Abstract:
BACKGROUND:Microvascular obstruction (MVO) following primary percutaneous coronary intervention (PPCI) treatment of ST-segment elevation myocardial infarction (STEMI) contributes to infarct expansion, left ventricular (LV) remodelling, and worse clinical outcomes. The REFLO-STEMI trial tested whether intra-coronary (IC) high-dose adenosine or sodium nitroprusside (SNP) reduce infarct size and/or MVO determined by cardiac magnetic resonance (CMR). METHODS AND RESULTS:REFLO-STEMI, a prospective, open-label, multi-centre trial with blinded endpoints, randomized (1:1:1) 247 STEMI patients with single vessel disease presenting within 6 h of symptom onset to IC adenosine (2-3 mg total) or SNP (500 μg total) immediately following thrombectomy and again following stenting, or to standard PPCI. The primary endpoint was infarct size % LV mass (%LVM) on CMR undertaken 24-96 h after PPCI (n = 197). Clinical follow-up was to 6 months. There was no significant difference in infarct size (%LVM, median, interquartile range, IQR) between adenosine (10.1, 4.7-16.2), SNP (10.0, 4.2-15.8), and control (8.3, 1.9-14.0), P = 0.062 and P = 0.160, respectively, vs. CONTROL:MVO (% LVM, median, IQR) was similar across groups (1.0, 0.0-3.7, P = 0.205 and 0.6, 0.0-2.4, P = 0.244 for adenosine and SNP, respectively, vs. control 0.3, 0.0-2.8). On per-protocol analysis, infarct size (%LV mass, 12.0 vs. 8.3, P = 0.031), major adverse cardiac events (hazard ratio, HR, 5.39 [1.18-24.60], P = 0.04) at 30 days and 6 months (HR 6.53 [1.46-29.2], P = 0.01) were increased and ejection fraction reduced (42.5 ± 7.2% vs. 45.7 ± 8.0%, P = 0.027) in adenosine-treated patients compared with control. CONCLUSIONS:High-dose IC adenosine and SNP during PPCI did not reduce infarct size or MVO measured by CMR. Furthermore, adenosine may adversely affect mid-term clinical outcome. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT01747174; https://clinicaltrials.gov/ct2/show/NCT01747174.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Nazir SA,McCann GP,Greenwood JP,Kunadian V,Khan JN,Mahmoud IZ,Blackman DJ,Been M,Abrams KR,Shipley L,Wilcox R,Adgey AA,Gershlick AHdoi
10.1093/eurheartj/ehw136subject
Has Abstractpub_date
2016-06-21 00:00:00pages
1910-9issue
24eissn
0195-668Xissn
1522-9645pii
ehw136journal_volume
37pub_type
杂志文章,随机对照试验abstract::Hypercholesterolaemia is an important risk factor for cardiovascular disease. Both total and LDL cholesterol levels are three-fold higher at the end of the first year of life and about four-fold higher in adulthood compared with the neonatal period. In the USA, only 25% of infants are exclusively breastfed and simple ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa868
更新日期:2020-12-16 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::AIMS More intense platelet-directed therapy for acute coronary syndrome (ACS) may increase bleeding risk. The aim of the current analysis was to determine the rate, clinical impact, and predictors of major and fatal bleeding complications in the PLATO study. METHODS AND RESULTS PLATO was a randomized, double-blind, ac...
