当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Long-Term Use of Cardiovascular Drugs: Challenges for Research and for Patient Care.

Long-Term Use of Cardiovascular Drugs: Challenges for Research and for Patient Care.

Abstract：

:Little is known about the benefits and risks of the long-term use of cardiovascular drugs. Evidence from randomized clinical trials (RCTs) rarely goes beyond a few years of follow-up, but patients are often given continuous treatment with multiple drugs well into old age. We focus on 4 commonly used cardiovascular drug classes: aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors given to patients after myocardial infarction. However, the issues raised apply more broadly to all long-term medications across cardiovascular diseases and the whole of medicine. The evidence and limitations of RCTs are addressed, as well as current practice in pre-licensing trials, the increasing problems of polypharmacy (especially in the elderly), the lack of trial evidence for withdrawal of drugs, the role of regulatory authorities and other stakeholders in this challenging situation, and the potential educational solutions for the medical profession. We conclude with a set of recommendations on how to improve the situation of long-term drug use.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Rossello X,Pocock SJ,Julian DG

doi

10.1016/j.jacc.2015.07.018

subject

Has Abstract

pub_date

2015-09-15 00:00:00

pages

1273-1285

issue

11

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(15)04463-0

journal_volume

66

pub_type

杂志文章,评审

相关文献

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY文献大全
  • Anterior leaflet procedures during mitral valve repair do not adversely influence long-term outcome.

    abstract：OBJECTIVES:This study was done to assess the impact of anterior mitral leaflet reconstructive procedures on initial and long-term results of mitral valve repair. BACKGROUND:It has been suggested that involvement of the anterior leaflet in mitral valve disease adversely affects the long-term outcome of mitral valve rep...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(94)00325-k

    authors： Grossi EA,Galloway AC,LeBoutillier M 3rd,Steinberg B,Baumann FG,Delianides J,Spencer FC,Colvin SB

    更新日期：1995-01-01 00:00:00

  • Ablation of rotor and focal sources reduces late recurrence of atrial fibrillation compared with trigger ablation alone: extended follow-up of the CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulat

    abstract：OBJECTIVES:The aim of this study was to determine if ablation that targets patient-specific atrial fibrillation (AF)-sustaining substrates (rotors or focal sources) is more durable than trigger ablation alone at preventing late AF recurrence. BACKGROUND:Late recurrence substantially limits the efficacy of pulmonary ve...

    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.2014.02.543

    authors： Narayan SM,Baykaner T,Clopton P,Schricker A,Lalani GG,Krummen DE,Shivkumar K,Miller JM

    更新日期：2014-05-06 00:00:00

  • Provocation of neurocardiogenic syncope by clomipramine administration during the head-up tilt test in vasovagal syndrome.

    abstract：OBJECTIVES:We sought to test the hypothesis that activation of the serotonergic system in patients with vasovagal syndrome during the head-up tilt test provokes syncope. BACKGROUND:Central serotonergic activation participates in the pathogenesis of neurocardiogenic syncope. Drugs increasing serotonin (5-HT) in the cen...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(00)00719-1

    authors： Theodorakis GN,Markianos M,Zarvalis E,Livanis EG,Flevari P,Kremastinos DT

    更新日期：2000-07-01 00:00:00

  • Prediction of serious arrhythmic events after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography.

    abstract：:Noninvasive assessment was undertaken before hospital discharge in 210 patients who had recovered from acute myocardial infarction. This comprised signal-averaged electrocardiography, Holter monitoring and radionuclide left ventriculography. An abnormal signal-averaged electrocardiogram was defined as the presence of ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(87)80045-1

    authors： Kuchar DL,Thorburn CW,Sammel NL

    更新日期：1987-03-01 00:00:00

  • The QT interval is associated with incident cardiovascular events: the MESA study.

    abstract：BACKGROUND:Prolonged heart rate-corrected QT interval on electrocardiograms (ECGs) is associated with increased risk of myocardial infarction and cardiovascular disease (CVD)-related deaths in patients with prevalent coronary heart disease. OBJECTIVES:This study sought to examine the prognostic association between the...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2014.08.039

    authors： Beinart R,Zhang Y,Lima JA,Bluemke DA,Soliman EZ,Heckbert SR,Post WS,Guallar E,Nazarian S

