Abstract:
BACKGROUND:Patients with reduced left ventricular function and ventricular enlargement after myocardial infarction are at significantly greater risk for congestive heart failure and death. Nevertheless, recovery of ventricular function occurs in a significant proportion of patients after myocardial infarction, and modern reperfusion strategies have been associated with increased recovery of function. OBJECTIVE:To determine the extent and predictors of recovery of ventricular function after anterior Q-wave myocardial infarction in the reperfusion era. DESIGN:Subgroup analysis of the Healing and Early Afterload Reducing Therapy study. SETTING:35 medical centers in the United States and Canada. PATIENTS:352 patients with Q-wave anterior myocardial infarction. INTERVENTION:Placebo for 14 days, followed by full-dose (10 mg) ramipril until day 90; low-dose (0.625 mg) ramipril for 90 days; or full-dose ramipril for 90 days. All patients underwent reperfusion therapy. MEASUREMENTS:Echocardiography was performed on day 1 (before randomization), day 14, and day 90 after myocardial infarction. Left ventricular volume and ejection fraction were measured and wall-motion analyses were performed at all three time points in 249 patients and at baseline in an additional 12 patients who died during follow-up. Echocardiographic and nonechocardiographic predictors of ventricular recovery were examined. RESULTS:By day 90, 55 of 252 (22%) patients who had abnormal ejection fraction and wall-motion abnormalities on day 1 demonstrated complete recovery of function (ejection fraction in the normal range and infarct segment length of 0%), and an additional 36% (91 of 252 patients) demonstrated partial recovery of function. At 90 days, 53% (132 of 249) of patients had greater than 5% improvement in ejection fraction, whereas only 16% (39 of 249) had a decrease in ejection fraction of more than 5%. The majority of functional improvement occurred by day 14 after infarction. Of various clinical and echocardiographic measures obtained on day 1, peak creatine kinase level was the strongest independent predictor of subsequent recovery of ventricular function in multivariate analysis. Each 100-unit increase in peak creatine kinase was associated with a 4.3% decreased odds of recovery (P < 0.001) after adjustment for ejection fraction on day 1, extent of akinesis or dyskinesis, treatment regimen, Killip class, age, and sex. CONCLUSION:Significant myocardial stunning with subsequent improvement of ventricular function occurred in the majority of patients after Q-wave anterior myocardial infarction. A lower peak level of creatine kinase, an estimate of the extent of necrosis, is independently predictive of recovery of function. Early functional assessment (day 1 after acute myocardial infarction) had limited ability to predict recovery of ventricular function.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Solomon SD,Glynn RJ,Greaves S,Ajani U,Rouleau JL,Menapace F,Arnold JM,Hennekens C,Pfeffer MAdoi
10.7326/0003-4819-134-6-200103200-00009subject
Has Abstractpub_date
2001-03-20 00:00:00pages
451-8issue
6eissn
0003-4819issn
1539-3704pii
200103200-00009journal_volume
134pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::Conventional interpretation of clinical trials relies heavily on the classic p value. The p value, however, represents only a false-positive rate, and does not tell the probability that the investigator's hypothesis is correct, given his observations. This more relevant posterior probability can be quantified by an ex...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-3-385
更新日期:1983-03-01 00:00:00
abstract::The study of events in time is fundamental to biomedical research and public health surveillance. Clinicians have an intuitive appreciation for the relevance of time to health and disease, and patients invariably ask questions relating to time for which clinicians need answers. An appreciation of the picture of health...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-1-200001040-00007
更新日期:2000-01-04 00:00:00
abstract:BACKGROUND:The appropriate roles for several diagnostic tests for coronary disease are uncertain. OBJECTIVE:To evaluate the cost-effectiveness of alternative approaches to diagnosis of coronary disease. DESIGN:Meta-analysis of the accuracy of alternative diagnostic tests plus decision analysis to assess the health ou...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-130-9-199905040-00003
更新日期:1999-05-04 00:00:00
abstract::The U.S. Preventive Services Task Force (USPSTF) makes recommendations on which preventive services to routinely incorporate into primary care for specific populations. Behavioral counseling interventions are preventive services designed to help persons engage in healthy behaviors and limit unhealthy ones. The USPSTF'...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M13-2128
更新日期:2014-03-18 00:00:00
