International journal of cardiology
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Review Meta Analysis
Network meta-analysis for evidence synthesis: what is it and why is it posed to dominate cardiovascular decision making?
Clinical decision-making requires synthesis of an often complex evidence base. Novel tools have been developed building upon the historical approach of reviewing the literature focusing on a specific topic. Stemming from qualitative reviews, systematic reviews of randomized clinical trials, typically encompassing statistical pooling with pairwise meta-analysis, have been devised and are now considered one of the uppermost ladders in the hierarchy of clinical evidence. ⋯ These methods include adjusted indirect comparison meta-analysis, network meta-analysis, and mixed treatment comparison. While still the focus of intense research and debate, they represent a powerful tool for evidence synthesis and comparative effectiveness in cardiovascular research, and thus are likely to become increasingly popular and impactful in shaping research agenda and clinical practice. This is clearly highlighted by a number of recent landmark network meta-analyses on smoking cessation therapies, coronary stents, and management of patent foramen ovale in patients with history of cryptogenic stroke.
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Multicenter Study Comparative Study
Transfemoral transcatheter aortic valve replacement compared with surgical replacement in patients with severe aortic stenosis and comparable risk: cost-utility and its determinants.
To evaluate cost-effectiveness of transfemoral TAVR vs surgical replacement (SAVR) and its determinants in patients with severe symptomatic aortic stenosis and comparable risk. ⋯ In countries with relatively low health care costs TAVR is not likely to be cost-effective compared to SAVR in patients with intermediate risk for surgery, mainly because of the high cost of the valve compared to the cost of hospitalization. TAVR could be cost-effective in specific subgroups and in countries with higher hospitalization costs.
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Multicenter Study
The shock index predicts acute mortality outcomes in stroke.
Shock index (SI) (ratio between heart rate and systolic blood pressure) has been shown to be associated with poor mortality outcomes in trauma and pneumonia; however it has yet to be examined in stroke. We aimed to examine the relationship between SI and acute outcomes of inpatient, 3-day and 7-day mortality in stroke. Secondly, we aimed to compare SI and systolic blood pressure (SBP) alone in predicting above outcomes. ⋯ SI at extremely high and low values appeared to predict stroke mortality and appears to be particularly useful in predicting very early (3-day) mortality.
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Patients with acute myocardial infarction (AMI) are frequently complicated with major cardiovascular events (MACEs). Endothelial dysfunction has been found to be involved in pathogenesis of AMI, but its role in development of MACEs after AMI is not clearly investigated. This study aimed to determine whether the plasma markers of endothelial dysfunction could serve as independent predictors for MACEs in patients with AMI. ⋯ Decreased plasma Ang-1 levels on admission, LVEF and multivessel disease independently predicted the development of 1-year MACEs in patients with STEMI. These results suggest that endothelial dysfunction may play an important role in mediating MACEs in patients with STEMI.
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Biography Historical Article
A review on the Avicenna's contribution to the field of cardiology.
The cardiology and field of cardiovascular approaches are often mentioned as of the earliest concerns throughout the history of mankind civilization. During the golden ages of Islamic era, 9th to 12th centuries A. D., medical knowledge from various fields including cardiology was flourished by prominent Persian physicians and scholars. ⋯ Also, his books and manuscripts on cardiology as well as findings and theories on cardiovascular and allied diseases were discussed. These findings are included in his descriptions on cardiac tamponade, stroke, palpitation, atherosclerosis, hypertension, association of the cardiovascular complications with erection and ejaculation, interaction between the heart and emotions as well as some of his mentioned drugs for cardiological disorders and the early concepts of drug targeting. These results can show Avicenna's great contribution to improve the sciences of cardiology in early medieval era.