Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Clinical Microbiology & Infectious Diseases
Published in: European Journal of Clinical Microbiology & Infectious Diseases 7/2019

Open Access 01-07-2019 | Metronidazole | Review

Clostridium difficile infection: review

Authors: Jacek Czepiel, Mirosław Dróżdż, Hanna Pituch, Ed J. Kuijper, William Perucki, Aleksandra Mielimonka, Sarah Goldman, Dorota Wultańska, Aleksander Garlicki, Grażyna Biesiada

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 7/2019

Login to get access

Abstract

Clostridium difficile (C. difficile) is a Gram-positive, spore-forming, anaerobic bacillus, which is widely distributed in the intestinal tract of humans and animals and in the environment. In the last decade, the frequency and severity of C. difficile infection has been increasing worldwide to become one of the most common hospital-acquired infections. Transmission of this pathogen occurs by the fecal-oral route and the most important risk factors include antibiotic therapy, old age, and hospital or nursing home stay. The clinical picture is diverse and ranges from asymptomatic carrier status, through various degrees of diarrhea, to the most severe, life threatening colitis resulting with death. Diagnosis is based on direct detection of C. difficile toxins in feces, most commonly with the use of EIA assay, but no single test is suitable as a stand-alone test confirming CDI. Antibiotics of choice are vancomycin, fidaxomicin, and metronidazole, though metronidazole is considered as inferior. The goal of this review is to update physicians on current scientific knowledge of C. difficile infection, focusing also on fecal microbiota transplantation which is a promising therapy.
Literature
1.
Oren A, Garrity GM (2017) List of new names and new combinations previously effectively, but not validly, published. Int J Syst Evol Microbiol 67:3140–3143CrossRefPubMedPubMedCentral
2.
Lawson PA, Citron DM, Tyrrell KL, Finegold SM (2016) Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O'Toole 1935) Preevot 1938. Anaerobe 40:95–99CrossRefPubMed
3.
Leffler DA, Lamont JT (2015) Clostridium difficile infection. N Engl J Med 373:287–288PubMed
4.
Hall IC, O'Toole E (1935) Intestinal flora in newborn infants with description of a new pathogenic anaerobe. Am J Dis Child 49:390–402CrossRef
5.
Tedesco FJ, Barton RW, Alpers DH (1974) Clindamycin-associated colitis. A prospective study. Ann Intern Med 81:429–433CrossRefPubMed
6.
Hensgens MP, Goorhuis A, Dekkers OM, Kuijper EJ (2012) Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother 67:742–748CrossRefPubMed
7.
Czepiel J, Kędzierska J, Biesiada G et al (2015) Epidemiology of Clostridium difficile infection: results of a hospital-based study in Krakow, Poland. Epidemiology & Infection 143:3235–3243CrossRef
8.
Khanna S, Pardi DS, Aronson SL et al (2012) The epidemiology of community-acquired Clostridium difficile infection: a population based study. Am J Gastroenterol 107:89–95CrossRefPubMed
9.
Hung YP, Lin HJ, Wu TC et al (2013) Risk factors of fecal toxigenic or nontoxigenic Clostridium difficile colonization: impact of Toll-like receptor polymorphisms and prior antibiotic exposure. PLoS One 8:e69577CrossRefPubMedPubMedCentral
10.
Loo VG, Bourgault AM, Poirier L et al (2011) Host and pathogen factors for Clostridium difficile infection and colonization. N Engl J Med 365:1693–1703CrossRefPubMed
11.
12.
Clabots CR, Johnson S, Olson M et al (1992) Acquisition of Clostridium difficile by hospitalized patients: evidence for colonized new admissions as a source of infection. J Infect Dis 166:561–567CrossRefPubMed
13.
Marciniak C, Chen D, Stein AC et al (2006) Prevalence of Clostridium difficile colonization at admission to rehabilitation. Arch Phys Med Rehabil 87:1086–1090CrossRefPubMed
14.
Johnson S, Clabots CR, Linn FV et al (1990) Nosocomial Clostridium difficile colonization and disease. Lancet 336:97–100CrossRefPubMed
15.
