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Randomized trials in cardiology

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https://www.readbyqxmd.com/read/29880501/sleep-apnea-and-cardiovascular-disease-an-enigmatic-risk-factor
#1
REVIEW
John S Floras
Synchronization of molecular, metabolic, and cardiovascular circadian oscillations is fundamental to human health. Sleep-disordered breathing, which disrupts such temporal congruence, elicits hemodynamic, autonomic, chemical, and inflammatory disturbances with acute and long-term consequences for heart, brain, and circulatory and metabolic function. Sleep apnea afflicts a substantial proportion of adult men and women but is more prevalent in those with established cardiovascular diseases and especially fluid-retaining states...
June 8, 2018: Circulation Research
https://www.readbyqxmd.com/read/29868614/interventional-cardio-oncology-adding-a-new-dimension-to-the-cardio-oncology-field
#2
Victor Y Liu, Ali M Agha, Juan Lopez-Mattei, Nicolas Palaskas, Peter Kim, Kara Thompson, Elie Mouhayar, Konstantinos Marmagkiolis, Saamir A Hassan, Kaveh Karimzad, Cezar A Iliescu
The management of cardiovascular disease in patients with active cancer presents a unique challenge in interventional cardiology. Cancer patients often suffer from significant comorbidities such as thrombocytopenia and coagulopathic and/or hypercoagulable states, which complicates invasive evaluation and can specifically be associated with an increased risk for vascular access complications. Furthermore, anticancer therapies cause injury to the vascular endothelium as well as the myocardium. Meanwhile, improvements in diagnosis and treatment of various cancers have contributed to an increase in overall survival rates in cancer patients...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29805407/comparing-the-efficacy-of-morphine-alone-with-morphine-and-mgso4-in-pain-management-after-coronary-artery-bypass-surgery
#3
Rana Altaf Ahmad, Syed Suhail Ahmad, Waqas Hamid, Aamir Furqan
Objective: To compare the effectiveness of Morphine alone and Morphine with MgSo4 in pain management after CABG surgery. Methods: This randomized control trial was conducted in the department of anesthesia and critical care Choudhary Pervaiz Ellahi Institute of Cardiology, Multan from November 2016 to June 2017. All collected data was entered and analyzed by using computer software SPSS version 23.1. Quantitative data like age, VAS score was analyzed and presented as mean and standard deviation...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29805387/effects-of-structured-patient-education-on-knowledge-level-and-inr-control-of-patients-receiving-warfarin-randomized-controlled-trial
#4
Ebru Baysal, Tulay Sagkal Midilli
Objective: To determine the effects of patient education about the safety of warfarin therapy on related-knowledge levels and on International Normalized Ratio (INR) control. Methods: In the study, randomized controlled experimental study design was used. It was conducted between September 2014-March 2015 with 63 patients who use warfarin at least two months at cardiology and cardiovascular surgery outpatient departments of two different hospitals in Manisa. Participants in the intervention group received one-to-one education about the safety of warfarin therapy and a booklet...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29805386/short-term-clinical-outcomes-of-everolimus-eluting-stents-in-patients-with-stable-angina-pectoris
#5
Muhammad Habeel Dar, Yasir Adnan, Mohammad Faheem, Imran Khan, Lubna Noor
Background & Objective: Everolimus-eluting stents, compared with bare metal stents, reduced the risk of restenosis in clinical trials with strict inclusion and exclusion criteria. The objective of this study was to determine the three months clinical outcomes of Everolimus Eluting Stents in patients with stable angina pectoris in Pakistani population. Methods: It was a descriptive cross-sectional study and the data was collected from Catheterization Laboratory Cardiology Department Lady Readings Hospital Peshawar...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29798776/3-year-clinical-follow-up-of-the-ribs-iv-clinical-trial-a-prospective-randomized-study-of-drug-eluting-balloons-versus-everolimus-eluting-stents-in-patients-with-in-stent-restenosis-in-coronary-arteries-previously-treated-with-drug-eluting-stents
#6
Fernando Alfonso, María José Pérez-Vizcayno, Javier Cuesta, Bruno García Del Blanco, Arturo García-Touchard, José Ramón López-Mínguez, Mónica Masotti, Javier Zueco, Angel Cequier, Maite Velázquez, Raúl Moreno, Vicente Mainar, Antonio Domínguez, Cesar Moris, Eduardo Molina, Fernando Rivero, Pilar Jiménez-Quevedo, Nieves Gonzalo, Cristina Fernández-Pérez
OBJECTIVES: This study sought to compare the long-term safety and efficacy of drug-eluting balloons (DEB) and everolimus-eluting stents (EES) in patients with in-stent restenosis (ISR) of drug-eluting stents (DES). BACKGROUND: Treatment of patients with DES-ISR remains a challenge. METHODS: The RIBS IV (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloons vs Everolimus-Eluting Stents) trial is a prospective multicenter randomized clinical trial comparing DEB and EES in patients with DES-ISR...
