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Practice: General Cardiology

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16 papers 0 to 25 followers
Stephan D Fihn, James C Blankenship, Karen P Alexander, John A Bittl, John G Byrne, Barbara J Fletcher, Gregg C Fonarow, Richard A Lange, Glenn N Levine, Thomas M Maddox, Srihari S Naidu, E Magnus Ohman, Peter K Smith
No abstract text is available yet for this article.
November 4, 2014: Circulation
Steen Dalby Kristensen, Juhani Knuuti, Antti Saraste, Stefan Anker, Hans Erik Bøtker, Stefan De Hert, Ian Ford, Jose Ramón Gonzalez-Juanatey, Bulent Gorenek, Guy Robert Heyndrickx, Andreas Hoeft, Kurt Huber, Bernard Iung, Keld Per Kjeldsen, Dan Longrois, Thomas F Lüscher, Luc Pierard, Stuart Pocock, Susanna Price, Marco Roffi, Per Anton Sirnes, Miguel Sousa-Uva, Vasilis Voudris, Christian Funck-Brentano
No abstract text is available yet for this article.
September 14, 2014: European Heart Journal
Bernard De Bruyne, William F Fearon, Nico H J Pijls, Emanuele Barbato, Pim Tonino, Zsolt Piroth, Nikola Jagic, Sven Mobius-Winckler, Gilles Rioufol, Nils Witt, Petr Kala, Philip MacCarthy, Thomas Engström, Keith Oldroyd, Kreton Mavromatis, Ganesh Manoharan, Peter Verlee, Ole Frobert, Nick Curzen, Jane B Johnson, Andreas Limacher, Eveline Nüesch, Peter Jüni
BACKGROUND: We hypothesized that in patients with stable coronary artery disease and stenosis, percutaneous coronary intervention (PCI) performed on the basis of the fractional flow reserve (FFR) would be superior to medical therapy. METHODS: In 1220 patients with stable coronary artery disease, we assessed the FFR in all stenoses that were visible on angiography. Patients who had at least one stenosis with an FFR of 0.80 or less were randomly assigned to undergo FFR-guided PCI plus medical therapy or to receive medical therapy alone...
September 25, 2014: New England Journal of Medicine
Marie-Claude Morice, Patrick W Serruys, A Pieter Kappetein, Ted E Feldman, Elisabeth Ståhle, Antonio Colombo, Michael J Mack, David R Holmes, James W Choi, Witold Ruzyllo, Grzegorz Religa, Jian Huang, Kristine Roy, Keith D Dawkins, Friedrich Mohr
BACKGROUND: Current guidelines recommend coronary artery bypass graft surgery (CABG) when treating significant de novo left main coronary artery (LM) stenosis; however, percutaneous coronary intervention (PCI) has a class IIa indication for unprotected LM disease in selected patients. This analysis compares 5-year clinical outcomes in PCI- and CABG-treated LM patients in the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, the largest trial in this group to date. METHODS AND RESULTS: The SYNTAX trial randomly assigned 1800 patients with LM or 3-vessel disease to receive either PCI (with TAXUS Express paclitaxel-eluting stents) or CABG...
June 10, 2014: Circulation
Rick A Nishimura, Catherine M Otto, Robert O Bonow, Blase A Carabello, John P Erwin, Robert A Guyton, Patrick T O'Gara, Carlos E Ruiz, Nikolaos J Skubas, Paul Sorajja, Thoralf M Sundt, James D Thomas
No abstract text is available yet for this article.
June 10, 2014: Circulation
Horng H Chen, Kevin J Anstrom, Michael M Givertz, Lynne W Stevenson, Marc J Semigran, Steven R Goldsmith, Bradley A Bart, David A Bull, Josef Stehlik, Martin M LeWinter, Marvin A Konstam, Gordon S Huggins, Jean L Rouleau, Eileen O'Meara, W H Wilson Tang, Randall C Starling, Javed Butler, Anita Deswal, G Michael Felker, Christopher M O'Connor, Raphael E Bonita, Kenneth B Margulies, Thomas P Cappola, Elizabeth O Ofili, Douglas L Mann, Víctor G Dávila-Román, Steven E McNulty, Barry A Borlaug, Eric J Velazquez, Kerry L Lee, Monica R Shah, Adrian F Hernandez, Eugene Braunwald, Margaret M Redfield
IMPORTANCE: Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested. OBJECTIVE: To test the 2 independent hypotheses that, compared with placebo, addition of low-dose dopamine (2 μg/kg/min) or low-dose nesiritide (0.005 μg/kg/min without bolus) to diuretic therapy will enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction...
