#1
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The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain:acomparison with ESC/EAS guidelines for the management of dyslipidaemias 2011
European Heart Journal doi:10.1093/eurheartj/ehu107 [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Ñ óâàæåíèåì |
#3
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Cardiovasc Ther. 2014 Apr 23. doi: 10.1111/1755-5922.12076.
Pentoxifylline in heart failure: a meta-analysis of clinical trials. Champion S, Lapidus N, Cherié G, Spagnoli V, Oliary J, Solal AC. BACKGROUND: Pentoxifylline possess anti-inflammatory and rheological properties and has been tested in heart failure (HF). METHODS: A comprehensive search was performed from 1980 until July 2013 in PubMed, to identify randomized controlled trials evaluating pentoxifylline versus placebo in HF, in order to determine impact on mortality. Search strategy: "Pentoxifylline" AND "heart" AND "trial". Study selection of 6 randomized controlled trials evaluating mortality as outcome. Then we conducted a meta-analysis of randomized controlled trials versus placebo in HF. Determination of Mantel-Haenszel fixed effect and random effect pooled odds ratios for all-cause mortality and corresponding 95% confidence intervals. RESULTS: Data from a total of 221 patients with LVEF≤40% from six randomized controlled trials were included in this analysis. Pentoxifylline 1200 mg per day was administered during 6 months, except in one study (administered during 1 month for severe acute HF). The use of pentoxifylline was not significantly associated with a reduction of mortality in HF in individual studies. The pooled data including 221 patients showed a nearly fourfold reduction in mortality (5.4% vs 18.3%; OR 0.29; CI 0.12-0.74; p<0.01) with homogenous results (I² 0%). CONCLUSION: A meta-analysis evaluating pentoxifylline versus placebo in HF suggested a significant nearly fourfold decrease in all-cause mortality in the pentoxifylline group.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#4
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Õì-ì. Èíòåðåñíî, à åñëè òàê- [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#5
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"Cardiology's Biggest Lie: No MRI for Your Device Patient"
Melissa Walton-Shirley, MD Cardiologist, Cardiology Associates, Glasgow, Kentucky Öèòàòà:
Öèòàòà:
äðóãîå ìíåíèå: Öèòàòà:
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#6
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Íó î÷åíü ëþáîïûòíàÿ ýòà ïàíåëü 8 ïî ÀÃ
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) 1. Êëàññèôèêàöèÿ è ðèñêè óæå íå íóæíû, â ëþáîì ñëó÷àå, íå âàæíû. 2. Öåëåâîå ÀÄ äëÿ ëèö ðàâíî ñòàðøå 60 ëåò ìåíüøå 150/90, ìåíüøå 60 ëåò - ìåíüøå 140/90, äëÿ ÑÄ è áîëåçíè ïî÷åê ñòàðøå 18 ëåò - ìåíüøå 140/90. 3. Ïðè ÀÄ áîëüøå öåëåâîãî ñðàçó ìåäèêàìåíòîçíîå ëå÷åíèå. 4. Òèòðîâàíèå äî 3 ïðåïàðàòîâ òîëüêî 4 ãðóïïàìè: èÀÏÔ, ÁÐÀ (âìåñòå íåëüçÿ), òèàçèäû, ÁÊÊ. Åñëè íóæåí ÷åòâåðòûé ïðåïàðàò - ëþáîé èç ÁÁ èëè àëüôà-áëîêàòîðîâ è äðóãèõ ãðóïï (ÁÁ íèêàê íå âûäåëÿþòñÿ) |
#7
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ñâåæåíüêàÿ èíôî
Öèòàòà:
Background Atrial fibrillation and heart failure often coexist, causing substantial cardiovascular morbidity and mortality. β blockers are indicated in patients with symptomatic heart failure with reduced ejection fraction; however, the efficacy of these drugs in patients with concomitant atrial fibrillation is uncertain. We therefore meta-analysed individual-patient data to assess the efficacy of β blockers in patients with heart failure and sinus rhythm compared with atrial fibrillation. Methods We extracted individual-patient data from ten randomised controlled trials of the comparison of β blockers versus placebo in heart failure. The presence of sinus rhythm or atrial fibrillation was ascertained from the baseline electrocardiograph. The primary outcome was all-cause mortality. Analysis was by intention to treat. Outcome data were meta-analysed with an adjusted Cox proportional hazards regression. The study is registered with Clinicaltrials.gov, number NCT0083244, and PROSPERO, number CRD42014010012. Findings 18 254 patients were assessed, and of these 13 946 (76%) had sinus rhythm and 3066 (17%) had atrial fibrillation at baseline. Crude death rates over a mean follow-up of 1·5 years (SD 1·1) were 16% (2237 of 13 945) in patients with sinus rhythm and 21% (633 of 3064) in patients with atrial fibrillation. β-blocker therapy led to a significant reduction in all-cause mortality in patients with sinus rhythm (hazard ratio 0·73, 0·67—0·80; p<0·001), but not in patients with atrial fibrillation (0·97, 0·83—1·14; p=0·73), with a significant p value for interaction of baseline rhythm (p=0·002). The lack of efficacy for the primary outcome was noted in all subgroups of atrial fibrillation, including age, sex, left ventricular ejection fraction, New York Heart Association class, heart rate, and baseline medical therapy. Interpretation Based on our findings, β blockers should not be used preferentially over other rate-control medications and not regarded as standard therapy to improve prognosis in patients with concomitant heart failure and atrial fibrillation. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Ñ óâàæåíèåì |
