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Heart failure clinical trial

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https://www.readbyqxmd.com/read/28917545/effects-of-acarbose-on-cardiovascular-and-diabetes-outcomes-in-patients-with-coronary-heart-disease-and-impaired-glucose-tolerance-ace-a-randomised-double-blind-placebo-controlled-trial
#1
Rury R Holman, Ruth L Coleman, Juliana C N Chan, Jean-Louis Chiasson, Huimei Feng, Junbo Ge, Hertzel C Gerstein, Richard Gray, Yong Huo, Zhihui Lang, John J McMurray, Lars Rydén, Stefan Schröder, Yihong Sun, Michael J Theodorakis, Michal Tendera, Lynne Tucker, Jaakko Tuomilehto, Yidong Wei, Wenying Yang, Duolao Wang, Dayi Hu, Changyu Pan
BACKGROUND: The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. METHODS: The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28917544/effects-on-the-incidence-of-cardiovascular-events-of-the-addition-of-pioglitazone-versus-sulfonylureas-in-patients-with-type-2-diabetes-inadequately-controlled-with-metformin-tosca-it-a-randomised-multicentre-trial
#2
Olga Vaccaro, Maria Masulli, Antonio Nicolucci, Enzo Bonora, Stefano Del Prato, Aldo P Maggioni, Angela A Rivellese, Sebastiano Squatrito, Carlo B Giorda, Giorgio Sesti, Paolo Mocarelli, Giuseppe Lucisano, Michele Sacco, Stefano Signorini, Fabrizio Cappellini, Gabriele Perriello, Anna Carla Babini, Annunziata Lapolla, Giovanna Gregori, Carla Giordano, Laura Corsi, Raffaella Buzzetti, Gennaro Clemente, Graziano Di Cianni, Rossella Iannarelli, Renzo Cordera, Olga La Macchia, Chiara Zamboni, Cristiana Scaranna, Massimo Boemi, Ciro Iovine, Davide Lauro, Sergio Leotta, Elisabetta Dall'Aglio, Emanuela Cannarsa, Laura Tonutti, Giuseppe Pugliese, Antonio C Bossi, Roberto Anichini, Francesco Dotta, Antonino Di Benedetto, Giuseppe Citro, Daniela Antenucci, Lucia Ricci, Francesco Giorgino, Costanza Santini, Agostino Gnasso, Salvatore De Cosmo, Donatella Zavaroni, Monica Vedovato, Agostino Consoli, Maria Calabrese, Paolo di Bartolo, Paolo Fornengo, Gabriele Riccardi
BACKGROUND: The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS: TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28917011/prevalence-predictors-and-prognostic-implications-of-pr-interval-prolongation-in-patients-with-heart-failure
#3
Theodora Nikolaidou, Pierpaolo Pellicori, Jufen Zhang, Syed Kazmi, Kevin M Goode, John G Cleland, Andrew L Clark
AIMS: To determine the prevalence, incidence, predictors, and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. METHODS AND RESULTS: Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included...
September 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28916239/effect-of-body-mass-index-on-clinical-events-after-acute-coronary-syndromes
#4
Pablo Lamelas, Jon-David Schwalm, Ibrahim Quazi, Shamir Mehta, P J Devereaux, Sanjit Jolly, Salim Yusuf
The association between body mass index (BMI) and major clinical events after acute coronary syndrome (ACS) remains controversial. We investigated the impact of BMI on major clinical events after ACS in a large individual patient data meta-analysis. Data on 81,553 patients from 45 different countries with ACS enrolled in 8 large randomized clinical trials were included, followed up for a median of 171 days. The mean age was 63.4 ± 11.7, 70% were male, and the mean BMI was 27.3 ± 4.7 kg/m(2). Compared with upper-normal-weight participants (BMI 21...
July 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28916152/effects-of-inspiratory-muscle-training-on-cardiovascular-autonomic-control-a-systematic-review
#5
REVIEW
Raphael Martins de Abreu, Patrícia Rehder-Santos, Vinicius Minatel, Gabriela Lopes Dos Santos, Aparecida Maria Catai
PURPOSE: To carry out a systematic review to determine if inspiratory muscle training (IMT) promotes changes in cardiovascular autonomic responses in humans. METHODS: The methodology followed the PRISMA statement for reporting systematic review analysis. MEDLINE, PEDro, SCOPUS and PubMed electronic databases were searched from the inception to March 2017. The quality assessment was performed using a PEDro scale. The articles were included if: (1) primary objective was related to the effects of IMT on the cardiovascular autonomic nervous system, and (2) randomized clinical trials and quasi-experimental studies...
