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Cardiology landmark trials

Dimitrios Alexopoulos, Christos Pappas, Danai Sfantou, John Lekakis
Cangrelor is an intravenously administered P2Y12 receptor antagonist with very fast, potent, and quickly reversible action. In the CHAMPION PHOENIX trial, cangrelor provided an improved anti-ischemic protection compared with clopidogrel, without increasing the risk of severe bleeding. Cangrelor is currently approved by drug regulating authorities for patients undergoing percutaneous coronary intervention (PCI) without prior treatment with a P2Y12 receptor antagonist and not receiving a glycoprotein IIb/IIIa inhibitor, while its use is endorsed with a class IIb recommendation by the European Society of Cardiology guidelines...
January 2018: Journal of Cardiovascular Pharmacology and Therapeutics
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
June 2017: Clinical Cardiology
Krystal S Titus-Rains, Matthew A Cantrell, Jason A Egge, Bruce Alexander, Robert F Shaw, Tami R Argo
PURPOSE: The question of whether publication of selected clinical trials is temporally followed by changes in prescribing of adjunctive lipid-lowering medications was evaluated. METHODS: In this retrospective preanalysis and postanalysis, Veterans Health Administration (VHA) patients 18 years or older who received a new or renewed order for any lipid-lowering medication between April 2, 2004, and September 2, 2014, were included. This period was chosen based on the publication dates of three trials investigating the efficacy of nonstatin medications: Simvastatin with or without Ezetimibe in Familial Hypercholesterolemia (ENHANCE, April 3, 2008), Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus (ACCORD Lipid, March 14, 2010), and Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy (AIM-HIGH, December 15, 2011)...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
Anish Amin, Aseel Houmsse, Abiodun Ishola, Jaret Tyler, Mahmoud Houmsse
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Aging populations coupled with improved outcomes for many chronic medical conditions has led to increases in AF diagnoses. AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death. This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure. The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings...
January 2016: Avicenna Journal of Medicine
Peter McKavanagh, Claire McCune, Ian B Menown
INTRODUCTION: Over the last year, multiple, potentially practice-changing, cardiology trials or studies have been published or presented at international meetings including the American College of Cardiology, European Association for Percutaneous Cardiovascular Interventions, European Society of Cardiology, Transcatheter Cardiovascular Therapeutics, Heart Failure Congress, Heart Rhythm Society, Heart Failure Society of America, American Society of Hypertension and the American Heart Association...
June 2015: Cardiology and Therapy
Emily G McDonald, Ramy R Saleh, Todd C Lee
OBJECTIVES: The US Food and Drug Administration licensed ezetimibe in 2002 because of its ability to lower low-density lipoprotein cholesterol levels, a surrogate marker for the risk of coronary artery disease. The negative results of the Effect of Ezetimibe Plus Simvastatin Versus Simvastatin Alone on Atherosclerosis in the Carotid Artery trial were published in 2008. Since then, we have seen 6 additional years without a landmark study in favor of ezetimibe. Furthermore, the new American Heart Association/American College of Cardiology guidelines (2013) now strongly downplay the use of nonstatin agents...
February 2015: American Journal of Medicine
Reginald Liew
Important advances have been made in the past few years in the fields of clinical cardiac electrophysiology and pacing. Researchers and clinicians have a greater understanding of the pathophysiological mechanisms underlying atrial fibrillation (AF), which has transpired into improved methods of detection, risk stratification, and treatments. The introduction of novel oral anticoagulants has provided clinicians with alternative options in managing patients with AF at moderate to high thromboembolic risk and further data has been emerging on the use of catheter ablation for the treatment of symptomatic AF...
April 2014: Acta Cardiologica
José Pedro Lopes Nunes
The field of medical therapeutics may be characterized as having suffered major scientific evolution in the last decades. The publication of landmark studies has been important enough to produce shifts in patient care. However, the scientific evolution in this field does not necessarily imply a progressively greater degree of certitude. In fact, it is not uncommon for new knowledge, when reflected in clinical practice, to weaken previous knowledge. In medical therapeutics, strict inductive reasoning implies the existence of empirical intervention data, typically clinical trial data...
2013: Perspectives in Biology and Medicine
Maciej Banach, Corina Serban, Wilbert S Aronow, Jacek Rysz, Simona Dragan, Edgar V Lerma, Mugurel Apetrii, Adrian Covic
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA...
May 2014: International Urology and Nephrology
Reginald Liew
Important advances have been made in the past few years in the fields of clinical cardiac electrophysiology and pacing. Researchers and clinicians have a greater understanding of the pathophysiological mechanisms underlying atrial fibrillation (AF), which has transpired into improved methods of detection,risk stratification, and treatments. The introduction of novel oral anticoagulants has provided clinicians with alternative options in managing patients with AF at moderate to high thromboembolic risk and further data has been emerging on the use of catheter ablation for the treatment of symptomatic AF...
December 2013: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Steven Hsu, Van-Khue Ton, M Dominique Ashen, Seth S Martin, Ty J Gluckman, Payal Kohli, Stephen D Sisson, Roger S Blumenthal, Michael J Blaha
Atherosclerotic cardiovascular disease (CVD) is the leading cause of death in the United States and worldwide. Fortunately, it is often preventable with early adoption of lifestyle modification, prevention of risk factor onset, and aggressive treatment of existing risk factors. The Million Hearts Initiative is an effort by the Centers for Disease Control that aims to prevent 1 million myocardial infarctions and strokes over the next 5 years. As part of this initiative, we present a simply organized "ABCDE" approach for guiding a consistent comprehensive approach to managing cardiovascular risk in daily clinical practice...
