Abstract:
BACKGROUND:Firm evidence exists for reduction in mortality and morbidity by lipid-lowering therapy in patients with coronary artery disease (CAD), yet a significant proportion remain untreated. This prospective study determined the effectiveness of a planned strategy of management using a cardiac rehabilitation nurse in achieving (1) lower 6-month low-density lipoprotein (LDL) levels and (2) a higher proportion of patients on pharmacologic therapy. METHODS:A cardiac rehabilitation nurse arranged for the lipid profiles and initiated pharmacologic therapy as soon as possible after the diagnosis of CAD. In phase 1, this planned-strategy intervention group (n = 80) was compared with the usual-care control group (n = 189), where the management was left at the discretion of the attending cardiologist with the assignment to the 2 groups based on the weekly on-call rotations of the attending cardiologists in a nonrandomized manner. In phase 2 of the study all patients (n = 366) were enrolled in the planned strategy of management. RESULTS:There were no significant differences in the baseline lipid values between the control and intervention groups. The 6-month cholesterol and LDL values and the percentage of patients on lipid-lowering medications were significantly better in the intervention group (P =.01). In phase 2 the results obtained in the intervention group were duplicated in a much larger group of consecutive patients. The 6-month (millimoles per liter) results in the control, intervention, and phase 2 groups (respectively) were cholesterol 4.92 +/- 0.06, 4.60 +/- 0.07, 4.30 +/- 0.05; low-density lipoprotein 2.91 +/- 0.06, 2.68 +/- 0.07, 2.4 +/- 0.06; high-density lipoprotein 1.18 +/- 0.07, 1.12 +/- 0.09, 1.10 +/- 0.01; triglycerides 1.89 +/- 0.12, 1.78 +/- 0.09, 1.70 +/- 0.05; and on medications 49%, 83%, and 84%. CONCLUSION:A planned strategy of management with use of early pharmacologic therapy with a cardiac rehabilitation nurse assigned to obtain and follow lipid profiles and initiate therapy is more effective in controlling dyslipidemia than leaving the management to the cardiologist.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Senaratne MP,Griffiths J,Mooney D,Kasza L,Macdonald K,Hare Sdoi
10.1067/mhj.2001.118739subject
Has Abstractpub_date
2001-12-01 00:00:00pages
975-81issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(01)79121-1journal_volume
142pub_type
临床试验,杂志文章abstract::The purpose of this study was to evaluate feasibility, safety, and efficacy of implantation of unsheathed Palmaz-Schatz coronary stents via the radial artery. Anticoagulation after coronary stenting has the hazard of vascular complications if large-bore guiding catheters are introduced via the femoral artery. Such com...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90023-x
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Chronic periodontal infection is associated with an increased risk of coronary heart disease. Although the mechanism responsible for the relationship between periodontal disease and cardiovascular events is not fully understood, it is hypothesized that the chronic inflammatory burden of periodontal disease m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.002
更新日期:2006-01-01 00:00:00
abstract::Vasodilators facilitate ventricular emptying by affording earlier onset of left ventricular (LV) ejection and increased stroke volume with achievement of a reduced end-systolic pressure and volume. Agents with positive inotropic properties increase stroke volume by shifting the end-systolic pressure-volume curve to th...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(81)90738-9
更新日期:1981-09-01 00:00:00
abstract::Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intraven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90477-5
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to estimate the cost-effectiveness of beta-blocker therapy with either metoprolol or carvedilol in addition to conventional therapy for patients with heart failure (HF) in Canada. DESIGN:A Markov simulation was used to estimate the costs and life expectancy for treating patients...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.116479
更新日期:2001-09-01 00:00:00
abstract::Inhibition of the enzyme that synthesizes thromboxanes may protect against the development of ventricular fibrillation (VF) during acute myocardial ischemia. This study was carried out to test this hypothesis with a new thromboxane synthetase inhibitor, and to extend the studies to alternative animal models of myocard...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90622-4
更新日期:1989-04-01 00:00:00
abstract::Flow beyond a stenotic aortic valve (AS) is dynamically complex. Numerous hydraulic studies have demonstrated that at least four well-known major flow areas occur distal to a stenotic valve. These include a jet, an area alongside the jet (the parajet), an area of flow disturbance, and an area in which disturbed flow a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90400-8
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:The randomized BASKET-PROVE study showed no significant differences between sirolimus-eluting stents (SES), everolimus-eluting stents (EES), and bare-metal stents (BMS) with respect to the primary end point, rates of death from cardiac causes, or myocardial infarction (MI) at 2 years of follow-up, in patient...
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.2015.11.007
更新日期:2016-03-01 00:00:00
abstract::Bacterial shock due to Gram-negative bacilli is best managed by prompt control of the infection with appropriate antibiotics and surgical drainage or excision. Corticosteroids for purposes of controlling systemic reactions to bacteria and their toxins constitute adjunctive therapy. Volume repletion and respiratory sup...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80352-9
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:Familial dilated cardiomyopathy (FDCM) is attributed to defects in cytoskeletal proteins, and different patterns of inheritance and phenotypic expressions according to assorted-protein modifications have been identified to date. We describe a clinical family study with 24 individuals in 3 generations affecte...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.141
更新日期:2003-02-01 00:00:00
abstract::Increased intracellular calcium (calcium overload) is considered one of the factors that can initiate ventricular fibrillation. In addition, ventricular fibrillation itself can cause and possibly maintain calcium overload. The goal of this study was to determine whether the class IA antiarrhythmic agent procainamide c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90453-0
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Pulmonary vein antrum isolation (PVI) as a treatment of paroxysmal atrial fibrillation (AF) is associated with a high rate of success; however, outcomes for treating persistent and long-standing persistent AF with PVI alone are substantially lower and often require multiple procedures to maintain long-term f...
