7 research outputs found
Riesgo cardiovascular en estudiantes de medicina del municipio Puerto Padre de Las Tunas
- Author
- Adán V
- Almeida AL
- Alwan A
- American Heart Association Nutrition Committee
- Anderson RN
- Aoki Y
- Auerbach D
- Bach DS
- Barnes PM
- Bartoli F
- Blanck HM
- Bloom DE
- Caffrey C
- Carnethon MR
- Carroll MD
- Carroll MD
- Casper M
- Casper ML
- Casper ML
- CDC growth charts
- Centers for Disease Control and Prevention
- Centers for Disease Control and Prevention
- Centers for Disease Control and Prevention
- Centers for Disease Control and Prevention
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Centers for Disease Control and Prevention (CDC)
- Chan PS
- Chen JJ
- Chen X
- Chiuve SE
- Cho I
- Committee on Quality of Health Care in America Institute of Medicine
- Courcoulas AP
- Davis C
- Deshmukh-Taskar P
- Diercks DB
- Dunn WF
- Elixhauser A
- Ervin RB
- Ervin RB
- Filardo G
- Food and Drug Administration HHS
- Ford ES
- Fox CK
- Frieden T
- Fryar CD
- Fryar CD
- Gage B
- Gahche J
- Gold MR
- Guirguis-Blake J
- Hackett ML
- Hernesniemi JA
- Holman RC
- Homa DM
- Hong HC
- Institute for Health Metrics and Evaluation (IHME)
- Institute for Health Metrics and Evaluation (IHME)
- Issa Z
- Janczura M
- Johnson NB
- Kann L
- Kann L
- Kramer A
- Kung HC
- Lee YA
- Leonard CE
- Li CY
- Lisabeth LD
- Liu F
- Makam RP
- Mechanick JI
- Moran PS
- Mozaffarian RS
- Murman DH
- My Life Check: Life’s Simple 7
- National Association for Sport and Physical Education
- National Cancer Institute
- National Center for Health Statistics
- National Center for Health Statistics
- National Center for Health Statistics
- National Center for Health Statistics
- Nwankwo T
- Ogden CL
- Ogden CL
- Ogden CL
- Oster ME
- Pfuntner A
- Quilliam BJ
- Rasmussen LD
- Roach RE
- Rodriguez LA
- Rodriguez RD
- Ruilope LM
- Russo C
- Schoenborn CA
- Shaw K
- Soni A
- Sorice GP
- Stone NJ
- Stone NJ
- Stroke Unit Trialists’ Collaboration
- Thom T
- Tisdale JE
- Trimarchi S
- US Census Bureau population estimates
- US Department of Health and Human Services
- US Department of Health and Human Services
- US Department of Health and Human Services
- US Department of Health and Human Services
- US Department of Health and Human Services Agency for Healthcare Research and Quality
- US Department of Health and Human Services Secretary’s Advisory Committee on Heritable Disorders
- van Wijk JP
- Wing RR
- Wolbrette D
- World Health Organization
- World Health Organization
- World Health Organization
- World Obesity Federation
- Wright JD
- Writing Group for the SEARCH for Diabetes in Youth Study Group
- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 05/07/2020
- Field of study
Introduction: cardiovascular diseases are the first cause of death in Cuba; as a result, the identification of cardiovascular risks from early ages allows the implementation of health promotion and prevention strategies to reduce their impact in the futureObjective: to identify the cardiovascular risk in medical students in Puerto Padre Municipality, Las Tunas province.Methods: an observational, descriptive and cross-sectional study was conducted. The target group included 545 medical students, 237 of whom were selected by means of a simple random sample. The body mass index and waist-hip ratio were studied. Descriptive statistics was applied.Results: the predominant age group was 18-21 years old (50,2 %). The 51,47 % of the students presented a high waist-hip ratio, 54,02 % a high abdominal circumference, 52,74 % a high body mass index, and in all groups 35,44 % presented blood pressure figures lower than 120/80 mmHg; 39 % had a cardiovascular risk.Conclusions: low percentages of cardiovascular risk were identified in medical students from Puerto Padre Municipality, Las Tunas province, determined by high values of waist-hip index, body mass index and abdominal circumference.Introducción: las enfermedades