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Fenton H. McCarthy Sreekanth Vemulapalli Zhuokai Li Vinod Thourani Roland A. Matsouaka Nimesh D. Desai Ajay Kirtane Saif Anwaruddin Matthew L. Williams Jay Giri Prashanth Vallabhajosyula Robert H. Li Howard C. Herrmann Joseph E. Bavaria Wilson Y. Szeto 《The Annals of thoracic surgery》2018,105(4):1121-1128
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Adam S. Evans Menachem Weiner Prakash A. Patel Elvera L. Baron Jacob T. Gutsche Arun Jayaraman J. Ross Renew Archer K. Martin Ashley V. Fritz Emily K. Gordon Hynek Riha Saumil Patel Kamrouz Ghadimi Eric Guelaff Jared W. Feinman Jillian Dashell Ray Munroe Derek Lauter Harish Ramakrishna 《Journal of cardiothoracic and vascular anesthesia》2018,32(1):1-13
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I. Sanz Pérez F. Martínez Valle A. Guillén-del-Castillo A. Roque Pérez H. Cuéllar Calàbria M.N. Pizzi A. Fernández Codina E. Callejas-Moraga O. Orozco Gálvez V. Fonollosa Pla C.P. Simeón Aznar 《Autoimmunity reviews》2018,17(9):900-905
Background and objectives
Recently published population-based cohort studies have shown a high prevalence of cardiovascular disease in Systemic Sclerosis (SSc) patients. The aim of this study is to compare three different methods to measure cardiovascular risk in patients with scleroderma.Methods
Forty-three SSc patients were included. A prospective study was performed for evaluation of cardiovascular risk and subclinical atheromatosis using 3 non-invasive methods: cardiovascular risk tables, carotid Doppler ultrasonography and quantification of coronary calcium by computerized tomography (CT).Results
The cardiovascular risk charts for the Spanish population did not identify patients at high cardiovascular risk. Framingham-REGICOR identified 13 intermediate-risk patients. Twenty-two patients (51.2%) had plaques on carotid ultrasonography. We performed a ROC curve to identify the best cutoff point for the quantification of coronary artery calcium (CACscore), the value of CACscore?>?28?AU (Agatston Units) had the highest sensitivity (73%) and specificity (81%) for the diagnosis of subclinical atheromatosis. In the multiple regression study, age and decreased HDL cholesterol levels were identified as independent factors for subclinical atherosclerotic disease. No disease-related factors were associated with increased subclinical arteriosclerosis.Conclusion
Carotid ultrasound and CACscore are useful for identifying subclinical atheromatosis in patients with SSc and are superior compared to risk charts used for general population. HDL cholesterol and age were independent factors for the presence of subclinical atherosclerotic disease. A carotid ultrasound or CT should be performed for early detection of subclinical atheromatosis if these factors are present. 相似文献40.
《JACC: Cardiovascular Interventions》2015,8(3):382-394
ObjectivesA Bayesian network meta-analysis was performed comparing the efficacy and safety of drug-eluting balloons (DEB), drug-eluting stents (DES), or plain old balloon angioplasty (POBA) for treatment of in-stent restenosis (ISR).BackgroundOptimal treatment options for ISR have not been well established.MethodsRandomized, controlled trials comparing DEB, DES, and POBA for the treatment of ISR after percutaneous coronary intervention with bare metal stent or DES were included. The primary outcome was target lesion revascularization (TLR). The pairwise posterior median odds ratio (OR) with 95% credible interval (CrI) was the effect measure.ResultsThis analysis included 2,059 patients from 11 RCTs. The risk of TLR was markedly lower in patients treated with DEB (OR: 0.22, 95% CrI: 0.10 to 0.42) or DES (OR: 0.24, 95% CrI: 0.11 to 0.47) than in those treated with POBA in a random-effects model. In a comparison of DEB and DES, the risk of TLR (OR: 0.92, 95% CrI: 0.43 to 1.90) was similar. The risk of MI or all-cause mortality was lowest in the DEB group compared with the DES and POBA groups, which did not meet statistical significance. The risk of major adverse cardiac events, which was mainly driven by TLR, was also significantly lower in the DEB or and DES group (OR: 0.28, 95% CrI: 0.14 to 0.53) than in the POBA group, but it was similar between the DEB and DES groups (OR: 0.84, 95% CrI: 0.45 to 1.50). The probability of being ranked as the best treatment was 59.9% (DEB), 40.1% (DES), and 0.1% (POBA) in terms of TLR, whereas it was 63.0% (DEB), 35.3% (POBA), and 1.7% (DES) in terms of MI.ConclusionsLocal drug delivery by DEB or DES for ISR lesions was markedly better than POBA in preventing TLR, but not for MI or mortality. Among the 2 different strategies of drug delivery for ISR lesions, treatment with DEB showed a trend of less development of MI than did treatment with DES. 相似文献