Risultati per: Il dolore neuropatico: review

Circulation, Volume 150, Issue Suppl_1, Page A4145376-A4145376, November 12, 2024. Background:Carbon monoxide (CO) poisoning is a significant public health threat, with emerging attention on its cardiovascular consequences such as myocardial injury, heart failure, and arrhythmias. Notably, atrial fibrillation (AF) has been sporadically reported, suggesting a potential link between CO exposure and cardiac dysrhythmias.Case Report:A 72-year-old female with hypothyroidism and IBS presented to the emergency department with sudden gait imbalance, dizziness, and an occipital headache. Her ECG showed new-onset atrial fibrillation, with subsequent unremarkable echocardiography and brain imaging. Remarkably, her husband exhibited similar symptoms and both had recently been camping. Suspecting CO poisoning, carboxyhemoglobin was tested and found to be 2.9%, with no methemoglobinemia. The patient spontaneously converted to normal sinus rhythm during hospitalization and maintained it during hospitalization without hyperbaric oxygen therapy.Systematic Review of Case Reports: We identified seven cases of carbon monoxide-induced atrial fibrillation from 45 citations. Patients were mostly male (57.14%), aged 21 to 82, and presented with diverse symptoms, primarily headache (57.1%) and nausea (57.1%). Rapid ventricular response occurred in 85.7% of cases, none with a prior history of atrial fibrillation. Most (85.7%) returned to normal sinus rhythm upon discharge, and 71.4% maintained it on follow-up. Normobaric oxygen therapy was given in 57.1% of cases, and hyperbaric oxygen in 42.9%. Most patients (85.7%) had no known cardiovascular disease.Discussion:Despite being underexplored, evidence suggests a notable escalation in dysrhythmia risk, particularly in patients with pre-existing cardiovascular conditions, following acute CO poisoning. Potential mechanisms for CO-induced dysrhythmias include the strong binding of CO to hemoglobin, resulting in hypoxia-induced myocardial changes, and molecular alterations affecting cardiac voltage-gated channels.Conclusion:While the association between acute CO poisoning and dysrhythmias warrants further investigation, emerging evidence underscores the necessity of raising awareness among healthcare providers regarding the potential cardiovascular consequences of CO exposure.

Circulation, Volume 150, Issue Suppl_1, Page A4143604-A4143604, November 12, 2024. Background:Rivaroxaban is a novel oral anticoagulant suggested as an alternative to low molecular weight heparin (LMWH). However, its efficacy and safety compared to LMWH for treating venous thromboembolism (VTE) in cancer patients remain unclear.Hypothesis:This study aims to compare the efficacy and safety of rivaroxaban against LMWH for treating VTE in cancer patients.Methods:We conducted a literature search for relevant articles on PubMed, Google Scholar, and Embase. Outcomes were pooled using the DerSimonian and Laird random-effects model as risk ratios (RR) with 95% confidence intervals (CI). A p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4144840-A4144840, November 12, 2024. Background:Cardiac transplantation has significantly evolved since its inception in 1967. While the USA and Europe lead in transplant numbers and innovations, the Middle East and North Africa (MENA) region is progressively developing its programs. Countries such as Saudi Arabia, Turkey, the UAE, and Jordan have made notable advancements; however, challenges including donor organ shortages, cultural and religious barriers, and economic constraints persist.Research Question:What is the current status of cardiac transplantation in the MENA region, and what are the main challenges and advancements faced by these programs?Goals:This narrative review aims to provide a comprehensive overview of the development, challenges, and outcomes of cardiac transplantation programs in the MENA region.Methods:A thorough literature review was conducted, examining scholarly articles, clinical reports, and data from national and international transplant registries. Key topics reviewed include the establishment and growth of cardiac transplant centers, advancements in surgical techniques and immunosuppressive therapies, patient outcomes, and barriers specific to the MENA region.Results:The review found variability in the development and outcomes of cardiac transplantation programs across the MENA region. Saudi Arabia has one of the most developed programs, with 1-year survival rates of 85% and 5-year rates of 75%. Turkey reports 1-year survival rates of approximately 80%. The UAE has recently expanded its transplant capabilities, yet faces challenges in donor organ availability and long-term patient follow-up. Jordan’s program shows promising outcomes with a 1-year survival rate of around 80%, but financial constraints are significant hurdles.Common challenges include low donor registration rates, lack of public awareness about organ donation, and high operational costs. Disparities in healthcare infrastructure also hinder progress. Innovations such as ex-vivo heart perfusion and new immunosuppressive therapies are being adopted selectively, with Saudi Arabia and Turkey at the forefront.Conclusions:Enhancing public education on organ donation, establishing robust organ procurement systems, and developing specialized heart failure clinics are crucial. Addressing these issues could potentially improve cardiac transplantation success, leading to a subsequent reduction of cardiovascular disease burden in the MENA region.

