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Cardiovascular outcome trials

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https://www.readbyqxmd.com/read/28340216/meta-analysis-of-statins-in-chronic-kidney-disease-who-benefits
#1
C M Messow, C Isles
Background: Attempts to reduce the burden of vascular disease in advanced chronic kidney disease (CKD) by control of lipids have not been as successful as predicted. Aim: : To determine the extent to which the effectiveness of statins varies by kidney class. Design: Meta-analysis. Methods: We selected randomized trials of statin vs. placebo that gave outcomes for CKD3 (eGFR 30-59 ml/min), CKD4 (eGFR 15-29 ml/min), CKD5 (eGFR < 15 ml/min)/5D(dialysis) and transplant patients separately...
March 14, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28339883/interventions-to-improve-immigrant-health-a-scoping-review
#2
Esperanza Diaz, Gaby Ortiz-Barreda, Yoav Ben-Shlomo, Michelle Holdsworth, Bukola Salami, Anu Rammohan, Roger Yat-Nork Chung, Sabu S Padmadas, Thomas Krafft
: Disparities in health between immigrants and their host populations have been described across countries and continents. Hence, interventions for improving health targeting general populations are not necessarily effective for immigrants. To conduct a systematic search of the literature evaluating health interventions for immigrants; to map the characteristics of identified studies including range of interventions, immigrant populations and their host countries, clinical areas targeted and reported evaluations, challenges and limitations of the interventions identified...
February 27, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28335038/a-comparative-effectiveness-education-trial-for-lifestyle-health-behavior-change-in-african-americans
#3
Chanita Hughes Halbert, Scarlett Bellamy, Vanessa Briggs, Ernestine Delmoor, Joseph Purnell, Rodney Rogers, Benita Weathers, Jerry C Johnson
Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. Outcomes variables were physical activity (PA) and fruit and vegetable intake. Outcomes were evaluated at baseline and 1-month following interventions about shared risk factors for cancer and cardiovascular disease (CVD) (integrated, INT) or CVD only (disease-specific)...
March 18, 2017: Health Education Research
https://www.readbyqxmd.com/read/28334220/effect-of-vitamin-d-deficiency-in-developed-countries
#4
Zaki K Hassan-Smith, Martin Hewison, Neil J Gittoes
Introduction: Vitamin D deficiency is common worldwide with adverse effects on skeletal health. In recent years, there has been great interest in non-classical actions of vitamin D. Basic research has uncovered actions in a range of non-skeletal tissues, and observational studies have identified inverse relationships with risk of a number of disease states including sarcopenia, obesity, the metabolic syndrome, cardiovascular disease, cancer and autoimmune diseases. Sources of data: PubMed, Medline and Cochrane Systematic Reviews...
March 9, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28333114/inflammatory-cytokines-as-uremic-toxins-ni-son-todos-los-que-estan-ni-estan-todos-los-que-son
#5
REVIEW
Esmeralda Castillo-Rodríguez, Soledad Pizarro-Sánchez, Ana B Sanz, Adrian M Ramos, Maria Dolores Sanchez-Niño, Catalina Martin-Cleary, Beatriz Fernandez-Fernandez, Alberto Ortiz
Chronic kidney disease is among the fastest growing causes of death worldwide. An increased risk of all-cause and cardiovascular death is thought to depend on the accumulation of uremic toxins when glomerular filtration rate falls. In addition, the circulating levels of several markers of inflammation predict mortality in patients with chronic kidney disease. Indeed, a number of cytokines are listed in databases of uremic toxins and uremic retention solutes. They include inflammatory cytokines (IL-1β, IL-18, IL-6, TNFα), chemokines (IL-8), and adipokines (adiponectin, leptin and resistin), as well as anti-inflammatory cytokines (IL-10)...
March 23, 2017: Toxins
https://www.readbyqxmd.com/read/28332871/sodium-glucose-cotransporter-2-and-dipeptidyl-peptidase-4-inhibition-promise-of-a-dynamic-duo
#6
Ildiko Lingvay
OBJECTIVE: This article reviews evidence supporting sodium glucose cotransporter 2 (SGLT2) inhibitor and dipeptidyl peptidase-4 (DPP-4) inhibitor combination therapy for management of type 2 diabetes mellitus (T2DM). METHODS: We conducted a non-systematic review of the literature focusing on single-pill or fixed-dose combinations of SGLT2 inhibitors and DPP-4 inhibitors available in the United States. RESULTS: SGLT2 inhibitors and DPP-4 inhibitors have complementary mechanisms of action that address several of the underlying pathophysiological abnormalities present in T2DM without overlapping toxicities...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28330458/the-effects-of-an-extensive-exercise-programme-on-the-progression-of-mild-cognitive-impairment-mci-study-protocol-for-a-randomised-controlled-trial
#7
Kate E Devenney, Brian Lawlor, Marcel G M Olde Rikkert, Stefan Schneider
BACKGROUND: Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI...
