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001-es BibID:	BIBFORM007426
Első szerző:	Fox, K.
Cím:	Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL) : a randomised, double-blind, placebo-controlled trial / Fox, K., Ford, I., Steg, P. G., Tendera, M., Ferrari, R., The BEAUTIFUL Investigators
Dátum:	2008
ISSN:	1474-547X (Electronic)
Megjegyzések:	Ivabradine specifically inhibits the I(f) current in the sinoatrial node to lower heart rate, without affecting other aspects of cardiac function. We aimed to test whether lowering the heart rate with ivabradine reduces cardiovascular death and morbidity in patients with coronary artery disease and left-ventricular systolic dysfunction. METHODS: Between December, 2004, and December, 2006, we screened 12 473 patients at 781 centres in 33 countries. We enrolled 10 917 eligible patients who had coronary artery disease and a left-ventricular ejection fraction of less than 40% in a randomised, double-blind, placebo-controlled, parallel-group trial. 5479 patients received 5 mg ivabradine, with the intention of increasing to the target dose of 7.5 mg twice a day, and 5438 received matched placebo in addition to appropriate cardiovascular medication. The primary endpoint was a composite of cardiovascular death, admission to hospital for acute myocardial infarction, and admission to hospital for new onset or worsening heart failure. We analysed patients by intention to treat. The study is registered with ClinicalTrials.gov, number NCT00143507. FINDINGS: Mean heart rate at baseline was 71.6 (SD 9.9) beats per minute (bpm). Median follow-up was 19 months (IQR 16-24). Ivabradine reduced heart rate by 6 bpm (SE 0.2) at 12 months, corrected for placebo. Most (87%) patients were receiving beta blockers in addition to study drugs, and no safety concerns were identified. Ivabradine did not affect the primary composite endpoint (hazard ratio 1.00, 95% CI 0.91-1.1, p=0.94). 1233 (22.5%) patients in the ivabradine group had serious adverse events, compared with 1239 (22.8%) controls (p=0.70). In a prespecified subgroup of patients with heart rate of 70 bpm or greater, ivabradine treatment did not affect the primary composite outcome (hazard ratio 0.91, 95% CI 0.81-1.04, p=0.17), cardiovascular death, or admission to hospital for new-onset or worsening heart failure. However, it did reduce secondary endpoints: admission to hospital for fatal and non-fatal myocardial infarction (0.64, 95% CI 0.49-0.84, p=0.001) and coronary revascularisation (0.70, 95% CI 0.52-0.93, p=0.016). INTERPRETATION: Reduction in heart rate with ivabradine does not improve cardiac outcomes in all patients with stable coronary artery disease and left-ventricular systolic dysfunction, but could be used to reduce the incidence of coronary artery disease outcomes in a subgroup of patients who have heart rates of 70 bpm or greater.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Aged Benzazepines Coronary Disease Double-Blind Method Female Follow-Up Studies Heart Rate Hospital Mortality Humans Kaplan-Meiers Estimate Male Middle Aged Ventricular Dysfunction, Left
Megjelenés:	Lancet. - 372 : 9641 (2008), p. 807-816. -
További szerzők:	Ford, Ian Steg, Philippe Gabriel Tendera, Michal Ferrari, Roberto Édes István (1952-) (kardiológus) The BEAUTIFUL Investigators
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001-es BibID:	BIBFORM023647
Első szerző:	Kőszegi Zsolt (kardiológus, belgyógyász)
Cím:	Myocardial dysfunction : hibernation and remodelling / Zsolt Kőszegi, Emília Balogh
Dátum:	2003
ISSN:	0140-6736
Tárgyszavak:	Orvostudományok Klinikai orvostudományok szerkesztői levél
Megjelenés:	Lancet 362 (2003), p. 1416-1417. -
További szerzők:	Balogh Emília (1965-) (kardiológus)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM020589
Első szerző:	Swedberg, Karl
