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Heart failure trial

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https://www.readbyqxmd.com/read/29159410/use-of-health-care-databases-to-support-supplemental-indications-of-approved-medications
#1
Michael Fralick, Aaron S Kesselheim, Jerry Avorn, Sebastian Schneeweiss
Importance: Manufacturers of US Food and Drug Administration-approved prescription drugs often apply for additional indications based on randomized clinical trials. Real-world database analyses on a medication's use and outcomes in routine settings of care might help to inform decision making regarding such supplemental indications. Objective: To examine whether longitudinal data from a health care database can support the results of a randomized clinical trial that led to a supplemental indication for telmisartan...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29159187/the-role-of-costimulation-blockade-in-solid-organ-and-islet-xenotransplantation
#2
REVIEW
Kannan P Samy, James R Butler, Ping Li, David K C Cooper, Burcin Ekser
Pig-to-human xenotransplantation offers a potential bridge to the growing disparity between patients with end-stage organ failure and graft availability. Early studies attempting to overcome cross-species barriers demonstrated robust humoral immune responses to discordant xenoantigens. Recent advances have led to highly efficient and targeted genomic editing, drastically altering the playing field towards rapid production of less immunogenic porcine tissues and even the discussion of human xenotransplantation trials...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/29158831/identification-and-validation-of-a-salivary-protein-panel-to-detect-heart-failure-early
#3
Xi Zhang, Terry Walsh, John J Atherton, Karam Kostner, Benjamin Schulz, Chamindie Punyadeera
BACKGROUND: Over 26 million people suffer from heart failure (HF) globally. Current diagnosis of HF relies on clinical evaluation, blood assays and imaging techniques. Our aim is to develop a diagnostic assay to detect HF in at risk individuals within the community using human saliva as a medium, potentially leading to a simple, safe early warning system. METHODS: Saliva samples were collected from healthy controls (n=36) and HF patients (n=75). Salivary proteome profiles were analysed by Sequential Window Acquisition of All Theoretical fragment ion spectra - Mass Spectrometry (SWATH-MS)...
2017: Theranostics
https://www.readbyqxmd.com/read/29158679/treatment-of-pulmonary-hypertension-with-left-heart-disease-a-concise-review
#4
REVIEW
Anish Desai, Shilpa A Desouza
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29158435/symptom-diary-use-and-improved-survival-for-patients-with-heart-failure
#5
Linda G Park, Kathleen Dracup, Mary A Whooley, Charles McCulloch, Chengshi Jin, Debra K Moser, Robyn A Clark, Michele M Pelter, Martha Biddle, Jill Howie Esquivel
BACKGROUND: Attention to symptoms of weight gain and dyspnea are central tenets of patient education in heart failure (HF). However, it is not known whether diary use improves patient outcomes. The aims of this study were to compare mortality among rural patients with HF who completed versus did not complete a daily diary of weight and symptom self-assessment and to identify predictors of diary use. METHODS AND RESULTS: This is a secondary analysis of a 3-arm randomized controlled trial on HF education of self-care with 2 intervention groups versus control who were given diaries for 24 months to track daily weight, HF symptoms, and response to symptom changes...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29157592/the-effects-of-continuous-positive-airway-pressure-therapy-on-troponin-t-and-n-terminal-pro-b-type-natriuretic-peptide-in-patients-with-obstructive-sleep-apnoea-a-randomised-controlled-trial
#6
Ya-Shu Chang, Brendon J Yee, Camilla M Hoyos, Keith K Wong, David R Sullivan, Ronald R Grunstein, Craig L Phillips
INTRODUCTION: Untreated obstructive sleep apnoea (OSA) is associated with increased risk of coronary artery disease (CAD) and heart failure. High-sensitivity cardiac troponin (hs Trop-T) and B-type natriuretic peptide (NT-pro-BNP) are sensitive biomarkers for myocardial injury and heart failure respectively. No randomised controlled trials have examined the treatment effect of continuous positive airway pressure (CPAP) in patients with OSA on these biomarkers. METHOD: Patients >21 years old with apnoea-hypopnoea index (AHI) ≥25/h by overnight polysomnography were recruited...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29157297/smoldering-myocarditis-following-immune-checkpoint-blockade
#7
Timothy G Norwood, Brian C Westbrook, Douglas B Johnson, Silvio H Litovsky, Nina L Terry, Svetlana B McKee, Alan S Gertler, Javid J Moslehi, Robert M Conry
BACKGROUND: Severe myocarditis associated with electrical conduction abnormalities and occasionally heart failure has been well documented following treatment with immune checkpoint blockade with an estimated incidence of less than 1%. However, the incidence, early detection, and management of less severe immune-related myocarditis are unknown since most immunotherapy trials have not included routine cardiac monitoring. Herein, we provide the first description of subclinical or smoldering myocarditis with minimal signs and symptoms following immune checkpoint blockade with a single dose of ipilimumab and nivolumab...
