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Heart failure trial

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https://www.readbyqxmd.com/read/28803840/development-and-validation-of-risk-equations-for-complications-of-type-2-diabetes-recode-using-individual-participant-data-from-randomised-trials
#1
Sanjay Basu, Jeremy B Sussman, Seth A Berkowitz, Rodney A Hayward, John S Yudkin
BACKGROUND: In view of substantial mis-estimation of risks of diabetes complications using existing equations, we sought to develop updated Risk Equations for Complications Of type 2 Diabetes (RECODe). METHODS: To develop and validate these risk equations, we used data from the Action to Control Cardiovascular Risk in Diabetes study (ACCORD, n=9635; 2001-09) and validated the equations for microvascular events using data from the Diabetes Prevention Program Outcomes Study (DPPOS, n=1018; 1996-2001), and for cardiovascular events using data from the Action for Health in Diabetes (Look AHEAD, n=4760; 2001-12)...
August 10, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28803082/addressing-patient-emotional-and-existential-needs-during-serious-illness-results-of-the-outlook-randomized-controlled-trial
#2
Karen E Steinhauser, Stewart Alexander, Maren K Olsen, Karen M Stechuchak, Jennifer Zervakis, Natalie Ammarell, Ira Byock, James A Tulsky
CONTEXT: Few interventions exist to address patients' existential needs. OBJECTIVE: Determine whether an intervention to address seriously-ill patients' existential concerns improves preparation, completion (elements of quality-of-life at end-of-life) and reduces anxiety and depression. METHODS: A randomized control trial comparing: 1)Outlook intervention, 2)Relaxation meditation (RM); and 3)Usual care (UC). Measures included: primary - quality-of-life (QUAL-E) and secondary - FACT-G, anxiety (POMS), depression (CES-D), and spiritual well-being (FACIT-sp)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801415/randomised-feasibility-trial-into-the-effects-of-low-frequency-electrical-muscle-stimulation-in-advanced-heart-failure-patients
#3
Stuart Ennis, Gordon McGregor, Thomas Hamborg, Helen Jones, Robert Shave, Sally J Singh, Prithwish Banerjee
OBJECTIVES: Low-frequency electrical muscle stimulation (LF-EMS) may have the potential to reduce breathlessness and increase exercise capacity in the chronic heart failure population who struggle to adhere to conventional exercise. The study's aim was to establish if a randomised controlled trial of LF-EMS was feasible. DESIGN AND SETTING: Double blind (participants, outcome assessors), randomised study in a secondary care outpatient cardiac rehabilitation programme...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801407/the-boundaries-of-mild-chronic-obstructive-pulmonary-disease-copd-design-of-the-searching-clinical-copd-onset-soon-study
#4
Gonzalo Labarca, Andrea Bustamante, Gonzalo Valdivia, Rodrigo Díaz, Álvaro Huete, Paul Mac Nab, Laura Mendoza, Jaime Leppe, Carmen Lisboa, Fernando Saldías, Orlando Díaz
INTRODUCTION: Clinical onset of chronic obstructive pulmonary disease (COPD) is the point at which the disease is first identifiable by physicians. It is a poorly defined stage which seems to include both mild spirometric and non-spirometric disease, and could be described as early grade COPD, for practical purposes. While dyspnoea; chronic bronchitis and CT imaging evidence of emphysema and airway disease may be present very early, the lone significance of dyspnoea, the most relevant symptom in COPD in identifying these individuals, has been scarcely assessed...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801001/examining-the-effects-of-a-home-based-palliative-heart-failure-program-on-quality-of-life-symptom-burden-satisfaction-with-care-and-caregiver-burden-among-patients-with-end-stage-heart-failure
#5
Alina Yee Man Ng, Frances Kam Yuet Wong