cardiovasculares constituyen la primera causa de mortalidad en Cuba; por lo cual la identificación de riesgos cardiovasculares desde edades tempranas permite implementar estrategias de promoción y prevención de salud para disminuir su impacto en el futuroObjetivo: identificar el riesgo cardiovascular en estudiantes de medicina del municipio Puerto Padre de Las Tunas.Método: se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 545 estudiantes de medicina, seleccionándose 237 mediante un muestreo aleatorio simple. Se estudió el índice de masa corporal, la circunferencia abdominal y la índice cintura cadera. Se empleó estadística descriptiva.Resultados: se encontró predominio del grupo etario de 18 a 21 años (50,2 %). El 51,47 % de los estudiantes presentó un índice cintura-cadera alto, el 54,02 % una circunferencia abdominal alta, el 52,74 % un índice de masa corporal alta, así como en todos los grupos el 35,44 % presentó cifras de tensión arterial inferiores a 120/80 mmHg. El 39 % presentó riesgo cardiovascular.Conclusiones: se identificaron bajos porcientos de riesgo cardiovascular en los estudiantes de medicina del municipio Puerto Padre de Las Tunas, determinado por altos valores los índice cintura-cadera, índice de masa corporal y circunferencia abdominal
Hydrazine clubbed 1,3-thiazoles as potent urease inhibitors: design, synthesis and molecular docking studies
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature
- Author
- A Dregan
- A Dregan
- A Dregan
- A Dregan
- A Dregan
- A Nicholson
- A Nicholson
- A Parsons
- A Ruigómez
- A Taylor
- A van Lier
- AG Crawford
- Agnès Banâtre
- AJ Lisi
- AL Terry
- AM Gallagher
- AM Walker
- AN Makam
- Anthony Chapron
- AR Tate
- B Bolíbar
- B Mason
- C Chmiel
- C Ferrajolo
- C Pearce
- C Sistrom
- C Truyers
- CA Rushton
- Camille Hagenbourger
- CJ Sammon
- D Barber
- D Darmon
- D Darmon
- D Opondo
- D Redd
- D Reeves
- D Shelley
- D White
- DA Butt
- DA Fisher
- DA Springate
- DP Miller
- E De Clercq
- E Ford
- E Herrett
- E Shephard
- E Van Ganse
- EE Tripoliti
- EL Herrett
- EM Geraghty
- Eric Renault
- ES Brouwer
- F Stevenson
- FT Smits
- G Avenin
- G De Moor
- G Wilson
- GC Hall
- GTH Liljeqvist
- Guillaume Bouzille
- H Maddocks
- HF Elkhenini
- I Cricelli
- I Olier
- I Torjesen
- IN Mohamed
- J Freund
- J Meiman
- J Torti
- J Widdifield
- J Young
- JA McCart
- JB Kruskal
- JD Shadd
- JE Devoe
- JK Quint
- JK Soler
- JP Yaeger
- JT van Wyk
- JV Tu
- K Dentler
- K Haynes
- K Keshavjee
- K Tu
- K Tu
- K Tu
- KE Wurst
- L Kalankesh
- L Szatkowski
- L Wang
- Laure Fiquet
- M Cuggia
- M Garcia-Gil
- M Gil
- M Greiver
- M Greiver
- M Greiver
- M Hufty
- M Pujades-Rodriguez
- M Staff
- M Tolar
- M-H Metzger
- MA Murtaugh
- Marc Cuggia
- Marie-Line Gentil
- MC Irizarry
- MD Esteban-Vasallo
- MDM García-Gil
- MMJ Nielen
- N Bossuyt
- N Coleman
- N Poh
- N Serrano
- NF Khan
- P Farahani
- P Shin
- P Wallace
- PJ Woestenberg
- PL Elkin
- R Birtwhistle
- R Cornish
- R Mamtani
- R Morkem
- R Vijayakrishnan
- RA Charlton
- RJ Byrd
- RL Phillips
- RM Salem
- RP Cornish
- S Allin
- S de Lusignan
- S Devine
- S Garies
- S Johansson
- S Mazumdar
- S Muller
- S Streit
- S Toh
- SB Harris
- SB Meropol
- SC Denaxas
- SE Schultz
- SK Kurd
- T Neumark
- T Williamson
- T Williamson
- TA Hammad
- TE Langley
- Thomas Le Berre
- TP van Staa
- TY Tian
- VE Valkhoff
- W Kuchinke
- Y Wang
- Y-C Chen
- Z Afzal
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients
- Author
- A A
- Abbott Jd
- Abdullah S
- Abib E Jr
- Ables Lr
- Abrantes Ja
- Acosta R
- Adams A
- Adams F
- Adroer Martori R
- Agafina As
- Agaiby Jm
- Aggarwala G
- Agraou B
- Aguilarsalinas Ca
- Ahmad A
- Ajala B
- Akdeniz B
- Akhtar N
- Akright L
- Aksentiev S
- Al-Zoebi A
- Alappat P
- Albert M
- Alfieri Ad
- Alhakim M
- Allaw Ma
- Alpizar-Salazar M
- Altafullah Im
- Alvarado Op
- Alvarez Ca
- Alvarez Jg
- Alvarez Ms
- Alvarez-Sala Walther La
- Alves AR Jr
- Alwine Lk
- Alzand B
- Amarenco P.