September 7, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28914109/stem-cell-therapy-for-the-systemic-right-ventricle
#6
Ming-Sing Si, Richard G Ohye
In specific forms of congenital heart defects and pulmonary hypertension, the right ventricle (RV) is exposed to systemic levels of pressure overload. The RV is prone to failure in these patients because of its vulnerability to chronic pressure overload. As patients with a systemic RV reach adulthood, an emerging epidemic of RV failure has become evident. Medical therapies proven for LV failure are ineffective in treating RV failure. Areas covered: In this review, the pathophysiology of the failing RV under pressure overload is discussed, with specific emphasis on the pivotal roles of angiogenesis and oxidative stress...
September 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28912263/hemodynamic-phenotyping-of-pulmonary-hypertension-in-left-heart-failure
#7
REVIEW
Robert Naeije, Mario Gerges, Jean-Luc Vachiery, Sergio Caravita, Christian Gerges, Irene M Lang
Increased pulmonary venous pressure secondary to left heart disease is the most common cause of pulmonary hypertension (PH). The diagnosis of PH due to left heart disease relies on a clinical probability assessment followed by the invasive measurements of a mean pulmonary artery pressure (PAP) ≥25 mm Hg and mean wedged PAP (PAWP) >15 mm Hg. A combination of mean PAP and mean PAWP defines postcapillary PH. Postcapillary PH is generally associated with a diastolic pulmonary pressure gradient (diastolic PAP minus mean PAWP) <7 mm Hg, a transpulmonary pressure gradient (mean PAP minus mean PAWP) <12 mm Hg, and pulmonary vascular resistance ≤3 Wood units (WU)...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28912121/cortical-bone-stem-cell-therapy-preserves-cardiac-structure-and-function-after-myocardial-infarction
#8
Thomas E Sharp, Giana J Schena, Alexander R Hoachlandr-Hobby, Timothy Starosta, Remus M Berretta, Markus Wallner, Giulia Borghetti, Polina Gross, Daohai Yu, Jaslyn Johnson, Eric A Feldsott, Danielle M Trappanese, Amir Toib, Joseph E Rabinowitz, Jon C George, Hajime Kubo, Sadia Mohsin, Steven R Houser
Rationale: Cortical bone stem cells (CBSCs) have been shown to reduce ventricular remodeling and improve cardiac function in a murine myocardial infarction (MI) model. These effects were superior to other stem cell types that have been used in recent early stage clinical trials. However, CBSC efficacy has not been tested in a preclinical large animal model using approaches that could be applied to patients. Objective: To determine if post-MI transendocardial injection of allogeneic CBSCs reduces pathological structural and functional remodeling and prevents the development of heart failure in a swine MI model...
September 14, 2017: Circulation Research
https://www.readbyqxmd.com/read/28905172/n-terminal-pro-b-type-natriuretic-peptide-and-the-risk-of-stroke-among-patients-hospitalized-with-acute-heart-failure-an-apex-trial-substudy
#9
Gerald Chi, James L Januzzi, Serge Korjian, Yazan Daaboul, Samuel Z Goldhaber, Adrian F Hernandez, Russell D Hull, Alex Gold, Alexander T Cohen, Robert A Harrington, C Michael Gibson
BACKGROUND: Among patients hospitalized with acute heart failure (HF), the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in short-term stroke prediction remains unclear. METHODS: In the APEX trial, 7513 patients hospitalized for an acute medical illness were randomized to receive either extended-duration betrixaban (80 mg once daily for 35-42 days) or standard-of-care enoxaparin (40 mg once daily for 10 ± 4 days) for venous thromboprophylaxis...