    更新日期：2014-11-18 00:00:00

  • Comparison of angioscopy, intravascular ultrasound imaging and quantitative coronary angiography in predicting clinical outcome after coronary intervention in high risk patients.

    abstract：OBJECTIVES:The purpose of this study was to identify qualitative or quantitative variables present on angioscopy, intravascular ultrasound imaging or quantitative coronary arteriography that were associated with adverse clinical outcome after coronary intervention in high risk patients. BACKGROUND:Patients with acute ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(96)00102-7

    authors： Feld S,Ganim M,Carell ES,Kjellgren O,Kirkeeide RL,Vaughn WK,Kelly R,McGhie AI,Kramer N,Loyd D,Anderson HV,Schroth G,Smalling RW

    更新日期：1996-07-01 00:00:00

  • Efficacy of antiarrhythmic drugs in arrhythmogenic right ventricular cardiomyopathy: a report from the North American ARVC Registry.

    abstract：OBJECTIVES:This study sought to examine the efficacy of empiric antiarrhythmic drugs in a rigorously characterized cohort of arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. BACKGROUND:Antiarrhythmic drugs are important in protecting against ventricular arrhythmias in ARVC, but no studies have provided...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2009.04.052

    authors： Marcus GM,Glidden DV,Polonsky B,Zareba W,Smith LM,Cannom DS,Estes NA 3rd,Marcus F,Scheinman MM,Multidisciplinary Study of Right Ventricular Dysplasia Investigators.

    更新日期：2009-08-11 00:00:00

  • Comparison of double kissing crush versus Culotte stenting for unprotected distal left main bifurcation lesions: results from a multicenter, randomized, prospective DKCRUSH-III study.

    abstract：OBJECTIVES:The study aimed to investigate the difference in major adverse cardiac event (MACE) at 1-year after double kissing (DK) crush versus Culotte stenting for unprotected left main coronary artery (UPLMCA) distal bifurcation lesions. BACKGROUND:DK crush and Culotte stenting were reported to be effective for trea...

    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.2013.01.023

    authors： Chen SL,Xu B,Han YL,Sheiban I,Zhang JJ,Ye F,Kwan TW,Paiboon C,Zhou YJ,Lv SZ,Dangas GD,Xu YW,Wen SY,Hong L,Zhang RY,Wang HC,Jiang TM,Wang Y,Chen F,Yuan ZY,Li WM,Leon MB

    更新日期：2013-04-09 00:00:00

  • Clinical Outcomes for Peripartum Cardiomyopathy in North America: Results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy).

    abstract：BACKGROUND:Peripartum cardiomyopathy (PPCM) remains a major cause of maternal morbidity and mortality. OBJECTIVES:This study sought to prospectively evaluate recovery of the left ventricular ejection fraction (LVEF) and clinical outcomes in the multicenter IPAC (Investigations of Pregnancy Associated Cardiomyopathy) s...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jacc.2015.06.1309

    authors： McNamara DM,Elkayam U,Alharethi R,Damp J,Hsich E,Ewald G,Modi K,Alexis JD,Ramani GV,Semigran MJ,Haythe J,Markham DW,Marek J,Gorcsan J 3rd,Wu WC,Lin Y,Halder I,Pisarcik J,Cooper LT,Fett JD,IPAC Investigators.