July 2013: Clinical Cardiology
Antonis S Manolis, Theodora A Manolis, Prokopis Papadimitriou, Spyros Koulouris, Helen Melita
Platelets play a key role in the pathogenesis of atherothrombosis, involved in both the development and progression of atherosclerotic heart disease, and the attendant acute thrombotic complications. Antiplatelet therapy constitutes a mainstay therapy for patients with acute coronary syndromes and generally high-risk patients with atherothrombosis. Until recently, dual antiplatelet therapy (DAPT) for the treatment and prevention of the complications of atherothrombotic disease was traditionally limited to aspirin plus clopidogrel...
June 2013: Cardiovascular & Hematological Agents in Medicinal Chemistry
Chantal Elamm, James C Fang
The optimal management for ischemic cardiomyopathy has been a clinical conundrum for years. Until the publication of the Surgical Treatment of Ischemic Cardiac Heart Failure (STICH) trial, recommendations have been primarily based upon expert opinion, retrospective literature, and clinical anecdotes. However, medical and device management have matured significantly in an era where surgical morbidity and mortality remain significant for coronary bypass grafting in the setting of severe left ventricular dysfunction...
March 2013: Progress in Cardiovascular Diseases
Lenard Conradi, Hermann Reichenspurner
Coronary artery bypass grafting (CABG) is the standard of care for patients with three-vessel or left main coronary artery disease. However, clinical practice has proven to differ substantially with even the most complex coronary lesions being targeted by percutaneous coronary intervention (PCI) today. An abundancy of both large registries and randomized clinical trials has demonstrated superiority of surgery over PCI in advanced coronary artery disease. Recently, these results have been confirmed by the landmark SYNTAX trial where CABG was found to be superior to PCI for three-vessel and/or left main coronary artery disease regarding repeat revascularization, rate of myocardial infarction, and cardiac mortality at the latest follow-up of 3 years...
May 2011: Clinical Research in Cardiology Supplements
Marc P Bonaca, Stephen D Wiviott, Eugene Braunwald, Sabina A Murphy, Christian T Ruff, Elliott M Antman, David A Morrow
BACKGROUND: The availability of more sensitive biomarkers of myonecrosis and a new classification system from the universal definition of myocardial infarction (MI) have led to evolution of the classification of MI. The prognostic implications of MI defined in the current era have not been well described. METHODS AND RESULTS: We investigated the association between new or recurrent MI by subtype according to the European Society of Cardiology/American College of Cardiology/American Heart Association/World Health Federation Task Force for the Redefinition of MI Classification System and the risk of cardiovascular death among 13 608 patients with acute coronary syndrome in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel-Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38)...
January 31, 2012: Circulation
Johannes Holzmeister, Christophe Leclercq
Implantable cardioverter defibrillators and cardiac resynchronisation therapy (CRT) have become standard of care in modern treatment for heart failure. Results from trials have provided ample evidence that CRT, in addition to its proven benefits in patients with symptomatic heart failure (New York Heart Association [NYHA] class III), might also reduce morbidity and mortality in those with mildly symptomatic heart failure (NYHA class II). As a result, the 2010 European Society of Cardiology guidelines now recommend CRT for both patient populations...
August 20, 2011: Lancet
G B Danzi, B Chevalier, M Ostojic, M Hamilos, W Wijns
Drug eluting stents (DES) have changed the landscape of interventional cardiology with their high efficacy in preventing restenosis. Several DES are available for clinical use with different drugs, polymers and platforms. The Nobori™ is a novel generation drug eluting stent. The drug, Biolimus A9™, a sirolimus analogue, is immersed in a biodegradable polymer which is applied solely to the abluminal surface of a flexible stainless steel stent platform. The drug-polymer matrix is designed to release the drug simultaneously with the polymer degradation in a process lasting between 6-9 months...
October 2010: Minerva Cardioangiologica
John Concato, Peter Peduzzi, Grant D Huang, Timothy J O'Leary, Joel Kupersmith
Comparative effectiveness research (CER) is increasingly popular, yet discussions of its conduct and consequences often overlook the extensive history of comparing different therapeutic options in patient-oriented research. In particular, research in the Department of Veterans Affairs (VA) has included a decades-long focus on generating information that can enhance medical decision making and improve health outcomes. Categories of such research include multisite randomized controlled trials (conducted by the Cooperative Studies Program) and observational studies involving either primary or secondary data collection...
August 2010: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Abid Hussain, Upendra Kaul
No abstract text is available yet for this article.
October 2009: Journal of the Indian Medical Association
James A Reiffel, Peter R Kowey, Robert Myerburg, Gerald V Naccarelli, Douglas L Packer, Craig M Pratt, Michael J Reiter, Albert L Waldo et al.
The Atrial Fibrillation: Focus on Effective Clinical Treatment Strategies (AFFECTS) Registry was designed to examine atrial fibrillation (AF) treatment by United States cardiologists in the context of the American College of Cardiology, American Heart Association, and European Society of Cardiology guidelines after recent landmark clinical trials. Most patients in AFFECTS had AF without clinically significant structural heart disease or only uncomplicated hypertension. Among the all-enrolled population (n = 1,461), initial treatment strategies assigned were rhythm control in 64% and rate control in 36%...
April 15, 2010: American Journal of Cardiology
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