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1.

001-es BibID:BIBFORM020688
Első szerző:Barrett-Connor, Elizabeth
Cím:Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women / Barrett-Connor E., Mosca L., Collins P., Geiger M. J., Grady D., Kornitzer M., McNabb M. A., Wenger N. K., the Raloxifene Use for The Heart (RUTH) Trial Investigators
Dátum:2006
Megjegyzések:The effect of raloxifene, a selective estrogen-receptor modulator, on coronary heart disease (CHD) and breast cancer is not established. METHODS: We randomly assigned 10,101 postmenopausal women (mean age, 67.5 years) with CHD or multiple risk factors for CHD to 60 mg of raloxifene daily or placebo and followed them for a median of 5.6 years. The two primary outcomes were coronary events (i.e., death from coronary causes, myocardial infarction, or hospitalization for an acute coronary syndrome) and invasive breast cancer. RESULTS: As compared with placebo, raloxifene had no significant effect on the risk of primary coronary events (533 vs. 553 events; hazard ratio, 0.95; 95 percent confidence interval, 0.84 to 1.07), and it reduced the risk of invasive breast cancer (40 vs. 70 events; hazard ratio, 0.56; 95 percent confidence interval, 0.38 to 0.83; absolute risk reduction, 1.2 invasive breast cancers per 1000 women treated for one year); the benefit was primarily due to a reduced risk of estrogen-receptor-positive invasive breast cancers. There was no significant difference in the rates of death from any cause or total stroke according to group assignment, but raloxifene was associated with an increased risk of fatal stroke (59 vs. 39 events; hazard ratio, 1.49; 95 percent confidence interval, 1.00 to 2.24; absolute risk increase, 0.7 per 1000 woman-years) and venous thromboembolism (103 vs. 71 events; hazard ratio, 1.44; 95 percent confidence interval, 1.06 to 1.95; absolute risk increase, 1.2 per 1000 woman-years). Raloxifene reduced the risk of clinical vertebral fractures (64 vs. 97 events; hazard ratio, 0.65; 95 percent confidence interval, 0.47 to 0.89; absolute risk reduction, 1.3 per 1000). CONCLUSIONS: Raloxifene did not significantly affect the risk of CHD. The benefits of raloxifene in reducing the risks of invasive breast cancer and vertebral fracture should be weighed against the increased risks of venous thromboembolism and fatal stroke. (ClinicalTrials.gov number, NCT00190593 [ClinicalTrials.gov].).
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:The New England Journal of Medicine. - 355 : 2 (2006), p. 125-137. -
További szerzők:Mosca, Lori Collins, Peter Geiger, Mary Jane Grady, Deborah Kornitzer, Marcel McNabb, Michelle A. Wenger, Nanette K. Czuriga István (1948-2018) (kardiológus) the Raloxifene Use for The Heart (RUTH) Trial Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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2.

001-es BibID:BIBFORM099099
Első szerző:Bonaca, Marc P.
Cím:Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction / Bonaca Marc P., Bhatt Deepak L., Cohen Marc, Steg Philippe Gabriel, Storey Robert F., Jensen Eva C., Magnani Giulia, Bansilal Sameer, Fish M. Polly, Im Kyungah, Bengtsson Olof, Ophuis Ton Oude, Budaj Andrzej, Theroux Pierre, Ruda Mikhail, Hamm Christian, Goto Shinya, Spinar Jindrich, Nicolau José Carlos, Kiss Robert G., Murphy Sabina A., Wiviott Stephen D., Held Peter, Braunwald Eugene, Sabatine Marc S., PEGASUS-TIMI 54 Steering Committee and Investigators
Dátum:2015
ISSN:0028-4793
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:New England Journal Of Medicine. - 372 : 19 (2015), p. 1791-1800. -
További szerzők:Bhatt, Deepak L. Cohen, Marc A. Steg, Philippe Gabriel Storey, Robert F. Jensen, Eva C. Magnani, Giulia Bansilal, Sameer Fish, M. Polly Im, Kyungah Bengtsson, Olof Ophuis, Ton Oude Budaj, Andrzej Theroux, Pierre Ruda, Mikhail Hamm, Christian Goto, Shinya Špinar, Jindrich Nicolau, José Carlos Kiss Róbert Gábor Murphy, Sabina A. Wiviott, Stephen D. Held, Peter Braunwald, Eugene Sabatine, Marc S. Jenei Csaba (1976-) (kardiológus) PEGASUS-TIMI 54 Steering Committee and Investigators
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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3.

