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Cardiovascular outcome trials

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https://www.readbyqxmd.com/read/29471572/-cardiovascular-medication-in-elderly-patients
#1
Robert H G Schwinger
Elderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure - most often following coronary heart disease - as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29470410/the-evolving-role-of-multivitamin-multimineral-supplement-use-among-adults-in-the-age-of-personalized-nutrition
#2
REVIEW
Jeffrey B Blumberg, Regan L Bailey, Howard D Sesso, Cornelia M Ulrich
Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS) are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition...
February 22, 2018: Nutrients
https://www.readbyqxmd.com/read/29470367/what-are-the-cardiovascular-effects-of-the-newer-classes-of-drugs-for-type-2-diabetes
#3
Jean Covino, Jennifer Hoffman
New classes of drugs to treat type 2 diabetes are continually being developed and marketed. The FDA has issued guidance to the pharmaceutical industry that newer hypoglycemic agents should not be associated with unacceptable increases in cardiovascular risk. To date, five trials have assessed specific cardiovascular endpoints for these newer agents. Empagliflozin and liraglutide have been found to improve cardiovascular outcomes.
March 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29468529/right-ventricular-dysfunction-and-its-contribution-to-morbidity-and-mortality-in-left-ventricular-heart-failure
#4
REVIEW
Amresh Raina, Talha Meeran
PURPOSE: In patients with left-sided HF, there has been less emphasis on the pathophysiology of the RV in terms of diagnostic evaluation and treatment, versus focus on structural abnormalities of the LV. This review seeks to delineate the importance of RV dysfunction in terms of its contribution to symptomatic limitations and cardiovascular outcomes in patients with left-sided HF. RECENT FINDINGS: Recent studies have demonstrated that RV dysfunction is common in both HFpEF and HFrEF, but more pronounced in HFrEF...
February 21, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29467161/outcomes-of-non-invasive-diagnostic-modalities-for-the-detection-of-coronary-artery-disease-network-meta-analysis-of-diagnostic-randomised-controlled-trials
#5
George Cm Siontis, Dimitris Mavridis, John P Greenwood, Bernadette Coles, Adriani Nikolakopoulou, Peter Jüni, Georgia Salanti, Stephan Windecker
OBJECTIVE: To evaluate differences in downstream testing, coronary revascularisation, and clinical outcomes following non-invasive diagnostic modalities used to detect coronary artery disease. DESIGN: Systematic review and network meta-analysis. DATA SOURCES: Medline, Medline in process, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, SCOPUS, WHO International Clinical Trials Registry Platform, and Clinicaltrials.gov...
February 21, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29467030/drug-discontinuation-before-contrast-procedures-and-the-effect-on-acute-kidney-injury-and-other-clinical-outcomes-a-systematic-review-protocol
#6
Swapnil Hiremath, Jeanne Françoise Kayibanda, Benjamin J W Chow, Dean Fergusson, Greg A Knoll, Wael Shabana, Brianna Lahey, Olivia McBride, Alexandra Davis, Ayub Akbari
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is defined as worsening of renal function after the administration of iodinated contrast material. In patients with cardiovascular disease, kidney disease, and/or diabetes, renin-angiotensin system blockers, non-steroidal anti-inflammatory drugs, diuretics, and metformin can increase the risk of CI-AKI when undergoing contrast imaging. Despite CI-AKI being the leading iatrogenic cause of acute kidney injury, there is a lack of sufficient scientific evidence supporting which drugs should be stopped, when they should be stopped, and when they should be resumed...
February 21, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29465713/hydrochlorothiazide-and-alternative-diuretics-versus-renin-angiotensin-system-inhibitors-for-the-regression-of-left-ventricular-hypertrophy-a-head-to-head-meta-analysis
#7
George C Roush, Ramy Abdelfattah, Steven Song, John B Kostis, Michael E Ernst, Domenic A Sica
BACKGROUND: Found in 36-41% of hypertension, elevated left ventricular mass (LVM) independently predicts cardiovascular events and total mortality. Conversely, drug-induced regression of LVM predicts improved outcomes. Previous studies have favored renin-angiotensin system inhibitors (RASIs) over other antihypertensives for reducing LVM but ignored differences among thiazide-type diuretics. From evidence regarding potency, cardiovascular events, and electrolytes, we hypothesized a priori that 'CHIP' diuretics [CHlorthalidone, Indapamide and Potassium-sparing Diuretic/hydrochlorothiazide (PSD/HCTZ)] would rival RASIs for reducing LVM...