abstract::Type 2 diabetes mellitus is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. An elevated rate of basal hepatic glucose production in the presence of hyperinsulinemia is the primary cause of fasting hyperglycemia; after a meal, impaired suppression of hepatic glucose ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-131-4-199908170-00008
更新日期:1999-08-17 00:00:00
abstract:BACKGROUND:The current standard initial therapies for deep venous thrombosis are low-molecular-weight heparin and unfractionated heparin. In a dose-ranging study of patients with symptomatic deep venous thrombosis, fondaparinux had efficacy and a safety profile similar to those of low-molecular-weight heparin (daltepar...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-140-11-200406010-00007
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Some health plans profile physicians on the basis of their relative costs and use these profiles to assign physicians to cost categories. Physician organizations have questioned whether the rules used to attribute costs to a physician affect the cost category to which that physician is assigned. OBJECTIVE:T...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-152-10-201005180-00005
更新日期:2010-05-18 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of the addition of ifosfamide to cisplatin plus etoposide (VIP), or vinblastine (VeIP), in patients with recurrent germ cell tumors. DESIGN:Nonrandomized, prospective phase II trial. SETTING:Tertiary referral university hospital. PATIENTS:Fifty-six of fifty-eight entered pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-7-540
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Although the efficacy of adjuvant chemotherapy in prolonging survival for women with breast cancer has been well documented, limited population-based information is available on the actual use of chemotherapy. OBJECTIVE:To examine the relationship between age and chemotherapy use. DESIGN:Cohort study. SET...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-2-200301210-00009
更新日期:2003-01-21 00:00:00
abstract::Rising health care expenditures have led to numerous cost-control proposals. An examination of the ethical questions surrounding the role that physicians play in the control of health care costs suggests that unilateral rationing decisions by individual physicians at the bedside are morally unacceptable. Such decision...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-11-920
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Screening for hereditary hemochromatosis is traditionally done by using serum iron studies. However, mutation analysis of the hemochromatosis-associated HFE gene has recently become available. OBJECTIVE:To compare the cost-effectiveness of no screening with four screening strategies that incorporate HFE gen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-4-200002150-00003
更新日期:2000-02-15 00:00:00
abstract::The relation of menopause to cardiovascular disease incidence was examined in women less than 55 years old from the cohort of 2873 women in the initial Framingham examination. Although the number of person-years of experience during the 20 years of observation was nearly the same for premenopausal and postmenopausal s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-4-447
更新日期:1976-10-01 00:00:00
abstract::In recent years there has been increasing attention to the appropriate interpretation of a clinical study. One special concern has been the difficulty inherent in interpreting studies that were not statistically significant: Was the sample size sufficient to detect a clinically important effect if, in fact, it existed...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-2-248
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Few treatments exist for coronavirus disease 2019 (COVID-19). PURPOSE:To evaluate the effectiveness and harms of remdesivir for COVID-19. DATA SOURCES:Several databases, tables of contents of journals, and U.S. Food and Drug Administration and company websites were searched from 1 January through 31 August...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-5752
更新日期:2020-10-05 00:00:00
abstract::Wilson's disease is an inherited disorder of copper accumulation that is fatal if untreated. Because penicillamine, the established treatment, is toxic in a substantial number of patients, we studied the efficacy of zinc treatment. We induced a negative or neutral copper balance in five out of five patients with Wilso...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-3-314
更新日期:1983-09-01 00:00:00
abstract:Background:The benefits of pay-for-performance (P4P) programs are uncertain. Purpose:To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. Data Sources...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-1881
更新日期:2017-03-07 00:00:00
