International journal of cardiology
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Meta Analysis Comparative Study
Medical therapy versus implantable cardioverter -defibrillator in preventing sudden cardiac death in patients with left ventricular systolic dysfunction and heart failure: a meta-analysis of > 35,000 patients.
Patients with left ventricular systolic dysfunction (LVSD) are at high risk of sudden cardiac death (SCD). Implantable cardioverter defibrillators (ICDs) have an important role in preventing SCD in selected patients with LVSD and chronic heart failure (CHF). Drug therapies for LVSD and CHF also appear to also be useful in reducing SCD. However, the magnitude of benefit of these approaches on SCD is uncertain. We therefore conducted a meta-analysis comparing the effect on SCD achieved by ICDs versus medical therapies, additional to standard background medical therapies including ACE inhibitors and/or beta-blockers (BBs). ⋯ Drug therapies when added to a standard background regimen comprising ACE inhibitor and/or BB reduced SCD overall and MRAs alone were most effective in this regard. ICDs were more effective than drugs in SCD abrogation. However, the added procedural morbidity and the cost of ICD need to be considered in decision-making re-approach to SCD reduction in the individual patient.
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Multicenter Study Observational Study
Risk factors and incidence of stroke and MACE in Chinese atrial fibrillation patients presenting to emergency departments: a national wide database analysis.
Contemporary clinical risk stratification schemata for predicting stroke and thromboembolism in patients with atrial fibrillation (AF) are largely derived from western cohorts. The purpose of the present study is to assess the potential risk factors for stroke and major adverse cardiac events (MACE) in a large population of Chinese AF patients presenting to emergency department. ⋯ We demonstrated that, except for the traditional risk factors, clinicians should pay more attention to patients with prior major bleeding or COPD in Chinese AF patients presenting to emergency department.
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Statins are widely used in clinical treatment. However, an U.S. Food and Drug Administration issued health alert has raised concerns for the adverse effects of statin-associated confusion and memory loss in the elderly people. It is necessary to clarify the relationship between statin use and risk of incident dementia as well as whether class effects exist. ⋯ Statin use was associated with a significantly lower risk of dementia in the elderly patients in Taiwan. The potency and the cumulative duration of statin utilized played critical roles.
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Letter Case Reports
Spontaneous coronary artery dissection following a preeclampsia pregnancy.