Search results for "RCT"

Resultados de la estrategia farmacoinvasiva y de la angioplastia primaria en la reperfusión del infarto con elevación del segmento ST. Estudio con re…

2011

Introduction and objectives: Pharmacoinvasive strategy represents an attractive alternative to primary angioplasty. Using cardiovascular magnetic resonance imaging we compared the left ventricular outcome of the pharmacoinvasive strategy and primary angioplasty for the reperfusion of ST-segment elevation myocardial infarction. Methods: Cardiovascular magnetic resonance was performed 1 week and 6 months after infarction in two consecutive cohorts of patients included in a prospective university hospital ST-segment elevation myocardial infarction registry. During the period 2004-2006, 151 patients were treated with pharmacoinvasive strategy (thrombolysis followed by routine non-immediate angi…

New Risk Score for Patients With Acute Chest Pain, Non-ST-Segment Deviation, and Normal Troponin Concentrations

2005

Objectives The purpose of this research was to develop a risk score for patients with chest pain, non-ST-segment deviation electrocardiogram (ECG), and normal troponin levels. Background Prognosis assessment in this population remains a challenge. Methods A total of 646 consecutive patients were evaluated by clinical history (risk factors and chest pain score according to pain characteristics), ECG, and early exercise testing. ST-segment deviation and troponin elevation were exclusion criteria. The primary end point was mortality or myocardial infarction at one year. The secondary end point was mortality, myocardial infarction, or urgent revascularization at 14 days (similar to the Thrombol…

2013

A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD). In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n=5000 Mid-Europeans aged 35–74 years from the Gutenberg Health Study (GHS). Only the somatic symptom dimension of depression was assoc…

280 Impact of ozone air pollution on ischemic cerebral and cardiac events in Dijon, France

2011

Background There is strong evidence that short-term exposure to ozone (O3) is associated with respiratory disease and death, but the effects of short-term exposure to ozone on ischemic heart and cerebrovascular disease have not been clearly established. Methods Daily levels of urban O3 pollution, the incidence of first-ever, recurrent, fatal and non-fatal ischemic cerebro-vascular events (ICVE) and myocardial infarction (MI) were compared using a bi-directional case-crossover design analysis. We analysed 1 574 ICVE and 913 MI that occurred in Dijon, France from 2001 to 2007. Sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), particulate matter with an aerodiameter of 10μg/…

Making it More Sensitive

2011

About a decade ago, the prevailing wisdom was that conventional risk factors explained only approximately half of the risk for a myocardial infarction or stroke. Consequently, efforts to identify novel risk factors were undertaken to improve cardiovascular risk prediction. The hypothesis that inflammation is a central contributor to atherothrombosis has stimulated sustained efforts to characterize the specific molecules and pathways that may be involved and to identify biomarkers in humans that enable detection of underlying inflammatory activation to improve cardiovascular risk prediction. Ridker et al1 pioneered this work and reported that systemic low-grade inflammation assessed by measu…

Primary percutaneous transluminal coronary angioplasty for Acute Myocardial Infarction in patients not included in randomized studies

1999

Abstract Patients with acute myocardial infarction included in randomized trials comparing primary percutaneous transluminal coronary angioplasty (pPTCA) with thrombolysis represent a special subgroup of patients with a low event rate. Patients excluded from these trials represent a variety of different subgroups, with different patient characteristics and possibly different clinical event rates. Primary PTCA was performed in 491 consecutive patients with acute myocardial infarction in the prospective multicenter observational Maximal Individual Therapy in Acute Myocardial Infarction trial. They were divided into the following groups: group I, patients fulfilling the inclusion criteria of t…

Low-density-lipoprotein peak particle size in a Mediterranean population

2003

Background The predominance of small, dense low-density lipoprotein (LDL) particles (‘LDL phenotype B’) has been associated with a three-fold increased risk of myocardial infarction, but the feasibility of the identification of small, dense LDL as independent predictors of coronary artery disease risk in population studies remains questioned. Design We evaluated the LDL peak particle size and its relation with other established risk factors for coronary heart disease in a group of 156 randomized subjects living on the Mediterranean island of Ustica (71 males and 85 women, range of age 20–69 years), representing approximately 30% of the total population. Results The prevalence of LDL phenoty…

Effect of Scar Development on Fast Electrophysiological Models of the Human Heart: In-Silico Study on Atlas-Based Virtual Populations

2011

The main goal of this work is to study the effect of scar development in the electrophysiological function of the human left ventricle by statistically analyzing large-scale simulation data including hypertrophic and dilated hearts. Electrophysiological simulations are obtained by solving the classical Eikonal equation in both the ventricular tissue and a customized Purkinje system. This Purkinje system is obtained assuming a geodesic rule to connect different Purkinje-myocardial junctions into a tree-like structure. Infarction shape and function is modeled with taking into account the occlusion in coronary arteries. Infarct, core and border zones of the scar are estimated by calculating bl…

Subclinical atherosclerosis: independent predictor of cardiovascular events in a 20-years follow up of patients with or without metabolic syndrome

2013

Purpose: To evaluate the influence of carotid atherosclerosis and metabolic syndrome (MetS) on the prediction of cardiovascular events during a 20-years follow-up. Methods: We studied a population of 529 asymptomatic patients, divided into 2 groups according to the results of the carotid ultrasound evaluation: one without atherosclerotic lesions (198 patients) and a second one with an increased carotid IMT or asymptomatic carotid plaque (331 patients). In each of these groups, we identified two subgroups of subjects with and without MetS. Cardiovascular endpoints were investigated in a 20-years follow-up: acute myocardial infarction, angina, transient ischemic attack, ischemic stroke, abdom…

Mechanism of reperfusion damage after thrombolysis and ‘direct PTCA’

1997

Summary There is general agreement between cardiologists, that reperfusion of the infarct related coronary artery (PTCA) is the method of choice for the treatment of an acute myocardial infarction. However, the method utilized for inducing a rapid and complete reperfusion is still discussed. Even if thrombolysis will remain the method of choice for the major part of the population, part of the patient cohort with acute infarction will be treated by direct PTCA. Rapid reperfusion of ischemic myocardium reduces infarct size by limiting infarct extension into the entire area at risk, although a reperfusion damage is induced in the core ischemic area. This reperfusion damage has been convincing…