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Randomized trials in cardiology

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https://www.readbyqxmd.com/read/29042191/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#1
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Anzouan Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority action to reduce heart disease and stroke on the continent. OBJECTIVES: The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
October 14, 2017: Global Heart
https://www.readbyqxmd.com/read/29020259/report-of-an-esc-eapci-task-force-on-the-evaluation-and-use-of-bioresorbable-scaffolds-for-percutaneous-coronary-intervention-executive-summary
#2
Robert A Byrne, Giulio G Stefanini, Davide Capodanno, Yoshinobu Onuma, Andreas Baumbach, Javier Escaned, Michael Haude, Stefan James, Michael Joner, Peter Jüni, Adnan Kastrati, Semih Oktay, William Wijns, Patrick W Serruys, Stephan Windecker
A previous Task Force of the European Society of Cardiology (ESC) and European Association of Percutaneous Cardiovascular Interventions (EAPCI) provided a report on recommendations for the non-clinical and clinical evaluation of coronary stents. Following dialogue with the European Commission, the Task Force was asked to prepare an additional report on the class of devices known as bioresorbable scaffolds (BRS). Five BRS have CE-mark approval for use in Europe. Only one device-the Absorb bioresorbable vascular scaffold-has published randomized clinical trial data and this data show inferior outcomes to conventional drug-eluting stents (DES) at 2-3 years...
August 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29018938/heart-failure-with-preserved-ejection-fraction-current-management-and-future-strategies-expert-opinion-on-the-behalf-of-the-nucleus-of-the-heart-failure-working-group-of-the-german-society-of-cardiology-dkg
#3
REVIEW
Carsten Tschöpe, Christoph Birner, Michael Böhm, Oliver Bruder, Stefan Frantz, Andreas Luchner, Lars Maier, Stefan Störk, Behrouz Kherad, Ulrich Laufs
About 50% of all patients suffering from heart failure (HF) exhibit a reduced ejection fraction (EF ≤ 40%), termed HFrEF. The others may be classified into HF with midrange EF (HFmrEF 40-50%) or preserved ejection fraction (HFpEF, EF ≥ 50%). Presentation and pathophysiology of HFpEF is heterogeneous and its management remains a challenge since evidence of therapeutic benefits on outcome is scarce. Up to now, there are no therapies improving survival in patients with HFpEF. Thus, the treatment targets symptom relief, quality of life and reduction of cardiac decompensations by controlling fluid retention and managing risk factors and comorbidities...
October 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28982506/palliative-care-in-heart%C3%A2-failure-rationale-evidence-and-future-priorities
#4
REVIEW
Dio Kavalieratos, Laura P Gelfman, Laura E Tycon, Barbara Riegel, David B Bekelman, Dara Z Ikejiani, Nathan Goldstein, Stephen E Kimmel, Marie A Bakitas, Robert M Arnold
Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF...
October 10, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28964433/cost-effectiveness-analysis-of-natriuretic-peptide-testing-and-specialist-management-in-patients-with-suspected-acute-heart-failure
#5
Edward A Griffin, David Wonderling, Andrew J Ludman, Abdallah Al-Mohammad, Martin R Cowie, Suzanna M C Hardman, John J V McMurray, Jason Kendall, Polly Mitchell, Aminat Shote, Katharina Dworzynski, Jonathan Mant
OBJECTIVES: To determine the cost-effectiveness of natriuretic peptide (NP) testing and specialist outreach in patients with acute heart failure (AHF) residing off the cardiology ward. METHODS: We used a Markov model to estimate costs and quality-adjusted life-years (QALYs) for patients presenting to hospital with suspected AHF. We examined diagnostic workup with and without the NP test in suspected new cases, and we examined the impact of specialist heart failure outreach in all suspected cases...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28956866/-the-importance-of-defining-methodology-for-post-marketing-observational-studies-on-cardiovascular-therapies
#6
Francesco Pelliccia, Francesco Barillà, Gaetano Tanzilli, Nicola Viceconte, Vincenzo Paravati, Enrico Mangieri, Carlo Gaudio
In recent years, a growing number of observational studies in cardiology have been carried out following the criticism that rigid design of randomized clinical trials produces information that is not applicable to the general patient. This approach is very common in several branches of medicine, first of all oncology, but has often been considered marginal in cardiology. The recent introduction of new oral anticoagulants (NOACs) on the market, however, has seen a proliferation of "real-life" studies, drawing the attention of cardiologists to the advantages and limitations of post-marketing studies...