March 22, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28329340/baseline-characteristics-of-participants-in-the-aspree-aspirin-in-reducing-events-in-the-elderly-study
#8
John J McNeil, Robyn L Woods, Mark R Nelson, Anne M Murray, Christopher M Reid, Brenda Kirpach, Elsdon Storey, Raj C Shah, Rory S Wolfe, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Jessica E Lockery, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Ruth E Trevaks, Suzanne G Orchard, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Richard H Grimm
Background: There are no primary prevention trials of aspirin with relevant geriatric outcomes in elderly people. ASPirin in Reducing Events in the Elderly (ASPREE) is a placebo-controlled trial of low-dose aspirin that will determine whether 5 years of daily 100-mg enteric-coated aspirin extends disability-free and dementia-free life in a healthy elderly population and whether these benefits outweigh the risks. Methods: Set in primary care, this randomized double-blind placebo-controlled trial has a composite primary endpoint of death, incident dementia or persistent physical disability...
January 20, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329241/lipoprotein-a-the-revenant
#9
Baris Gencer, Florian Kronenberg, Erik S Stroes, François Mach
In the mid-1990s, the days of lipoprotein(a) [Lp(a)] were numbered and many people would not have placed a bet on this lipid particle making it to the next century. However, genetic studies brought Lp(a) back to the front-stage after a Mendelian randomization approach used for the first time provided strong support for a causal role of high Lp(a) concentrations in cardiovascular disease and later also for aortic valve stenosis. This encouraged the use of therapeutic interventions to lower Lp(a) as well numerous drug developments, although these approaches mainly targeted LDL cholesterol, while the Lp(a)-lowering effect was only a 'side-effect'...
February 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329235/improving-public-health-by-improving-clinical-trial-guidelines-and-their-application
#10
Martin J Landray, Jeroen J Bax, Laurence Alliot, Marc Buyse, Adam Cohen, Rory Collins, Gerhard Hindricks, Stefan K James, Sile Lane, Aldo P Maggioni, Ann Meeker-O'Connell, Gunnar Olsson, Stuart J Pocock, Michael Rawlins, Jonathan Sellors, Kaori Shinagawa, Karin R Sipido, Liam Smeeth, Richard Stephens, Murray W Stewart, Wendy Gattis Stough, Fergus Sweeney, Frans Van de Werf, Kerrie Woods, Barbara Casadei
Evidence generated from randomized controlled trials forms the foundation of cardiovascular therapeutics and has led to the adoption of numerous drugs and devices that prolong survival and reduce morbidity, as well as the avoidance of interventions that have been shown to be ineffective or even unsafe. Many aspects of cardiovascular research have evolved considerably since the first randomized trials in cardiology were conducted. In order to be large enough to provide reliable evidence about effects on major outcomes, cardiovascular trials may now involve thousands of patients recruited from hundreds of clinical sites in many different countries...
March 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329095/congestive-heart-failure-more-common-as-well-as-an-important-cardiovascular-outcome
#11
Anil Pareek
Hydroxychloroquine, due to its multifaceted pleiotropic benefits including anti-inflammatory effects has great potential in reducing cardiovascular (CV) morbidity and mortality. CV outcome data of hydroxychloroquine is available through 2 retrospective studies in rheumatoid arthritis patients, both of which have not considered congestive heart failure (CHF) as an outcome measure. CHF is an important CV outcome and is more common than myocardial infarction and stroke; and increased age is associated with increased risk of CHF...
December 20, 2016: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28328833/drug-coated-balloon-in-combination-with-bare-metal-stent-strategy-for-de-novo-coronary-artery-disease-a-prisma-compliant-meta-analysis-of-randomized-clinical-trials
#12
Wenjie Lu, Yongjian Zhu, Zhanying Han, Xi Wang, Xule Wang, Chunguang Qiu
BACKGROUND: Studies examining the efficiency of drug-coated balloon (DCB) + bare metal stent (BMS) compared with stents alone for de novo lesions have reported inconsistent results. The present comprehensive meta-analysis of randomized controlled trials (RCTs) assessed and compared the clinical efficacy and safety of DCB + BMS with those of stents alone for de novo coronary artery disease. METHODS: We formally searched electronic databases before September 2016 to identify potential studies...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#13
Ganesh Ramanathan, John K Olynyk, Paolo Ferrari
Absolute or functional iron (Fe) deficiency is an important determinant of anemia in hemodialysis patients and parenteral Fe is routinely used to treat this condition in conjunction with erythropoiesis stimulating agents. While restoration of hemoglobin toward the target range is a good outcome of Fe replacement, it is well known that Fe overload and toxicity may be adverse consequences of this therapy. Dialysis clinical practice guidelines recommend tailoring Fe therapy based on transferrin saturation and serum ferritin levels...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28327186/clinical-behavioural-and-pharmacogenomic-factors-influencing-the-response-to-levothyroxine-therapy-in-patients-with-primary-hypothyroidism-protocol-for-a-systematic-review
#14
Rosie Dew, Onyebuchi Okosieme, Colin Dayan, Vinay Eligar, Ishrat Khan, Salman Razvi, Simon Pearce, Scott Wilkes
BACKGROUND: Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism...