Circulation, Volume 150, Issue Suppl_1, Page A4120966-A4120966, November 12, 2024. Background The development of in-stent restenosis (ISR) has emerged as a substantial barrier to interventional treatment for coronary heart disease. Drug-coated balloon (DCB) is an efficacious interventional technique for the management of ISR. This meta-analysis compares the efficacy of DCB in the treatment of ISR with that of an uncoated balloon (UCB). Methods We comprehensively searched literature on MEDLINE, Embase, Cochrane, and clinicaltrials.gov using MeSH terms and relevant keywords for “Balloon Angioplasty” and “in-stent Restenosis” from inception to June 1, 2024, followed by a meta-analysis of all randomized controlled trials (RCTs) to assess both strategies for treatment of ISR. Random effects model was used to aggregate the risk ratios (RR) for dichotomous and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). Results The search strategy retrieved 2330 studies. Duplicates and irrelevant articles were removed and data from seven RCTs (1,408 patients) was extracted. The mean age ranged from 64 to 74 years. The mean clinical follow-up ranged from 1 to 10 years. DCB was found to be superior to UCB at latest follow up in terms of target lesion revascularization (TLR) (RR 0.34, 95% CI 0.19-0.58; p 0.0001; I2 79%), major adverse cardiovascular events (MACE) (RR 0.41, 95% CI 0.23-0.73; p 0.003; I2 84%), late lumen loss (LLL) (MD -0.46 mm, 95% CI -0.64- -0.28]; p

Circulation, Volume 150, Issue Suppl_1, Page A4117438-A4117438, November 12, 2024. Introduction:Transcatheter Mitral Valve Edge to Edge Repair (TEER) is an established percutaneous treatment for patients with severe symptomatic Mitral Regurgitation (MR). The current AHA/ACC guidelines recommend TEER for inoperable patients with severe primary MR or patients with symptomatic severe secondary MR despite medical therapy. Machine learning (ML) has emerged as a tool for TEER risk stratification due to the paucity of established risk scores. To address the lack of consensus on its efficacy, we conducted a systematic review and meta-analysis of studies that utilized ML to predict the success of TEER.Methods:Electronic databases, including Embase, MEDLINE, and the Cochrane Library, were searched from inception through April 2024. We included studies that used TEER and employed at least one ML model to predict the success of TEER. The Area Under the Receiver Operating Characteristic Curve (AUC) was used to measure the accuracy of ML risk stratification algorithms.Results:102 publications were screened, with seven eventually included in this analysis. Two studies employed clustering techniques, two utilized extreme gradient boosting, and three used multiple ML algorithms to predict outcomes. Of the four studies that compared the accuracy of ML with traditional Cox regression, all four demonstrated higher accuracy with ML, and this difference was statistically significant in three of the four studies. The mean AUC of the aggregated ML data was 0.737 [95% CI: 0.717, 0.758], compared to 0.627 [95% CI: 0.600, 0.653] for the pooled traditional methods.Conclusions:To our knowledge, we conducted the first systematic review and meta-analysis of ML methods for prediction of TEER success. ML outperformed established risk scores, demonstrating promising potential. Future ML models, trained on larger patient datasets, may further improve predictive accuracy in this patient population.

