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Cardiovascular outcome trials

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https://www.readbyqxmd.com/read/29915617/deprescribing-antihypertensive-treatment-in-nursing-home-patients-and-the-effect-on-blood-pressure
#1
Christine Gulla, Elisabeth Flo, Reidun Ls Kjome, Bettina S Husebo
Background: It is debatable whether treating multimorbid nursing home patients with antihypertensive drugs produces beneficial effects. Most cardiovascular guidelines promote treatment; few have advice on how to deprescribe when treatment may no longer be necessary. We investigated the effect of medication review on antihypertensive drug use and the association between cognition, blood pressure, and prescribing. Methods: From August 2014 to December 2015, 765 patients from 72 units (clusters) in 32 Norwegian nursing homes were included in a 4-month, multicentre, cluster-randomized, controlled trial, with 9-month follow-up...
April 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29914623/efficacy-of-tea-catechin-rich-beverages-to-reduce-abdominal-adiposity-and-metabolic-syndrome-risks-in-obese-and-overweight-subjects-a-pooled-analysis-of-6-human-trials
#2
REVIEW
Masanobu Hibi, Hideto Takase, Masaki Iwasaki, Noriko Osaki, Yoshihisa Katsuragi
This post hoc pooled analysis assessed the effectiveness of green tea catechins (GTC) to reduce the risk of metabolic syndrome (MetS) associated with abdominal fat reduction, because previous findings are unclear. Data were pooled from six human trials (n=921, 505 men) comparing the effects of GTC-containing beverages (540-588 mg GTC/beverage) and a placebo beverage. Outcome measures were abdominal fat [total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA)], and MetS risk. We estimated mean changes from baseline and calculated confidence intervals (CI) to assess reductions in abdominal fat accumulation and MetS improvement...
July 2018: Nutrition Research
https://www.readbyqxmd.com/read/29912999/implications-of-cardiovascular-outcomes-trials-in-type-2-diabetes-for-primary-care
#3
Jeff Unger
Patients with type 2 diabetes (T2D) are at a greater risk of cardiovascular (CV) morbidity and mortality than their counterparts without diabetes. Worsening glycemic control is associated with increasing risk of CV events and mortality, but glycemic control alone does not appear sufficient to improve CV outcomes. Furthermore, some glucose-lowering drugs have been associated with an increased risk of CV events. As a result, the US Food and Drug Administration (FDA) issued guidance in 2008 for the investigation of CV risk with new diabetes therapies...
June 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29912995/an-overview-of-the-burden-of-illness-and-the-role-of-once-weekly-glucagon-like-peptide-1-receptor-agonists-in-the-treatment-of-type-2-diabetes
#4
Stephen A Brunton
Type 2 diabetes (T2D) is a debilitating condition and more people are being diagnosed each year. T2D increases patients' risk of developing disabling micro- and macrovascular complications, significantly reduces patients' quality of life, and is a substantial global economic burden. The efficacy and safety of antihyperglycemic therapies have improved over the years and have increased the lifespan for these patients. Consequently, patients are living longer with the condition and the associated comorbidities, but with a lowered quality of life...
June 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29912924/hemodiafiltration-is-associated-with-reduced-inflammation-oxidative-stress-and-improved-endothelial-risk-profile-compared-to-high-flux-hemodialysis-in-children
#5
Ayşe Ağbaş, Nur Canpolat, Salim Çalışkan, Alev Yılmaz, Hakan Ekmekçi, Mark Mayes, Helen Aitkenhead, Franz Schaefer, Lale Sever, Rukshana Shroff
Randomized trials in adults have shown reduced all-cause and cardiovascular mortality on hemodiafiltration (HDF) compared to high-flux hemodialysis (HD), but the mechanisms leading to improved outcomes are not clear. We studied biomarkers of inflammation, oxidative stress, anti-oxidant capacity and endothelial dysfunction in 22 children (13 female, age 8-15 years). All children received HD for at least 3 months, and were then switched to HDF, keeping all dialysis related parameters and dialysis time constant...