001-es BibID:BIBFORM010419
Első szerző:Giugliano, Robert P.
Cím:Early versus delayed, provisional eptifibatide in acute coronary syndromes / Giugliano, R. P., White, J. A., Bode, C., Armstrong, P. W., Montalescot, G., Lewis, B. S., van't Hof, A., Berdan, L. G., Lee, K. L., Strony, J. T., Hildemann, S., Veltri, E., Van de Werf, F., Braunwald, E., Harrington, R. A., Califf, R. M., Newby, L. K., The EARLY ACS Investigators, Keltai M.
Dátum:2009
ISSN:1533-4406 (Electronic)
Megjegyzések:Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. METHODS: We compared a strategy of early, routine administration of eptifibatide with delayed, provisional administration in 9492 patients who had acute coronary syndromes without ST-segment elevation and who were assigned to an invasive strategy. Patients were randomly assigned to receive either early eptifibatide (two boluses, each containing 180 microg per kilogram of body weight, administered 10 minutes apart, and a standard infusion > or = 12 hours before angiography) or a matching placebo infusion with provisional use of eptifibatide after angiography (delayed eptifibatide). The primary efficacy end point was a composite of death, myocardial infarction, recurrent ischemia requiring urgent revascularization, or the occurrence of a thrombotic complication during percutaneous coronary intervention that required bolus therapy opposite to the initial study-group assignment ("thrombotic bailout") at 96 hours. The key secondary end point was a composite of death or myocardial infarction within the first 30 days. Key safety end points were bleeding and the need for transfusion within the first 120 hours after randomization. RESULTS: The primary end point occurred in 9.3% of patients in the early-eptifibatide group and in 10.0% in the delayed-eptifibatide group (odds ratio, 0.92; 95% confidence interval [CI], 0.80 to 1.06; P=0.23). At 30 days, the rate of death or myocardial infarction was 11.2% in the early-eptifibatide group, as compared with 12.3% in the delayed-eptifibatide group (odds ratio, 0.89; 95% CI, 0.79 to 1.01; P=0.08). Patients in the early-eptifibatide group had significantly higher rates of bleeding and red-cell transfusion. There was no significant difference between the two groups in rates of severe bleeding or nonhemorrhagic serious adverse events. CONCLUSIONS: In patients who had acute coronary syndromes without ST-segment elevation, the use of eptifibatide 12 hours or more before angiography was not superior to the provisional use of eptifibatide after angiography. The early use of eptifibatide was associated with an increased risk of non-life-threatening bleeding and need for transfusion.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Acute Coronary Syndrome
Aged
Angina Pectoris
Angioplasty, Transluminal, Percutaneous Coronary
Combined Modality Therapy
Coronary Angiography
Coronary Artery Bypass
Drug Administration Schedule
Drug Therapy, Combination
Electrocardiography
Female
Hemorrhage
Humans
Infusions, Intravenous
Kaplan-Meiers Estimate
Male
Middle Aged
Myocardial Infarction
Odds Ratio
Peptides
dosage
Platelet Aggregation Inhibitors
dosage
Platelet Glycoprotein GPIIb-IIIa Complex
inhibitors
Thrombosis
control
Treatment Failure
Megjelenés:The New England Journal of Medicine. - 360 : 21 (2009), p. 2176-2190. -
További szerzők:White, Jennifer A. Bode, Christoph Armstrong, Paul W. Montalescot, Gilles Lewis, Basil S. van't Hof, Arnoud Berdan, Lisa G. Lee, Kerry L. Strony, John T. Hildemann, Steven Veltri, Enrico Werf, Frans, van de Braunwald, Eugene Harrington, Robert A. Califf, Robert M. Newby, L. Kristin Keltai Mátyás (1942-) (kardiológus) The EARLY ACS Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM019413
Első szerző:James, W. Philip
Cím:Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects / James W. P., Caterson I. D., Coutinho W., Finer N., Van Gaal L. F., Maggioni A. P., Torp-Pedersen C., Sharma A. M., Shepherd G. M., Rode R. A., Renz C. L., for the SCOUT Investigators
Dátum:2010
Megjegyzések:The long-term effects of sibutramine treatment on the rates of cardiovascular events and cardiovascular death among subjects at high cardiovascular risk have not been established. METHODS: We enrolled in our study 10,744 overweight or obese subjects, 55 years of age or older, with preexisting cardiovascular disease, type 2 diabetes mellitus, or both to assess the cardiovascular consequences of weight management with and without sibutramine in subjects at high risk for cardiovascular events. All the subjects received sibutramine in addition to participating in a weight-management program during a 6-week, single-blind, lead-in period, after which 9804 subjects underwent random assignment in a double-blind fashion to sibutramine (4906 subjects) or placebo (4898 subjects). The primary end point was the time from randomization to the first occurrence of a primary outcome event (nonfatal myocardial infarction, nonfatal stroke, resuscitation after cardiac arrest, or cardiovascular death). RESULTS: The mean duration of treatment was 3.4 years. The mean weight loss during the lead-in period was 2.6 kg; after randomization, the subjects in the sibutramine group achieved and maintained further weight reduction (mean, 1.7 kg). The mean blood pressure decreased in both groups, with greater reductions in the placebo group than in the sibutramine group (mean difference, 1.2/1.4 mm Hg). The risk of a primary outcome event was 11.4% in the sibutramine group as compared with 10.0% in the placebo group (hazard ratio, 1.16; 95% confidence interval [CI], 1.03 to 1.31; P=0.02). The rates of nonfatal myocardial infarction and nonfatal stroke were 4.1% and 2.6% in the sibutramine group and 3.2% and 1.9% in the placebo group, respectively (hazard ratio for nonfatal myocardial infarction, 1.28; 95% CI, 1.04 to 1.57; P=0.02; hazard ratio for nonfatal stroke, 1.36; 95% CI, 1.04 to 1.77; P=0.03). The rates of cardiovascular death and death from any cause were not increased. CONCLUSIONS: Subjects with preexisting cardiovascular conditions who were receiving long-term sibutramine treatment had an increased risk of nonfatal myocardial infarction and nonfatal stroke but not of cardiovascular death or death from any cause. (Funded by Abbott; ClinicalTrials.gov number, NCT00234832.)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:The New England Journal of Medicine. - 363 : 10 (2010), p. 905-917. -
További szerzők:Caterson, Ian D. Coutinho, Walmir Finer, Nick Gaal, Luc, Van Maggioni, Aldo Torp-Pedersen, Christian Sharma, Arya Shepherd, Gillian Rode, Richard A. Renz, Cheryl L. Czuriga István (1948-2018) (kardiológus) for the SCOUT Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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5.