Hung YP, Lee LC, Lin HJ et al (2015) Clinical impact of Clostridium difficile colonization. J Microbiol Immunol Infect 48:241–248CrossRefPubMed
16.
Hensgens MPM, Keessen EC, Squire MM et al (2012) Clostridium difficile infection in the community: a zoonotic disease? Clin Microbiol Infect 18:635–645CrossRefPubMed
17.
Johnson S, Gerding DN, Olson MM et al (1990) Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 88:137–140CrossRefPubMed
18.
Simor AE (2010) Diagnosis, management, and prevention of Clostridium difficile infection in long-term care facilities: a review. J Am Geriatr Soc 58:1556–1564CrossRefPubMed
19.
Kyne L, Sougioultzis S, McFarland LV, Kelly CP (2002) Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea. Infect Control Hosp Epidemiol 23:653–659CrossRefPubMed
20.
Novack L, Kogan S, Gimpelevich L et al (2014) Acid suppression therapy does not predispose to Clostridium difficile infection: the case of the potential bias. PLoS One 9:e110790CrossRefPubMedPubMedCentral
21.
Arriola V, Tischendorf J, Musuuza J et al (2016) Assessing the risk of hospital-acquired Clostridium Difficile infection with proton pump inhibitor use: a meta-analysis. Infect Control Hosp Epidemiol 37:1408–1417CrossRefPubMedPubMedCentral
22.
Deshpande A, Pasupuleti V, Thota P et al (2015) Risk factors for recurrent Clostridium difficile infection: a systematic review and metaanalysis. Infect Control Hosp Epidemiol 36:452–460CrossRefPubMed
23.
Trifan A, Stanciu C, Girleanu I et al (2017) Proton pump inhibitors therapy and risk of Clostridium difficile infection: systematic review and meta-analysis. World J Gastroenterol 23:6500–6515CrossRefPubMedPubMedCentral
24.
Beaulieu M, Williamson D, Pichette G, Lachaine J (2007) Risk of Clostridium difficile-associated disease among patients receiving proton-pump inhibitors in a Quebec medical intensive care unit. Infect Control Hosp Epidemiol 28:1305–1307CrossRefPubMed
25.
Shah S, Lewis A, Leopold D et al (2000) Gastric acid suppression does not promote clostridial diarrhoea in the elderly. QJM 93:175–181CrossRefPubMed
26.
Campbell KA, Phillips MS, Stachel A et al (2013) Incidence and risk factors for hospital-acquired Clostridium difficile infection among inpatients in an orthopaedic tertiary care hospital. J Hosp Infect 83:146–149CrossRefPubMed
27.
Chitnis AS, Holzbauer SM, Belflower RM et al (2013) Epidemiology of community associated Clostridium difficile infection, 2009 through 2011. JAMA Intern Med 173:1359–1367CrossRefPubMed
28.
Kochan TJ, Somers MJ, Kaiser AM et al (2017) Intestinal calcium and bile salts facilitate germination of Clostridium difficile spores. PLoS Pathog 13:e1006443CrossRefPubMedPubMedCentral
29.
Baktash A, Terveer EM, Zwittink RD et al (2018) Mechanistic insights in the success of fecal microbiota transplants for the treatment of Clostridium difficile infections. Front Microbiol 9:1242CrossRefPubMedPubMedCentral
30.
31.
Francis MB, Allen CA, Shrestha R, Sorg JA (2013) Bile acid recognition by the Clostridium difficile germinant receptor, CspC, is important for establishing infection. PLoS Pathog 9:e1003356CrossRefPubMedPubMedCentral
32.
Thanissery R, Winston JA, Theriot CM (2017) Inhibition of spore germination, growth, and toxin activity of clinically relevant C. difficile strains by gut microbiota derived secondary bile acids. Anaerobe 45:86–100CrossRefPubMedPubMedCentral
33.
Allegretti JR, Kearney S, Li N et al (2016) Recurrent Clostridium difficile infection associates with distinct bile acid and microbiome profiles. Aliment Pharmacol Ther 43:1142–1153CrossRefPubMedPubMedCentral
34.
35.
Androga GO, Hart J, Foster NF et al (2015) Infection with toxin A-negative, toxin B-negative, binary toxin-positive Clostridium difficile in a young patient with ulcerative colitis. J Clin Microbiol 53:3702–3704CrossRefPubMedPubMedCentral
36.
Lyerly DM, Saum KE, MacDonald DK et al (1985) Effects of Clostridium difficile given intragastrically to animals. Infect Immun 47:349–352PubMedPubMedCentral
37.
