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81.
Alam M Bandeali SJ Virani SS Jneid HM Shahzad SA Ramanathan KB Kar B Kleiman NS Lakkis N 《Clinical cardiology》2012,35(5):291-296
Background:
Clinical outcomes of percutaneous coronary intervention (PCI) in patients with saphenous vein grafts (SVGs) remain poor despite the use of drug‐eluting stents (DES). There is a disparity in clinical outcomes in SVG PCI based on various registries, and randomized clinical data remain scant. We conducted a meta‐analysis of all existing randomized controlled trials (RCTS) comparing bare‐metal stents (BMS) and DES in SVGPCIs.Hypothesis:
PCI in patients with SVG disease using DES may reduce need for repeat revascularization without an excess mortality when compared to BMS.Methods:
An aggregate data meta‐analysis of clinical outcomes in RCTs comparing PCI with DES vs BMS for SVGs reporting at least 12 months of follow‐up was performed. A literature search between Janurary 1, 2003 and September 30, 2011 identified 4 RCTs (812 patients; DES = 416, BMS = 396). Summary odds ratio (OR) and 95% confidence interval (CI) were calculated using the random‐effects model. The primary endpoint was all‐cause mortality. Secondary outcomes included nonfatal myocardial infarction (MI), repeat revascularization, and major adverse cardiac events (MACE). These outcomes were assessed in a cumulative fashion at 30 days, 18 months, and 36 months.Results:
There were no intergroup differences in baseline clinical and sociodemographic characteristics. At a median follow‐up of 25 months, patients in the DES and BMS group had similar rates of death (OR: 1.63, 95% CI: 0.45–5.92), MI (OR; 0.83, 95% CI: 0.27‐2.60), and MACE (OR: 0.58, 95% CI: 0.25–1.32). Patients treated with DES had lower rates of repeat revascularization (OR: 0.40, 95% CI: 0.22–0.75).Conclusions:
In this comprehensive meta‐analysis of all RCTs comparing clinical outcomes of PCI using DES vs BMS in patients with SVG disease, use of DES was associated with a reduction in rate of repeat revascularization and no difference in rates of all‐cause death and MI. Clin. Cardiol. 2012 DOI: 10.1002/clc.21984 Dr. Virani is supported by a Department of Veterans Affairs Health Services Research and Development Service (HSR&D) Career Development Award (CDA‐09‐028), and has research support from Merck and National Football League Charities (all grants to the institution and not individual). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors have no other funding, financial relationships, or conflicts of interest to disclose. 相似文献82.
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84.
Bandeali SJ Kayani WT Lee VV Pan W Elayda MA Nambi V Jneid HM Alam M Wilson JM Birnbaum Y Ballantyne CM Virani SS 《The American journal of cardiology》2012,110(7):919-923
The association between preoperative use of angiotensin-converting enzyme (ACE) inhibitors and outcomes after coronary artery bypass grafting (CABG) remain controversial. Our aim was to study in-hospital outcomes after isolated CABG in patients on preoperative ACE inhibitors. A retrospective analysis of 8,889 patients who underwent isolated CABG from 2000 through 2011 was conducted. The primary outcome of interest was the incidence of major adverse events (MAEs) defined as a composite of mortality, postoperative renal dysfunction, myocardial infarction, stroke, and atrial fibrillation during index hospitalization. The secondary outcome was the incidence of individual outcomes included in MAEs. Logistic regression analyses were performed. Of 8,889 patients, 3,983 (45%) were on preoperative ACE inhibitors and 4,906 (55%) were not. Overall incidence of MAEs was 38.1% (n = 1,518) in the ACE inhibitor group compared to 33.6% (n = 1,649) in the no-ACE inhibitor group. Preoperative use of ACE inhibitors was independently associated with MAEs (odds ratio 1.13, 95% confidence interval 1.03 to 1.24), most of which was driven by a statistically significant increase in postoperative renal dysfunction (odds ratio 1.18, 95% confidence interval 1.03 to 1.36) and atrial fibrillation (odds ratio 1.15, 95% confidence interval 1.05 to 1.27). In-hospital mortality, postoperative myocardial infarction, and stroke were not significantly associated with preoperative ACE inhibitor use. Analyses performed after excluding patients with low ejection fractions yielded similar results. In conclusion, preoperative ACE inhibitor use was associated with an increased risk of MAEs after CABG, in particular postoperative renal dysfunction and atrial fibrillation. 相似文献
85.
S Yüce IO Uysal M Doğan T Ersin S Müderris 《The Journal of craniofacial surgery》2012,23(5):e396-e398
ABSTRACT: Canalicular adenomas are uncommon, benign epithelial neoplasm of the salivary glands that usually involve the upper lip and the buccal mucosa of elderly people. Differential diagnosis of the canalicular adenoma versus adenocarcinoma is important because it may result in unjustified radiotherapy or extensive and aggressive surgery. Despite the benign nature of canalicular adenomas, complete surgical removal and a regular clinical follow-up are recommended. The current study describes the diagnostic procedures, surgical management, and follow-up of a canalicular adenoma involving the palate of a 79-year-old man. 相似文献
86.
Heart disease and stroke statistics--2012 update: a report from the American Heart Association 总被引:1,自引:0,他引:1
Roger VL Go AS Lloyd-Jones DM Benjamin EJ Berry JD Borden WB Bravata DM Dai S Ford ES Fox CS Fullerton HJ Gillespie C Hailpern SM Heit JA Howard VJ Kissela BM Kittner SJ Lackland DT Lichtman JH Lisabeth LD Makuc DM Marcus GM Marelli A Matchar DB Moy CS Mozaffarian D Mussolino ME Nichol G Paynter NP Soliman EZ Sorlie PD Sotoodehnia N Turan TN Virani SS Wong ND Woo D Turner MB;American Heart Association Statistics Committee Stroke Statistics Subcommittee 《Circulation》2012,125(1):e2-e220
87.
Hohnloser SH Oldgren J Yang S Wallentin L Ezekowitz M Reilly P Eikelboom J Brueckmann M Yusuf S Connolly SJ 《Circulation》2012,125(5):669-676
88.
89.
Mariana Ferreira Leal Danielle Queiroz Calcagno André Salim Khayat Tanielly Cristina Raiol Silva José Augusto Pereira Carneiro Muniz Paulo Pimentel Assumpção Marília de Arruda Cardoso Smith Rommel Rodríguez Burbano 《Clinical and experimental medicine》2013,13(3):221-224
Despite the high incidence, the molecular events involved in intestinal-type gastric carcinogenesis remains unclear. We previously established an intestinal-type gastric carcinogenesis model in Cebus apella, a New World monkey. In the present study, we evaluated hTERT and TP53 mRNA expression, as well as their protein immunoreactivity, in normal mucosa, non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal-type gastric cancer samples of non-human primates treated with N-methyl-nitrosourea. In addition, we evaluated the number of TP53 copies in these samples. Although hTERT immunoreactivity was only detected in gastric cancer, a continuous increase of hTERT mRNA expression was observed from non-atrophic gastritis to gastric tumors. No sample presented p53 immunoreactivity. However, we also observed a continuous decrease of TP53 mRNA expression during the sequential steps of gastric carcinogenesis. Moreover, loss of TP53 copies was observed in intestinal metaplasia and gastric cancer samples. Our study highlights that hTERT and TP53 have a key role in intestinal-type gastric cancer initiation. 相似文献
90.