Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2007
ReviewCardiovascular protection using beta-blockers: a critical review of the evidence.
For more than 3 decades, beta-blockers have been widely used in the treatment of hypertension and are still recommended as first-line agents by national and international guidelines. Recent meta-analyses indicate that, in patients with uncomplicated hypertension, compared with other antihypertensive agents, first-line therapy with beta-blockers was associated with an increased risk of stroke, especially in the elderly cohort with no benefit for the end points of all-cause mortality, cardiovascular morbidity, and mortality. ⋯ Given the increased risk of stroke, their "pseudo-antihypertensive" efficacy (failure to lower central aortic pressure), lack of effect on regression of target end organ effects like left ventricular hypertrophy and endothelial dysfunction, and numerous adverse effects, the risk benefit ratio for beta-blockers is not acceptable for this indication. However, beta-blockers remain very efficacious agents for the treatment of heart failure, certain types of arrhythmia, hypertropic obstructive cardiomyopathy, and in patients with prior myocardial infarction.
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J. Am. Coll. Cardiol. · Aug 2007
Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study.
The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea. ⋯ Among dyspneic patients with and without acute HF, ST2 concentrations are strongly predictive of mortality at 1 year and might be useful for prognostication when used alone or together with NT-proBNP.
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The present study evaluated the effect of phosphorylcholine (PC) immunization on the extent of experimental atherosclerosis. ⋯ Phosphorylcholine immunization drives a specific humoral immune response that reduces foam cell formation in vitro and is atheroprotective in vivo.
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J. Am. Coll. Cardiol. · Aug 2007
Clinical TrialST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) trial.
Our goal was to examine the effects of implementing a fully automated wireless network to reduce door-to-intervention times (D2I) in ST-segment elevation myocardial infarction (STEMI). ⋯ A fully automated wireless network that transmits ECGs simultaneously to the ED and offsite cardiologists for the early evaluation and triage of patients with suspected STEMI can decrease D2I times to <90 min and has the potential to be broadly applied in clinical practice.
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J. Am. Coll. Cardiol. · Jul 2007
Randomized Controlled Trial Multicenter StudyAcute Myocardial Infarction with Hyperoxemic Therapy (AMIHOT): a prospective, randomized trial of intracoronary hyperoxemic reperfusion after percutaneous coronary intervention.
This study sought to determine whether hyperoxemic reperfusion with aqueous oxygen (AO) improves recovery of ventricular function after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). ⋯ Intracoronary hyperoxemic reperfusion was safe and well tolerated after PCI for AMI, but did not improve regional wall motion, ST-segment resolution, or final infarct size. A possible treatment effect was observed in anterior AMI patients reperfused <6 h of symptom onset.