February 20, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29463621/ventilatory-support-or-respiratory-muscle-training-as-adjuncts-to-exercise-in-obese-cpap-treated-patients-with-obstructive-sleep-apnoea-a-randomised-controlled-trial
#8
Isabelle Vivodtzev, Renaud Tamisier, Marilie Croteau, Jean-Christian Borel, Angélique Grangier, Bernard Wuyam, Patrick Lévy, Caroline Minville, Frédéric Sériès, François Maltais, Jean-Louis Pépin
BACKGROUND: Obstructive sleep apnoea (OSA) and obesity are interdependent chronic diseases sharing reduced exercise tolerance and high cardiovascular risk. INTERVENTION: A 3-month intervention with innovative training modalities would further improve functional capacity and cardiovascular health than usual cycle exercise training in already continuous positive airway pressure (CPAP)-treated obese patients with OSA. METHODS: Fifty three patients (35<body mass index (BMI) <45 kg/m2 ) were randomly allocated to exercise training on a cycle ergometer, either alone (ERGO) or with respiratory muscle training (ERGO+RMT) or non-invasive ventilation (ERGO+NIV)...
February 20, 2018: Thorax
https://www.readbyqxmd.com/read/29463597/safety-of-intravenous-iron-in-dialysis-a-systematic-review-and-meta-analysis
#9
Ingrid Hougen, David Collister, Mathieu Bourrier, Thomas Ferguson, Laura Hochheim, Paul Komenda, Claudio Rigatto, Navdeep Tangri
BACKGROUND AND OBJECTIVES: The safety of intravenous iron dosing in dialysis is uncertain. Higher-dose intravenous iron may be associated with a higher risk of infections, cardiovascular events, hospitalizations, and mortality. This systematic review aimed to determine the safety of higher-dose versus lower-dose intravenous iron, oral iron, or no iron supplementation in adult patients treated with dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched Medline, EMBASE, Cochrane library, and CINAHL from inception to January 6, 2017 for randomized, controlled trials and observational studies comparing higher-dose intravenous iron with lower-dose intravenous iron, oral iron, or no iron in patients treated with dialysis that had all-cause mortality, infection, cardiovascular events, or hospitalizations as outcomes...
February 20, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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
#10
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/29462263/regular-yogurt-intake-and-risk-of-cardiovascular-disease-among-hypertensive-adults
#11
Justin R Buendia, Yanping Li, Frank B Hu, Howard J Cabral, M Loring Bradlee, Paula A Quatromoni, Martha R Singer, Gary C Curhan, Lynn L Moore
BACKGROUND: High blood pressure (HBP) is a major cardiovascular disease (CVD) risk factor. Clinical trials including Dietary Approaches to Stop Hypertension (DASH) have demonstrated beneficial effects of dairy consumption on risks of HBP and CVD. Yogurt, a fermented dairy product, may independently be related to CVD risk. OBJECTIVE: To evaluate the association between yogurt consumption and CVD risk among hypertensive individuals in 2 large cohorts and to determine whether the association differs among those whose eating pattern more closely resembles the DASH diet...
February 15, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29462179/patient-navigators-for-people-with-chronic-disease-a-systematic-review
#12
Kerry A McBrien, Noah Ivers, Lianne Barnieh, Jacob J Bailey, Diane L Lorenzetti, David Nicholas, Marcello Tonelli, Brenda Hemmelgarn, Richard Lewanczuk, Alun Edwards, Ted Braun, Braden Manns
BACKGROUND: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. OBJECTIVE: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017...
2018: PloS One
https://www.readbyqxmd.com/read/29461566/nya-glukoss%C3%A3-nkande-l%C3%A3-kemedel-%C3%A3-r-kardiovaskul%C3%A3-rt-s%C3%A3-kra-enstaka-diabetesl%C3%A3-kemedel-har-%C3%A3-ven-visats-skydda-mot-kardiovaskul%C3%A3-ra-och-renala-komplikationer
#13
Eva Toft, Mikael Rydén
Do novel therapies in type 2 diabetes have protective effects on cardiovascular and renal complications? A number of new antidiabetic drug classes have been introduced on the market in the last decade. Regulatory authorities have required that their safety in type 2 diabetes populations with high cardiovascular risk must be assessed. Consequently, a large number of outcome studies have been initiated, several of which have been published in recent years. Overall, this has so far shown that long-acting insulin analogues, DPP4-inhibitors, GLP1-receptor agonists and SGLT2-inhibitors are safe...
February 20, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29460812/the-acute-effect-of-black-tea-consumption-on-resistance-artery-endothelial-function-in-healthy-subjects-a-randomized-controlled-trial
#14
Arno Greyling, Thalijn L C Wolters, David M de Bresser, Sean H P P Roerink, Niels P Riksen, Theo P Mulder, Matthew J Rowson, Maria T Hopman, Dick H J Thijssen
BACKGROUND & AIMS: Black tea is a main source of flavonoids in the Western diet and has been associated with reduced risk for cardiovascular disease, possibly through lowering blood pressure. These effects may be mediated through improving endothelial function of resistance arteries. The aim of this study was therefore to examine the acute impact of black tea on forearm resistance artery endothelial function in healthy, normotensive middle-aged subjects. METHODS: Twenty middle-aged men and women (age-range 45-75 years) were recruited into a double-blind, randomized, placebo-controlled crossover intervention study...
