American heart journal
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American heart journal · Dec 2007
Randomized Controlled Trial Multicenter StudyC-reactive protein, bezafibrate, and recurrent coronary events in patients with chronic coronary heart disease.
Elevated C-reactive protein (CRP) levels are related to increased coronary risk in healthy subjects and in patients with acute coronary syndromes. The aims of the present study were to assess the following: (1) the association between CRP and subsequent coronary risk in patients with chronic coronary heart disease (CHD), (2) the effect of long-term bezafibrate treatment on CRP levels, and (3) to evaluate the consequences of change in CRP level over time on subsequent risk. ⋯ Baseline CRP and 2-year CRP levels were associated with subsequent risk of myocardial infarction and death in patients with chronic CHD. Bezafibrate did not reduce CRP levels as compared with placebo.
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American heart journal · Dec 2007
ReviewHow to prevent perioperative myocardial injury: the conundrum continues.
Perioperative myocardial injury (PMI) remains a major cause of perioperative morbidity and mortality but clinical strategies to prevent PMI are still uncertain. ⋯ Further studies, especially randomized clinical trials and mechanistic investigation are needed to find the best and effective clinical strategies to prevent/reduce PMI.
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American heart journal · Dec 2007
In patients with ST-segment elevation myocardial infarction with cardiogenic shock treated with percutaneous coronary intervention, admission glucose level is a strong independent predictor for 1-year mortality in patients without a prior diagnosis of diabetes.
Primary percutaneous coronary intervention (PCI) reduces mortality in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Despite PCI, mortality in CS is still approximately 50%. Admission glucose concentration is an independent predictor of mortality in patients with STEMI and is associated with the occurrence of CS. Whether admission glucose is also a predictor of mortality in CS patients treated with primary PCI is unexplored. We therefore assessed the relation between admission glucose concentration and 1-year mortality in patients with STEMI with CS without a prior diagnosis of diabetes on admission and treated with PCI. ⋯ In patients with STEMI with CS and without a prior diagnosis of diabetes undergoing primary PCI, admission glucose concentration is a very strong independent predictor for 1-year mortality. Further studies are warranted to determine whether concomitant glycometabolic regulation in patients with STEMI treated with PCI, particularly those with CS, will improve clinical outcome.
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American heart journal · Nov 2007
Statin therapy is associated with improved outcomes in vascular surgery patients with renal impairment.
Little is known about the association between baseline kidney function, statin therapy, and outcome after vascular surgery in patients with and without chronic kidney disease. ⋯ The level of kidney function is an independent predictor of short- and long-term outcome after major noncardiac surgery. In addition, perioperative statin use in patients with kidney disease is associated with a reduction in the short- and long-term all-cause, cardiac, and cerebrocardiovascular mortality.
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American heart journal · Oct 2007
Randomized Controlled Trial Multicenter StudyEffects of carvedilol early after myocardial infarction: analysis of the first 30 days in Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN).
In the CAPRICORN trial, carvedilol reduced all-cause mortality by 23% over a mean follow-up of 1.3 years in clinically stabilized post-myocardial infarction (MI) patients with left ventricular dysfunction (LVD) with or without signs of heart failure. This analysis sought to assess the impact of carvedilol within the first 30 days of randomization. ⋯ In clinically stabilized post-MI patients with LVD, there is an early benefit with carvedilol treatment that is similar to that seen during long-term therapy.