    更新日期：2015-08-25 00:00:00

  • Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients.

    abstract：OBJECTIVES:The aim of the present study was to verify whether angiotensin-II converting enzyme (ACE) inhibition is also effective in preventing relapses of lone atrial fibrillation (LAF), that is, in the absence of hypertension and/or heart disease. BACKGROUND:Several studies have shown that ACE inhibitors are effecti...

    journal_title：Journal of the American College of Cardiology

    pub_type： 评论,杂志文章,随机对照试验

    doi：10.1016/j.jacc.2008.08.071

    authors： Belluzzi F,Sernesi L,Preti P,Salinaro F,Fonte ML,Perlini S

    更新日期：2009-01-06 00:00:00

  • Heart rate and blood pressure response to upright tilt in young patients with unexplained syncope.

    abstract：:Syncope in apparently normal patients has been attributed to an inhibitory reflex originating in cardiac sensory receptors. The reflex may be elicited by upright tilt with or without isoproterenol infusion. In this study, an upright 90 degree tilt protocol was evaluated in 20 young patients aged 7 to 22 years with syn...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(90)90474-4

    authors： Pongiglione G,Fish FA,Strasburger JF,Benson DW Jr

    更新日期：1990-07-01 00:00:00

  • A randomized trial of transfer for primary angioplasty versus on-site thrombolysis in patients with high-risk myocardial infarction: the Air Primary Angioplasty in Myocardial Infarction study.

    abstract：OBJECTIVES:The Air Primary Angioplasty in Myocardial Infarction (PAMI) study was designed to determine the best reperfusion strategy for patients with high-risk acute myocardial infarction (AMI) at hospitals without percutaneous transluminal coronary angioplasty (PTCA) capability. BACKGROUND:Previous studies have sugg...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：10.1016/s0735-1097(02)01870-3

    authors： Grines CL,Westerhausen DR Jr,Grines LL,Hanlon JT,Logemann TL,Niemela M,Weaver WD,Graham M,Boura J,O'Neill WW,Balestrini C,Air PAMI Study Group.

    更新日期：2002-06-05 00:00:00

  • Bromocriptine treatment of digitalis-induced ventricular tachyarrhythmias: studies in a canine model.

    abstract：:Ventricular tachyarrhythmias associated with digitalis toxicity are believed to be due, in part, to cardiac glycoside-mediated increased central sympathetic neural activity. Because dopaminergic receptor agonists reduce sympathetic outflow, this study assessed effectiveness of the available dopaminergic agonist, bromo...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(84)80137-0

    authors： Kao A,Kriett JM,Tobler HG,Detloff BL,Pritzker MR,Benson DW Jr,Benditt DG

    更新日期：1984-12-01 00:00:00

  • Response of angina and ischemia to long-term treatment in patients with chronic stable angina: a double-blind randomized individualized dosing trial of nifedipine, propranolol and their combination.

    abstract：:Seventy-four patients with chronic stable mild angina, mild coronary artery disease (83% had one- or two-vessel disease) and normal left ventricular function were studied to measure the response of treadmill exercise performance and painful and silent ischemia in the ambulatory setting to randomly assigned treatment w...

    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(92)90499-d

    authors： Kawanishi DT,Reid CL,Morrison EC,Rahimtoola SH

    更新日期：1992-02-01 00:00:00

  • Left ventricular mechanics during right ventricular apical or left ventricular-based pacing in patients with chronic atrial fibrillation after atrioventricular junction ablation.

    abstract：OBJECTIVES:The aim of the study was to evaluate whether left ventricular (LV) mechanics are better under LV-based pacing than under right ventricular (RV) apical pacing in patients with permanent atrial fibrillation (AF) after atrioventricular junction (AVJ) ablation. BACKGROUND:"Ablate and pace" is an acceptable ther...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2003.10.038

    authors： Simantirakis EN,Vardakis KE,Kochiadakis GE,Manios EG,Igoumenidis NE,Brignole M,Vardas PE

    更新日期：2004-03-17 00:00:00

  • Infarct artery perfusion and changes in left ventricular volume in the month after acute myocardial infarction.

    abstract：:The relation between perfusion of the infarct-related artery and changes in left ventricular volume and function during the month after a first myocardial infarction was examined in 40 patients who did not receive thrombolytic therapy. Infarct artery perfusion was documented at predischarge coronary angiography, and l...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(87)80298-x

    authors： Jeremy RW,Hackworthy RA,Bautovich G,Hutton BF,Harris PJ

    更新日期：1987-05-01 00:00:00

  • Renal artery stent placement: utility in lesions difficult to treat with balloon angioplasty.

