SALT-E 2

50 %
50 %
Information about SALT-E 2

Published on May 13, 2016

Author: IsabellaLai

Source: slideshare.net

1. SCD-HEFT: AMIODARONE OR AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR FOR CONGESTIVE HEART FAILURE BARDY GH, LEE KL, MARK DB, POOLE JE, PACKER DL, ET AL. N ENGL J MED. 2005 JAN 20;352(3):225-37. SALT-E: OVMC LANDMARK TRIAL SERIES 2016 ACCESS ON WEBSITE: HTTP://TINYURL.COM/SALTE2

2. CLINICAL QUESTION  ICD placement in post-MI patients with LVEF ≤ 30% was shown to improve survival (MADIT-II, 2002)  What is the role of ICDs and amiodarone in patients with heart failure with reduced EF regardless of MI history?

3. STUDY DESIGN  Multicenter  double-blinded, parallel-group, randomized placebo-controlled trial  N = 2521  Amiodarone (n = 845)  Shock-only ICD (n = 829)  Placebo (n = 847)  Median follow up: 45.5 month

4. STUDY DESIGN (CONT’D)  Inclusion criteria  Age > 18 years  NYHA class II-III chronic stable HF due to ischemic or nonischemic causes  LVEF ≤ 35%

5. INTERVENTION  Randomized to ICD vs amiodarone vs placebo  All patient received conventional medical therapy as well

6. OUTCOMES  Primary outcome: all-cause mortality  ICD vs placebo: 22% vs 29% (p = 0.007)  Amiodarone vs placebo: 28 vs 29% (p = 0.53)  Subgroup analysis  NYHA class III  Amiodarone -- 44% increase in risk of death compared to placebo (HR 1.44, 97.5 CI 1.05 – 1.97)  ICD therapy -- no reduction in risk of death with ID therapy compared to placebo

7. CRITICISMS  Based on subgroup analysis, ICD therapy only shown to have significant benefit in patients with NYHA class II, but not in those with NYHA class III

8. BOTTOM LINE  ICDs reduce mortality compared to conventional therapy or amiodarone among patients with HF with EF<35%, NYHA II/III

9. DISCUSSION QUESTION Patients with what types of heart failure and what ejection fraction should be considered for ICD placement? Why don’t we use amiodarone for patient’s with HFrEF? What is the primary end-point for this study?

10. CLINICAL APPLICATION  You are in clinic seeing Mr. Rodriguez, a 59YO M with DM, HTN, HL, OSA, obesity, and CAD s/p MI in 2013 with two stents placed in his LAD. Most recent ejection fraction was 15-20%. He denies shortness of breath at rest but states that he has difficulty breathing after walking 2-3 blocks. Current medications include atorvastatin 80 mg PO daily, lasix 20 mg PO daily, Coreg 12.5 mg PO BID, and benazepril 40 mg PO daily.What is the most appropriate next step in management?

Add a comment

Related presentations

Related pages

Salt - Microsoft Store

2. Mourning Palace Ace Ov Spades. Salt. 4:14 0,99 € 3. Kindergarten ...
Read more

SALT (institution) - Wikipedia

SALT e-publications can be read in PDF or EPUB formats, ... Modern Essays 2: Istory (1 November – 31 December 2011; SALT Beyoğlu)
Read more

SALT-E-NUTS - YouTube

Hey Guys I'm SALT-E-NUTS! I play Call Of Duty Black Ops 3 And im planning on playing more games in the future.I Livestream and make Montages.I Upload once ...
Read more

Salt (cryptography) - Wikipedia

The salt is 8 characters, ... If the rainbow tables do not have passwords matching the length (e.g. an 8-byte password, and 2-byte salt, ...
Read more

Salt | Definition of Salt by Merriam-Webster

2: a container for salt at table —often used in the ... skepticism —usually used in the phrases with a grain of salt and with a pinch of salt e: ...
Read more

Salztopf Wandschale aus Porzellan Aufschrift SALT | eBay

an den Seitenteilen 2 Löcher, 5 mm Durchmesser Maße: Höhe Rückseite 17,0 cm Schale 10,5 cm Breite 13,0 cm Tiefe 10,0 cm Inhalt 1 Liter
Read more

The Price of Salt: OR Carol - Kindle edition by Patricia ...

The Price of Salt: OR Carol - Kindle edition by Patricia Highsmith. ... Add narration for a reduced price of $2.99 when you buy the Kindle book. Ready
Read more

Salt | e.tv

SCREAM 2; SKYFALL; THE ONE; Highlights. New movies on e in September; TV Guide; e On Demand; Search form. Search . Salt. Genre: Crime.
Read more

Himalayan Salt | Pure Cooking Salt - Mercola.com

Measuring a generous 16-1/2 inches by 8 ... Mercola encourages you to make your own health care decisions based upon your research and in partnership ...
Read more

Salt Optics

Salt Optics. Instagram; Facebook; Twitter; Optical; Sun; Find a Store; New Releases; About; Contact; Warranty; Press; Blog; Inspiration; Assets ...
Read more