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Cardiovascular outcome trials

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https://www.readbyqxmd.com/read/29228101/spironolactone-and-resistant-hypertension-in-heart-failure-with-preserved-ejection-fraction
#1
P Rossignol, B Claggett, J Liu, O Vardeny, B Pitt, F Zannad, S Solomon
Background: Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown. Methods: We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mmHg on 3 or more medications, in the Americas cohort of the TOPCAT trial, in which patients with HFpEF were randomized to spironolactone vs...
December 7, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29228000/an-in-vivo-assessment-of-the-cholesterol-lowering-efficacy-of-lactobacillus-plantarum-ecgc-13110402-in-normal-to-mildly-hypercholesterolaemic-adults
#2
Adele Costabile, Ivan Buttarazzi, Sofia Kolida, Sara Quercia, Jessica Baldini, Jonathan R Swann, Patrizia Brigidi, Glenn R Gibson
Coronary heart disease (CHD) is one of the major causes of death and disability in industrialised countries, with elevated blood cholesterol an established risk factor. Total plasma cholesterol reduction in populations suffering from primary hypercholesterolemia may lower CHD incidence. This study investigated the cholesterol reducing capacity of Lactobacillus plantarum ECGC 13110402, a strain selected for its high bile salt hydrolase activity, in 49 normal to mildly hypercholesterolaemic adults. Primary efficacy outcomes included effect on blood lipids (total cholesterol (TC), low density lipoproteins (LDL-C), high density lipoproteins (HDL-C) and triacylgycerides (TAG), inflammatory biomarkers and occurrence/severity of gastrointestinal side effects to establish safety and tolerance of the intervention...
2017: PloS One
https://www.readbyqxmd.com/read/29226041/dapagliflozin-cardiovascular-safety-and-benefits-in-type-2-diabetes-mellitus
#3
REVIEW
Fatima Saleem
Sodium-glucose co-transporter 2 inhibitors (SGLT2is) such as dapagliflozin, canagliflozin, and empagliflozin, are a promising new therapy in the treatment of type 2 diabetes mellitus (T2DM). SGLT2is can effectively reduce hyperglycemia thus improving glycemic control and they offer some beneficial effects on the cardiovascular (CV) system which can benefit patients with heart failure in addition toT2DM. The United States Food and Drug Administration requires new diabetes mellitus therapies to show a CV safety profile...
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29224586/a-scoping-review-of-the-evidence-for-efficacy-of-acupuncture-in-companion-animals
#4
Wesley J Rose, Jan M Sargeant, W J Brad Hanna, David Kelton, Dianna M Wolfe, Lee V Wisener
Acupuncture has become increasingly popular in veterinary medicine. Within the scientific literature there is debate regarding its efficacy. Due to the complex nature of acupuncture, a scoping review was undertaken to identify and categorize the evidence related to acupuncture in companion animals (dogs, cats, and horses). Our search identified 843 relevant citations. Narrative reviews represented the largest proportion of studies (43%). We identified 179 experimental studies and 175 case reports/case series that examined the efficacy of acupuncture...
December 11, 2017: Animal Health Research Reviews
https://www.readbyqxmd.com/read/29223954/effect-of-pcsk9-inhibitors-on-clinical-outcomes-in-patients-with-hypercholesterolemia-a-meta-analysis-of-35-randomized-controlled-trials
#5
REVIEW
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele K Roesle, Thomas Knickelbine, Michael D Miedema, Houman Khalili, Zahid Ahmad, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included. Mean age was 61.0±2.8 years, and mean baseline low-density lipoprotein cholesterol was 106±22 mg/dL...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29222605/the-endocannabinoid-system-in-cardiovascular-function-novel-insights-and-clinical-implications
#6
REVIEW
Salvador Sierra, Natasha Luquin, Judith Navarro-Otano
RATIONALE: Cardiovascular disease is now recognized as the number one cause of death in the world, and the size of the population at risk continues to increase rapidly. The dysregulation of the endocannabinoid (eCB) system plays a central role in a wide variety of conditions including cardiovascular disorders. Cannabinoid receptors, their endogenous ligands, as well as enzymes conferring their synthesis and degradation, exhibit overlapping distributions in the cardiovascular system. Furthermore, the pharmacological manipulation of the eCB system has effects on blood pressure, cardiac contractility, and endothelial vasomotor control...