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/ehr422
更新日期:2011-12-01 00:00:00
abstract::Randomized clinical trials (RCTs) are the definitive contributors to evidence-based medicine. RCTs assessing serious outcomes in cardiovascular disease have grown, with 'megatrials' becoming more common with the realization that wrong conclusions resulted from random error in inadequately sized trials. Simple design a...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehl152
更新日期:2006-09-01 00:00:00
abstract::The evaluation for European Union market approval of coronary stents falls under the Medical Device Directive that was adopted in 1993. Specific requirements for the assessment of coronary stents are laid out in supplementary advisory documents. In response to a call by the European Commission to make recommendations ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv203
更新日期:2015-10-07 00:00:00
abstract::The aim of the study was to assess the relationship between paroxysmal atrial fibrillation during acute myocardial infarction and the long-term prognosis of patients after acute myocardial infarction. The incidence of paroxysmal atrial fibrillation among 5803 consecutive hospitalized patients was 9.9% (557/5803). Inci...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060046
更新日期:1992-01-01 00:00:00
abstract:AIM:To study the relationship between outcomes and peak creatine kinase (CK)-MB levels after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS:Peak CK-MB ratios (peak CK-MB level/upper limit of normal [ULN]) after PCI were analys...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ehj.2003.12.009
更新日期:2004-02-01 00:00:00
abstract:AIMS:To determine the impact of surgical myectomy on ventricular arrhythmias in obstructive hypertrophic cardiomyopathy (HCM). Left ventricular outflow tract obstruction (LVOTO) correlates with adverse outcomes, including sudden cardiac death (SCD) in patients with HCM. Surgical myectomy is the primary treatment strate...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm117
更新日期:2007-11-01 00:00:00
abstract:AIMS:Anaemia is often observed in patients with chronic heart failure (CHF), and it may be associated with a worse prognosis. Aim of this study was to identify the individual mechanisms of anaemia in CHF patients. METHODS AND RESULTS:One hundred and forty-eight consecutive patients with haemoglobin concentration <13 g...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehi388
更新日期:2005-11-01 00:00:00
abstract::Heart rate and age are independent variables associated with the pattern of normal left ventricular filling. Since heart rate variability also varies with age, the relationship between these and left ventricular filling in normal subjects was assessed. In 31 subjects (age range 21 to 71 years), power spectral analysis...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060800
更新日期:1995-11-01 00:00:00
abstract:AIMS:Large randomized trials have shown that beta-blockers reduce mortality and hospital admissions in patients with heart failure. The effects of beta-blockers in elderly patients with a broad range of left ventricular ejection fraction are uncertain. The SENIORS study was performed to assess effects of the beta-block...
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:10.1093/eurheartj/ehi115
更新日期:2005-02-01 00:00:00
abstract::It is now recognised after many years of speculation regarding the role of mammalian atria in the direct regulation of intravascular volume, that atrial myocites produce a peptide hormone that results in natriuresis and diuresis, under the condition of atrial distention. This atrial natriuretic factor (ANF) is secrete...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_h.29
更新日期:1988-06-01 00:00:00
abstract::The clinical value of QRST isointegral maps (I-maps) for the detection of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) was investigated. We recorded I-maps during sinus rhythm and right ventricular (RV) pacing, which simulated LBBB, in 62 patients with MI (42 patients had at least one ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.8.1094
更新日期:1993-08-01 00:00:00
abstract::Atrial fibrillation is a common arrhythmia and one which may cause pilot incapacitation. In many cases there may be no more than one episode and there will be no organic heart disease. Prediction of the risk of recurrence is not possible. Atrial fibrillation in both paroxysmal and persistent forms should be disqualify...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/5.suppl_a.89
更新日期:1984-03-01 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:Aim:Hypertrophic cardiomyopathy (HCM) exhibits genetic heterogeneity that is dominated by variation in eight sarcomeric genes. Genetic variation in a large number of non-sarcomeric genes has also been implicated in HCM but not formally assessed. Here we used very large case and control cohorts to determine the extent t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehw603
更新日期:2017-12-07 00:00:00
abstract::In 16 male patients with heart failure (NYHA II-III), the influence of a single dose of 25 mg captopril on the carotid sinus baroreceptor reflex was examined. Blood pressure fell significantly by 11 +/- 1.7 mm Hg (P less than 0.001), whereas heart rate remained unchanged (85 +/- 3 vs. 83 +/- 3 beats min-1). Carotid si...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062411
