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Cardiology randomized controlled trial

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https://www.readbyqxmd.com/read/27867524/varying-effects-of-recommended-treatments-for-heart-failure-with-reduced-ejection-fraction-meta-analysis-of-randomized-controlled-trials-in-the-esc-and-accf-aha-guidelines
#1
REVIEW
Marius Mark Thomsen, Christian Lewinter, Lars Køber
The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27803727/effectiveness-of-acupressure-on-the-taichong-acupoint-in-lowering-blood-pressure-in-patients-with-hypertension-a-randomized-clinical-trial
#2
Gan-Hon Lin, Wei-Chun Chang, Kuan-Ju Chen, Chen-Chen Tsai, Sung-Yuan Hu, Li-Li Chen
Objectives. To evaluate the effectiveness of acupressure on the Taichong acupoint in lowering systolic and diastolic blood pressure (BP) in hypertensive patients. Methods. Eighty patients with hypertension attending a cardiology outpatient department in central Taiwan were included in this randomized clinical trial. Acupressure was applied to the Taichong acupoint in the experimental group (n = 40) and to the first metatarsal (sham acupoint) in the control group (n = 40). Blood pressure was measured by electronic monitoring before and immediately 15 min and 30 min after acupressure...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27777324/the-prognostic-effect-of-cardiac-rehabilitation-in-the-era-of-acute-revascularisation-and-statin-therapy-a-systematic-review-and-meta-analysis-of-randomized-and-non-randomized-studies-the-cardiac-rehabilitation-outcome-study-cros
#3
REVIEW
Bernhard Rauch, Constantinos H Davos, Patrick Doherty, Daniel Saure, Maria-Inti Metzendorf, Annett Salzwedel, Heinz Völler, Katrin Jensen, Jean-Paul Schmid
BACKGROUND: The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. DESIGN: Structured review and meta-analysis. METHODS: Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later...
October 24, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27765184/effect-of-aldosterone-antagonism-on%C3%A2-exercise-tolerance-in-heart-failure-with%C3%A2-preserved-ejection-fraction
#4
Wojciech Kosmala, Aleksandra Rojek, Monika Przewlocka-Kosmala, Leah Wright, Andrzej Mysiak, Thomas H Marwick
BACKGROUND: Impaired functional capacity is a hallmark of patients with heart failure with preserved ejection fraction (HFpEF). Despite the association of HFpEF with reduced myocardial compliance attributed to fibrosis, spironolactone has not been shown to alter outcomes-perhaps reflecting the heterogeneity of underlying pathological mechanisms. OBJECTIVES: The authors sought to identify improvement in exercise capacity with spironolactone in the subset of patients with HFpEF with exercise-induced increase in ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e') reflecting elevation of left ventricular (LV) filling pressure...
October 25, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27753841/sy-07-2-should-diabetes-mellitus-remain-a-compelling-indication-for-use-of-renin-angiotensin-system-blockers
#5
Franz Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27683534/can-natriuretic-peptides-be-used-to-guide-therapy
#6
Antoni Bayes-Genis, Josep Lupón, Allan S Jaffe
Over the last 15 years, the hypothesis that intensified treatment directed at reducing natriuretic peptide (NP) concentrations may improve the outcomes of patients with heart failure (HF) has been scrutinized in several prospective clinical trials, with conflicting results. Collectively, however, the data suggest that NP concentrations may be useful in guiding HF management and improving HF-related morbidity and mortality. In this review, we summarize the existing data investigating the use of NPs as targets for outpatient HF therapy...
August 2016: EJIFCC
https://www.readbyqxmd.com/read/27671175/skeletonization-of-left-internal-mammary-artery-in-coronary-artery-bypass-grafting
#7
Muhammad Sohail Chaudhri, Muhammad Usman Ali Shah, Muhammad Imran Asghar, Rashad Siddiqi, Asif Mahmood Janjua, Afsheen Iqbal
OBJECTIVE: To compare mean per-operative flow capacity between skeletonized and pedicled left internal mammary artery (LIMA) in patients undergoing coronary artery bypass grafting (CABG) surgery. STUDY DESIGN: Randomized control trial. PLACE AND DURATION OF STUDY: Department of Cardiac Surgery, Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan from February to August, 2013. METHODOLOGY: Patients undergoing CABG for coronary artery disease, under 80 years, excluded by the exclusion criteria; and fulfilling the inclusion criteria were randomly assigned to two groups of 70 each...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27642960/sy-07-2-should-diabetes-mellitus-remain-a-compelling-indication-for-use-of-renin-angiotensin-system-blockers
#8
Franz Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27585512/pci-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary%C3%A2-artery%C3%A2-disease
#9
REVIEW
Eric R Bates, Jacqueline E Tamis-Holland, John A Bittl, Patrick T O'Gara, Glenn N Levine
Recent randomized controlled trials have suggested that patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease may benefit more from multivessel percutaneous coronary intervention (PCI) compared with culprit vessel-only primary PCI. The American College of Cardiology, American Heart Association, and Society for Cardiovascular Angiography and Interventions recently published an updated recommendation on this topic. The purpose of this State-of-the-Art Review is to accurately document existing published reports, describe their limitations, and establish a base for future studies...