- Ambrovicova V
- Amerena J
- Andersen Jl
- Andersen Lt
- Anderson P
- Anderson Tj
- Andrassy P
- Andrei Ld
- Andreka P
- Angoulvant D
- Angun M
- Annamalai N
- Ansari Sh
- Anselmi M
- Antonicelli R
- Appel Kf
- Aracil Villar J
- Arain S
- Arambula Rm
- Araz M
- Arca M
- Arcanese Ml
- Arden C
- Areas Ca
- Ari H
- Ariani Mk
- Arif I
- Aroney C
- Aronson R
- Arstall M
- Arstila L
- Arya Kw
- Asamoah-Owusu N
- Askonen K
- Aslam Aa
- Assadourian A
- Assef V
- Atar S
- Auriel E
- Avaca H
- Averna M
- Avornyo Aa
- Avram Ri
- Axthelm C
- Ayesu K
- Aylward Pe
- Ayoub Jc
- Baar M
- Babapulle M
- Badat Ae
- Bailey Sr
- Bajaj H
- Bajcsi D
- Baker J
- Bakhai A
- Baldari D
- Ball Em
- Ballantyne Cm
- Ballyuzek M
- Balo T
- Banaszkiewicz K
- Bandeira e Farias FA
- Banerjee M
- Banik M
- Banyai M
- Baranova E
- Barbarash Ol
- Barbieri Ds
- Barettella Mb
- Barker Ba
- Barnum O
- Barreda Gonzalez Mj
- Barrera Cm
- Barrington P
- Baultrukonis D
- Bax Wa
- Bayat J
- Bayron Cj
- Bays He
- Beaudry P
- Beckett Pl
- Begg A
- Behmanesh B
- Behnke T
- Belenkiy Di
- Belicova M
- Bellido Guerrero D
- Bellingar B
- Beltran Lg
- Benacka J
- Benatar Jr
- Benczur B
- Benitez O
- Benjamin Sa
- Berenguer Ra
- Bergeron J
- Bergerot C
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- Berlingieri Jc
- Bernard Jv
- Berrouschot J
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- Bhindi R
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- Bijata-Bronisz R
- Bilz S
- Bittar Gd
- Bitzur R
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- Blach E
- Black H
- Blagden Md
- Blaha V
- Blake G
- Blanco Coronado Jl
- Blaze K
- Blignault Sc
- Blokhin A
- Bloom Sa
- Bocek P
- Bod E
- Bogaard K
- Bogdanov E
- Bokern Mj
- Boman K
- Bonansea Tc
- Bonfanti Ja
- Bonner Jh
- Bonora E
- Boonyavarakul A
- Borer Js
- Botas Rodrigues J
- Botelho Rv
- Botella Serrano M
- Botero-Lopez R
- Botta Ce
- Bourgeois R
- Bourhaial H
- Boye A
- Boyett Be
- Brandon Dm
- Brar Hs
- Brauer C
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- Brenner H
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- Bretton Em
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- Broncel M
- Bronnum Schou J
- Brotons Cuixart C
- Broughton R
- Bruguera Cortada J
- Brunell R.
