wurden jetzt Registerdaten aus Frankreich ausgewertet.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2024

Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program: a cohort study

Antiplatelet therapy in elderly patients with ACS: moving targets need more tailored treatments

Improved visual outcomes of central retinal artery occlusion with local intra-arterial fibrinolysis beyond the conventional time window

Effects of elevated remnant cholesterol on outcomes of acute ischemic stroke patients receiving mechanical thrombectomy

Prospective analysis of pre and postoperative laboratory parameters associated with thrombosis in patients with ovarian cancer