Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Nov 2014
Randomized Controlled Trial Multicenter Study Observational StudyA polypill strategy to improve adherence: results from the FOCUS project.
Adherence to evidence-based cardiovascular (CV) medications after an acute myocardial infarction (MI) is low after the first 6 months. The use of fixed-dose combinations (FDC) has been shown to improve treatment adherence and risk factor control. However, no previous randomized trial has analyzed the impact of a polypill strategy on adherence in post-MI patients. ⋯ For secondary prevention following acute MI, younger age, depression, and a complex drug treatment plan are associated with lower medication adherence. Meanwhile, adherence is increased in patients with higher insurance coverage levels and social support. Compared with the 3 drugs given separately, the use of a polypill strategy met the primary endpoint for adherence for secondary prevention following an acute MI. (Fixed Dose Combination Drug [Polypill] for Secondary Cardiovascular Prevention [FOCUS]; NCT01321255).
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J. Am. Coll. Cardiol. · Nov 2014
Randomized Controlled Trial Multicenter Study Comparative StudySecond-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial.
The optimal duration of dual antiplatelet therapy (DAPT) following second-generation drug-eluting stent (DES) implantation is still debated. ⋯ In a low-risk population, the noninferiority hypothesis of 6 vs. 12 months DAPT following second-generation DES implantation appears accepted for the incidence of cardiac death, MI, stroke, definite/probable stent thrombosis, and BARC type 3 or 5 bleeding at 12 months. (Second Generation Drug-Eluting Stent Implantation Followed by Six- Versus Twelve-Month Dual Antiplatelet Therapy; NCT00944333).
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J. Am. Coll. Cardiol. · Nov 2014
Comparative StudyVector flow mapping in obstructive hypertrophic cardiomyopathy to assess the relationship of early systolic left ventricular flow and the mitral valve.
The hydrodynamic cause of systolic anterior motion of the mitral valve (SAM) is unresolved. ⋯ Early systolic flow impacts the posterior surfaces of protruding MVL initiating SAM in obstructive HCM.