Minerva cardioangiologica
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Minerva cardioangiologica · Oct 2014
Randomized Controlled Trial Comparative StudyEffects of verapamil and adenosine in an adjunct to tirofiban on resolution and prognosis of noreflow phenomenon in patients with acute myocardial infarction.
We aimed to investigate the effects of verapamil and adenosine in an adjunct to intravenous tirofiban on management and prognosis of no-reflow phenomenon during primary percutaneous coronary intervention (PPCI) and to compare their efficacies on reversing of no-reflow phenomenon and short and midterm survival. ⋯ In conclusion, intracoronary verapamil restored the impaired coronary blood flow more effectively than adenosine or placebo. However, none of them has changed the clinical course in the first 6 months.
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Minerva cardioangiologica · Jun 2012
Review Randomized Controlled Trial Multicenter StudyRenalguard system in high-risk patients for contrast-induced acute kidney injury.
Contrast-induced acute kidney injury (CI-AKI) predicts unfavorable outcomes. The use of the RenalGuard™® system, to create high urine output and fluid balancing, may be beneficial in preventing CI-AKI. The REMEDIAL II trial is a randomized, multicenter, investigator-driven trial addressing the prevention of CI-AKI in high risk patients. ⋯ CI-AKI (defined as an increase of ≥0.3 mg/dL in the serum creatinine concentration at 48 hours after the procedure) occurred in 16/146 patients in the RenalGuard group (11%) and in 30/146 patients in the Control group (20.5%) (P=0.025; OR=0.47; 95% CI=0.24-0.92). Absolute changes in CyC at 24 hours (0.02±0.32 versus -0.08±0.26; P=0.002) and at 48 hours (0.12±0.42 versus -0.03±0.31; P=0.001), as well as the rate of in-hospital dialysis (4.1% versus 0.7%; P=0.056) were higher in the Control group. In conclusion, the RenalGuard therapy seems to be a promising new approach in preventing CI-AKI in high risk patients.
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Minerva cardioangiologica · Oct 2008
Randomized Controlled Trial Comparative StudyCarotid endarterectomy: comparing anesthesia in awakened and intubated patients with general anesthesia.
The purpose of this study was to determine utility and efficacy of anesthesia with remifentanil in awakened and intubated patients in comparison with general anesthesia and routine shunting. ⋯ General anesthesia with remifentanil produces an association between the advantage of locoregional anesthesia and those of general anesthesia, probably lowering the risk for the patients.
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Minerva cardioangiologica · Dec 2007
Randomized Controlled Trial Comparative StudyStem cells mobilization in acute myocardial infarction (stem-AMI trial): preliminary data of a perspective, randomized, single blind trial.
Clinical trials demonstrated that granulocyte colony-stimulating factor (G-CSF) administration seems to be safe in patients with acute myocardial infarction but the results about the effectiveness are not so encouraging. The main problem is to distinguish the effects that early revascularization and regenerative therapy have on left ventricular (LV) function. The purpose of our perspective randomized trial is to evaluate the efficacy of G-CSF administration, assessed by improvement of LV ejection fraction by cardiac magnetic resonance imaging (MRI), in patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention (PCI) and with evidence of LV dysfunction. ⋯ Preliminary data of our study do not support any conclusive result. However, the characteristics of our population could allow us to distinguish the effects that revascularization and regenerative therapy have on LV function in patients with acute myocardial infarction.
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Minerva cardioangiologica · Dec 2000
Randomized Controlled Trial Comparative Study Clinical TrialNormothermic versus hypothermic perfusion during cardiopulmonary bypass. A randomized study on 132 patients.
A prospective randomized trial to compare normothermic CPB with hypothermic CPB has been performed. ⋯ In conclusion, we think that normothermic CPB is favourable because it can reduce costs, it can improve the management of a cardiac surgery unit and it is more comfortable for patients.