Abstract:
BACKGROUND:Chronic heart failure remains a major cause of mortality and morbidity. The role of antithrombotic therapy in patients with chronic heart failure has long been debated. The objective of this study was to determine the optimal antithrombotic agent for heart failure patients with reduced ejection fractions who are in sinus rhythm. METHODS AND RESULTS:This prospective, randomized clinical trial of open-label warfarin (target international normalized ratio of 2.5 to 3.0) and double-blind treatment with either aspirin (162 mg once daily) or clopidogrel (75 mg once daily) had a 30-month enrollment period and a minimum of 12 months of treatment. We enrolled 1587 men and women >/=18 years of age with symptomatic heart failure for at least 3 months who were in sinus rhythm and had left ventricular ejection fraction of =35%. The primary outcome was the time to first occurrence of death, nonfatal myocardial infarction, or nonfatal stroke. For the primary composite end point, the hazard ratios were as follows: for warfarin versus aspirin, 0.98 (95% CI, 0.86 to 1.12; P=0.77); for clopidogrel versus aspirin, 1.08 (95% CI, 0.83 to 1.40; P=0.57); and for warfarin versus clopidogrel, 0.89 (95% CI, 0.68 to 1.16; P=0.39). Warfarin was associated with fewer nonfatal strokes than aspirin or clopidogrel. Hospitalization for worsening heart failure occurred in 116 (22.2%), 97 (18.5%), and 89 (16.5%) patients treated with aspirin, clopidogrel, and warfarin, respectively (P=0.02 for warfarin versus aspirin). CONCLUSIONS:The primary outcome measure and the mortality data do not support the primary hypotheses that warfarin is superior to aspirin and that clopidogrel is superior to aspirin.
journal_name
Circulationjournal_title
Circulationauthors
Massie BM,Collins JF,Ammon SE,Armstrong PW,Cleland JG,Ezekowitz M,Jafri SM,Krol WF,O'Connor CM,Schulman KA,Teo K,Warren SR,WATCH Trial Investigators.doi
10.1161/CIRCULATIONAHA.108.801753subject
Has Abstractpub_date
2009-03-31 00:00:00pages
1616-24issue
12eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.108.801753journal_volume
119pub_type
临床试验,杂志文章,随机对照试验相关文献
CIRCULATION文献大全abstract::In a porcine preparation of cardiac arrest, we demonstrated that there is a marked paradox of venous acidemia and arterial alkalemia. This paradox is related to decreased clearance of CO2 from the lungs when pulmonary blood flow is critically reduced. Accordingly, increased venous PCO2 rather than metabolic acidosis d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.5.1071
更新日期:1986-11-01 00:00:00
abstract::Considerable variability was observed among recruitment sources and centers in the proportion of first protocol visits proceeding to entry. Some of the reasons for these differences are explored. Several characteristics of the participants were also analyzed to determine whether significant variability existed among r...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Functional mitral regurgitation (MR) is caused by systolic traction on the mitral leaflets related to ventricular distortion. Little is known about whether chronic tethering causes the mitral leaflet area to adapt to the geometric needs imposed by tethering, in part because of inability to reconstruct leafle...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.749440
更新日期:2008-08-19 00:00:00
abstract:BACKGROUND:Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, an...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.894824
更新日期:2010-01-26 00:00:00
abstract:BACKGROUND:Macrophages contribute to the progression and acute complications of atherosclerosis. Macrophage imaging may serve as a biomarker to identify subclinical inflamed lesions, to predict future risk, and to aid in the assessment of novel therapies. METHODS AND RESULTS:To test the hypothesis that nanoparticle-en...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.891804
更新日期:2010-10-26 00:00:00
abstract:BACKGROUND:Induction of matrix metalloproteinases (MMPs) contributes to adverse remodeling after myocardial infarction (MI). Whether a region- and type-specific distribution of MMPs occurs within the post-MI myocardium remained unknown. METHODS AND RESULTS:Ten sheep were instrumented with a sonomicrometry array to mea...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000068375.40887.FA
更新日期:2003-06-10 00:00:00
abstract:BACKGROUND:Endothelin (ET), a coronary vasoconstrictor, mediates its activity through the specific receptors ET-A and ET-B, which may demonstrate different activity under pathophysiological conditions. Thoracic inferior vena cava constriction (TIVCC) is an experimental model of congestive heart failure that is characte...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.4.646
更新日期:1996-02-15 00:00:00
abstract:BACKGROUND:In the event of rupture of an abdominal aortic aneurysm (AAA), mortality is very high. AAA prevalence and incidence of ruptures have been reported to be decreasing. The treatment of AAA has also undergone a change in recent decades with a shift toward endovascular aneurysm repair (EVAR). Our aim was to evalu...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.117.028259
更新日期:2017-10-31 00:00:00
abstract:BACKGROUND:Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the eff...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.117.030582
更新日期:2017-10-17 00:00:00
abstract::Heart-lung transplantation results in afferent and efferent denervation of the transplanted organs including interruption of the central connections from the low-pressure receptors in the atria and pulmonary veins. We investigated whether the cardiovascular and neurohumoral responses to the postural stimulus of head-u...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.82.3.863
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Human endothelial and vascular smooth muscle cells synthesize prostanoids. Several of these have been implicated in the physiological and pathophysiological regulation of vascular tone; however, there is no direct evidence that human blood vessels synthesize sufficient prostanoid to alter vessel tone. METHO...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.8.2113
更新日期:1995-10-15 00:00:00
abstract:BACKGROUND:It has been suggested that the survival benefit associated with primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction may be attenuated if door-to-balloon (DB) time is delayed by >1 hour beyond door-to-needle (DN) times for fibrinolytic therapy. Whereas DB times are ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.638353
更新日期:2006-11-07 00:00:00
