Dexamethasone could improve myocardial infarction outcomes and provide new therapeutic options for non-interventional patients

Alisky, Joseph Martín

doi:10.1016/j.mehy.2005.12.034

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…In the current study, the participant who reported experiencing psychosis from steroids remained in this state for many months while on treatment and required ongoing psychiatric care. Although documented as uncommon, psychosis is noted as a complication of steroids in a number of diagnostic conditions other than hematological malignancies such as myocardial infarction, asthma, and Sheehan's syndrome (Alisky, 2006;Hong et al, 2006;Koh et al, 2002). Depression has been reported elsewhere as a serious side effect of steroid administration in a case study of a 15-year-old girl with acute lymphoblastic leukemia, a common hematological malignancy (Sutor et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

“…Steroids are used in treatment regimens for diagnostic groups ranging from asthma (Koh et al, 2002), systemic lupus erythematosus (Chau & Mok, 2003;Mok, Ying, Mak, To, & Szeto, 2006), myocardial infarction (Alisky, 2006), orthognathic surgery (Fleming & Flood, 2005), autoimmune disorders (Weiss, Dyrud, House, & Beresford, 2005), severe acute respiratory syndrome 336 P. McGrath and H. Holewa (Sheng, Cheng, Lau, Li, & Chan, 2005), dementia (Sacks & Shulman, 2005), Churg-Strauss syndrome (Ismail & Lyster, 2002), and inflammatory bowel disease (Buchman, 2001). The potential for steroid treatments to cause severe emotional and even psychiatric disturbances, ranging from mood disturbances to (florid) psychosis, are well documented (Hong, Cho, Kang, Chung, & Chung, 2006;Ruiz, Dabi, Matusevich, & Finkelsztein, 2002).…”

Section: Introductionmentioning

confidence: 99%

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The Emotional Consequences of Corticosteroid Use in Hematology: Preliminary Findings

McGrath

Holewa

2010

Journal of Psychosocial Oncology

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This article presents the findings from a pilot study conducted as a first step in understanding the myriad psychological and psychiatric sequelae stemming from the use of steroids for hematology patients. Descriptions of the side effects experienced by 10 hematology patients undergoing steroid treatment are documented and discussed. Steroid usage can have a range of physical and emotional side effects on patients, including hematology patients. The insights are a serious reminder to all who care for hematology patients that the psychological and psychiatric side effects of steroids need to be taken seriously.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Emotional Consequences of Corticosteroid Use in Hematology: Preliminary Findings

McGrath

Holewa

2010

Journal of Psychosocial Oncology

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“…Given their anti-inflammatory effects, glucocorticoids have been proposed to be useful in reducing tissue damage after myocardial infarction (122). However, as noted above, the mechanisms of glucocorticoid action are complex.…”

Section: Recovery From Myocardial Infarctionmentioning

confidence: 99%

Glucocorticoids and Cardiovascular Disease

Walker¹

2007

European Journal of Endocrinology

477

386

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Chronic excessive activation of glucocorticoid receptors induces obesity, insulin resistance, glucose intolerance, dyslipidaemia and hypertension. Subtle abnormalities of the hypothalamic-pituitaryadrenal axis and/or of tissue sensitivity to glucocorticoids are also associated with these cardiovascular risk factors in patients with the metabolic syndrome. Furthermore, glucocorticoids have direct effects on the heart and blood vessels, mediated by both glucocorticoid and mineralocorticoid receptors and modified by local metabolism of glucocorticoids by the 11b-hydroxysteroid dehydrogenase enzymes. These effects influence vascular function, atherogenesis and vascular remodelling following intravascular injury or ischaemia. This article reviews the systemic and cardiovascular effects of glucocorticoids, and the evidence that glucocorticoids not only promote the incidence and progression of atherogenesis but also modify the recovery from occlusive vascular events and intravascular injury. The conclusion is that manipulation of glucocorticoid action within metabolic and cardiovascular tissues may provide novel therapeutic avenues to combat cardiovascular disease.European Journal of Endocrinology 157 545-559

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“…Glucocorticoids have been used clinically to reduce arrhythmia following cardiac surgery and to improve the outcome of cardiac arrest, which supports its protective role in certain cardiac events (23,24). They are also helpful in decreasing tissue injury after myocardial infarction by acting as an anti-inflammatory reagent (25). The protective actions of glucocorticoids can also be observed during cardiopulmonary bypass and coronary ischemia (26,27).…”

Section: Glucocorticoids and Cardiovascular Diseasesmentioning

confidence: 95%

Glucocorticoid signaling in cardiac disease

Ren

Cidlowski

2010

Hormone Molecular Biology and Clinical Investigation

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As major mediators of stress regulation, glucocorticoids have an essential role in maintaining cardiovascular homeostasis under both physiological and pathological conditions. The release of glucocorticoids into the peripheral circulation is adjusted by the hypothalamic-pituitary-adrenal axis in response to various pathological challenges such as sepsis, starvation, and psychological stress. Clinically, dysregulation of the glucocorticoid-mediated signaling as a result of either excess ligand or receptor hypersensitivity is connected with the progression of unfavorable cardiovascular events such as cardiac hypertrophy, atherosclerosis, and coronary artery disease. The direct effects of glucocorticoids on cardiac tissues are mediated by two steroid receptors, the glucocorticoid receptor and mineralocorticoid receptor, which are both expressed by cardiomyocytes. Although each receptor has some shared responses to glucocorticoids, each receptor also has unique effects on cardiac functions. Elucidating the selective actions of each receptor is critical for determining the proper pharmaceutical targets in cardiovascular diseases.

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Dexamethasone could improve myocardial infarction outcomes and provide new therapeutic options for non-interventional patients

Cited by 13 publications

References 26 publications

The Emotional Consequences of Corticosteroid Use in Hematology: Preliminary Findings

The Emotional Consequences of Corticosteroid Use in Hematology: Preliminary Findings

Glucocorticoids and Cardiovascular Disease

Glucocorticoid signaling in cardiac disease

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