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- Massimo Imazio
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Antonio Brucato
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Davide Cumetti
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Giovanni Brambilla
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Brunella Demichelis
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Silvia Ferro
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Silvia Maestroni
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Enrico Cecchi
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Riccardo Belli
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Giancarlo Palmieri
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
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- Rita Trinchero
- From the Cardiology Department, Ospedale Maria Vittoria, Torino (M.I., B.D., S.F., E.C., R.B., R.T.); Department of Internal Medicine, Ospedali Riuniti, Bergamo (A.B., D.C., S.M.); and Department of Emergency Medicine, and Internal Medicine, Ospedale Niguarda, Milan (G.B., G.P.), Italy.
書誌事項
- タイトル別名
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- High Versus Low Doses: A Nonrandomized Observation
抄録
<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Corticosteroid use is widespread in recurrent pericarditis, even if rarely indicated, and high doses (eg, prednisone 1.0 to 1.5 mg · kg <jats:sup>−1</jats:sup> · d <jats:sup>−1</jats:sup> ) are generally recommended, although only weak evidence supports their use with possible severe side effects. The aim of this work was to compare side effects, recurrences and other complications, and hospitalizations of a low- versus high-dose regimen of prednisone for recurrent pericarditis. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> A retrospective review of all cases of recurrent pericarditis treated with corticosteroids according to different regimens from January 1996 to June 2004 was performed in 2 Italian referral centers. One hundred patients with recurrent pericarditis (mean age, 50.1±15.8 years; 57 females) were included in the study; 49 patients (mean age, 47.5±16.0; 25 females) were treated with low doses of prednisone (0.2 to 0.5 mg · kg <jats:sup>−1</jats:sup> · d <jats:sup>−1</jats:sup> ), and 51 patients (mean age, 52.6±15.3; 32 females) were treated with prednisone 1.0 mg · kg <jats:sup>−1</jats:sup> · d <jats:sup>−1</jats:sup> . Baseline demographic and clinical characteristics were well balanced across the groups. Each initial dose was maintained for 4 weeks and then slowly tapered. After adjustment for potential confounders (age, female gender, nonidiopathic origin), only high doses of prednisone were associated with severe side effects, recurrences, and hospitalizations (hazard ratio, 3.61; 95% confidence interval, 1.96 to 6.63; <jats:italic>P</jats:italic> <0.001). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Use of higher doses of prednisone (1.0 mg · kg <jats:sup>−1</jats:sup> · d <jats:sup>−1</jats:sup> ) for recurrent pericarditis is associated with more side effects, recurrences, and hospitalizations. Lower doses of prednisone should be considered when corticosteroids are needed to treat pericarditis. </jats:p>
収録刊行物
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- Circulation
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Circulation 118 (6), 667-671, 2008-08-05
Ovid Technologies (Wolters Kluwer Health)