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( Jah Yeon Choi ),( Eun Jin Park ),( Ji Young Song ),( Sung Hun Park ),( Hee Dong Kim ),( Dong Oh Kang ),( Jae Joong Lee ),( Kwang No Lee ),( Ji Bak Kim ),( Sun Ki Lee ),( Jin Oh Na ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Hepatitis A infection with cardiac involvement, especially that needs Extra-Corporeal Membrane Oxygenation (ECMO), had been rarely reported. Here, we report a case of severe acute myocarditis that might be due to acute viral hepatitis A infection. A 35- year old women suffered from dyspnea, nausea, vomiting. Initial Electrocardiogram (ECG) showed sinus tachycardia, but soon it became wide QRS tachycardia and RBBB pattern and hypotension was shown. Liver transaminase and cardiac enzyme was elevated and serologic studies for viral infection showed positive in IgM anti-HAV antibodies with negative in anti-HAV IgG. Echocardiography revealed a decreased ejection fraction of 18% with global hypokinesia of left ventricle. Despite of fi uid loading and inotropics application, hypotension was not corrected and Extra-Corporeal Membrane Oxygenation (ECMO) started. After conservative management for several days, ECMO was removed the patient recovered without any serious sequelae.
Choi, Jah Yeon,Choi, Cheol Ung,Hwang, Soon-Young,Choi, Byoung Geol,Jang, Won Young,Kim, Do Young,Kim, Woohyeun,Park, Eun Jin,Lee, Sunki,Na, Jin Oh,Kim, Jin Won,Kim, Eung Ju,Rha, Seung-Woon,Park, Chang Elsevier 2018 The American Journal of Cardiology Vol.122 No.6
<P>Although statin use in patients with acute myocardial infarction (AMI) is mandatory, it has been suggested to be associated with new-onset diabetes mellitus (NODM). In real world practice, moderate-intensity statin therapy is more commonly used than high-intensity statin therapy. In this study, we investigated the impact of moderate-intensity pitavastatin (2 to 4 mg) compared with moderate-intensity atorvastatin (10 to 20 mg) and rosuvastatin (5 to 10 mg) on the development of NODM during a follow-up period of up to 3years. Between November 2011 and May 2015, 2001 patients with AMI who did not have diabetes mellitus were investigated. The cumulative incidence of NODM was evaluated in all groups. To adjust for potential confounders, multinomial propensity scores were used. Cox proportional hazard models were used to assess the hazard ratio of NODM in the atorvastatin and rosuvastatin groups compared with pitavastatin group. The cumulative incidence of NODM was significantly lower in pitavastatin group compared with the atorvastatin and rosuvastatin groups (3.0% vs 8.4% vs 10.4%, respectively; Log-rank p value = 0.001). After weighting the baseline characteristics of the 3 statin groups by multinomial propensity scores, atorvastatin (hazard ratio: 2.615, 95% confidence interval: 1.163 to 5.879) and rosuvastatin (hazard ratio: 3.906, 95% confidence interval: 1.756 to 8.688) were found to be associated with a higher incidence of NODM compared with pitavastatin therapy on multivariable analysis. Moderate-intensity pitavastatin therapy is associated with a lower incidence of NODM in patients with AMI andhas similar clinical outcomes to moderate-intensity atorvastatin and rosuvastatin therapy.</P>