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 Cardioljournal_title
Clinical cardiologyauthors
Richard Conti Cdoi
10.1002/clc.20598subject
Has Abstractpub_date
2009-04-01 00:00:00pages
174-5issue
4eissn
0160-9289issn
1932-8737journal_volume
32pub_type
社论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
更新日期:2016-11-01 00:00:00
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
更新日期:2016-12-01 00:00:00
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
更新日期:2016-11-01 00:00:00
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
更新日期:2016-10-01 00:00:00
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
更新日期:1985-10-01 00:00:00
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
更新日期:1990-06-01 00:00:00
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
更新日期:2017-04-01 00:00:00
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
更新日期:2017-06-01 00:00:00
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
更新日期:1993-03-01 00:00:00
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
更新日期:2002-07-01 00:00:00
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
更新日期:2002-12-01 00:00:00
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
更新日期:2001-03-01 00:00:00
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
更新日期:2006-03-01 00:00:00
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
更新日期:1986-07-01 00:00:00
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
更新日期:2015-02-01 00:00:00
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
更新日期:1993-11-01 00:00:00
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
更新日期:2008-11-01 00:00:00
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
更新日期:2014-03-01 00:00:00
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
更新日期:2001-11-01 00:00:00
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
更新日期:1999-10-01 00:00:00
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
更新日期:2003-04-01 00:00:00
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
更新日期:2019-06-01 00:00:00
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
更新日期:2009-11-01 00:00:00
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
更新日期:1996-01-01 00:00:00
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
更新日期:2013-07-01 00:00:00
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
更新日期:1991-07-01 00:00:00
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
更新日期:1985-01-01 00:00:00
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
更新日期:1999-03-01 00:00:00
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
更新日期:1997-06-01 00:00:00
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
更新日期:2018-06-01 00:00:00