共查询到20条相似文献，搜索用时 15 毫秒
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Karen K. Stout Curt J. Daniels Jamil A. Aboulhosn Biykem Bozkurt Craig S. Broberg Jack M. Colman Stephen R. Crumb Joseph A. Dearani Stephanie Fuller Michelle Gurvitz Paul Khairy Michael J. Landzberg Arwa Saidi Anne Marie Valente George F. Van Hare 《Journal of the American College of Cardiology》2019,73(12):1494-1563
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Paul K. Whelton Robert M. Carey Wilbert S. Aronow Donald E. Casey Karen J. Collins Cheryl Dennison Himmelfarb Sondra M. DePalma Samuel Gidding Kenneth A. Jamerson Daniel W. Jones Eric J. MacLaughlin Paul Muntner Bruce Ovbiagele Sidney C. Smith Crystal C. Spencer Randall S. Stafford Sandra J. Taler Randal J. Thomas Jackson T. Wright 《Journal of the American College of Cardiology》2018,71(19):2199-2269
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David M. Reboussin Norrina B. Allen Michael E. Griswold Eliseo Guallar Yuling Hong Daniel T. Lackland Edgar R. Miller Tamar Polonsky Angela M. Thompson-Paul Suma Vupputuri 《Journal of the American College of Cardiology》2018,71(19):2176-2198
Objective
To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy?Methods
Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses.Results
Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (i.e., angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome. 相似文献5.
Frederick L. Grover Sreekanth Vemulapalli John D. Carroll Fred H. Edwards Michael J. Mack Vinod H. Thourani Ralph G. Brindis David M. Shahian Carlos E. Ruiz Jeffrey P. Jacobs George Hanzel Joseph E. Bavaria E. Murat Tuzcu Eric D. Peterson Susan Fitzgerald Matina Kourtis Joan Michaels Barbara Christensen David R. Holmes 《Journal of the American College of Cardiology》2017,69(10):1215-1230
Background
The Society of Thoracic Surgeons (STS)/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry captures all procedures with Food and Drug Administration–approved transcatheter valve devices performed in the United States, and is mandated as a condition of reimbursement by the Centers for Medicaid & Medicare Services.Objectives
This annual report focuses on patient characteristics, trends, and outcomes of transcatheter aortic and mitral valve catheter-based valve procedures in the United States.Methods
We reviewed data for all patients receiving commercially approved devices from 2012 through December 31, 2015, that are entered in the TVT Registry.Results
The 54,782 patients with transcatheter aortic valve replacement demonstrated decreases in expected risk of 30-day operative mortality (STS Predicted Risk of Mortality [PROM]) of 7% to 6% and transcatheter aortic valve replacement PROM (TVT PROM) of 4% to 3% (both p < 0.0001) from 2012 to 2015. Observed in-hospital mortality decreased from 5.7% to 2.9%, and 1-year mortality decreased from 25.8% to 21.6%. However, 30-day post-procedure pacemaker insertion increased from 8.8% in 2013 to 12.0% in 2015. The 2,556 patients who underwent transcatheter mitral leaflet clip in 2015 were similar to patients from 2013 to 2014, with hospital mortality of 2% and with mitral regurgitation reduced to grade ≤2 in 87% of patients (p < 0.0001). The 349 patients who underwent mitral valve-in-valve and mitral valve-in-ring procedures were high risk, with an STS PROM for mitral valve replacement of 11%. The observed hospital mortality was 7.2%, and 30-day post-procedure mortality was 8.5%.Conclusions
The TVT Registry is an innovative registry that that monitors quality, patient safety and trends for these rapidly evolving new technologies. 相似文献6.