December 18, 2013: JAMA: the Journal of the American Medical Association
Leonard S Lilly
No abstract text is available yet for this article.
April 23, 2013: Circulation
Paul W Armstrong, Anthony H Gershlick, Patrick Goldstein, Robert Wilcox, Thierry Danays, Yves Lambert, Vitaly Sulimov, Fernando Rosell Ortiz, Miodrag Ostojic, Robert C Welsh, Antonio C Carvalho, John Nanas, Hans-Richard Arntz, Sigrun Halvorsen, Kurt Huber, Stefan Grajek, Claudio Fresco, Erich Bluhmki, Anne Regelin, Katleen Vandenberghe, Kris Bogaerts, Frans Van de Werf
BACKGROUND: It is not known whether prehospital fibrinolysis, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary percutaneous coronary intervention (PCI) early after acute ST-segment elevation myocardial infarction (STEMI). METHODS: Among 1892 patients with STEMI who presented within 3 hours after symptom onset and who were unable to undergo primary PCI within 1 hour, patients were randomly assigned to undergo either primary PCI or fibrinolytic therapy with bolus tenecteplase (amended to half dose in patients ≥75 years of age), clopidogrel, and enoxaparin before transport to a PCI-capable hospital...
April 11, 2013: New England Journal of Medicine
Lars H Lund, Lina Benson, Ulf Dahlström, Magnus Edner
CONTEXT: Heart failure with preserved ejection fraction (HFPEF) may be as common and as lethal as heart failure with reduced ejection fraction (HFREF). Three randomized trials of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ie, renin-angiotensin system [RAS] antagonists) did not reach primary end points but may have had selection bias or been underpowered. OBJECTIVE: To test the hypothesis that use of RAS antagonists is associated with reduced all-cause mortality in an unselected population with HFPEF...
November 28, 2012: JAMA: the Journal of the American Medical Association
Thomas G Brott, Robert W Hobson, George Howard, Gary S Roubin, Wayne M Clark, William Brooks, Ariane Mackey, Michael D Hill, Pierre P Leimgruber, Alice J Sheffet, Virginia J Howard, Wesley S Moore, Jenifer H Voeks, L Nelson Hopkins, Donald E Cutlip, David J Cohen, Jeffrey J Popma, Robert D Ferguson, Stanley N Cohen, Joseph L Blackshear, Frank L Silver, J P Mohr, Brajesh K Lal, James F Meschia
BACKGROUND: Carotid-artery stenting and carotid endarterectomy are both options for treating carotid-artery stenosis, an important cause of stroke. METHODS: We randomly assigned patients with symptomatic or asymptomatic carotid stenosis to undergo carotid-artery stenting or carotid endarterectomy. The primary composite end point was stroke, myocardial infarction, or death from any cause during the periprocedural period or any ipsilateral stroke within 4 years after randomization...
July 1, 2010: New England Journal of Medicine
William C Cushman, Gregory W Evans, Robert P Byington, David C Goff, Richard H Grimm, Jeffrey A Cutler, Denise G Simons-Morton, Jan N Basile, Marshall A Corson, Jeffrey L Probstfield, Lois Katz, Kevin A Peterson, William T Friedewald, John B Buse, J Thomas Bigger, Hertzel C Gerstein, Faramarz Ismail-Beigi
BACKGROUND: There is no evidence from randomized trials to support a strategy of lowering systolic blood pressure below 135 to 140 mm Hg in persons with type 2 diabetes mellitus. We investigated whether therapy targeting normal systolic pressure (i.e., <120 mm Hg) reduces major cardiovascular events in participants with type 2 diabetes at high risk for cardiovascular events. METHODS: A total of 4733 participants with type 2 diabetes were randomly assigned to intensive therapy, targeting a systolic pressure of less than 120 mm Hg, or standard therapy, targeting a systolic pressure of less than 140 mm Hg...