更新日期:1988-10-01 00:00:00
abstract::Advanced coronary artery disease (CAD), impaired left ventricular function and prolongation of the QT-interval are considered risk factors for sudden cardiac death in CAD-patients. So far, however, there are no studies investigating in detail whether there is a correlation between the QT-interval and changes in corona...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061951
更新日期:1986-01-01 00:00:00
abstract:AIMS:To perform a retrospective analysis of subgroups of patients enrolled into the European Myocardial Infarct Amiodarone Trial (EMIAT) in order to identify patients who might benefit from prophylactic amiodarone treatment and patients in whom amiodarone might be harmful. METHODS:Baseline characteristics of the 1486 ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0823
更新日期:1998-01-01 00:00:00
abstract:AIMS:To assess the long-term benefit-risk ratio of drug-eluting (DES) vs. bare-metal stents (BMS) relative to stent size. METHODS AND RESULTS:All 826 consecutive BASKET (BAsel Stent Kosten-Effektivitäts Trial) patients randomized 2:1 to DES vs. BMS were followed after 3 years. Data were analysed separately for patient...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn516
更新日期:2009-01-01 00:00:00
abstract::Ventricular arrhythmias present with strongly varying intensity. This spontaneous variability makes it difficult to use one of the existing arrhythmia grading systems for risk or therapy efficacy studies. We attempted to explain the variability by the changing autonomic, ischaemic, circadian, and rhythmic factors. Fou...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060972
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:The primary objectives of this study were to assess the feasibility of temperature-controlled radiofrequency catheter ablation of left and right sided manifest accessory pathways in patients with Wolff-Parkinson-White syndrome and to gain more insights into biophysical aspects of temperature-controlled cathe...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014878
更新日期:1996-03-01 00:00:00
abstract:AIMS:Patients with pulmonary hypertension (PHT) are often excluded from surgical therapies for tricuspid regurgitation (TR). Transcatheter tricuspid valve repair (TTVR) with the MitraClip™ technique is a novel treatment option for these patients. We aimed to assess the role of PHT in severe TR and its implications for ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa138
更新日期:2020-08-01 00:00:00
abstract::An investigation was undertaken to assess the value of adding streptokinase therapy to standard penicillin treatment of artificially induced infective endocarditis due to Streptococcus sanguis. In pigs a low-grade infection could be induced which closely simulated streptococcal endocarditis in man, but for technical r...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062100
更新日期:1986-06-01 00:00:00
abstract:AIMS:We used the hospital discharge records of Piedmont region (northern Italy) to evaluate whether a national law banning smoking in public resulted in a short-term reduction in hospital admissions for acute myocardial infarction (AMI). METHODS AND RESULTS:Rates of admission for AMI before the ban (October-December 2...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl201
更新日期:2006-10-01 00:00:00
abstract::Pulmonary arterial hypertension (PAH) can be a rapidly progressive disorder and is associated with high rate of mortality, despite medical intervention. With the availability of effective therapy, early disease detection is an important strategic objective to improve treatment outcomes. Resting echocardiography is cur...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehr160
更新日期:2011-10-01 00:00:00
abstract:AIMS:We examined the left lateral ridge (LLR) between the orifices of the left pulmonary veins and the left atrial appendage for a better understanding of its structural composition relevant to ablations for atrial fibrillation (AF). METHODS AND RESULTS:The LLR and its surrounding areas were studied in 40 heart specim...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm606
更新日期:2008-02-01 00:00:00
abstract:AIMS:Inhibition of nitric oxide synthesis causes a decrease in the basal diameter of normal distal epicardial coronary arteries in normal subjects. The effects of inhibition of nitric oxide in atheromatous coronary arteries is unknown. This study assessed the effects of the inhibition of nitric oxide synthesis in epica...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015304
更新日期:1997-04-01 00:00:00
abstract:AIMS:The Occluded Artery Trial (OAT) (n = 2201) showed no benefit for routine percutaneous intervention (PCI) (n = 1101) over medical therapy (MED) (n = 1100) on the combined endpoint of death, myocardial infarction (MI), and class IV heart failure (congestive heart failure) in stable post-MI patients with late occlude...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn486
更新日期:2009-01-01 00:00:00
abstract::Haemodynamic effects of pharmacological doses of insulin during acute ischaemic heart failure were studied in 8 dogs. Severe depression of left ventricular function was induced by the injection of 50 micron plastic microspheres into the left main coronary artery. This was demonstrated by a significant increase in left...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061885
更新日期:1985-05-01 00:00:00