abstract:BACKGROUND:Residual renal function is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis. However, few studies have evaluated therapeutic approaches for preserving residual renal function after the initiation of dialysis. OBJECTIVE:To test the hypothesis that the angiotensin-...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-139-2-200307150-00010
更新日期:2003-07-15 00:00:00
abstract::During the last 2 years, the use of pulsed Doppler echocardiography for assessing left ventricular diastolic function has received increased attention. This method is based on measurements derived from a waveform that reflects the velocity of blood flow through the mitral valve during ventricular filling. The techniqu...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-2-122
更新日期:1988-07-15 00:00:00
abstract::Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture rejec...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-136-5-200203050-00010
更新日期:2002-03-05 00:00:00
abstract:BACKGROUND:Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE:To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN:An expert development panel reviewed established and new qu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-3-200702060-00008
更新日期:2007-02-06 00:00:00
abstract:STUDY OBJECTIVE:To determine whether obesity preceded knee osteoarthritis and was thus a possible cause. DESIGN:Cohort study with weight and other important variables measured in 1948 to 1951 (mean age of subjects, 37 years) and knee arthritis evaluated in 1983 to 1985 (mean age of subjects, 73 years). SETTING:Popula...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-1-18
更新日期:1988-07-01 00:00:00
abstract:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202101190-004
更新日期:2021-01-01 00:00:00
abstract:Background:Whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection is unknown. Objective:To assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis. Des...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M18-2753
更新日期:2019-09-03 00:00:00
abstract::We recently implemented a full-featured electronic health record in our independent, 4-internist, community-based practice of general internal medicine. We encountered various challenges, some unexpected, in moving from paper to computer. This article describes the effects that use of electronic health records has had...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-143-3-200508020-00008
更新日期:2005-08-02 00:00:00
abstract:OBJECTIVE:To determine whether prolonging the duration of tamoxifen administration beyond the cessation of a combined chemotherapy regimen benefits patients with primary breast cancer with positive findings in axillary nodes who benefit initially from the combined regimen. DESIGN:Nonrandomized, nonconcurrent cohort st...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-106-5-649
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To measure changes in spinal and femoral neck bone mineral densities in patients treated for Graves thyrotoxicosis. DESIGN:Cohort study. SETTING:Tertiary care center. PATIENTS:Fifteen women with active Graves thyrotoxicosis. Six patients were premenopausal and nine were postmenopausal. All patients had evi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-1-199401010-00002
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To determine whether growth hormone replacement in older men improves functional ability. DESIGN:Randomized, controlled, double-blind trial. SETTING:General community. PATIENTS:52 healthy men older than 69 years of age with well-preserved functional ability but low baseline insulin-like growth factor 1 lev...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-124-8-199604150-00002
更新日期:1996-04-15 00:00:00
abstract:BACKGROUND:The risk for venous thromboembolism during pregnancy or postpartum is uncertain. OBJECTIVES:To estimate the relative and absolute risk for deep venous thrombosis and pulmonary embolism during pregnancy and postpartum and to describe trends in incidence. DESIGN:Population-based inception cohort study using ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-143-10-200511150-00006
更新日期:2005-11-15 00:00:00
abstract:OBJECTIVE:To reassess the natural history of polycythemia vera and to obtain reliable estimates of both incidence of thrombosis and survival for use in defining the sample size for therapeutic clinical trials. STUDY DESIGN:Retrospective cohort study of patients with polycythemia who had been followed for 20 years. SE...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-9-199511010-00003
更新日期:1995-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of cisplatin-based combination chemotherapy in patients with advanced ovarian germ-cell tumors. DESIGN:Nonrandom prospective trial with endpoints of tumor response, results of repeat surgical exploration, progression-free interval, and survival. SETTING:Cooperative university-...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-111-1-22
更新日期:1989-07-01 00:00:00