Circulation, Volume 150, Issue Suppl_1, Page A4120246-A4120246, November 12, 2024. Introduction:Transthoracic (TTE) guidelines after PFO device closure are vague.Goal:To perform a literature search to characterize the type, frequency, and timing of complications that occur after PFO device placement to determine the utility of routine TTE in post-device patients.Methods:A search was performed in Medline (PubMed) with English language and publication date (2000-2023) filters applied. Studies were included if they reported on PFO device closures. If a study included both PFO and ASD device closures with no distinction between the groups, it was included. Studies were excluded if it only reported on ASD device closures, were meta-analysis/review papers, or did not report any outcomes for the PFO device procedure.Results:Total of 305 articles met criteria. Incidence of complications was 6.9% (3358/48348). Maximum range of follow-up was 0 – 17 years. Types and timing of complications presented in Tables 1 and 2. Majority of complications occurred 5 years post-device. All patients with complications > 5 years device placement presented with clinical symptoms related to their complications.Conclusion:Incidence of complications after PFO device placement appeared to significantly decrease 5 years post-procedure. Late complications were all preceded by clinical symptoms. Routine use of TTE < 5 years post-device may be reasonable, but > 5 years, TTE may only be needed if clinical symptoms occur.

Circulation, Volume 150, Issue Suppl_1, Page A4145520-A4145520, November 12, 2024. Background:The previous literature reports similar cardiovascular (CV) benefits for either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in patients with left main coronary artery disease (LMCAD). However, limited data exist on the influence of prior cerebrovascular disease (CEVD) in such patients. Thus, our aim is to compare the CV outcomes in patients with LMCAD and prior CEVD, undergoing either PCI or CABG.Methods:A comprehensive search of electronic databases, PubMed, SCOPUS, and Cochrane Central was conducted from their inception till May 2024. Outcomes of interest included all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE), Myocardial Infarction (MI), and risk of stroke in patients undergoing either PCI or CABG for LMCAD. Data were pooled and analyzed using a random effects model and presented as hazard ratios (HR) along with their 95% confidence intervals (CI). Heterogeneity was quantified using the I(2) index.Results:We included three studies in our analysis (n = 5,732). Our analysis demonstrated that in patients with prior CEVD, PCI lead to significantly increased risk of MACCE (HR = 2.56, 95% CI:[1.23, 5.37], p = 0.01] and MI (HR = 2.97, 95% CI: [1.72, 5.13], p< 0.01). While an elevated risk of all-cause mortality (HR: 1.35, 95% CI: [0.92, 1.98]; p = 0.12) and repeat stroke (HR: 1.67, 95% CI: [0.81, 3.42], p = 0.16) was observed, these were comparable across procedures. Similarly, an elevated but comparable risk of repeat revascularization was observed between the two procedures (HR: 3.44, 95% CI: [0.50, 23.60]; p = 0.21).Conclusion:Our results show that PCI significantly elevates the risk of MACCE and MI in patients with prior CEVD compared to CABG. However, risks of all-cause mortality, repeat stroke, and revascularization were comparable. The increased risk of adverse CV events in CEVD patients may be due to co-morbidities like hypertension, smoking, diabetes, peripheral vascular disease, renal insufficiency, inflammation, and hypercoagulability. We recommend including prior CEVD in pre-operative assessments for revascularization and developing novel strategies for patients with LMCAD and prior CEVD.

Circulation, Volume 150, Issue Suppl_1, Page A4117406-A4117406, November 12, 2024. Objectives:This meta-analysis sought to explore the long-term arrhythmic outcomes of cardiac sympathetic denervation (CS) by measuring event rates of recurrent ventricular arrhythmias (VA) and implantable cardiac defibrillator shocks (ICD) post CSD.Background:The role of sympathetic nervous system in the beginning and continuation of ventricular arrhythmias (VAs) is well known. CS has been associated with improved arrhythmic outcomes in patients with refractory ventricular arrhythmias. However, whether CSD lowers shock event rates after the procedure is still uncertain and therefore, we performed a systematic review and meta-analysis to evaluate this.Methods&Materials:A comprehensive literature search was performed at Medline and Embase until March 2023. Our primary outcome was event rate of ICD shocks at 30 days, 90 days, and 1 year following CS. All analysis was conducted using Comprehensive Meta-Analysis software.Results:The initial search found 1,324 articles. After all articles were examined, a total of 29 studies fit our criteria. ICD shocks 1 year post CSD had a pooled event rate of 66.5% with a 95% confidence interval (CI) of 57.7% to 74.3% and the I-squared (I2) statistics. ICD shocks at 6 months had an event rate at 61.7% with a 95% confidence interval of 53.3% to 69.4% with I2 at 46. VA in one year post CSD had a pooled event rate of 62.5 with a 95% with a CI of 53.3% to 69.1% and I2 at 22%. At 6 months the event rate was 64.2 with a 95% CI of 56.3% to 71.4% with I2 at 33% Mortality from cardiac arrhythmia and classified 0-30 days (short term), 21-364 days (medium term), and >365 days (long term). The pooled event rate for short term morality was 6.8% with a 95% CI of 4.2%-11.0% with I2 at 0%, medium term was 5.2% with a 95% CI of 2.9% to 8.9% with I2 at 0%, and long term was 5.0% with a 95% CI of 2.7% to 9.2% and I2 at 0%.Conclusion:CSD may be an alternative form of therapy that reduces shock event rates and recurrent VA in patients that are refractory to ablation and medical therapy. However larger prospective studies are needed to further evaluate the usefulness and safety of CSD.

