European heart journal
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European heart journal · Dec 2002
Randomized Controlled Trial Clinical TrialLong-term effects of spinal cord stimulation and coronary artery bypass grafting on quality of life and survival in the ESBY study.
To assess the long-term outcome regarding quality of life and survival in patients who were included in the ESBY study 1992-1995. The ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris) included 104 patients-with severe angina, increased surgical risk and no prognostic benefits from revascularization-randomized to coronary artery bypass grafting or spinal cord stimulation. ⋯ Spinal cord stimulation as well as coronary artery bypass grafting offered long-lasting improvement in quality of life. Survival up to 5 years was comparable between the groups. Both methods can be considered as effective treatment options for patients with severe angina, increased surgical risks and estimated to have no prognostic benefits from coronary artery bypass grafting.
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European heart journal · Nov 2002
Randomized Controlled Trial Clinical TrialClopidogrel does not suppress blood markers of coagulation activation in aspirin-treated patients with non-ST-elevation acute coronary syndromes.
The Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Study demonstrated that clopidogrel plus aspirin was superior to aspirin alone for prevention of recurrent vascular events in patients with acute coronary syndromes. The aim of this study was to compare the effect of these two regimens on biochemical markers of platelet and coagulation activation. ⋯ Our results indicate that the clinical benefits of clopidogrel are not associated with a parallel reduction in markers of coagulation activation. Early suppression of coagulation markers most likely reflects the effects of heparin. The persistence of thrombin generation despite long-term clopidogrel and aspirin therapy suggests that even more intensive antithrombotic therapy may be required in these patients.
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European heart journal · Sep 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialSafety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN).
To evaluate the safety and efficacy of levosimendan in patients with left ventricular failure complicating acute myocardial infarction. ⋯ s Levosimendan at doses 0.1-0.2 microg x kg(-1) x min(-1) did not induce hypotension or ischaemia and reduced the risk of worsening heart failure and death in patients with left ventricular failure complicating acute myocardial infarction.
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European heart journal · Sep 2002
Randomized Controlled Trial Comparative Study Clinical TrialRandomised controlled trial of continuous positive airway pressure and standard oxygen therapy in acute pulmonary oedema; effects on plasma brain natriuretic peptide concentrations.
The study aim was to compare the effects of continuous positive airway pressure (CPAP) on clinical outcomes and plasma neurohormonal concentrations in patients with acute pulmonary oedema. ⋯ CPAP produces a more rapid clinical and symptomatic improvement in patients with acute pulmonary oedema, particularly within the first hour. CPAP is a useful adjunctive treatment in the early management of acute heart failure.
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European heart journal · Apr 2002
Randomized Controlled Trial Comparative Study Clinical TrialThe impact of pre-operative education on recovery following coronary artery bypass surgery. A randomized controlled clinical trial.
Research has demonstrated the beneficial impact that pre-operative education exerts on the postoperative recovery of patients having surgery but little work has focused specifically on cardiac surgery. Therefore a randomized controlled trial was designed to elucidate the consequences of pre-operative education, given before admission, on postoperative pain, anxiety, depression and wellbeing in the 6 months following a first episode of coronary artery surgery. ⋯ The findings demonstrate that there is no benefit to be gained from this form of pre-operative education and that there is an associated increase in length of hospital stay. Future research could examine an ongoing programme of education and support, and might use alternative methods such as CD-ROM or the Internet.