Clinical practice guides.

Abstract:

:In this editorial, I would like to share some thoughts about clinical studies, including value and limitations using as an example a recently published randomized clinical trial. Randomized and non-randomized clinical trials, epidemiologic studies, and registries guide our clinical practice. They are good but not perfect. Why is this the case? One of the answers is that they provide mean values for outcomes, and mean values do not explain the clinical outcomes of the outliers. A good illustrative example is survival after myocardial infarction. The data that are provided are usually average data, but these data may not reflect the same outcome in patients with little myocardial ischemia and good ventricular function compared to those with poor ventricular function and a large amount of myocardium in jeopardy due to myocardial ischemia.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Richard Conti C

doi

10.1002/clc.20598

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

174-5

issue

4

eissn

0160-9289

issn

1932-8737

journal_volume

32

pub_type

社论
  • Assessment of Respiratory Distress by the Roth Score.

    abstract:INTRODUCTION:Health care demand is increasing due to greater longevity of patients with chronic comorbidities. This increasing demand is occurring in a setting of resource scarcity. To address these changes, high-value care initiatives, such as telemedicine, are valuable resource-preservation strategies. This study int...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22586

    authors: Chorin E,Padegimas A,Havakuk O,Birati EY,Shacham Y,Milman A,Topaz G,Flint N,Keren G,Rogowski O

    更新日期:2016-11-01 00:00:00

  • High incidence of ventricular arrhythmias in patients with left ventricular enlargement and moderate left ventricular dysfunction.

    abstract:BACKGROUND:Left ventricular ejection fraction (LVEF) ≤35% is the cutoff value used to identify patients at high risk of sudden cardiac death. However, whether patients who have moderate left ventricular dysfunction and left ventricular enlargement (LVE) have a high risk of ventricular arrhythmias (VAs) and cardiac deat...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22588

    authors: Zhao S,Chen K,Su Y,Hua W,Yang J,Chen S,Liang Z,Xu W,Zhang S

    更新日期:2016-12-01 00:00:00

  • Effect of remote ischemic preconditioning on electrophysiological and biomolecular parameters in nonvalvular paroxysmal atrial fibrillation (RIPPAF study): Rationale and study design of a randomized, controlled clinical trial.

    abstract::Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related p...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.22584

    authors: Kosiuk J,Milani R,Ueberham L,Uhe T,Stegmann C,Hindricks G,Bollmann A

    更新日期:2016-11-01 00:00:00

  • Percutaneous Closure of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation: A Systematic Review.

    abstract::Paravalvular regurgitation (PVR) remains one of the drawbacks of transcatheter aortic valve implantation (TAVI). Details of percutaneous closure (PCC) of PVR after TAVI remain obscure. We aimed to explore the patient characteristics, procedural details, closure devices used, and outcomes of PCC after TAVI. A systemati...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22569

    authors: Ando T,Takagi H,ALICE (All-Literature Investigation of Cardiovascular Evidence) Group.

    更新日期:2016-10-01 00:00:00

  • Cardiac arrhythmias during sleep in morbidly obese sleep-apneic patients before and after gastric bypass surgery.

    abstract::Fourteen morbidly obese patients scheduled for gastric bypass surgery were diagnosed preoperatively as suffering from sleep apnea syndrome. There were 13 males and 1 female aged 24 to 59 years. Mean preoperative excessive body weight was 222 +/- 38%; mean apnea index prior to surgery was 84 +/- 44. A whole night lead ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960081005

    authors: Peiser J,Ovnat A,Uwyyed K,Lavie P,Charuzi I

    更新日期:1985-10-01 00:00:00

  • Malignant restenosis after primary successful excimer laser coronary angioplasty.

    abstract::In a series of 20 coronary excimer laser angioplasties, two patients presented with a peculiar type of malignant restenosis 6 and 8 weeks after a successful laser angioplasty procedure. One patient had a successful recanalization of an occluded left anterior descending (LAD) coronary artery and the second patient had ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960130606

    authors: Buchwald A,Werner G,Unterberg C,Voth A,Wiegand V

    更新日期:1990-06-01 00:00:00

  • Impact of prior permanent pacemaker on long-term clinical outcomes of patients undergoing percutaneous coronary intervention.