001-es BibID:BIBFORM010423
Első szerző:Jones, Robert H.
Cím:Coronary bypass surgery with or without surgical ventricular reconstruction / Robert H. Jones, Eric J. Velazquez, Robert E. Michler, George Sopko, Jae K. Oh, Christopher M. O'Connor, James A. Hill, Lorenzo Menicanti, Zygmunt Sadowski, Patrice Desvigne-Nickens, Jean-Lucien Rouleau, Kerry L. Lee, The STICH Hypothesis 2 Investigators
Dátum:2009
ISSN:0028-4793 (Print)
Megjegyzések:Surgical ventricular reconstruction is a specific procedure designed to reduce left ventricular volume in patients with heart failure caused by coronary artery disease. We conducted a trial to address the question of whether surgical ventricular reconstruction added to coronary-artery bypass grafting (CABG) would decrease the rate of death or hospitalization for cardiac causes, as compared with CABG alone. METHODS: Between September 2002 and January 2006, a total of 1000 patients with an ejection fraction of 35% or less, coronary artery disease that was amenable to CABG, and dominant anterior left ventricular dysfunction that was amenable to surgical ventricular reconstruction were randomly assigned to undergo either CABG alone (499 patients) or CABG with surgical ventricular reconstruction (501 patients). The primary outcome was a composite of death from any cause and hospitalization for cardiac causes. The median follow-up was 48 months. RESULTS: Surgical ventricular reconstruction reduced the end-systolic volume index by 19%, as compared with a reduction of 6% with CABG alone. Cardiac symptoms and exercise tolerance improved from baseline to a similar degree in the two study groups. However, no significant difference was observed in the primary outcome, which occurred in 292 patients (59%) who were assigned to undergo CABG alone and in 289 patients (58%) who were assigned to undergo CABG with surgical ventricular reconstruction (hazard ratio for the combined approach, 0.99; 95% confidence interval, 0.84 to 1.17; P=0.90). CONCLUSIONS: Adding surgical ventricular reconstruction to CABG reduced the left ventricular volume, as compared with CABG alone. However, this anatomical change was not associated with a greater improvement in symptoms or exercise tolerance or with a reduction in the rate of death or hospitalization for cardiac causes.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Aged
Coronary Artery Bypass
Coronary Disease
Female
Follow-Up Studies
Heart Failure
Heart Ventricles
Hospitalization
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Mortality
Patient Selection
Stroke Volume
Treatment Outcome
Ventricular Dysfunction, Left
Ventricular Remodeling
Megjelenés:The New England Journal of Medicine. - 360 : 17 (2009), p. 1705-1717. -
További szerzők:Velazquez, Eric J. Michler, Robert E. Sopko, George Oh, Jae K. O'Connor, Christopher M. Hill, James A. Menicanti, Lorenzo Sadowski, Zygmunt Desvigne-Nickens, Patrice Rouleau, Jean-Lucien Lee, Kerry L. Édes István (1952-) (kardiológus) The STICH Hypothesis 2 Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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6.

