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Randomized trials in cardiology

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https://www.readbyqxmd.com/read/29664530/-clinical-practice-guidelines-for-smoking-cessation
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/29578921/updated-clinical-indications-for-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis-expert-opinion-of-the-italian-society-of-cardiology-and-gise
#6
Ciro Indolfi, Antonio L Bartorelli, Sergio Berti, Paolo Golino, Giovanni Esposito, Giuseppe Musumeci, Sonia Petronio, Corrado Tamburino, Giuseppe Tarantini, Gianpaolo Ussia, Corrado Vassanelli, Carmen Spaccarotella, Roberto Violini, Giuseppe Mercuro, Francesco Romeo
: The introduction of percutaneous treatment of severe aortic stenosis with transcatheter aortic valve implantation (TAVI) remains one of the greatest achievements of interventional cardiology. In fact, TAVI emerged as a better option than either medical therapy or balloon aortic valvuloplasty for patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high surgical risk. Recently, increased operator experience and improved device systems have led to a worldwide trend toward the extension of TAVI to low-risk or intermediate-risk patients...
May 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29565423/short-term-costs-of-integrating-whole-genome-sequencing-into-primary-care-and-cardiology-settings-a-pilot-randomized-trial
#7
Kurt D Christensen, Jason L Vassy, Kathryn A Phillips, Carrie L Blout, Danielle R Azzariti, Christine Y Lu, Jill O Robinson, Kaitlyn Lee, Michael P Douglas, Jennifer M Yeh, Kalotina Machini, Natasha K Stout, Heidi L Rehm, Amy L McGuire, Robert C Green, Dmitry Dukhovny
PurposeGreat uncertainty exists about the costs associated with whole-genome sequencing (WGS).MethodsOne hundred cardiology patients with cardiomyopathy diagnoses and 100 ostensibly healthy primary care patients were randomized to receive a family-history report alone or with a WGS report. Cardiology patients also reviewed prior genetic test results. WGS costs were estimated by tracking resource use and staff time. Downstream costs were estimated by identifying services in administrative data, medical records, and patient surveys for 6 months...
March 22, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29532297/the-impact-of-automated-notification-on-follow-up-of-actionable-tests-pending-at-discharge-a-cluster-randomized-controlled-trial
#8
Anuj K Dalal, Adam Schaffer, Esteban F Gershanik, Ranganath Papanna, Katyuska Eibensteiner, Nyryan V Nolido, Cathy S Yoon, Deborah Williams, Stuart R Lipsitz, Christopher L Roy, Jeffrey L Schnipper
BACKGROUND: Follow-up of tests pending at discharge (TPADs) is poor. We previously demonstrated a twofold increase in awareness of any TPAD by attendings and primary care physicians (PCPs) using an automated email intervention OBJECTIVE: To determine whether automated notification improves documented follow-up for actionable TPADs DESIGN: Cluster-randomized controlled trial SUBJECTS: Attendings and PCPs caring for adult patients discharged from general medicine and cardiology services with at least one actionable TPAD between June 2011 and May 2012 INTERVENTION: An automated system that notifies discharging attendings and network PCPs of finalized TPADs by email MAIN MEASURES: The primary outcome was the proportion of actionable TPADs with documented action determined by independent physician review of the electronic health record (EHR)...
March 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29502793/a-meta-analysis-comparing-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-disease
#9
Vamsi Kodumuri, Senthil Balasubramanian, Aviral Vij, Sisir Siddamsetti, Ankur Sethi, Rommy Khalafallah, Sandeep Khosla
Coronary artery bypass grafting (CABG) is the preferred revascularization strategy for unprotected left main disease (UPLMD). Multiple small-scale trials and registry data showed that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is a noninferior strategy with a Class IIa American College of Cardiology/American Heart Association recommendation in patients with high surgical risk and favorable anatomy. However, 2 recent large-scale randomized trials showed conflicting evidence. We conducted a meta-analysis of the existing data to compare outcomes of PCI with DES versus CABG for UPLMD...
January 31, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29483397/drug-eluting-balloon-versus-new-generation-drug-eluting-stent-for-the-treatment-of-in-stent-restenosis-an-updated-systematic-review-and-meta-analysis
#10
Kong-Yong Cui, Shu-Zheng Lyu, Min Zhang, Xian-Tao Song, Fei Yuan, Feng Xu
Background: Currently, drug-eluting balloon (DEB) appears to be an attractive alternative option for the treatment of in-stent restenosis (ISR). Nevertheless, the clinical outcomes of DEB have seldom been compared to those of new-generation drug-eluting stent (DES). Thus, this meta-analysis aimed to evaluate the safety and efficacy of DEB compared to those of new-generation DES in the treatment of ISR. Methods: A comprehensive search of electronic databases including PubMed, EMBASE, and Cochrane Library up to November 2, 2017 was performed to identify pertinent articles comparing DEB to new-generation DES for the treatment of ISR...
March 5, 2018: Chinese Medical Journal
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
#11
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
#12
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
#13
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
#14
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
#15
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...
March 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29366425/hypertriglyceridemia-common-causes-prevention-and-treatment-strategies
#16
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
#17
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
#18
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
#19
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...
March 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
#20
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
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