American journal of cardiovascular drugs : drugs, devices, and other interventions
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Am J Cardiovasc Drugs · Mar 2021
Meta AnalysisEfficacy and Safety of Long-Term Oral Bosentan in Different Types of Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis.
This systematic review and meta-analysis was conducted to identify if long-term bosentan is an effective and safe treatment for pulmonary arterial hypertension (PAH) regardless of type, including idiopathic PAH (IPAH), and PAH associated with congenital heart disease (APAH-CHD), connective tissue disease (APAH-CTD), and human immunodeficiency virus (APAH-HIV). ⋯ In this systematic review and meta-analysis, long-term administration of oral bosentan has been identified as a well-tolerated and effective agent in different types of PAH. In addition, we conclude that long-term oral bosentan should be considered for patients with CTD to achieve a satisfactory exercise capacity, and for those with APAH-HIV to improve survivals, where more attention on adverse events is required.
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Am J Cardiovasc Drugs · Apr 2020
Meta Analysis Comparative StudyNon-vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation and Liver Disease: A Meta-Analysis and Systematic Review.
The effect of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) and liver disease remains largely unresolved. Therefore, we performed a meta-analysis to compare the efficacy and safety of NOACs with warfarin in this population. ⋯ Based on current publications, the use of NOACs is at least non-inferior to warfarin in patients with AF and liver disease.
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Am J Cardiovasc Drugs · Feb 2016
Review Meta Analysis Comparative StudyOutcomes After Cardioversion in Atrial Fibrillation Patients Treated with Non-Vitamin K Antagonist Oral Anticoagulants (NOACs): Insights from a Meta-Analysis.
There are limited data on outcomes following cardioversion in atrial fibrillation (AF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). A meta-analysis was performed to evaluate the efficacy and safety of NOACs in patients with AF undergoing cardioversion. ⋯ Data from patients enrolled in RCTs, showed that NOACs are effective and safe for AF patients undergoing cardioversion.
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Am J Cardiovasc Drugs · Oct 2013
Review Meta Analysis Comparative StudyUltrafiltration versus intravenous diuretic therapy to treat acute heart failure: a systematic review.
Patients with decompensated heart failure frequently present with volume overload, which is conventionally treated with diuretics. These drugs have been associated with several adverse effects, including increased mortality, leading some clinicians to propose ultrafiltration as a safe alternative to remove sodium and water. ⋯ The available evidence suggests that early ultrafiltration is safe and effective for patients with hypervolemic acute heart failure. It allows greater fluid removal and weight loss by 48 h than do intravenous diuretics, with no significant increase in adverse effects.
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Am J Cardiovasc Drugs · Feb 2012
Review Meta AnalysisPharmacologic prevention of microvascular and macrovascular complications in diabetes mellitus: implications of the results of recent clinical trials in type 2 diabetes.
Observational epidemiologic data indicate that lower blood glucose levels, blood pressure (BP), and lipid parameters are associated with a lower incidence of micro- and macrovascular complications in people with diabetes. While no threshold for this effect is discernible in these observational studies, intervention studies do not mirror this finding. The earliest glycemia target study in type 2 diabetes mellitus, UKPDS, demonstrated unequivocal benefits of tight glucose control on microvascular complications, but needed a prolonged follow-up to demonstrate a benefit on macrovascular outcomes and mortality. ⋯ There is a significant risk of major hypoglycemia with this approach, thereby probably limiting its utility to younger patients with new-onset disease. Similarly, lowering systolic BP below 120 mmHg in high CV risk people with diabetes is associated with significant excess adverse events, limiting the utility of such an intervention. However, a clear benefit, which is also cost effective, is observed with strategies for multiple risk-factor control, which should be universally adopted in clinical practice.