Archives of cardiovascular diseases
-
Arch Cardiovasc Dis · Nov 2015
Review Meta Analysis Comparative StudyTransradial versus transfemoral approach for percutaneous coronary intervention in cardiogenic shock: A radial-first centre experience and meta-analysis of published studies.
The transradial approach for percutaneous coronary intervention (PCI) is associated with a better outcome in myocardial infarction (MI), but patients with cardiogenic shock (CS) were excluded from most trials. ⋯ The transradial approach in the setting of PCI for ischaemic CS is associated with a dramatic reduction in mortality, ischaemic and bleeding events, and should be preferred to the transfemoral approach in radial expert centres.
-
Arch Cardiovasc Dis · Oct 2013
Review Meta AnalysisCytochrome CYP2C19 polymorphism and risk of adverse clinical events in clopidogrel-treated patients: a meta-analysis based on 23,035 subjects.
Previous studies have investigated the relationship between CYP2C19 polymorphism and clinical prognosis in coronary artery disease patients treated with clopidogrel, but the results were inconsistent. ⋯ CYP2C19 polymorphism is significantly associated with risk of adverse clinical events in clopidogrel-treated patients.
-
Arch Cardiovasc Dis · Nov 2012
Meta Analysis Comparative StudyZotarolimus-eluting stent versus sirolimus-eluting and paclitaxel-eluting stents for percutaneous coronary intervention: a meta-analysis of randomized trials.
The zotarolimus-eluting stent (ZES) is a new drug-eluting stent that delivers zotarolimus, a synthetic analogue of sirolimus, through a biocompatible phosphorylcholine polymer coating. ZES has shown promising results compared with bare-metal stents, but its safety and efficacy against sirolimus-eluting (SES) and paclitaxel-eluting (PES) stents is yet to be established. ⋯ ZES is not superior to PES and is inferior to SES in terms of angiographic outcomes and clinically driven revascularization.
-
Arch Cardiovasc Dis · Oct 2012
Review Meta AnalysisNon-compliance with digoxin in patients with heart failure and/or atrial fibrillation: a systematic review and meta-analysis of observational studies.
Digoxin is highly potent and efficacious for treatment of heart failure (HF) and/or atrial fibrillation (AF) yet compliance is often poor. ⋯ Non-compliance with digoxin is prevalent among patients with HF and/or AF. A better understanding of the factors influencing compliance and improved intervention strategies are necessary to increase digoxin compliance.
-
Arch Cardiovasc Dis · Apr 2012
Review Meta AnalysisRate versus rhythm control in atrial fibrillation and clinical outcomes: updated systematic review and meta-analysis of randomized controlled trials.
Atrial fibrillation is the most frequently occurring sustained cardiac arrhythmia and is associated with a significantly increased risk of thromboembolic events and death. We sought to compare the clinical efficacy of rate and rhythm control strategies in patients with non-postoperative atrial fibrillation. We searched the PubMed database and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing rate versus rhythm control in patients with atrial fibrillation. ⋯ There were no significant differences in the effects of rate and rhythm control on any outcome: all-cause mortality (RR: 0.95; CI: 0.86-1.05), cardiovascular mortality (RR: 0.99; CI: 0.87-1.13), arrhythmic/sudden death (RR: 1.12; CI: 0.91-1.38), ischaemic stroke (RR: 0.89; CI: 0.52-1.53), systemic embolism (RR: 0.89; CI: 0.69-1.14) and major bleeding (RR: 1.10; CI: 0.89-1.36). Updated data pooled from a large population of patients with atrial fibrillation suggests that rate and rhythm control strategies have similar effects on major clinical outcomes. Other factors, including individual preferences, comorbidities, drug tolerance and cost issues, should be considered when choosing the approach for these patients.