Riegler M, Sedivy R, Pothoulakis C et al (1995) Clostridium difficile toxin B is more potent than toxin A in damaging human colonic epithelium in vitro. J Clin Invest 95:2004–2011CrossRefPubMedPubMedCentral
38.
Savidge TC, Pan WH, Newman P et al (2003) Clostridium difficile toxin B is an inflammatory enterotoxin in human intestine. Gastroenterology 125:413–420CrossRefPubMed
39.
McDonald LC, Killgore GE, Thompson A et al (2005) An epidemic, toxin-gene variant strain of Clostridium difficile. N Engl J Med 353:2433–2441CrossRefPubMed
40.
Loo VG, Poirier L, Miller MA et al (2005) Apredominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 353:2442–2449CrossRefPubMed
41.
Rocha MFG, Maia MET, Bezerra LR et al (1997) Clostridium difficile toxin A induces the release of neutrophil chemotactic factors from rat peritoneal macrophages: role of interleukin- 1β, tumor necrosis factor alpha, and leukotrienes. Infect Imm 65:2740–2746
42.
Steiner TS, Flores CA, Pizarro TT, et al. (1997) Fecal lactoferrin, interleukin-1β and interleukin-8 are elevated in patients with severe Clostridium difficile colitis. Clin. Diagn Lab Immun 4:719–722
43.
Vaishnavi C (2010) Clinical spectrum & pathogenesis of Clostridium difficile associated diseases. Indian J Med Res 131:487–499PubMed
44.
McFarland LV, Mulligan ME, Kwok RY et al (1989) Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 320:204–210CrossRefPubMed
45.
Toshniwal R, Silva J Jr, Fekety R et al (1981) Studies on the epidemiology of colitis due to Clostridium difficile in hamsters. J Infect Dis 143:51–54CrossRefPubMed
46.
Samore MH, DeGirolami PC, Tlucko A et al (1994) Clostridium difficile colonization and diarrhea at a tertiary care hospital. Clin Infect Dis 18:181–187CrossRefPubMed
47.
McDonald LC, Gerding DN, Johnson S et al (2018) Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 66:e1–e48CrossRefPubMedPubMedCentral
48.
Vincent JL, Rello J, Marshall J et al (2009) International study of the prevalence and outcomes of infection in intensive care units. J Am Med Assoc 302:2323–2329CrossRef
49.
Sidler JA, Battegay M, Tschudin-Sutter S et al (2014) Enterococci, Clostridium difficile and ESBL producing bacteria: epidemiology, clinical impact and prevention in ICU patients. Swiss Med Wkly 144:14009
50.
McFarland LV (2008) Antibiotic-associated diarrhea: epidemiology, trends and treatment. Fut Microbiol 3:563–578CrossRef
51.
McFarland LV, Surawicz CM, Rubin M et al (1999) Recurrent Clostridium difficile disease: epidemiology and clinical characteristics. Infect Control Hosp Epidemiol 20:43–50CrossRefPubMed
52.
Fekety R, McFarland LV, Surawicz CM et al (1997) Recurrent Clostridium difficile diarrhea: characteristics of and risk factors for patients enrolled in a prospective, randomized, double-blinded trial. Clin Infect Dis 24:324–333CrossRefPubMed
53.
Moore SC (2018) Clostridium difficile: more challenging than ever. Crit Care Nurs Clin North Am 30:41–53CrossRefPubMed
54.
Boyce JM, Havill NL, Otter JA et al (2008) Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol 29:723–729CrossRefPubMed
55.
Bartlett JG (2010) Detection of Clostridium difficile infection. Infect Control Hosp Epidemiol 31:35–37CrossRef
56.
Crobach MJ, Dekkers OM, Wilcox MH et al (2009) Data review and recommendations for diagnosing Clostridium difficile infection (CDI). Clin Microbiol Infect 15:1053–1066CrossRefPubMed
57.
58.
Crobach MJT, Planche T, Eckert C, et al. (2016) European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection Clinical Microbiology and Infection 22:S63-S81
59.
American Academy of Pediatrics, Committee on Infectious Diseases. Red Book, 28th Edition. 2009 Report of the Committee on Infectious Diseases, pp. 263–265
60.
Sethi AK, Al-Nassir WN, Nerandzic MM et al (2010) Persistence of skin contamination and environmental shedding of Clostridium difficile during and after treatment of C. difficile infection. Infect Control Hosp Epidemiol 31:21–27CrossRefPubMed
61.
Hookman P, Barkin JS (2009) Clostridium difficile associated infection, diarrhea, and colitis. W J Gastroenterol 15:1554–1580CrossRef
