Bmc Cardiovasc Disor
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Bmc Cardiovasc Disor · Jan 2009
Multicenter StudyYounger age of escalation of cardiovascular risk factors in Asian Indian subjects.
Cardiovascular risk factors start early, track through the young age and manifest in middle age in most societies. We conducted epidemiological studies to determine prevalence and age-specific trends in cardiovascular risk factors among adolescent and young urban Asian Indians. ⋯ Low prevalence of multiple cardiovascular risk factors (smoking, hypertension, dyslipidemias, diabetes and metabolic syndrome) in adolescents and rapid escalation of these risk factors by age of 30-39 years is noted in urban Asian Indians. Interventions should focus on these individuals.
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Bmc Cardiovasc Disor · Jul 2008
Factors associated with poor prognosis among patients admitted with heart failure in a Nigerian tertiary medical centre: a cross-sectional study.
Heart failure is a major and growing public health problem worldwide. The prognosis of Heart Failure (HF) is uniformly poor despite advances in treatment. The aims of the present study were to determine the causes of HF among patients admitted to a Nigerian tertiary medical centre, to determine the prevalence of factors known to be associated with poor prognosis among these patients, and to compare the factors and causes between males and females. ⋯ The most prevalent factor associated with poor prognosis was low LVEF. Hypertensive heart disease and cardiomyopathies were the most common causes of HF in males and females respectively. The findings of the study should guide decision-making regarding management of HF patients.
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Bmc Cardiovasc Disor · Jan 2008
B-type natriuretic peptide is a long-term predictor of all-cause mortality, whereas high-sensitive C-reactive protein predicts recurrent short-term troponin T positive cardiac events in chest pain patients: a prognostic study.
Few studies have addressed whether the combined use of B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) improves risk stratification for mortality and cardiovascular events in a population with chest pain and suspected acute coronary syndromes (ACS). Therefore, we wanted to assess the incremental prognostic value of these biomarkers with respect to long-term all-cause mortality and recurrent troponin T (TnT) positive cardiac events in 871 patients admitted to the emergency department. ⋯ BNP may act as a clinically useful biomarker when obtained at admission in an unselected patient population following hospitalization with chest pain and potential ACS, and may provide complementary prognostic information to established risk determinants at long-term follow-up. Our data do not support the hypothesis that the additional assessment of hsCRP will lead to better risk stratification for survival than BNP alone.
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Bmc Cardiovasc Disor · Jan 2008
Letter Randomized Controlled Trial Multicenter Study Comparative StudyCorrection: PAIS: paracetamol (acetaminophen) in stroke; protocol for a randomized, double blind clinical trial. [ISCRTN74418480].
The Paracetamol (Acetaminophen) In Stroke (PAIS) study is a phase III multicenter, double blind, randomized, placebo-controlled clinical trial of high-dose acetaminophen in patients with acute stroke. The trial compares treatment with a daily dose of 6 g acetaminophen, started within 12 hours after the onset of symptoms, with matched placebo. The purpose of this study is to assess whether treatment with acetaminophen for 3 days will result in improved functional outcome through a modest reduction in body temperature and prevention of fever.The previously planned statistical analysis based on a dichotomization of the scores on the modified Rankin Scale (mRS) may not make the most efficient use of the available baseline information. Therefore, the planned primary analysis of the PAIS study has been changed from fixed dichotomization of the mRS to a sliding dichotomy analysis. ⋯ The protocol change was initiated because of both advances in statistical approaches and to increase the efficiency of the trial by improving statistical power.
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Bmc Cardiovasc Disor · Jan 2008
Comparative StudyDoes interhospital transfer improve outcome of acute myocardial infarction? A propensity score analysis from the Cardiovascular Cooperative Project.
Many patients suffering acute myocardial infarction (AMI) are transferred from one hospital to another during their hospitalization. There is little information about the outcomes related to interhospital transfer. The purpose of this study was to compare processes and outcomes of AMI care among patients undergoing interhospital transfer with special attention to the impact on mortality in rural hospitals. ⋯ Transferred patients were vastly different than non-transferred patients. However, even after a rigorous propensity-score analysis, transferred patients had lower mortality than non-transferred patients. Mortality was similar in rural and urban hospitals. Identifying patients who derive the greatest benefit from transfer may help physicians faced with the complex decision of whether to transfer a patient suffering an acute MI.