December 8, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29222139/effect-of-losartan-on-rv-dysfunction-results-from-the-double-blind-randomized-redefine-trial-in-adults-with-repaired-tetralogy-of-fallot
#7
Jouke P Bokma, Michiel M Winter, Arie P van Dijk, Hubert W Vliegen, Joost P van Melle, Folkert Meijboom, Martijn C Post, Jacqueline K Berbee, S Matthijs Boekholdt, Maarten Groenink, Aeilko H Zwinderman, Barbara J M Mulder, Berto J Bouma
Background -The effect of angiotensin II receptor blockers (ARBs) on right ventricular (RV) function is still unknown. ARBs are beneficial in patients with acquired left ventricular (LV) dysfunction and recent findings suggested a favorable effect in symptomatic patients with systemic RV dysfunction. The current study aimed to determine the effect of losartan, an ARB, on subpulmonary RV dysfunction in adults after repair of tetralogy of Fallot (rTOF). Methods -REDEFINE is an investigator-initiated, multicenter, prospective, 1:1 randomized, double-blind, placebo-controlled study...
December 8, 2017: Circulation
https://www.readbyqxmd.com/read/29221659/cardiovascular-outcomes-with-glucagon-like-peptide-1-receptor-agonists-in-patients-with-type-2-diabetes-a-meta-analysis
#8
M Angelyn Bethel, Rishi A Patel, Peter Merrill, Yuliya Lokhnygina, John B Buse, Robert J Mentz, Neha J Pagidipati, Juliana C Chan, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Peter Öhman, Neil R Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez, Rury R Holman
BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective glucose-lowering drugs. Findings from cardiovascular outcome trials showed cardiovascular safety of GLP-1 receptor agonists, but results for cardiovascular efficacy were varied. We aimed to examine overall cardiovascular efficacy for lixisenatide, liraglutide, semaglutide, and extended-release exenatide. METHODS: In this systematic review and meta-analysis, we analysed data from eligible trials that assessed the safety and efficacy of GLP-1 receptor agonists compared with placebo in adult patients (aged 18 years or older) with type 2 diabetes and had a primary outcome including, but not limited to, cardiovascular mortality, non-fatal myocardial infarction, and non-fatal stroke...
December 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29220345/a-randomized-trial-of-bifurcation-stenting-technique-in-chronic-total-occlusions-percutaneous-coronary-intervention
#9
Vitaly I Baystrukov, Evgeniy I Kretov, Marouane Boukhris, Alexander G Osiev, Igor O Grazhdankin, Alexey V Biryukov, Hatem Najjar, Vladimir V Verin, Dmitriy D Zubarev, Ivan A Naryshkin, Alexander V Bogachev-Prokophiev, Kambis Mashayekhi, Alfredo R Galassi, Alexey A Prokhorikhin
BACKGROUND: The optimal strategy to treat bifurcation lesions (BFLs) in a percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. AIMS: We sought to assess whether T-provisional or mini-crush is appropriate for BFLs within CTO vessels. PATIENTS AND METHODS: From January 2011 to December 2013, patients who underwent successful CTO guidewire crossing and with a BFL within the CTO target vessel were enrolled prospectively and assigned randomly to either T-provisional stenting or the mini-crush technique for BFL treatment...
January 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29219052/adverse-events-of-proton-pump-inhibitors-potential-mechanisms
#10
Andrea Corsonello, Fabrizia Lattanzio, Silvia Bustacchini, Sabrina Garasto, Annalisa Cozza, Roberto Schepisi, Federica Lenci, Filippo Luciani, Marcello Giuseppe Maggio, Andrea Ticinesi, Valeria Butto, Sara Tagliaferri, Francesco Corica
OBJECTIVE: We aimed at summarizing current evidence about mechanisms for potentially harmful effects of proton pump inhibitors (PPIs). METHODS: A Pubmed search was performed, and 207 studies concerning the relationship between use of PPIs and cardiovascular diseases, kidney impairment, nutritional disorders, fractures, infections, functional decline, and mortality were selected and reviewed. RESULTS: PPIs may cause potentially harmful effects by several mechanisms, including endothelial dysfunction, hypomagnesemia, drug interactions, reduced absorption of selected nutrients, increased gastric microbiota and small intestine bacterial overgrowth, reduced immune response, tubular-interstitial inflammation, increased bone turnover, accumulation of amyloid in the brain...