July 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28950366/clinical-practice-of-contrast-echocardiography-recommendation-by-the-european-association-of-cardiovascular-imaging-eacvi-2017
#7
Roxy Senior, Harald Becher, Mark Monaghan, Luciano Agati, Jose Zamorano, Jean Louis Vanoverschelde, Petros Nihoyannopoulos, Thor Edvardsen, Patrizio Lancellotti
Contrast echocardiography is widely used in cardiology. It is applied to improve image quality, reader confidence and reproducibility both for assessing left ventricular (LV) structure and function at rest and for assessing global and regional function in stress echocardiography. The use of contrast in echocardiography has now extended beyond cardiac structure and function assessment to evaluation of perfusion both of the myocardium and of the intracardiac structures. Safety of contrast agents have now been addressed in large patient population and these studies clearly established its excellent safety profile...
September 12, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28949844/when-bins-blur-patient-perspectives-on-categories-of-results-from-clinical-whole-genome-sequencing
#8
Leila Jamal, Jill O Robinson, Kurt D Christensen, Jennifer Blumenthal-Barby, Melody J Slashinski, Denise Lautenbach Perry, Jason L Vassy, Julia Wycliff, Robert C Green, Amy L McGuire
BACKGROUND: Clinical genome and exome sequencing (CGES) is being used in an expanding range of clinical settings. Most approaches to offering patients choices about learning CGES results classify results according to expert definitions of clinical actionability. Little is known about how patients conceptualize different categories of CGES results. METHODS: The MedSeq Project is a randomized controlled trial studying the use of whole-genome sequencing (WGS) in primary care and cardiology...
April 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28948934/report-of-an-esc-eapci-task-force-on-the-evaluation-and-use-of-bioresorbable-scaffolds-for-percutaneous-coronary-intervention-executive-summary
#9
Robert A Byrne, Giulio F Stefanini, Davide Capodanno, Yoshinobu Onuma, Andreas Baumbach, Javier Escaned, Michael Haude, Stefan James, Michael Joner, Peter Ju Ni, Adnan Kastrati, Semih Oktay, William Wijns, Patrick W Serruys, Stephan Windecker
A previous Task Force of the European Society of Cardiology (ESC) and European Association of Percutaneous Cardiovascular Interventions (EAPCI) provided a report on recommendations for the nonclinical and clinical evaluation of coronary stents. Following dialogue with the European Commission, the Task Force was asked to prepare an additional report on the class of devices known as bioresorbable scaffolds (BRS). Five BRS have CE-mark approval for use in Europe. Only one device - the Absorb bioresorbable vascular scaffold - has published randomized clinical trial data and this data show inferior outcomes to conventional drug-eluting stents (DES) at 2-3 years...
September 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#10
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28886926/2017-focused-update-of-the-2016%C3%A2-acc%C3%A2-expert-consensus-decision-pathway-on-the-role-of-non-statin-therapies-for-ldl-cholesterol-lowering-in%C3%A2-the-management-of-atherosclerotic-cardiovascular-disease-risk-a-report-of-the-american-college-of-cardiology-task-force
#11
Donald M Lloyd-Jones, Pamela B Morris, Christie M Ballantyne, Kim K Birtcher, David D Daly, Sondra M DePalma, Margo B Minissian, Carl E Orringer, Sidney C Smith
In 2016, the American College of Cardiology published the first expert consensus decision pathway (ECDP) on the role of non-statin therapies for low-density lipoprotein (LDL)-cholesterol lowering in the management of atherosclerotic cardiovascular disease (ASCVD) risk. Since the publication of that document, additional evidence and perspectives have emerged from randomized clinical trials and other sources, particularly considering the longer-term efficacy and safety of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors in secondary prevention of ASCVD...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28862926/alirocumab-treatment-and-achievement-of-non-high-density-lipoprotein-cholesterol-and-apolipoprotein-b-goals-in-patients-with-hypercholesterolemia-pooled-results-from-10-phase-3-odyssey-trials
#12
Harold E Bays, Lawrence A Leiter, Helen M Colhoun, Desmond Thompson, Laurence Bessac, Robert Pordy, Peter P Toth
BACKGROUND: Non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein (apo) B are better predictors of atherosclerotic cardiovascular disease risk than low-density lipoprotein cholesterol alone. US and European lipid management guidelines support non-HDL-C and apoB as targets for lipid-lowering therapy. METHODS AND RESULTS: This analysis evaluated the efficacy of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, on non-HDL-C and apoB...