    abstract:BACKGROUND:The impact of permanent pacemaker (PPM) on long-term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been studied. HYPOTHESIS:PPM may increase heart failure (HF) burden on patients undergoing PCI. METHODS:We recruited consecutive patients undergoing PCI and carried...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22645

    authors: Li YJ,Zhang WW,Yang XX,Li N,Qiu XB,Qu XK,Fang WY,Yang YQ,Li RG

    更新日期:2017-04-01 00:00:00

  • Optimal secondary prevention medication use in acute myocardial infarction patients with nonobstructive coronary artery disease is modified by management strategy: insights from the TRIUMPH Registry.

    abstract:BACKGROUND:Patients with acute myocardial infarction (AMI) and nonobstructive coronary artery disease (nonobCAD) may be perceived to be at lower risk for cardiac events, relative to those with obstructive CAD (obCAD), and thus less likely to receive optimal preventive medications in the year following AMI. HYPOTHESIS:...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22686

    authors: Pitts R,Daugherty SL,Tang F,Jones P,Ho PM,Tsai TT,Spertus J,Maddox TM

    更新日期:2017-06-01 00:00:00

  • Transient left ventricular aneurysm in a patient with hypertrophic cardiomyopathy and myocarditis.

    abstract::Left ventricular wall motion abnormalities, aneurysm formation, and progression to global hypokinesis have been described in patients with myocarditis and in patients with hypertrophic cardiomyopathy. We document a case of reversible aneurysm formation, cardiogenic shock, and complete recovery in a patient with myocar...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960160317

    authors: Fisher DZ,DiSalvo TG,Dec GW,DeSanctis RW

    更新日期:1993-03-01 00:00:00

  • Prolonged low-dose thrombolytic therapy: a novel adjunctive strategy in the management of an infected right atrial thrombus.

    abstract::An 81-year-old man presented with a large, infected right atrial thrombus that was refractory to anticoagulants and several courses of antibiotics. The risk of surgical removal of the thrombus, which was associated with a pacemaker electrode, was considered prohibitive. The patient was treated for 7 days with low-dose...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4950250709

    authors: Chuang S,Mehta RH,Fay WP

    更新日期:2002-07-01 00:00:00

  • Treatment options for angina pectoris and the future role of enhanced external counterpulsation.

    abstract::Patients with coronary artery disease have a variety of treatment options available to them. These include medications to control anginal episodes and, when appropriate, revascularization interventions in the form of coronary artery bypass graft and angioplasty. Despite advances in the treatment of angina, a substanti...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960251407

    authors: Holmes DR Jr

    更新日期:2002-12-01 00:00:00

  • Atrial fibrillation: is there a role for low-molecular-weight heparin?

    abstract::Atrial fibrillation (AF) is the most common form of tachyarrhythmia and carries a significant risk of serious thromboembolic complications. Anticoagulation is used for long-term thromboprophylaxis and for short-term management in a number of clinical situations, among which is the medical or electrical cardioversion o...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960241306

    authors: Camm AJ

    更新日期:2001-03-01 00:00:00

  • Antiarrhythmic drug therapy for atrial fibrillation: are the guidelines guiding clinical practice?

    abstract::The AFFIRM study showed no clear survival advantage for a rhythm versus rate control strategy in patients with atrial fibrillation (AF). However, rhythm control with antiarrhythmic drugs (AADs) is appropriate in a large number of patients with AF. The American College of Cardiology/ American Heart Association/European...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960290303

    authors: Reiffel JA,Naccarelli GV

    更新日期:2006-03-01 00:00:00

  • Isolated rheumatic tricuspid regurgitation and stenosis.

    abstract::The case of a 73-year-old man with right heart failure and systolic and diastolic murmur at the fourth left intercostal space is described. There was a history of rheumatic fever. Two-dimensional echocardiography showed rheumatic change of the tricuspid valve with giant right atrium and ventricle, which was confirmed ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960090710

    authors: Fujii S,Funaki K,Denzumi N

    更新日期:1986-07-01 00:00:00

  • Late percutaneous coronary intervention prevents left ventricular remodeling and improves clinical outcomes in patients with ST-elevation myocardial infarction.

