American heart journal
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American heart journal · Jan 2004
Microvascular alterations in patients with acute severe heart failure and cardiogenic shock.
Microvascular blood flow alterations may impair tissue oxygenation and may participate in the development of multiple organ failure in patients with severe heart failure. We hypothesized that microvascular blood flow alterations are present in patients with severe heart failure and cardiogenic shock. ⋯ Microvascular blood flow alterations are frequently observed in patients with severe heart failure and are more severe in patients who do not survive.
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American heart journal · Jan 2004
Randomized Controlled Trial Multicenter Study Clinical TrialPatients with chest pain calling 9-1-1 or self-transporting to reach definitive care: which mode is quicker?
We examined differences in transport times for patients with chest pain who used private transportation compared with patients who used emergency medical services (EMS) to reach definitive medical care. ⋯ Although private transportation results in a faster trip to the ED, quicker care is obtained with the use of EMS.
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American heart journal · Dec 2003
Randomized Controlled Trial Clinical TrialA randomized, placebo-controlled trial of early eptifibatide for non-ST-segment elevation acute coronary syndromes.
The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST-segment elevation acute coronary syndromes (NSTE ACS) remain unclear. ⋯ In this pilot trial, early administration of eptifibatide in the emergency department did not modulate serologic measurements of infarct size in patients with NSTE ACS.
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American heart journal · Dec 2003
Randomized Controlled Trial Clinical TrialAcetylcysteine in the prevention of contrast-induced nephropathy after coronary angiography.
Contrast-induced nephropathy (CIN) after coronary angiography is associated with increased morbidity and mortality rates. Preliminary studies with N-acetylcysteine (NAC) have found conflicting results in the prevention of CIN in patients undergoing coronary angiography. This study was designed to evaluate the efficacy and safety of NAC in the prevention of CIN in patients undergoing coronary angiography. ⋯ In patients with reduced renal function undergoing elective coronary angiography, NAC does not reduce the risk of CIN.
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American heart journal · Nov 2003
Randomized Controlled Trial Multicenter Study Clinical TrialInfluence of thrombolytic therapy, with or without intra-aortic balloon counterpulsation, on 12-month survival in the SHOCK trial.
The enhancement of diastolic coronary blood flow by the combination of thrombolytic therapy (TT) and intra-aortic balloon counterpulsation (IABP) in experimental studies provides a rationale for their combined use in acute myocardial infarction (MI) complicated by cardiogenic shock. We examined the relation between TT (with and without IABP) and 12-month survival in the SHould We Emergently Revascularize Occluded Coronaries for Cardiogenic ShocK (SHOCK) Trial. ⋯ Among patients randomly assigned to IMS in the SHOCK Trial, TT was associated with improved 12-month survival and did not significantly increase the risk of severe bleeding.