Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Jun 1998
Multicenter Study[Cardiac abscess in infectious endocarditis. A multicenter study apropos of 233 cases. The Working Group on Valvulopathy of the French Society of Cardiology].
The aim of this retrospective multicenter study was to determine present characteristics of infectious endocarditis complicated by abscess and to identifying predictive factors of mortality. The files of 233 patients with infectious endocarditis complicated by perivalvular abscesses between January 1989 and December 1993 were analysed. Two hundred and thirteen patients underwent medico-surgical treatment (175 aortic and 38 mitral abscesses) and 20 patients underwent medical treatment alone (17 aortic and 3 mitral abscesses). ⋯ The survival rate three months after surgery was 75 +/- 10% and 59 +/- 11% at 27 months. An age over 65, staphylococcal infection, uncontrolled infection, circumferential abscess and fistulisation were independent predictive factors of global mortality (the first month and after). The mortality rate in unoperated patients was 40%: cardiac failure and fistulisation of the abscess detected by echocardiography were predictive factors of mortality on univariate analysis.
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Arch Mal Coeur Vaiss · Aug 1997
Randomized Controlled Trial Multicenter Study Clinical Trial[Isolated systolic hypertension and cognitive function in the aged. Experience of the Syst-Eur study].
To determinate cognitive status and its correlates in older patients with isolated systolic hypertension. ⋯ In a European cohort of 2225 patients over 60 years of age with isolated systolic hypertension, the level of cognitive functions evaluated with the MMSE decreases with advancing age or lesser educational level. It also decreases with higher systolic blood pressure or lower diastolic blood pressure. The influence of antihypertensive therapy on cognitive status will be prospectively evaluated in Syst-Eur Vascular Dementia Project.
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Arch Mal Coeur Vaiss · Feb 1990
Randomized Controlled Trial Multicenter Study Clinical Trial[Study of survival using anistreplase (Eminase)].
Thrombolytic therapy has been one of the most important advances in the field of cardiovascular medicine. Several agents are available and research is continuing to develop new effective thrombolytics with a rapid onset of action. ⋯ Survival is certainly the parameter of choice for assessing any thrombolytic protocol. The aim of this paper is therefore to review the results of survival studies with Eminase, one of the new thrombolytic agents used in the treatment of acute myocardial infarction.
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Arch Mal Coeur Vaiss · Oct 1989
Review Multicenter Study Clinical Trial[Effects of thrombolytic treatments on the mortality of myocardial infarction. Characteristics of large-scale trials, main results].
The characteristic features and principal results of the 5 large-scale randomised therapeutic trials (GISSI, ISIS 2, ASSET, AIMS, ISAM), each including over 1000 patients, designed to evaluate the effects of thrombolysis on mortality in myocardial infarction, are reviewed. The methodologies are very different, which prevents comparison of results. The thrombolytic therapy significantly reduced hospital mortality in all the trials except ISAM. ⋯ The tolerance was satisfactory, the frequency of complications being comparable in all the trials. The association of aspirin therapy significantly reduced mortality and occurrence of myocardial infarction in the ISIS 2 trial and would seem to be therefore a recommended association with streptokinase and probably with other thrombolytic drugs. Other trials are needed to compare the efficacy of the different thrombolytic agents in reducing patient mortality.