001-es BibID:BIBFORM005636
Első szerző:Massie, Barry M.
Cím:Irbesartan in patients with heart failure and preserved ejection fraction / Massie, B. M., Carson, P. E., McMurray, J. J., Komajda, M., McKelvie, R., Zile, M. R., Anderson, S., Donovan, M., Iverson, E., Staiger, C., Ptaszynska, A., The I-PRESERVE Investigators
Dátum:2008
ISSN:1533-4406 (Electronic)
Megjegyzések:Approximately 50% of patients with heart failure have a left ventricular ejection fraction of at least 45%, but no therapies have been shown to improve the outcome of these patients. Therefore, we studied the effects of irbesartan in patients with this syndrome. METHODS: We enrolled 4128 patients who were at least 60 years of age and had New York Heart Association class II, III, or IV heart failure and an ejection fraction of at least 45% and randomly assigned them to receive 300 mg of irbesartan or placebo per day. The primary composite outcome was death from any cause or hospitalization for a cardiovascular cause (heart failure, myocardial infarction, unstable angina, arrhythmia, or stroke). Secondary outcomes included death from heart failure or hospitalization for heart failure, death from any cause and from cardiovascular causes, and quality of life. RESULTS: During a mean follow-up of 49.5 months, the primary outcome occurred in 742 patients in the irbesartan group and 763 in the placebo group. Primary event rates in the irbesartan and placebo groups were 100.4 and 105.4 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% confidence interval [CI], 0.86 to 1.05; P=0.35). Overall rates of death were 52.6 and 52.3 per 1000 patient-years, respectively (hazard ratio, 1.00; 95% CI, 0.88 to 1.14; P=0.98). Rates of hospitalization for cardiovascular causes that contributed to the primary outcome were 70.6 and 74.3 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% CI, 0.85 to 1.08; P=0.44). There were no significant differences in the other prespecified outcomes. CONCLUSIONS: Irbesartan did not improve the outcomes of patients with heart failure and a preserved left ventricular ejection fraction.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Adrenergic beta-Antagonists/therapeutic use
Aged
Angiotensin II Type 1 Receptor Blockers/adverse effects/ therapeutic use
Angiotensin-Converting Enzyme Inhibitors/therapeutic use
Biphenyl Compounds/adverse effects/ therapeutic use
Cardiovascular Diseases/epidemiology/mortality
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Failure/ drug therapy/mortality/physiopathology
Hospitalization/statistics & numerical data
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Proportional Hazards Models
Quality of Life
Stroke Volume
Tetrazoles/adverse effects/ therapeutic use
Treatment Failure
Megjelenés:The New England Journal of Medicine. - 359 : 23 (2008), p. 2456-2467. -
További szerzők:Carson, Peter E. McMurray, John J. Komajda, Michel McKelvie, Robert Zile, Michael R. Anderson, Susan Donovan, Mark Iverson, Erik Staiger, Christoph Ptaszynska, Agata Édes István (1952-) (kardiológus) The I-PRESERVE Investigators
Internet cím:DOI
elektronikus változat
Borító:

7.