62.
Ananthakrishnan AN, Binion DG (2010) Impact of Clostridium difficile on inflammatory bowel disease. Expert Rev Gastroenterol Hepatol 4:589–600CrossRefPubMed
63.
Goodhand JR, Alazawi W, Rampton DS (2011) Systematic review: Clostridium difficile and inflammatory bowel disease. Aliment Pharmacol Ther 33:428–441CrossRefPubMed
64.
65.
Paláu-Dávila L, Lara-Medrano R, Negreros-Osuna AA et al (2016) Efficacy of computed tomography for the prediction of colectomy and mortality in patients with Clostridium difficile infection. Ann Med Surg (Lond) 12:101–105CrossRef
66.
Debast SB, Bauer MP, Kuijper EJ, ESCMID (2014) European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect 20:1–26CrossRef
67.
Johnson S, Louie TJ, Gerding DN et al (2014) Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis 59:345–354CrossRefPubMed
68.
Nelson RL, Suda KJ, Evans CT (2017) Antibiotic treatment for Clostridium difficile associated diarrhoea in adults. Cochrane Database Syst Rev 3:CD004610PubMed
69.
Louie TJ, Miller MA, Mullane KM et al (2011) Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med 364:422–431CrossRefPubMed
70.
Cornely OA, Crook DW, Esposito R et al (2012) Fidaxomicin versus vancomycin for infection with Clostridium difficile in Europe, Canada, and the USA: a double-blind, non-inferiority, randomised controlled trial. Lancet Infect Dis 12:281–289CrossRefPubMed
71.
Cornely OA, Miller MA, Louie TJ et al (2012) Treatment of first recurrence of Clostridium difficile infection: fidaxomicin versus vancomycin. Clin Infect Dis 55:S154–S161CrossRefPubMedPubMedCentral
72.
Cornely OA, Nathwani D, Ivanescu C et al (2014) Clinical efficacy of fidaxomicin compared with vancomycin and metronidazole in Clostridium difficile infections: a meta-analysis and indirect treatment comparison. J Antimicrob Chemother 69:2892e900CrossRef
73.
Guery B, Menichetti F, Anttila VJ et al (2018) Extended-pulsed fidaxomicin versus vancomycin for Clostridium difficile infection in patients 60 years and older (EXTEND): a randomised, controlled, open-label, phase 3b/4 trial. Lancet Infect Dis 18:296–307CrossRefPubMed
74.
Czepiel J, Biesiada G, Dróżdż M et al (2018) The presence of IL-8 +781 T/C polymorphism is associated with the parameters of severe Clostridium difficile infection. Microb Pathog 114:281–285CrossRefPubMed
75.
Bricker E, Garg R, Nelson R et al (2007) Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. Cochrane Database Syst Rev 3:CD004610
76.
DuPont HL, Garey K, Caeiro JP et al (2008) New advances in Clostridium difficile infection: changing epidemiology, diagnosis, treatment and control. Curr Opin Infect Dis 21:500–507CrossRefPubMed
77.
Gerding DN, Johnson S (2011) Clostridium difficile infection in 2010: advances in pathogenesis, diagnosis and management of CDI. Nat Rev Gastroenterol Hepatol 8:67–68CrossRefPubMed
78.
Hu MY, Katchar K, Kyne L et al (2009) Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection. Gastroenterology 136:1206–1214CrossRefPubMed
79.
Mullane KM, Miller MA, Weiss K et al (2011) Efficacy of fidaxomicin versus vancomycin as therapy for Clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. Clin Infect Dis 53:440CrossRefPubMedPubMedCentral
80.
Johnson S, Maziade PJ, McFarland LV et al (2012) Is primary prevention of Clostridium difficile infection possible with specific probiotics? Int J Infect Dis 16:786–792CrossRef
81.
Johnston BC, Ma SSY, Goldenberg JZ et al (2012) Probiotics for the prevention of Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Ann Intern Med 157:878–888CrossRefPubMed
82.
Goldenberg JZ, Ma SSY, Saxton JD et al (2013) Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children (review). Cochrane Database Syst Rev 5:1–153
83.
McFarland LV (2006) Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 101:812–822CrossRefPubMed
84.
Evans CT, Johnson S (2015) Prevention of Clostridium difficile infection with probiotics. Clin Infect Dis 60:122–128CrossRef
85.
