Background: Although studies have examined the incidence of stroke in heart failure(HF), their findings are inconsistent and difficult to interpret because of heterogeneity in study design and population. Although HF ...Background: Although studies have examined the incidence of stroke in heart failure(HF), their findings are inconsistent and difficult to interpret because of heterogeneity in study design and population. Although HF remains a highly fatal disease, the excess mortality imparted from stroke is unknown. Methods: A random sample of cases of HF from 1979 to 1999 was identified and validated according to Framingham criteria. Strokes were identified by screening medical diagnoses and subsequent physician validation. Stroke risk in HF was compared with the risk in the general population with standardized morbidity ratios. Associations between selected characteristics and stroke were examined using proportional hazards regression. Results: The study cohort included 630 persons with incident HF. During a median of 4.3 years of follow-up, 102(16%) experienced an ischemic stroke. Heart failure was associated with a 17.4-fold increased risk for stroke compared with the general population in the first 30 days after HF diagnosis and remained elevated during 5 years of follow-up. Older persons with prior stroke or diabetes were more likely to experience stroke after HF diagnosis. Persons with stroke after HF were 2.31 times more likely to die compared with persons without stroke. Conclusions: In the community, persons with HF have a large increase in the risk for ischemic stroke compared with the general population. Stroke results in a >2-fold increase in mortality. Thus, prevention of stroke has the potential to improve survival among patients with HF, particularly among the elderly and those with diabetes or prior stroke.展开更多
Objective To evaluate the predictive value of SYNTAX Score II （SS-II） for percutaneous coronary intervention （PCI） in octogenarian （≥ 80 years old） undergoing PCI. Methods ＆ Results Data from three consecutive...Objective To evaluate the predictive value of SYNTAX Score II （SS-II） for percutaneous coronary intervention （PCI） in octogenarian （≥ 80 years old） undergoing PCI. Methods ＆ Results Data from three consecutive years of octogenarian undergoing PCI from Ruijin Hospital （Shanghai, China） was retrospectively collected （n = 308）. Follow up clinical data at one year including all cause mortality, cardiac mortality and main adverse cardiovascular and cerebrovascular events （MACCE） were collected. Patients were stratified according to tertiles of SS-II for PCI： SS-II 〈 26 （n = 104）, SS-II： 27-31 （n = 102）, SS-II 〉 31 （n = 102）. After adjustment for confounding factors, SS-II for PCI was an independent risk factors for all cause mortality （odds ratio： 2.77, 95% CI： 1.13-8.06; P = 0.04）. Kaplan-Meier curves showed higher event rates for all cause mortality and cardiac mortality in higher tertile of SS-II for PCI （Log-Rank test P = 0.002 and P = 0.001, respectively）. SSdl for PCI predicted one year mortality in octogenarian population undergoing PCI. Conclusions In octogenarian, SS-II which incorporated clinical variables with angiographic anatomy variable was suitable in risk stratifying and predicting clinical outcomes at one year.展开更多
FDA日前发布了3项最终版本的指导方针，以开拓新途径来提高临床研究及日常使用中药物和生物制品的评估和监管方法。3项指导方针分别为“上市前风险评估”(premarketing risk assessment)、“开发及使用过程中风险最小化行动计划”(devel...FDA日前发布了3项最终版本的指导方针，以开拓新途径来提高临床研究及日常使用中药物和生物制品的评估和监管方法。3项指导方针分别为“上市前风险评估”(premarketing risk assessment)、“开发及使用过程中风险最小化行动计划”(development and use of risk．minimization action plans)和“药物警戒性管理和药物流行学评估规范”(good pharmacovigilance practices and pharmacoepidemiologic assessment)。这些指导方针中描述的附加安全测试、监督和干预能应用在药物临床研究及上市后的管理过程中。展开更多
文摘Background: Although studies have examined the incidence of stroke in heart failure(HF), their findings are inconsistent and difficult to interpret because of heterogeneity in study design and population. Although HF remains a highly fatal disease, the excess mortality imparted from stroke is unknown. Methods: A random sample of cases of HF from 1979 to 1999 was identified and validated according to Framingham criteria. Strokes were identified by screening medical diagnoses and subsequent physician validation. Stroke risk in HF was compared with the risk in the general population with standardized morbidity ratios. Associations between selected characteristics and stroke were examined using proportional hazards regression. Results: The study cohort included 630 persons with incident HF. During a median of 4.3 years of follow-up, 102(16%) experienced an ischemic stroke. Heart failure was associated with a 17.4-fold increased risk for stroke compared with the general population in the first 30 days after HF diagnosis and remained elevated during 5 years of follow-up. Older persons with prior stroke or diabetes were more likely to experience stroke after HF diagnosis. Persons with stroke after HF were 2.31 times more likely to die compared with persons without stroke. Conclusions: In the community, persons with HF have a large increase in the risk for ischemic stroke compared with the general population. Stroke results in a >2-fold increase in mortality. Thus, prevention of stroke has the potential to improve survival among patients with HF, particularly among the elderly and those with diabetes or prior stroke.
文摘Objective To evaluate the predictive value of SYNTAX Score II （SS-II） for percutaneous coronary intervention （PCI） in octogenarian （≥ 80 years old） undergoing PCI. Methods ＆ Results Data from three consecutive years of octogenarian undergoing PCI from Ruijin Hospital （Shanghai, China） was retrospectively collected （n = 308）. Follow up clinical data at one year including all cause mortality, cardiac mortality and main adverse cardiovascular and cerebrovascular events （MACCE） were collected. Patients were stratified according to tertiles of SS-II for PCI： SS-II 〈 26 （n = 104）, SS-II： 27-31 （n = 102）, SS-II 〉 31 （n = 102）. After adjustment for confounding factors, SS-II for PCI was an independent risk factors for all cause mortality （odds ratio： 2.77, 95% CI： 1.13-8.06; P = 0.04）. Kaplan-Meier curves showed higher event rates for all cause mortality and cardiac mortality in higher tertile of SS-II for PCI （Log-Rank test P = 0.002 and P = 0.001, respectively）. SSdl for PCI predicted one year mortality in octogenarian population undergoing PCI. Conclusions In octogenarian, SS-II which incorporated clinical variables with angiographic anatomy variable was suitable in risk stratifying and predicting clinical outcomes at one year.
文摘FDA日前发布了3项最终版本的指导方针，以开拓新途径来提高临床研究及日常使用中药物和生物制品的评估和监管方法。3项指导方针分别为“上市前风险评估”(premarketing risk assessment)、“开发及使用过程中风险最小化行动计划”(development and use of risk．minimization action plans)和“药物警戒性管理和药物流行学评估规范”(good pharmacovigilance practices and pharmacoepidemiologic assessment)。这些指导方针中描述的附加安全测试、监督和干预能应用在药物临床研究及上市后的管理过程中。