December 7, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/29218680/cardiovascular-profile-of-valbenazine-analysis-of-pooled-data-from-three-randomized-double-blind-placebo-controlled-trials
#11
Dao Thai-Cuarto, Christopher F O'Brien, Roland Jimenez, Grace S Liang, Joshua Burke
INTRODUCTION: Valbenazine is a novel vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. OBJECTIVE: Using data from double-blind, placebo-controlled trials, analyses were conducted to evaluate the cardiovascular effects of once-daily valbenazine in patients with a psychiatric disorder who developed tardive dyskinesia after exposure to a dopamine-blocking medication. METHODS: Data were pooled from three 6-week, double-blind, placebo-controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558)...
December 7, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29217597/outcomes-in-coronary-artery-disease-patients-with-sleepy-obstructive-sleep-apnoea-on-cpap
#12
Yüksel Peker, Erik Thunström, Helena Glantz, Karl Wegscheider, Christine Eulenburg
Coronary artery disease (CAD) patients with obstructive sleep apnoea (OSA) have increased risk for major adverse cardiovascular and cerebrovascular events (MACCEs) compared with CAD patients without OSA. We aimed to address if the risk is similar in both groups when OSA patients are treated.This study was a parallel observational arm of the RICCADSA randomised controlled trial, conducted in Sweden between 2005 and 2013. Patients with revascularised CAD and OSA (apnoea-hypopnoea index (AHI) ≥15 events·h-1) with daytime sleepiness (Epworth Sleepiness Scale score ≥10) were offered continuous positive airway pressure (CPAP) (n=155); CAD patients with no OSA (AHI <5 events·h-1) acted as controls (n=112), as a randomisation of sleepy OSA patients to no treatment would not be ethically feasible...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29216868/socio-demographic-determinants-and-effect-of-structured-personal-diabetes-care-a-19-year-follow-up-of-the-randomized-controlled-study-diabetes-care-in-general-practice-dcgp
#13
Andreas Heltberg, Volkert Siersma, John Sahl Andersen, Christina Ellervik, Henrik Brønnum-Hansen, Jakob Kragstrup, Niels de Fine Olivarius
BACKGROUND: We investigated how four aspects of socio-demography influence the effectiveness of an intervention with structured personal diabetes care on long-term outcomes. METHODS: The Diabetes Care in General Practice (DCGP) study is a cluster-randomized trial involving a population-based sample of 1381 patients with newly diagnosed type 2-diabetes mellitus. We investigated how education, employment, cohabitation status and residence influenced the effectiveness of 6 years of intervention with structured personal diabetes care, resembling present day recommendations...
December 8, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29214922/the-design-and-rationale-of-an-interdisciplinary-non-prescriptive-and-health-at-every-size%C3%A2-based-clinical-trial-the-health-and-wellness-in-obesity-study
#14
Mariana D Ulian, Bruno Gualano, Fabiana B Benatti, Patricia Lopes de Campos-Ferraz, Desire Coelho, Odilon J Roble, Fernanda Sabatini, Isabel Perez, Luiz Aburad, Ana Jéssica Pinto, André Vessoni, Jhessica Campos Victor, Victoria Kupper Lima, Ramiro Fernandez Unsain, Priscila de Morais Sato, Marcelo Macedo Rogero, Tatiana Natasha Toporcov, Fernanda B Scagliusi
BACKGROUND: This manuscript describes the design and rationale of a clinical trial that aims to investigate the multiple physiological, attitudinal, nutritional, and behavioral effects of a new interdisciplinary intervention based on the Health at Every Size® (HAES®) approach in obese women. METHODS: This will be a prospective, 7-month, randomized (2:1), mixed-method clinical trial. Obese women will be recruited and randomly allocated into two groups. The intervention group (I-HAES®; proposed n = 40) will undertake a novel HAES®-based intervention...
December 2017: Nutrition and Health
https://www.readbyqxmd.com/read/29214305/cardiovascular-outcomes-according-to-urinary-albumin-and-kidney-disease-in-patients-with-type-2-diabetes-at-high-cardiovascular-risk-observations-from-the-savor-timi-53-trial
#15
Benjamin M Scirica, Ofri Mosenzon, Deepak L Bhatt, Jacob A Udell, Ph Gabriel Steg, Darren K McGuire, KyungAh Im, Estella Kanevsky, Christina Stahre, Mikaela Sjöstrand, Itamar Raz, Eugene Braunwald
Importance: An elevated level of urinary albumin to creatinine ratio (UACR) is a marker of renal dysfunction and predictor of kidney failure/death in patients with type 2 diabetes. The prognostic use of UACR in established cardiac biomarkers is not well described. Objective: To evaluate whether UACR offers incremental prognostic benefit beyond risk factors and established plasma cardiovascular biomarkers. Design, Setting, and Participants: The Saxagliptin Assessment of Vascular Outcomes Recorded in Patients With Diabetes Mellitus-Thrombolysis in Myocardial Infarction (SAVOR-TIMI) 53 study was performed from May 2010 to May 2013 and evaluated the safety of saxagliptin vs placebo in patients with type 2 diabetes with overt cardiovascular disease or multiple risk factors...
