55 research outputs found
Rationale, design and population baseline characteristics of the PERFORM Vascular Project: an ancillary study of the Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack (PERFORM) trial
<p><b>Purpose</b></p>
<p>PERFORM is exploring the efficacy of terutroban
versus aspirin for secondary prevention in patients with a
history of ischemic stroke or transient ischemic attacks
(TIAs). The PERFORM Vascular Project will evaluate the
effect of terutroban on progression of atherosclerosis, as
assessed by change in carotid intima-media thickness
(CIMT) in a subgroup of patients.</p>
<p><b>Methods and results</b></p>
<p>The Vascular Project includes structural
(CIMT, carotid plaques) and functional (carotid
stiffness) vascular studies in all patients showing at least
one carotid plaque at entry. Expected mean follow-up is
36 months. Primary endpoint is rate of change of CIMT.
Secondary endpoints include emergent plaques and assessment
of carotid stiffness. 1,100 patients are required for
90% statistical power to detect treatment-related CIMT
difference of 0.025 mm. The first patient was randomized
in April 2006.</p>
<p><b>Conclusions</b></p>
<p>The PERFORM Vascular Project will investigate
terutroban’s effect on vascular structure and function in
patients with a history of ischemic stroke or TIAs.</p>
Sudden cardiac death and pump failure death prediction in chronic heart failure by combining ECG and clinical markers in an integrated risk model
BACKGROUND: Sudden cardiac death (SCD) and pump failure death (PFD) are common endpoints in chronic heart failure (CHF) patients, but prevention strategies are different. Currently used tools to specifically predict these endpoints are limited. We developed risk models to specifically assess SCD and PFD risk in CHF by combining ECG markers and clinical variables. METHODS: The relation of clinical and ECG markers with SCD and PFD risk was assessed in 597 patients enrolled in the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study. ECG indices included: turbulence slope (TS), reflecting autonomic dysfunction; T-wave alternans (TWA), reflecting ventricular repolarization instability; and T-peak-to-end restitution (ΔαTpe) and T-wave morphology restitution (TMR), both reflecting changes in dispersion of repolarization due to heart rate changes. Standard clinical indices were also included. RESULTS: The indices with the greatest SCD prognostic impact were gender, New York Heart Association (NYHA) class, left ventricular ejection fraction, TWA, ΔαTpe and TMR. For PFD, the indices were diabetes, NYHA class, ΔαTpe and TS. Using a model with only clinical variables, the hazard ratios (HRs) for SCD and PFD for patients in the high-risk group (fifth quintile of risk score) with respect to patients in the low-risk group (first and second quintiles of risk score) were both greater than 4. HRs for SCD and PFD increased to 9 and 11 when using a model including only ECG markers, and to 14 and 13, when combining clinical and ECG markers. CONCLUSION: The inclusion of ECG markers capturing complementary pro-arrhythmic and pump failure mechanisms into risk models based only on standard clinical variables substantially improves prediction of SCD and PFD in CHF patients
Use of a Novel Septal Occluder Device for Left Atrial Appendage Closure in Patients With Postsurgical and Postlariat Leaks or Anatomies Unsuitable for Conventional Percutaneous Occlusion
The Fixed Combination of Pioglitazone and Metformin Improves Biomarkers of Platelet Function and Chronic Inflammation in Type 2 Diabetes Patients: Results from the PIOfix Study
Impact of left atrial appendage morphology on thrombus formation after successful left atrial appendage occlusion: Assessment with cardiac-computed-tomography
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