Publications by authors named "P R D Clephas"
Postictal agitation (PIA) is an adverse effect of electroconvulsive therapy (ECT) and is known to predict other side effects of ECT, but inconsistencies in the literature remain regarding PIA prognostic factors and incidence. Therefore, a systematic review and meta-analysis were conducted (1) to identify prognostic factors for PIA following ECT and (2) to elucidate the diverse incidences of PIA following ECT based on demographic and clinical characteristics. Specifically, electronic databases were searched for retrospective observational studies and randomized controlled trials (RCTs) that objectively reported PIA incidence.
View Article and Find Full Text PDFSerial cardiac biomarkers, pulmonary artery pressures and traditional parameters of fluid status in relation to prognosis in patients with chronic heart failure: Design and rationale of the BioMEMS study.
Eur J Heart Fail
August 2024
Article Synopsis
- Heart failure (HF) is a widespread issue that requires improved predictive tools for better treatment, particularly focusing on congestion, which leads to hospitalizations.
- The BioMEMS study, part of the MONITOR-HF trial, collects blood samples from participants to analyze the relationship between biomarker patterns and pulmonary artery pressures over time.
- By adopting a dynamic approach to biomarker measurement rather than relying on single baseline values, the study aims to enhance understanding of HF progression and tailor therapies for individual patients.
Article Synopsis
- The TITRATE-HF study investigates the real-world application and barriers to guideline-directed medical therapy (GDMT) for heart failure patients, aligning with the 2021 ESC HF guidelines and 2023 updates.
- Conducted in the Netherlands, the study involved 4,288 patients, highlighting that while 44% of chronic and worsening heart failure patients received quadruple therapy, only 1% achieved target doses for all drug classes.
- The findings indicate that there is significant room for improvement in GDMT usage and dosing, emphasizing the need for enhanced strategies in heart failure management.
Background And Aims: In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups.
Methods: The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator.
Aims: Remote haemodynamic monitoring with an implantable pulmonary artery (PA) sensor has been shown to reduce heart failure (HF) hospitalizations and improve quality of life. Cost-effectiveness analyses studying the value of remote haemodynamic monitoring in a European healthcare system with a contemporary standard care group are lacking.
Methods And Results: A Markov model was developed to estimate the cost-effectiveness of PA-guided therapy compared to the standard of care based upon patient-level data of the MONITOR-HF trial performed in the Netherlands in patients with chronic HF (New York Heart Association class III and at least one previous HF hospitalization).