December 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29212812/pharmacologic-prevention-of-incident-atrial-fibrillation-long-term-results-from-the-allhat-antihypertensive-and-lipid-lowering-treatment-to-prevent-heart-attack-trial
#16
Thomas A Dewland, Elsayed Z Soliman, Jose-Miguel Yamal, Barry R Davis, Alvaro Alonso, Christine M Albert, Lara M Simpson, L Julian Haywood, Gregory M Marcus
BACKGROUND: Although atrial fibrillation (AF) guidelines indicate that pharmacological blockade of the renin-angiotensin system may be considered for primary AF prevention in hypertensive patients, previous studies have yielded conflicting results. We sought to determine whether randomization to lisinopril reduces incident AF or atrial flutter (AFL) compared with chlorthalidone in a large clinical trial cohort with extended post-trial surveillance. METHODS AND RESULTS: We performed a secondary analysis of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), a randomized, double-blind, active-controlled clinical trial that enrolled hypertensive individuals ≥55 years of age with at least one other cardiovascular risk factor...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29212477/nurse-health-and-lifestyle-modification-versus-standard-care-in-40-to-70-year-old-regional-adults-study-protocol-of-the-management-to-optimise-diabetes-and-metabolic-syndrome-risk-reduction-via-nurse-led-intervention-modern-randomized-controlled-trial
#17
Melinda J Carrington, Paul Zimmet
BACKGROUND: Metabolic syndrome (MetS), the clustering of multiple leading risk factors, predisposes individuals to increased risk for developing type 2 diabetes and/or cardiovascular disease (CVD). Cardio-metabolic disease risk increases with greater remoteness where specialist services are scarce. Nurse-led interventions are effective for the management of chronic disease. The aim of this clinical trial is to determine whether a nurse-implemented health and lifestyle modification program is more beneficial than standard care to reduce cardio-metabolic abnormalities and future risk of CVD and diabetes in individuals with MetS...
December 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29211509/pharmacist-based-antihypertensive-medication-review-and-assignment-of-morning-versus-evening-dosing-of-once-daily-antihypertensive-medications-a-pilot-study-to-assess-feasibility-and-efficacy-in-chronic-kidney-disease-patients
#18
Julia R Smith, Lisa Hillman, Paul E Drawz
Evening dosing of antihypertensive medications lowers nighttime blood pressure, and in one large randomized trial, it reduced the risk for cardiovascular outcomes. However, the feasibility of nighttime dosing in routine clinical practice is unknown. The purpose of this pilot study was to evaluate the effect of a brief pharmacist intervention to assign patients to take antihypertensive medications at specific times of the day. In this pilot, randomized controlled trial, 79 patients with moderate to severe chronic kidney disease (CKD) taking one or more antihypertensive medications once daily were randomized to take one once-daily antihypertensive either in the morning or in the evening...
December 6, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29211367/coronary-artery-disease-new-insights-into-revascularization-treatment-of-diabetic-patients
#19
REVIEW
Joanna Bednarska, Dorota Bednarska-Chabowska, Joanna Adamiec-Mroczek
Diabetes mellitus is an independent cardiovascular risk factor, considered an equivalent of coronary artery disease in terms of prognosis. A history of acute coronary syndrome is a strong predictor of another coronary episode, and cardiovascular complications are the leading cause of mortality in diabetic patients. Many patients with coronary artery disease suffer from concomitant diabetes or pre-diabetes. There are 3 strategies of coronary artery disease treatment: conservative management, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI)...
October 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29211222/cabg-surgery-remains-the-best-option-for-patients-with-left-main-coronary-disease-in-comparison-with-pci-des-meta-analysis-of-randomized-controlled-trials
#20
Michel Pompeu Barros Oliveira Sá, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Alexandre Motta Menezes, Frederico Pires Vasconcelos Silva, Ricardo Carvalho Lima
OBJECTIVE: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis...
September 2017: Brazilian Journal of Cardiovascular Surgery
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