Circulation, Volume 150, Issue Suppl_1, Page A4147426-A4147426, November 12, 2024. Background:Calcified left main disease is a high-risk and procedurally complex subset of coronary artery disease. So, adequate lesion preparation before stenting is crucial in achieving a favorable outcome. We performed a meta-analysis to compare the safety of intravascular lithotripsy (IVL) and rotational atherectomy (RA) in preparation of calcified left main coronary artery disease.Hypothesis:We hypothesize that there are no significant differences in angiographic and in-hospital outcomes between RA and IVL while treating calcified left main coronary disease.Methods:We systematically searched PubMed, Embase, and Cochrane databases until May 2024 for studies comparing IVL and RA in calcified left main coronary disease. A random-effects model was used to pool risk ratios (RR) with corresponding 95% confidence intervals (CI). Statistical analyses were performed using software R and heterogeneity was assessed using I2statistics.Results:We included 3 studies comprising 276 patients undergoing PCI for calcified left main disease, of whom 109 (39.5%) underwent lesion preparation with IVL. The mean age was 72.9 years and 73.1% were males. In the pooled analysis, there were no significant differences between the IVL and RA treated groups in terms of in-hospital mortality (RR 0.30; 95% CI 0.08 to 1.13, p=0.07, I2=0%; Figure 1A) and in-hospital myocardial infarction (RR 0.85; 95% CI 0.17 to 4.11, p=0.83, I2=0%; Figure 1B). There was also no significant difference in angiographic outcomes such as coronary perforation (RR 0.56; 95% CI 0.15 to 2.04; p=0.37, I2=0%; Figure 2A) and slow-flow/no-reflow (RR 1.43; 95% CI 0.22 to 9.51; p=0.70, I2=0%; Figure 2B).Conclusion:This meta-analysis showed that both IVL and RA were comparable in terms of in-hospital and angiographic outcomes while treating calcified left main coronary disease.

Circulation, Volume 150, Issue Suppl_1, Page A4137180-A4137180, November 12, 2024. Introduction:Breast cancer patients receiving anticancer therapy are at risk of developing cancer therapy-related cardiac dysfunction (CTRCD). While exercise has been shown to improve cardiorespiratory fitness in these patients, its effectiveness in preventing CTRCD remains unclear.Research Questions:How do exercise-based interventions affect CTRCD in breast cancer patients? Which exercise modality is most effective in preventing CTRCD?Goals:This network meta-analysis aimed to synthesize the available evidence on the effectiveness of exercise-based interventions based on cardiac function parameters and to identify the optimal exercise modality for preventing CTRCD.Methods:A comprehensive search was conducted in PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from inception to March 4, 2024. Studies that used exercise interventions, either exercise alone or with other interventions, were included. Outcome measures included at least one cardiac function parameter such as left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS). Pairwise and network meta-analyses were performed using R software (v.4.3.3).Results:A total of 1149 participants from 14 RCTs were included. Compared to the usual care, exercise-based interventions significantly improved LVEF (MD=1.68; 95% CI=0.59-2.77; p＜0.05) and GLS (MD=1.40; 95% CI=0.59-2.21; p＜0.05). Based on the ranking probabilities, combined aerobic and resistance exercise was the most effective way to improve LVEF (4 studies, SUCRA: 96.46%), followed by cardiac rehabilitation (2 studies, SUCRA: 45.31%) and aerobic exercise (4 studies, SUCRA: 41.57%). In terms of improving GLS, combined aerobic and resistance exercise also ranked highest (3 studies, SUCRA: 87.77%). However, cardiac rehabilitation (2 studies, SUCRA: 46.70%) and aerobic exercise (1 study, SUCRA: 44.92%) were still less effective.Conclusion:This network meta-analysis provides low-certainty evidence for the potential efficacy of exercise-based interventions in preventing CTRCD, especially the combined aerobic and resistance training. Further rigorous studies are needed to confirm the effectiveness of exercise-based interventions in the prevention of CTRCD.

