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Effect of More Intensive LDL-C-Lowering Therapy on Long-term Cardiovascular Outcomes in Early-Phase Acute Coronary Syndrome: A Systematic Review and Meta-analysis
Clin Ther. 2021 Jun 3:S0149-2918(21)00215-0. doi: 10.1016/j.clinthera.2021.04.019. Online ahead of print.ABSTRACTPURPOSE: The effect of more intensive LDL-C-lowering therapy (ILLT) on long-term cardiovascular outcomes during the early phase of acute coronary syndromes (ACSs) remains uncertain. We aimed to explore the influence of more intensive LDL-C-lowering therapyduring the early disease phase on long-term cardiovascular events among patients with ACSs.METHODS: Randomized controlled trials that focused on the effect of more ILLT during early-phase ACSs on long-term major adverse cardiac events (MACEs) were searched in e...
Source: Clinical Therapeutics - June 7, 2021 Category: Drugs & Pharmacology Authors: Siyao Jin Xiaolu Nie Yuxi Li Jinjie Yuan Yimin Cui Libo Zhao Source Type: research

Evaluating the Risk of Digitalis Intoxication Associated With Concomitant Use of Dronedarone and Digoxin Using Real-World Data
Clin Ther. 2021 Apr 20:S0149-2918(21)00126-0. doi: 10.1016/j.clinthera.2021.03.014. Online ahead of print.ABSTRACTPURPOSE: Dronedarone may increase digoxin plasma levels through inhibition of P-glycoprotein. Using real-world data, we evaluated the risk of digitalis intoxication in concomitant users of dronedarone and digoxin compared digoxin-alone users.METHODS: We used the Clinformatics DataMart, a US claims database, to identify adult patients with atrial fibrillation (AF) or atrial flutter (AFL) who concomitantly used dronedarone and digoxin and those who used digoxin alone between July 2009 and March 2016. Digitalis in...
Source: Clinical Therapeutics - April 23, 2021 Category: Drugs & Pharmacology Authors: Chuntao Wu Rania Boiron Hayet Kechemir Sampada Gandhi Stephen Lin Mattias Wieloch Juhaeri Juhaeri Source Type: research

Potential Therapeutic Effects of Sodium Glucose-linked Cotransporter 2 Inhibitors in Stroke.
CONCLUSIONS: It is unlikely that SGLT inhibitors have a positive or negative effect on stroke risk, but the question that remains unanswered is whether SGLT inhibitors can yield a protective effect after acute ischemic stroke. Future observational studies and registries may be the first step to help answer this question. (Clin Ther. 2020; XX:XXX-XXX) © 2020 Elsevier HS Journals, Inc. PMID: 33008610 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - September 28, 2020 Category: Drugs & Pharmacology Authors: Al Hamed FA, Elewa H Tags: Clin Ther Source Type: research

Reduced Time in Therapeutic Range and Higher Mortality in Atrial Fibrillation Patients Taking Acenocoumarol.
Abstract PURPOSE: The efficacy and tolerability of vitamin K antagonists (VKAs) depends on the quality of anticoagulant control, reflected by the mean time in therapeutic range (TTR) of international normalized ratio 2.0 to 3.0. In the present study, we aimed to investigate the association between TTR and change in TTR (ΔTTR) with the risk of mortality and clinically significant events in a consecutive cohort of atrial fibrillation (AF) patients. METHODS: We included 1361 AF patients stable on VKAs (international normalized ratio 2.0-3.0) during at least the previous 6 months. After 6 months of follow-up we ...
Source: Clinical Therapeutics - December 20, 2017 Category: Drugs & Pharmacology Authors: Rivera-Caravaca JM, Roldán V, Esteve-Pastor MA, Valdés M, Vicente V, Marín F, Lip GYH Tags: Clin Ther Source Type: research