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.2015.09.019
更新日期:2015-12-01 00:00:00
abstract::The acute hemodynamic and electrophysiologic effects of flecainide in tachycardia-induced ventricular dysfunction were investigated using an animal model. Seven swine were initially (CON) evaluated by echocardiography and then by right heart catheterization and provocative electrical ventricular stimulation both befor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90018-d
更新日期:1991-06-01 00:00:00
abstract::A retrospective analysis of our experience with intraprocedural thrombus complicating percutaneous transluminal coronary angioplasty (PTCA) was undertaken. Of 983 PTCA procedures reviewed, 62 (6.3%) were complicated by thrombus. Patients were managed conservatively (group I, n = 18), with redilation (group II, n = 17)...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90912-f
更新日期:1992-07-01 00:00:00
abstract::M-mode echocardiographic records of 26 patients with surgically proven complete atrioventricular canal defect were reviewed. Fragmentation of the interventricular septum and anterior displacement of the mitral annulus into the left ventricular outflow tract were noted in all patients. In 25 of 26 a common atrioventric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90228-3
更新日期:1981-05-01 00:00:00
abstract::We previously reported that single-head SPECT imaging with teboroxime is feasible. However, excessive hepatic uptake in some patients may interfere with image interpretation. This study examined the feasibility of improving image quality by use of a preprocessing masking technique to subtract hepatic activity. A band ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)90079-b
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Recent work has demonstrated a link between retinopathy, a marker of microvascular disease, and the development of heart failure, a finding particularly relevant in individuals with diabetes. Our objective was to assess the relationship between retinopathy and cardiac structure and function in a cohort of in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.019
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The Fontan operation results in a circulation that is dependent on low pulmonary vascular resistance to maintain an adequate cardiac output. Medical therapies that lower pulmonary vascular resistance may augment cardiac output and improve long-term outcomes. OBJECTIVES:This phase I/II clinical trial conduct...
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.2017.02.030
更新日期:2017-06-01 00:00:00
abstract::Mitochondria in skeletal and cardiac muscle have been found to be less stable in aging hamsters, in contrast to preparations from young animals. We have found previously that clofibrate (Atromid-S) will reverse this degeneration in the older hamsters. This study examined the exercise tolerance of aged hamsters, to see...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80040-9
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Chronic heart failure is associated with impaired renal function, which may worsen during therapy. The incidence, predictors, and consequences of aggravated renal dysfunction (ARD) in patients undergoing intensive therapy for advanced chronic heart failure are unknown. METHODS:We reviewed the experience of ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70113-4
更新日期:1999-08-01 00:00:00
abstract::The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma li...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:In a previous study from a single center, radionuclide measures of collateral flow with technetium 99m sestamibi have been shown to be significantly associated with angiographic residual (antegrade and collateral) flow and independent predictors of final infarct size in acute myocardial infarction. This stud...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-8703(97)70046-2
更新日期:1997-10-01 00:00:00
abstract::Polymorphic ventricular arrhythmias (PVAs) initiated by programmed electrical stimulation may be a nonspecific response or evidence of ventricular electrical instability. To determine if PVAs initiated in patients with spontaneous sustained ventricular tachycardia or fibrillation differ from those which are clearly a ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90008-6
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:In patients with chronic heart failure, the use of carvedilol therapy induces clinical and hemodynamic improvement. However, although the benefits of this beta-blocker have been established in patients with chronic heart failure, the mechanisms underlying them and the changes in left ventricular systolic fun...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(00)90036-x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The contemporary magnitude and prognostic implications of complete heart block (CHB) in patients with acute myocardial infarction (AMI) are unknown. As part of a community-based study of patients hospitalized with AMI in the Worcester, MA, metropolitan area, changes over time in the incidence rates of CHB co...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.03.011
更新日期:2008-08-01 00:00:00
abstract::Twenty-seven patients with asymptomatic, nonsustained ventricular tachycardia whose evaluation suggested they were at high risk for sustained ventricular arrhythmias were treated with implantable cardioverter defibrillators. The option of conventional therapy (including the option of no therapy) was presented to each ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-8703(96)90051-4
更新日期:1996-01-01 00:00:00
abstract::To determine whether a dose of 5 mg of nifedipine would be useful in the treatment of hypertensive emergencies, we compared the acute hypotensive effects of two different doses of nifedipine, 5 mg and 10 mg, in patients with severe hypertension. In this prospective, randomized, double-blind study, 30 consecutive black...
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(92)90283-2
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:We investigated the role of the renin-angiotensin system in women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). Although microvascular dysfunction has been suggested to explain this syndrome and recently was found to predict adverse outcomes, the mechanisms and treatm...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.07.011
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Larger studies evaluating the angiographic results of second-generation stents are scarce. The objectives of this study were to assess current standards of angiographic and clinical outcomes after implantation of the second-generation stainless steel stent, NIR (Medinol Ltd, Tel Aviv, Israel), and to compare...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mhj.2003.32
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:In patients with acute myocardial infarction (AMI), the rate of microvascular embolization and no-reflow promoted by coronary stenting with the use of conventional techniques (CS) appears to be greater than the one that occurs with balloon angioplasty. The minor invasiveness of direct stenting (DS) of the in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.117778
更新日期:2001-10-01 00:00:00