May 28, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29789301/orbita-2-bringing-some-oxygen-back-to-pci-in-stable-ischemic-heart-disease
#7
Ajay J Kirtane
With the presentation and publication of the ORBITA trial in late 2017,1 for the first time the cardiology community had the results of a blinded randomized trial examining the efficacy of percutaneous coronary intervention (PCI) for stable ischemic heart disease (SIHD). ORBITA was a mechanistic trial, carefully examining a host of endpoints in order to determine potentially measurable effects of PCI vs. a sham comparator at 6 weeks of follow-up. The trial was performed in 200 highly committed research subjects with single vessel SIHD who were treated within a protocol that put them on an average of ~3 antianginal medications, subjected them to serial assessments of symptom status and tests for ischemia, and led to multiple cardiac catheterization procedures (2 procedures for subjects in the PCI arm and 15% of the sham arm, and 3 procedures for the 85% of subjects in the sham arm who underwent post-study treatment with PCI)...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29786535/evaluating-the-importance-of-sham-controlled-trials-in-the-investigation-of-medical-devices-in-interventional-cardiology
#8
Robert A Byrne, Davide Capodanno, Felix Mahfoud, Jean Fajadet, Stephan Windecker, Peter Jüni, Andreas Baumbach, William Wijns, Michael Haude
Cardiovascular medicine is one of the specialties that has relied most heavily on evidence from randomized clinical trials in determining best practice for the management of common disease conditions. When comparing treatment approaches, trials incorporating random allocation are the most appropriate method for protecting against treatment allocation bias. In order to protect against performance and ascertainment bias, trial designs including placebo control are preferable where feasible. In contrast to testing of medicines, treatments based on procedures or use of medical devices are more challenging to assess, as sham procedures are necessary to facilitate blinding of participants...
May 22, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29782272/-duration-and-timing-of-initiation-of-therapy-with-platelet-p2y12-inhibitors-in-the-treatment-of-patients-with-acute-coronary-syndrome
#9
S V SHalaev, Z M Safiullina
In recent years, the issues of choice of an agent for dual antiplatelet therapy (DAPT) as well as timing of initiation and duration of DAPT in patients with acute coronary syndrome (ACS) have been actively discussed. In this article we present data of major randomized trials of clopidogrel and novel P2Y12 inhibitors - prasugrel, ticagrelor, cangrelor - assessing strategy of administration of antiaggregants in patients with ACS before coronary angiography / percutaneous coronary intervention. The article also contains analysis of differences between recommendations of the European Society of Cardiology and American College of Cardiology/American Heart Association on therapy with oral P2Y12 inhibitors in the management of patients with ACS...
