Current medical research and opinion
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Objective: To investigate the coexistence effect of hypertension and angiotensin II on the risk of coronary heart disease based on a prospective study in an Inner Mongolian population of China. Methods: The participants were categorized into four subgroups according to hypertension status and median of angiotensin II level. Incident coronary heart disease (CHD) was defined as study outcome. ⋯ Furthermore, compared to normotensives with angiotensin II ≤49 pg/mL, the multivariate-adjusted HRs (95% CIs) of CHD for normotensives with angiotensin II >49 pg/mL, hypertensives with angiotensin II ≤49 pg/mL and hypertensives with angiotensin II >49 pg/mL were 1.33 (0.60-2.91), 2.35 (1.16-4.76) and 3.00 (1.52-5.92), respectively (p for trend <.05). The hypertensives with angiotensin II >49 pg/mL were at the highest risk of CHD. Conclusions: Hypertension not angiotensin II was an independent risk factor for incident CHD, but the coexistence of both hypertension and high angiotensin II level further increased risk of incident CHD among the Inner Mongolians.
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Observational Study
National trend of utilization, clinical and economic outcomes of transcatheter aortic valve replacement among patients with chronic obstructive pulmonary disease.
Objectives: We aimed to trend the utilization of transcatheter aortic valve replacement (TAVR) among COPD patients, compare its outcomes to surgical aortic valve replacement (SAVR) and assess any social disparities in its outcomes. Background: Patients with chronic obstructive pulmonary disease (COPD) have been increasingly undergoing TAVR, but studies to evaluate the national trend of TAVR utilization and outcomes are still lacking. Methods: We conducted a retrospective observational study using a nationally representative database, the National Inpatient Sample (NIS). ⋯ Conclusions: The rate of TAVR among COPD patients has been increasing nationally since 2011. In spite of higher comorbidities, TAVR did not show a difference in hospital mortality compared to SAVR but demonstrated shorter length of stay and more home discharges. This suggests that TAVR is a viable and potentially better option for patients with COPD.
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Meta Analysis
Topical medical therapy and ocular perfusion pressure in open angle glaucoma: a systematic review and meta-analysis.
Objective: We compared the benefits and harms of topical interventions for ocular perfusion pressure in open angle glaucoma. Methods: We searched the databases MEDLINE, EMBASE and CENTRAL for randomized controlled trials comparing topical hypotensive agents in glaucoma. Of the 9433 citations identified, 10 randomized controlled trials were included. ⋯ Bimatoprost increases mean ocular perfusion pressure when compared to timolol. As a class, prostaglandins increase mean ocular perfusion pressure. Prostaglandins may provide beneficial ocular perfusion pressure profiles compared to alternative agents.
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Randomized Controlled Trial Multicenter Study
Results of VERTIS SU extension study: safety and efficacy of ertugliflozin treatment over 104 weeks compared to glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin.
Objective: To assess the safety and efficacy of ertugliflozin over 104 weeks in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin. Methods: In this double-blind, multicenter, randomized, phase III study (VERTIS SU; NCT01999218), adults with T2DM and glycated hemoglobin (HbA1c) 7.0-9.0% on metformin ≥1500 mg/day received ertugliflozin 5 mg or 15 mg, or glimepiride. The primary efficacy time point was Week 52; double-blinded treatment continued until Week 104. ⋯ Genital mycotic infections were reported in 5.3%, 2.6% and 0% of men, respectively, and 9.2%, 12.3% and 1.4% of women, respectively. The incidence of urinary tract infection and hypovolemia AEs was similar across groups. Conclusions: Ertugliflozin was well tolerated and provided clinically meaningful glycemic control and durable reductions in body weight and SBP over 104 weeks.