Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2000
Randomized Controlled Trial Clinical TrialAntiremodeling effects on the left ventricle during beta-blockade with metoprolol in the treatment of chronic heart failure.
The purpose of the study was to investigate the effects of beta1-blockade on left ventricular (LV) size and function for patients with chronic heart failure. ⋯ This study is the first randomized study to demonstrate that the beta1-blocker metoprolol CR/XL has antiremodeling effects on the LV in patients with chronic heart failure and consequently provides an explanation for the highly significant decrease in mortality from worsening heart failure found in the MERIT-HF trial.
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J. Am. Coll. Cardiol. · Nov 2000
Randomized Controlled Trial Multicenter Study Clinical TrialHemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure.
We sought to define the therapeutic dose range of levosimendan in patients with New York Heart Association class II-IV heart failure of ischemic origin. ⋯ Dosing of levosimendan with a 10-min bolus of 6 to 24 microg/kg followed by an infusion of 0.05 to 0.2 microg/kg/min is well tolerated and leads to favorable hemodynamic effects.
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J. Am. Coll. Cardiol. · Nov 2000
Randomized Controlled Trial Clinical TrialA randomized trial of the effects of early cardiac serum marker availability on reperfusion therapy in patients with acute myocardial infarction: the serial markers, acute myocardial infarction and rapid treatment trial (SMARTT).
The purpose of this study was to assess whether the immediate availability of serum markers would increase the appropriate use of thrombolytic therapy. ⋯ The availability of 0- and 1-h myoglobin and CK-MB results after ED evaluation had no effect on the use of thrombolytic therapy for patients presenting with AMI, and it slightly increased the number of patients admitted to the hospital who had no evidence of acute myocardial necrosis.
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J. Am. Coll. Cardiol. · Sep 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialDiabetes mellitus in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK?
We sought to examine the role of diabetes mellitus in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) in the SHOCK Trial Registry. ⋯ Diabetics with CS complicating AMI have a higher-risk profile at baseline, but after adjustment, diabetics have an in-hospital survival rate that is only marginally lower than that of nondiabetics. Diabetics who undergo revascularization derive a survival benefit similar to that of nondiabetics.
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J. Am. Coll. Cardiol. · Sep 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialCardiogenic shock with non-ST-segment elevation myocardial infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK?
We sought to determine the outcomes of patients with cardiogenic shock (CS) complicating non-ST-segment elevation acute myocardial infarction (MI). ⋯ Patients with CS and non-ST-segment elevation MI have a higher-risk profile than shock patients with ST-segment elevation, but similar in-hospital mortality. More recurrent ischemia and less angiography represent opportunities for earlier intervention, and early reperfusion therapy for circumflex artery occlusion should be considered when non-ST-elevation MI causes CS.