Abstract:
BACKGROUND:Patients with kidney failure have a heavy burden of coronary artery disease. The results of preventive, diagnostic, and therapeutic measures developed in nonuremic populations cannot automatically be extrapolated to this unique group of patients. METHODS AND RESULTS:Articles were reviewed if they contained English language text or an abstract identified by MEDLINE search from 1980 to 1999, supplemented by manual review of bibliographies of published articles and abstract issues of national cardiology meetings, studies on diagnostic techniques, risk modification measures, pharmacologic agents, and coronary revascularization procedures in patients with uremia. Descriptive and quantitative data as appropriate were extracted. Lipid-lowering agents may be safely administered to uremic patients. Direct evidence of lipid lowering in this population is not available and is not likely to be forthcoming. Erythropoietin therapy is effective in reversing the cardiovascular perturbations of uremic anemia, but an approach of normalizing the hematocrit cannot be recommended. Glycoprotein IIb/IIIa inhibitors used in acute coronary syndromes require downward dose adjustment or are contraindicated. Thrombolytic agents are underutilized in the management of myocardial infarction. Noninvasive testing is less accurate than in nonuremic populations. Coronary revascularization offers relative clinical advantages over medical therapy similar to non-kidney failure populations, even though the results in uremic patients is significantly less favorable than for nonuremic patients. Stenting is the preferred revascularization approach, and conventional balloon percutaneous transluminal coronary angioplasty the least favorable. CONCLUSIONS:Many but not all of the benefits of therapies developed in nonuremic patients extend to patients with kidney failure. Physicians should be familiar with the advantages and limitations of each of these modalities in this population.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Vaitkus PTdoi
10.1067/mhj.2000.105300subject
Has Abstractpub_date
2000-06-01 00:00:00pages
1000-8issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(00)99542-5journal_volume
139pub_type
杂志文章,评审abstract::Although successful dilatation of a target lesion by means of percutaneous transluminal coronary angioplasty (PTCA) can be attained as frequently in elderly as in younger patients, elderly patients have a higher risk of complications. Furthermore, cohorts of patients older than 75 years and undergoing PTCA include mor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90267-4
更新日期:1994-10-01 00:00:00
abstract::Our purpose was to determine the incidence of mitral valve prolapse in patients with anxiety neurosis or panic disorder, with symptoms including recurrent anxiety attacks, dyspnea, palpitations, chest pain, dizziness, and paresthesias. Twenty-one patients and 20 age- and sex-matched normal controls were studied. Objec...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90142-8
更新日期:1980-09-01 00:00:00
abstract::To investigate the significance and mechanism of dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging, we performed both dipyridamole thallium-201 imaging and dipyridamole radionuclide angiography on 83 patients with known angiograms. The dipyridamole/delayed ratio of the left ventricular dim...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90713-r
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel ≥12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific eviden...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.09.009
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of early (<48 hours) ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) in patients with an acute myocardial infarction remains controversial. Emerging data suggest that some of the benefit of renin-angiotensin-aldosterone system (RAAS) antagonism ma...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.05.023
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Long-term treatment with beta-blockers reduces mortality after acute myocardial infarction (AMI). Whether beta-blockers exert a class effect is unknown. METHODS:We analyzed mortality after AMI in Canadian patients 65 years or older who were discharged from hospital with a diagnosis of AMI from April 1996 to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.11.008
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Late prognosis after infective endocarditis has not been systematically studied in large series of patients with different underlying heart conditions in recent years. METHODS:We studied an inception cohort study of 420 patients discharged after treatment of endocarditis from a university tertiary care hosp...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.111952
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Diabetes is associated with a high rate of events after acute coronary syndrome and percutaneous coronary intervention despite aspirin treatment. Once daily aspirin might not provide 24-hour stable biological efficacy in patients with diabetes. We compared the biological efficacy of the same daily dose of as...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.06.008
更新日期:2012-10-01 00:00:00
abstract::An expression representative of the rate of change of ventricular power during ejection was derived. The primary advantages of the expression are its theoretical value and its ability to characterize ventricular performance. The rate of change of ventricular power, measured during ejection, is virtually free of assump...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80577-7
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Recent experimental studies have suggested that the angiogenic cytokines hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) may play a role in the pathogenesis of congestive heart failure (CHF). The aim of the present study was to test the hypothesis that HGF and VEGF concentrations...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.047
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:31-Phosphorus-magnetic resonance spectroscopy may provide pathophysiological insights into the high-energy phosphate metabolism of the myocardium as measured by phosphocreatine to adenosine triphosphate (PCr/ATP) ratio. Aim of the present study was to determine in vivo the relation between cardiac PCr/ATP ra...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.04.012
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Statins are effective in the prevention of coronary events and the treatment of acute coronary syndromes. However, their efficacy and safety in patients with heart failure (HF) are unknown. In this review, we discuss the evidence for the efficacy and safety of statin therapy in patients with HF. METHODS:We ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2005.09.008
