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Cardiology randomized controlled trial

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https://www.readbyqxmd.com/read/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#1
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28164009/infarct-related-artery-only-versus-complete-revascularization-in-st-segment-elevation-myocardial-infarction-and-multi-vessel-disease-a-meta-analysis
#2
Satyanarayana R Vaidya, Santhosh R Devarapally, Sameer Arora
BACKGROUND: The 2015 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) focused update on primary percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) only gives a class II b (weak) indication for non-infarct artery intervention at the time of primary PCI. Recent randomized controlled trials, however, suggest strong evidence supporting complete revascularization. METHODS: A systematic search was conducted in PUBMED, MEDLINE, EMBASE and Cochrane central register for randomized controlled trials comparing complete versus infarct artery (IRA) only revascularization in patients with STEMI...
February 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28144168/a-multicenter-prospective-randomized-study-comparing-the-efficacy-of-escalating-higher-biphasic-versus-low-biphasic-energy-defibrillations-in-patients-presenting-with-cardiac-arrest-in-the-in-hospital-environment
#3
Venkataraman Anantharaman, Seow Yian Tay, Peter George Manning, Swee Han Lim, Terrance Siang Jin Chua, Mohan Tiru, Rabind Antony Charles, Vidya Sudarshan
BACKGROUND: Biphasic defibrillation has been practiced worldwide for >15 years. Yet, consensus does not exist on the best energy levels for optimal outcomes when used in patients with ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT). METHODS: This prospective, randomized, controlled trial of 235 adult cardiac arrest patients with VF/VT was conducted in the emergency and cardiology departments. One group received low-energy (LE) shocks at 150-150-150 J and the other escalating higher-energy (HE) shocks at 200-300-360 J...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28143414/impact-of-oral-hygiene-involving-toothbrushing-versus-chlorhexidine-in-the-prevention-of-ventilator-associated-pneumonia-a-randomized-study
#4
Claudia Fernanda de Lacerda Vidal, Aurora Karla de Lacerda Vidal, José Gildo de Moura Monteiro, Aracele Cavalcanti, Ana Paula Trindade Henriques, Márcia Oliveira, Michele Godoy, Mirella Coutinho, Pollyanna Dutra Sobral, Claudia Ângela Vilela, Bárbara Gomes, Marta Amorim Leandro, Ulisses Montarroyos, Ricardo de Alencar Ximenes, Heloísa Ramos Lacerda
BACKGROUND: Nosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP). METHODS: The study design was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilatior-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0...
January 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28130653/addressing-knowledge-gaps-in-the-2013-acc-aha-guideline-on-the-assessment-of-cardiovascular-risk-a-review-of-recent-coronary-artery-calcium-literature
#5
REVIEW
Vasanth Sathiyakumar, Roger S Blumenthal, Khurram Nasir, Seth S Martin
PURPOSE OF REVIEW: Coronary artery calcium (CAC) has been proposed as an integrator of information from traditionally measured, non-traditionally measured, and unmeasured risk factors for coronary atherosclerosis. The 2013 American College of Cardiology/American Heart Association Guideline on the Assessment of Cardiovascular Risk identified several knowledge gaps regarding CAC, including radiation risks, cost-effectiveness, and improving discrimination and reclassification of estimated risk over the Pooled Cohort Equations in the ACC/AHA Atherosclerotic Cardiovascular Disease Estimator...
February 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28104075/challenges-in-infective-endocarditis
#6
REVIEW
Thomas J Cahill, Larry M Baddour, Gilbert Habib, Bruno Hoen, Erwan Salaun, Gosta B Pettersson, Hans Joachim Schäfers, Bernard D Prendergast
Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations...
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28068415/same-day-discharge-versus-overnight-stay-in-the-hospital-following-percutaneous-coronary-intervention-in-patients-with-stable-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Wei-Qiang Huang
BACKGROUND: New research in interventional cardiology has shown the demand for percutaneous coronary interventions (PCI) to have increased tremendously. Effective treatment with a lower hospital cost has been the aim of several PCI capable centers. This study aimed to compare the adverse clinical outcomes associated with same day discharge versus overnight stay in the hospital following PCI in a population of randomized patients with stable coronary artery disease (CAD). METHODS: The National Library of Medicine (MEDLINE/PubMed), the Cochrane Registry of Randomized Controlled Trials and EMBASE databases were searched (from March to June 2016) for randomized trials comparing same-day discharge versus overnight stay in the hospital following PCI...
2017: PloS One
https://www.readbyqxmd.com/read/28028979/a-controlled-trial-of-the-efficacy-of-a-training-walking-program-in-patients-recovering-from-abdominal-aortic-aneurysm-surgery
#8
Bartosz R Wnuk, Jacek Durmała, Krzysztof Ziaja, Przemysław Kotyla, Marek Woźniewski, Edward Błaszczak
BACKGROUND: Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. OBJECTIVES: We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. MATERIAL AND METHODS: Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/27993908/implantable-cardioverter-defibrillator-for-nonischemic-cardiomyopathy-an-updated-meta-analysis
#9
LETTER
Harsh Golwala, Navkaranbir Singh Bajaj, Garima Arora, Pankaj Arora
No abstract text is available yet for this article.
January 10, 2017: Circulation
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
Maria Drakopoulou, Konstantinos Toutouzas, Konstantinos Stathogiannis, Andreas Synetos, George Trantalis, Dimitrios Tousoulis
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. Area covered: This review article discusses and provides a summary of the current recommendations for lipid profile management in patients with coronary heart disease, with a view to present lifestyle modification and novel treatment strategies, and to indicate areas of dispute among recent guidelines...
November 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
#20
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...
October 1, 2016: JAMA Cardiology
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