September 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27552726/managing-the-lipid-profile-of-coronary-heart-disease-patients
#10
Maria Drakopoulou, Konstantinos Toutouzas, Konstantinos Stathogiannis, Andreas Synetos, George Trantalis, Dimitrios Tousoulis
INTRODUCTION: Lipid profile management is even more critical in patients treated for secondary prevention, since patients with established coronary heart disease are at higher risk of developing events. Current guidelines encourage lifestyle modification and patient engagement in disease prevention. However, the American College of Cardiology/American Heart Association guidelines seem to differ considerably from their predecessors, having an impact on clinical practice of lipid management...
August 23, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27547895/effect-of-educational-intervention-on-the-rate-of-rarely-appropriate-outpatient-echocardiograms-ordered-by-attending-academic-cardiologists-a-randomized-clinical-trial
#11
David M Dudzinski, R Sacha Bhatia, Michael Y Mi, Eric M Isselbacher, Michael H Picard, Rory B Weiner
Importance: Appropriate use criteria-based educational initiatives have been shown to improve transthoracic echocardiography (TTE) ordering practices of physicians in training. Whether such an intervention is successful with attending cardiologists remains unknown. Objective: To prospectively investigate the effect of an appropriate use criteria-based educational intervention on ordering of outpatient TTEs by attending academic cardiologists. Design, Setting, and Participants: We conducted a prospective, randomized clinical trial of an educational intervention designed to reduce the number of outpatient TTEs that were deemed to be rarely appropriate by published appropriate use criteria...
August 10, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27543277/almond-supplementation-reduces-serum-uric-acid-in-coronary-artery-disease-patients-a-randomized-controlled-trial
#12
Humaira Jamshed, Anwar-Ul-Hassan Gilani, Fateh Ali Tipoo Sultan, Faridah Amin, Jamshed Arslan, Sumaira Ghani, Madiha Masroor
OBJECTIVE: Elevated serum uric acid (UA), a biomarker of renal insufficiency, is also an independent prognostic marker for morbidity in coronary artery disease (CAD) and poses serious health risks. This study reports the effect of almond consumption on UA in CAD patients. STUDY DESIGN: A randomized controlled clinical trial was conducted with three groups: no-intervention (NI), Pakistani almonds (PA) or American almonds (AA). Patients were recruited from the Cardiology Clinics, Aga Khan University Hospital...
August 19, 2016: Nutrition Journal
https://www.readbyqxmd.com/read/27532447/contemporary-registries-on-p2y12-inhibitors-in-patients-with-acute-coronary-syndromes-in-europe-overview-and-methodological-considerations
#13
J Wouter Jukema, Maddalena Lettino, Petr Widimský, Nicolas Danchin, Alfredo Bardaji, Jose A Barrabes, Angel Cequier, Marc J Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M Koul, Gilles Lemesle, Thomas F Lüscher, Christian M Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez-Sendón, Petr Tousek, Franz Weidinger, Clive F M Weston, Azfar Zaman, Uwe Zeymer
Patient registries that document real-world clinical experience play an important role in cardiology as they complement the data from randomized controlled trials, provide valuable information on drug use and clinical outcomes, and evaluate to what extent guidelines are followed in practice. The Platelet Inhibition Registry in ACS EvalUation Study (PIRAEUS) project is an initiative of registry holders who are managing national or international registries observing patients with acute coronary syndromes (ACS)...
