Circulation
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Randomized Controlled Trial Multicenter Study Comparative Study
Angiotensin Receptor Neprilysin Inhibitor for Functional Mitral Regurgitation.
The morbidity and mortality of patients with functional mitral regurgitation (MR) remain high, but no pharmacological therapy has been proven effective. The hypothesis of this study was that sacubitril/valsartan would be superior to valsartan alone in improving functional MR via dual inhibition of the renin-angiotensin system and neprilysin. ⋯ URL: https://www.clinicaltrials.gov . Unique identifier: NCT02687932.
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Multicenter Study Comparative Study
Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock.
Percutaneous mechanical circulatory support devices are increasingly used in acute myocardial infarction complicated by cardiogenic shock (AMI-CS), despite limited evidence for their effectiveness. The aim of this study was to evaluate outcomes associated with use of the Impella device compared with intra-aortic balloon pump (IABP) and medical treatment in patients with AMI-CS. ⋯ URL: https://www.clinicaltrials.gov . Unique identifier: NCT03313687.
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Comparative Study
Ambulance Density and Outcomes After Out-of-Hospital Cardiac Arrest.
In out-of-hospital cardiac arrest (OHCA), geographic disparities in outcomes may reflect baseline variations in patients' characteristics but may also result from differences in the number of ambulances providing basic life support (BLS) and advanced life support (ALS). We aimed at assessing the association between allocated ambulance resources and outcomes in OHCA patients in a large urban community. ⋯ In this large urban population-based study of out-of-hospital cardiac arrests patients, we observed that allocated resources of emergency medical service are associated with outcome, suggesting that improving healthcare organization may attenuate disparities in prognosis.
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Multicenter Study
Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery.
Contemporary outcomes after surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood. ⋯ Women experience worse outcomes after thoracic aortic surgery with hypothermic circulatory arrest. Further investigation is required to better delineate which measures may reduce sex-related outcome differences after complex aortic surgery.