abstract:BACKGROUND:Numerous scales exist for the classification of major bleeding events. Limited data compare the most commonly used bleeding scales within a single at-risk cohort of patients with atrial fibrillation. Here, we analyze bleeding outcomes according to the ISTH (International Society on Thrombosis and Hemostasis)...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.119.041346
更新日期:2019-11-26 00:00:00
abstract:BACKGROUND:Although early intravenous beta-blocker therapy during acute myocardial infarction (AMI) reduces the incidence of fatal arrhythmias in patients not treated with thrombolytic agents, its antiarrhythmic effect in thrombolysed patients remains controversial. We investigated prospectively the arrhythmia incidenc...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.89.3.1051
更新日期:1994-03-01 00:00:00
abstract::Patients undergoing carotid endarterectomy were pretreated with low-dose, oral beta carotene to determine whether the carotenoid content of plaque could be increased in vivo. Beta carotene-treated patients had a 50-fold increase in their plaque beta carotene level from 0.066 to 3.3 micrograms beta carotene/g plaque. M...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.2.338
更新日期:1988-08-01 00:00:00
abstract::To estimate the effect of distance between the electrode and the signal source on the amplitude of the His bundle electrogram (HBE) recorded during open heart surgery, a specially designed probe, containing six pairs of closely spaced (1 mm) electrodes was placed on the endocardial surface of the right atrium such tha...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.53.2.224
更新日期:1976-02-01 00:00:00
abstract::Mitral valve closure during cardiopulmonary resuscitation may result from direct cardiac compression. An alternative hypothesis is that with a rise in intrathoracic pressure, mitral valve closure can occur but may be influenced by whether the lungs are inflated or deflated. To test this hypothesis, we placed a large-b...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.3.754
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:An objective of the United States' Healthy People 2010 Initiative is to eliminate disparities based on socioeconomic status. We assessed the effect of difficulty affording health care on the health status (symptoms, function, and quality of life) of patients treated with percutaneous coronary intervention or...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.474775
更新日期:2005-05-24 00:00:00
abstract::The automatic implantable cardioverter-defibrillator (ICD) is highly effective in reducing sudden death rates in patients with life-threatening ventricular tachyarrhythmias. However, the magnitude of the ability of the ICD to improve overall survival is less certain. Data supporting the contention that the ICD prolong...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.cir.89.4.1851
更新日期:1994-04-01 00:00:00
abstract::The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIR.0000000000000380
更新日期:2016-05-24 00:00:00
abstract:BACKGROUND:Previous studies have documented the strong association between availability of on-site cardiac catheterization facilities and increased use of coronary angiography in patients with acute myocardial infarction (AMI). Although these studies have shown little influence of the availability of catheterization la...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.6.1770
更新日期:1997-09-16 00:00:00
abstract:BACKGROUND:The clinical significance and pathophysiological mechanisms of reverse redistribution on stress-redistribution thallium-201 myocardial scintigraphy in patients with chronic coronary artery disease are unclear. Recent studies have shown that thallium-201 reinjection is a useful technique for the detection of ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.4.1736
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Although diabetes is a well-known risk factor of atherosclerotic cardiovascular diseases, the cardiovascular disease risk of glycemia below the current diabetic threshold remains uncertain. METHODS AND RESULTS:A total of 652,901 Korean men aged 30 to 64 years from the Korean National Health Insurance System...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.776989
更新日期:2009-02-17 00:00:00
abstract::High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Although global ischemia induces troponin I (TnI) degradation, regional ischemia does not. We hypothesized that this disparity is related to preload-induced proteolysis, which varies as a function of the amount of myocardium at risk of ischemia. METHODS AND RESULTS:Isolated rat hearts were buffer-perfused a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.16.2035
更新日期:2001-04-24 00:00:00
abstract:BACKGROUND:Few data are available on the long-term outcome of patients who undergo laser-assisted balloon angioplasty for recanalization of occluded peripheral arteries. Because the cost of laser angioplasty is high, the value of the method should be carefully analyzed before it can be considered a routine method for r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.3.787
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:A family history of premature coronary artery disease (CAD) in a first-degree relative is an independent risk factor for coronary disease. Both genetic and environmental influences are likely to be responsible and may interact, but their relative importance is unclear. METHODS AND RESULTS:We studied endothe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.10.3378
更新日期:1997-11-18 00:00:00
abstract:BACKGROUND:Autograft reinforcement interventions (R) during the Ross procedure are intended to preserve autograft function and improve durability. The aim of this study is to evaluate this hypothesis. METHODS AND RESULTS:1335 adult patients (mean age:43.5+/-12.0 years) underwent a Ross procedure (subcoronary, SC, n=63...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.843391
更新日期:2009-09-15 00:00:00
abstract:BACKGROUND:Recent studies have identified critical roles for microRNAs (miRNAs) in a variety of cellular processes, including regulation of cardiomyocyte death. However, the signature of miRNA expression and possible roles of miRNA in the ischemic heart have been less well studied. METHODS AND RESULTS:We performed miR...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.814145
更新日期:2009-05-05 00:00:00
abstract:BACKGROUND:Sudden cardiac death in children is a rare but devastating event. Experts have debated the merits of community-based screening programs using an ECG and targeting 2 potential high-risk groups: school-aged children initiating stimulant medications to treat attention-deficit/hyperactivity disorder and adolesce...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.087940
更新日期:2012-05-29 00:00:00