Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2011
Randomized Controlled TrialThe effect of age on clinical outcomes and health status BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes).
The purpose of this study was to determine the extent to which effectiveness of cardiac and diabetes treatment strategies varies by patient age. ⋯ Among patients with stable heart disease and type 2 diabetes, the relative beneficial effects of a strategy of prompt revascularization versus initial medical therapy and insulin-sensitizing versus insulin-providing therapy on clinical endpoints, symptom relief, and perceived health status outcomes do not vary by age. Health status improved significantly after treatment for all ages, and this improvement was sustained longer among younger patients. (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes [BARI 2D]; NCT00006305).
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J. Am. Coll. Cardiol. · Aug 2011
Multicenter StudyAge- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease.
We examined mortality in relation to coronary artery disease (CAD) as assessed by ≥64-detector row coronary computed tomography angiography (CCTA). ⋯ Among individuals without known CAD, nonobstructive and obstructive CAD by CCTA are associated with higher rates of mortality, with risk profiles differing for age and sex. Importantly, absence of CAD is associated with a very favorable prognosis.
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J. Am. Coll. Cardiol. · Aug 2011
Multicenter StudyPrevalence and characteristics of early repolarization in the CASPER registry: cardiac arrest survivors with preserved ejection fraction registry.
We evaluated the prevalence and characteristics of early repolarization in patients in CASPER (Cardiac Arrest Survivors With Preserved Ejection Fraction Registry). ⋯ Early repolarization is present in a significant proportion of causally diagnosed and idiopathic VF. It is often intermittent and more pronounced in IVF patients. (Registry of Unexplained Cardiac Arrest; NCT00292032).
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J. Am. Coll. Cardiol. · Aug 2011
International participation in cardiovascular randomized controlled trials sponsored by the National Heart, Lung, and Blood Institute.
The aim of this study was to describe international enrollment and participation in National Institutes of Health (NIH)-sponsored cardiovascular randomized controlled trials (RCTs). ⋯ Cardiovascular RCTs sponsored by the National Heart, Lung, and Blood Institute have substantial rates of international enrollment, particularly coronary artery disease trials. Given questions of applicability and ethical and financial considerations, IP in U.S. clinical trials deserves further scrutiny.
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J. Am. Coll. Cardiol. · Aug 2011
Aspirin extrusion from human platelets through multidrug resistance protein-4-mediated transport: evidence of a reduced drug action in patients after coronary artery bypass grafting.
In this study we investigate: 1) the role of multidrug resistance protein-4 (MRP4), an organic anion unidirectional transporter, in modulating aspirin action on human platelet cyclooxygenase (COX)-1; and 2) whether the impairment of aspirin-COX-1 interaction, found in coronary artery bypass grafting (CABG) patients, could be dependent on MRP4-mediated transport. ⋯ Aspirin is a substrate for MRP4 and can be extruded from platelet through its transportation. Aspirin effect on COX-1 is little-related to MRP4-mediated aspirin transport in HV, but in CABG patients with MRP4 over-expression, its pharmacological inhibition enhances aspirin action in an efficient way.