CONTEXT: Provision of home-based palliative care for seriously ill patients is important, yet few home-based palliative care services specifically or exclusively focus on end-stage heart failure (ESHF) patients. OBJECTIVES: This study aimed to examine the effect of a home-based palliative heart failure (HPHF) program on quality of life (QOL), symptoms burden, functional status, patient satisfaction and caregiver burden among patients with ESHF. METHODS: A two-group randomized controlled trial in three hospitals...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28800834/benefits-and-harms-of-sacubitril-in-adults-with-heart-failure-and-reduced-left-ventricular-ejection-fraction
#6
REVIEW
Wilbert S Aronow, Tatyana A Shamliyan
The quality of evidence regarding patient-centered outcomes in adults with heart failure (HF) after sacubitril combined with valsartan has not been systematically appraised. We searched 4 databases in February 2017 and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation working group approach. We reviewed 1 meta-analysis and multiple publications of 2 randomized controlled trials (RCT) and 1 unpublished RCT. In adults with HF and reduced ejection fraction, low-quality evidence from 1 RCT of 8,432 patients suggests that sacubitril combined with valsartan reduces all-cause (number needed to treat [NNT] to prevent 1 event [NNTp] = 35) and cardiovascular mortality (NNTp = 32), hospitalization (NNTp = 11), emergency visits (NNTp = 69), and serious adverse effects, leading to treatment discontinuation (NNTp = 63) and improves quality of life when compared with enalapril...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28800093/omega-3-fatty-acids-and-cardiovascular-disease-summary-of-the-2016-agency-of-healthcare-research-and-quality-evidence-review
#7
REVIEW
Ethan M Balk, Alice H Lichtenstein
We summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality's evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. There is high strength of evidence, based on numerous trials, of no significant effects of marine oils on systolic or diastolic blood pressures, but there are small, yet statistically significant increases in high density lipoprotein and low density lipoprotein cholesterol concentrations...
August 11, 2017: Nutrients
https://www.readbyqxmd.com/read/28800035/the-anti-malarial-drug-artesunate-attenuates-cardiac-injury-in-a-rodent-model-of-myocardial-infarction
#8
Areeg I Khan, Amar Kapoor, Jianmin Che, Lukas Martin, Mara Rogazzo, Thomas Mercier, Laurent Decosterd, Massimo Collino, Christoph Thiemermann
Ischaemic heart disease remains the leading cause of morbidity and mortality in the Western world. Artesunate is the WHO-recommended drug of choice for complicated malaria (with organ failure). The administration of high doses of artesunate is safe in healthy volunteers (up to 8 mg/kg i.v) and patients with severe malaria (2.4 mg/kg i.v). We investigated the effects of artesunate (1 mg/kg) or its active metabolite dihydroartemisinin (DHA; 0.1 mg/kg) in a model of transient myocardial ischaemia/reperfusion (I/R) and evaluated the mechanism of action of the observed cardioprotective effects of artesunate and DHA...
August 9, 2017: Shock
https://www.readbyqxmd.com/read/28795936/relationship-of-health-literacy-of-heart-failure-patients-and-their-family-members-on-heart-failure-knowledge-and-self-care
#9
Jia-Rong Wu, Carolyn M Reilly, James Holland, Melinda Higgins, Patricia C Clark, Sandra B Dunbar
We explored the relationships among patients' and family members' (FMs) health literacy, heart failure (HF) knowledge, and self-care behaviors using baseline data from HF patients and their FMs ( N = 113 pairs) in a trial of a self-care intervention. Measures included Rapid Estimate of Adult Literacy in Medicine, Atlanta HF Knowledge Test, a heart failure Medication Adherence Scale, and sodium intake (24-hr urine and 3-day food record). Patients with low health literacy (LHL) were more likely to have lower HF knowledge ( p < ...