    abstract:BACKGROUND:The optimal strategy for treating late presenters of ST-elevation myocardial infarction (STEMI) remains uncertain. HYPOTHESIS:percutaneous coronary intervention (PCI) has a favorable effect on left ventricular (LV) remodeling and clinical outcomes in late presenters of STEMI. METHODS:Patients with STEMI wh...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22356

    authors: Fan Y,Bai X,Chen Y,Shen G,Lu Q,Wan Z,Zhou D,Shen Y,Ma A

    更新日期:2015-02-01 00:00:00

  • Assessment of right ventricular diastolic filling in patients with coronary artery disease.

    abstract::To assess right ventricular (RV) diastolic filling in coronary artery disease (CAD), with special reference to the involved lesions of the coronary arteries and left ventricular (LV) systolic function, gated radionuclide ventriculography was performed at rest in 106 patients with single-vessel CAD. Based on the site o...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960161112

    authors: Yamagishi T,Matsuda Y,Nakatsuka M,Maeda J,Matsuda M

    更新日期:1993-11-01 00:00:00

  • Prognosis of large, symptomatic pericardial effusion treated by echo-guided percutaneous pericardiocentesis.

    abstract:BACKGROUNDS:The causes and prognosis of pericardial effusion (PE) may be different according to time, region, economy, and hospital. This study was performed to evaluate the etiology, clinical outcome, and prognosis of patients with large, symptomatic PE treated by echo-guided pericardiocentesis at Kangnam St. Mary's H...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20305

    authors: Kil UH,Jung HO,Koh YS,Park HJ,Park CS,Kim PJ,Baek SH,Seung KB,Choi KB

    更新日期:2008-11-01 00:00:00

  • New antithrombotics for secondary prevention of acute coronary syndrome.

    abstract::Patients with acute coronary syndrome (ACS) usually receive acetylsalicylic acid plus an adenosine diphosphate (ADP) receptor inhibitor to reduce the long-term risk of recurrent events. However, patients receiving standard antiplatelet prophylaxis still face a substantial risk of recurrent events. Strategies involving...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22233

    authors: Goto S,Tomita A

    更新日期:2014-03-01 00:00:00

  • INVEST: results of combined strategies to control blood pressure.

    abstract::The treatment of hypertension continues to be challenging due to the lack of understanding regarding underlying modulators of blood pressure as well as co-existing conditions such as atherosclerosis and diabetes. This has led to uncertainty regarding treatment strategy and intensity. The INternational VErapamil SR/tra...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960241705

    authors: Kolloch RE

    更新日期:2001-11-01 00:00:00

  • Global T-wave inversion: limited QT dispersion despite QTc prolongation--a correlate of benignity in patients with strikingly abnormal electrocardiograms.

    abstract:BACKGROUND:The global T-inversion (GTI) electrocardiogram (ECG) is strikingly abnormal with major QTc prolongation, but with a surprisingly good prognosis by Kaplan-Meier curve. This contrasts with most significant QTc prolongations. HYPOTHESIS:This study was undertaken to ascertain QT interval dispersion (QTd) in glo...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960221012

    authors: Desai SA,Mehrok S,Spodick DH

    更新日期:1999-10-01 00:00:00

  • Partial fatty acid oxidation (pFOX) inhibition: a new therapy for chronic stable angina.

    abstract::During myocardial ischemia, fatty acids are the principal source of energy, increasing myocardial oxygen consumption and making a decrease in coronary blood flow less well tolerated. Increasing glucose oxidation during myocardial ischemia may improve cardiac efficiency. The pFOX inhibitors have the potential to accomp...

    journal_title:Clinical cardiology

    pub_type: 社论

    doi:10.1002/clc.4960260402

    authors: Conti CR

    更新日期:2003-04-01 00:00:00

  • Eicosapentaenoic acid therapy is associated with decreased coronary plaque instability assessed using optical frequency domain imaging.

    abstract:BACKGROUND:The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described. HYPOTHESIS:EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23185

    authors: Konishi T,Sunaga D,Funayama N,Yamamoto T,Murakami H,Hotta D,Nojima M,Tanaka S

    更新日期:2019-06-01 00:00:00

  • Systolic blood pressure and subjective well-being in patients with coronary artery disease.

    abstract:BACKGROUND:Limited information exists regarding the association between subjective well-being (SWB) and systolic blood pressure (SBP) among hypertensive patients with coronary artery disease (CAD). HYPOTHESIS:We tested the hypothesis that there is an association between SBP and SWB. METHODS:We studied 22,576 hyperten...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1002/clc.20501

    authors: Gong Y,Handberg EM,Gerhard T,Cooper-Dehoff RM,Ried LD,Johnson JA,Pepine CJ,INVEST Investigators.

