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Randomized Clinical Trial of Aspirin and Simvastatin for Pulmonary Arterial Hypertension


Circulation, 05/24/2011  Clinical Article

Kawut SM et al. – Neither aspirin nor simvastatin had a significant effect on the 6–minute walk distance, although patients randomized to simvastatin tended to have a lower 6–minute walk distance at 6 months. These results do not support the routine treatment of patients with PAH with these medications.

  • A randomized, double–blind, placebo–controlled
  • 2x2 factorial clinical trial of aspirin and simvastatin in patients with PAH receiving background therapy at 4 centers
  • A total of 92 patients with PAH were to be randomized to aspirin 81 mg or matching placebo and simvastatin 40 mg or matching placebo
  • Sixty–five subjects had been randomized when the trial was terminated by the Data Safety and Monitoring Board after an interim analysis showed futility in reaching the primary end point for simvastatin
  • The primary outcome was 6–minute walk distance at 6 months
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Acute coronary syndromes in young patients: Presentation, treatment and outcome


International Journal of Cardiology, 05/03/2011  Clinical Article

Schoenenberger AW et al. - Young patients with Acute coronary syndromes (ACS) differed from older patients in that the younger often presented with ST-segment elevation myocardial infarction (STEMI), received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.

  • In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008.
  • ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).
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Cost Effectiveness of Warfarin Versus Aspirin in Patients Older Than 75 Years With Atrial Fibrillation


Stroke, 04/25/2011  Clinical Article

Jowett S et al. – Warfarin is cost–effective compared with aspirin in atrial fibrillation patients age ≥75 years. These data support the anticoagulant therapy option in this high–risk patient population. However, the small differences in costs and effects indicate the importance of exploring patient preferences.

  • An economic evaluation was conducted alongside a randomized, controlled trial; 973 patients ≥75 years of age with atrial fibrillation were recruited from primary care and randomly assigned to either take warfarin or aspirin.
  • Follow-up was for a mean of 2.7 years. Costs of thrombotic and hemorrhagic events, anticoagulation clinic visits, and primary care utilization were determined.
  • Clinical benefits were expressed in terms of a primary event avoided: fatal/nonfatal disabling stroke, intracranial hemorrhage, or systemic embolism.
  • A cost-utility analysis was performed using quality-adjusted life years as the benefit measure.
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Clinical observation on acupuncture for migraine


Journal of Acupuncture and Tuina Science, 04/22/2011  Clinical Article

Dai M et al. – Acupuncture can effectively alleviate the pain of migraine sufferers and exert a two–way regulation on the cerebral blood flow.

  • Forty cases were randomly allocated to a treatment group and a control group, 20 cases in each group.
  • Cases in the treatment group were treated with acupuncture, while cases in the control group were treated with oral Sibelium.
  • After that, the changes of cerebral blood flow were observed before and after treatment.
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High risk of cardiovascular disease in iron overload patients


European Journal of Clinical Investigation, 04/13/2011

Meroño T et al. – Iron overload (IO) patients presented not only insulin resistance but also metabolic alterations that were related to elevated iron stores and are associated with high risk of cardiovascular disease.

  • Twenty male patients with IO were compared with 20 sex– and age–matched controls.
  • General biochemical parameters, lipoprotein profile, and activities of paraoxonase 1, employing two substrates, paraoxon (PON) and phenylacetate (ARE), lipoprotein–associated phospholipase A2 (Lp–PLA2) and CETP were determined.
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Predictors of New-Onset Diabetes in Patients Treated With Atorvastatin


JACC - Journal of the American College of Cardiology, 03/30/2011  Clinical Article

Waters DD et al. - High-dose atorvastatin treatment compared with placebo in the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial is associated with a slightly increased risk of new-onset type 2 diabetes mellitus (T2DM). Baseline fasting glucose level and features of the metabolic syndrome are predictive of new-onset T2DM across the 3 trials.

  • A standard definition of diabetes and excluded patients with prevalent diabetes at baseline was used.
  • Baseline predictors of new-onset T2DM and compared the event rates in patients with and without new-onset T2DM was identified.
  • In the TNT (Treating to New Targets) trial, 351 of 3,798 patients randomized to more

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Hypovitaminosis D as a risk factor of hip fracture severity


Osteoporosis International, 03/16/2011  Clinical Article

Larrosa M et al. – In a cross-sectional study including 324 patients older than 65 years admitted to our hospital for osteoporotic hip fracture, the authors found that those patients with a more severe vitamin D deficiency had more severe osteoporotic hip fractures.

  • Cross-sectional study including consecutive individuals over 65 admitted to hospital for osteoporotic hip fracture over year
  • Demographic data, fracture type, comorbidities, history of osteoporosis, functional capacity, nutritional status and vitamin D storage evaluated
  • Included 324 patients (83±7years, 80% women) more

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Methotrexate versus leflunomide in rheumatoid arthritis: What is new in 2011?


Current Opinion in Rheumatology, 03/15/2011  Clinical Article

AuthorLastNameFI et al. – Leflunomide (LEF) offers an alternative with comparable efficacy to methotrexate ( MTX) as both monotherapy and, as preliminary data suggest, in combination with certain biologics agents. Addition of LEF to MTX in rheumatoid arthritis patients who have failed MTX monotherapy has added therapeutic benefit. Safety data on LEF compared to MTX are less conclusive. All patients on LEF, and particularly those on combined LEF+MTX, should be monitored closely for hepatotoxicity.

  • Reviewed recent studies
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Mineral metabolism abnormalities and vitamin D receptor activation in cardiorenal syndromes


Heart Failure Reviews, 03/08/2011  Clinical Article

Ronco C et al. – Administration of calcitriol increases serum calcium levels and reduces parathyroid hormone (PTH) levels, and is associated with elevated serum levels of calcium–phosphorus product. The compounds that selectively activate vitamin D receptors, potentially reducing calcium × phosphate toxicity, are likely to enhance read more

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Vitamin D and Depression


Journal of Psychosocial Nursing and Mental Health Services, 02/10/2011

Howland RH – Vitamin D is an essential nutrient proven to be important for bone health. It has other physiological functions, and there are plausible reasons for investigating vitamin D in depressive disorders. Some cross–sectional clinical and epidemiologic studies, but not all studies, have found that read more

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