- Bruno Rl
- Budassi N
- Budoff Mj
- Bueno Diez M
- Bufka V
- Buganova I
- Bulanova N
- Buonanno M
- Burgess Lj
- Burnier M
- Burova N
- Busch Rs
- Busegeanu M
- Butuk Dj
- Buynak Rj
- Buysschaert I
- Bybee Ka
- Cabella Pr
- Cabezas Mc
- Caccavo A
- Calin A
- Calvo Gomez C
- Camp Ad
- Capiau L
- Caputo Rp
- Caramori Pr
- Carlier M
- Carlier Sg
- Carmena R
- Carnero Gs
- Carroll Pa
- Casabella Te
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- Castro Montes Be
- Castro Ma
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- Catano Js
- Caudmont S
- Cayla G
- Cech V
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- Cha Jy
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- Chandna H
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- Chati Z
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- Cheek Hb
- Chen J
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- Chiong R
- Cho Br
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- Chochinov Rh
- Chorin E
- Chouinard G
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- Cifkova R
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- Civeira Murillo F
- Civeira F.
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- Codutti Or
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- Coisne D
- Collier Dj
- Colombo Hr
- Colquhoun D
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- Comlekci A
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- Connelly T
- Connery L
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- Crean P
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- de Barros e Silva PG
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- Dimas Al
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- dos Santos Fr
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- Fedacko J
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- Joensen A
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- Jones Af
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- Jukema J. W.
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- Yoon J
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- Zannad F
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- Zateyshchikov D
- Zavaro Sh
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- Zeig S
- Zemek S
- Zemour G
- Zeng X
- Zeno Ml
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- Zhang X
- Zhang Y
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- Zidkova E
- Zieba B
- Zilahi Z
- Zoet-Nugteren Sk
- Zrazhevskiy K
- Zubek V
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2017
- Field of study
Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P<0.001) and a median reduction from baseline of 64.2% (P<0.001). In the lower-risk, shorter-duration trial (in which the patients had a baseline LDL cholesterol level of ≥70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of ≥100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P = 0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no benefit with respect to major adverse cardiovascular events in the trial involving lower-risk patients but did have a significant benefit in the trial involving higher-risk patients
Serious Asthma Events with Fluticasone plus Salmeterol versus Fluticasone Alone
- Author
- Abalos-Galito M
- Abboy C
- Abrahamian F
- Abreu E
- Ackerman If
- Acosta Ia
- Adams L
- Adaoag Aa
- Adiaz-Baui Tt
- Aggarwal Nk
- Aguilar Dominguez Pe
- Aguilar-Orozco Ra
- Aguirre Sosa I
- Ahmed M
- Aleksandrova E
- Alekseeva E
- Alexandrescu Ds
- Ali Mi
- Allen GG Jr
- Allen Dr
- Allison Dc
- Altieri Hh
- Alvey Jc
- Alwine Lk
- Amer L
- Anand S
- Andrasofszky Z
- Anspach Rb
- Antuni Jd
- Antépara Ercoreca I
- Anwar J
- Apaliski Sj
- Arastu Rs
- Aries Sp
- Arimah C
- Arnedillo Muñoz A
- Arora Cm
- Arthur Cp
- Asherova I
- Auerbach D
- Austri Investigators
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- Backer V
- Badar FL 3rd
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- Zykov K
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2016
- Field of study
BACKGROUND:
The safe and appropriate use of long-acting beta-agonists (LABAs) for the treatment of asthma has been widely debated. In two large clinical trials, investigators found a potential risk of serious asthma-related events associated with LABAs. This study was designed to evaluate the risk of administering the LABA salmeterol in combination with an inhaled glucocorticoid, fluticasone propionate.
METHODS:
In this multicenter, randomized, double-blind trial, adolescent and adult patients (age, ≥12 years) with persistent asthma were assigned to receive either fluticasone with salmeterol or fluticasone alone for 26 weeks. All the patients had a history of a severe asthma exacerbation in the year before randomization but not during the previous month. Patients were excluded from the trial if they had a history of life-threatening or unstable asthma. The primary safety end point was the first serious asthma-related event (death, endotracheal intubation, or hospitalization). Noninferiority of fluticasone-salmeterol to fluticasone alone was defined as an upper boundary of the 95% confidence interval for the risk of the primary safety end point of less than 2.0. The efficacy end point was the first severe asthma exacerbation.
