Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Feb 2012
Randomized Controlled Trial Comparative StudyImproved estimation of glomerular filtration rate (GFR) by comparison of eGFRcystatin C and eGFRcreatinine.
GFR-prediction equations based upon cystatin C and creatinine have better diagnostic performance in estimating GFR than equations based upon only one of the two markers. The present work concerns in what way a comparison between separate estimations of GFR based upon cystatin C (eGFR(cystatin C)) or creatinine (eGFR(creatinine)) can be used to evaluate the diagnostic performance of a combined cystatin C- and creatinine-based estimation of GFR. ⋯ Comparison of the agreement between eGFR(cystatin C) and eGFR(creatinine) can be used to evaluate the diagnostic performance of combined cystatin C- and creatinine-based estimations of GFR. If 'threshold values' for discordance are exceeded, it must be considered whether the clinical context requires the use of an invasive gold standard method to measure GFR. In some clinical contexts either creatinine or cystatin C are known to be invalidated as markers of GFR and in these situations the use of only the cystatin C- or the creatinine-based GFR estimate should be considered when the 'threshold values' are exceeded.
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Scand. J. Clin. Lab. Invest. · Jan 2009
Randomized Controlled TrialEffects of aldosterone blockade on left ventricular function and clinical status during acute myocardial infarction.
Heart failure is frequently a serious complication of acute myocardial infarction (AMI). ACE inhibitors, Angiotensin II receptor blockers, beta-blockers and aldosterone receptor blockers have been shown to improve outcomes in this setting. This study aimed to determine the effect of spironolactone on the frequency of clinical heart failure, mortality, rehospitalization and left ventricular functions determined by echocardiography. ⋯ In concordance with these findings, the ejection fraction was slightly higher in Group A than in Group B, although this was not statistically significant (47% versus 44%). This trend continued during a 6-month follow-up after randomization. Our findings suggest that early administration of aldosterone blockers provides additional benefits after AMI, reducing the incidence of post-MI angina pectoris and rhythm and conduction disturbances.
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Scand. J. Clin. Lab. Invest. · Jul 1997
Randomized Controlled Trial Comparative Study Clinical TrialEffect of bolus injection versus continuous infusion of furosemide on diuresis and neurohormonal activation in patients with severe congestive heart failure.
Previous studies have demonstrated that continuous infusion of furosemide results in increased diuresis and natriuresis compared with bolus administration of the drug in patients with severe heart failure. We reasoned that continuous infusion of furosemide caused less activation of neurohumoral mechanisms, since other studies have shown that bolus administration of furosemide may activate this system. We therefore tested the hypothesis that continuous administration of furosemide would increase water and sodium excretion due to less activation of neurohormones. ⋯ Neither regimens of furosemide caused any further significant changes in neurohumoral response except that pro-ANF decreased more during the first 8 h after bolus administration compared to continuous infusion. This study has demonstrated that bolus administration of furosemide in conventional doses is equally effective as continuous intravenous infusion in patients with severe heart failure. This may be due to maximal neurohormonal activation in severe heart failure (NYHA III-IV) which could not be further activated by bolus administration.
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Scand. J. Clin. Lab. Invest. · Dec 1976
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic effects of two cardioselective beta-adrenoceptive antagonists, metoprolol and H 87/07, in coronary insufficiency.
Nineteen patients with ischemic heart disease were randomized into two groups and received either metoprolol or H 87/07. Heart catheterization was performed, and the groups were studied at rest and during exercise--before and after intravenous drug administration. During work metoprolol gave a statistically significant reduction in left ventricular work (expressed as pressure-rate product) of about 20%, mainly depending on a reduction in heart rate. ⋯ For H 87/07 no significant changes were found in the corresponding variables. This seems, however, to depend on an inadequate dosage, since not even the heart rate during work was significantly reduced. In conclusion, in the doses used metoprolol has been shown to be a potent beta-adrenoceptive antagonist in contrast to H 87/07.