September 13, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28904068/empagliflozin-and-clinical-outcomes-in-patients-with-type-2-diabetes-established-cardiovascular-disease-and-chronic-kidney-disease
#10
Christoph Wanner, John M Lachin, Silvio E Inzucchi, David Fitchett, Michaela Mattheus, Jyothis T George, Hans-Juergen Woerle, Uli C Broedl, Maximilian von Eynatten, Bernard Zinman
Background -Empagliflozin, a sodium glucose cotransporter 2 inhibitor, reduced cardiovascular morbidity and mortality in patients with type 2 diabetes and established cardiovascular disease in the EMPA-REG OUTCOME(®) trial. Urinary glucose excretion with empagliflozin decreases with declining renal function, resulting in less potency for glucose lowering in patients with kidney disease. We investigated the effects of empagliflozin on clinical outcomes in patients with type 2 diabetes, established cardiovascular disease and chronic kidney disease...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28903983/ivabradine-in-heart-failure-the-representativeness-of-shift-systolic-heart-failure-treatment-with-the-if-inhibitor-ivabradine-trial-in-a-broad-population-of-patients-with-chronic-heart-failure
#11
Debraj Das, Gianluigi Savarese, Ulf Dahlström, Michael Fu, Jonathan Howlett, Justin A Ezekowitz, Lars H Lund
BACKGROUND: The sinus node inhibitor ivabradine was approved for patients with heart failure (HF) after the ivabradine and outcomes in chronic HF (SHIFT [Systolic Heart Failure Treatment With the IF Inhibitor Ivabradine Trial]) trial. Our objective was to characterize the proportion of patients with HF eligible for ivabradine and the representativeness of the SHIFT trial enrollees compared with those in the Swedish Heart Failure Registry. METHODS AND RESULTS: We examined 26 404 patients with clinical HF from the Swedish Heart Failure Registry and divided them into SHIFT type (left ventricular ejection fraction <40%, New York Heart Association class II-IV, sinus rhythm, and heart rate ≥70 beats per minute) and non-SHIFT type...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28903775/nonclinical-and-clinical-pharmacology-evidence-for-cardiovascular-safety-of-saxagliptin
#12
REVIEW
Pia S Pollack, Kristina D Chadwick, David M Smith, Martin Billger, Boaz Hirshberg, Nayyar Iqbal, David W Boulton
BACKGROUND: In the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR) trial in patients with type 2 diabetes mellitus (T2D) at high risk of cardiovascular (CV) disease, saxagliptin did not increase the risk for major CV adverse events. However, there was an unexpected imbalance in events of hospitalization for heart failure (hHF), one of six components of the secondary CV composite endpoint, with a greater number of events observed with saxagliptin...
September 13, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28902412/interventions-for-treating-tuberculous-pericarditis
#13
REVIEW
Charles S Wiysonge, Mpiko Ntsekhe, Lehana Thabane, Jimmy Volmink, Dumisani Majombozi, Freedom Gumedze, Shaheen Pandie, Bongani M Mayosi
BACKGROUND: Tuberculous pericarditis can impair the heart's function and cause death; long term, it can cause the membrane to fibrose and constrict causing heart failure. In addition to antituberculous chemotherapy, treatments include corticosteroids, drainage, and surgery. OBJECTIVES: To assess the effects of treatments for tuberculous pericarditis. SEARCH METHODS: We searched the Cochrane Infectious Diseases Group Specialized Register (27 March 2017); the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library (2017, Issue 2); MEDLINE (1966 to 27 March 2017); Embase (1974 to 27 March 2017); and LILACS (1982 to 27 March 2017)...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28899603/anaemia-but-not-iron-deficiency-is-associated-with-clinical-symptoms-and-quality-of-life-in-patients-with-severe-heart-failure-and-palliative-home-care-a-substudy-of-the-prefer-trial
#14
Kurt Boman, Mona Olofsson, Ann-Charlotte R Bergman, Margareta Brännström
BACKGROUND: To explore the relationships between anaemia or iron deficiency (ID) and symptoms, quality of life (QoL), morbidity, and mortality. METHODS: A post-hoc, non-prespecified, explorative substudy of the prospective randomized PREFER trial. One centre study of outpatients with severe HF and palliative need managed with advanced home care. Associations between anaemia, ID, and the Edmonton Symptom Assessment Scale (ESAS), Euro QoL (EQ-5D), Kansas City Cardiomyopathy Questions (KCCQ) were examined only at baseline but at 6months for morbidity and mortality...
September 9, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28898880/personalized-management-of-cardiovascular-disorders
#15
Kewal K Jain
Personalized management of cardiovascular disorders (CVDs), also referred to as personalized or precision cardiology in accordance with general principles of personalized medicine, is the selection of best treatment for an individual patient. It involves the integration of various 'omics' technologies such as genomics and proteomics as well as other new technologies such as nanobiotechnology. Molecular diagnostics and biomarkers are important for linking diagnosis with therapy and monitoring of therapy. Because CVDs involve perturbations of large complex biological networks, a systems biology approach to CVD risk stratification may be used for improving risk-estimating algorithms and modeling of personalized benefit-of-treatment may be helpful for guiding choice of intervention...
