17.0%±4.1,p=0.01.There was no significant GLS or RLS improvement in C Group patients. GLS in STEMI patientsConclusions: After STEMI and ventricular dysfunction, only patients treated with G-CSF showed a significant improvement of EF at 6 months.Moreover, only in these patients, 2D GLS improved at 6 months.This effect was observed in remote areas, too, maybe showing long lasting and diffuse effects of the cytokine.
Background: Studies have shown that obese patients with atrial fibrillation (AF) have a favorable prognosis compared to those with a lower body mass index (BMI); however, the underlying cause for t...
Background— Studies of recurrent or subsequent disease events may be susceptible to bias caused by selection of subjects who both experience and survive the primary indexing event. Currently, the magnitude of any selection bias, particularly for subsequent time-to-event analysis in genetic association studies, is unknown. Methods and Results— We used empirically inspired simulation studies to explore the impact of selection bias on the marginal hazard ratio for risk of subsequent events among those with established coronary heart disease. The extent of selection bias was determined by the magnitudes of genetic and nongenetic effects on the indexing (first) coronary heart disease event. Unless the genetic hazard ratio was unrealistically large (>1.6 per allele) and assuming the sum of all nongenetic hazard ratios was <10, bias was usually <10% (downward toward the null). Despite the low bias, the probability that a confidence interval included the true effect decreased (undercoverage) with increasing sample size because of increasing precision. Importantly, false-positive rates were not affected by selection bias. Conclusions— In most empirical settings, selection bias is expected to have a limited impact on genetic effect estimates of subsequent event risk. Nevertheless, because of undercoverage increasing with sample size, most confidence intervals will be over precise (not wide enough). When there is no effect modification by history of coronary heart disease, the false-positive rates of association tests will be close to nominal.
Purpose: We aimed to study the relationship between Bleeding Academic Research Consortium (BARC)-graded events and mortality in the TRACER trial, which randomized 12,944 patients with non–ST-segment elevation acute coronary syndromes (NSTE ACS) to vorapaxar or placebo. Methods: In this analysis from the TRACER trial data, all non-coronary artery bypass graft (CABG)-related bleeding events were reclassified using the BARC bleeding scale, using data from clinical events committee adjudication. The association between BARC hierarchical grading and death from all causes was assessed. Results: During the median follow-up of 502 days post randomization (interquartile range, 349–667), BARC-grade ≥2 and BARC-grade ≥3 bleeding events occurred in 1803 (14.0%) and 572 (4.4%) of 12,887 patients, respectively. The rate of death from all causes in the first year 1) following the first BARC-class ≥2 bleeding event was 9.8%, and 2) following the first BARC-class ≥3 bleeding event was 21.0%. There was a gradual increase in post randomization mortality with an increase in the severity of bleeding. The adjusted estimated hazard of fatality for intracranial hemorrhage (3c) was at least 6 times higher than BARC classes 3a and 3b. Table 1. Association between BARC bleeding classification and mortality post randomization *Estimated by Cox regression model of all-cause mortality with BARC bleeding as time-dependent covariate. Conclusions: Following an NSTE ACS episode, there was a graded association between bleeding severity according to the BARC scale and subsequent mortality.
BackgroundThe purpose of this study was to assess the independent contribution of left bundle branch block (LBBB) on long-term mortality in a large cohort with symptomatic heart failure (HF) requiring hospitalization.
Background: Variation in patient characteristics and medical practice may influence outcomes at a regional level. We sought to describe differences in demographics, practice patterns, and outcomes of patients enrolled in the ARISTOTLE trial by region of the world (North America [NA], Latin America [LA], Europe, Asia Pacific [AP]). Methods: Baseline clinical characteristics, medication use, procedures, and clinical outcomes were assessed in the 18201 patients with AF included in the ARISTOTLE trial. Results: Patients were younger in AP and older in NA. Women were more commonly included in LA. Coronary artery disease was more prevalent in Europe with the lowest prevalence being in LA. AP had highest rate of prior stroke and renal impairment (25%). Use of amiodarone and digoxin were higher in LA. More than 50% of patients in NA were taking ≥9 concomitant drugs at randomization, compared with only 10% in LA. Temporary discontinuation of study drug was highest in NA, along with an increased rate of procedures ...
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