November 21, 2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29154687/pyruvate-enhancement-of-cardiac-performance-cellular-mechanisms-and-clinical-application
#8
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
Cardiac contractile function is adenosine-5'-triphosphate (ATP)-intensive, and the myocardium's high demand for oxygen and energy substrates leaves it acutely vulnerable to interruptions in its blood supply. The myriad cardioprotective properties of the natural intermediary metabolite pyruvate make it a potentially powerful intervention against the complex injury cascade ignited by myocardial ischemia-reperfusion. A readily oxidized metabolic substrate, pyruvate augments myocardial free energy of ATP hydrolysis to a greater extent than the physiological fuels glucose, lactate and fatty acids, particularly when it is provided at supra-physiological plasma concentrations...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29154427/design-of-a-multicentre-randomized-controlled-trial-to-assess-the-safety-and-efficacy-of-dose-titration-by-specialized-nurses-in-patients-with-heart-failure-etific-study-protocol
#9
Juana Oyanguren, LLuisa García-Garrido, Magdalena Nebot Margalef, Iñaki Lekuona, Josep Comin-Colet, Nicolás Manito, Julia Roure, Pilar Ruiz Rodriguez, Cristina Enjuanes, Pedro Latorre, Jesús Torcal Laguna, Susana García-Gutiérrez
AIMS: Heart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta-blockers (BBs), angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse-managed) and control (cardiologist-managed) groups...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154422/beta-blocker-dose-and-markers-of-sympathetic-activation-in-heart-failure-patients-interrelationships-and-prognostic-significance
#10
Alain Cohen-Solal, Arnold F Jacobson, Ileana L Piña
AIMS: Extent of cardiac sympathetic activation can be estimated from physiological parameters, blood biomarkers, and imaging findings. This study examined the prognostic value of three markers of sympathetic activity and their relationship to beta blocker dose in heart failure patients. METHODS AND RESULTS: A post hoc analysis of 858 heart failure subjects in the ADMIRE-HF trial was performed. Variables related to sympathetic activity were plasma norepinephrine, baseline heart rate, the heart to mediastinum (H/M) ratio of (123) I-mIBG uptake, and beta blocker dose...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154131/impact-of-age-sex-therapeutic-intent-race-and-severity-of-advanced-heart-failure-on-short-term-principal-outcomes-in-the-momentum-3-trial
#11
Daniel J Goldstein, Mandeep R Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D Pagani, Eric R Skipper, Geetha Bhat, Nirav Raval, Brian A Bruckner, Jerry D Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendelander, John B O'Connell, Joseph Cleveland
BACKGROUND: Primary outcomes analysis of the Multicenter Study of MagLev Technology in Patients Undergoing MCS Therapy With HeartMate 3 (MOMENTUM 3) trial short-term cohort demonstrated a higher survival rate free of debilitating stroke and reoperation to replace/remove the device (primary end-point) in patients receiving the HeartMate 3 (HM3) compared with the HeartMate (HMII). In this study we sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent [bridge to transplant/bridge to candidacy/destination therapy] and severity of illness) on primary end-point outcomes in MOMENTUM 3 patients implanted with HM3 and HMII devices...