    更新日期:2009-11-01 00:00:00

  • Heart rate variability during repeated incremental head-up tilt discloses time dependence of individual autonomic dynamics.

    abstract::According to the Rosenblueth-Simeone model, the heart rate (HR) is proportional to the sympathovagal balance. The individual proportionality constant is the intrinsic HR, which can be determined only invasively. The percentage low-frequency spectral HR variability power, relative to the low- plus high-frequency spectr...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960190112

    authors: Bootsma M,Swenne CA,Bruschke AV

    更新日期:1996-01-01 00:00:00

  • A prospective randomized study comparing isolation of the arrhythmogenic vein versus all veins in paroxysmal atrial fibrillation.

    abstract:BACKGROUND:Ablation procedures in patients with paroxysmal atrial fibrillation (PAF) includes isolation of all pulmonary veins (PVs). We hypothesized that an approach using an algorithm to detect arrhythmogenic PVs (aPVs) might lead to shorter procedure duration (PD) and fewer proarrhythmic effects (PE). HYPOTHESIS:Is...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.22132

    authors: Fichtner S,Hessling G,Ammar S,Reents T,Estner HL,Jilek C,Kathan S,Büchner M,Dillier R,Deisenhofer I

    更新日期:2013-07-01 00:00:00

  • High-energy catheter ablation of cardiac arrhythmias: an outmoded technique in the 1990s.

    abstract::Catheter ablation has become an accepted technique for creating complete heart block in patients with drug refractory supraventricular tachycardias. However, it remains experimental for other indications, such as ablation of accessory pathway or ventricular tachycardia. The use of high energy defibrillator discharges ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960140712

    authors: Cunningham D

    更新日期:1991-07-01 00:00:00

  • Two-dimensional and M-mode echocardiographic evaluation of fetal arrhythmia.

    abstract::Cardiac anatomy and rhythm were evaluated in the fetuses of 18 pregnant women (between 20 and 42 weeks of gestation) referred because of abnormal fetal heart rate or rhythm. Utilizing a 3 MHz two-dimensional scan head with M-mode capability, M-mode recordings were obtained at paper speeds of 50 and 100 mm/s from 16 fe...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960080102

    authors: Crowley DC,Dick M,Rayburn WF,Rosenthal A

    更新日期:1985-01-01 00:00:00

  • The independent effects of left ventricular ejection fraction on short-term outcomes and resource utilization following hospitalization for heart failure.

    abstract:BACKGROUND:While depressed left ventricular ejection fraction is clearly associated with poor long-term outcome in heart failure (HF), the effect of ejection fraction on short-term outcomes and resource utilization following hospitalization for HF remains unclear. HYPOTHESIS:We evaluated the independent effect of depr...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960220306

    authors: Harjai KJ,Nunez E,Turgut T,Shah MP,Humphrey JS,Newman J,Cheirif J,Smart FW,Ventura HO

    更新日期:1999-03-01 00:00:00

  • Abnormalities of the S-T segment--Part I.

    abstract::The usual normal S-T segment of the surface electrocardiogram (ECG) contributes little to the diagnostic procedure. When the S-T segment is too long or too short, or when it is displaced upward or downward, it is commonly abnormal. Under such circumstances, an S-T segment abnormality usually contributes considerable d...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960200602

    authors: Hurst JW

    更新日期:1997-06-01 00:00:00

  • Importance of baseline heart rate as a predictor of cardiac functional recovery in newly diagnosed heart failure with reduced ejection fraction.

    abstract:BACKGROUND:Left ventricular ejection fraction (LVEF) has shown to predict outcomes in patients with heart failure (HF). Left ventricular recovery (LVR) has shown to improve prognosis. HYPOTHESIS:Guideline-directed medical therapy will predict LVR in patients with HF and reduced LVEF. METHODS:We studied 244 patients w...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22937

    authors: Valika A,Paprockas K,Villines D,Costanzo MR

    更新日期:2018-06-01 00:00:00