Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis
Likui Fang, Wenfeng Yu, Guocan Yu, Gang Chen, Bo Ye Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of ChinaCorrespondence: Likui Fang, Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of China, Email 21...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-01-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/clinical-significance-of-preoperative-pyrazinamide-containing-therapy--peer-reviewed-fulltext-article-IDR |
| _version_ | 1797357136955572224 |
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| author | Fang L Yu W Yu G Chen G Ye B |
| author_facet | Fang L Yu W Yu G Chen G Ye B |
| author_sort | Fang L |
| collection | DOAJ |
| description | Likui Fang, Wenfeng Yu, Guocan Yu, Gang Chen, Bo Ye Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of ChinaCorrespondence: Likui Fang, Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of China, Email 21618100@zju.edu.cnBackground: Tuberculous constrictive pericarditis (TCP) is recommended to be treated with anti-tuberculosis (TB) therapy before pericardiectomy. Whether different preoperative anti-TB regimens may lead to different outcomes is unclear.Methods: We retrospectively collected patients diagnosed as TCP and received pericardiectomy from April 2016 to June 2023. The study patients were assigned into the active TCP (A-TCP) group and the inactive TCP (IA-TCP) group according to the results of Mycobacterium tuberculosis (MTB) culture and MTB RNA assay. Baseline characteristics including anti-TB regimens and surgical outcomes were compared between the two groups. Logistic regression analysis and subgroup analysis were conducted to identify the protective factors of A-TCP.Results: Of the 102 study patients, 24 was in the A-TCP group and 78 was in the IA-TCP group. The rate of preoperative anti-TB regimen containing pyrazinamide was 37.5% in the A-TCP group, as compared with 74.4% in the IA-TCP group (P = 0.001). Multivariate analysis showed that preoperative use of pyrazinamide was the protective factor of A-TCP (OR 0.194, 95% CI 0.053– 0.703, P = 0.013). Subgroup analysis based on age also showed consistent findings. In the analyses of surgical outcomes, A-TCP was the independent risk factor of postoperative cardiac complications (OR 4.231, 95% CI 1.317– 13.593, P = 0.015) and associated with longer hospital stay (P = 0.004) and higher hospitalization cost (P = 0.001).Conclusion: A strategy involving anti-TB regimen containing pyrazinamide before pericardiectomy was superior to that without pyrazinamide in the patients with TCP. The strategy was associated with lower risk of A-TCP and might lead to better postoperative recovery and cost-effectiveness.Keywords: tuberculous constrictive pericarditis, pericardiectomy, pyrazinamide, outcomes |
| first_indexed | 2024-03-08T14:40:36Z |
| format | Article |
| id | doaj.art-46fb32b51a8747e3ac7aa76974abebf2 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-03-08T14:40:36Z |
| publishDate | 2024-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-46fb32b51a8747e3ac7aa76974abebf22024-01-11T18:05:55ZengDove Medical PressInfection and Drug Resistance1178-69732024-01-01Volume 1713113989656Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive PericarditisFang LYu WYu GChen GYe BLikui Fang, Wenfeng Yu, Guocan Yu, Gang Chen, Bo Ye Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of ChinaCorrespondence: Likui Fang, Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People’s Republic of China, Email 21618100@zju.edu.cnBackground: Tuberculous constrictive pericarditis (TCP) is recommended to be treated with anti-tuberculosis (TB) therapy before pericardiectomy. Whether different preoperative anti-TB regimens may lead to different outcomes is unclear.Methods: We retrospectively collected patients diagnosed as TCP and received pericardiectomy from April 2016 to June 2023. The study patients were assigned into the active TCP (A-TCP) group and the inactive TCP (IA-TCP) group according to the results of Mycobacterium tuberculosis (MTB) culture and MTB RNA assay. Baseline characteristics including anti-TB regimens and surgical outcomes were compared between the two groups. Logistic regression analysis and subgroup analysis were conducted to identify the protective factors of A-TCP.Results: Of the 102 study patients, 24 was in the A-TCP group and 78 was in the IA-TCP group. The rate of preoperative anti-TB regimen containing pyrazinamide was 37.5% in the A-TCP group, as compared with 74.4% in the IA-TCP group (P = 0.001). Multivariate analysis showed that preoperative use of pyrazinamide was the protective factor of A-TCP (OR 0.194, 95% CI 0.053– 0.703, P = 0.013). Subgroup analysis based on age also showed consistent findings. In the analyses of surgical outcomes, A-TCP was the independent risk factor of postoperative cardiac complications (OR 4.231, 95% CI 1.317– 13.593, P = 0.015) and associated with longer hospital stay (P = 0.004) and higher hospitalization cost (P = 0.001).Conclusion: A strategy involving anti-TB regimen containing pyrazinamide before pericardiectomy was superior to that without pyrazinamide in the patients with TCP. The strategy was associated with lower risk of A-TCP and might lead to better postoperative recovery and cost-effectiveness.Keywords: tuberculous constrictive pericarditis, pericardiectomy, pyrazinamide, outcomeshttps://www.dovepress.com/clinical-significance-of-preoperative-pyrazinamide-containing-therapy--peer-reviewed-fulltext-article-IDRtuberculous constrictive pericarditispericardiectomypyrazinamideoutcomes |
| spellingShingle | Fang L Yu W Yu G Chen G Ye B Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis Infection and Drug Resistance tuberculous constrictive pericarditis pericardiectomy pyrazinamide outcomes |
| title | Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis |
| title_full | Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis |
| title_fullStr | Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis |
| title_full_unstemmed | Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis |
| title_short | Clinical Significance of Preoperative Pyrazinamide-Containing Therapy in Tuberculous Constrictive Pericarditis |
| title_sort | clinical significance of preoperative pyrazinamide containing therapy in tuberculous constrictive pericarditis |
| topic | tuberculous constrictive pericarditis pericardiectomy pyrazinamide outcomes |
| url | https://www.dovepress.com/clinical-significance-of-preoperative-pyrazinamide-containing-therapy--peer-reviewed-fulltext-article-IDR |
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