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#8
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Öèòàòà:
Èíòåðåñíî ñêîëüêî ýòî áóäåò ñòîèòü ëåò õîòÿ áû ÷åðåç äåñÿòü (íå â àáñîëþòíûõ öèôðàõ, à â îòíîøåíèè ê ñòîèìîñòè ìàêñèìàëüíîé äîçû ñòàòèíîâ)???? |
#9
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Íàêîíåö-òî ïîÿâèëñÿ ìîùíûé íåãàòèâ ïî ñåðâüåøíîìó Èâàáðàäèíó:
Öèòàòà:
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Àëåêñàíäð Èâàíîâè÷ ñ ïîæåëàíèÿìè êðåïêîãî çäîðîâüÿ |
#10
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Ðåçóëüòàòû DAPT:
Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] ðåä.êîììåíò [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#12
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Àñïèðèíêà ïåðåä ñíîì ó ïàöèåíòîâ ñ ÈÁÑ íå âëèÿåò íà ÀÄ, íî ñíèæàåò óòðåííþþ ðåàêòèâíîñòü òðîìáîöèòîâ:
Hypertension. 2015 Feb 17. Time-Dependent Effects of Aspirin on Blood Pressure and Morning Platelet Reactivity: A Randomized Cross-Over Trial. Bonten TN è ñîàâò. Aspirin is used for cardiovascular disease (CVD) prevention by millions of patients on a daily basis. Previous studies suggested that aspirin intake at bedtime reduces blood pressure compared with intake on awakening. This has never been studied in patients with CVD. Moreover, platelet reactivity and CVD incidence is highest during morning hours. Bedtime aspirin intake may attenuate morning platelet reactivity. This clinical trial examined the effect of bedtime aspirin intake compared with intake on awakening on 24-hour ambulatory blood pressure measurement and morning platelet reactivity in patients using aspirin for CVD prevention. In this randomized open-label crossover trial, 290 patients were randomized to take 100 mg aspirin on awakening or at bedtime during 2 periods of 3 months. At the end of each period, 24-hour blood pressure and morning platelet reactivity were measured. The primary analysis population comprised 263 (blood pressure) and 133 (platelet reactivity) patients. Aspirin intake at bedtime did not reduce blood pressure compared with intake on awakening (difference systolic/diastolic: -0.1 [95% confidence interval, -1.0, 0.9]/-0.6 [95% confidence interval, -1.2, 0.0] mm Hg). Platelet reactivity during morning hours was reduced with bedtime aspirin intake (difference: -22 aspirin reaction units [95% confidence interval, -35, -9]). The intake of low-dose aspirin at bedtime compared with intake on awakening did not reduce blood pressure of patients with CVD. However, bedtime aspirin reduced morning platelet reactivity. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#13
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Íàëè÷èå àíåìèè ïîâûøàåò â ïîëòîðà ðàçà ðèñê ñìåðòíîñòè è âîçíèêíîâåíèÿ äð. òðîìáîòè÷åñêèõ îñëîæíåíèé ó ïàöèåíòîâ ñ ÔÏ íà ôîíå íàçíà÷åíèÿ àíòèêîàãóëÿíòîâ è â 2 ðàçà ðèñê áîëüøèõ êðîâîòå÷åíèé - äàííûå èç RE-LY:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#14
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 Schein's common sense 'Prevention and management of Surgical complications' îáíàðóæèëà çàáàâíóþ çàìåòêó
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Ñ óâàæåíèåì |
#15
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Êàê ïðàçîëû èëè Í2-áëîêåðû è ó êîãî ïðåäîòâðàùàþò ÆÊÊ íà ôîíå ïðèåìà äàáèãàòðàíà:
Among the 5041 patients newly prescribed dabigatran, 124 (2.5%) developed GIB during follow-up (4.2/100 patient-years). The risk of GIB in this population increased among patients 75 y old or older (IRR, 2.47; 95% confidence interval [CI], 1.66-3.68), patients with a history of peptic ulcers or GIB (IRR, 2.31; 95% CI, 1.54-3.46), and patients who used aspirin (IRR, 1.52; 95% CI, 1.03-2.24). Concomitant use of GPAs was associated with a reduced risk of GIB (IRR, 0.52; 95% CI, 0.35-0.77). Subcategory analysis showed that use of proton-pump inhibitors (IRR, 0.53; 95% CI, 0.31-0.91) or histamine type-2 receptor antagonists (IRR, 0.61; 95% CI, 0.40-0.94) were associated with lower risk of GIB. Further analysis revealed that the risk reduction by GPAs was significant for only upper GIB (IRR, 0.29; 95% CI, 0.15-0.54) and only for patients with prior history of peptic ulcers or GIB (IRR, 0.14; 95% CI, 0.06-0.30). --- Gastroenterology. 2015 May 7. Prevention of Dabigatran-related Gastrointestinal Bleeding With Gastroprotective Agents: A Population-Based Study. Chan EW, è ñîàâò. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |