共查询到7条相似文献，搜索用时 4 毫秒
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Carolina Santiago de Araújo Pio Susan Marzolini Maureen Pakosh Sherry L. Grace 《Mayo Clinic proceedings. Mayo Clinic》2017,92(11):1644-1659
Objective
To ascertain the effect of cardiac rehabilitation (CR) dose (ie, duration × frequency/wk; categorized as low [<12 sessions], medium [12-35 sessions], or high [≥36 sessions]) on mortality and morbidity.Methods
The Cochrane, CINAHL, EMBASE, PsycINFO, and MEDLINE databases were systematically searched from inception through November 30, 2015. Inclusion criteria included randomized or nonrandomized studies with a minimum CR dose of 4 or higher and presence of a control/comparison group. Citations were considered for inclusion, and data were extracted in included studies independently by 2 investigators. Studies were pooled using random-effects meta-analysis and meta-regression where warranted (covariates included study quality, country, publication year, and diagnosis).Results
Of 4630 unique citations, 33 trials were included comparing CR to usual care (ie, no dose). In meta-regression, greater dose was significantly related to lower all-cause mortality (high: ?0.77; SE, 0.22; P<.001; medium: ?0.80; SE, 0.21; P<.001) when compared with low dose. With regard to morbidity, meta-analysis revealed that dose was significantly associated with fewer percutaneous coronary interventions (high: relative risk, 0.65; 95% CI, 0.50-0.84; medium/low: relative risk, 1.04; 95% CI, 0.74-1.48; between subgroup difference P=.03). This reduction was also significant in meta-regression (high vs medium/low: ?0.73; SE, 0.20; P<.001). Publication bias was not evident. No dose-response association was found for cardiovascular mortality, all-cause hospitalization, coronary artery bypass graft surgery, or myocardial infarction.Conclusion
A minimum of 36 CR sessions may be needed to reduce percutaneous coronary interventions. Future studies should examine the effect of actual dose of CR, and trials are needed comparing different doses.3.
Ye Ma Lili Huang Lu Zhang Hai Yu Bin Liu 《The American journal of emergency medicine》2018,36(7):1270-1279
Background
Obesity as one of the risk factors for cardiovascular diseases increases mortality in general population. Several clinical studies investigated clinical outcomes in patients with different body mass index (BMI) after cardiac arrest (CA). Controversial data regarding BMI on clinical outcomes in those patients exist in those studies. Therefore, we conducted a meta-analysis to evaluate the effect of BMI on survival condition and neurological prognosis in those patients.Methods
We searched Pubmed, Embase, Ovid/Medline and EBM reviews databases for relational studies investigating the association between BMI and clinical outcomes of patients after CA. Seven studies involving 25,035 patients were included in this meta-analysis. Primary outcome was survival condition and secondary outcome was neurological prognosis. Three comparisons were conducted: underweight (BMI < 18.5) versus normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30) versus normal weight and obese (BMI ≥ 30) versus normal weight.Results
Using normal weight patients as reference, underweight patients had a higher mortality (odds ratio [OR] 1.35; 95% confidence interval [CI] 1.10 to 1.66; P = 0.004; I2 = 17%). Overweight was associated with increased hospital survival (OR 0.80; 95% CI 0.65 to 0.98; P = 0.03; I2 = 62%) and better neurological recovery (OR 0.72; 95% CI 0.61 to 0.85; P < 0.001; I2 = 0%). No significant difference was found in clinical outcomes between obese and normal weight patients.Conclusions
Low BMI was associated with lower survival rate in CA patients. Overweight was associated with a higher survival rate and better neurological recovery. Clinical outcomes did not differ between obese and normal weight patients. Further studies are needed to explore the underlying mechanisms. 相似文献4.
Lawrence G. Rudski Luna Gargani William F. Armstrong Patrizio Lancellotti Steven J. Lester Ekkehard Grünig Michele D&#x;Alto Meriam ?str?m Aneq Francesco Ferrara Rajeev Saggar Rajan Saggar Robert Naeije Eugenio Picano Nelson B. Schiller Eduardo Bossone 《Journal of the American Society of Echocardiography》2018,31(5):527-550.e11
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《Journal of the American Society of Echocardiography》2020,33(3):259-294
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《Mayo Clinic proceedings. Mayo Clinic》2014,89(9):1257-1278
The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines has recently released the new cholesterol treatment guideline. This update was based on a systematic review of the evidence and replaces the previous guidelines from 2002 that were widely accepted and implemented in clinical practice. The new cholesterol treatment guideline emphasizes matching the intensity of statin treatment to the level of atherosclerotic cardiovascular disease (ASCVD) risk and replaces the old paradigm of pursuing low-density lipoprotein cholesterol targets. The new guideline also emphasizes the primacy of the evidence base for statin therapy for ASCVD risk reduction and lists several patient groups that will not benefit from statin treatment despite their high cardiovascular risk, such as those with heart failure (New York Heart Association class II-IV) and patients undergoing hemodialysis. The guideline has been received with mixed reviews and significant controversy. Because of the evidence-based nature of the guideline, there is room for several questions and uncertainties on when and how to use lipid-lowering therapy in clinical practice. The goal of the Mayo Clinic Task Force in the assessment, interpretation, and expansion of the ACC/AHA cholesterol treatment guideline is to address gaps in information and some of the controversial aspects of the newly released cholesterol management guideline using additional sources of evidence and expert opinion as needed to guide clinicians on key aspects of ASCVD risk reduction. 相似文献