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Cardiologia

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58 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28605779/use-of-the-dual-antiplatelet-therapy-score-to-guide-treatment-duration-after-percutaneous-coronary-intervention
#1
RANDOMIZED CONTROLLED TRIAL
Raffaele Piccolo, Giuseppe Gargiulo, Anna Franzone, Andrea Santucci, Sara Ariotti, Andrea Baldo, Carlo Tumscitz, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
Background: The dual-antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive harm (score <2) or benefit (score ≥2) from prolonged DAPT after percutaneous coronary intervention (PCI). Objective: To evaluate the safety and efficacy of DAPT duration according to DAPT score. Design: Retrospective assessment of DAPT score-guided treatment duration in a randomized clinical trial. (ClinicalTrials.gov: NCT00611286)...
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#2
REVIEW
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28460827/heart-failure
#3
REVIEW
Marco Metra, John R Teerlink
Heart failure is common in adults, accounting for substantial morbidity and mortality worldwide. Its prevalence is increasing because of ageing of the population and improved treatment of acute cardiovascular events, despite the efficacy of many therapies for patients with heart failure with reduced ejection fraction, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists, and advanced device therapies. Combined angiotensin receptor blocker neprilysin inhibitors (ARNIs) have been associated with improvements in hospital admissions and mortality from heart failure compared with enalapril, and guidelines now recommend substitution of ACE inhibitors or ARBs with ARNIs in appropriate patients...
April 28, 2017: Lancet
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#4
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28357786/the-real-role-of-%C3%AE-blockers-in-daily-cardiovascular-therapy
#5
REVIEW
Csaba András Dézsi, Veronika Szentes
The role of β-adrenoceptor antagonists (β-blockers) in cardiovascular therapy has been subject to diverse trends and changes over the decades. With the advent of a wide variety of excellent drugs for the treatment of antihypertension, β-blockers have been relegated from the first-line treatment of essential hypertension. However, they remain the drugs of first choice in recommendations from the respective medical societies for heart failure, coronary artery disease, and atrial fibrillation as well as in hypertension complicated with heart failure, angina pectoris, or prior myocardial infarction...
March 29, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28190577/dilated-cardiomyopathy
#6
REVIEW
Robert G Weintraub, Christopher Semsarian, Peter Macdonald
Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine disturbances. The most common presenting symptoms relate to congestive heart failure, but can also include circulatory collapse, arrhythmias, and thromboembolic events...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/27832612/current-diagnostic-and-treatment-strategies-for-specific-dilated-cardiomyopathies-a-scientific-statement-from-the-american-heart-association
#7
Biykem Bozkurt, Monica Colvin, Jennifer Cook, Leslie T Cooper, Anita Deswal, Gregg C Fonarow, Gary S Francis, Daniel Lenihan, Eldrin F Lewis, Dennis M McNamara, Elfriede Pahl, Ramachandran S Vasan, Kumudha Ramasubbu, Kismet Rasmusson, Jeffrey A Towbin, Clyde Yancy
No abstract text is available yet for this article.
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#8
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
BACKGROUND: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. METHODS: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27011791/sepsis-induced-myocardial-dysfunction-pathophysiology-and-management
#9
REVIEW
Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27348414/heart-rate-and-left-ventricular-adverse-remodelling-after-st-elevation-myocardial-infarction
#10
Martin Reindl, Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Christina Tiller, Agnes Mayr, Gert Klug, Bernhard Metzler
BACKGROUND: Discharge heart rate (HR) following ST-elevation myocardial infarction (STEMI) is a predictor of adverse left ventricular remodelling (LVR). However, the prognostic relevance of HR values in the earlier phase after revascularization is unknown. We aimed to investigate resting HR assessed at different time points during hospital stay following STEMI for the prediction of LVR. METHODS: In this prospective observational study of 143 consecutive STEMI patients, HR was measured serially on admission (AHR), at day 1 (HRd1) and 2 (HRd2) following revascularization and finally at discharge (DHR)...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27406184/interventional-procedures-and-future-drug-therapy-for-hypertension
#11
Melvin D Lobo, Paul A Sobotka, Atul Pathak
Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious...
April 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/27217297/myocardial-revascularization-for-patients-with-diabetes-coronary-artery-bypass-grafting-or-percutaneous-coronary-intervention
#12
REVIEW
Serenella Castelvecchio, Lorenzo Menicanti, Andrea Garatti, Roberto Tramarin, Marianna Volpe, Alessandro Parolari
Patients affected by diabetes usually have extensive coronary artery disease. Coronary revascularization has a prominent role in the treatment of coronary artery disease in the expanding diabetic population. However, diabetic patients undergoing coronary artery bypass grafting or percutaneous coronary intervention experience worse outcomes than nondiabetic patients. Several studies comparing coronary artery bypass grafting vs percutaneous coronary intervention in subgroups of diabetic patients demonstrated a survival advantage and fewer repeat revascularization procedures with an initial surgical strategy...
