Current Controlled Trials in Cardiovascular Medicine最新文献_第3页

Elevated levels of matrix metalloprotein-3 in patients with coronary aneurysm: A case control study. 冠状动脉瘤患者基质金属蛋白-3水平升高:一项病例对照研究。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-10-13 DOI: 10.1186/1468-6708-5-10

Istemihan Tengiz, Ertugrul Ercan, Emil Aliyev, Cevad Sekuri, Can Duman, Imre Altuglu

{"title":"Elevated levels of matrix metalloprotein-3 in patients with coronary aneurysm: A case control study.","authors":"Istemihan Tengiz, Ertugrul Ercan, Emil Aliyev, Cevad Sekuri, Can Duman, Imre Altuglu","doi":"10.1186/1468-6708-5-10","DOIUrl":"https://doi.org/10.1186/1468-6708-5-10","url":null,"abstract":"BACKGROUND: Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of arterial aneurysms through increased proteolysis of extracellular matrix proteins. Increased proteolysis due to elevated matrix degrading enzyme activity in the arterial wall may act as a susceptibility factor for the development of coronary aneurysms. The aim of this study was to investigate the association between MMPs and presence of coronary aneurysms. METHODS: Thirty patients with aneurysmal coronary artery disease and stable angina were enrolled into study (Group 1). Fourteen coronary artery disease patients with stable angina were selected as control group (Group 2). MMP-1, MMP-3 and C-reactive protein (CRP) were measured in peripheral venous blood and matched between the groups. RESULTS: Serum MMP-3 level was higher in patients with aneurismal coronary artery disease compared to the control group (20.23 +/- 14.68 vs 11.45 +/- 6.55 ng/ml, p = 0.039). Serum MMP-1 (13.63 +/- 7.73 vs 12.15 +/- 6.27 ng/ml, p = 0.52) and CRP levels (4.78 +/- 1.47 vs 4.05 +/- 1.53 mg/l, p = 0.13) were not significantly different between the groups. CONCLUSION: MMPs can cause arterial wall destruction. MMP-3 may play role in the pathogenesis of coronary aneurysm development through increased proteolysis of extracellular matrix proteins.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":" ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2004-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1468-6708-5-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40917697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A novel approach to treatment of hypertension in diabetic patients - a multicenter, double-blind, randomized study comparing the efficacy of combination therapy of Eprosartan versus Ramipril with low-dose Hydrochlorothiazide and Moxonidine on blood pressure levels in patients with hypertension and associated diabetes mellitus type 2 - rationale and design [ISRCTN55725285]. 治疗糖尿病患者高血压的新方法--一项多中心、双盲、随机研究，比较依普沙坦与雷米普利、小剂量氢氯噻嗪和莫索尼定联合疗法对高血压合并 2 型糖尿病患者血压水平的疗效--原理与设计 [ISRCTN55725285]。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-10-01 DOI: 10.1186/1468-6708-5-9

Cornel Pater, Deepak Bhatnagar, Jean-Pascal Berrou, Joachim Luszick, Katrin Beckmann

{"title":"A novel approach to treatment of hypertension in diabetic patients - a multicenter, double-blind, randomized study comparing the efficacy of combination therapy of Eprosartan versus Ramipril with low-dose Hydrochlorothiazide and Moxonidine on blood pressure levels in patients with hypertension and associated diabetes mellitus type 2 - rationale and design [ISRCTN55725285].","authors":"Cornel Pater, Deepak Bhatnagar, Jean-Pascal Berrou, Joachim Luszick, Katrin Beckmann","doi":"10.1186/1468-6708-5-9","DOIUrl":"10.1186/1468-6708-5-9","url":null,"abstract":"Hypertension and diabetes mellitus are closely interrelated and coexist in as many as two-thirds of patients with type 2 diabetes. The consequent risk of such an association is an accelerated development of atherosclerotic cardiovascular disease and nephropathy complications.In choosing an antihypertensive agent, effectiveness needs to be accompanied by favourable metabolic, cardioprotective, and nephroprotective properties. Given the multifactorial nature of hypertension, the approach that has gained widespread agreement is treatment with more than one agent. Agents with different mechanisms of action increase antihypertensive efficacy because of synergistic impacts on the cardiovascular system. Combination therapy allows the use of lower doses of each antihypertensive agent which accounts for the excellent tolerability of combination products.The aim of the present study is to quantify the efficacy of combination therapy of Eprosartan 600 mg respectively Ramipril 5 mg with low-dose Hydrochlorothiazide and Moxonidine on blood pressure levels in patients with essential hypertension and associated diabetes mellitus type 2.The use of monotherapy (Eprosartan or Ramipril) followed by addition of low-dose Hydrochlorothiazide as second agent and of Moxonidine as a third agent will be individualized to the severity of hypertension in the particular patient and to his/her degree of response to current treatment.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":" ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40900680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Equivalence and noninferiority trials - are they viable alternatives for registration of new drugs? (III). 等效性和非劣效性试验——它们是新药注册的可行选择吗?(3)。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-08-17 DOI: 10.1186/1468-6708-5-8

