The Canadian journal of cardiology
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A cardiologist and respirologist examined the recent, neutral Prospective Randomized Placebo-Controlled Trial of Simvastatin in the Prevention of COPD Exacerbations (STATCOPE) for issues of relevance to cardiovascular risk reduction with statin medications. Although the potential benefit of the pleiotropic effects of statins on this inflammatory disease was not borne out, the effect over the longer term on total respiratory and cardiovascular morbidity and mortality remain unexplored. This study was unique as the only statin trial to date to use a national guideline (Adult Treatment Panel III) to exclude patients from the trial if at sufficient cardiovascular risk to warrant statin therapy. ⋯ The magnitude of this beneficial trend paralleled the magnitude of lowering of low-density lipoprotein cholesterol achieved in the active statin arm. Finally, the authors questioned whether the current standard of care adequately includes adherence to any national lipid guideline or adequate attention to the cardiovascular comorbidity of these patients. In conclusion, knowledge translation of the STATCOPE trial should at a minimum encourage assessment of cardiovascular risk in patients with chronic obstructive pulmonary disease, implementation of proven cardiovascular risk reduction therapies based on national guidelines, including statins, and plans to undertake a trial adequate in size and duration to address cardiovascular event reduction in patients not already eligible for evidence-based risk-reducing therapies.
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Review Meta Analysis
Preoperative Statin Therapy and Renal Outcomes After Cardiac Surgery: A Meta-analysis and Meta-regression of 59,771 Patients.
The purpose of this study was to investigate the effects of preoperative statin therapy (PST) on short- and long-term renal dysfunction after cardiac surgery. ⋯ PST might be a promising therapy to reduce renal complications after cardiac surgery although large-scaled randomized controlled trials are needed to further verify the conclusion.
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Randomized Controlled Trial
CHA2DS2-VAS(C) and CHADS2 Scores Predict Adverse Clinical Events in Patients With Pacemakers and Sinus Node Dysfunction Independent of Atrial Fibrillation.
CHA2DS2-VASc and CHADS2 scores were derived and validated for stroke-risk stratification in patients who have a diagnosis of atrial fibrillation (AF). We hypothesized that these scores would predict adverse cardiovascular events even in the absence of AF. ⋯ Both CHA2DS2-VASc and CHADS2 scores predict risk of death or stroke in patients with sick sinus syndrome, regardless of AF history. These scores could be risk-stratification tools for clinical events that might respond to new therapies—ie, anticoagulation or other interventions—even in the absence of AF.