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https://www.readbyqxmd.com/read/28927706/cardiovascular-safety-and-efficacy-of-the-pcsk9-inhibitor-evolocumab-in-patients-with-and-without-diabetes-and-the-effect-of-evolocumab-on-glycaemia-and-risk-of-new-onset-diabetes-a-prespecified-analysis-of-the-fourier-randomised-controlled-trial
#1
Marc S Sabatine, Lawrence A Leiter, Stephen D Wiviott, Robert P Giugliano, Prakash Deedwania, Gaetano M De Ferrari, Sabina A Murphy, Julia F Kuder, Ioanna Gouni-Berthold, Basil S Lewis, Yehuda Handelsman, Armando Lira Pineda, Narimon Honarpour, Anthony C Keech, Peter S Sever, Terje R Pedersen
BACKGROUND: The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab reduced LDL cholesterol and cardiovascular events in the FOURIER trial. In this prespecified analysis of FOURIER, we investigated the efficacy and safety of evolocumab by diabetes status and the effect of evolocumab on glycaemia and risk of developing diabetes. METHODS: FOURIER was a randomised trial of evolocumab (140 mg every 2 weeks or 420 mg once per month) versus placebo in 27 564 patients with atherosclerotic disease who were on statin therapy, followed up for a median of 2·2 years...
September 14, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28926377/sequential-and-urgent-coronary-artery-bypass-surgery-followed-by-kidney-transplantation-in-a-highly-sensitized-patient-with-unstable-angina
#2
Han Yao, Mark Smilovitch, Renzo Cerere, Shaifali Sandal, Steven Paraskevas, Dana Baran, Maria Helena Calixto Fernandes, Chee Loong Saw, Jean Tchervenkov, Marcelo Cantarovich
No abstract text is available yet for this article.
September 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28925859/effects-of-evolocumab-on-cardiovascular-events
#3
Nasser Mikhail
BACKGROUND: Evolocumab is a potent lipid-lowering drug that decreases plasma levels of low-density lipoprotein cholesterol (LDL-C) by 50-60%. FOURIER is a landmark randomized, trial involving 27,564 patients with established cardiovascular disease already on statins and plasma LDL-C levels > 70 mg/dl. OBJECTIVE: the main objective of FOURIER was to examine the effects of evolocumab on cardiovascular events. RESULTS: After a mean follow-up of 2...
September 18, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28923989/competing-risks-of-cardiovascular-versus-noncardiovascular-death-during-long-term-follow-up-after-acute-coronary-syndromes
#4
Alexander C Fanaroff, Matthew T Roe, Robert M Clare, Yuliya Lokhnygina, Ann Marie Navar, Robert P Giugliano, Stephen D Wiviott, Andrew M Tershakovec, Eugene Braunwald, Michael A Blazing
BACKGROUND: Understanding the relative risk of cardiovascular versus noncardiovascular death is important for designing clinical trials. These risks may differ depending on patient age, sex, and type of acute coronary syndrome (ACS). METHODS AND RESULTS: IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) was a randomized controlled trial of simvastatin plus either ezetimibe or placebo following stabilized ACS. Cause of death was adjudicated by an independent committee...
September 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28917545/effects-of-acarbose-on-cardiovascular-and-diabetes-outcomes-in-patients-with-coronary-heart-disease-and-impaired-glucose-tolerance-ace-a-randomised-double-blind-placebo-controlled-trial
#5
Rury R Holman, Ruth L Coleman, Juliana C N Chan, Jean-Louis Chiasson, Huimei Feng, Junbo Ge, Hertzel C Gerstein, Richard Gray, Yong Huo, Zhihui Lang, John J McMurray, Lars Rydén, Stefan Schröder, Yihong Sun, Michael J Theodorakis, Michal Tendera, Lynne Tucker, Jaakko Tuomilehto, Yidong Wei, Wenying Yang, Duolao Wang, Dayi Hu, Changyu Pan
BACKGROUND: The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. METHODS: The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#6
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28913846/cardioprotective-effects-of-pomegranate-punica-granatum-juice-in-patients-with-ischemic-heart-disease
#7
Zahra Razani, Mostafa Dastani, Hamid Reza Kazerani
Ischemic heart disease is the leading cause of mortality worldwide. The purpose of this study was to evaluate the cardioprotective effects of pomegranate juice in patients with ischemic heart disease. One hundred patients, diagnosed with unstable angina or myocardial infarction, were randomly assigned to the test and the control groups (n = 50, each). During 5 days of hospitalization, in addition to the conventional medical therapies, the test groups received 220 mL pomegranate juice, daily. During the hospitalization period, the blood pressure, heart rate, as well as the intensity, occurrence, and duration of the angina were evaluated on a regular basis...
