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501. Prognosis after aortic valve replacement with a bioprosthesis: predictions based on meta-analysis and microsimulation.
作者: J P Puvimanasinghe.;E W Steyerberg.;J J Takkenberg.;M J Eijkemans.;L A van Herwerden.;A J Bogers.;J D Habbema.
来源: Circulation. 2001年103卷11期1535-41页
Bioprostheses are widely used as an aortic valve substitute, but knowledge about prognosis is still incomplete. The purpose of this study was to provide insight into the age-related life expectancy and actual risks of reoperation and valve-related events of patients after aortic valve replacement with a porcine bioprosthesis.
502. Increased mortality with oral platelet glycoprotein IIb/IIIa antagonists: a meta-analysis of phase III multicenter randomized trials.
Numerous clinical trials have established the benefits of intravenous glycoprotein IIb/IIIa inhibition in the management of coronary artery disease. In contrast, the recent large-scale, placebo-controlled, randomized trials of the oral glycoprotein IIb/IIIa antagonists have failed to provide commensurate reductions in late composite ischemic end points despite potent inhibition of platelet aggregation.
503. Defining the optimal activated clotting time during percutaneous coronary intervention: aggregate results from 6 randomized, controlled trials.
作者: D P Chew.;D L Bhatt.;A M Lincoff.;D J Moliterno.;S J Brener.;K E Wolski.;E J Topol.
来源: Circulation. 2001年103卷7期961-6页
Unfractionated heparin has been the primary anticoagulant therapy for percutaneous coronary intervention for >20 years. Despite the availability of rapid "point of care" testing, little clinical data defining the optimal level of anticoagulation are available. Furthermore, recent reports have advocated the use of low-dose heparin regimens in the absence of large-scale, well-conducted studies to support this practice.
504. Lipoprotein(a) and coronary heart disease. Meta-analysis of prospective studies.
-Studies of the association between the plasma concentration of lipoprotein(a) [Lp(a)] and coronary heart disease (CHD) have reported apparently conflicting findings. We report a meta-analysis of the prospective studies with at least 1 year of follow-up published before 2000.
505. Lack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years.
作者: D R Thiemann.;J Coresh.;S P Schulman.;G Gerstenblith.;W J Oetgen.;N R Powe.
来源: Circulation. 2000年101卷19期2239-46页
The benefit of intravenous thrombolytic therapy in elderly patients with myocardial infarction is uncertain. There are no randomized trials of thrombolytic efficacy or observational studies of clinical effectiveness that focus specifically on the elderly.
506. Clinical outcomes after ablation and pacing therapy for atrial fibrillation : a meta-analysis.
Radiofrequency ablation of the atrioventricular node and permanent pacing are used for symptomatic relief in patients with medically refractory atrial fibrillation. In this study, meta-analysis was used to clarify clinical outcomes and survival after ablation and pacing therapy using data from the published literature.
507. The athlete's heart. A meta-analysis of cardiac structure and function.
作者: B M Pluim.;A H Zwinderman.;A van der Laarse.;E E van der Wall.
来源: Circulation. 2000年101卷3期336-44页
It has been postulated that depending on the type of exercise performed, 2 different morphological forms of athlete's heart may be distinguished: a strength-trained heart and an endurance-trained heart. Individual studies have not tested this hypothesis satisfactorily.
508. Clinical outcomes of bivalirudin for ischemic heart disease.
作者: D F Kong.;E J Topol.;J A Bittl.;H D White.;P Théroux.;V Hasselblad.;R M Califf.
来源: Circulation. 1999年100卷20期2049-53页
Current treatment strategies for percutaneous coronary revascularization and acute coronary syndromes incorporate thrombin inhibition with either unfractionated or fractionated heparin. The peptide bivalirudin (Hirulog) is a direct thrombin inhibitor whose pharmacological properties differ from those of heparin. We conducted a systematic overview (meta-analysis) to assess the effect of bivalirudin on 4 end points: death, myocardial infarction, major hemorrhage, and the composite of death or infarction.
509. Identification of risk factors in hypertensive patients: contribution of randomized controlled trials through an individual patient database.
作者: F Gueyffier.;J P Boissel.;S Pocock.;F Boutitie.;J Coope.;J Cutler.;T Ekbom.;R Fagard.;L Friedman.;K Kerlikowske.;M Perry.;R Prineas.;E Schron.
来源: Circulation. 1999年100卷18期e88-94页
Predicting individual risk is needed to target preventive interventions toward people with the highest probability of benefit over a given time period. We assessed which prognostic factors should be used in predicting risk for hypertensive patients and in searching for treatment modifiers.
510. Assessment of the treatment effect of enoxaparin for unstable angina/non-Q-wave myocardial infarction. TIMI 11B-ESSENCE meta-analysis.
作者: E M Antman.;M Cohen.;D Radley.;C McCabe.;J Rush.;J Premmereur.;E Braunwald.
来源: Circulation. 1999年100卷15期1602-8页
Two phase III trials of enoxaparin for unstable angina/non-Q-wave myocardial infarction have shown it to be superior to unfractionated heparin for preventing a composite of death and cardiac ischemic events. A prospectively planned meta-analysis was performed to provide a more precise estimate of the effects of enoxaparin on multiple end points.