February 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29459977/evidence-underpinning-the-u-s-government-mandated-hemodynamic-interventions-for-sepsis-a-systematic-review
#15
Dominique J Pepper, Dharmvir Jaswal, Junfeng Sun, Judith Welsh, Charles Natanson, Peter Q Eichacker
Background: The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced by the Centers for Medicare & Medicaid Services (CMS), requires up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. Purpose: To evaluate whether moderate- or high-level evidence shows that use of SEP-1 or its hemodynamic interventions improves survival in adults with sepsis. Data Sources: PubMed, Embase, Scopus, Web of Science, and ClinicalTrials...
February 20, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29459462/sex-difference-in-patients-with-ischemic-heart-failure-undergoing-surgical-revascularization-results-from-the-stich-trial-surgical-treatment-for-ischemic-heart-failure
#16
Ileana L Piña, Qi Zheng, Lilin She, Hanna Szwed, Irene M Lang, Pedro S Farsky, Serenella Castelvecchio, Jolanta Biernat, Alexandros Paraforos, Dragana Kosevic, Liliana E Favaloro, José C Nicolau, Padmini Varadarajan, Eric J Velazquez, Ramdas G Pai, Nicole Cyrille, Kerry L Lee, Patrice Desvigne-Nickens
BACKGROUND: Female sex is conventionally considered a risk factor for coronary artery bypass grafting (CABG) and has been included as a poor prognostic factor in multiple cardiac operative risk evaluation scores. We aimed to investigate the association of sex and the long-term benefit of CABG in patients with ischemic left ventricular dysfunction enrolled in the prospective STICH trial (Surgical Treatment for Ischemic Heart Failure Study). METHODS: The STICH trial randomized 1212 patients (148 [12%] women and 1064 [88%] men) with coronary artery disease and left ventricular ejection fraction ≤35% to CABG+medical therapy (MED) versus MED alone...
February 20, 2018: Circulation
https://www.readbyqxmd.com/read/29458368/report-from-the-3rd-cardiovascular-outcome-trial-cvot-summit-of-the-diabetes-cardiovascular-disease-d-cvd-easd-study-group
#17
EDITORIAL
Oliver Schnell, Eberhard Standl, Doina Catrinoiu, Stefano Genovese, Nebojsa Lalic, Katarina Lalic, Jan Skrha, Paul Valensi, Antonio Ceriello
The 3rd Cardiovascular Outcome Trial Summit of the Diabetes & Cardiovascular Disease EASD Study Group was held on the 26-27 October 2017 in Munich. As in 2015 and 2016, this summit was organised in light of recently completed and published CVOTs on diabetes, aiming to serve as a reference meeting for in-depth discussions on the topic. Amongst others, the CVOTs EXSCEL, DEVOTE, the CANVAS program and the ACE-trial, which released primary outcome results in 2017, were discussed. Trial implications for diabetes management and recent perspectives of diabetologists, cardiologists, endocrinologists, nephrologists and general practitioners were highlighted...
February 19, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29455345/the-antidiabetic-armamentarium-reducing-the-residual-cardiovascular-risk-with-hba-1c-v-lowering-medications-editorial-to-glp-1-receptor-agonists-and-cardiovascular-disease-a-meta-analysis-of-recent-cardiac-outcome-trials-by-jia-x-alam-m-ye-y-et-al
#18
EDITORIAL
https://www.readbyqxmd.com/read/29455058/physical-activity-combined-with-resistance-training-reduces-symptoms-of-frailty-in-older-adults-a-randomized-controlled-trial
#19
Koutatsu Nagaia, Toshiaki Miyamato, Akio Okamae, Akira Tamaki, Hiroyuki Fujioka, Yosuke Wada, Yuki Uchiyama, Ken Shinmura, Kazuhisa Domen
INTRODUCTION: Increased physical activity (PA) is a crucial factor in the prevention of physical deterioration, and resistance training (RT) is also a common and effective intervention for older adults. However, the effects of PA as an adjunct to RT on frailty status remains unclear; therefore, we clarified the effect of a PA intervention with feedback, as an adjunct to resistance strength training, on the physical and mental outcomes of frail older adults. MATERIALS AND METHODS: We employed a randomized controlled trial...
February 13, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29453594/time-to-first-event-versus-recurrent-event-analysis-points-to-consider-for-selecting-a-meaningful-analysis-strategy-in-clinical-trials-with-composite-endpoints
#20
Geraldine Rauch, Meinhard Kieser, Harald Binder, Antoni Bayes-Genis, Antje Jahn-Eimermacher
BACKGROUND: Composite endpoints combining several event types of clinical interest often define the primary efficacy outcome in cardiologic trials. They are commonly evaluated as time-to-first-event, thereby following the recommendations of regulatory agencies. However, to assess the patient's full disease burden and to identify preventive factors or interventions, subsequent events following the first one should be considered as well. This is especially important in cohort studies and RCTs with a long follow-up leading to a higher number of observed events per patients...
February 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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