    abstract：OBJECTIVES:We assessed the safety and efficacy of stent placement in patients with poorly controlled hypertension and renal artery stenoses, which are difficult to treat with balloon angioplasty alone. BACKGROUND:Preliminary experience with stent placement suggests improved results over balloon angioplasty alone in pa...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章

    doi：10.1016/s0735-1097(97)00348-3

    authors： White CJ,Ramee SR,Collins TJ,Jenkins JS,Escobar A,Shaw D

    更新日期：1997-11-15 00:00:00

  • Measurement accuracy of cardiac output in humans: indicator-dilution technique versus geometric analysis by ultrafast computed tomography.

    abstract：OBJECTIVES:The aim of this study was to evaluate measurement accuracy of cardiac output in humans by comparing the indicator-dilution technique with geometric analysis by ultrafast computed tomography. BACKGROUND:Ultrafast computed tomography can be used to measure cardiac output by two methods. First, by scanning to ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(93)90328-x

    authors： Ludman PF,Coats AJ,Poole-Wilson PA,Rees RS

    更新日期：1993-05-01 00:00:00

  • Incidence and prognostic implications of heart block complicating inferior myocardial infarction treated with thrombolytic therapy: results from TIMI II.

    abstract：OBJECTIVES:The aim of this study was to determine the incidence and significance of second- or third-degree heart block among patients with inferior myocardial infarction treated with thrombolytic therapy. BACKGROUND:Data from the prethrombolytic era suggest that heart block occurs in approximately 20% of patients wit...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：10.1016/0735-1097(92)90004-7

    authors： Berger PB,Ruocco NA Jr,Ryan TJ,Frederick MM,Jacobs AK,Faxon DP

    更新日期：1992-09-01 00:00:00

  • Laser catheter-induced atrioventricular nodal delays and atrioventricular block in dogs: acute and chronic observations.

    abstract：:Selective modification of atrioventricular (AV) nodal conduction, that is, induction of varying degrees of AV nodal delays or block (second or third degree), or both, was achieved with a pervenous laser catheter technique. In six adult mongrel dogs anesthetized with pentobarbital (Nembutal), 5F leads were placed throu...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(85)80045-0

    authors： Narula OS,Boveja BK,Cohen DM,Narula JT,Tarjan PP

    更新日期：1985-02-01 00:00:00

  • Role of the endothelium in the vascular effects of the thrombin receptor (protease-activated receptor type 1) in humans.

    abstract：OBJECTIVES:The purpose of this study was to determine the role of the endothelium in the vascular actions of protease-activated receptor type 1 (PAR-1) activation in vivo in man. BACKGROUND:Thrombin is central to the pathophysiology of atherothrombosis. Its cellular actions are mediated via PAR-1. Protease-activated r...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2007.12.047

    authors： Gudmundsdóttir IJ,Lang NN,Boon NA,Ludlam CA,Webb DJ,Fox KA,Newby DE

    更新日期：2008-05-06 00:00:00

  • Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology.

    abstract：OBJECTIVES:This study was designed to evaluate whether calcium deposition in the coronary arteries is related to atherosclerotic plaque burden and narrowing of the arterial lumen. BACKGROUND:Many studies have recently documented the feasibility of electron beam computed tomography to detect and quantify coronary arter...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(97)00443-9

    authors： Sangiorgi G,Rumberger JA,Severson A,Edwards WD,Gregoire J,Fitzpatrick LA,Schwartz RS

    更新日期：1998-01-01 00:00:00

  • A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long-lasting persistent atrial fibrillation.

