1,721,903 research outputs found
European Perpectives in Cardiology-spotlight on Rberto Ferrari
No full textDespite his current dedication to cardiology, as a young
boy Roberto Ferrari, MD, PhD, FESC, wanted to be an
architect. But the late 1960s represented a difficult time for
the Faculty of Architecture in Italy, as it was more involved
in political issues than in teaching architecture. So, he chose
medicine. He now serves as professor of cardiology at the
University of Ferrara, director of the clinical cardiology
department at the University Hospital of Ferrara, and
director of the Centre of Cardiovascular Research S.
Maugeri, part of the S. Maugeri Foundation. However, he
still maintains an interest in design, as is shown by his many
innovative and colourful books and publications
Effetti mioangiogenetici della mobilitazione periferica delle cellule staminali in corso di infarto miocardico acuto (studio di Fase I/II)
No full textIl progetto presentato si è proposto di verificare l'ipotesi secondo cui la somministrazione esogena di un fattore di crescita midollare quale il rhG-CSF (filgastrin) sia in grado di favorire la mobilizzazione dei precursori midollari in pazienti con infarto miocardio acuto in cui vi è necessità di attuare trapianti cellulari al fine di ridurre l'area necrotica. Il progetto di ricerca si articola in due fasi distinte:
1. in cui si proponeva di randomizzare 30 pazienti con schema 1:1 al fine di ottenere un profilo di safety del filgastrin.
2. sperimentazione con 10mg/kg/die di filgastrin e l'analisi della cinetica di rilascio dei CD34
It is time to stop comparing blood pressure-lowering drugs with placebo - In reply
No full textI n the March 27 issue of the ARCHIVES, the Perindopril
and Remodeling in Elderly with Acute Myocardial
Infarction (PREAMI) investigators showed
that the use of an angiotensin-converting enzyme (ACE)
inhibitor in patients who recovered from an acute myocardial
infarction, with mildly depressed or preserved
ejection fraction (40%), lowered the incidence of left
ventricular remodeling.1 The internal validity of this
double-blind trial, with meticulous evaluation of outcome,
is undisputable. The conception of this trial, however,
particularly with the choosing of a placebo control
arm, casts doubt about its external validity. The absence
of effect on hard outcomes was expected, in view of the
small sample size, but even the effect on cardiac remodeling
can be attributed to the blood pressure–lowering
effect of perindopril. The magnitude of this effect, despite
being statistically significant, cannot be fully captured
by occasional office blood pressure measurement,
as it was shown in the Heart Outcomes Prevention Evaluation
(HOPE) trial.2 The expectations about the putative
antiatherosclerotic and myocardial effects of antagonists
of the renin-angiotensin system may be down in face
of the results of trials comparing them with active treatments,
3,4 and the use of ACE inhibitors has been recommended
for any patient recovering from an acute myocardial
infarction, even if blood pressure is within the
prehypertensive levels.5 The blood pressure–lowering
effect of the several classes of antihypertensive drugs explains
most, if not all, of their clinical efficacy, and it is
surely time to stop comparing them with placebo to prevent
cardiovascular outcome
The story of the heartbeat, continued
No full textAncient civilization, in one way or another, has linked the heart and heart rate to life. But what about modern cardiology? Is there any link today? Indeed, according to a fascinating theory, yet to be proven, living beings are born with a predisposed number of heartbeats. Those with a particularly high heart rate have a lower life expectancy than those with a lower heart rate
Treatment with angiotensin-converting-enzyme inhibitors:insight into perindopril cardiovasular protection
No full textAngiotensin-converting enzyme (ACE) inhibitors have an established role in the
treatment of patients across the cardiovascular disease continuum, from uncomplicated
hypertension to established cardiovascular disease. The first data showing the
efficacy of ACE inhibitors for the prevention of cardiovascular events came from the
Heart Outcomes Prevention Evaluation trial with ramipril. Since then a number of
other large, randomized, controlled trials have confirmed the beneficial effects of
ACE inhibitors on cardiovascular outcomes in a variety of patient groups. In addition,
