American heart journal
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American heart journal · Jan 2005
Randomized Controlled Trial Clinical TrialEfficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: experiences from MERIT-HF.
The objective of the current study was to examine the efficacy and tolerability of the beta-blocker metoprolol succinate controlled release/extended release (CR/XL) in patients with diabetes in the Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). ⋯ Patients with heart failure and diabetes have a much higher risk of hospitalization than patients without diabetes. Regardless of diabetic status, a highly significant reduction in hospitalizations for heart failure was observed with metoprolol CR/XL therapy, which was very well tolerated also by patients with diabetes. Furthermore, the pooled data showed a statistically significant survival benefit in patients with diabetes.
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American heart journal · Dec 2004
Clinical TrialPulsed wave tissue Doppler-derived myocardial performance index for the assessment of left ventricular thrombus formation risk after acute myocardial infarction.
Assessment of left ventricular (LV) thrombosis risk after acute myocardial infarction (AMI) is important because of potential embolic sequelae that are reduced by oral anticoagulant agents. The goal of this study was to investigate whether early assessment of LV systolic and diastolic performance with pulsed wave tissue Doppler ultrasound scanning (PWTD) predicts LV thrombosis after AMI. ⋯ The MPI derived with PWTD soon after admission appears to be a useful parameter for assessing the risk of LV thrombosis after AMI. Patients with an MPI >0.6 after AMI seem to be at a higher risk for thrombus formation.
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American heart journal · Dec 2004
Impact of the choice of benchmark on the conclusions of hospital report cards.
Hospital report cards for outcomes following acute myocardial infarction (AMI) are being produced with increasing frequency. Implicit in the statistical methods used is the fact that hospitals are being compared with an average hospital. Prior research has demonstrated that institutional characteristics such as a high annual volume of AMI patients and academic status are associated with improved outcomes. This raises the important issue of what is an appropriate benchmark against which hospitals should be compared. The objective of the current study was to determine whether the number of hospitals identified as mortality outliers depended upon the benchmark against which hospitals are compared. ⋯ The use of peer-group-defined rather than overall benchmarks has a substantial impact on the identification of mortality outliers. The choice of the appropriate benchmark is related to the underlying purpose of the comparison.