September 15, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/28902646/a-massive-left-to-right-shunt-due-to-delayed-spontaneous-perforation-of-polyvinyl-alcohol-membrane-of-atrial-septal-occluder
#8
Serdar Bozyel, Tayfun Şahin, Emir Dervis, Müjdat Aktaş, Hüseyin Şaşkın
Percutaneous closure of an atrial septal defect (ASD) has emerged as an alternative to surgery. A 54-yearold woman with a history of percutaneous ASD closure with a 30-mm Cardia Ultrasept septal occluder (Cardia Inc., Eagan, MN, USA) comprising 2 discs made of Nitinol wire mesh covered with polyvinyl alcohol (PVA) membrane, was admitted to the hospital with unstable angina pectoris. In a routine examination, transthoracic echocardiography revealed a left-to-right shunt through the device. Transesophageal echocardiography (TEE) also demonstrated significant left-to-right shunt through the central portion of the prosthesis...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28902641/assessment-of-the-association-between-the-personality-traits-of-young-patients-with-acute-coronary-syndrome-and-the-severity-of-coronary-artery-disease
#9
Nermin Bayar, Ramazan Güven, Zehra Erkal, Kamil Can Akyol, Mustafa Ilker Edebali, Selçuk Küçükseymen, Şakir Arslan
OBJECTIVE: The role of psychosocial risk factors is becoming increasingly important in the etiology of acute coronary syndrome (ACS). The purpose of this study was to assess an association between the personality types of young patients with ACS and the prevalence and severity of coronary artery disease (CAD). METHODS: Patients younger than 45 years of age who presented with ACS and who underwent coronary angiography in the period from 2012 to 2016 were included in the study...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28892218/quality-of-erections-by-age-group-in-men-with-erectile-dysfunction
#10
Jed C Kaminetsky, Vera Stecher, Li-Jung Tseng
AIMS: The aim of this study was to assess erection quality with sildenafil vs placebo and adverse events (AEs) according to age (≤45, 46-55 and ≥56 years) in 997 men with erectile dysfunction (ED) using pooled data from four randomized, double-blind, placebo-controlled, flexible-dose trials. METHODS: The trials included 6- to 10-week treatment periods. The starting sildenafil dose was 50 mg, taken ~1 hour before sexual activity but not more than once daily, with subsequent adjustment to 100 or 25 mg based on efficacy and safety...
September 11, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28891590/co-administration-of-cyclosporine-and-ticagrelor-may-lead-to-a-higher-exposure-to-cyclosporine-a-case-report-of-a-49-year-old-man
#11
T T van Sloten, P A G de Klaver, A W L van den Wall Bake
A drug interaction leading to higher exposure to cyclosporine DRUGS IMPLICATED: Cyclosporine and ticagrelor THE PATIENT: A 49-year old man with a stable renal graft, managed with cyclosporine with stable trough blood concentrations for several years, was treated with ticagrelor for unstable angina pectoris EVIDENCE THAT LINKS THE DRUG TO THE EVENT: The timeline was consistent with the appearance of an interaction, the interaction was confirmed by an increase in trough concentration of cyclosporine, and there were no alternative causes that by themselves could have caused the increase in cyclosporine exposure MANAGEMENT: Cessation of ticagrelor MECHANISM: Inhibition of CYP3A4 and P-glycoprotein by ticagrelor IMPLICATIONS FOR THERAPY: Clinicians should be aware of this potential interaction as ticagrelor is frequently prescribed in individuals using cyclosporine...