John W. Hirshfeld Victor A. Ferrari Frank M. Bengel Lisa Bergersen Charles E. Chambers Andrew J. Einstein Mark J. Eisenberg Mark A. Fogel Thomas C. Gerber David E. Haines Warren K. Laskey Marian C. Limacher Kenneth J. Nichols Daniel A. Pryma Gilbert L. Raff Geoffrey D. Rubin Donnette Smith Arthur E. Stillman L. Samuel Wann 《Journal of the American College of Cardiology》2018,71(24):e283-e351
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Suzanne V. Arnold Sean M. O’Brien Sreekanth Vemulapalli David J. Cohen Amanda Stebbins J. Matthew Brennan David M. Shahian Fred L. Grover David R. Holmes Vinod H. Thourani Eric D. Peterson Fred H. Edwards 《JACC: Cardiovascular Interventions》2018,11(6):581-589
Objectives
The aim of this study was to develop and validate a risk adjustment model for 30-day mortality after transcatheter aortic valve replacement (TAVR) that accounted for both standard clinical factors and pre-procedural health status and frailty.Background
Assessment of risk for TAVR is important both for patient selection and provider comparisons. Prior efforts for risk adjustment have focused on in-hospital mortality, which is easily obtainable but can be biased because of early discharge of ill patients.Methods
Using data from patients who underwent TAVR as part of the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry (June 2013 to May 2016), a hierarchical logistic regression model to estimate risk for 30-day mortality after TAVR based only on pre-procedural factors and access site was developed and internally validated. The model included factors from the original TVT Registry in-hospital mortality model but added the Kansas City Cardiomyopathy Questionnaire (health status) and gait speed (5-m walk test).Results
Among 21,661 TAVR patients at 188 sites, 1,025 (4.7%) died within 30 days. Independent predictors of 30-day death included older age, low body weight, worse renal function, peripheral artery disease, home oxygen, prior myocardial infarction, left main coronary artery disease, tricuspid regurgitation, nonfemoral access, worse baseline health status, and inability to walk. The predicted 30-day mortality risk ranged from 1.1% (lowest decile of risk) to 13.8% (highest decile of risk). The model was able to stratify risk on the basis of patient factors with good discrimination (C = 0.71 [derivation], C = 0.70 [split-sample validation]) and excellent calibration, both overall and in key patient subgroups.Conclusions
A clinical risk model was developed for 30-day death after TAVR that included clinical data as well as health status and frailty. This model will facilitate tracking outcomes over time as TAVR expands to lower risk patients and to less experienced sites and will allow an objective comparison of short-term mortality rates across centers. 相似文献9.
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Sean M. Davidson Péter Ferdinandy Ioanna Andreadou Hans Erik Bøtker Gerd Heusch Borja Ibáñez Michel Ovize Rainer Schulz Derek M. Yellon Derek J. Hausenloy David Garcia-Dorado 《Journal of the American College of Cardiology》2019,73(1):89-99
Many treatments have been identified that confer robust cardioprotection in experimental animal models of acute ischemia and reperfusion injury. However, translation of these cardioprotective therapies into the clinical setting of acute myocardial infarction (AMI) for patient benefit has been disappointing. One important reason might be that AMI is multifactorial, causing cardiomyocyte death via multiple mechanisms, as well as affecting other cell types, including platelets, fibroblasts, endothelial and smooth muscle cells, and immune cells. Many cardioprotective strategies act through common end-effectors and may be suboptimal in patients with comorbidities. In this regard, emerging data suggest that optimal cardioprotection may require the combination of additive or synergistic multitarget therapies. This review will present an overview of the state of cardioprotection today and provide a roadmap for how we might progress towards successful clinical use of cardioprotective therapies following AMI, focusing on the rational combination of judiciously selected, multitarget therapies. This paper emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225. 相似文献
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Pierre Deharo Nicolas Jaussaud Dominique Grisoli Olivier Camus Noemie Resseguier Herve Le Breton Vincent Auffret Jean Philippe Verhoye René Koning Thierry Lefevre Eric Van Belle Helene Eltchaninoff Martine Gilard Pascal Leprince Bernard Iung Marc Lambert Frédéric Collart Thomas Cuisset 《JACC: Cardiovascular Interventions》2018,11(19):1956-1965
Objectives
This study sought to describe the current practices and compare outcomes according to the use of balloon aortic valvuloplasty (BAV) or not during transcatheter aortic valve replacement (TAVR).Background
Since its development, aortic valve pre-dilatation has been an essential step of TAVR procedures. However, the feasibility of TAVR without systematic BAV has been described.Methods
TAVR performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (Registry of Aortic Valve Bioprostheses Established by Catheter) registry. We compared outcomes according to BAV during the TAVR procedure.Results
A total of 5,784 patients have been included in our analysis, corresponding to 2,579 (44.6%) with BAV avoidance and 3,205 (55.4%) patients with BAV performed. We observed a progressive decline in the use of BAV over time (78% of procedures in 2013 and 49% in the last trimester of 2015). Avoidance of BAV was associated with similar device implantation success (97.3% vs. 97.6%; p = 0.40). TAVR procedures without BAV were quicker (fluoroscopy 17.2 ± 9.1 vs. 18.5 ± 8.8 min; p < 0.01) and used lower amounts of contrast (131.5 ± 61.6 vs. 141.6 ± 61.5; p < 0.01) and radiation (608.9 ± 576.3 vs. 667.0 ± 631.3; p < 0.01). The rates of moderate to severe aortic regurgitation were lower with avoidance of BAV (8.3% vs. 12.2%; p < 0.01) and tamponade rates (1.5% vs. 2.3%; p = 0.04).Conclusions
We confirmed that TAVR without BAV is frequently performed in France with good procedural results. This procedure is associated with procedural simplification and lower rates of residual aortic regurgitation. 相似文献16.