April 29, 2010: New England Journal of Medicine
Keith Wheatley, Natalie Ives, Richard Gray, Philip A Kalra, Jonathan G Moss, Colin Baigent, Susan Carr, Nicholas Chalmers, David Eadington, George Hamilton, Graham Lipkin, Anthony Nicholson, John Scoble
BACKGROUND: Percutaneous revascularization of the renal arteries improves patency in atherosclerotic renovascular disease, yet evidence of a clinical benefit is limited. METHODS: In a randomized, unblinded trial, we assigned 806 patients with atherosclerotic renovascular disease either to undergo revascularization in addition to receiving medical therapy or to receive medical therapy alone. The primary outcome was renal function, as measured by the reciprocal of the serum creatinine level (a measure that has a linear relationship with creatinine clearance)...
November 12, 2009: New England Journal of Medicine
Olaf Schouten, Eric Boersma, Sanne E Hoeks, Robbert Benner, Hero van Urk, Marc R H M van Sambeek, Hence J M Verhagen, Nisar A Khan, Martin Dunkelgrun, Jeroen J Bax, Don Poldermans
BACKGROUND: Adverse cardiac events are common after vascular surgery. We hypothesized that perioperative statin therapy would improve postoperative outcomes. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned patients who had not previously been treated with a statin to receive, in addition to a beta-blocker, either 80 mg of extended-release fluvastatin or placebo once daily before undergoing vascular surgery. Lipid, interleukin-6, and C-reactive protein levels were measured at the time of randomization and before surgery...
September 3, 2009: New England Journal of Medicine
Paul M Ridker, Eleanor Danielson, Francisco A H Fonseca, Jacques Genest, Antonio M Gotto, John J P Kastelein, Wolfgang Koenig, Peter Libby, Alberto J Lorenzatti, Jean G MacFadyen, Børge G Nordestgaard, James Shepherd, James T Willerson, Robert J Glynn
BACKGROUND: Increased levels of the inflammatory biomarker high-sensitivity C-reactive protein predict cardiovascular events. Since statins lower levels of high-sensitivity C-reactive protein as well as cholesterol, we hypothesized that people with elevated high-sensitivity C-reactive protein levels but without hyperlipidemia might benefit from statin treatment. METHODS: We randomly assigned 17,802 apparently healthy men and women with low-density lipoprotein (LDL) cholesterol levels of less than 130 mg per deciliter (3...
November 20, 2008: New England Journal of Medicine
Denis Roy, Mario Talajic, Stanley Nattel, D George Wyse, Paul Dorian, Kerry L Lee, Martial G Bourassa, J Malcolm O Arnold, Alfred E Buxton, A John Camm, Stuart J Connolly, Marc Dubuc, Anique Ducharme, Peter G Guerra, Stefan H Hohnloser, Jean Lambert, Jean-Yves Le Heuzey, Gilles O'Hara, Ole Dyg Pedersen, Jean-Lucien Rouleau, Bramah N Singh, Lynne Warner Stevenson, William G Stevenson, Bernard Thibault, Albert L Waldo
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure and suggesting that the suppression of atrial fibrillation may favorably affect the outcome. However, the benefits and risks of this approach have not been adequately studied. METHODS: We conducted a multicenter, randomized trial comparing the maintenance of sinus rhythm (rhythm control) with control of the ventricular rate (rate control) in patients with a left ventricular ejection fraction of 35% or less, symptoms of congestive heart failure, and a history of atrial fibrillation...
June 19, 2008: New England Journal of Medicine
P J Devereaux, Homer Yang, Salim Yusuf, Gordon Guyatt, Kate Leslie, Juan Carlos Villar, Denis Xavier, Susan Chrolavicius, Launi Greenspan, Janice Pogue, Prem Pais, Lisheng Liu, Shouchun Xu, German Málaga, Alvaro Avezum, Matthew Chan, Victor M Montori, Mike Jacka, Peter Choi
BACKGROUND: Trials of beta blockers in patients undergoing non-cardiac surgery have reported conflicting results. This randomised controlled trial, done in 190 hospitals in 23 countries, was designed to investigate the effects of perioperative beta blockers. METHODS: We randomly assigned 8351 patients with, or at risk of, atherosclerotic disease who were undergoing non-cardiac surgery to receive extended-release metoprolol succinate (n=4174) or placebo (n=4177), by a computerised randomisation phone service...
May 31, 2008: Lancet
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