September 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27232927/the-role-of-levosimendan-in-acute-heart-failure-complicating-acute-coronary-syndrome-a-review-and-expert-consensus-opinion
#13
REVIEW
Markku S Nieminen, Michael Buerke, Alain Cohen-Solál, Susana Costa, István Édes, Alexey Erlikh, Fatima Franco, Charles Gibson, Vojka Gorjup, Fabio Guarracino, Finn Gustafsson, Veli-Pekka Harjola, Trygve Husebye, Kristjan Karason, Igor Katsytadze, Sundeep Kaul, Matti Kivikko, Giancarlo Marenzi, Josep Masip, Simon Matskeplishvili, Alexandre Mebazaa, Jacob E Møller, Jadwiga Nessler, Bohdan Nessler, Argyrios Ntalianis, Fabrizio Oliva, Emel Pichler-Cetin, Pentti Põder, Alejandro Recio-Mayoral, Steffen Rex, Richard Rokyta, Ruth H Strasser, Endre Zima, Piero Pollesello
Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease...
September 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27207980/the-neprilysin-pathway-in-heart-failure-a-review-and-guide-on-the-use-of-sacubitril-valsartan
#14
REVIEW
Pardeep S Jhund, John J V McMurray
Inhibition of neurohumoural pathways such as the renin angiotensin aldosterone and sympathetic nervous systems is central to the understanding and treatment of heart failure (HF). Conversely, until recently, potentially beneficial augmentation of neurohumoural systems such as the natriuretic peptides has had limited therapeutic success. Administration of synthetic natriuretic peptides has not improved outcomes in acute HF but modulation of the natriuretic system through inhibition of the enzyme that degrades natriuretic (and other vasoactive) peptides, neprilysin, has proven to be successful...
September 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27207191/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-and-chronic-heart-failure-the-task-force-for-the-diagnosis-and-treatment-of-acute-and-chronic-heart-failure-of-the-european-society-of-cardiology-esc-developed-with-the-special-contribution-of-the
#15
Piotr Ponikowski, Adriaan A Voors, Stefan D Anker, Héctor Bueno, John G F Cleland, Andrew J S Coats, Volkmar Falk, José Ramón González-Juanatey, Veli-Pekka Harjola, Ewa A Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T Parissis, Burkert Pieske, Jillian P Riley, Giuseppe M C Rosano, Luis M Ruilope, Frank Ruschitzka, Frans H Rutten, Peter van der Meer
No abstract text is available yet for this article.
August 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27252452/antithrombotic-therapy-in-heart-failure-patients-with-and-without-atrial-fibrillation-update-and-future-challenges
#16
REVIEW
João Pedro Ferreira, Nicolas Girerd, Saleh Alshalash, Marvin A Konstam, Faiez Zannad
Atrial fibrillation (AF) and heart failure (HF) often coexist, and patients with AF and HF have a higher risk of thromboembolic events and overall mortality compared with those with AF without HF. Additionally, the prevalence of AF increases with the severity of HF. The use of vitamin K antagonists is more unstable in patients with concomitant AF and HF, which is an independent risk factor for reduced time under therapeutic range. More recently, non-vitamin K antagonists oral anticoagulants (NOACs) have emerged as therapeutic alternatives for stroke prevention in patients with non-valvular AF, as they have been shown to be at least as efficacious and safe, with less intracranial bleeding events, compared with vitamin K antagonists...
August 2016: European Heart Journal
https://www.readbyqxmd.com/read/26933848/stopping-vs-continuing-aspirin-before-coronary-artery-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Sophie Wallace
BACKGROUND: Most patients with coronary artery disease receive aspirin for primary or secondary prevention of myocardial infarction, stroke, and death. Aspirin poses a risk of bleeding in patients undergoing surgery, but it is unclear whether aspirin should be stopped before coronary artery surgery. METHODS: We used a 2-by-2 factorial trial design to randomly assign patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
February 25, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26318604/assessment-of-the-cha2ds2-vasc-score-in-predicting-ischemic-stroke-thromboembolism-and-death-in-patients-with-heart-failure-with-and-without-atrial-fibrillation
#18
Line Melgaard, Anders Gorst-Rasmussen, Deidre A Lane, Lars Hvilsted Rasmussen, Torben Bjerregaard Larsen, Gregory Y H Lip
IMPORTANCE: The CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke/transient ischemic attack/thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) is used clinically for stroke risk stratification in atrial fibrillation (AF). Its usefulness in a population of patients with heart failure (HF) is unclear. OBJECTIVE: To investigate whether CHA2DS2-VASc predicts ischemic stroke, thromboembolism, and death in a cohort of patients with HF with and without AF...
September 8, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27195462/sprint-results-in-older-patients-how-low-to-go
#19
EDITORIAL
Aram V Chobanian
No abstract text is available yet for this article.
June 28, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27147609/taxonomy-of-segmental-myocardial-systolic-dysfunction
#20
REVIEW
Adam K McDiarmid, Pierpaolo Pellicori, John G Cleland, Sven Plein
The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms 'viable' and 'hibernating' are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions...
April 1, 2017: European Heart Journal
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