Roberta Rossini Giuseppe Tarantini Giuseppe Musumeci Giulia Masiero Emanuele Barbato Paolo Calabrò Davide Capodanno Sergio Leonardi Maddalena Lettino Ugo Limbruno Alberto Menozzi U.O. Alfredo Marchese Francesco Saia Marco Valgimigli Walter Ageno Anna Falanga Antonio Corcione Alessandro Locatelli Dominick J. Angiolillo 《JACC: Cardiovascular Interventions》2018,11(5):417-434
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided. These observations underscore the need for a multidisciplinary collaboration among cardiologists, anesthesiologists, hematologists and surgeons to reach this goal. The present document is an update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents (Surgery After Stenting 2) in various types of surgery according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications. Cardiologists defined the thrombotic risk using a “combined ischemic risk” approach, while surgeons classified surgeries according to their inherent hemorrhagic risk. Finally, a multidisciplinary agreement on the most appropriate antithrombotic treatment regimen in the perioperative phase was reached for each surgical procedure. 相似文献
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Paul K. Whelton Robert M. Carey Wilbert S. Aronow Donald E. Casey Karen J. Collins Cheryl Dennison Himmelfarb Sondra M. DePalma Samuel Gidding Kenneth A. Jamerson Daniel W. Jones Eric J. MacLaughlin Paul Muntner Bruce Ovbiagele Sidney C. Smith Crystal C. Spencer Randall S. Stafford Sandra J. Taler Randal J. Thomas Jackson T. Wright 《Journal of the American Society of Hypertension》2018,12(8):579.e1-579.e73
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Background
Diversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical condition of patients have been reported.Methods
Data from 23 patients who underwent stoma creation were analysed during the reversal period (A) and at an average of 3 months (B1) and 5.6 years (B2) after restoration of GI tract continuity. Every monitoring visit included endoscopy, histology and assessment of the clinical condition of patients.Results
Shortly after GI tract restoration (B1), a significant decrease in inflammation was observed. The Ki67 positivity percentage increased, but this was not significant. At an average of 5.6 years after restoration (group B2), the clinical symptoms were mild. More patients presented with endoscopically detected inflammation of the mucosa, but its severity was not significantly higher than that at 3 months after reversal. Histological inflammation was more common, and its severity was significantly higher than that shortly after reversal but similar to that before reversal. The Ki67 positivity percentage decreased at the last examination (B2).Conclusions
The results of this study show a complex recurrence of histological inflammation several years after GI tract restoration but without clinical and endoscopic inflammation and with good clinical condition. DC can potentially have a late influence on the rectal mucosa, even after stoma closure.19.
Robert A. Phillips Jiaqiong Xu Leif E. Peterson Ryan M. Arnold Joseph A. Diamond Adam E. Schussheim 《Journal of the American College of Cardiology》2018,71(15):1601-1610
Background
The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology/American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment.Objectives
This study investigated the effect of baseline 10-year CVD risk on primary outcome events and all-cause SAEs in SPRINT.Methods
Stratifying by quartiles of baseline 10-year CVD risk, Cox proportional hazards models were used to examine the associations of treatment group with the primary outcome events and SAEs. Using multiplicative Poisson regression, a predictive model was developed to determine the benefit-to-harm ratio as a function of CVD risk.Results
Within each quartile, there was a lower rate of primary outcome events and no significant differences in all-cause SAEs for the intensive treatment group compared to the standard treatment group. From the first to fourth quartiles, the number needed to treat to prevent primary outcomes decreased from 91 to 38. The number needed to harm for all-cause SAEs increased from 62 to 250. The predictive model demonstrated significantly increasing benefit-to-harm ratios (± SE) of 0.50 ± 0.15, 0.78 ± 0.26, 2.13 ± 0.73, and 4.80 ± 1.86, for the first, second, third, and fourth quartile, respectively (p for trend <0.001). All possible pairwise comparisons of between-quartile mean values of benefit-to-harm ratios were significantly different (p < 0.001).Conclusions
In SPRINT, those with lower baseline CVD risk had more harm than benefit from intensive treatment, whereas those with higher risk had more benefit. With the 2017 American College of Cardiology/American Heart Association blood pressure treatment guidelines, this analysis may help providers and patients make decisions regarding the intensity of blood pressure treatment. 相似文献20.
Grant W. Reed Mouin S. Abdallah Mingyuan Shao Kathy Wolski Lisa Wisniewski Neville Yeomans Thomas F. Lüscher Jeffrey S. Borer David Y. Graham M. Elaine Husni Daniel H. Solomon Peter Libby Venu Menon A. Michael Lincoff Steven E. Nissen 《Journal of the American College of Cardiology》2018,71(16):1741-1751