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Randomized trials in cardiology

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https://www.readbyqxmd.com/read/29463490/motivational-interviewing-and-medication-review-in-coronary-heart-disease-mimeric-protocol-for-a-randomized-controlled-trial-investigating-effects-on-clinical-outcomes-adherence-and-quality-of-life
#1
Malin Johansson Östbring, Tommy Eriksson, Göran Petersson, Lina Hellström
BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes. OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease...
February 20, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29462823/early-psychological-counseling-for-the-prevention-of-posttraumatic-stress-induced-by-acute-coronary-syndrome-the-mi-sprint-randomized-controlled-trial
#2
Roland von Känel, Jürgen Barth, Mary Princip, Rebecca E Meister-Langraf, Jean-Paul Schmid, Hansjörg Znoj, Claudia Herbert, Ulrich Schnyder
BACKGROUND: Acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) and clinically significant PTSD symptoms (PTSS) are found in 4 and 12% of patients, respectively. We hypothesized that trauma-focused counseling prevents the incidence of ACS-induced PTSS. METHODS: Within 48 h of hospital admission, 190 patients with high distress during ACS were randomized to a single-session intervention of either trauma-focused counseling or an active control intervention targeting the general role of stress in patients with heart disease...
February 21, 2018: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/29453020/2018-consensus-of-the-taiwan-society-of-cardiology-and-the-diabetes-association-of-republic-of-china-taiwan-on-the-pharmacological-management-of-patients-with-type-2-diabetes-and-cardiovascular-diseases
#3
Chern-En Chiang, Shih-Yi Lin, Tsung-Hsien Lin, Tzung-Dau Wang, Hung-I Yeh, Jung-Fu Chen, Chia-Ti Tsai, Yi-Jen Hung, Yi-Heng Li, Ping-Yen Liu, Kuan-Cheng Chang, Kang-Ling Wang, Ting-Hsing Chao, Kou-Gi Shyu, Wei-Shiung Yang, Kwo-Chang Ueng, Pao-Hsien Chu, Wei-Hsian Yin, Yen-Wen Wu, Hao-Min Cheng, Shyi-Jang Shin, Chien-Ning Huang, Lee-Ming Chuang, Shing-Jong Lin, San-Jou Yeh, Wayne Huey-Herng Sheu, Jiunn-Lee Lin
The global incidence and prevalence of type 2 diabetes have been escalating in recent decades. Patients with type 2 diabetes have an increased risk of atherosclerotic cardiovascular disease (ASCVD). About two-thirds of death in type 2 diabetes are due to ASCVD, including 40% from coronary heart disease (CHD), 15% from heart failure (HF), and 10% from stroke. The association between hyperglycemia and elevated CV risk has been demonstrated in multiple cohort studies. However, clinical trials of intensive glucose reduction did not significantly reduce macrovascular outcomes...
February 13, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#4
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29411216/pharmacological-treatments-for-heart-failure-with-preserved-ejection-fraction-a-systematic-review-and-indirect-comparison
#5
REVIEW
Kwadwo Osei Bonsu, Poukwan Arunmanakul, Nathorn Chaiyakunapruk
Pharmacological interventions for heart failure with preserved ejection fraction (HFpEF) have failed to reduce mortality and hospitalization. Evidence for mineralocorticoid antagonists (MRAs), β-adrenoceptor blockers (β-blockers), and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs)-to reduce clinical outcomes in HFpEF remains unclear. We conducted a systematic search of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov for randomized controlled trials (RCTs) assessing pharmacological treatments in HFpEF diagnosed according the recommendations of the European Society of Cardiology (ESC) 2016 guidelines from inception to August, 2017...
February 7, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29366425/hypertriglyceridemia-common-causes-prevention-and-treatment-strategies
#6
Katarzyna Rygiel
Prevention and treatment of dyslipidemias represent the key issues of cardiovascular disease (CVD) prophylaxis, and thus, the effective management of different types of lipid disorders should be a priority for healthcare practitioners (primary care physicians, cardiology or endocrinology specialists, dietitians, and pharmacists), who provide medical care, and for patients, who receive this care, and should be engaged in it, to improve outcomes. The aim of this review is to facilitate translation of current trends in hypertriglyceridemia treatment to a daily patient management...