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29754667/is-there-a-role-for-pharmacokinetic-pharmacodynamic-guided-dosing-for-novel-oral-anticoagulants
#10
REVIEW
Noel Chan, Philip T Sager, Jack Lawrence, Thomas's Ortel, Paul Reilly, Scott Berkowitz, Dagmar Kubitza, John Eikelboom, Jeffry Florian, Norman Stockbridge, Martin Rose, Robert Temple, Jonathan H Seltzer
The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke as dose-adjusted warfarin in phase 3 randomized trials and less likely to cause hemorrhagic stroke. Pharmacokinetic and/or pharmacodynamic subanalyses of the major NOAC trials in patients with atrial fibrillation have established relationships between clinical characteristics, and drug levels and/or pharmacodynamic responses with both efficacy and safety...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29733433/statin-therapy-on-glycemic-control-in-type-2-diabetic-patients-a-network-meta-analysis
#11
J Y Cui, R R Zhou, S Han, T S Wang, L Q Wang, X H Xie
WHAT IS KNOWN AND OBJECTIVE: Statins are the cornerstone of primary and secondary prevention of cardiovascular diseases (CVDs) and are effective for the prevention of vascular events in diabetic patients. Diabetes mellitus is an important risk factor for CVDs .The majority of patients with diabetes mellitus benefits from statin therapy. According to the recent clinical guidelines of the American College of Cardiology and the American Heart Association, moderate-intensity or high-intensity statin therapy should be used as the primary prevention for individuals with diabetes mellitus, aged between 40 and 75 years and with low-density lipoprotein cholesterol (LDL-C) from 70 to 189 mg/dL...
May 7, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29723341/impact-of-discharge-medication-counseling-in-the-cardiology-unit-of-a-tertiary-hospital-in-brazil-a-randomized-controlled-trial
#12
Aline F Bonetti, Bruna Q Bagatim, Antonio M Mendes, Inajara Rotta, Renata C Reis, Maria Luiza D Fávero, Fernando Fernandez-Llimós, Roberto Pontarolo
OBJECTIVES: This study aimed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate, hospital readmissions, emergency department visits, and medication adherence at 30 days post discharge. METHODS: This randomized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital. The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge...
2018: Clinics
https://www.readbyqxmd.com/read/29706388/understanding-the-patient-perspective-on-research-access-to-national-health-records-databases-for-conduct-of-randomized-registry-trials
#13
Robert Avram, Guillaume Marquis-Gravel, François Simard, Christine Pacheco, Étienne Couture, Maxime Tremblay-Gravel, Olivier Desplantie, Isabelle Malhamé, Lior Bibas, Samer Mansour, Marie-Claude Parent, Paul Farand, Luc Harvey, Marie-Gabrielle Lessard, Hung Ly, Geoffrey Liu, Annette E Hay, E Marc Jolicoeur
BACKGROUND: Use of health administrative databases is proposed for screening and monitoring of participants in randomized registry trials. However, access to these databases raises privacy concerns. We assessed patient's preferences regarding use of personal information to link their research records with national health databases, as part of a hypothetical randomized registry trial. METHODS AND RESULTS: Cardiology patients were invited to complete an anonymous self-reported survey that ascertained preferences related to the concept of accessing government health databases for research, the type of personal identifiers to be shared and the type of follow-up preferred as participants in a hypothetical trial...
July 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29690966/effects-of-lower-limb-cycle-training-on-echocardiographic-parameters-of-left-ventricle-in-dilated-cardiomyopathy-patients
#14
Mehwish Waseem, Naveed Yaqoob, Muhammad Iqbal Tariq, Muhammad Qasim Raza, Imran Amjad
OBJECTIVE: To determine the effect of lower limb ergometric training on echocardiographic parameters of left ventricle in dilated cardiomyopathy (DMC) patients. STUDY DESIGN: Randomized control trial. PLACE AND DURATION OF STUDY: Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan, from September 2016 to February 2017. METHODOLOGY: Clinically stable patients with DCM (n=60), were randomly allocated into an interventional group with two-month interventional program and a non-trained control group (n=30 each)...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29673467/transition-intervention-for-adolescents-with-congenital-heart-disease
#15
Andrew S Mackie, Gwen R Rempel, Adrienne H Kovacs, Miriam Kaufman, Kathryn N Rankin, Ahlexxi Jelen, Maryna Yaskina, Renee Sananes, Erwin Oechslin, Dimi Dragieva, Sonila Mustafa, Elina Williams, Michelle Schuh, Cedric Manlhiot, Samantha J Anthony, Joyce Magill-Evans, David Nicholas, Brian W McCrindle
BACKGROUND: There is little evidence regarding the efficacy of interventions to prepare adolescents with congenital heart disease (CHD) to enter adult care. OBJECTIVES: The goal of this study was to evaluate the impact of a nurse-led transition intervention on lapses between pediatric and adult care. METHODS: A cluster randomized clinical trial was conducted of a nurse-led transition intervention for 16- to 17-year-olds with moderate or complex CHD versus usual care...
