Abstract:
BACKGROUND:Comparing the dose-response of a new drug to that of a previously studied drug can aid in understanding their relative potencies. Two dose-finding studies addressed the effect of a new drug, rosuvastatin, on its ability to decrease low-density lipoprotein cholesterol (LDL-C) levels. One of these studies included 2 doses of atorvastatin, and substantial additional information is available in the literature about the effect of atorvastatin on LDL-C level lowering. METHODS:The 2 dose-finding studies of rosuvastatin considered otherwise healthy patients who had hypercholesterolemia. Comparable studies of atorvastatin were identified via a MEDLINE search in December 1999. Multiple reviewer consensus identified 15 of 41 studies on atorvastatin published since 1996 that met these selection criteria: reporting of LDL-C level change from baseline at least 6 weeks after treatment initiation, doses administered, and treatment group sizes. Eligible populations had clinical evidence of hypercholesterolemia. We excluded studies with patients who had severe illness or a previous history of transplantation. Data extraction of the mean, sample sizes, and SDs (or CIs) by dose was carried out independently by multiple reviewers. We combined the results from the various studies with Bayesian hierarchical modeling and analyzed them with Markov chain Monte Carlo techniques. RESULTS:Combining this study and literature results substantially increased the power to compare the dose-response relationships of rosuvastatin and atorvastatin. Rosuvastatin reduced LDL-C level by an estimated 10 to 17 percentage points more than atorvastatin when both were given at the same dose. Approximately one quarter of the dose of rosuvastatin achieved about the same magnitude of LDL-C level reduction as atorvastatin at dosages as high as 80 mg. This finding does not imply a 4-fold difference in efficacy overall and specifically does not describe the results at higher dosage levels. CONCLUSIONS:Bayesian meta-analysis of results from related studies allows the comparison of the dose-response relationships of 2 drugs, better estimates of a particular dose-response relationship within an individual study, and the expression of relative benefits (of dose and drug) in terms of probabilities. Explicitly comparing a study's results with historical data using Bayesian meta-analysis allows clinicians to view the study in the larger context of medical research.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Berry DA,Berry SM,McKellar J,Pearson TAdoi
10.1016/S0002-8703(03)00106-6subject
Has Abstractpub_date
2003-06-01 00:00:00pages
1036-45issue
6eissn
0002-8703issn
1097-6744pii
S0002870303001066journal_volume
145pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Assessment of left ventricular (LV) thrombosis risk after acute myocardial infarction (AMI) is important because of potential embolic sequelae that are reduced by oral anticoagulant agents. The goal of this study was to investigate whether early assessment of LV systolic and diastolic performance with pulsed...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2004.05.025
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and coronary artery disease (CAD) is associated with high morbidity and mortality. METHODS:The NIS database from 1998 to 2006 was used to identify 1,216,759 PCIs performed for ACS and CAD. We sou...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.09.009
更新日期:2011-12-01 00:00:00
abstract::It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive e...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90272-0
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) remain at risk for death and cardiac ischemic events after being discharged from the hospital. METHODS:We examined whether the Thrombolysis In Myocardial Infarction (TIMI) risk score for UA/NSTEMI, ascertained at presenta...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2002.122870
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained platelet inhibition in stented patients. METHODS AND RESULTS:Pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.109
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Coronary artery disease (CAD) is the most common cause of left ventricular systolic dysfunction (LVSD). Patients with ischemia as the cause of LVSD may warrant revascularization. Angiography is the most accurate method of CAD diagnosis but is invasive, expensive, and associated with some risk. Noninvasive im...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2010.03.026
更新日期:2010-06-01 00:00:00
abstract::Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) have been identified as potential risk factors for stroke, but information about the risk of recurrent cerebral ischemia is scarce. The aim of this retrospective study was to assess the absolute risk of recurrent cerebrovascular events in 132 patients under 6...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90212-0
更新日期:1995-11-01 00:00:00
abstract::To estimate the incidence of residual atrial septal perforation (ASP) following percutaneous transvenous mitral commissurotomy (PTMC) with the Inoue balloon catheter and to examine the factors contributing to ASP, we studied 46 patients with mitral stenosis undergoing PTMC. Residual ASP was evaluated by Doppler color ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90203-a
更新日期:1990-10-01 00:00:00
abstract::This study attempted to define the role of endothelin (ET) in preconditioning. We previously showed that ET Is produced during myocardial ischemia and reperfusion. Because both preconditioning and ET act through protein kinase C, ET could play a role in preconditioning. Dogs were randomized to three groups subjected t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90394-4
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:The effect of raloxifene on aortic elasticity in healthy postmenopausal women is unknown. The purpose of the present study was to examine the effect of raloxifene on aortic elasticity and cardiovascular structure and function in healthy postmenopausal women. METHODS:A randomized, crossover, double-blind, pl...
