Efficacy and Safety of Abciximab in Diabetic Patients Who Underwent Percutaneous Coronary Intervention with Thienopyridines Loading: A Meta-Analysis

It has been controversial whether abciximab offered additional benefits for diabetic patients who underwent percutaneous coronary intervention (PCI) with thienopyridines loading.MEDLINE, EMBASE, the Cochrane library clinical trials registry, ISI Science Citation Index, ISI Web of Knowledge and China National Knowledge Infrastructure (CNKI) were searched, supplemented with manual-screening for relevant publications. Quantitative meta-analyses were performed to assess differences between abciximab groups and controls with respect to post-PCI risk of major cardiac events (MACEs), angiographic restenosis and bleeding complications.<0.001), whereas major bleedings rate was similar (RR: 0.83, 95% CI: 0.27–2.57).Concomitant dosing of abciximab and thienopyridines provides no additional benefit among diabetic patients who underwent PCI; this conclusion, though, needs further confirmation in larger studies

Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

An Innovative Piezoelectric-Based Method for Measuring Pulse Wave Velocity in Patients With Hypertension

J Clin Hypertens (Greenwich). 2011;13:497–505.©2011 Wiley Periodicals, Inc. Pulse wave velocity (PWV) is an accepted surrogate marker of arterial stiffness and may be a useful tool for assessing cardiovascular risk in hypertensive patients. The authors sought to compare a novel polyvinylidene fluoride (PVDF) piezoelectric–based sensing device for measuring PWV in the arm with a validated SphygmoCor device (AtCor Medical, West Ryde, Australia) in normal and hypertensive patients. They also sought to compare measured PWV in the forearm (brachial‐radial PWV [BRPWV]) with values obtained in the carotid‐radial segment (carotid‐radial PWV [CRPWV]). Under standardized conditions, CRPWV in 108 normotensive patients with both devices was measured. BRPWV was measured with the PVDF device. Identical measurements were made in a group of 82 hypertensive patients before and after optimization of blood pressure control. Mean CRPWV was 8.7 m/s in the normotensive group and 9.4 m/s in the hypertensive group. Mean BRPWV was 9.2 m/s in the normotensive group and 10.3 m/s in the hypertensive group. There was excellent correlation between the 2 devices when comparing individual CRPWV values (normotensive group, R (2)=0.92; mean bias 0.04 m/s; hypertensive group, R (2)=0.89, mean bias 0.08 m/s). Correlation was also favorable when measuring changes in CRPWV in hypertensive patients undergoing pharmacotherapy (PVDF −0.52±0.90 m/s vs SphygmoCor −0.53±1.01 m/s; R (2)=0.81). Measured values for BRPWV were significantly higher than CRPWV values, and this discrepancy was more marked in the hypertensive group. The PVDF piezoelectric device has excellent correlation with the validated SphygmoCor device when measuring PWV. This novel device may have an important role in patients with conditions such as hypertension