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Loperamide-Induced Cardiac Events: Case Reports And Review., Vivek Modi, Matthew Krinock, Ravi V. Desai Md, Steven Stevens, Sudip Nanda

Cardiology Division

Reports of cardiac arrhythmia secondary to loperamide toxicity have become increasingly common in the literature. We present two patients in their mid-20s, each having overdosed on loperamide and subsequently manifesting life-threatening cardiac arrhythmias not otherwise explained by known pathology. An analysis of the limited research available indicates that loperamide's capacity to block ion channels may be responsible for these events. A better mechanistic understanding of loperamide's effects can help inform clinical management of patients with these life-threatening symptoms as at this time no set guidelines for management have yet been established.

Management And Outcomes Of Cardiogenic Shock In Cardiac Icus With Versus Without Shock Teams., Alexander I Papolos, Benjamin B Kenigsberg, David D Berg, Carlos L Alviar, Erin Bohula, James A Burke Md, Anthony P Carnicelli, Sunit-Preet Chaudhry, Stavros Drakos, Daniel A Gerber, Jianping Guo, James M Horowitz, Jason N Katz, Ellen C Keeley, Thomas S Metkus, Jose Nativi-Nicolau, Jeffrey R Snell, Shashank S Sinha, Wayne J Tymchak, Sean Van Diepen, David A Morrow, Christopher F Barnett

Cardiology Division

BACKGROUND: Single-center studies suggest that implementation of multidisciplinary cardiogenic shock (CS) teams is associated with improved CS survival.

OBJECTIVES: The aim was to characterize practice patterns and outcomes in the management of CS across multiple centers with versus without shock teams.

METHODS: The Critical Care Cardiology Trials Network is a multicenter network of cardiac intensive care units (CICUs) in North America. All consecutive medical admissions to each CICU (n = 24) were captured during annual 2-month collection periods (2017-2019; n = 6,872). Shock management and CICU mortality among centers with versus without shock teams were compared using inverse probability weighting. …

Risk Stratification Among Survivors Of Cardiac Arrest Considered For Coronary Angiography., Ahmed A Harhash, Teresa L May, Chiu-Hsieh Hsu, Sachin Agarwal, David B Seder, Michael R Mooney, Nainesh C. Patel Md, John Mcpherson, Paul Mcmullan, Richard Riker, Eldar Soreide, Karen G Hirsch, Pascal Stammet, Alison Dupont, Sten Rubertsson, Hans Friberg, Niklas Nielsen, Tanveer Rab, Karl B Kern

Cardiology Division

BACKGROUND: The American College of Cardiology Interventional Council published consensus-based recommendations to help identify resuscitated cardiac arrest patients with unfavorable clinical features in whom invasive procedures are unlikely to improve survival.

OBJECTIVES: This study sought to identify how many unfavorable features are required before prognosis is significantly worsened and which features are most impactful in predicting prognosis.

METHODS: Using the INTCAR (International Cardiac Arrest Registry), the impact of each proposed "unfavorable feature" on survival to hospital discharge was individually analyzed. Logistic regression was performed to assess the association of such unfavorable features with poor outcomes.

RESULTS: Seven unfavorable features (of …