JAMA cardiology
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Early cardiovascular and bleeding events after coronary stenting are associated with high risk of morbidity and mortality. ⋯ In patients treated with dual antiplatelet therapy for at least 1 year after coronary stenting, ischemic events were more frequent than bleeding events, and both events were associated with high risk of mortality.
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Randomized Controlled Trial
Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol : A Prespecified Analysis of the IMPROVE-IT Trial.
In the Improved Reduction of Outcomes: Vytorin Efficacy International Trial, intensive low-density lipoprotein cholesterol (LDL-C)-reducing therapy with ezetimibe/simvastatin compared with simvastatin alone was associated with a significant reduction in cardiovascular events in 18 144 patients after acute coronary syndrome. The safety of very low LDL-C levels over the long-term is unknown. ⋯ Patients achieving an LDL-C level less than 30 mg/dL at 1 month had a similar safety profile (and numerically the lowest rate of cardiovascular events) over a 6-year period compared with patients achieving higher LDL-C concentrations. These data provide reassurance regarding the longer-term safety and efficacy of the continuation of intensive lipid-lowering therapy in very higher-risk patients resulting in very low LDL-C levels.
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Comparative Study
Bystander Defibrillation for Out-of-Hospital Cardiac Arrest in Public vs Residential Locations.
Bystander-delivered defibrillation (hereinafter referred to as bystander defibrillation) of patients with out-of-hospital cardiac arrests (OHCAs) remains limited despite the widespread dissemination of automated external defibrillators (AEDs). ⋯ Initiatives to facilitate bystander defibrillation were associated with a marked increase in bystander defibrillation in public locations, whereas bystander defibrillation remained limited in residential locations. Concomitantly, survival increased after bystander defibrillation in residential and public locations.