September 11, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28868073/antithrombotic-treatment-tailoring-and-risk-score-evaluation-in-elderly-patients-diagnosed-with-an-acute-coronary-syndrome
#12
REVIEW
Alexandru Nicolae Mischie, Catalina Liliana Andrei, Crina Sinescu, Gani Bajraktari, Eugen Ivan, Georgios Nikolaos Chatziathanasiou, Michele Schiariti
Age is an important prognostic factor in the outcome of acute coronary syndromes (ACS). A substantial percentage of patients who experience ACS is more than 75 years old, and they represent the fastest-growing segment of the population treated in this setting. These patients present different patterns of responses to pharmacotherapy, namely, a higher ischemic and bleeding risk than do patients under 75 years of age. Our aim was to identify whether the currently available ACS ischemic and bleeding risk scores, which has been validated for the general population, may also apply to the elderly population...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28859947/clinical-efficacy-and-safety-of-achieving-very-low-ldl-cholesterol-concentrations-with-the-pcsk9-inhibitor-evolocumab-a-prespecified-secondary-analysis-of-the-fourier-trial
#13
Robert P Giugliano, Terje R Pedersen, Jeong-Gun Park, Gaetano M De Ferrari, Zbigniew A Gaciong, Richard Ceska, Kalman Toth, Ioanna Gouni-Berthold, Jose Lopez-Miranda, François Schiele, François Mach, Brian R Ott, Estella Kanevsky, Armando Lira Pineda, Ransi Somaratne, Scott M Wasserman, Anthony C Keech, Peter S Sever, Marc S Sabatine
BACKGROUND: LDL cholesterol is a well established risk factor for atherosclerotic cardiovascular disease. How much one should or safely can lower this risk factor remains debated. We aimed to explore the relationship between progressively lower LDL-cholesterol concentrations achieved at 4 weeks and clinical efficacy and safety in the FOURIER trial of evolocumab, a monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9). METHODS: In this prespecified secondary analysis of 25 982 patients from the randomised FOURIER trial, the relationship between achieved LDL-cholesterol concentration at 4 weeks and subsequent cardiovascular outcomes (primary endpoint was the composite of cardiovascular death, myocardial infarction, stroke, coronary revascularisation, or unstable angina; key secondary endpoint was the composite of cardiovascular death, myocardial infarction, or stroke) and ten prespecified safety events of interest was examined over a median of 2·2 years of follow-up...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28845751/antiinflammatory-therapy-with-canakinumab-for-atherosclerotic-disease
#14
Paul M Ridker, Brendan M Everett, Tom Thuren, Jean G MacFadyen, William H Chang, Christie Ballantyne, Francisco Fonseca, Jose Nicolau, Wolfgang Koenig, Stefan D Anker, John J P Kastelein, Jan H Cornel, Prem Pais, Daniel Pella, Jacques Genest, Renata Cifkova, Alberto Lorenzatti, Tamas Forster, Zhanna Kobalava, Luminita Vida-Simiti, Marcus Flather, Hiroaki Shimokawa, Hisao Ogawa, Mikael Dellborg, Paulo R F Rossi, Roland P T Troquay, Peter Libby, Robert J Glynn
Background Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo...
