International journal of cardiology
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Concerns regarding the use of selected bone marrow stem cells (BMSCs) in the field of cardiac repair after acute ischemic events have been raised. The current meta-analysis aimed to assess the efficacy and safety of selected BMSC transplantation in patients with acute myocardial infarction (AMI) based on published randomized controlled trials (RCTs). ⋯ Transplantation of selected BMSCs for patients with AMI is safe and induces a significant increase in LVEF with a limited impact on left ventricular remodeling.
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Despite the widespread use of Inferior vena cava (IVC) filters, there is no quality evidence to demonstrate their efficacy for routine use, nor there is a consensus on their appropriate indications among major medical societies. The introduction of retrievable filters led to further increase in the utilization of these devices. However, several studies have shown that retrievable filters are rarely retrieved. ⋯ Food and Drug Administration has recently issued a safety alert advocating for consideration of filter retrieval when the protection offered by the filter is no longer needed. The controversies surrounding IVC filter placement and retrieval, however, will likely to continue in the absence of good evidence on their efficacy and side effects. Time has come for initiatives to conduct well designed trials based on agreed-upon criteria to settle this debate.
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Randomized Controlled Trial Comparative Study
Diagnostic performance and cost of CT angiography versus stress ECG--a randomized prospective study of suspected acute coronary syndrome chest pain in the emergency department (CT-COMPARE).
Coronary CT angiography (CCTA) has high sensitivity, with 3 recent randomized trials favorably comparing CCTA to standard-of-care. Comparison to exercise stress ECG (ExECG), the most available and least expensive standard-of-care worldwide, has not been systematically tested. ⋯ CCTA had improved diagnostic performance compared to ExECG, combined with 35% relative reduction in length-of-stay, and 20% reduction in hospital costs. These data lend further evidence that CCTA is useful as a first line assessment in emergency department chest pain.
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Randomized Controlled Trial Multicenter Study
Acute decompensated heart failure patients admitted to critical care units: insights from ASCEND-HF.
Little is known about global patterns of critical care unit (CCU) care and the relationship with outcomes in patients with acute decompensated heart failure (ADHF). Whether a ward or a CCU admission is associated with better outcomes is unclear. ⋯ Management of patients with ADHF varies significantly, and after adjustment, CCU care was associated with higher risk of early mortality, not explained by international differences. These findings may help to improve the early decisions regarding risk stratification of patients hospitalized with ADHF.