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
Duration of Electrocardiographic Monitoring of Emergency Department Patients With Syncope.
The optimal duration of cardiac rhythm monitoring after emergency department (ED) presentation for syncope is poorly described. We sought to describe the incidence and time to arrhythmia occurrence to inform decisions regarding duration of monitoring based on ED risk stratification. ⋯ Serious underlying arrhythmia was often identified within the first 2 hours of ED arrival for CSRS low-risk patients and within 6 hours for CSRS medium- and high-risk patients. Outpatient cardiac rhythm monitoring for 15 days for selected medium-risk patients and all high-risk patients discharged from the hospital should also be considered.
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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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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.
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Randomized Controlled Trial Multicenter Study Comparative Study
Cost-Effectiveness of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Intermediate Risk.
In patients with severe aortic stenosis (AS) at intermediate surgical risk, treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in similar rates of death or stroke at 2 years. Whether TAVR is cost-effective compared with SAVR for intermediate-risk patients remains uncertain. ⋯ URL: https://www.clinicaltrials.gov . Unique identifier: NCT01314313.