001-es BibID:BIBFORM010426
Első szerző:Serruys, Patrick W.
Cím:Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease / Patrick W. Serruys, Marie-Claude Morice, A. Pieter Kappetein, Antonio Colombo, David R. Holmes, Michael J. Mack, Elisabeth Stähle, Ted E. Feldman, Marcel van den Brand, Eric J. Bass, Nic Van Dyck, Katrin Leadley, Keith D. Dawkins, Friedrich W. Mohr, The SYNTAX Investigators
Dátum:2009
ISSN:0028-4793 (Print)
Megjegyzések:Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating patients with previously untreated three-vessel or left main coronary artery disease (or both). METHODS: We randomly assigned 1800 patients with three-vessel or left main coronary artery disease to undergo CABG or PCI (in a 1:1 ratio). For all these patients, the local cardiac surgeon and interventional cardiologist determined that equivalent anatomical revascularization could be achieved with either treatment. A noninferiority comparison of the two groups was performed for the primary end point--a major adverse cardiac or cerebrovascular event (i.e., death from any cause, stroke, myocardial infarction, or repeat revascularization) during the 12-month period after randomization. Patients for whom only one of the two treatment options would be beneficial, because of anatomical features or clinical conditions, were entered into a parallel, nested CABG or PCI registry. RESULTS: Most of the preoperative characteristics were similar in the two groups. Rates of major adverse cardiac or cerebrovascular events at 12 months were significantly higher in the PCI group (17.8%, vs. 12.4% for CABG; P=0.002), in large part because of an increased rate of repeat revascularization (13.5% vs. 5.9%, P<0.001); as a result, the criterion for noninferiority was not met. At 12 months, the rates of death and myocardial infarction were similar between the two groups; stroke was significantly more likely to occur with CABG (2.2%, vs. 0.6% with PCI; P=0.003). CONCLUSIONS: CABG remains the standard of care for patients with three-vessel or left main coronary artery disease, since the use of CABG, as compared with PCI, resulted in lower rates of the combined end point of major adverse cardiac or cerebrovascular events at 1 year.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cardiovascular Diseases
Coronary Artery Bypass
Coronary Artery Disease
Drug-Eluting Stents
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Myocardial Infarction
Prospective Studies
Retreatment
numerical data
Severity of Illness Index
Stroke
Treatment Outcome
Megjelenés:The New England Journal of Medicine. - 360 : 10 (2009), p. 961-972. -
További szerzők:Morice, Marie-Claude Kappetein, Arie Pieter Colombo, Antonio Holmes, David R. Mack, Michael J. Stähle, Elisabeth Feldman, Ted E. Brand, Marcel, van den Bass, Eric J. Dyck, Nic, Van Leadley, Katrin Dawkins, Keith D. Mohr, Friedrich Wilhelm Édes István (1952-) (kardiológus) The SYNTAX Investigators
Internet cím:DOI
Intézményi repozitóriumban (DEA) tárolt változat
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8.

