Abstract:
:Glycaemic control is an inadequate surrogate marker of cardiovascular event reduction in patients with type 2 diabetes. Clinical trials to date have been unsuccessful in identifying a therapeutic approach that addresses the underlying problem in diabetes (glycaemic control) and reduces cardiovascular risk. The potential for some agents to increase the risk of cardiovascular events has led to substantial changes in regulatory requirements for new anti-diabetic therapies. These requirements, while key to ensuring the cardiovascular safety of new agents, fail to emphasize the need to show clinical benefits, such as less visual impairment, less need for dialysis, or fewer cardiovascular events and deaths. Changes in test results such as glycaemic control, serum creatinine, micro-albuminuria, or retinopathy are inadequate surrogates. Regulators should consider the potential advantages of offering extended patent protection in order to encourage companies to conduct long-term trials in diabetes and many other chronic medical conditions. Cooperative efforts among physicians, clinical trialists, regulators, and sponsors are needed to address unresolved issues including re-defining therapeutic targets that are meaningful to patients with diabetes, determining the appropriate length of follow-up for future trials, and considering the ethical and operational challenges of non-inferiority designs.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Zannad F,Stough WG,Pocock SJ,Sleight P,Cushman WC,Cleland JG,McMurray JJ,Lonn E,Geller NL,Wedel H,Abadie E,Alonso-Garcia A,Pitt Bdoi
10.1093/eurheartj/ehr437subject
Has Abstractpub_date
2012-05-01 00:00:00pages
1049-57issue
9eissn
0195-668Xissn
1522-9645pii
ehr437journal_volume
33pub_type
杂志文章,评审abstract:AIMS:Reperfusion injury following acute myocardial infarction impacts not only on the myocardium but also on the coronary microcirculation, and microembolization from the culprit lesion contributes to microvascular obstruction. Prior experimental studies have not accounted for microembolization in ischaemia/reperfusion...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs434
更新日期:2013-11-01 00:00:00
abstract::The objectives of this study were to assess the impact of the new 'Shahal' (pre-hospital cardiac service) on subscribers' 'decision time'. A professional 24-h mobile emergency cardiac service has been set up, monitored by intensive care nurses via a central computerized operation unit. All subscribers carry a cardiobe...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.1.129
更新日期:1995-01-01 00:00:00
abstract::We examined two 'cohorts' of elderly men, 60 and 67 years old. The two 'cohorts' overlapped to a large extent in terms of numbers but not in the follow-up periods. The mean have been followed-up for 7 and 8 years respectively. Among the 748 60-year-old men without prior myocardial infarction the 7-year incidence of co...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:AIMS:To quantify the prevalence of coronary artery calcification (CAC) in relation to cardiovascular risk factors in marathon runners, and to study its role for myocardial damage and coronary events. METHODS AND RESULTS:In 108 apparently healthy male marathon runners aged >or=50 years, with >or=5 marathon competitions...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehn163
更新日期:2008-08-01 00:00:00
abstract::The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference i...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a062491
更新日期:1988-03-01 00:00:00
abstract::The endothelins are a family of three widely expressed 21 amino acid peptides. Apart from the ability to constrict vascular smooth muscle, they have numerous other potent effects, from enhancing mitogenesis to influencing nervous function. The pathway of their production involves the initial synthesis of a predominant...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract:AIMS:To evaluate the effectiveness and safety of bivalirudin as used in routine care. Bivalirudin has been studied as an alternative to heparin plus glycoprotein IIb/IIIa inhibitor (GPI) during percutaneous coronary intervention (PCI). Trials have indicated that bivalirudin is non-inferior to heparin with respect to de...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp437
更新日期:2010-03-01 00:00:00
abstract::The haemodynamic effects on the peripheral vascular bed of L-acetylcarnitine, L-propionylcarnitine, and nitroglycerin were tested by echo-Doppler in a double blind cross-over study. Eleven male patients suffering from peripheral arterial obliterative disease (PAOD) in the second stage of Fontaine's classification, and...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060392
更新日期:1994-10-01 00:00:00
abstract:AIMS:To evaluate efficacy and safety of intrapericardial treatment with the crystalloid corticosteroid triamcinolone in autoreactive pericardial effusion. METHODS AND RESULTS:Two hundred and sixty consecutive patients with pericarditis/myopericarditis underwent pericardiocentesis, pericardioscopy (Storz-AF1101B1), and...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1053/euhj.2002.3152
更新日期:2002-10-01 00:00:00
abstract::We conducted a survey by questionnaire to assess whether patients 'at risk' from infective endocarditis are aware of the need for good dental hygiene and antibiotic prophylaxis, and receive appropriate advice or treatment. Of 189 patients surveyed, half had told a dentist about their heart, 8% were aware of a dental p...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.6.812
更新日期:1993-06-01 00:00:00
abstract:AIMS:To test the hypothesis that diabetic status may be used as a prognostic indicator in heart failure (HF) patients. METHODS AND RESULTS:We studied 1246 consecutive patients with left ventricular dysfunction. All patients had a cardiopulmonary exercise test and an echocardiogram. Cardiac catheterisation was systemat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.01.010
更新日期:2004-04-01 00:00:00
abstract:AIMS:Hypertrophic cardiomyopathy (HCM) is a disease with marked regional differences in wall thickness. However, the relation between myocardial function and wall thickness has not been well studied. Ultrasonic strain rate (SR) imaging makes it possible to study the regional myocardial deformation. We investigated whet...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm444
更新日期:2007-12-01 00:00:00
abstract:AIM:Unstable coronary artery disease (CAD) is a multifactorial disease involving both thrombotic and inflammatory processes. We have assessed the time-course and the influence of thrombin inhibitors on changes in fibrinogen and C-reactive protein levels, and their relation to myocardial ischaemia in unstable CAD. METH...
