Abstract:
BACKGROUND:Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers effectively reduce blood pressure in patients with renovascular disease (RVD); yet, randomized cardiovascular prevention trials of these drugs typically exclude individuals with this condition. PATIENTS AND METHODS:We studied the association of renin-angiotensin system inhibition with prognosis in a population-based cohort comprising 3,570 patients with RVD in Ontario, Canada; slightly more than half (n = 1,857, 53%) were prescribed angiotensin inhibitors. The primary outcome was the composite of death, myocardial infarction, or stroke. Secondary outcomes included individual cardiovascular and renal events. RESULTS:Patients receiving angiotensin inhibitors had a significantly lower risk for the primary outcome during follow-up (10.0 vs 13.0 events per 100 patient-years at risk, multivariable adjusted hazard ratio [HR] 0.70, 95% CI 0.59-0.82). In addition, hospitalization for congestive heart failure (HR 0.69, 95% CI 0.53-0.90), chronic dialysis initiation (HR 0.62, 95% CI 0.42-0.92), and mortality (HR 0.56, 95% CI 0.47-0.68) was lower in treated patients. Conversely, patients receiving angiotensin inhibitors were significantly more likely to be hospitalized for acute renal failure during follow-up (HR 1.87, 95% CI 1.05-3.33; 1.2 vs 0.6 events per 100 patient-years at risk). CONCLUSIONS:These data emphasize the high vascular risk of RVD and suggest that angiotensin inhibitors may improve prognosis in this setting at the expense of acute renal toxicity. If the latter are selected in the management of RVD, renal function parameters should be assiduously followed.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Hackam DG,Duong-Hua ML,Mamdani M,Li P,Tobe SW,Spence JD,Garg AXdoi
10.1016/j.ahj.2008.05.013subject
Has Abstractpub_date
2008-09-01 00:00:00pages
549-55issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(08)00385-2journal_volume
156pub_type
杂志文章abstract::Incidence of myonecrosis in patients undergoing rotational atherectomy was evaluated by preprocedural statin use. The incidence of any myonecrosis (24.1% vs 52.3%, P < .001) or significant myonecrosis (7.5% vs 21.8%, P < .001) was significantly lower among patients pretreated with statins. This difference remained sig...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.026
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:In recent reports, human toll-like receptor (TLR) 8 mediates the antiviral response by recognizing single-stranded RNA. The inflammatory response against enteroviral (EV) RNA replication may play an important role in dilated cardiomyopathy (DCM). The purpose of this study was to determine whether TLR8 was ex...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.05.010
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Plasma levels of brain natriuretic peptide (BNP) are increased in patients with left heart failure. In patients with severe pulmonary embolism (PE), primary right ventricular (RV) dysfunction is frequent. Little is known about BNP secretion in acute RV failure. METHODS:We prospectively studied 50 consecutiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00528-3
更新日期:2004-01-01 00:00:00
abstract::Several autoimmune diseases have been associated with increased frequencies of specific histocompatibility (HLA) antigens, particularly for the D (DR) locus, that may be linked to immune response genes. Rheumatic valvular heart disease (RHD) has been postulated to have autoimmune features, but HLA associations have no...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90311-x
更新日期:1986-11-01 00:00:00
abstract::A case of tricuspid atresia with unusual echocardiographic findings is presented. The echocardiogram was successful in defining great artery interrelationships, ventricular looping, and cavity sizes. An echo pattern resembling the motion of a small tricuspid valve was observed; this was proven to be spurious at cathet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90508-2
更新日期:1978-06-01 00:00:00
abstract:BACKGROUND:Balloon inflation during coronary angioplasty results in shear stress-induced vessel wall injury with development of restenosis. This randomized trial compared the impact of two different balloon inflation strategies (slow versus fast) on restenosis after coronary angioplasty. METHODS:Two hundred seven pati...
