Abstract:
:To be of clinical value in the treatment of heart failure, a drug must permit patients either to feel better or to live longer, or both. Yet, because the assessment of both quality and quantity of life is difficult, many investigators have proposed using alternate measures (namely, surrogate end points) that may indicate the probable effect of a drug on symptoms or survival but are not direct measures of clinical benefit. Surrogate end points are usually physiologic variables that are known to be statistically associated and are believed to be pathophysiologically related to the clinical outcome. Although the adoption of such surrogate end points would dramatically facilitate the evaluation of new drugs, experience to date has shown that the effect of a drug on a surrogate end point is not a reliable predictor of the clinical utility of the drug, usually because the assumption that the end point is pathophysiologically related to the outcome proves to be invalid. Consequently, the evaluation of the effect of a drug on a surrogate end point provides us with a hypothesis rather than data about the possible effect of a drug on clinical events; such a hypothesis can be tested in controlled clinical trials that directly measure the clinical benefit of the therapeutic intervention. In the area of heart failure, no surrogate end point currently exists that can be used in lieu of the direct assessment of a drug on symptoms or survival, ideally in the context of a placebo-controlled trial.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Lipicky RJ,Packer Mdoi
10.1016/0735-1097(93)90487-lsubject
Has Abstractpub_date
1993-10-01 00:00:00pages
179A-184Aissue
4 Suppl Aeissn
0735-1097issn
1558-3597pii
0735-1097(93)90487-Ljournal_volume
22pub_type
杂志文章abstract:OBJECTIVES:We sought to assess the prognosis of patients with atrial fibrillation (AF) and dense spontaneous echo contrast (SEC) and to determine the incidence of cerebral embolism under continued oral anticoagulation. BACKGROUND:Patients with AF and dense SEC have an increased risk of cerebral embolism. However, ther...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.11.071
更新日期:2005-06-07 00:00:00
abstract::This is a report of successful dilation of stenosis of the common trunk in a case of total anomalous pulmonary vein return into the left superior vena cava in a 3 month old infant. Percutaneous angioplasty was performed with a 6 mm diameter balloon catheter. Right ventricular systolic pressure decreased from 96 to 60 ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80501-5
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVES:This study was designed to examine the relation between the timing and adequacy of perfusion of the infarct bed and changes in ventricular size and the extent of abnormal wall motion after acute myocardial infarction. METHODS:A validated echocardiographic mapping technique was used to measure the left ventr...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90101-6
更新日期:1993-03-01 00:00:00
abstract::The maximal exercise capacity of cardiac transplant recipients is reduced compared with that of normal subjects. To determine if this reduced exercise capacity is related to inadequate myocardial perfusion during exercise, myocardial perfusion was measured noninvasively with use of positron emission tomography and nit...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(91)90608-c
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVES:To explain the discrepancy between the symptomatic status of patients and the hemodynamically calculated mitral valve area during long-term follow-up after mitral balloon valvulotomy, mitral valve orifice variability after dobutamine infusion was investigated in two groups of patients. BACKGROUND:A signific...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90597-t
更新日期:1993-11-15 00:00:00
abstract:OBJECTIVES:This study investigates alterations in myocardial microvasculature, fibrosis, and hypertrophy before and after mechanical unloading of the failing human heart. BACKGROUND:Recent studies demonstrated the pathophysiologic importance and significant mechanistic links among microvasculature, fibrosis, and hyper...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.04.019
更新日期:2010-07-27 00:00:00
abstract:OBJECTIVES:The objective of this study was to determine the frequency of pulmonary complications, feasibility of early hospital discharge and requirements for postoperative inotropic and chronotropic support in patients receiving amiodarone therapy before heart transplantation. BACKGROUND:Although many patients waitin...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/0735-1097(92)90450-2
更新日期:1992-12-01 00:00:00
abstract::Transesophageal Doppler color flow imaging was performed in 19 adult patients (mean age 35 years) with an atrial septal defect demonstrated by cardiac catheterization or at surgery, or both. The transesophageal study correctly identified and classified 19 of 19 shunts in contrast to 16 of 18 shunts identified by the t...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80355-9
更新日期:1990-10-01 00:00:00
abstract::The utility of using an endurance test as well as a maximal exercise test to assess the effect of amlodipine, a dihydropyridine calcium antagonist, was evaluated in 16 patients with angina pectoris. Amlodipine, 10 mg/day, was compared with placebo in a double blind crossover study. After a 2 week single blind placebo ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(88)90323-3
更新日期:1988-09-01 00:00:00
abstract::Between 25,000 and 75,000 new cases of angina refractory to maximal medical therapy and standard coronary revascularization procedures are diagnosed each year. In addition, heart failure also places an enormous burden on the U.S. health care system, with an estimated economic impact ranging from $20 billion to more th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2007.07.024
更新日期:2007-10-16 00:00:00
abstract:OBJECTIVES:This study sought to determine whether ablation of complex fractionated atrial electrograms (CFAEs) after antral pulmonary vein isolation (APVI) further improves the clinical outcome of APVI in patients with long-lasting persistent atrial fibrillation (AF). BACKGROUND:Ablation of CFAEs has been reported to ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jacc.2008.10.054
更新日期:2009-03-03 00:00:00
abstract:OBJECTIVES:We sought to evaluate the prognostic value of cardiac troponin I (cTnI) in asymptomatic, ambulatory patients with chronic renal failure treated with long-term hemodialysis. BACKGROUND:Smaller, short-term follow-up studies on this subject have given conflicting results. METHODS:A total of 126 ambulatory pat...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01513-3
更新日期:2001-10-01 00:00:00