Circulation, Volume 150, Issue Suppl_1, Page A4145568-A4145568, November 12, 2024. Background:Embolic stroke of undetermined source (ESUS) is a nonlacunar ischemic stroke with no clear cause, having a 4%-5% annual recurrence rate. The potential benefits of direct oral anticoagulants (DOACs) relative to aspirin in patients with ESUS remain unclear.Objective:We aimed to perform a systematic review and meta-analysis to determine the efficacy of the DOACs in secondary prevention for patients with ESUS compared with aspirin.Methods:MEDLINE, Embase, Cochrane, and ClinicalTrias.gov were searched for RCTs comparing DOACs versus aspirin for secondary stroke prevention after ESUS. We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review (PRISMA) and Cochrane guidelines. Statistical analysis was performed using R software 4.3.2. A random-effects model was employed to measure mean differences and hazard ratios (HR) with 95% confidence intervals (CI).Results:We included 4 RCTs comprising 13,970 patients. The median age was 67 years (IQR 65.5-68.2), 61% were male, 76% had hypertension, and 51% had diabetes. DOACs were administered to 50% of the participants. No significant difference was found between groups for stroke recurrence [RR 0.95 (95% CI 0.8-1.11) p=0.52; I2=0%]. Death from any cause [HR 1.11 (95% CI 0.87-1.42) p=0.38; I2=0%], cardiovascular death [HR 1.08 (95% CI 0.61-1.94) p=0.77; I2=18%] and myocardial infarction [HR 0.92 (95% CI 0.54-1.54) p=0.76; I2=16%] were also similar between groups. However, there was a significant increase in clinically relevant non-major bleeding for patients treated with DOACs [HR 1.53 (95% CI 1.22-1.92) p

Circulation, Volume 150, Issue Suppl_1, Page A4144205-A4144205, November 12, 2024. INTRODUCTION:AI-based EKG has shown good accuracy for diagnosing heart failure. However, due to the heterogeneity of studies regarding cutoff points, its precision for specifically detecting heart failure with reduced ejection fraction (LVEF

Circulation, Volume 150, Issue Suppl_1, Page A4147467-A4147467, November 12, 2024. Background:The Fontan procedure has transformed the management of congenital heart defects (CHD) characterized by single ventricle physiology, yet it predisposes individuals to Fontan-associated liver disease (FALD), potentially leading to end-stage liver disease (ESLD). Combined heart and liver transplantation (CHLT) emerges as a therapeutic option, but evidence on its efficacy, safety, and outcomes remains limited.Objectives:This systematic review and single-arm meta-analysis aims to comprehensively evaluate the literature on CHLT in Fontan patients, focusing on patient characteristics, perioperative outcomes, and post-transplant morbidity and mortality.Methods:A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted following PRISMA guidelines. Studies meeting the intervention of CHLT in Fontan patients were included and data were collected and synthesized using proportion meta-analysis techniques. Statistical analysis was carried out using R software.Results:Four studies met inclusion criteria, comprising 67 Fontan patients undergoing CHLT. All included studies were observational retrospective cohorts performed in the United States. One-year survival rate post-CHLT was 84% (95% CI 66%-94%), Figure 1A. Rates of liver and heart graft rejection were low 10% (95% CI 3%-33%) and 8% (95% CI 2%-31%), respectively, Figure 1B. Postoperative complications included acute kidney injury 72% (95% CI 46%-88%), temporary dialysis 31% (95% CI 14%-55%), neurologic events 14% (95% CI 5%-34%), infection 24% (95% CI 6%-63%), and unplanned medical procedures 41% (95% CI 24%-60%), Figure 1C.Conclusion:CHLT in Fontan patients demonstrates promising survival rates, but graft rejection and postoperative complications pose challenges. The rate of renal complications is particularly notable and requires further evaluation. Future research should prioritize comparative different management strategies and long-term follow-up to refine protocols and optimize outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4120898-A4120898, November 12, 2024. Background:Chronic inflammatory diseases are associated with a higher risk for atherosclerosis and adverse cardiovascular events. Psoriasis is a systemic inflammatory condition that significantly increases coronary artery disease risk. Subclinical atherosclerosis can be estimated by echocardiographic parameters like coronary flow velocity reserve (CFVR), diastolic peak flow velocity (DPFV), and hyperemic DPFV. Limited literature investigates these parameters in psoriasis, with inconsistent results.Methods:We systematically searched the major bibliographic databases including PubMed, Embase, Cochrane Library, and Google Scholar from inception to 7th May 2024 to retrieve relevant studies. The outcomes were pooled using the inverse variance random-effects model, and the results were presented as standardized mean difference (SMD) with the corresponding 95% confidence interval (CI).Results:4 studies with 557 participants (281: psoriasis and 276: controls) were included. The mean age of the psoriasis group was 44.7 ± 7.7 years and of the control group was 45.2 ± 5.9 years. Psoriasis patients had a significantly lower CFVR [SMD: -0.71; 95% CI: -0.97, -0.45; p