Impact of CHA2DS2VASc Score on Candidacy for Anticoagulation in Patients With Atrial Fibrillation: A Multipayer Analysis.
Abstract PURPOSE: The purpose of this study is to report on the effect of using CHA2DS2VASc (congestive heart failure, hypertension, age ≥75 years [doubled], type 1 or type 2 diabetes mellitus, stroke or transient ischemic attack or thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) rather than CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke) to determine candidacy for anticoagulant prophylaxis in insured patients with atrial fibrillation (AF). MET...
Source: Clinical Therapeutics - September 22, 2016 Category: Drugs & Pharmacology Authors: Patel AA, Nelson WW, Schein J Tags: Clin Ther Source Type: research

EMPA-REG and Other Cardiovascular Outcome Trials of Glucose-lowering Agents: Implications for Future Treatment Strategies in Type 2 Diabetes Mellitus.
Abstract During the last decade, the armamentarium for glucose-lowering drugs has increased enormously by the development of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors, allowing individualization of antidiabetic therapy for patients with type 2 diabetes (T2DM). Some combinations can now be used without an increased risk for severe hypoglycemia and weight gain. Following a request of the US Food and Drug Administration, many large cardiovascular (CV) outcome studies have been performed in patients with longstanding disease and established CV disease. In the majority of CV outcome studies, CV ris...
Source: Clinical Therapeutics - May 18, 2016 Category: Drugs & Pharmacology Authors: Schernthaner G, Schernthaner-Reiter MH, Schernthaner GH Tags: Clin Ther Source Type: research

Effects on All-Cause Mortality and Cardiovascular Outcomes in Patients With Type 2 Diabetes by Comparing Insulin With Oral Hypoglycemic Agent Therapy: A Meta-Analysis of Randomized Controlled Trials.
Abstract PURPOSE: Retrospective, case-control studies and prospective randomized controlled trials (RCTs) on insulin treatment for diabetic patients yielded contradictory mortality and cardiovascular outcomes. We aimed to evaluate the effects of insulin versus oral hypoglycemic agents (OHAs) on all-cause mortality and cardiovascular outcomes in patients with type 2 diabetes (T2D). METHODS: We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biological Medicine Database, China National Knowledge Infrastructure, Chinese Technical Periodicals, and Wanfang Data, up to July 10, 201...
Source: Clinical Therapeutics - January 7, 2016 Category: Drugs & Pharmacology Authors: Li J, Tong Y, Zhang Y, Tang L, Lv Q, Zhang F, Hu R, Tong N Tags: Clin Ther Source Type: research

The Impact of Heart Failure and Left Ventricular Dysfunction in Predicting Stroke, Thromboembolism, and Mortality in Atrial Fibrillation Patients: A Systematic Review.
Abstract PURPOSE: Atrial fibrillation (AF) is commonly associated with structural heart disease. Although heart failure (HF) has been proposed as a risk factor for stroke, the coexistence of the 2 diseases increases disproportionally the risk of thromboembolic events. Our objective was to conduct a systematic review to assess the effect of HF on the end points of stroke, systemic embolism (SE), or mortality in patients with AF. METHODS: A literature search was performed to identify studies that examined stroke/ SE in relation to AF and HF. Overall, 405 articles satisfied the preinclusion criteria. FINDIN...
Source: Clinical Therapeutics - August 18, 2014 Category: Drugs & Pharmacology Authors: Agarwal M, Apostolakis S, Lane DA, Lip GY Tags: Clin Ther Source Type: research

Bleeding as an Outcome Among Patients With Nonvalvular Atrial Fibrillation in a Large Managed Care Population.
CONCLUSIONS: Bleeding incidence among patients with NVAF in a real-world setting was high and increased with greater stroke and bleeding risk scores. Health care costs for patients with major bleeding events were elevated. All rights reserved. PMID: 24075151 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - September 25, 2013 Category: Drugs & Pharmacology Authors: Deitelzweig SB, Pinsky B, Buysman E, Lacey M, Makenbaeva D, Wiederkehr D, Graham J Tags: Clin Ther Source Type: research