evidence suggests that these beneficial effects of ACE inhibitors occur independently
of their blood pressure (BP)-lowering effects, a phenomenon that has not been
observed for angiotensin receptor blockers. Among the ACE inhibitors, perindopril
has the greatest body of evidence for cardiovascular preventive efficacy from major
morbidity–mortality trials (e.g. ADVANCE, ASCOT-BPLA, EUROPA, PREAMI, PEP-CHF,
PROGRESS). In addition, perindopril may be the treatment of choice in stable coronary
artery disease because of its unique anti-apoptotic activity and protective effects on
the endothelium. A current major trend in cardiovascular medicine is the increased
use of combination therapies. The data reviewed here suggest that any combination
therapy for secondary prevention across the continuum of cardiovascular disease
should contain an ACE inhibitor
European heart for Children: a Humaniatiran Project of the ESC
No full textThe project consisting of three stages: the mission, the training and creating the necessary conditions for suitable health care development in countries in transistio
Preface
No full textThroughout the world, cardiovascular disease (CVD) is a
leading cause of mortality and illness. This is mainly
because of atherosclerosis and its clinical manifestation.
As the ultimate cause of atherosclerosis is still a mystery,
all of our attention is devoted to the treatment of its
sequence or to reduce modifiable risk factors such
as smoking, sedentariness, nutritional imbalance, blood
pressure elevation, impaired glucose tolerance and
diabetes, dislypidemia, overweight and abdominal adiposity
and markers of chronic inflammation
Optimising the treatment of hypertension and stable CAD: clinical evidence for fixed combination perindorpil/Amlodipine
No full textBackground: Optimized management of hypertension and
coronary artery disease (CAD) improves cardiovascular risk
and outcomes, and prevents complications. This article
reviews evidence for the fixed combination of the angiotensin-
converting enzyme (ACE) inhibitor perindopril and
the calcium channel blocker amlodipine.
Methods: A literature search was performed in PubMed/
MEDLINE to identify articles published in English between
1988 and March 2008 describing clinical trials, particularly
outcome trials, or mechanisms of therapeutic action relevant
to the use of combination therapy in patients with
hypertension or stable coronary artery disease with an ACE
inhibitor (perindopril) and a calcium channel blocker
(amlodipine).
Findings: Clinical trials indicate that this combination
may have a positive impact on cardiovascular mortality
and morbidity in hypertensive individuals. The two complementary
mechanisms of action appear to work in
synergy, leading to more efficient blood pressure
lowering, improved fibrinolytic function, and reduction of
secondary effects. This also represents a simplified
management strategy for stable CAD. Perindopril has
proven efficacy in the prevention of cardiovascular
events and mortality in CAD patients, while amlodipine
is widely used in the symptomatic management of
CAD. Both aspects of guideline-recommended
management of CAD are therefore addressed in a single
tablet.
Conclusions: The clinical evidence for fixed-combination
perindopril/amlodipine indicates it as a credible option
for the optimization of the management of hypertension
and CAD
School for clinical and epidemiological researchers, Ferrara, Italy
No full textClinical researchers are essential to verify and to assess the safety and efficacy of nwe treatments or therapeutic and rehabilitation approaches. the conduction of clinical multi-centre research is becoming more and more complex as it needs to be in compliance with the stringent rules of evidence-based medicine and requiring knowledge of regulatory and legal aspects unheard or for the practising doctor. the result is that clinical research today is suffering, at least in Italy 8one of the leading European countries for clinical research, known for having successfully conducted six GISSI studies involving more than 60.000 patients). On the one hand, doctors are more and more involved in daily clinical routines leaving limited time to conduct multi-centre research, while on the other hand, multi centre research is very demanding, requiring much time and appropriate knowledge
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