The American journal of cardiology
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Biography Historical Article
Edward David Frohlich, MD: a conversation with the editor. Interview by William Clifford Roberts.
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To determine whether the cyclooxygenase-2 (COX-2) inhibitor celecoxib affects cardiovascular thrombotic risk, we analyzed the incidence of cardiovascular events for celecoxib, placebo, and nonsteroidal anti-inflammatory drugs (NSAIDs) in the entire controlled, arthritis clinical trial database for celecoxib. The primary analysis used the Antiplatelet Trialists' Collaboration end points, which include: (1) cardiovascular, hemorrhagic, and unknown deaths, (2) nonfatal myocardial infarction, and (3) nonfatal stroke. Other secondary thrombotic events were also examined. ⋯ The relative risks comparing celecoxib with the NSAIDs for the primary events were 1.06 (95% confidence interval 0.70 to 1.61, p = 0.79) for all patients, and 0.86 (95% confidence interval 0.48 to 1.56, p = 0.62) for the subgroup not taking aspirin. Similarly, for secondary cardiovascular end points, all relative risks were < or =1 for celecoxib compared with either placebo or NSAIDs. These comparative analyses demonstrate no evidence of increased risk of cardiovascular thrombotic events associated with celecoxib compared with either conventional NSAIDs or placebo.
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This study determined whether electrocardiographic analysis of ventricular fibrillation (VF) can predict 1-year survival from bystander-witnessed, out-of-hospital cardiac arrests of cardiac origin. VF was analyzed using fast-Fourier transformation in a community in which emergency medical technicians delivered shock with an automated external defibrillator before arrival to the hospital. The frequency of VF can predict survival 1 year after hospital discharge from shock-delivered, bystander-witnessed cardiac arrests of cardiac etiology.