Cornel Pater

引用次数: 21

Individualizing therapy - in search of approaches to maximize the benefit of drug treatment (II). 个体化治疗-寻求药物治疗效益最大化的方法(II)。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-08-16 DOI: 10.1186/1468-6708-5-7

Cornel Pater

引用次数: 1

Balancing commercial and public interests. 平衡商业和公共利益。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-07-07 DOI: 10.1186/1468-6708-5-6

Curt D Furberg, Mark A Hall, Mary Ann Sevick

{"title":"Balancing commercial and public interests.","authors":"Curt D Furberg, Mark A Hall, Mary Ann Sevick","doi":"10.1186/1468-6708-5-6","DOIUrl":"https://doi.org/10.1186/1468-6708-5-6","url":null,"abstract":"Alarge number of randomized clinical trials with important health outcomes are completed each year. Those with favorable findings are typically reported and published rapidly, while the publication of those with unfavorable results is often delayed or given a positive \"spin.\" This observation applies primarily to industry-sponsored trials. Our objectives are to discuss the responsibility of pharmaceutical firms to the public with respect to timely, complete, and unbiased information from all randomized clinical trials and to propose solutions for improvements. We believe that in addition to financial obligations to their shareholders, pharmaceutical companies have social responsibilities to the public and to health care providers. However, private markets do not reward or compel optimal disclosure of drug safety or inferiority information on a voluntary basis.A problem which has not previously been identified relates to non-comparability of drugs. A case report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) illustrates how public interests may be violated due to failure to inform about drug inferiority. The current system for dissemination of relevant medical information could be improved if all involved parties collaborated fully. However, full disclosure of trial results is unlikely when research results are unfavorable to the firm. We conclude that expanded government regulations will be required for a satisfactory solution to the problem.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":"5 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2004-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1468-6708-5-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24603090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Informative noncompliance in endpoint trials. 终点试验中的信息不依从性。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-07-03 DOI: 10.1186/1468-6708-5-5

Steven M Snapinn, Qi Jiang, Boris Iglewicz

引用次数: 18

Current trends in the cardiovascular clinical trial arena (I). 心血管临床试验领域的当前趋势(一)。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-06-04 DOI: 10.1186/1468-6708-5-4

Cornel Pater

{"title":"Current trends in the cardiovascular clinical trial arena (I).","authors":"Cornel Pater","doi":"10.1186/1468-6708-5-4","DOIUrl":"10.1186/1468-6708-5-4","url":null,"abstract":"The existence of effective therapies for most cardiovascular disease states, coupled with increased requirements that potential benefits of new drugs be evaluated on clinical rather than surrogate endpoints, makes it increasingly difficult to substantiate any incremental improvements in efficacy that these new drugs might offer. Compounding the problem is the highly controversial issue of comparing new agents with placebos rather than active pharmaceuticals in drug efficacy trials. Despite the recent consensus that placebos may be used ethically in well-defined, justifiable circumstances, the problem persists, in part because of increased scrutiny by ethics committees but also because of considerable lingering disagreement regarding the propriety and scientific value of placebo-controlled trials (and trials of antihypertensive drugs in particular).The disagreement also substantially affects the most viable alternative to placebo-controlled trials: actively controlled equivalence/noninferiority trials. To a great extent, this situation was prompted by numerous previous trials of this type that were marked by fundamental methodological flaws and consequent false claims, inconsistencies, and potential harm to patients.As the development and use of generic drugs continue to escalate, along with concurrent pressure to control medical costs by substituting less-expensive therapies for established ones, any claim that a new drug, intervention, or therapy is \"equivalent\" to another should not be accepted without close scrutiny. Adherence to proper methods in conducting studies of equivalence will help investigators to avoid false claims and inconsistencies. These matters will be addressed in the third article of this three-part series.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":"5 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2004-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC437651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24551793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticoagulation for non-valvular atrial aibrillation - towards a new beginning with ximelagatran. 非瓣膜性心房颤动的抗凝治疗--迈向西美加群的新起点。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-04-22 DOI: 10.1186/1468-6708-5-3