RESULTS:
Of 11,679 patients who were enrolled, 67 had 74 serious asthma-related events, with 36 events in 34 patients in the fluticasone-salmeterol group and 38 events in 33 patients in the fluticasone-only group. The hazard ratio for a serious asthma-related event in the fluticasone-salmeterol group was 1.03 (95% confidence interval [CI], 0.64 to 1.66), and noninferiority was achieved (P=0.003). There were no asthma-related deaths; 2 patients in the fluticasone-only group underwent asthma-related intubation. The risk of a severe asthma exacerbation was 21% lower in the fluticasone-salmeterol group than in the fluticasone-only group (hazard ratio, 0.79; 95% CI, 0.70 to 0.89), with at least one severe asthma exacerbation occurring in 480 of 5834 patients (8%) in the fluticasone-salmeterol group, as compared with 597 of 5845 patients (10%) in the fluticasone-only group (P<0.001).
CONCLUSIONS:
Patients who received salmeterol in a fixed-dose combination with fluticasone did not have a significantly higher risk of serious asthma-related events than did those who received fluticasone alone. Patients receiving fluticasone-salmeterol had fewer severe asthma exacerbations than did those in the fluticasone-only group
Ezetimibe added to statin therapy after acute coronary syndromes
- Author
- Aagnes I
- Aambakk MB
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- Abdel-Latief A
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- Aboufakher R
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- Zweiker R
- Ångman K
- Édes I
- Östberg S
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2015
- Field of study
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit
Edoxaban versus warfarin in patients with atrial fibrillation
- Author
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- Yukhno E
- Yukihiro Koretsune
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- Zamlynskyy M
- Zamorano JL
- Zanotti A
- Zanwar I
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- Zareczky P
- Zarpentin C
- Zateyshchikov D
- Zateyshchikova A
- Zeig S
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- Zeltser D
- Zenin S
- Zhang HQ
- Zhang P
- Zhang X
- Zhang YL
- Zhang Z
- Zhao RP
- Zhao XL
- Zharinov O
- Zheng X
- Zheng Y
- Zheng ZQ
- Zhou SX
- Zhukova N
- Zhurba S
- Zidkova E
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- Ziegler K
- Zielinski M
- Zienciuk-Krajka A
- Zimmermann EB
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- Åkerberg A
- Östberg S
- Ŝpinar J
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2013
- Field of study
Contains fulltext :
125374.pdf (publisher's version ) (Open Access)BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two once-daily regimens of edoxaban with warfarin in 21,105 patients with moderate-to-high-risk atrial fibrillation (median follow-up, 2.8 years). The primary efficacy end point was stroke or systemic embolism. Each edoxaban regimen was tested for noninferiority to warfarin during the treatment period. The principal safety end point was major bleeding. RESULTS: The annualized rate of the primary end point during treatment was 1.50% with warfarin (median time in the therapeutic range, 68.4%), as compared with 1.18% with high-dose edoxaban (hazard ratio, 0.79; 97.5% confidence interval [CI], 0.63 to 0.99; P<0.001 for noninferiority) and 1.61% with low-dose edoxaban (hazard ratio, 1.07; 97.5% CI, 0.87 to 1.31; P=0.005 for noninferiority). In the intention-to-treat analysis, there was a trend favoring high-dose edoxaban versus warfarin (hazard ratio, 0.87; 97.5% CI, 0.73 to 1.04; P=0.08) and an unfavorable trend with low-dose edoxaban versus warfarin (hazard ratio, 1.13; 97.5% CI, 0.96 to 1.34; P=0.10). The annualized rate of major bleeding was 3.43% with warfarin versus 2.75% with high-dose edoxaban (hazard ratio, 0.80; 95% CI, 0.71 to 0.91; P<0.001) and 1.61% with low-dose edoxaban (hazard ratio, 0.47; 95% CI, 0.41 to 0.55; P<0.001). The corresponding annualized rates of death from cardiovascular causes were 3.17% versus 2.74% (hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), and 2.71% (hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.008), and the corresponding rates of the key secondary end point (a composite of stroke, systemic embolism, or death from cardiovascular causes) were 4.43% versus 3.85% (hazard ratio, 0.87; 95% CI, 0.78 to 0.96; P=0.005), and 4.23% (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.32). CONCLUSIONS: Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes. (Funded by Daiichi Sankyo Pharma Development; ENGAGE AF-TIMI 48 ClinicalTrials.gov number, NCT00781391.)