journal_title:European 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/s0195-668x(02)00312-3
更新日期:2003-01-01 00:00:00
abstract:AIMS:This study investigated the effects of irbesartan vs. enalapril, with early vs. late treatment, on markers of inflammation and ischaemic heart disease in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). METHODS AND RESULTS:Patients hospitalized with ischaemic symptoms and evidence of NSTE...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehp301
更新日期:2009-11-01 00:00:00
abstract:AIMS:Monocytes are critical mediators of healing following acute myocardial infarction (AMI), making them an interesting target to improve myocardial repair. The purpose of this study was a gain of insight into the source and recruitment of monocytes following AMI in humans. METHODS AND RESULTS:Post-mortem tissue spec...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht331
更新日期:2014-02-01 00:00:00
abstract:AIMS:A substantial number of patients with dysfunctional but potentially viable myocardium cannot be accurately evaluated by transthoracic echocardiography due to a poor acoustic window. This study compares the diagnostic value of alternative functional imaging techniques, such as dobutamine-transoesophageal echocardio...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.1946
更新日期:2000-06-01 00:00:00
abstract:AIMS:The aim of this study was to compare on-thienopyridine platelet reactivity of elderly patients (≥75 years) vs. younger patients (<75 years). Elderly patients represent a growing and challenging segment of the coronary population for whom the effect of dual antiplatelet therapy on platelet inhibition has not been s...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr407
更新日期:2012-05-01 00:00:00
abstract:AIMS:Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening wo...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz300
更新日期:2019-07-01 00:00:00
abstract:AIMS:Habitual cigarette smokers, paradoxically, present improved short-term prognosis after acute myocardial infarction, a phenomenon often termed "smoker's paradox". We sought to examine cigarette smokers' post-infarction survival advantage in a countrywide survey of unselected, consecutive patients presenting with ac...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2315
更新日期:2001-05-01 00:00:00
abstract::This report concerns a patient with cardiac manifestation of Whipple's disease. For the first time, the gene that encodes the 16s rRNA of Tropheryma whippelii was identified in a native aortic valve by means of a polymerase chain reaction technique. DNA amplification gives evidence of Tropheryma whippelii as a causati...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060928
更新日期:1995-03-01 00:00:00
abstract::Strong experimental evidence links ventricular fibrillation to an increased temporal dispersion of the recovery of excitability. The effect of an overall prolongation of repolarization and an increased basic dispersion of repolarization on premature dispersion was studied on ventricular surface in 10 dogs. Our observa...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/6.suppl_d.15
更新日期:1985-11-01 00:00:00
abstract:AIM:In this study we sought to determine the safety, feasibility and prognostic value of pharmacological stress echocardiography performed in a primary care cardiology centre, populated by unselected patients evaluated with the aid of limited financial and technological resources. METHODS AND RESULTS:The study populat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1998.1096
更新日期:1998-11-01 00:00:00
abstract:AIMS:Increasing evidence supports a role for inflammation in promoting atrial fibrillation (AF) and statins have anti-inflammatory effects that may be relevant for the prevention of AF. However, studies of statin therapy and incident AF have yielded mixed results and not focused on individuals with an underlying pro-in...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehr460
更新日期:2012-02-01 00:00:00
abstract::From 1978 to 1980, 260 healthy subjects, 40-79 years of age, underwent 24 h ambulatory electrocardiography in order to determine the prevalence and complexity of ventricular premature beats (VPBs) in adults without apparent heart disease. The number of types of VPBs seem in 5% or less were considered 'abnormal' and th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059946
更新日期:1991-05-01 00:00:00
abstract::Five patients with recurrent tachycardias exhibiting right bundle branch block with left axis deviation were referred for investigation. In each case, a supraventricular mechanism was suspected. During sinus rhythm the QRS morphology and axis (-10 to +60 degrees) and HV intervals were normal. Tachycardia was initiated...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061589
更新日期:1984-11-01 00:00:00
abstract::We investigated whether left ventricular hypertrophy in elite cyclists is associated with functional changes or abnormal energy metabolism. Left ventricular hypertrophy is a powerful risk factor for sudden cardiac death with different prognostic significance among the various geometric forms. Cyclists may have a combi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015046
更新日期:1996-08-01 00:00:00
abstract:AIMS:To investigate the effects of secretory phospholipase A2 (sPLA(2)) inhibition on plasma lipoproteins. Secretory phospholipase A2 isoenzymes promote atherosclerosis by mechanisms that include lipoprotein modification, retention, and oxidation. METHODS AND RESULTS:Phospholipase Levels And Serological Markers of Ath...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehq374
更新日期:2011-04-01 00:00:00
abstract::In isolated atherosclerotic human coronary arteries endothelium-dependent vascular relaxation is abolished with acetylcholine whereas another EDRF-dependent vasodilator, substance P, still produces significant relaxation. To study further these in vitro findings, graded doses of acetylcholine and substance P, which pr...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_f.44
更新日期:1989-11-01 00:00:00
abstract:AIMS:Long-term randomized comparisons of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG) in left main coronary (LM) disease and/or three-vessel disease (3VD) patients have been limited. This analysis compares 3-year outcomes in LM and/or 3VD patients treated with CABG or PCI with TAXU...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehr213
更新日期:2011-09-01 00:00:00
abstract:Aims:To elucidate the effects of intensive LDL-C lowering treatment with a standard dose of statin and ezetimibe in patients with dyslipidaemia and high risk of coronary events, targeting LDL-C less than 70 mg/dL (1.8 mmol/L), compared with standard LDL-C lowering lipid monotherapy targeting less than 100 mg/dL (2.6 mm...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehx162
更新日期:2017-08-01 00:00:00