001-es BibID:BIBFORM010427
Első szerző:Steinbeck, Gerhard
Cím:Defibrillator implantation early after myocardial infarction / Gerhard Steinbeck, Dietrich Andresen, Karlheinz Seidl, Johannes Brachmann, Ellen Hoffmann, Dariusz Wojciechowski, Zdzislawa Kornacewicz-Jach, Beata Sredniawa, Géza Lupkovics, Franz Hofgärtner, Andrzej Lubinski, Marten Rosenqvist, Alphonsus Habets, Karl Wegscheider, Jochen Senges, The IRIS Investigators
Dátum:2009
ISSN:0028-4793 (Print)
Megjegyzések:The rate of death, including sudden cardiac death, is highest early after a myocardial infarction. Yet current guidelines do not recommend the use of an implantable cardioverter-defibrillator (ICD) within 40 days after a myocardial infarction for the prevention of sudden cardiac death. We tested the hypothesis that patients at increased risk who are treated early with an ICD will live longer than those who receive optimal medical therapy alone. METHODS: This randomized, prospective, open-label, investigator-initiated, multicenter trial registered 62,944 unselected patients with myocardial infarction. Of this total, 898 patients were enrolled 5 to 31 days after the event if they met certain clinical criteria: a reduced left ventricular ejection fraction (< or = 40%) and a heart rate of 90 or more beats per minute on the first available electrocardiogram (ECG) (criterion 1: 602 patients), nonsustained ventricular tachycardia (> or = 150 beats per minute) during Holter monitoring (criterion 2: 208 patients), or both criteria (88 patients). Of the 898 patients, 445 were randomly assigned to treatment with an ICD and 453 to medical therapy alone. RESULTS: During a mean follow-up of 37 months, 233 patients died: 116 patients in the ICD group and 117 patients in the control group. Overall mortality was not reduced in the ICD group (hazard ratio, 1.04; 95% confidence interval [CI], 0.81 to 1.35; P=0.78). There were fewer sudden cardiac deaths in the ICD group than in the control group (27 vs. 60; hazard ratio, 0.55; 95% CI, 0.31 to 1.00; P=0.049), but the number of nonsudden cardiac deaths was higher (68 vs. 39; hazard ratio, 1.92; 95% CI, 1.29 to 2.84; P=0.001). Hazard ratios were similar among the three groups of patients categorized according to the enrollment criteria they met (criterion 1, criterion 2, or both). CONCLUSIONS: Prophylactic ICD therapy did not reduce overall mortality among patients with acute myocardial infarction and clinical features that placed them at increased risk.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Aged
Cause of Death
Death, Sudden, Cardiac
control
Defibrillators, Implantable
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction
Proportional Hazards Models
Registries
Risk
Survival Rate
Time Factors
Megjelenés:The New England Journal of Medicine. - 361 : 15 (2009), p. 1427-1436. -
További szerzők:Andresen, Dietrich Seidl, Karlheinz Brachmann, Johannes Hoffmann, Ellen Wojciechowski, Dariusz Kornacewicz-Jach, Zdzislawa Sredniawa, Beata Lupkovics Géza Hofgärtner, Franz Lubinski, Andrzej Rosenqvist, Marten Habets, Alphonsus Wegscheider, Karl Senges, Jochen Édes István (1952-) (kardiológus) Kolozsvári Rudolf (1976-) (kardiológus) The IRIS Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
Borító:

9.

001-es BibID:BIBFORM010429
Első szerző:Wallentin, Lars
Cím:Ticagrelor versus clopidogrel in patients with acute coronary syndromes / Lars Wallentin, Richard C. Becker, Andrzej Budaj, Christopher P. Cannon, Häkan Emanuelsson, Claes Held, Jay Horrow, Steen Husted, Stefan James, Hugo Katus, Kenneth W. Mahaffey, Benjamin M. Scirica, Allan Skene, Philippe Gabriel Steg, Robert F. Storey, Robert A. Harrington, The PLATO Investigators, Matyas Keltai
Dátum:2009
ISSN:0028-4793 (Print)
Megjegyzések:Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and more pronounced platelet inhibition than clopidogrel. METHODS: In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation. RESULTS: At 12 months, the primary end point--a composite of death from vascular causes, myocardial infarction, or stroke--had occurred in 9.8% of patients receiving ticagrelor as compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84; 95% confidence interval [CI], 0.77 to 0.92; P<0.001). Predefined hierarchical testing of secondary end points showed significant differences in the rates of other composite end points, as well as myocardial infarction alone (5.8% in the ticagrelor group vs. 6.9% in the clopidogrel group, P=0.005) and death from vascular causes (4.0% vs. 5.1%, P=0.001) but not stroke alone (1.5% vs. 1.3%, P=0.22). The rate of death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel; P<0.001). No significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% and 11.2%, respectively; P=0.43), but ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P=0.03), including more instances of fatal intracranial bleeding and fewer of fatal bleeding of other types. CONCLUSIONS: In patients who have an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke without an increase in the rate of overall major bleeding but with an increase in the rate of non-procedure-related bleeding.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Acute Coronary Syndrome
Adenosine
derivatives
Aged
Double-Blind Method
Dyspnea
Electrocardiography
Female
Hemorrhage
Humans
Kaplan-Meiers Estimate
Male
Myocardial Infarction
Platelet Aggregation Inhibitors
Receptors, Purinergic P2
inhibitors
Stroke
Ticlopidine
derivatives
Megjelenés:The New England Journal of Medicine. - 361 : 11 (2009), p. 1045-1057. -
További szerzők:Becker, Richard C. Budaj, Andrzej Cannon, Christopher P. Emanuelsson, Häkan Held, Claes Horrow, Jay Husted, Steen James, Stefan Katus, Hugo Mahaffey, Kenneth W. Scirica, Benjamin M. Skene, Allan Steg, Philippe Gabriel Storey, Robert F. Harrington, Robert A. Keltai Mátyás (1942-) (kardiológus) The PLATO Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
Borító:

10.

