American heart journal
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American heart journal · Oct 2002
Randomized Controlled Trial Multicenter Study Clinical TrialTezosentan in patients with acute heart failure and acute coronary syndromes: design of the Randomized Intravenous Tezosentan study (RITZ-4).
Endothelin-1 is the most potent known endogenous vasoconstrictor. It is released during ischemia, and elevated levels have been demonstrated in hypertension, myocardial infarction, and heart failure. Tezosentan is a dual endothelin receptor antagonist, and it has improved cardiac output and reduced pulmonary and systemic vascular resistance in experimental animal models and in initial human acute decompensated heart failure studies. ⋯ The RITZ-4 study evaluated an important population in which few data are available to guide medical management. RITZ-4 will provide valuable safety and efficacy data with the novel compound tezosentan in patients with acute heart failure and acute coronary syndrome.
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American heart journal · Oct 2002
Effectiveness of a multidisciplinary chest pain unit for the assessment of coronary syndromes and risk stratification in the Florence area.
In patients seen at the emergency department (ED) with chest pain (CP), noninvasive diagnostic strategies may differentiate patients at high or intermediate risk from those at low-risk for cardiovascular events and optimize the use of high-cost resources. However, in welfare healthcare systems, the feasibility, accuracy, and potential benefits of such management strategy need further investigation. ⋯ An effective screening program with an observation area inside the ED (1) could be implemented in a public healthcare environment and contribute significantly to the reduction of admissions, (2) could optimize the management of patients at high and intermediate risk and succeed in recognizing CAD in 20% of patients at low risk, and (3) could allow screening for alternative causes of CP in patients without evidence of CAD.
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American heart journal · Sep 2002
Comparative StudyImpact of disease activity on left ventricular performance in patients with acromegaly.
In patients with acromegaly, abnormalities of systolic and diastolic left ventricular (LV) performance, mostly associated with hypertension or LV hypertrophy, have been reported. We used 2-dimensional/Doppler echocardiographic methods and tissue Doppler imaging (TDI) to elucidate the impact of disease activity on LV function in patients with acromegaly. ⋯ Disease activity has a significant impact on LV performance in patients with acromegaly. In subjects with active disease, diastolic dysfunction and beginning impairment of overall LV performance are present. In patients with cured/well-controlled disease, systolic and diastolic function appear normal.
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American heart journal · Sep 2002
Editorial Comment Comparative StudyReperfusion in waiting: what queue should we join?
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American heart journal · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialRandomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restenosis.
Cilostazol is a newly developed antiplatelet drug that has been widely applied for clinical use. Its antiplatelet action appears to be mainly related to inhibition of intracellular phosphodiesterase activity. Recently, cilostazol has been used for antiplatelet therapy after coronary stent implantation. However, its evaluation has not been established yet. ⋯ Aspirin plus cilostazol therapy may be an effective regimen for prevention of not only stent thrombosis but also restenosis.