November 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29153390/current-trends-and-future-perspectives-in-the-treatment-of-pulmonary-hypertension-who-group-ii-v
#12
Sukhdeep Bhogal, Debabrata Mukherjee, Subhash Banerjee, Akm Monwarul Islam, Ramesh Daggubati, Timir K Paul
Pulmonary hypertension continues to be a life-threatening illness with debilitating physical and emotional consequences affecting around 1% of global population. The progression of this devastating disease is characterized by increase in pulmonary vascular resistance resulting in elevated pulmonary pressure, eventually leading to right heart failure and death. Better understanding of pathophysiology has led to substantial improvements in terms of availability of treatment options. The purpose of this review is to summarize the currently available treatment options along with pertinent trials and possible future therapies of pulmonary hypertension group II-V...
October 31, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29153198/n-terminal-b-type-natriuretic-peptide-in-heart-failure
#13
REVIEW
Arthur Mark Richards
Plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is a guideline-mandated biomarker in heart failure (HF). Used as an inclusion criterion for therapeutic trials, NT-proBNP enriches trial populations and is a valid surrogate endpoint. Its diagnostic performance is best validated in acute decompensated HF (ADHF). NT-proBNP offers prognostic information independent of standard clinical predictors and refines risk stratification. With the advent of combined angiotensin 2 type 1 receptor blockade and neprilysin inhibition (ARNI) NT-proBNP retains its relationship to cardiac status and is the marker of choice in assessment of possible ADHF and in serial monitoring of HF patients receiving ARNI treatment...
January 2018: Heart Failure Clinics
https://www.readbyqxmd.com/read/29152151/aliskiren-for-heart-failure-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Hongzhi Liu, Hongxing Luo, Suqin Wang, Cong Zhang, Jialiang Hao, Chuanyu Gao
Objective: To systematically review and synthesize the currently available evidence of aliskiren for the treatment of heart failure. Materials and Methods: We systematically searched the Cochrane, Embase and PubMed databases to identify the randomized controlled trials (RCT) on the effects of aliskiren on heart failure. Data were synthesized with random effects model and presented in forest plot. Publication bias was evaluated with funnel plot. Heterogeneity was evaluated with Begg's test and Egger's test...
October 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/29151026/regional-validation-and-recalibration-of-clinical-predictive-models-for-patients-with-acute-heart-failure
#15
Benjamin S Wessler, Robin Ruthazer, James E Udelson, Mihai Gheorghiade, Faiez Zannad, Aldo Maggioni, Marvin A Konstam, David M Kent
BACKGROUND: Heart failure clinical practice guidelines recommend applying validated clinical predictive models (CPMs) to support decision making. While CPMs are now widely available, the generalizability of heart failure CPMs is largely unknown. METHODS AND RESULTS: We identified CPMs derived in North America that predict mortality for patients with acute heart failure and validated these models in different world regions to assess performance in a contemporary international clinical trial (N=4133) of patients with acute heart failure treated with guideline-directed medical therapy...
November 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29150300/permanent-his-bundle-pacing-to-replace-biventricular-pacing-for-cardiac-resynchronization-therapy
#16
Benjamin J Scherlag, Alexa Papaila
INTRODUCTION: Cardiac resynchronization therapy (CRT) or biventricular pacing (BIVP) has become a common procedure for the treatment of ventricular dyssynchrony in patients with heart failure, particularly in those with bundle branch block patterns (QRS durations >150ms) on the electrocardiogram (ECG). However, a large group of non-responders are made up of patients with dyssynchrony and QRS duration below 130ms. Recent studies have introduced permanent His bundle pacing as another method for achieving normalization of the QRS duration even in a majority of patients with right or left bundle branch block pattern on the ECG...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#17
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29149823/olive-oil-related-anti-inflammatory-effects-on-atherosclerosis-potential-clinical-implications
#18
Tanakal Wongwarawipat, Nikolaos Papageorgiou, Dimitrios Bertsias, Gerasimos Siasos, Dimitris Tousoulis
BACKGROUND AND OBJECTIVE: Atherosclerosis is characterized by a chronic low-grade inflammatory process which can result in atherothrombosis and a number of cardiovascular diseases (CVD). It is believed to be caused by multiple processes that involve inflammation and immunity. Mediterranean Diet (MedD) has been discovered to possess anti-inflammatory properties and associated with a reduction in the CVD risk and mortality. Its main component, extra-virgin olive oil (EVOO), is believed to be largely responsible for these effects and therefore, has been investigated in various studies...
November 15, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#19
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#20
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 7, 2017: Journal of the American College of Cardiology
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