001-es BibID:BIBFORM005644
Első szerző:Yusuf, Salim (belgyógyász)
Cím:Telmisartan, ramipril, or both in patients at high risk for vascular events / Yusuf, S., Teo, K. K., Pogue, J., Dyal, L., Copland, I., Schumacher, H., Dagenais, G., Sleight, P., Anderson, C., The Ontarget Investigators
Dátum:2008
ISSN:1533-4406 (Electronic)
Megjegyzések:In patients who have vascular disease or high-risk diabetes without heart failure, angiotensin-converting-enzyme (ACE) inhibitors reduce mortality and morbidity from cardiovascular causes, but the role of angiotensin-receptor blockers (ARBs) in such patients is unknown. We compared the ACE inhibitor ramipril, the ARB telmisartan, and the combination of the two drugs in patients with vascular disease or high-risk diabetes. METHODS: After a 3-week, single-blind run-in period, patients underwent double-blind randomization, with 8576 assigned to receive 10 mg of ramipril per day, 8542 assigned to receive 80 mg of telmisartan per day, and 8502 assigned to receive both drugs (combination therapy). The primary composite outcome was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure. RESULTS: Mean blood pressure was lower in both the telmisartan group (a 0.9/0.6 mm Hg greater reduction) and the combination-therapy group (a 2.4/1.4 mm Hg greater reduction) than in the ramipril group. At a median follow-up of 56 months, the primary outcome had occurred in 1412 patients in the ramipril group (16.5%), as compared with 1423 patients in the telmisartan group (16.7%; relative risk, 1.01; 95% confidence interval [CI], 0.94 to 1.09). As compared with the ramipril group, the telmisartan group had lower rates of cough (1.1% vs. 4.2%, P<0.001) and angioedema (0.1% vs. 0.3%, P=0.01) and a higher rate of hypotensive symptoms (2.6% vs. 1.7%, P<0.001); the rate of syncope was the same in the two groups (0.2%). In the combination-therapy group, the primary outcome occurred in 1386 patients (16.3%; relative risk, 0.99; 95% CI, 0.92 to 1.07); as compared with the ramipril group, there was an increased risk of hypotensive symptoms (4.8% vs. 1.7%, P<0.001), syncope (0.3% vs. 0.2%, P=0.03), and renal dysfunction (13.5% vs. 10.2%, P<0.001). CONCLUSIONS: Telmisartan was equivalent to ramipril in patients with vascular disease or high-risk diabetes and was associated with less angioedema. The combination of the two drugs was associated with more adverse events without an increase in benefit.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Aged
Angioedema
Angiotensin II Type 1 Receptor Blockers
Benzimidazoles
Benzoates/adverse effects
Blood Pressure
Cardiovascular Diseases
Creatinine
Diabetes Mellitus
Double-Blind Method
Drug Therapy, Combination
Female
Follow-Up Studies
Hospitalization
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Ramipril
Risk
Megjelenés:The New England Journal of Medicine. - 358 : 15 (2008), p. 1547-1559. -
További szerzők:Teo, K. K. Pogue, J. Dyal, L. Copland, I. Schumacher, H. Dagenais, G. Sleight, Peter Anderson, C. Édes István (1952-) (kardiológus) Czuriga István (1948-2018) (kardiológus) The Ontarget Investigators
Internet cím:Letölthető pdf
elektronikus változat
DOI
Borító:

11.