2018: PloS One
https://www.readbyqxmd.com/read/29912422/age-and-outcomes-following-guided-de-escalation-of-antiplatelet-treatment-in-acute-coronary-syndrome-patients-undergoing-percutaneous-coronary-intervention-results-from-the-randomized-tropical-acs-trial
#6
Dirk Sibbing, Lisa Gross, Dietmar Trenk, Claudius Jacobshagen, Tobias Geisler, Martin Hadamitzky, Béla Merkely, Róbert Gábor Kiss, András Komócsi, Radoslaw Parma, Stephan B Felix, Franz-Josef Neumann, Jörg Hausleiter, Monika Baylacher, Lukasz Koltowski, Julinda Mehilli, Kurt Huber, Zenon Huczek, Dániel Aradi, Steffen Massberg
Aims: Guided de-escalation of P2Y12-inhibitor treatment was recently identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention. Safety and efficacy of this strategy may differ in relation to patient's age. This pre-specified analysis of the TROPICAL-ACS trial aimed to assess the impact of age on clinical outcomes following guided de-escalation of antiplatelet treatment in ACS patients. Methods and results: Patients were randomly assigned in a 1:1 fashion to either standard treatment with prasugrel for 12 months (control group) or to a guided de-escalation regimen (1 week prasugrel followed by 1 week clopidogrel and platelet function testing guided maintenance therapy with clopidogrel or prasugrel from day 14 after hospital discharge; guided de-escalation group)...
June 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29911393/renal-and-cardiac-implications-of-sodium-glucose-cotransporter-2-sglt2-inhibitors-the-state-of-the-science
#7
Joseph E Cruz, Tania Ahuja, Mary Barna Bridgeman
OBJECTIVE: To review the role of the sodium-glucose cotransporter-2 (SGLT2) inhibitors in the management of type 2 diabetes (T2DM), including the effects on renal and cardiovascular (CV) outcomes. DATA SOURCES: A literature search of MEDLINE databases (1964 through May 2018) was conducted utilizing key words sodium-glucose co-transporter-2 inhibitors, SGLT2 inhibitors, and diabetes; additional limits for drug names were added. STUDY SELECTION AND DATA EXTRACTION: Available English-language data from reviews, abstracts, presentations, and clinical trials of use of SGLT2 therapy specifically detailing outcomes on CV and renal disease in humans were reviewed...
June 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29910605/role-of-etelcalcetide-in-the-management-of-secondary-hyperparathyroidism-in-hemodialysis-patients-a-review-on-current-data-and-place-in-therapy
#8
REVIEW
Claudia Friedl, Emanuel Zitt
Secondary hyperparathyroidism (sHPT) is a frequently occurring severe complication of advanced kidney disease. Its clinical consequences include extraskeletal vascular and valvular calcifications, changes in bone metabolism resulting in renal osteodystrophy, and an increased risk of cardiovascular morbidity and mortality. Calcimimetics are a cornerstone of parathyroid hormone (PTH)-lowering therapy, as confirmed by the recently updated 2017 Kidney Disease: Improving Global Outcomes chronic kidney disease - mineral and bone disorder clinical practice guidelines...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29910068/leisure-time-physical-activity-at-moderate-and-high-intensity-is-associated-with-parameters-of-body-composition-muscle-strength-and-sarcopenia-in-aged-adults-with-obesity-and-metabolic-syndrome-from-the-predimed-plus-study
#9
Nuria Rosique-Esteban, Nancy Babio, Andrés Díaz-López, Dora Romaguera, J Alfredo Martínez, Vicente Martin Sanchez, Helmut Schröder, Ramón Estruch, Josep Vidal, Pilar Buil-Cosiales, Jadwiga Konieczna, Itziar Abete, Jordi Salas-Salvadó
AIMS: We aimed to examine the associations of leisure-time physical activity (PA) and sedentary behavior (SB) with the prevalence of sarcopenia, body composition and muscle strength among older adults having overweight/obesity and metabolic syndrome, from the PREDIMED-Plus trial. METHODS: Cross-sectional baseline analysis including 1539 men and women (65 ± 5 y). Sarcopenia was defined as low muscle mass (according to FNIH cut-offs) plus low muscle strength (lowest sex-specific tertile for 30-s chair-stand test)...
June 6, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29910056/rationale-and-design-of-the-seneca-stem-cell-injection-in-cancer-survivors-trial
#10
Roberto Bolli, Joshua M Hare, Timothy D Henry, Carrie G Lenneman, Keith L March, Kathy Miller, Carl J Pepine, Emerson C Perin, Jay H Traverse, James T Willerson, Phillip C Yang, Adrian P Gee, João A Lima, Lem Moyé, Rachel W Vojvodic, Shelly L Sayre, Judy Bettencourt, Michelle Cohen, Ray F Ebert, Robert D Simari
OBJECTIVES: SENECA (StEm cell iNjECtion in cAncer survivors) is a phase I, randomized, double-blind, placebo-controlled study to evaluate the safety and feasibility of delivering allogeneic mesenchymal stromal cells (allo-MSCs) transendocardially in subjects with anthracycline-induced cardiomyopathy (AIC). BACKGROUND: AIC is an incurable and often fatal syndrome, with a prognosis worse than that of ischemic or nonischemic cardiomyopathy. Recently, cell therapy with MSCs has emerged as a promising new approach to repair damaged myocardium...