October 2015: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27513650/the-effects-of-exercise-modality-on-maximal-and-submaximal-exercise-parameters-obtained-by-graded-maximal-exercise-testing
#14
Nils Cornelis, Roselien Buys
BACKGROUND: Cardiopulmonary exercise testing (CPET) has become part of screening and evaluation in cardiology. The exercise modalities most often used in CPET are the treadmill (TM) and upright bicycle (UB). Nowadays, also the supine bicycle (SB) is becoming more often used, especially when combined with cardiac imaging. OBJECTIVES: Our aim was to examine whether a maximal CPET on a SB leads to similar results as TM and UB in terms of different CPET measures. Secondly, we explored whether peak VO2 relates to the person's preference and experience with the different exercise modalities...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27494115/a-review-of-the-relative-efficacy-of-dietary-nutritional-supplements-lifestyle-and-drug-therapies-in-the-management-of-hypertension
#15
Stephanie P B Caligiuri, Grant N Pierce
Despite advancements in hypertensive therapies, the prevalence of hypertension and associated morbidities are still immense. Physicians are in great need for updated information on novel and effective anti-hypertensive therapies. Therefore, the study objective was to provide comprehensive information on the efficacy of available anti-hypertensive therapies. Anti-hypertensive therapies were divided into four general approaches: diet, nutritional supplements, lifestyle modification, and conventional anti-hypertensive medications...
August 5, 2016: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/27488764/nitrates-for-the-prevention-of-cardiac-morbidity-and-mortality-in-patients-undergoing-non-cardiac-surgery
#16
REVIEW
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27484905/the-effect-of-door-to-balloon-delay-in-primary-percutaneous-coronary-intervention-on-clinical-outcomes-of-stemi-a-systematic-review-and-meta-analysis-protocol
#17
Chee Yoong Foo, Daniel D Reidpath, Nathorn Chaiyakunapruk
BACKGROUND: Acute myocardial infarction (AMI) is a medical emergency in which sudden occlusion of coronary artery(ies) results in ischemia and necrosis of the cardiac tissues. Reperfusion therapies that aim at reopening the occluded artery remain the mainstay of treatment for AMI. Primary percutaneous coronary intervention (PCI), which enables the restoration of blood flow by reopening the occluded artery(ies) via a catheter with an inflatable balloon, is currently the preferred treatment for AMI with ST segment elevation (STEMI)...
2016: Systematic Reviews
https://www.readbyqxmd.com/read/27466873/autologous-adipose-derived-regenerative-cells-a-platform-for-therapeutic-applications
#18
Steven Kesten, John K Fraser
Adipose derived regenerative cells (ADRCs) are a heterogeneous population of cells including multipotent adipose derived stems cells, other progenitor cells, fibroblasts, T-regulatory cells, and macrophages. Preclinical data exist supporting benefits that are predominantly through angiogenesis, modulation of inflammation, and wound remodeling. Such effects are likely paracrine in nature. The application of autologous ADRCs has been investigated across multiple therapeutic areas. While there are numerous publications, there is a relative lack of double-blind, well-controlled, randomized clinical trials in the literature...
July 29, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27431644/universal-classification-system-type-of-incident-myocardial-infarction-in-patients-with-stable-atherosclerosis-observations-from-thrombin-receptor-antagonist-in-secondary-prevention-of-atherothrombotic-ischemic-events-tra-2%C3%A2-p-timi-50
#19
Stephen K Kidd, Marc P Bonaca, Eugene Braunwald, Gaetano M De Ferrari, Basil S Lewis, Piera A Merlini, Sabina A Murphy, Benjamin M Scirica, Harvey D White, David A Morrow
BACKGROUND: Our dual aims were as follows: (1) to classify new or recurrent myocardial infarctions (MI) in patients with stable atherosclerosis using the Universal Definition of MI classification system; and (2) to characterize the effects of vorapaxar, a first-in-class platelet protease-activated receptor -1 antagonist, on new or recurrent MI. METHODS AND RESULTS: We analyzed data from TRA 2°P-TIMI 50, a multinational, randomized, double-blind, placebo-controlled trial of vorapaxar...
July 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27378486/surrogate-and-clinical-endpoints-in-interventional-cardiology-are-statistics-the-brakes
#20
REVIEW
Matthias Waliszewski, Harald Rittger
BACKGROUND: Randomized controlled trials are the gold standard for demonstrating safety and efficacy of coronary devices with or without accompanying drug treatments in interventional cardiology. With the advent of last-generation drug-eluting stents having enhanced technical attributes and long-term clinical benefits, the proof of incremental angiographic or long-term clinical efficacy becomes more challenging. The purpose of this review is to provide an overview of the most common and alternative study endpoints in interventional cardiology and their potential reimbursement value...
October 2016: Therapeutic Advances in Cardiovascular Disease
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