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.2005.02.020
更新日期:2005-12-01 00:00:00
abstract::Adenosine thallium stress testing has a demonstrated utility in the detection of coronary artery disease. The optimal dose for diagnostic efficacy with minimal side effects has not been critically evaluated. A randomized 3- and 6-minute infusion of adenosine (140 micrograms/kg/min) was performed in 11 subjects. Subjec...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(07)80015-9
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, bloo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.014
更新日期:2008-02-01 00:00:00
abstract::We evaluated the usefulness of peripherally injected sonicated albumin microbubbles in transesophageal echo-Doppler cardiographic assessment of the left atrial appendage in 19 patients (age 61 +/- 19 [range 21 to 86] years; 12 [63%] women). Multiplane transesophageal echocardiography was performed before and after int...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70180-7
更新日期:1997-04-01 00:00:00
abstract:UNLABELLED:Antiarrhythmic agents enhance maintenance of sinus rhythm (SR) after direct current cardioversion (DCC) for atrial fibrillation but there are few comparative trials. BACKGROUND:The aims of the study were (1) to establish whether patients successfully cardioverted to SR are more likely to stay in SR over 6 m...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.09.009
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Analyses of country or regional differences in cardiovascular (CV) trials are based on geographical subgroup analyses. However, apart from map location and related racial, ethnic, and genetic variations, identified differences may also depend on social structure and provision and access to health care, for w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.08.019
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of delay times on racial differences in thrombolysis for acute myocardial infarction. BACKGROUND:Lower rates of thrombolytic therapy in blacks with acute myocardial infarction have recently been reported, but the reasons for this disparity are unknown. We hypothesized that lower rates o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.109644
更新日期:2000-10-01 00:00:00
abstract::In vitro studies have established that intravascular ultrasound is a reliable technique for accurate assessment of vascular anatomic structure and disease conditions before and after intervention. In addition, quantitative data from intravascular ultrasound studies correspond well with histologic findings, which serve...
journal_title:American heart journal
pub_type: 社论,评审
doi:10.1016/s0002-8703(96)90263-x
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:beta-blockers have been shown to benefit patients after myocardial infarction by decreasing mortality, sudden cardiac death, and reinfarction. Although beta-blockers are recommended for all patients with acute coronary syndromes (ACS) without contraindications, a target heart rate (HR) is recommended only fo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.06.023
更新日期:2009-09-01 00:00:00
abstract:AIMS:Paclitaxel-eluting stents (PESs) have been shown to inhibit neointimal hyperplasia after percutaneous coronary intervention. Coroflex Please (B Braun, Melsungen, Germany) is a newly developed PES. We compared the clinical and angiographic efficacy of Coroflex Please with Taxus Liberte (Boston Scientific, Natick, M...
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:10.1016/j.ahj.2013.02.009
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:A common regimen for patients requiring dual-antiplatelet therapy who are at risk for gastrointestinal complications is the synchronous administration of enteric-coated (EC) aspirin, a proton pump inhibitor, and clopidogrel, although proton pump inhibitors have the potential for pharmacodynamic interaction w...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.07.032
更新日期:2013-02-01 00:00:00
abstract::Epinephrine increases coronary blood flow but may not improve the balance between myocardial oxygen supply and demand during cardiopulmonary resuscitation (CPR). The objective of this study was to determine whether this balance can be improved by administering a relatively pure alpha-adrenergic vasoconstrictor, alone ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90120-1
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a recently recognized condition where biomarkers and prognosis are less well studied than in MI with obstructive coronary artery disease (MI-CAD). We therefore aimed to investigate the one-year prognostic value of high-sensitivity ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2018.03.005
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.09.010
更新日期:2016-12-01 00:00:00
abstract::To investigate the sequence of changes in regional myocardial perfusion which precedes stress-induced angina, we measured great cardiac vein flow (GCVF), draining the anterior left ventricle, during incremental atrial pacing in 10 patients with normal anterior perfusion (group I) and in 11 patients with greater than o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90374-0
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:In regional systems of ST-segment elevation myocardial infarction (STEMI) care, patients presenting to hospitals without percutaneous coronary intervention (PCI) are transferred to PCI-capable hospitals for primary PCI. Repatriation, a practice whereby such patients are transferred back to non-PCI referral h...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.04.017
更新日期:2016-07-01 00:00:00
abstract::Externally recorded STI were compared with invasively determined EF in 10 normal subjects and 86 patients with various forms of chronic heart disease. From phono-, apex-, and electrocardiograms and carotid pulse tracings, recorded without rigidly controlled conditions (postabsorptive state, fixed time of day, exclusio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80246-9
更新日期:1977-03-01 00:00:00
abstract::To evaluate the mechanisms involved in nitrate tolerance, we randomized 23 patients with congestive heart failure resulting from coronary artery disease to an isosorbide dinitrate or a molsidomine infusion. The drugs were titrated to decrease pulmonary capillary wedge pressure by > or = 30% or > or = 10 mm Hg. Then is...
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(94)90632-7
更新日期:1994-09-01 00:00:00
abstract::A study of nonbacterial thrombotic endocarditis has been carried out in a series of 3,404 autopsies performed upon atomic bomb survivors in Hiroshima in the period 1953-1970. The prevalence of the lesion was 2.4 per cent, with a greater frequency among the elderly and among females, and with a significant relationship...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90119-2
更新日期:1975-08-01 00:00:00
abstract::Fifteen cases of the sick-sinus syndrome in young Negroes are presented. The etiology was unknown in all cases; organic heart disease was absent. The very high default rate suggests that the prognosis may be grave. This disorder is by no means uncommon in young persons in tropical countries and the dangers of a mistak...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90078-2
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:Sexuality is an important factor influencing quality of life that may be altered for patients with coronary disease. Little is known about the extent to which patients want their cardiologists to counsel them about sexuality. PURPOSE:Our study evaluated the extent to which patients with known coronary disea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.124053
更新日期:2002-08-01 00:00:00