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Journal : Cardiovascular and Cardiometabolic Journal (CCJ)

Dapagliflozin Use in Heart Failure with Reduced Ejection Fraction Accompanied by Type 2 Diabetes Mellitus: A Systematic Review Sinta Dwi Juniar; Mochamad Yusuf Alsagaff; Budi Susetyo Pikir; Pudji Lestari
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 1 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i1.2022.60-74

Abstract

Abstract: Heart failure patients with reduced ejection fraction (HFrEF) respond well to pharmacological therapy and show a better prognosis. Heart failure patients with reduced ejection fraction and type 2 diabetes who were given SGLT-2 inhibitor therapy showed a strong and consistent reduction in the risk of death and hospitalization. The therapy that has recently begun to be investigated for its benefits for heart failure from the SGLT-2 inhibitor class is Dapagliflozin. The systematic review aims to analyze the effect of Dapagliflozin on the prognosis of HFrEF patients with type 2 diabetes mellitus. Material and Methods: The literature was searched from e-database PubMed, ScienceDirect, and ClinicalTrial.gov. Quality assessment was done using the Critical Appraisal Skills Program (CASP) Randomized Controlled Trial Standard Checklist. Results: A total of 22,167 patients from 4 RCTs eligible studies were included. The analysis results of all of the included studies indicate that Dapagliflozin affected the patient's prognosis. Two studies discuss mortality and hospitalization, and two studies discuss symptoms, functional status, and Quality of Life (QoL). Conclusion: Dapagliflozin can improve the prognosis of HFrEF patients with type 2 DM. The improved prognosis includes reduced mortality, reduced hospitalizations by minimizing disease worsening, reducing symptoms, improving functional status and QoL. Keyword: Cardiovascular disease, Dapagliflozin, Diabetes, Prognosis, SGLT 2 inhibitor
Unresponsive to Cardioversion Pre-excited Irregular Rhythm Mochamad Yusuf A, MD, PhD; Dara N. Ghassani, M.D; Nupriyanto, MD; Rerdin Julario, M.D
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 4 No. 2 (2023): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v4i2.2023.115-123

Abstract

Highlights: 1. Atrial fibrillation in the presence of an accessory pathway may present with confounding electrocardiographic signs. 2. The clinical recognition of WPW may be hindered by the presence of pre-excited AF. - Case Summary: A 46-year-old man without known past medical history was referred to the tertiary hospital emergency department after being found collapsed at home. There are no any complaints of any headache, nausea, chest pain, or paralysis of extremities before losing consciousness. His chest examination to bilateral auscultation was clear. Chest X-ray, routine blood work, and transthoracic echocardiography did not reveal any abnormalities. The initial heart rate before referral was 250-300/min and the ECG shows irregular wide QRS complex tachycardia. The ECG after cardioversions shows sinus rhythm 86 bpm with WPW type A pattern. The patient got intravenous amiodarone and intravenous lidocaine during the transfer. And the ECG on arrival at the emergency department, the heart rate was 50-150 bpm irregularly and the ECG shows atrial fibrillation with a narrow QRS complex. Discussion: Rapid anterograde accessory pathway conduction during atrial fibrillation (AF) can result in sudden cardiac death. During pre-excited AF, delta waves as the key feature of Wolff-Parkinson-White (WPW) syndrome might be obscured. We should keep in mind the diagnosis of pre-excited AF in patients presenting with irregular and wide complex tachycardia.