July 2018: American Heart Journal
https://www.readbyqxmd.com/read/29909156/high-dose-influenza-vaccine-to-reduce-clinical-outcomes-in-high-risk-cardiovascular-patients-rationale-and-design-of-the-invested-trial
#11
Orly Vardeny, Jacob A Udell, Jacob Joseph, Michael E Farkouh, Adrian F Hernandez, Alison J McGeer, H Keipp Talbot, Deepak L Bhatt, Christopher P Cannon, Shaun G Goodman, Inder Anand, David L DeMets, Jon Temte, Janet Wittes, Kristin Nichol, Clyde W Yancy, J Michael Gaziano, Lawton S Cooper, KyungMann Kim, Scott D Solomon
BACKGROUND: Influenza leads to significant cardiopulmonary morbidity and mortality-particularly in patients with cardiovascular disease-that may be prevented with a standard influenza vaccine. However, patients with cardiovascular conditions have a reduced immune response to influenza vaccine, potentially resulting in reduced effectiveness for preventing clinical events. High-dose vaccine augments immune response in cardiac patients, suggesting that a high-dose influenza vaccination strategy may further reduce morbidity and mortality...
May 23, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29909105/rationale-and-design-of-the-strain-surveillance-of-chemotherapy-for-improving-cardiovascular-outcomes-succour-trial
#12
Tomoko Negishi, Paaladinesh Thavendiranathan, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to evaluate the hypothesis that global longitudinal strain (GLS) guidance of cardioprotective therapy would improve cardiac function of at-risk patients undergoing potentially cardiotoxic chemotherapy, compared with usual care. BACKGROUND: The conventional criteria for diagnosis of chemotherapy-related cardiac dysfunction (CTRCD) are dependent on the recognition of heart failure symptoms and/or changes in left ventricular ejection fraction...
June 8, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29908826/intramyocardial-autologous-cd34-cell-therapy-for-refractory-angina-a-meta-analysis-of-randomized-controlled-trials
#13
Poonam Velagapudi, Mohit Turagam, Dhaval Kolte, Sahil Khera, Omar Hyder, Paul Gordon, Herbert D Aronow, Jane Leopold, J Dawn Abbott
BACKGROUND: Previous studies have demonstrated that intramyocardial human CD34+ cells may relieve symptoms and improve clinical outcomes in chronic refractory angina unresponsive to optimal medical therapy or not amenable to revascularization. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of human CD34+ cells compared with placebo in chronic refractory angina. Primary efficacy outcomes in our analysis were angina frequency and exercise time...
June 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29908669/safety-and-efficacy-of-upadacitinib-in-patients-with-rheumatoid-arthritis-and-inadequate-response-to-conventional-synthetic-disease-modifying-anti-rheumatic-drugs-select-next-a-randomised-double-blind-placebo-controlled-phase-3-trial
#14
Gerd R Burmester, Joel M Kremer, Filip Van den Bosch, Alan Kivitz, Louis Bessette, Yihan Li, Yijie Zhou, Ahmed A Othman, Aileen L Pangan, Heidi S Camp
BACKGROUND: Upadacitinib is a selective inhibitor of Janus kinase 1 and was efficacious in phase 2 studies in patients with moderate-to-severe rheumatoid arthritis. We aimed to assess the efficacy of upadacitinib in patients with inadequate response to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). METHODS: This study is a double-blind, placebo-controlled trial at 150 sites in 35 countries. We enrolled patients aged 18 years or older with active rheumatoid arthritis for 3 months or longer, who had received csDMARDs for at least 3 months with a stable dose for at least 4 weeks before study entry, and had an inadequate response to at least one of the following csDMARDs: methotrexate, sulfasalazine, or leflunomide...
June 12, 2018: Lancet
https://www.readbyqxmd.com/read/29907363/critical-roles-of-inflammation-in-atherosclerosis
#15
REVIEW
Junji Moriya
There is accumulating evidence that vascular inflammation plays critical roles in pathophysiology of atherosclerosis. It is widely accepted that both innate and adaptive immune responses are important for initiation and progression of atherosclerosis, which mainly consist of monocytes, macrophages, neutrophils, T lymphocytes, and B lymphocytes. Moreover, inflammatory biomarkers such as high-sensitivity C-reactive protein and interleukin-6 are known to predict future cardiovascular events, as well as conventional low-density or high-density lipoprotein cholesterol...