511. Lipoprotein lipase mutations, plasma lipids and lipoproteins, and risk of ischemic heart disease. A meta-analysis.
We assessed in meta-analyses the effect of the Gly188Glu, Asp9Asn, Asn291Ser, and Ser447Ter substitutions in lipoprotein lipase in the heterozygous state on lipid metabolism and risk of ischemic heart disease (same order used below).
512. Coronary heart disease and iron status: meta-analyses of prospective studies.
Studies of iron status and coronary heart disease (CHD) have yielded conflicting results. In a systematic review ("meta-analysis"), we quantitatively assessed epidemiological associations reported in prospective studies.
513. Reporting risks and benefits of therapy by use of the concepts of unqualified success and unmitigated failure: applications to highly cited trials in cardiovascular medicine.
The NNT (number needed to treat) and NNH (number needed to harm) are useful in conveying the results of clinical trials because they emphasize the effort that must be expended to accomplish a single, tangible outcome. But NNT conveys the effort required to achieve a positive outcome without distinguishing between the presence or absence of treatment-related adverse events. Similarly, NNH conveys harm without accounting for the achievement or lack of achievement of the benefit of therapy. Consequently, a mathematical model was developed to extend the NNT and NNH to represent the effort required to achieve "unqualified success" (NNTUS, treatment success without treatment-induced side effects) and "unmitigated failure" (NNHUF, lack of treatment success with treatment-induced side effects).
514. Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding with cardiac surgery?: a meta-analysis.
作者: J J Munoz.;N J Birkmeyer.;J D Birkmeyer.;G T O'Connor.;L J Dacey.
来源: Circulation. 1999年99卷1期81-9页
Although aprotinin is known to be effective in reducing postoperative hemorrhage after cardiac surgery, epsilon-aminocaproic acid, an alternative antifibrinolytic, is considerably less expensive. Because the results of 3 small randomized clinical trials comparing these 2 agents directly were inconclusive, we performed a meta-analysis to compare the relative effectiveness and adverse-effect profile of these 2 agents against placebo.
515. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease.
作者: D F Kong.;R M Califf.;D P Miller.;D J Moliterno.;H D White.;R A Harrington.;J E Tcheng.;A M Lincoff.;V Hasselblad.;E J Topol.
来源: Circulation. 1998年98卷25期2829-35页
Several platelet glycoprotein (GP) IIb/IIIa receptor antagonists have been evaluated in clinical trials. We conducted a systematic overview (meta-analysis) to assess the effect of these compounds on death, myocardial infarction (MI), and revascularization.
516. Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease: the result of a meta-analysis.
The results of retrospective and prospective case-control studies have clearly established that mild elevations of the plasma homocysteine level are associated with increased risk of coronary, cerebral, and peripheral vascular disease. Recently, a mutation (677C-->T) was identified in the methylenetetrahydrofolate reductase (MTHFR) gene that results in reduced folate-dependent enzyme activity and reduced remethylation of homocysteine to methionine. Mutant homozygotes (TT genotype) constitute approximately 12% of the white population and frequently have mildly elevated circulating homocysteine. Therefore, it seems likely that they would also be at increased risk of vascular disease. A number of studies have investigated this during the past 3 years, and the present article evaluates the results in a meta-analysis.
517. Clinical effects of beta-adrenergic blockade in chronic heart failure: a meta-analysis of double-blind, placebo-controlled, randomized trials.
作者: P Lechat.;M Packer.;S Chalon.;M Cucherat.;T Arab.;J P Boissel.
来源: Circulation. 1998年98卷12期1184-91页
beta-Blockers have improved symptoms and reduced the risk of cardiovascular events in studies of patients with heart failure, but it is unclear which end points are most sensitive to the therapeutic effects of these drugs.
518. Indications for ACE inhibitors in the early treatment of acute myocardial infarction: systematic overview of individual data from 100,000 patients in randomized trials. ACE Inhibitor Myocardial Infarction Collaborative Group.
来源: Circulation. 1998年97卷22期2202-12页
Several large-scale trials have demonstrated improved survival with ACE-inhibitor therapy started during acute myocardial infarction. A systematic overview was conducted to resolve uncertainties regarding time of initiation, time course of effect, and identification of patients in whom the benefits or the risks may be greater.
519. Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis.
作者: A Da Costa.;G Kirkorian.;M Cucherat.;F Delahaye.;P Chevalier.;A Cerisier.;K Isaaz.;P Touboul.
来源: Circulation. 1998年97卷18期1796-801页
Infection remains a serious complication after permanent pacemaker implantation. Antibiotic prophylaxis is frequently prescribed at the time of insertion to reduce its incidence, although results of well-designed, controlled studies are lacking.
520. Insulin and risk of cardiovascular disease: a meta-analysis.
作者: J B Ruige.;W J Assendelft.;J M Dekker.;P J Kostense.;R J Heine.;L M Bouter.
来源: Circulation. 1998年97卷10期996-1001页
Our purposes were to estimate the strength of the longitudinal relationship between hyperinsulinemia and cardiovascular diseases (CVD) from the available literature and to identify study characteristics that modify this relationship.
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