Christopher J Boos, Ranjit S More

{"title":"Anticoagulation for non-valvular atrial aibrillation - towards a new beginning with ximelagatran.","authors":"Christopher J Boos, Ranjit S More","doi":"10.1186/1468-6708-5-3","DOIUrl":"10.1186/1468-6708-5-3","url":null,"abstract":"OBJECTIVES: Ximelagatran is a novel oral direct thrombin inhibitor. It has favorable pharmacodynamic properties, with a broad therapeutic range without the need for anticoagulation monitoring. We aimed to discover whether ximelagatran offers a genuine future replacement to warfarin for patients in persistent atrial fibrillation (AF). MATERIALS AND METHODS: We provide an evidence-based review of the relative merits and disadvantages of warfarin and aspirin. We subsequently present an overview of the evidence for the utility of ximelagatran in the treatment of AF. RESULTS: Adjusted dose warfarin is recommended over aspirin for patients in AF at high risk of future stroke. Some of this benefit is partially offset by the higher bleeding risks associated with warfarin therapy. The SPORTIF III and V studies have shown that ximelagatran is not inferior to warfarin in the prevention of all strokes in patients with AF (both persistent and paroxysmal). This benefit was partially offset by the finding of a significant elevation of liver transaminases (>3 x normal) in 6% of patients. CONCLUSIONS: Current data would suggest that ximelagatran might represent a future alternative to warfarin. The lack of need for anticoagulant monitoring has been partially offset by a need for regular monitoring of liver function. Further data from randomized clinical trials is clearly needed.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":"5 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2004-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC420263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24485466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unanswered ethical and scientific questions for trials of invasive interventions for coronary disease: The case of single vessel disease. 冠状动脉疾病侵入性干预试验中未解决的伦理和科学问题:单血管疾病的病例。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-03-29 DOI: 10.1186/1468-6708-5-2

Samer Jabbour, Shmuel Ravid, Bernard Lown

引用次数: 3

Effects of oral anticoagulation with various INR levels in deep vein thrombosis cases. 不同INR水平口服抗凝治疗深静脉血栓的疗效。

Current Controlled Trials in Cardiovascular Medicine Pub Date : 2004-02-18 DOI: 10.1186/1468-6708-5-1

Ufuk Yetkin, Ozalp Karabay, Hakan Onol

{"title":"Effects of oral anticoagulation with various INR levels in deep vein thrombosis cases.","authors":"Ufuk Yetkin, Ozalp Karabay, Hakan Onol","doi":"10.1186/1468-6708-5-1","DOIUrl":"https://doi.org/10.1186/1468-6708-5-1","url":null,"abstract":"AIM: In order to avoid the complications associated with thromboembolic disease, patients with this condition typically are placed on long-term anticoagulant therapy. This report compares bleeding complications in this patient population by level of achieved INR. MATERIALS AND METHODS: During the 6-year period between January 1997 and January 2003, 386 patients with venous thromboembolism of the lower extremities were admitted to the Cardiovascular Surgery Outpatient Clinic of Alsancak State Hospital. Of the 386 patients, 198 (51.2%) were women, and the average age was 52.3 years. All diagnoses of venous thromboembolism were confirmed by means of Doppler ultrasonography. Further investigation showed occult neoplasms in 22 (5.6%) of the cases. We excluded the patients with occult disease, and the remaining 364 constituted our study population. RESULTS: Oral anticoagulation was standardized at 6 months' duration in all cases. We divided the patients into two groups. Group I consisted of 192 patients (52.7%) with INR values between 1.9 and 2.5; Group II comprised 172 patients with INR values between 2.6 and 3.5. Complications in each group were assessed and compared. The minor hemorrhage rate was 1.04% in Group I and 4.06% in Group II. The major hemorrhage rate was also 1.04% in Group I and was 6.3% in Group II. We determined that the complication rates for both minor and major hemorrhage were significant in patients with INR values above 2.5. CONCLUSION: Oral anticoagulation must be followed closely in patients with venous thromboembolism. Higher INR levels are associated with significant increases in hemorrhage and associated complications. INR values of 2.0 to 2.5 are sufficient for long-term anticoagulant therapy, ensuring ideal anticoagulation levels and minimizing the complication rate.","PeriodicalId":53230,"journal":{"name":"Current Controlled Trials in Cardiovascular Medicine","volume":"5 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2004-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1468-6708-5-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24403599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8