Circulation, Volume 150, Issue Suppl_1, Page A4147498-A4147498, November 12, 2024. Background:Echocardiographic evaluation of Aortic valve stenosis (AS) severity relies on aortic valve area, peak jet velocity, and mean transaortic gradient. In pursuit of improving accuracy, the transaortic flow rate (FR), defined as the ratio of stroke volume to systolic ejection time, has been introduced. However, its prognostic value in AS patients remains controversial.Aim:This study aims to systematically review the predictive value of FR in AS patients and provide quantitative pooled analysis results where applicable.Methods:A systematic search of PubMed/Medline, Embase, Scopus, Web of Science, and Cochrane was conducted for observational studies on AS patients published up to March 15, 2024. Studies were included if they assessed the clinical prognostic utility of FR with at least three months of follow-up. Pooled estimates and 95% CI for FR’s hazard ratio (HR) in each binary outcome were calculated using a random effects model.Results:Nineteen studies with 9456 patients (mean age 75) underwent descriptive analysis, and 17 eligible studies were included in the meta-analysis. For predicting all-cause mortality, the pooled HR for low FR measured at rest (cut-off value 200-210 mL/s) was 1.32 (95% CI: 1.01–1.63, I2: 69%, p

Circulation, Volume 150, Issue Suppl_1, Page ASu1103-ASu1103, November 12, 2024. Background:Older adults are at high risk for experiencing out-of-hospital cardiac arrest, and therefore they are an important target for CPR training efforts. Physical, mental, and other barriers associated with advanced age present plausible obstacles to training/learning, and may warrant a need for tailored training programs.Hypothesis:Barriers to CPR training for older adults may be widely characterized, but efforts to resolve them are limited.Goal:This literature review’s purpose is to consolidate existing knowledge on teaching CPR to older adults and identify any gaps for future study.Methods:A complete search in both CINAHL and PubMed was conducted for the capture period 2014-2024. The terms “CPR”, “bystander CPR”, “older adult”, “training”, “development”, “out-of-hospital cardiac arrest”, “chest compressions”, and synonyms were used. The full search strategy will be shared at time of presentation. Search results not mentioning CPR, elderly people, and training of older adults were excluded. Any duplicates between the two databases were resolved. Included articles were reviewed by 2 researchers. Age, sex, and study designs were documented and summarized, with ranges, percentages or means reported where appropriate.Results:A total of 14 articles from CINAHL (n=8) and PubMed (n=6) were selected and were either qualitative surveys (n=4) or randomized control trials (n=10). In the studies reviewed, disparate knowledge or retention of CPR skills in older adults was linked to increased course duration or intricacy, physical or mental limitations (real or perceived), and lack of confidence. When analyzing the participants, the definition of older adult ranged from 55 to 65 years old and above with variable sample sizes (n=21-119, median=58). All the studies that documented sex had over 53% of older adults being female (n=53%-100%, median=64.85%). Studies identified methods to address limitations in older adults, including employing continuous chest compression delivery (versus 30:2) to improve quality/compliance, and Andrew’s Maneuver, also known as 4-hands CPR, for increasing effective compression depth while mitigating limited mobility and frailty.Conclusion:Within current literature, established best practices for teaching older adults CPR are limited, and few studies attempt to characterize the limitations of training older adults. Of those studies available in the literature, valuable foundations are available for future work.