April 24, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29664530/-clinical-practice-guidelines-for-smoking-cessation
#16
María Paz Corvalán B, Leonardo Véjar M, Claudia Bambs S, Juana Pavié G, Mónica Zagolin B, Jaime Cerda L
Considering that a high proportion of the Chilean general population smokes, the Chilean Society of Respiratory Diseases in collaboration with the Chilean Societies of Cardiology and, Endocrinology and Diabetes, formed an interdisciplinary group, who issued a set of recommendations for the treatment of the smoker, methodologically advised by experts. These interventions should be prioritized in high-risk groups. Methods The panel elaborated and graded the recommendations following the GRADE methodology. To assess the effect of each intervention, systematic reviews and randomized clinical trials were identified...
November 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29651786/the-why-when-and-how-to-test-for-obstructive-sleep-apnea-in-patients-with-atrial-fibrillation
#17
REVIEW
Lien Desteghe, Jeroen M L Hendriks, R Doug McEvoy, Ching Li Chai-Coetzer, Paul Dendale, Prashanthan Sanders, Hein Heidbuchel, Dominik Linz
Sleep apnea is associated with increased cardiovascular risk and may be important in atrial fibrillation (AF) management. It is present in up to 62% of the AF population and is highly under-recognized and underdiagnosed. Obstructive sleep apnea (OSA) is strongly associated with AF and non-randomized trials have shown that its treatment can help to reduce AF recurrences and maintain sinus rhythm. The 2016 European Society of Cardiology guidelines for the management of AF recommend that AF patients should be questioned regarding the symptoms of OSA and that OSA-treatment should be optimized to improve AF treatment results...
April 12, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29625993/an-observational-study-of-the-association-of-video-versus-text-based-informed-consent-with-multicenter-trial-enrollment-lessons-from-the-palm-study-patient-and-provider-assessment-of-lipid-management
#18
Alexander C Fanaroff, Shuang Li, Laura E Webb, Vincent Miller, Ann Marie Navar, Eric D Peterson, Tracy Y Wang
BACKGROUND: Patient participation in clinical research is low, in part because of the length and complexity of the informed consent process. Video informed consent may enhance the appeal of research and help break down barriers to participation. METHODS AND RESULTS: The PALM study (Patient and Provider Assessment of Lipid Management) enrolled 7904 patients at cardiology, endocrinology, and primary care clinics across the United States to evaluate cholesterol management practices...
April 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29618329/a-randomized-controlled-trial-to-evaluate-utilization-of-physical-activity-recommendations-among-patients-of-cardiovascular-healthcare-centres-in-eastern-slovakia-study-design-and-rationale-of-the-awatar-study
#19
Aurel Zelko, Alena Bukova, Peter Kolarcik, Peter Bakalar, Ivan Majercak, Jana Potocnikova, Sijmen A Reijneveld, Jitse P van Dijk
BACKGROUND: Guidelines on modifiable risk factors regarding cardiological patients are poorly implemented in clinical practice perhaps due to low health literacy. Several digital tools for improving lifestyle and behavioural intervention were developed. Our primary aim is to evaluate the effectiveness of a digital exercise prescription tool on the adherence to physical activity recommendations among patients with cardiovascular diseases. METHODS: A randomized controlled trial will be realized in cooperation with Cardiovascular Health Centres in Eastern Slovakia...
April 4, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29602648/dual-antiplatelet-therapy-after-coronary-stent-implantation-individualizing-the-optimal-duration
#20
REVIEW
Leslie Marisol Lugo, José Luis Ferreiro
Dual antiplatelet therapy (DAPT) with a P2Y12 receptor antagonist in addition to aspirin is the antiplatelet treatment of choice in patients undergoing percutaneous coronary intervention. Despite DAPT being one of the most widely investigated treatment strategies in the cardiology field, its optimal duration after coronary stenting remains controversial. The balance between the possible benefit of preventing a thrombotic event and the risk of suffering a bleeding complication due to maintenance of therapy is of critical relevance to determine the duration of DAPT in a given patient...
March 27, 2018: Journal of Cardiology
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