Scandinavian cardiovascular journal : SCJ
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Scand. Cardiovasc. J. · Mar 2004
Randomized Controlled Trial Comparative Study Clinical TrialOff-pump CABG reduces complement activation but does not significantly affect peripheral endothelial function: a prospective randomized study.
Cardiac surgery initiates a systemic inflammatory response, which may affect endothelial function. The aim of this study was to investigate if off-pump CABG (OPCAB) reduces the postoperative inflammatory response and affects endothelial function less than conventional on-pump CABG. ⋯ OPCAB reduces complement activation compared with on-pump CABG but does not significantly affect TNF-alpha and IL-8 release or endothelial function.
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Scand. Cardiovasc. J. · Dec 2003
ReviewResults from clinical trials on ST-elevation myocardial infarction in a historic perspective with some pathophysiological aspects.
Since the publication of the large trials on streptokinase and aspirin improving mortality related to an acute ST-elevation myocardial infarction (STEMI) there has been numerous studies on improving treatment results with new fibrinolytics, adjuvant heparin therapy and primary percutaneous intervention (PCI). The aim of the present overview is, in a historic perspective, to link some of the pathophysiology of mechanisms related to plaque rupture and following thrombosis to the effects of drug combinations and PCI observed in major clinical trials conducted in patients with STEMI. ⋯ During the last 15 years the optimal antithrombotic treatment of STEMI has developed from a combination of streptokinase and aspirin to the new bolus-teplases combined with LMWH and aspirin. The use of primary PCI may be a better alternative than fibrinolytic therapy, but such a statement needs confirmation in a large comparison between PCI and a quick infusion of modern fibrinolytic agents.
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Scand. Cardiovasc. J. · Jun 2003
Comparative StudyPlatelet function after coronary artery bypass grafting: is there a procoagulant activity after off-pump compared with on-pump surgery?
After off-pump coronary artery bypass (OPCAB) haemostasis might be better preserved compared with on-pump coronary artery bypass grafting (CABG). The aim of this study was to investigate whether this possibly better preserved haemostasis results in a procoagulant activity of the platelets. ⋯ This study has mainly indicated that platelets after OPCAB were more easily activated in the early postoperative period. After CABG with cardiopulmonary bypass we found a temporary platelet dysfunction which seemed to be overcome within the first postoperative day.
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Scand. Cardiovasc. J. · Jun 2003
Comparative StudyPrehospital behaviour of patients admitted with acute coronary syndrome or witnessed cardiac arrest.
To study prehospital behaviour of patients admitted with acute coronary syndrome or witnessed cardiac arrest. ⋯ Patients misinterpret symptoms of acute coronary syndrome and are misguided when calling for medical assistance. Perceiving jeopardy had positive influence on the behaviour. Awareness of therapeutic options influences the decision-making process.
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According to published data, the ability to prevent various hypertension-related events differs between the various antihypertensive drug groups. Although absolute drug effects differ among studies, relative drug effects could be considered constant. We therefore explored the possibility of drawing statistically valid conclusions about the differences in clinical efficacy between various drug groups by doing an overview of published data. ⋯ There is statistically an indisputable difference between ACE inhibitors and calcium antagonists in respect of effects on coronary disease and heart failure when treating hypertensive individuals, ACE inhibitors being more efficacious. There are no differences in the effect on stroke. Moreover, beta-blockers or diuretics are also superior to calcium antagonists in preventing coronary events.