Cím:	Ivabradine and outcomes in chronic heart failure (SHIFT) : a randomised placebo-controlled study / Swedberg K., Komajda M., Böhm M., Borer J. S., Ford I., Dubost-Brama A., Lerebours G., Tavazzi L., the SHIFT Investigators
Dátum:	2010
ISSN:	0140-6736
Megjegyzések:	Chronic heart failure is associated with high mortality and morbidity. Raised resting heart rate is a risk factor for adverse outcomes. We aimed to assess the effect of heart-rate reduction by the selective sinus-node inhibitor ivabradine on outcomes in heart failure. METHODS: Patients were eligible for participation in this randomised, double-blind, placebo-controlled, parallel-group study if they had symptomatic heart failure and a left-ventricular ejection fraction of 35% or lower, were in sinus rhythm with heart rate 70 beats per min or higher, had been admitted to hospital for heart failure within the previous year, and were on stable background treatment including a β blocker if tolerated. Patients were randomly assigned by computer-generated allocation schedule to ivabradine titrated to a maximum of 7.5 mg twice daily or matching placebo. Patients and investigators were masked to treatment allocation. The primary endpoint was the composite of cardiovascular death or hospital admission for worsening heart failure. Analysis was by intention to treat. This trial is registered, number ISRCTN70429960. FINDINGS: 6558 patients were randomly assigned to treatment groups (3268 ivabradine, 3290 placebo). Data were available for analysis for 3241 patients in the ivabradine group and 3264 patients allocated placebo. Median follow-up was 22.9 (IQR 18-28) months. 793 (24%) patients in the ivabradine group and 937 (29%) of those taking placebo had a primary endpoint event (HR 0.82, 95% CI 0.75-0.90, p<0.0001). The effects were driven mainly by hospital admissions for worsening heart failure (672 [21%] placebo vs 514 [16%] ivabradine; HR 0.74, 0.66-0.83; p<0.0001) and deaths due to heart failure (151 [5%] vs 113 [3%]; HR 0.74, 0.58-0.94, p=0.014). Fewer serious adverse events occurred in the ivabradine group (3388 events) than in the placebo group (3847; p=0.025). 150 (5%) of ivabradine patients had symptomatic bradycardia compared with 32 (1%) of the placebo group (p<0.0001). Visual side-effects (phosphenes) were reported by 89 (3%) of patients on ivabradine and 17 (1%) on placebo (p<0.0001). INTERPRETATION: Our results support the importance of heart-rate reduction with ivabradine for improvement of clinical outcomes in heart failure and confirm the important role of heart rate in the pathophysiology of this disorder.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Lancet. - 376 : 9744 (2010), p. 875-885. -
További szerzők:	Komajda, Michel Böhm, Michael Borer, Jeffrey S. Ford, Ian Dubost-Brama, Ariane Lerebours, Guy Tavazzi, Luigi Czuriga István (1948-2018) (kardiológus) the SHIFT Investigators
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM082508
Első szerző:	Thuijs, Daniel J. F. M.
Cím:	Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease : 10-year follow-up of the multicentre randomised controlled SYNTAX trial / Daniel J. F. M. Thuijs, A. Pieter Kappetein, Patrick W. Serruys, Friedrich-Wilhelm Mohr, Marie-Claude Morice,Michael J. Mack, David R. Holmes Jr., Nick Curzen, Piroze Davierwala, Thilo Noack, Milan Milojevic, Keith D. Dawkins, Bruno R. da Costa, Peter Jüni, Stuart J. Head, SYNTAX Extended Survival Investigators
Dátum:	2019
ISSN:	0140-6736
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Lancet. - 394 : 10206 (2019), p. 1325-1334. -
További szerzők:	Kappetein, Arie Pieter Serruys, Patrick W. Mohr, Friedrich Wilhelm Morice, Marie-Claude Mack, Michael J. Holmes, David R. Curzen, Nick Davierwala, Piroze Noack, Thilo Milojevic, Milan Dawkins, Keith D. Costa, Bruno R. da Jüni, Peter Head, Stuart J. Szerafin Tamás (1960-) (szívsebész, mellkassebész) SYNTAX Extended Survival Investigators
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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