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28844035/state-of-the-art-optimal-medical-therapy-competing-with-or-complementary-to-revascularisation-in-patients-with-coronary-artery-disease
#15
Javaid Iqbal, Robert Widmer, Bernard J Gersh
The role of coronary revascularisation with PCI and CABG in patients with stable and unstable coronary artery disease (CAD) is well established and there is a general consensus among guidelines as regards the indications for coronary revascularisation. Although revascularisation has undoubtedly revolutionised the treatment of CAD, it is vital to understand the recent advances and importance of the concomitant use of evidence-based optimal medical therapy (OMT). In contemporary practice, OMT should include an antiplatelet agent (or dual antiplatelet therapy when indicated) and a lipid-lowering drug for all patients, and a beta-blocker and an ACE inhibitor (or angiotensin receptor blocker) for the vast majority of patients, along with addressing cardiac risk factors and lifestyle management...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28840737/-clinical-study-fourier
#16
Ján Murín
A new group of hypolipidemic substances, i.e. PCSK9 protein inhibitors, is now coming into use in clinical practice, to what extent a high residual cardiovascular risk remains also in patients treated with statins. The FOURIER study (Further cardiovascular OUtcomes Research with PCSK9 Inhibition subjects with Elevated Risk) is the first "event" study which has shown that evolocumab (PCSK9 antibody) further significantly reduces serum LDL cholesterol and subsequently also cardiovascular morbidity and mortality: (a) composite primary goal (cardiovascular mortality, incidence of heart attacks, strokes, hospitalizations for unstable angina, coronary revascularization) by 15 % (p < 0...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28836672/whole-grain-cereals-for-the-primary-or-secondary-prevention-of-cardiovascular-disease
#17
REVIEW
Sarah Am Kelly, Louise Hartley, Emma Loveman, Jill L Colquitt, Helen M Jones, Lena Al-Khudairy, Christine Clar, Roberta Germanò, Hannah R Lunn, Gary Frost, Karen Rees
BACKGROUND: There is evidence from observational studies that whole grains can have a beneficial effect on risk for cardiovascular disease (CVD). Earlier versions of this review found mainly short-term intervention studies. There are now longer-term randomised controlled trials (RCTs) available. This is an update and expansion of the original review conducted in 2007. OBJECTIVES: The aim of this systematic review was to assess the effect of whole grain foods or diets on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible RCTs...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28832903/drug-eluting-stents-versus-bare-metal-stents-for-acute-coronary-syndrome
#18
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Janette Greenhalgh, Juliet Hounsome, Naqash J Sethi, Sanam Safi, Christian Gluud, Janus C Jakobsen
BACKGROUND: Approximately 3.7 million people died from acute coronary syndrome worldwide in 2012. Acute coronary syndrome, also known as myocardial infarction or unstable angina pectoris, is caused by a sudden blockage of the blood supplied to the heart muscle. Percutaneous coronary intervention is often used for acute coronary syndrome, but previous systematic reviews on the effects of drug-eluting stents compared with bare-metal stents have shown conflicting results with regard to myocardial infarction; have not fully taken account of the risk of random and systematic errors; and have not included all relevant randomised clinical trials...
August 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28832745/predictors-of-mediastinitis-risk-after-coronary-artery-bypass-surgery-applicability-of-score-in-1-322-cases
#19
Fabiana Dos Santos Oliveira, Letícia Delfino Oliveira de Freitas, Eneida Rejane Rabelo-Silva, Laura Maggi da Costa, Renato Abdala Karam Kalil, Maria Antonieta Pereira de Moraes
Background: Mediastinitis is a severe surgical complication of low incidence, but high lethality. Scores used in the preoperative period to stratify the risk of postoperative mediastinitis may contribute to improve the results. Objective: To test the applicability of the MagedanzSCORE in predicting the risk factors for mediastinitis in patients undergoing coronary artery bypass grafting at a cardiology reference hospital. Methods: Historical cohort study with adult patients who underwent coronary artery bypass grafting...
August 17, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28830955/composite-primary-end-points-in-cardiovascular-outcomes-trials-involving-type-2-diabetes-patients-should-unstable-angina-be-included-in-the-primary-end-point
#20
Nikolaus Marx, Darren K McGuire, Vlado Perkovic, Hans-Juergen Woerle, Uli C Broedl, Maximilian von Eynatten, Jyothis T George, Julio Rosenstock
Reductions in cardiovascular (CV) outcomes in recently reported trials, along with the recent approval by the U.S. Food and Drug Administration of an additional indication for empagliflozin to reduce the risk of CV death in type 2 diabetes patients with evidence of CV disease, have renewed interest in CV outcome trials (CVOTs) of glucose-lowering drugs. Composite end points are a pragmatic necessity in CVOTs to ensure that sample size and duration of follow-up remain reasonable. Combining clinical outcomes into a composite end point increases the numbers of events ascertained and thus statistical power and precision...
September 2017: Diabetes Care
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