International journal of cardiology
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Randomized Controlled Trial Multicenter Study
Dexamethasone for the prevention of postoperative atrial fibrillation.
Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. Inflammation is believed to play a pivotal role in the etiology of postoperative AF. There is a suggestion from small studies that perioperative treatment with corticosteroids may reduce postoperative AF. The DExamethasone for Cardiac Surgery (DECS) study was a large randomized trial showing no protective effect of dexamethasone on major adverse events. The aim of this study was to investigate the effect of dexamethasone treatment on the occurrence of AF after cardiac surgery. ⋯ Intraoperative administration of dexamethasone had no protective effect on the occurrence of any or new-onset atrial fibrillation after cardiac surgery. Therefore, the use of dexamethasone for the reduction of postoperative AF should not be recommended.
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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.