January 23, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29350511/a-cost-effectiveness-analysis-of-cardiology-econsults-for-medicaid-patients
#7
Daren Anderson, Victor Villagra, Emil N Coman, Ianita Zlateva, Alex Hutchinson, Jose Villagra, J Nwando Olayiwola
OBJECTIVES: To evaluate the cost-effectiveness of electronic consultations (eConsults) for cardiology compared with traditional face-to-face consults. STUDY DESIGN: Cost-effectiveness analysis for a subset of Medicaid-insured patients in a cluster-randomized trial of eConsults versus the traditional face-to-face consultation process in a statewide federally qualified health center. METHODS: A total of 369 Medicaid patients were referred for cardiology consultations by primary care providers who were randomly assigned to use either eConsults or their usual face-to-face referral process...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29343412/implementing-genome-driven-personalized-cardiology-in-clinical-practice
#8
REVIEW
Ares Pasipoularides
Genomics designates the coordinated investigation of a large number of genes in the context of a biological process or disease. It may be long before we attain comprehensive understanding of the genomics of common complex cardiovascular diseases (CVDs) such as inherited cardiomyopathies, valvular diseases, primary arrhythmogenic conditions, congenital heart syndromes, hypercholesterolemia and atherosclerotic heart disease, hypertensive syndromes, and heart failure with preserved/reduced ejection fraction. Nonetheless, as genomics is evolving rapidly, it is constructive to survey now pertinent concepts and breakthroughs...
January 16, 2018: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29338462/rethinking-revascularization-in-patients-with-stable-angina
#9
Ralf E Harskamp, Duk-Woo Park
Traditional and current perception for benefit of percutaneous coronary intervention (PCI) is that patients with stable angina will obtain symptom relief as well as improved exercise capacity after percutaneous revascularization. This common clinical perception is put to test in the ORBITA trial, the first blinded, randomized placebo-controlled clinical study ever conducted.Areas covered: Coronary artery disease, percutaneous coronary intervention, medical therapy.Expert Commentary: The authors found no significant improvement in exercise time, functional status, angina relief and quality of life in the PCI group compared with placebo...
January 21, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#10
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29300387/patient-understanding-of-satisfaction-with-and-perceived-utility-of-whole-genome-sequencing-findings-from-the-medseq-project
#11
J Scott Roberts, Jill O Robinson, Pamela M Diamond, Archana Bharadwaj, Kurt D Christensen, Kaitlyn B Lee, Robert C Green, Amy L McGuire
PurposeTo examine patients' experiences with clinical use of whole-genome sequencing (WGS).MethodsA randomized trial compared primary care and cardiology patients receiving WGS and family health history (FH) information or FH information alone. 202 patients were surveyed before (BL) and up to 6 months after disclosure of results (6M).ResultsPatients (mean age = 55 years; 50% female; 81% college graduates) reported low levels of decisional regret (mean: 7.1/100) and high satisfaction with physicians' disclosure of results (median: 29/30)...
January 4, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29274809/antihyperglycemic-and-metabolic-effects-of-ranolazine-in-patients-with-diabetes-mellitus
#12
REVIEW
Brian W Gilbert, Max Sherard, Lindsey Little, Joshua Branstetter, Amber Meister, Joel Huffman
The antianginal drug ranolazine, because of its unique mechanism of action, has been shown to have antihyperglycemic effects. Here, we review the reports on the antihyperglycemic and metabolic effects of ranolazine. MEDLINE was searched from 2000 to October 1, 2016 using the terms ranolazine, antihyperglycemic, diabetes, cardiology, and antianginal. Studies and reviews were included if they were in English and provided relevant data to inform practicing clinicians. Ranolazine has been shown to be effective as an antihyperglycemic while utilized as monotherapy or in combination with traditional diabetic regimens...
February 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29248657/comprehensive-cardiac-ct-with-myocardial-perfusion-imaging-versus-functional-testing-in-suspected-coronary-artery-disease-the-multicenter-randomized-crescent-ii-trial
#13
Marisa Lubbers, Adriaan Coenen, Marcel Kofflard, Tobias Bruning, Bas Kietselaer, Tjebbe Galema, Marc Kock, Andre Niezen, Marco Das, Marco van Gent, Ewout-Jan van den Bos, Leon van Woerkens, Paul Musters, Suze Kooij, Fay Nous, Ricardo Budde, Miriam Hunink, Koen Nieman
OBJECTIVES: This study sought to assess the effectiveness, efficiency, and safety of a tiered, comprehensive cardiac computed tomography (CT) protocol in comparison with functional testing. BACKGROUND: Although CT angiography accurately rules out coronary artery disease (CAD), incorporation of CT myocardial perfusion imaging as part of a tiered diagnostic approach could improve the clinical value and efficiency of cardiac CT in the diagnostic work-up of patients with angina pectoris...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29208494/bleeding-in-advanced-ckd-patients-on-antithrombotic-medication-a-critical-appraisal
#14
Alexandru Burlacu, Simonetta Genovesi, David Goldsmith, Patrick Rossignol, Alberto Ortiz, Philip A Kalra, Jolanta Małyszko, Maciej Banach, Mehmet Kanbay, Adrian Covic
Patients with advanced chronic kidney disease (CKD) are at an increased risk of bleeding, especially in the context of the complex therapeutic schemes of coronary artery disease (CAD) (from stable angina to acute coronary syndromes), atrial fibrillation or venous thromboembolism. The bleeding issue increases morbidity and mortality, a serious problem in daily medical practice. However, these patients are largely excluded from major randomized clinical trials, which results in the lack of medical evidence-based foundation for specific recommendations regarding antithrombotic treatment in a high bleeding risk setting...