001-es BibID:BIBFORM003167
Első szerző:Warfarin Antiplatelet Vascular Evaluation Trial Investigators
Cím:Oral Anticoagulant and Antiplatelet Therapy and Peripheral Arterial Disease / Warfarin Antiplatelet Vascular Evaluation Trial Investigators, Anand S., Yusuf S., Xie C., Pogue J., Eikelboom J., Budaj A., Sussex B., Liu L., Guzman R., Cina C., Crowell R., Keltai M., Gosselin G., Olvasztó S.
Dátum:2007
Megjegyzések:Atherosclerotic peripheral arterial disease is associated with an increased risk of myocardial infarction, stroke, and death from cardiovascular causes. Antiplatelet drugs reduce this risk, but the role of oral anticoagulant agents in the prevention of cardiovascular complications in patients with peripheral arterial disease is unclear. METHODS: We assigned patients with peripheral arterial disease to combination therapy with an antiplatelet agent and an oral anticoagulant agent (target international normalized ratio [INR], 2.0 to 3.0) or to antiplatelet therapy alone. The first coprimary outcome was myocardial infarction, stroke, or death from cardiovascular causes; the second coprimary outcome was myocardial infarction, stroke, severe ischemia of the peripheral or coronary arteries leading to urgent intervention, or death from cardiovascular causes. RESULTS: A total of 2161 patients were randomly assigned to therapy. The mean follow-up time was 35 months. Myocardial infarction, stroke, or death from cardiovascular causes occurred in 132 of 1080 patients receiving combination therapy (12.2%) and in 144 of 1081 patients receiving antiplatelet therapy alone (13.3%) (relative risk, 0.92; 95% confidence interval [CI], 0.73 to 1.16; P=0.48). Myocardial infarction, stroke, severe ischemia, or death from cardiovascular causes occurred in 172 patients receiving combination therapy (15.9%) as compared with 188 patients receiving antiplatelet therapy alone (17.4%) (relative risk, 0.91; 95% CI, 0.74 to 1.12; P=0.37). Life-threatening bleeding occurred in 43 patients receiving combination therapy (4.0%) as compared with 13 patients receiving antiplatelet therapy alone (1.2%) (relative risk, 3.41; 95% CI, 1.84 to 6.35; P<0.001). CONCLUSIONS: In patients with peripheral arterial disease, the combination of an oral anticoagulant and antiplatelet therapy was not more effective than antiplatelet therapy alone in preventing major cardiovascular complications and was associated with an increase in life-threatening bleeding.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
oral anticoagulant
Megjelenés:The New England Journal of Medicine. - 357 : 3 (2007), p. 217-227. -
További szerzők:Anand, S. Yusuf, Salim (1929-2008) (belgyógyász) Xie, C. Pogue, J. Eikelboom, J. Budaj, Andrzej Sussex, B. Liu, Lisheng Guzman, R. Cina, C. Crowell, R. Keltai Mátyás (1942-) (kardiológus) Gosselin, G. Olvasztó Sándor (1957-) (sebész)
Internet cím:elektronikus változat
DOI
Borító:

12.

001-es BibID:BIBFORM029346
Cím:Comparison of fondaparinux and enoxaparin in acute coronary syndromes / The Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators
Dátum:2006
ISSN:0028-4793
Megjegyzések:The combined use of anticoagulants, antiplatelet agents, and invasive coronary procedures reduces ischemic coronary events but also increases bleeding in patients with acute coronary syndromes. We therefore assessed whether fondaparinux would preserve the anti-ischemic benefits of enoxaparin while reducing bleeding. METHODS: We randomly assigned 20,078 patients with acute coronary syndromes to receive either fondaparinux (2.5 mg daily) or enoxaparin (1 mg per kilogram of body weight twice daily) for a mean of six days and evaluated death, myocardial infarction, or refractory ischemia at nine days (the primary outcome); major bleeding; and their combination. Patients were followed for up to six months. RESULTS: The number of patients with primary-outcome events was similar in the two groups (579 with fondaparinux [5.8 percent] vs. 573 with enoxaparin [5.7 percent]; hazard ratio in the fondaparinux group, 1.01; 95 percent confidence interval, 0.90 to 1.13), satisfying the noninferiority criteria. The number of events meeting this combined outcome showed a nonsignificant trend toward a lower value in the fondaparinux group at 30 days (805 vs. 864, P=0.13) and at the end of the study (1222 vs. 1308, P=0.06). The rate of major bleeding at nine days was markedly lower with fondaparinux than with enoxaparin (217 events [2.2 percent] vs. 412 events [4.1 percent]; hazard ratio, 0.52; P<0.001). The composite of the primary outcome and major bleeding at nine days favored fondaparinux (737 events [7.3 percent] vs. 905 events [9.0 percent]; hazard ratio, 0.81; P<0.001). Fondaparinux was associated with a significantly reduced number of deaths at 30 days (295 vs. 352, P=0.02) and at 180 days (574 vs. 638, P=0.05). CONCLUSIONS: Fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days, but it substantially reduces major bleeding and improves long term mortality and morbidity.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:The New England Journal of Medicine 354 : 14 (2006), p. 1464-1476. -
További szerzők:Csiba László (1952-) (neurológus, pszichiáter) Édes István (1952-) (kardiológus) The Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators
Internet cím:DOI
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