    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

    authors： Oral H,Chugh A,Yoshida K,Sarrazin JF,Kuhne M,Crawford T,Chalfoun N,Wells D,Boonyapisit W,Veerareddy S,Billakanty S,Wong WS,Good E,Jongnarangsin K,Pelosi F Jr,Bogun F,Morady F

    更新日期：2009-03-03 00:00:00

  • Coronary artery calcification and changes in atheroma burden in response to established medical therapies.

    abstract：OBJECTIVES:This study sought to determine the relationship between coronary calcification and plaque progression in response to established medical therapies. BACKGROUND:Coronary calcification correlates with the extent of atherosclerosis and predicts clinical outcome. METHODS:Atheroma volume was determined in serial...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2006.10.038

    authors： Nicholls SJ,Tuzcu EM,Wolski K,Sipahi I,Schoenhagen P,Crowe T,Kapadia SR,Hazen SL,Nissen SE

    更新日期：2007-01-16 00:00:00

  • Endocardial mapping of ventricular tachycardia in the intact human ventricle. III. Evidence of multiuse reentry with spontaneous and induced block in portions of reentrant path complex.

    abstract：OBJECTIVES:This study was conducted to characterize the functional nature of the reentrant tract responsible for ventricular tachycardia due to ischemic heart disease. BACKGROUND:A zone of slow conduction forming the return path is though to form a critical component of the reentrant mechanism in ventricular tachycard...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(95)00086-j

    authors： Downar E,Saito J,Doig JC,Chen TC,Sevaptsidis E,Masse S,Kimber S,Mickleborough L,Harris L

    更新日期：1995-06-01 00:00:00

  • A relationship between vascular endothelial growth factor, angiogenesis, and cardiac repair after muscle stem cell transplantation into ischemic hearts.

    abstract：OBJECTIVES:We investigated whether vascular endothelial growth factor (VEGF) was associated with the angiogenic and therapeutic effects induced after transplantation of skeletal muscle-derived stem cells (MDSCs) into a myocardial infarction (MI). BACKGROUND:Because very few MDSCs were found to differentiate into new b...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2007.04.100

    authors： Payne TR,Oshima H,Okada M,Momoi N,Tobita K,Keller BB,Peng H,Huard J

    更新日期：2007-10-23 00:00:00

  • Pulmonary artery origin of the left coronary artery: diagnosis by two-dimensional echocardiography, pulsed Doppler ultrasound and color flow mapping.

    abstract：:Five children, aged 0.2 to 6.7 years, with pulmonary artery origin of the left coronary artery proved by angiography underwent echocardiographic examination from 1985 through 1986. Prospective identification of this condition was achieved by two-dimensional echocardiography alone in two patients. Using a parasagittal ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(88)90108-8

    authors： Schmidt KG,Cooper MJ,Silverman NH,Stanger P

    更新日期：1988-02-01 00:00:00

  • Clopidogrel responsiveness regardless of the discontinuation date predicts increased blood loss and transfusion requirement after off-pump coronary artery bypass graft surgery.

    abstract：OBJECTIVES:the purpose of this study was to evaluate the association of the percentage of platelet inhibitory response to clopidogrel as assessed by modified thromboelastography with bleeding and transfusion requirement after off-pump coronary artery bypass graft (OPCABG) surgery. BACKGROUND:Interindividual variabilit...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章

    doi：10.1016/j.jacc.2010.03.108

    authors： Kwak YL,Kim JC,Choi YS,Yoo KJ,Song Y,Shim JK

    更新日期：2010-12-07 00:00:00

  • Percutaneous angioscopy during coronary angioplasty using a steerable microangioscope.

    abstract：:The feasibility of using a flexible, steerable angioscope to perform coronary angioscopy before and after percutaneous coronary angioplasty was tested. The microangioscope fits through an 8F coronary angioplasty guiding catheter and contains a multifiber viewing bundle incorporated into the body of a 4.3F balloon cath...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章

    doi：10.1016/0735-1097(91)90710-q

    authors： Ramee SR,White CJ,Collins TJ,Mesa JE,Murgo JP

    更新日期：1991-01-01 00:00:00

  • Patients with atrial fibrillation and dense spontaneous echo contrast at high risk a prospective and serial follow-up over 12 months with transesophageal echocardiography and cerebral magnetic resonance imaging.

    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

    authors： Bernhardt P,Schmidt H,Hammerstingl C,Lüderitz B,Omran H

    更新日期：2005-06-07 00:00:00