AM Report: Pericardial Disease

pericardiumste

Learning Points

  • Pericardial Effusions–Indications for a pericardiocentesis
    • Hemodynamically unstable (therapeutic)
    • Hemodynamically stable (diagnostic):
      • If suspicious of Purulent, TB, Neoplastic pericarditis
      • Mod-large effusion s/p failed anti-inflammatory tx
  • Treatment:
    • COPE Study: Results of the COlchicine for acute PEricarditis (Imazio in Circulation 2005)
      • Colchicine + Conventional Tx (NSAIDS) = Less Recurrence than Conventional Tx alone for the FIRST episode of acute pericarditis
    • Comprehensive systematic review on pharmacologic treatments for acute or recurrent pericarditis. (Lotrionte in AHJ 2010)
      • Colchicine vs standard tx(NSAIDS) (3 studies, 265 patients) Colchicine assoc with reduced risk of tx failure and recurrence
      • Steroids vs standard tx (2 studies, 31 patients): Steroids assoc with high risk of recurrence
    • A Randomized Trial of Colchicine for Acute Pericarditis: (Imazio in NEJM 2013)
      • Multicenter, double-blind trial, randomized; 240 patients
      • Colchicine + conventional tx significantly reduced  rate of recurrent pericarditis