Mulligan ME, Miller SD, McFarland LV et al (1993) Elevated levels of serum immunoglobulins in asymptomatic carriers of Clostridium difficile. Clin Infect Dis 16:239–244CrossRef
86.
Goldberg EJ, Bhalodia S, Jacob S, et al. (2015) Clostridium difficile infection: A brief update on emerging therapies Am J Health-Syst Pharm 72:1007–1012
87.
Siddiqui F, O’Connor JR, Nagaro K et al (2012) Vaccination with parenteral toxoid B protects hamsters against lethal challenge with toxin A-negative, toxin B-positive Clostridium difficile but does not prevent colonization. J Infect Dis 205:128–133CrossRefPubMed
88.
Kyne L, Warny M, Qamar A, Kelly CP (2001) Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea. Lancet 357:189–193CrossRefPubMed
89.
Lowy I, Molrine DC, Leav BA et al (2010) Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med 362:197–205CrossRefPubMed
90.
Wilcox MH, Gerding DN, Poxton IR et al (2017) Bezlotoxumab for prevention of recurrent Clostridium difficile infection. N Engl J Med 376:305–317CrossRefPubMed
91.
Zhang F, Luo W, Fan Z, Ji G (2012) Should we standardize the 1700 year old fecal microbiota transplantation? Am J Gastroenterol 107:755CrossRef
92.
Borody TJ, Warren EF, Leis SM et al (2004) Bacteriotherapy using fecal flora: toying with human motions. J Clin Gastroenterol 38:475–483CrossRefPubMed
93.
Eiseman B, Silen W, Bascom GS, Kauvar AJ (1958) Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery 44:854–859PubMed
94.
Schwan A, Sjolin S, Trottestam U, Aronsson B (1983) Relapsing Clostridium difficile enterocolitis cured by rectal infusion of homologous faeces. Lancet 2:845CrossRefPubMed
95.
Austin M, Mellow M, Tierney WM (2014) Fecal microbiota transplantation in the treatment of Clostridium difficile infections. Am J Med 127:479–483CrossRefPubMed
96.
Dutta SK, Girotra M, Garg S et al (2014) Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile infection. Clin Gastroenterol Hepatol 12:1572–1576CrossRefPubMed
97.
98.
van Nood E, Vrieze A, Nieuwdorp M et al (2013) Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 368:407–415CrossRef
99.
Borody TJ, Khoruts A (2012) Fecal microbiota transplantation and emerging applications. Nature Rev Gastroenterol Hepatol 9:88–96CrossRef
100.
Terveer EM, van Beurden YH, Goorhuis A et al (2017) How to: establish and run a stool bank. Clin Microbiol Infect 23:924e930CrossRef
101.
Bafeta A, Yavchitz A, Riveros C et al (2017) Methods and reporting studies assessing fecal microbiota transplantation: a systematic review. Ann Intern Med 167:34–39CrossRefPubMed
Metadata
Title
Clostridium difficile infection: review
Authors
Jacek Czepiel
Mirosław Dróżdż
Hanna Pituch
Ed J. Kuijper
William Perucki
Aleksandra Mielimonka
Sarah Goldman
Dorota Wultańska
Aleksander Garlicki
Grażyna Biesiada
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 7/2019
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-019-03539-6

Other articles of this Issue 7/2019

European Journal of Clinical Microbiology & Infectious Diseases 7/2019 Go to the issue

Original Article

Culture of all sputum samples irrespective of quality adds value to the diagnosis of pneumococcal community-acquired pneumonia in the elderly

Original Article

Potential false-positive urine Legionella enzyme immunoassay test results

Original Article

Delay of appropriate antibiotic treatment is associated with high mortality in patients with community-onset sepsis in a Swedish setting

Original Article

Comparison of microbiological results obtained from per-wound bone biopsies versus transcutaneous bone biopsies in diabetic foot osteomyelitis: a prospective cohort study

Original Article

Predicting the risk of sepsis and causative organisms following urinary stones removal using urinary versus stone and stent cultures

Original Article

The clinical value of aquaporin-4 in children with hand, foot, and mouth disease and the effect of magnesium sulfate on its expression: a prospective randomized clinical trial
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits