Asymptomatic individuals with systolic left ventricular (LV) dysfunction have an increased mortality. Angiotensin converting enzymes inhibitors (ACEI) and angiotensin receptor blockers (ARB) favorably affect such patients, but little is known abut the effect of beta-blockers in this group.
Biomarkers such as brain natriuretic peptides (BNP) and troponin have been shown to be of diagnostic and prognostic value in patients with heart failure, but little is known abut the value of serial outpatient measurements.
This issue of Emergency Medicine Reports is devoted to increasing your understanding of these measures and the role they will play in your practice.
Several years ago, the PROWESS trial demonstrated a mortality benefit for drotrecogin alfa [activated] (DrotAA; APC) in patients with severe sepsis, and that this benefit was most pronounced in those at high risk of death (ie, APACHE score > 25 or multi-organ dysfunction).
The sample for this study comprised 15,846 patients admitted to 51 adult ICUs in 31 hospitals participating in the Centers for Disease Control and Prevention's Nosocomial Infection Surveillance system.
