Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Oct 2018
Randomized Controlled Trial Multicenter StudyLosartan Versus Atenolol for Prevention of Aortic Dilation in Patients With Marfan Syndrome.
Beta-blockers are the standard treatment in Marfan syndrome (MFS). Recent clinical trials with limited follow-up yielded conflicting results on losartan's effectiveness in MFS. ⋯ Long-term outcome of Marfan syndrome patients randomly assigned to losartan or atenolol showed no differences in aortic dilation rate or presence of clinical events between treatment groups. Therefore, losartan might be a useful, low-risk alternative to beta-blockers in the long-term management of these patients.
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J. Am. Coll. Cardiol. · Sep 2018
Randomized Controlled Trial Multicenter StudyCardiac Troponin I and Cardiovascular Risk in Patients With Chronic Obstructive Pulmonary Disease.
Patients with chronic obstructive pulmonary disease (COPD) have increased risk of cardiovascular events. ⋯ In patients with COPD and heightened cardiovascular risk, plasma cardiac troponin I concentrations are a specific and major indicator of future cardiovascular events and cardiovascular death. Inhaled therapies did not affect cardiac troponin I concentrations consistent with their neutral effect on mortality and cardiovascular outcomes. (Study to Evaluate the Effect of Fluticasone Furoate/Vilanterol on Survival in Subjects With Chronic Obstructive Pulmonary Disease [SUMMIT]; NCT01313676).
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J. Am. Coll. Cardiol. · Jul 2018
Randomized Controlled Trial Multicenter Study Comparative StudyEpinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction.
Vasopressor agents could have certain specific effects in patients with cardiogenic shock (CS) after myocardial infarction, which may influence outcome. Although norepinephrine and epinephrine are currently the most commonly used agents, no randomized trial has compared their effects, and intervention data are lacking. ⋯ In patients with CS secondary to acute myocardial infarction, the use of epinephrine compared with norepinephrine was associated with similar effects on arterial pressure and cardiac index and a higher incidence of refractory shock. (Study Comparing the Efficacy and Tolerability of Epinephrine and Norepinephrine in Cardiogenic Shock [OptimaCC]; NCT01367743).
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J. Am. Coll. Cardiol. · May 2018
Randomized Controlled Trial Multicenter StudyMajor Adverse Limb Events and Mortality in Patients With Peripheral Artery Disease: The COMPASS Trial.
Patients with lower extremity peripheral artery disease (PAD) are at increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). There is limited information on the prognosis of patients who experience MALE. ⋯ Among individuals with lower extremity PAD, the development of MALE is associated with a poor prognosis, making prevention of this condition of utmost importance. The combination of rivaroxaban 2.5 mg twice daily and aspirin significantly lowered the incidence of MALE and the related complications, and this combination should be considered as an important therapy for patients with PAD. (Cardiovascular Outcomes for People Using Anticoagulation Strategies [COMPASS]; NCT01776424).
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J. Am. Coll. Cardiol. · Apr 2018
Multicenter StudyMyocarditis in Patients Treated With Immune Checkpoint Inhibitors.
Myocarditis is an uncommon, but potentially fatal, toxicity of immune checkpoint inhibitors (ICI). Myocarditis after ICI has not been well characterized. ⋯ Myocarditis after ICI therapy may be more common than appreciated, occurs early after starting treatment, has a malignant course, and responds to higher steroid doses.