August 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28855886/advanced-imaging-of-intracranial-atherosclerosis-lessons-from-interventional-cardiology
#13
Davor Pavlin-Premrl, Rahul Sharma, Bruce C V Campbell, J Mocco, Nicholas L Opie, Thomas J Oxley
Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR), intravascular ultrasound (IVUS), and optical coherence tomography (OCT) are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28854072/acclimating-to-the-increase-in-statin-use-in-accountable-care-organizations-based-on-changes-in-quality-measures-a-report-from-the-accountable-care-organization-research-network-services-and-education
#14
Leah Bensimon, Genevieve Hale
The Accountable Care Organization Research Network, Services, and Education (ACORN SEED), founded by faculty members at Nova Southeastern University College of Pharmacy, is a group of pharmacists that provides unique pharmacy services to accountable care organizations (ACOs), patient-centered medical homes, and management services organizations to help maximize shared savings and target medication-related issues, while promoting the pharmacy profession and unique learning experiences for pharmacy students within these settings...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28853530/-novelties-in-pericardial-diseases-a-focused-review-of-the-latest-european-guidelines
#15
Alexander Fardman, Yehuda Adler
More than a decade has elapsed since the first international guidelines on the diagnosis and management of pericardial diseases were issued by the European Society of Cardiology (ESC) in 2004. Since then, significant advances have been made in this field due to several randomized double blinded controlled trials and also retrospective, as well as prospective, cohort studies that were conducted during this time frame. However, despite the amount of knowledge that has been accumulated, only Spanish and Brazilian national societies of cardiology have so far published national guidelines on the management of pericardial diseases...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28817821/endoscopic-lung-volume-reduction-an-expert-panel-recommendation-update-2017
#16
Felix J F Herth, Dirk-Jan Slebos, Gerard J Criner, Pallav L Shah
Interest in endoscopic lung volume reduction (ELVR) technologies for emphysema is consistently growing. In the last couple of months, several endoscopic options (e.g., endo- or intrabronchial valves, coil implants, and thermal vapor ablation) that have been evaluated in randomized controlled trials have been reported with the ultimate goal of improving respiratory mechanics and alleviating chronic dyspnea. Patients presenting with severe air trapping and thoracic hyperinflation have the greatest potential to derive benefit from ELVR procedures...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28812129/-device-based-remote-monitoring-current-evidence
#17
REVIEW
David Duncker, Roman Michalski, Johanna Müller-Leisse, Christos Zormpas, Thorben König, Christian Veltmann
Telemedicine is increasingly used in clinical cardiology. It offers early detection of arrhythmias, technical device follow-up and support of heart failure management. Regarding technical device follow-up, remote monitoring significantly reduces usage of the health care system. Furthermore, remote monitoring is associated with a significantly reduced time from device malfunction to physician's perception of the event. Using remote monitoring, inappropriate ICD (implantable cardioverter defibrillator) shocks can be significantly reduced compared to routine in-office follow-up...
August 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28810622/oral-n-acetylcysteine-for-prophylaxis-of-contrast-induced-nephropathy-in-patients-following-coronary-angioplasty-a-meta-analysis
#18
Jing-Xiu Li, En-Ze Jin, Long-Hao Yu, Yang Li, Nan-Nan Liu, Yu-Mei Dong, Xin Li, Xue-Qi Li
It is acknowledged that contrast-induced nephropathy (CIN) is a common cause of acute renal insufficiency after cardiac catheterization and affects mortality and morbidity. To date, it is unknown whether oral N-acetylcysteine (NAC) is able to prevent contrast-induced nephropathy (CIN) in patients undergoing coronary angioplasty. A meta-analysis of randomized controlled trials was performed to assess the effects of NAC in the prevention of CIN in patients following coronary angioplasty. A total of 19 studies published prior to January 2015 that investigated the efficacy of oral NAC for the prevention of CIN were collected from Medline, Cochrane and Embase databases and conference proceedings from cardiology and nephrology meetings...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28768800/factors-associated-with-time-to-site-activation-randomization-and-enrollment-performance-in-a-stroke-prevention-trial
#19
Bart M Demaerschalk, Robert D Brown, Gary S Roubin, Virginia J Howard, Eldina Cesko, Kevin M Barrett, Mary E Longbottom, Jenifer H Voeks, Seemant Chaturvedi, Thomas G Brott, Brajesh K Lal, James F Meschia, George Howard
BACKGROUND AND PURPOSE: Multicenter clinical trials attempt to select sites that can move rapidly to randomization and enroll sufficient numbers of patients. However, there are few assessments of the success of site selection. METHODS: In the CREST-2 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trials), we assess factors associated with the time between site selection and authorization to randomize, the time between authorization to randomize and the first randomization, and the average number of randomizations per site per month...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28754155/magnetic-resonance-adenosine-perfusion-imaging-as-gatekeeper-of-invasive-coronary-intervention-magnet-study-protocol-for-a-randomized-controlled-trial
#20
Dominik Buckert, Simon Witzel, Maciej Cieslik, Raid Tibi, Wolfgang Rottbauer, Peter Bernhardt
BACKGROUND: Current guidelines for the diagnosis and management of patients with stable coronary artery disease (CAD) recommend functional stress testing for risk stratification prior to revascularization procedures. Cardiac magnetic resonance imaging (CMR) is a modality of choice for stress testing because of its capability to detect myocardial ischemia sensitively and specifically. Nevertheless, evidence from randomized trials evaluating a CMR-based management of stable CAD patients in comparison to a more common angiography-based approach still is limited...
July 28, 2017: Trials
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