Impacts of Clinical Pharmacist Intervention on the Secondary Prevention of Coronary Heart Disease: A Randomized Controlled Clinical Study

This study aimed to investigate the impact of clinical pharmacist intervention on the prognosis of acute coronary syndrome (ACS) in Chinese patients with CHD. Two hundred and forty patients who had ACS were recruited. Participants were randomly assigned to the intervention group (n = 120) or the control group (n = 120). The intervention group received a medication assessment and education by the clinical pharmacist at discharge and telephone follow-ups at 1 week and 1 and 3 months after discharge. The control group received usual care. The primary outcomes of this study were the proportion of patients who had major adverse cardiovascular events (MACEs), including mortality, nonfatal myocardial infarction (MI), stroke, and unplanned cardiac-related rehospitalizations within 6 and 12 months after hospital discharge. Secondary outcome was self-reported medication adherence to evidence-based medications for CHD (antiplatelets, statins, β-blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). Of 240 enrolled patients, 238 (98.3%) completed 6-month follow-up, and 235 (97.9%) completed 12-month follow-up. There were no significant differences between intervention and control groups in the percentages of patients who incurred MACEs within the 6-month follow-up (3.3% vs 7.6%, respectively, P = 0.145) or 12-month follow-up (10.9% vs 12.1%, respectively, P = 0.783). Significant improvements were found in the prescribing rates of β-blockers an...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research

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Source: OnMedica Latest News - Category: UK Health Source Type: news
Publication date: Available online 1 July 2019Source: The Lancet Diabetes &EndocrinologyAuthor(s): Kausik K Ray, Helen M Colhoun, Michael Szarek, Marie Baccara-Dinet, Deepak L Bhatt, Vera A Bittner, Andrzej J Budaj, Rafael Diaz, Shaun G Goodman, Corinne Hanotin, Robert A Harrington, J Wouter Jukema, Virginie Loizeau, Renato D Lopes, Angèle Moryusef, Jan Murin, Robert Pordy, Arsen D Ristic, Matthew T Roe, José TuñónSummaryBackgroundAfter acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1·4–1·...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
Authors: Alves-Ferreira J, Rocha-Neves J, Dias-Neto M, F Braga S Abstract Objetives: Carotid endarterectomy (CEA) is an established treatment for carotid stenosis (CS). However, this procedure is not risk-free and it is insufficient to control disseminated atherosclerosis. Our aim was to determine long-term cardiovascular (CV) morbidity and mortality after CEA and identify associated risk predictors. DESIGN: Consecutive cohorts of CEAs performed between 2010-2018 in two Portuguese hospitals were retrospectively analysed. The major end-points were acute myocardial infarction (AMI), stroke, all-cause death and ma...
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
This study determine the relative treatment effects of NST on fatal and nonfatal CV events among statin-treated patients. Methods A network meta-analysis based on a systematic review of randomized controlled trials (RCTs) comparing non-statin lipid-modifying agents among statin-treated patients was performed. PubMed, EMBASE, CENTRAL, and Clinicaltrial.gov were searched up to April 10, 2018. The primary outcomes were CV and all-cause mortalities. Secondary CV outcomes were coronary heart disease (CHD) death, non-fatal myocardial infarction (MI), any stroke, and coronary revascularization. Risks of discontinuations were ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions In recent years, there have been many advances in the understanding of the molecular basis for vascular involvement in APS, but many areas need to be further investigated, in particular the association between altered genetic/epigenetic profiles, autoantibodies and clinical manifestations, and the effectiveness of new therapeutic strategies. It would be interesting to apply next generation sequencing technologies like RNA-Seq along with GWAS to screen both, the gene profile and the whole transcriptome of large cohorts of primary APS patients, in order to reveal the mutations/polymorphisms, post-transcriptiona...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion Activation of the Nrf2-dependent antioxidant system plays an important role in cell defense against oxidative stress damage, whereas the insufficiency of the Nrf2 system is associated with multiple aspects of the genesis and progression of metabolic diseases, posing a great risk to the cardiovascular system (Figure 1). The systemic increase of Nrf2 activity by several activators may be beneficial in the treatment of metabolic diseases. In addition, selective upregulation of Nrf2 genes may represent a potential therapy in obesity, diabetes and atherosclerosis. Looking to the future, experimental research that el...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Update In March 2019, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines that suggest that most adults without a history of heart disease should not take low-dose daily aspirin to prevent a first heart attack or stroke. Based on the ASPREE, ARRIVE, and ASCEND trials, the ACC/AHA guidelines concluded that the risk of side effects from aspirin, particularly bleeding, outweighed the potential benefit. The new guidelines do not pertain to people with established cardiovascular disease, in whom the benefits of daily aspirin have been found to outweigh the risks. ___________...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Heart Health Prevention Source Type: blogs
In this issue of Metabolism, Ong et al [1] report that fibroblast growth factor 21 (FGF21) levels could predict major cardiovascular (CV) events (MCVE) in statin-treated patients with stable coronary heart disease (CHD) using data from the Treating to New Targets (TNT) trial (n  = 10,001; median follow-up = 4.9 years) [2]; MCVE were defined as a composite of CHD death, cardiac arrest, fatal or non-fatal stroke and non-fatal myocardial infarction (MI). In the Ong et al study [1], 1996 patients with plasma FGF21 concentrations available at baseline were analyzed; 1 835 of them had also FGF21 measurements at the 1-year timepoint.
Source: Metabolism - Clinical and Experimental - Category: Biomedical Science Authors: Source Type: research
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