European heart journal
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European heart journal · Jun 2008
Review Meta AnalysisImpact of preoperative statin therapy on adverse postoperative outcomes in patients undergoing cardiac surgery: a meta-analysis of over 30,000 patients.
To determine the strength of evidence for preoperative statin use for prevention of adverse postoperative outcomes in patients undergoing cardiac surgery. ⋯ Our meta-analysis provides evidence that preoperative statin therapy exerts substantial clinical benefit on early postoperative adverse outcomes in cardiac surgery patients, but underscores the need for RCT trials.
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European heart journal · Jan 2008
Review Meta AnalysisSafety of carotid artery stenting for symptomatic carotid artery disease: a meta-analysis.
Clinical trials comparing carotid artery stenting (CAS) with carotid endarterectomy (CEA) for patients with symptomatic carotid artery disease have produced conflicting results. We performed a meta-analysis to systematically evaluate currently available data by comparing CAS with CEA in patients with symptomatic carotid artery disease. ⋯ No significant differences could be identified between CAS and CEA in the treatment of patients with symptomatic carotid artery disease. Larger randomized controlled trials are warranted to compare the two strategies.
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European heart journal · Dec 2007
Review Meta AnalysisQuantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials.
The impact on mortality outcomes of beta-blockers and calcium blockers in post-myocardial infarction (MI) has been suggested to be related to resting heart rate (HR) reduction. A meta-regression of randomized clinical trials was carried out to assess this relationship using weighted meta-regression of logarithm of odds ratio against absolute HR reduction. ⋯ The meta-regression of the randomized clinical trials strongly suggest that the beneficial effect of beta-blockers and calcium channel blockers in post-MI patients is proportionally related to resting HR reduction. Furthermore, the absence of residual heterogeneity indicated that resting HR reduction could be a major determinant of the clinical benefit.
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European heart journal · Dec 2007
Review Meta AnalysisD-dimer in ruling out acute aortic dissection: a systematic review and prospective cohort study.
Blood D-dimer testing has been proposed as diagnostic marker with high sensitivity for exclusion of acute aortic dissection (AAD). We performed a systematic review and validated the findings in a prospective patient cohort. ⋯ Current evidence supports a routine measurement of D-dimer in excluding AAD. A D-dimer <0.1 microg/mL will exclude AAD in all cases.
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European heart journal · Dec 2006
Meta AnalysisInterventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis.
Atrial fibrillation (AF) is the most common complication after cardiac surgery. We aimed to evaluate, by meta-analysis, all randomized trials testing interventions for preventing AF. ⋯ All five interventions reduced the incidence of AF, though the effect of BBs is less than previously thought. The significant reductions in length of stay and stroke in meta-analysis suggest that there are worthwhile benefits from aggressive prevention. Larger studies to confirm these clinical benefits and evaluate their cost-effectiveness would be worthwhile.