June 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29906425/diastolic-hypotension-may-attenuate-benefits-from-intensive-systolic-targets-secondary-analysis-of-a-randomized-controlled-trial
#16
Todd C Lee, Rodrigo B Cavalcanti, Emily G McDonald, Louise Pilote, James M Brophy
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) was a randomized controlled trial which studied 9361 adults aged 50 and older with systolic blood pressure above 130mmHg and one or more cardiovascular risk factor. Patients were randomized to intensive (≤ 120mmHg) or standard (≤ 140mmHg) systolic targets. In August 2016, a limited dataset was released for secondary analysis. We hypothesized that excessive lowering of diastolic blood pressure could cause harm. Using the data from SPRINT, we sought to determine whether the development of diastolic hypotension during treatment was associated with adverse outcomes...
June 12, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29905854/comparison-of-temporary-ventricular-assist-devices-and-extracorporeal-life-support-in-post-cardiotomy-cardiogenic-shock
#17
Prashant N Mohite, Anton Sabashnikov, Achim Koch, Raj Binu, Ashok Padukone, Sundip Kaul, Olaf Maunz, Diana García-Sáez, Bartlomiej Zych, Mubassher Husain, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVES: Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support (MCS). The aim of the study was to compare extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) utilized in the management of PCCS. METHODS: In total, 56 consecutive patients who developed PCCS from 2005 to 2014 required MCS as a bridge to decision-24 were supported with a VAD and 32 with an ECMO...
June 13, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29904777/science-behind-the-cardio-metabolic-benefits-of-omega-3-polyunsaturated-fatty-acids-biochemical-effects-vs-clinical-outcomes
#18
REVIEW
Rohith N Thota, Jessica J A Ferguson, Kylie A Abbott, Cintia B Dias, Manohar L Garg
Lower incidence of cardiovascular disease (CVD) in the Greenland Inuit, Northern Canada and Japan has been attributed to their consumption of seafood rich in long chain omega-3 polyunsaturated fatty acids (LCn-3PUFA). While a large majority of pre-clinical and intervention trials have demonstrated heart health benefits of LCn-3PUFA, some studies have shown no effects or even negative effects. LCn-3PUFA have been shown to favourably modulate blood lipid levels, particularly a reduction in circulating levels of triglycerides...
June 15, 2018: Food & Function
https://www.readbyqxmd.com/read/29904449/red-cell-distribution-width-and-mortality-in-patients-with-acute-coronary-syndrome-a-meta-analysis-on-prognosis
#19
Lauro L Abrahan, John Daniel A Ramos, Elleen L Cunanan, Marc Denver A Tiongson, Felix Eduardo R Punzalan
Background: Red cell distribution width (RDW), a routine component of the complete blood count (CBC), measures variation in the size of circulating erythrocytes. It has been associated with several clinical outcomes in cardiovascular disease. We sought to strengthen the association between RDW and mortality in patients admitted for acute coronary syndrome (ACS) by pooling together data from available studies. Methods: Studies that fulfilled the following were identified for analysis: 1) observational; 2) included patients admitted for ACS; 3) reported data on all-cause or cardiovascular (CV) mortality in association with a low or high RDW; and 4) used logistic regression analysis to control for confounders...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29904350/unique-contribution-of-haptoglobin-and-haptoglobin-genotype-in-aneurysmal-subarachnoid-hemorrhage
#20
REVIEW
Spiros L Blackburn, Peeyush T Kumar, Devin McBride, Hussein A Zeineddine, Jenna Leclerc, H Alex Choi, Pramod K Dash, James Grotta, Jaroslaw Aronowski, Jessica C Cardenas, Sylvain Doré
Survivors of cerebral aneurysm rupture are at risk for significant morbidity and neurological deficits. Much of this is related to the effects of blood in the subarachnoid space which induces an inflammatory cascade with numerous downstream consequences. Recent clinical trials have not been able to reduce the toxic effects of free hemoglobin or improve clinical outcome. One reason for this may be the inability to identify patients at high risk for neurologic decline. Recently, haptoglobin genotype has been identified as a pertinent factor in diabetes, sickle cell, and cardiovascular disease, with the Hp 2-2 genotype contributing to increased complications...
2018: Frontiers in Physiology
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