abstract::Forty-two defibrillating lead systems for the automatic implantable defibrillator were implanted and tested in 41 patients. Two basic lead configurations were used: 1) spring-patch, consisting of a transvenous superior vena cava spring electrode as the anode and an apical or left lateral ventricular patch electrode (e...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80219-9
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that post-shock dispersion of repolarization (PSDR) is higher in T wave shocks that induce ventricular fibrillation (VF) than in those that do not, as well as in implantable cardioverter defibrillator (ICD) defibrillation shocks which fail to terminate VF when compared with those that ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00579-3
更新日期:2000-02-01 00:00:00
abstract::Quality care reemerges as an issue amid the primary concern for cost. Primary problems revolve around whether treatments are efficacious and appropriate for the individual patient and whether the practice of medicine is being performed competently. A model is suggested for how these questions might be addressed. ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/0735-1097(89)90162-9
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the clinical course of women with long QT syndrome (LQTS) throughout their potential childbearing years. BACKGROUND:Only limited data exist regarding the risks associated with pregnancy in women with LQTS. METHODS:The risk of experiencing an adverse cardiac event, inc...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.09.054
更新日期:2007-03-13 00:00:00
abstract:BACKGROUND:Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, in younger and middle-aged adults is increasing in prevalence. OBJECTIVE:The aim of this study was to assess the risk for cardiovascular disease (CVD) with ISH in younger a...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2014.10.060
更新日期:2015-02-03 00:00:00
abstract:BACKGROUND:Tricuspid regurgitation (TR) is a prevalent disease with limited treatment options. OBJECTIVES:This is the first 30-day report of the U.S. single-arm, multicenter, prospective CLASP TR early feasibility study of the PASCAL transcatheter valve repair system in the treatment of TR. METHODS:Patients with symp...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2020.11.047
更新日期:2021-02-02 00:00:00
abstract:BACKGROUND:The currently recommended duration of dual antiplatelet therapy (DAPT) in drug-eluting stent (DES) recipients is 12 months to reduce the risk of late stent thrombosis, particularly in those with acute coronary syndrome (ACS). OBJECTIVES:This study hypothesized that antiplatelet treatment with DAPT for 6 mon...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2014.11.008
更新日期:2015-03-03 00:00:00
abstract:OBJECTIVES:We evaluated the accuracy of in vivo delayed-enhancement multislice computed tomography (DE-MSCT) and delayed-enhancement magnetic resonance imaging (DE-MRI) for the assessment of myocardial infarct size using postmortem triphenyltetrazolium chloride (TTC) pathology as standard of reference. BACKGROUND:The ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.02.059
更新日期:2006-07-04 00:00:00
abstract::Coronary heart disease (CHD) remains the leading cause of death among American women. Numerous differences exist between younger and older women and between women and men with respect to the pathology of CHD and its incidence and prevalence over the life cycle. Differences in lipoprotein levels and lipid fractions pla...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2005.05.089
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the association between hypertension and aortic valve stenosis (AVS) in a rabbit model. BACKGROUND:Degenerative AVS is a prevalent disease in elderly persons. Its molecular mechanisms remain unclear, in part because of the absence of experimental models. Epidemiologic ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.12.070
更新日期:2006-06-06 00:00:00
abstract::A spectrum of left ventricular diastolic filling abnormalities noted on Doppler echocardiography has been demonstrated in patients with cardiac amyloidosis. To determine how these filling abnormalities evolve over time and the significance of any change, serial pulsed wave Doppler studies of left ventricular inflow we...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(90)90545-z
更新日期:1990-11-01 00:00:00
abstract::Coronary artery reocclusion after thrombolysis with human recombinant tissue-type plasminogen activator (rt-PA) is related to the short half-life of this agent in plasma. K2P, a mutant of rt-PA lacking the fibronectin fingerlike, epidermal growth factor-like and first kringle domains (amino acids 6 to 173) and having ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90164-i
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:We sought to determine the frequency of spontaneous cerebrovascular events in adult patients with cyanotic congenital heart disease and to evaluate any contributing factors. BACKGROUND:Cerebrovascular events are a serious complication of cyanotic congenital heart disease in infants and children but are said...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00196-9
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Graft patency is one of the major determinants of long-term outcome following coronary artery bypass graft surgery (CABG). Biomarkers, if indicative of the underlying pathophysiological mechanisms, would suggest strategies to limit graft failure. The prognostic value of microvesicles (MVs) for midterm graft ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2020.03.073
更新日期:2020-06-09 00:00:00
abstract:OBJECTIVES:This study evaluated the response to prostacyclin dose reduction in patients with primary pulmonary hypertension (PPH) who developed high cardiac outputs. BACKGROUND:Patients on prostacyclin require chronic upward dose titration to overcome tolerance to the medication. No upper limit of effective dose has b...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00320-4
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Vascular endothelial growth factor (VEGF)-B activates cytoprotective/antiapoptotic and minimally angiogenic mechanisms via VEGF receptors. Therefore, VEGF-B might be an ideal candidate for the treatment of dilated cardiomyopathy, which displays modest microvascular rarefaction and increased rate of apoptosis...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2015.04.071
更新日期:2015-07-14 00:00:00
abstract:OBJECTIVES:This study was performed to describe the initial experience and follow-up of ultrasound-guided compression of pseudoaneurysms in patients receiving systemic anticoagulant or antiplatelet therapy, or both, after recent cardiac catheterization or percutaneous transluminal coronary angioplasty. BACKGROUND:Femo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90015-f
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events. BACKGROUND:Clinical studies have demonstrated the efficacy of ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00676-7
更新日期:1999-03-15 00:00:00