December 2, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29188357/-management-of-valvular-heart-disease-esc-eacts-guidelines-2017
#15
REVIEW
M Haude
After 5 years the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have released an update on the guidelines for the management of valvular heart diseases. In recent years published results of randomized trials in patients with aortic valve stenosis have resulted in updated recommendations for catheter-based prosthesis implantation (TAVI), which is now extended to patients presenting without a low risk for conventional surgical valve replacement. In mitral or tricuspid valvular disease, the recommendations for catheter-based therapies are less strong because of a lack of supportive scientific data...
December 2017: Herz
https://www.readbyqxmd.com/read/29185617/percutaneous-intervention-in-st-elevation-myocardial-infarction-culprit-only-or-complete-revascularization
#16
Ana Paula Susin Osório, Alexandre Schaan de Quadros, José Luiz da Costa Vieira, Vera Lucia Portal
The best approach of multivessel coronary artery disease in the context of acute myocardial infarction with ST segment elevation and primary percutaneous coronary intervention is one of the main reasons for controversy in cardiology. Although the main global guidelines do not recommend routine complete revascularization in these patients, recent randomized clinical trials have demonstrated benefit of this approach in reducing cardiovascular outcomes. For this reason, an adequate review of this evidence is essential in order to establish scientifically based strategy and achieve better outcomes for these patients who present with acute myocardial infarction...
November 27, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29182745/unmet-need-for-primary-prevention-in-individuals-with-hypertriglyceridaemia-not-eligible-for-statin-therapy-according-to-european-society-of-cardiology-european-atherosclerosis-society-guidelines-a-contemporary-population-based-study
#17
Christian M Madsen, Anette Varbo, Børge G Nordestgaard
Aims: To identify individuals at high risk of atherosclerotic cardiovascular disease (ASCVD), who are not definite statin eligible according to the 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines, based on high concentrations of plasma triglycerides. Methods and results: From the Copenhagen General Population Study (2003-2015) 58 547 individuals aged 40-65 and free of ASCVD, diabetes, and statin use at baseline were included...
November 22, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29169764/female-specific-survival-advantage-from-transcatheter-aortic-valve-implantation-over-surgical-aortic-valve-replacement-meta-analysis-of-the-gender-subgroups-of-randomised-controlled-trials-including-3758-patients
#18
Vasileios F Panoulas, Darrel P Francis, Neil Ruparelia, Iqbal S Malik, Andrew Chukwuemeka, Sayan Sen, Jonathan Anderson, Petros Nihoyannopoulos, Nilesh Sutaria, Edward L Hannan, Zaza Samadashvili, Paola D'Errigo, Gerhard Schymik, Roxana Mehran, Alaide Chieffo, Azeem Latib, Patrizia Presbitero, Julinda Mehilli, Anna Sonia Petronio, Marie-Claude Morice, Corrado Tamburino, Hans G H Thyregod, Martin Leon, Antonio Colombo, Ghada W Mikhail
Transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) is the first area of interventional cardiology where women are treated as often as men. In this analysis of the gender specific results of randomised controlled trials (RCTs) comparing TAVI with surgical aortic valve replacement (SAVR) we aimed to determine whether gender affects the survival comparison between TAVI and SAVR. We identified all RCTs comparing TAVI versus SAVR for severe AS and reporting 1 and/or 2year survival. Summary odds ratios (ORs) were obtained using a random-effects model...
January 1, 2018: International Journal of Cardiology
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
#19
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
https://www.readbyqxmd.com/read/29133355/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
REVIEW
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 13, 2017: Hypertension
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