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(98)70290-x
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:A high fasting glucose level may be a marker not only for microvascular complications, but also for macrovascular complications. We evaluated the clinical significance of a high fasting glucose level (> or =110 mg/dL), detected either at baseline or during follow-up, in the Bezafibrate Infarction Prevention ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2003.09.013
更新日期:2004-02-01 00:00:00
abstract::Electrical ablation techniques (ECT) have had limited success in achieving control of arrhythmias originating in the right atrial free wall (RAFW). To ascertain determinants for successful ECT, we studied the clinical and cellular electrophysiologic effects of electrical ablation of the RAFW. After performing electric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90655-7
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to test the hypothesis that intracellular calcium modulation by 5-methyl-2-[piperazin-1-yl] benzene sulfonic acid monohydrate (MCC-135 [Caldaret]; Mitsubishi Pharma Corporation, Osaka, Japan) would preserve left ventricular function and reduce infarct size in patients undergoin...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.08.020
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The recovery of left ventricular function (LVF) after revascularization takes time. alpha-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged alpha-adrenergic blockade on LVF recovery after stenting are unknown. METHODS:In 32 patients (age 58 +/- 12 y) wit...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2003.08.005
更新日期:2004-02-01 00:00:00
abstract::The efficacy and safety of sotalol therapy for ventricular arrhythmias was evaluated in 133 patients with drug-refractory ventricular arrhythmias. All patients had baseline electrophysiologic studies before and after oral sotalol therapy. Sixty-six patients were discharged home, treated with sotalol (52 patients witho...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90008-3
更新日期:1996-11-01 00:00:00
abstract::To understand the process of atherosclerosis, the homeostatic and protective functions of the endothelium must be considered. The endothelium serves as the interface between blood flow and the vascular tissues. It normally regulates vascular tone and structure through the release of vasoactive substances and maintenan...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90251-8
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Declines in case fatality post-myocardial infarction (MI) have been observed over the past 3 decades. Few studies report socioeconomic disparities in survival post-MI. METHODS:We assessed 1-year case fatality among 9,116 incident MI patients included in the Atherosclerosis Risk in Communities community surv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.10.022
更新日期:2013-01-01 00:00:00
abstract::This study evaluated the efficacy of a comprehensive transthoracic Doppler echocardiographic examination for correct detection of SVA and its associated lesions of VSD and aortic insufficiency. A consecutive series of 36 patients was obtained; all had surgical confirmation of the anatomic defects. The location of the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90153-1
更新日期:1995-12-01 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::We investigated the relation between the angiographic collateral grade (Rentrop's classification) and the collateral flow velocity pattern in 43 patients with angina pectoris. Collateral flow velocity was measured with a Doppler guide wire during balloon occlusion in coronary angioplasty. Collateral flow was detected ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90232-5
更新日期:1995-07-01 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:Hepatocyte growth factor (HGF), a member of the endothelial-specific growth factors with the greatest mitogenic activity, may play a role in the protection and/or repair of vascular endothelial cells injured by atherosclerosis. As a result, plasma HGF concentration may increase in response to endothelial cel...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.120151
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:The oxygen uptake efficiency slope (OUES) is a new submaximal parameter which objectively predicts the maximal exercise capacity in children and healthy subjects. However, the usefulness of OUES in adult patients with and without advanced heart failure remains undetermined. The present study investigates the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.004
更新日期:2005-01-01 00:00:00
abstract::Current antitachycardia systems are incapable of adequately distinguishing stable from unstable tachycardias. Previously, integration of a pressure sensor or an impedance sensor, together with electrogram analysis, has been investigated as an improved method of identifying unstable arrhythmias. A mixed venous oxygen s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90519-n
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare rate of onset, magnitude, and consistency of platelet inhibition after administration of prasugrel or clopidogrel and to relate platelet inhibition to systemic exposure to each active metabolite. Thienopyridines are prodrugs, metabolized in vivo to active metabolites that...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.10.010
更新日期:2007-01-01 00:00:00
abstract::A 47-year-old man presented with exertional angina. Selective coronary arteriography showed complete systolic segmental occlusion of the left anterior descending coronary artery producing milking effect. Permanent relief of symptoms was achieved by surgical excision of myocardial bridges. Postoperative angiography per...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90118-0
更新日期:1980-08-01 00:00:00
abstract::Atherosclerotic coronary artery disease is a serious clinical problem. Clinicians dealing with patients can make a diagnosis of coronary disease in several ways. Unfortunately all too often the diagnosis is made via sudden death or acute myocardial infarction. At other times the diagnosis is made by evaluation of pati...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(92)91039-4
更新日期:1992-05-01 00:00:00
abstract::The proximal flow convergence method of multiplying color Doppler aliasing velocity by flow convergence surface area has yielded a new means of quantifying flow rate by noninvasively derived measurements. Unlike previous methods of visualizing the turbulent jet of mitral regurgitation on color flow Doppler mapping, fl...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90025-5
更新日期:1993-02-01 00:00:00
abstract::The detection of premature ectopic beats coinciding with the T-wave of the antecedent beat is important for patient monitoring. In the method described here, the difficulties of direct measurement of QT time are avoided by evaluating the changes of QT time according to heart rate by use of a diode function generator. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90191-x
更新日期:1975-06-01 00:00:00
abstract:BACKGROUND:Single center studies using serial cerebral diffusion-weighted magnetic resonance imaging in patients having cardiac catheterization have suggested that cerebral microembolism might be responsible for silent cerebral infarct (SCI) as high as 15% to 22%. We evaluated in a multicenter trial the incidence of SC...
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.2012.04.005
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) continues to be one of the most common cardiac problems, placing an expanding burden on the public health system. In several circumstances, AF can increase the risk of stroke and heart failure. Current pharmacologic treatment options are associated with the potential for significant ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.05.024
更新日期:2009-08-01 00:00:00
abstract::The short-term hemodynamic effects of molsidomine (4 mg sublingually) were evaluated in 13 patients with congestive heart failure following acute myocardial infarction. Right heart catheterization was performed by means of a Swan-Ganz thermodilution catheter. Hemodynamic measurements were made 30, 60, 120, and 180 min...
journal_title:American heart journal
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa inhibitors can improve outcomes in patients with non-ST-segment elevation acute coronary syndromes but raise the risk of bleeding, particularly if dosed in excess. The impact of GP IIb/IIIa dosing feedback on safety and major bleeding is unknown. METHODS:Glycoprotein IIb/IIIa dosi...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.08.008
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Some pharmacist-managed anticoagulation services (PMAS) provide initial follow-up to patients on oral anticoagulant, who are transferred to their physician once they are stabilized. This may be as effective as and less expensive than long-term PMAS follow-up. METHODS:Once PMAS patients were stabilized and r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.02.009
更新日期:2008-07-01 00:00:00