February 2017: Journal of Family Nursing
https://www.readbyqxmd.com/read/28795098/data-on-administration-of-cyclosporine-nicorandil-metoprolol-on-reperfusion-related-outcomes-in-st-segment-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention
#10
Gianluca Campo, Rita Pavasini, Giampaolo Morciano, Michael A Lincoff, Michael C Gibson, Masafumi Kitakaze, Jacob Lonborg, Amrita Ahluwalia, Hideki Ishii, Michael Frenneaux, Michel Ovize, Marcello Galvani, Dan Atar, Borja Ibanez, Giampaolo Cerisano, Simone Biscaglia, Brandon J Neil, Masanori Asakura, Thomas Engstrom, Daniel A Jones, Dana Dawson, Roberto Ferrari, Paolo Pinton, Filippo Ottani
Mortality and morbidity in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) are still high [1]. A huge amount of the myocardial damage is related to the mitochondrial events happening during reperfusion [2]. Several drugs directly and indirectly targeting mitochondria have been administered at the time of the PCI and their effect on fatal (all-cause mortality, cardiovascular (CV) death) and non fatal (hospital readmission for heart failure (HF)) outcomes have been tested showing conflicting results [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28794139/denervated-myocardium-is-preferentially-associated-with-sudden-cardiac-arrest-in-ischemic-cardiomyopathy-a-pilot-competing-risks-analysis-of-cause-specific-mortality
#11
James A Fallavollita, Jonathan D Dare, Randolph L Carter, Sunil Baldwa, John M Canty
BACKGROUND: Previous studies have identified multiple risk factors that are associated with total cardiac mortality. Nevertheless, identifying specific factors that distinguish patients at risk of arrhythmic death versus heart failure could better target patients likely to benefit from implantable cardiac defibrillators, which have no impact on nonsudden cardiac death. METHODS AND RESULTS: We performed a pilot competing risks analysis of the National Institutes of Health-sponsored PAREPET trial (Prediction of Arrhythmic Events with Positron Emission Tomography)...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28793997/effect-of-intensive-versus-standard-blood-pressure-treatment-according-to-baseline-prediabetes-status-a-post-hoc-analysis-of-a-randomized-trial
#12
Adam P Bress, Jordan B King, Kathryn E Kreider, Srinivasan Beddhu, Debra L Simmons, Alfred K Cheung, Yingying Zhang, Michael Doumas, John Nord, Mary Ellen Sweeney, Addison A Taylor, Charles Herring, William J Kostis, James Powell, Anjay Rastogi, Christianne L Roumie, Alan Wiggers, Jonathan S Williams, Reem Yunis, Athena Zias, Greg W Evans, Tom Greene, Michael V Rocco, William C Cushman, David M Reboussin, Mark N Feinglos, Vasilios Papademetriou
OBJECTIVE: To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS: This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL)...
August 9, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28793822/dose-response-head-to-head-comparison-of-inodilators-dobutamine-milrinone-and-levosimendan-in-chronic-experimental-pulmonary-hypertension
#13
Marta Tavares-Silva, Mohamed Alaa, Sara Leite, José Oliveira-Pinto, Lucas Lopes, Adelino F Leite-Moreira, André P Lourenço
The choice of inodilator drug in the acute management of patients with pulmonary hypertension (PH) having right ventricular (RV) failure remains unsettled and challenging. Comprehensive experimental evaluations may provide further insight and fundamental translational research clues to support inodilator selection and clinical trial design. Our aim was to compare acute dose-response hemodynamic effects of inodilators dobutamine (DOB), milrinone (MIL), and levosimendan (LEV) in chronic experimental PH. Seven-week-old male Wistar rats were randomly injected with 60 mg·kg(-1) monocrotaline (MCT) or vehicle (Ctrl, n = 7) and underwent systemic and pulmonary artery (PA) pressure and RV pressure-volume (PV) hemodynamic evaluation under halogenate anesthesia 24 to 30 days after injection...
September 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28793821/the-effects-of-lcz696-in-patients-with-hypertension-compared-with-angiotensin-receptor-blockers-a-meta-analysis-of-randomized-controlled-trials
#14
Yang Zhao, Heng Yu, Xu Zhao, Ruixin Ma, Ningyin Li, Jing Yu
LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, has been demonstrated to have greater advantages in the treatment of heart failure compared with angiotensin-converting enzyme inhibitors, enalapril, or angiotensin receptor blockers (ARBs). However, studies that compared the efficacy and safety of LCZ696 against valsartan in patients with hypertension are limited. To provide further evidence for the benefits of LCZ696 and to make this assessment, a meta-analysis of randomized controlled trials (RCTs) was performed...