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHOD...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.08.017
更新日期:2017-02-01 00:00:00
abstract::We investigated the incidence and mechanism of pulmonary artery hypertension (PAH) in a consecutive series of patients with aortic stenosis who were undergoing diagnostic cardiac catheterization. Forty-five patients with severe aortic stenosis were divided into two groups: group 1 comprised 13 patients (29%) with PAH ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90067-j
更新日期:1993-01-01 00:00:00
abstract::The effects and possible mechanisms of actions of indomethacin on systemic and coronary hemodynamics were studied in 17 patients with coronary artery disease. Group I patients (12) were given either indomethacin or placebo in the absence of prior cyclooxygenase inhibition and group II (five) were given indomethacin af...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(85)90149-8
更新日期:1985-08-01 00:00:00
abstract:CLINICAL SCENARIO:A 67-year-old man is referred to your cardiology clinic complaining of worsening angina and dyspnea on exertion. Physical examination reveals a harsh grade IV/VI late-peaking crescendo-decresendo systolic murmur, loudest at the upper sternal border. The aortic closure sound is diminished. Echocardiogr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.05.031
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Guidelines recommend consideration of cardiac biomarker measurement after elective percutaneous coronary intervention (PCI), especially with complex cases or complicated procedures. However, the long-term prognostic implications of biomarker measurement after elective PCI have not been well characterized in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.09.007
更新日期:2013-11-01 00:00:00
abstract::We devised a nine-lead Holter monitor system with a lead-switching technique to record electrocardiograms from multiple sites in the anterior and the posterior or lateral chest. Leads CM1 to CM6, high lateral (HL), low lateral (LL), and low posterior chest (LB) were used. The sensitivity, specificity, and predictive a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(94)90595-9
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that cholesterol-lowering therapy prevented further events in patients with coronary heart disease and average cholesterol levels. The aim of this subgroup analysis was to assess the effects of pravastatin in women. METHOD...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,meta分析
doi:10.1067/mhj.2003.1
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:The ACUTE Trial studied a transesophageal echocardiography (TEE)-guided strategy compared with a conventional strategy for management of patients with atrial fibrillation undergoing direct current cardioversion. The primary aim was to determine if patient functional capacity, measured by the Duke Activity St...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.08.014
更新日期:2005-02-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract::TACT is an National Institutes of Health-sponsored, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial testing the benefits and risks of 40 infusions of a multicomponent disodium EDTA chelation solution compared with placebo and of an oral, high-dose multivitamin and mineral supplement. TACT ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.10.002
更新日期:2012-01-01 00:00:00
abstract::Fourteen fetuses with atrioventricular canal malformations were examined by two-dimensional echocardiography, pulsed-wave Doppler echocardiography, and color Doppler flow mapping. Eleven fetuses had complete and three fetuses had partial atrioventricular canal malformations. Nonimmune hydrops fetalis was associated wi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90156-c
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine if depression is associated with worse disease-specific functional status in patients with coronary artery disease. The study was designed as a cross-sectional survey and 3-month longitudinal cohort. METHODS AND RESULTS:The study took place in outpatient clinics ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.106600
更新日期:2000-07-01 00:00:00
abstract::The MAPHY Study was conducted to investigate whether metoprolol, a relatively beta 1-selective beta-blocker, given as initial antihypertensive treatment, would lower cardiovascular complications of high blood pressure to a greater extent than do thiazide diuretics as initial treatment at similar blood pressure control...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(88)90112-3
更新日期:1988-07-01 00:00:00
abstract::To observe the stereoscopic structure and the motion of the prolapsing mitral valve and its regurgitant jet in comparison with the normal mitral valve, four-dimensional (or dynamic three-dimensional) echocardiography of mitral valve apparatus was obtained in 20 patients with mitral valve prolapse and 10 unaffected sub...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70257-6
更新日期:1997-01-01 00:00:00
abstract::Patients with impaired glucose tolerance (IGT) have increased risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle modification and medication can prevent or delay progression to diabetes (PD), but whether such interventions also reduce the risk of CVD has not been rigorously...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2008.05.017
更新日期:2008-10-01 00:00:00
abstract::Acute ventricular septal rupture in the setting of acute myocardial infarction continues to present clinicians with a difficult therapeutic dilemma. The role of surgical intervention and its timing remains unresolved. A collaborative study from three institutions was undertaken to examine various clinical outcomes in ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0002-8703(88)90458-9
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Galectin-3, a β-galactoside binding lectin involved in important regulatory roles in adhesion, inflammation, immunity, and fibrosis, may be relevant to atrial fibrillation (AF) etiology. METHODS:We included 8,436 participants free of AF at baseline (1996-1998) and with measures of plasma galectin-3 from the...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2017.07.001
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Erythropoietin mitigates myocardial damage and improves ventricular performance after experimental ischemic injury. This study assessed safety and efficacy markers relevant to the biological activity of recombinant human erythropoietin (rHuEpo) in patients with acute myocardial infarction (MI). METHODS:We c...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.06.032
更新日期:2009-12-01 00:00:00