International journal of cardiology
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Randomized Controlled Trial Multicenter Study
Longer-term bosentan therapy improves functional capacity in Eisenmenger syndrome: results of the BREATHE-5 open-label extension study.
Bosentan, an oral endothelin ET(A)/ET(B) receptor antagonist, improves hemodynamics and exercise capacity in patients with Eisenmenger syndrome but longer-term effects are unknown. This study investigated the efficacy and safety of bosentan up to 40 weeks in these patients. ⋯ In conclusion, these longer follow-up data support the efficacy and safety profile reported in the preceding BREATHE-5 study of bosentan treatment of Eisenmenger syndrome, challenging the notion that pulmonary vascular disease and severe functional impairment in these patients are not amenable to therapy.
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Randomized Controlled Trial Comparative Study
Multimarker strategy for risk prediction in patients presenting with acute dyspnea to the emergency department.
Multimarker approaches improve risk prediction in patients presenting with acute coronary syndrome. We hypothesized that simultaneous assessment of B-type natriuretic peptide (BNP), cardiac troponin I (cTNI) and C-reactive protein (CRP) enables clinicians to better predict risk among patients with acute dyspnea presenting to the emergency department. ⋯ Our findings suggest that a simple multimarker approach with simultaneous assessment of BNP, and cTNI demonstrates potential to assist clinicians in predicting risk of death and/or rehospitalization in patients presenting with acute dyspnea in the emergency department.
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Letter Randomized Controlled Trial
Effect of levosimendan on E/E' ratio in patients with ischemic heart failure.
Levosimendan is a novel positive inotropic calcium sensitizer agent used in acute heart failure. In acute heart failure, it improves hemodynamic parameters more favorably than the conventional positive inotropes. In this study, the effect levosimendan on E/E' ratio as a non-invasive indicator of LV filling pressure was evaluated compared to dobutamine in a prospective, randomized, patient-blind manner. ⋯ Levosimendan causes a greater reduction of E/E' ratio compared to dobutamine in acute systolic left heart failure. This may explain the more favorable hemodynamic effects of levosimendan when compared to conventional positive inotropics in patients with systolic left heart failure.
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Randomized Controlled Trial
One year outcomes after glucose-insulin-potassium in ST elevation myocardial infarction. The Glucose-insulin-potassium study II.
There are conflicting data concerning the effect of treatment with glucose-insulin-potassium (GIK) in ST segment elevation myocardial infarction (STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long-term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy. ⋯ In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year.
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Randomized Controlled Trial Comparative Study
Home-based versus hospital-based rehabilitation after myocardial infarction: A randomized trial with preference arms--Cornwall Heart Attack Rehabilitation Management Study (CHARMS).
Participation in cardiac rehabilitation after acute myocardial infarction is sub-optimal. Offering home-based rehabilitation may improve uptake. We report the first randomized study of cardiac rehabilitation to include patient preference. ⋯ Home-based cardiac rehabilitation with the Heart Manual was as effective as hospital-based rehabilitation for patients after myocardial infarction. Choosing a rehabilitation programme did not significantly affect clinical outcomes.