September 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28791621/assessment-of-dyssynchrony-by-gated-myocardial-perfusion-imaging-does-not-improve-patient-management
#15
Ran Lee, Ravi V Shah, Venkatesh L Murthy
Clinical trials have demonstrated improved outcomes with cardiac resynchronization therapy in patients with heart failure and electrical evidence of dyssynchrony. There has been intense effort at developing imaging markers of dyssynchrony with the aim of improved risk stratification. However, these efforts have not been fruitful to date. This article discusses mechanisms of cardiac dyssynchrony, reviews clinical data supporting resynchronization therapy, and addresses the lack of convincing evidence to support the use of noninvasive imaging measures of dyssynchrony in improving patient management...
August 8, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28790052/dose-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-and-outcomes-in-heart-failure-a-meta-analysis
#16
Muhammad Shahzeb Khan, Gregg C Fonarow, Ali Ahmed, Stephen J Greene, Muthiah Vaduganathan, Hassan Khan, Catherine Marti, Mihai Gheorghiade, Javed Butler
BACKGROUND: The association between angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) doses on outcomes in patients with heart failure (HF) with reduced ejection fraction is uncertain. The objective of this study was to investigate the effect of dose of ACEI and ARBs on outcomes and drug discontinuation in patients with HF with reduced ejection fraction. METHODS AND RESULTS: MEDLINE, Ovid SP, and Embase were searched from the inception of these databases till August 2016...
August 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28789663/inorganic-nitrate-as-a-treatment-for-acute-heart-failure-a-protocol-for-a-single-center-randomized-double-blind-placebo-controlled-pilot-and-feasibility-study
#17
Roman Falls, Michael Seman, Sabine Braat, Joshua Sortino, Jason D Allen, Christopher J Neil
BACKGROUND: Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO3) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension...
August 8, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28782466/current-status-of-renal-artery-angioplasty-and-stenting-for-resistant-hypertension-a-case-series-and-review-of-the-literature
#18
Antonis S Manolis, Antonis A Manolis, Helen Melita
BACKGROUND: Renal artery stenosis (RAS) has a high prevalence in older patients, especially in the context of general atherosclerosis. It is frequently associated with resistant hypertension and impaired renal function and their attendant consequences. The issue whether revascularization via percutaneous renal angioplasty and stenting (PRA/S) can benefit these patients remains unsettled. OBJECTIVE: To present a case series of patients with refractory hypertension and RAS undergoing PRA/S and also to provide an extensive review of the literature on the current status of PRA/S for resistant hypertension...
August 4, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28781064/cardiovascular-mortality-and-morbidity-in-patients-with-type-2-diabetes-following-initiation-of-sodium-glucose-co-transporter-2-inhibitors-versus-other-glucose-lowering-drugs-cvd-real-nordic-a-multinational-observational-analysis
#19
Kåre I Birkeland, Marit E Jørgensen, Bendix Carstensen, Frederik Persson, Hanne L Gulseth, Marcus Thuresson, Peter Fenici, David Nathanson, Thomas Nyström, Jan W Eriksson, Johan Bodegård, Anna Norhammar
BACKGROUND: In patients with type 2 diabetes and a high cardiovascular risk profile, the sodium-glucose co-transporter-2 (SGLT2) inhibitors empagliflozin and canagliflozin have been shown to lower cardiovascular morbidity and mortality. Using real-world data from clinical practice, we aimed to compare cardiovascular mortality and morbidity in new users of SGLT2 inhibitors versus new users of other glucose-lowering drugs, in a population with a broad cardiovascular risk profile. METHODS: CVD-REAL Nordic was an observational analysis of individual patient-level data from the Prescribed Drug Registers, Cause of Death Registers, and National Patient Registers in Denmark, Norway, and Sweden...
August 3, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28780577/drug-treatment-effects-on-outcomes-in-heart-failure-with-preserved-ejection-fraction-a-systematic-review-and-meta-analysis
#20
Sean Lee Zheng, Fiona T Chan, Adam A Nabeebaccus, Ajay M Shah, Theresa McDonagh, Darlington O Okonko, Salma Ayis
BACKGROUND: Clinical drug trials in patients with heart failure and preserved ejection fraction have failed to demonstrate improvements in mortality. METHODS: We systematically searched Medline, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCT) assessing pharmacological treatments in patients with heart failure with left ventricular (LV) ejection fraction≥40% from January 1996 to May 2016. The primary efficacy outcome was all-cause mortality...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
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