March 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28325713/two-decades-of-cardiovascular-trials-with-primary-surrogate-endpoints-1990-2011
#15
Behnood Bikdeli, Natdanai Punnanithinont, Yasir Akram, Ike Lee, Nihar R Desai, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Surrogate endpoint trials test strategies more efficiently but are accompanied by uncertainty about the relationship between changes in surrogate markers and clinical outcomes. METHODS AND RESULTS: We identified cardiovascular trials with primary surrogate endpoints published in the New England Journal of Medicine, Lancet, and JAMA: Journal of the American Medical Association from 1990 to 2011 and determined the trends in publication of surrogate endpoint trials and the success of the trials in meeting their primary endpoints...
March 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28325524/current-status-of-lipid-management-in-acute-coronary-syndrome
#16
REVIEW
Koichiro Fujisue, Kenichi Tsujita
The development of coronary revascularization has dramatically improved early cardiovascular outcomes in patients with acute coronary syndrome (ACS). However, patients who have experienced myocardial infarction (MI) are at high risk of recurrence of cardiovascular events compared with those who are healthy or have stable coronary artery disease. Acute coronary events induce further inflammatory responses and plaque vulnerability in either a coronary culprit or whole vessels. The majority of data have supported the importance of coronary risk management to prevent secondary events...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28325140/vitamins-in-heart-failure-friend-or-enemy
#17
George Georgiopoulos, Christina Chrysohoou, Georgia Vogiatzi, Nikolaos Magkas, Ippokratis Bournelis, Sofia Bampali, Damien Gruson, Dimitris Tousoulis
BACKGROUND: The failing heart is characterized by a depleted metabolic energy reserve and the up-regulation of several molecular mechanisms leading to cardiac hypertrophy, inflammation, fibrosis, angiogenesis, and apoptosis. Dietary or non-dietary supplementation of vitamins could potentially benefit energy balance. OBJECTIVE: The objective of the present study was to evaluate all available information on vitamins supplementation in patients with chronic HF for possible beneficial effect on metabolic, inotropic, chronotropic and hemodynamic indices...
March 20, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28324484/sodium-glucose-co-transporter-2-sglt2-inhibitor-comparing-trial-data-and-real-world-use
#18
Andrew McGovern, Michael Feher, Neil Munro, Simon de Lusignan
INTRODUCTION: The first cardiovascular safety trial in the sodium-glucose co-transporter-2 (SGLT2) inhibitor drug class, the Empagliflozin Cardiovascular Outcomes and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) trial, demonstrated significant cardiovascular risk reduction with empagliflozin. It is currently not clear what proportions of people with type 2 diabetes (T2DM) have the same high cardiovascular risk as those included in the trial, and will therefore be likely to experience the same cardiovascular benefit...
March 21, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28323949/plasma-arginine-asymmetric-dimethylarginine-ratio-and-incidence-of-cardiovascular-events-a-case-cohort-study
#19
Edward Yu, Miguel Ruiz-Canela, Frank B Hu, Clary B Clish, Dolores Corella, Jordi Salas-Salvadó, Adela Hruby, Montserrat Fitó, Liming Liang, Estefania Toledo, Emilio Ros, Ramón Estruch, Enrique Gómez-Gracia, Jose Lapetra, Fernando Arós, Dora Romaguera, Lluís Serra-Majem, Marta Guasch-Ferré, Dong D Wang, Miguel A Martínez-González
CONTEXT: Arginine, its methylated metabolites and other metabolites related to the urea cycle have been independently associated with cardiovascular risk, but the potential causal meaning of these associations (positive for some metabolites and negative for others) remains elusive due to a lack of studies measuring metabolite changes over time. OBJECTIVE: To examine the association between baseline and 1-year concentrations of urea cycle metabolites and cardiovascular disease in a case-cohort setting...
March 2, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323625/the-effects-of-stretching-training-on-cardiac-autonomic-function-in-obese-postmenopausal-women
#20
Alexei Wong, Marcos Sanchez-Gonzalez, Roy Kalfon, Stacey Alvarez-Alvarado, Arturo Figueroa
Context • Menopause and obesity are associated with autonomic dysfunction. Unconventional exercise modalities that include an important flexibility component seem to improve cardiac autonomic function by lowering sympathetic tone and increasing vagal modulation of the heart rate (HR). Yet clear evidence of the effects of stretching training (ST) on cardiac autonomic modulation is limited. Objective • The present study intended to examine the effects of ST on HR variability (HRV) and flexibility in obese postmenopausal women...
March 2017: Alternative Therapies in Health and Medicine
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