September 11, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28898297/effects-and-safety-of-oral-tolvaptan-in-patients-with-congestive-heart-failure-a-systematic-review-and-network-meta-analysis
#16
Mei-Yi Wu, Tzu-Ting Chen, Ying-Chun Chen, Der-Cherng Tarng, Yun-Chun Wu, Hsien-Ho Lin, Yu-Kang Tu
AIMS: Several studies reported treatment benefits of tolvaptan in patients with congestive heart failure (CHF). However, the optimal dosage remains unclear. We aimed to compare different dosage of tolvaptan to determine the optimal dosage in terms of the efficacy and safety. METHODS: We searched MEDLINE, PubMed, EMBASE, Cochrane CENTRAL and ClinicalTrials.gov through Aug 31, 2016. Randomized controlled trials (RCTs) comparing tolvaptan of different dosages or to placebo in patients with CHF were included...
2017: PloS One
https://www.readbyqxmd.com/read/28894748/new-antihyperglycemic-drugs-and-heart-failure-synopsis-of-basic-and-clinical-data
#17
REVIEW
Dirk von Lewinski, Ewald Kolesnik, Markus Wallner, Michael Resl, Harald Sourij
The assessment of the cardiovascular safety profile of any newly developed antihyperglycemic drug is mandatory before registration, as a meta-analysis raised alarm describing a significant increase in myocardial infarction with the thiazolidinedione rosiglitazone. The first results from completed cardiovascular outcome trials are already available: TECOS, SAVOR-TIMI, and EXAMINE investigated dipeptidyl peptidase 4 (DPP-4) inhibitors, ELIXA, LEADER, and SUSTAIN-6 investigated glucagon-like peptide 1 (GLP-1) receptor agonists, and EMPA-REG OUTCOME and CANVAS investigated sodium-dependent glucose transporter 2 (SGLT-2) inhibitors...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28893549/continuous-optimization-of-cardiac-resynchronization-therapy-reduces-atrial-fibrillation-in-heart-failure-patients-results-of-the-adaptive-cardiac-resynchronization-therapy-trial
#18
David Birnie, Harrison Hudnall, Bernd Lemke, Kazutaka Aonuma, Kathy Lai-Fun Lee, Maurizio Gasparini, John Gorcsan, Jeffrey Cerkvenik, David O Martin
BACKGROUND: Data from randomized trials have suggested a modest or no effect of conventional cardiac resynchronization therapy (convCRT) on the incidence of atrial fibrillation (AF). AdaptivCRT (aCRT, Medtronic, Mounds View, MN) is a recently described algorithm for synchronized left ventricular (LV) pacing and continuous optimization of cardiac resynchronization therapy (CRT). OBJECTIVE: We compared the long-term effects of aCRT with convCRT pacing on the incidence of AF...
September 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28893244/a-randomized-placebo-controlled-study-of-the-cardiovascular-safety-of-the-once-weekly-dpp-4-inhibitor-omarigliptin-in-patients-with-type-2-diabetes-mellitus
#19
Ira Gantz, Menghui Chen, Shailaja Suryawanshi, Catherine Ntabadde, Sukrut Shah, Edward A O'Neill, Samuel S Engel, Keith D Kaufman, Eseng Lai
BACKGROUND: Omarigliptin is a once-weekly (q.w.) oral DPP-4 inhibitor that is approved for the treatment of patients with type 2 diabetes mellitus (T2DM) in Japan. To support approval of omarigliptin in the United States, the clinical development program included a cardiovascular (CV) safety study. Subsequently, a business decision was made not to submit a marketing application for omarigliptin in the United States, and the CV safety study was terminated. Herein we report an analysis of data from that early-terminated study...
September 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28891228/investigating-a-biomarker-driven-approach-to-target-collagen-turnover-in-diabetic-heart-failure-with-preserved-ejection-fraction-patients-effect-of-torasemide-vs-furosemide-on-serum-c-terminal-propeptide-of-procollagen-type-i-drop-pip-trial
#20
Tobias Daniel Trippel, Sophie Van Linthout, Dirk Westermann, Ruhdja Lindhorst, Anja Sandek, Stefanie Ernst, Anna Bobenko, Mario Kasner, Frank Spillmann, Arantxa González, Begoña López, Susana Ravassa, Burkert Pieske, Walter J Paulus, Javier Díez, Frank Edelmann, Carsten Tschöpe
AIM: Heart failure with preserved ejection fraction (HFpEF) is associated with myocardial remodelling including severe pro-fibrotic changes contributing to an increase in left ventricular stiffness and diastolic dysfunction. Serum C-terminal propeptide of procollagen type I (PIP) strongly correlates with the turnover of extracellular cardiac matrix proteins and fibrosis. Torasemide, but not furosemide, was described to reduce collagen type I synthesis in clinically unstable patients with heart failure with reduced ejection fraction...
September 11, 2017: European Journal of Heart Failure
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