1,720,967 research outputs found
Long-lasting Control of LDL-Cholesterol Induces a Forty Percent Reduction in the Incidence of Cardiovascular Events: New Insights from a 7-year Study
No full text: Recent studies have yielded controversial results on the long-term effects of statin treatment on the risk of cardiovascular (CV) events. In order to fill this knowledge gap, we analyzed the relationship between LDL-C levels and CV events in hypertensive patients without previous CV events and naïve to antidyslipidemic treatment, within the "Campania Salute Network" in Southern Italy. We studied 725 hypertensive patients with a mean follow-up of 85.4{plus minus}25.7 months. We stratified our population into 3 groups based on LDL-Cholesterol (LDL-C) levels in mg/dL: Group 1) patients showing during the follow-up a mean LDL-C value {less than or equal to}100 mg/dL in absence of statin therapy; Group 2) statin-treated patients with LDL {less than or equal to}100 mg/dL; Group 3) patients with LDL-C >100 mg/dL, with or without statins. No significant difference among the groups was observed in terms of demographic and clinical characteristics and medications. The incidence of first CV events was 6.0% in Group 1, 5.7% in Group 2 (n.s. vs Group 1), and 11.9% in Group 3 (p<0.05 vs Group 1 and Group 2). A stable long-term satisfactory control of LDL-C plasma concentration ({less than or equal to}100 mg/dL) reduced the incidence of major CV events from 1 event every 58,6 patient/years to 1 event every 115,9 patient/years. These findings were confirmed in a Cox regression analysis, adjusting for potential confounding factors. Taken together, our data demonstrate that a 7-year stable control of LDL-C induces a forty percent reduction in the incidence of CV events. Significance Statement There are several discrepancies between Mendelian studies and other investigations on the actual effects of reduction of plasma concentration of LDL cholesterol on the incidence of major cardiovascular events. Taken together, our data in non-diabetic subjects show that a 7-year stable control of LDL cholesterol induces a ~40% reduction in the incidence of cardiovascular events
Stress Hyperglycemia Drives the Risk of Hospitalization for Chest Pain in Patients With Ischemia and Nonobstructive Coronary Arteries (INOCA)
No full textObjective: Ischemia with nonobstructive coronary arteries (INOCA) is a prevailing finding in patients with angina. However, the main factors underlying the risk of being rehospitalized for chest pain in patients with INOCA remain mostly unknown. Research design and methods: We evaluated INOCA patients referred to the "Casa di Cura Montevergine" in Mercogliano (Avellino), Italy, from January 2016 to January 2021 for percutaneous coronary intervention (PCI). In these subjects, we assessed the impact of the stress hyperglycemia ratio (SHR), defined as the ratio of mmol/L blood glucose and % HbA1c, on the risk of rehospitalization for chest pain. Results: A total of 2,874 patients with INOCA successfully completed the study. At the 1-year follow-up, the risk of rehospitalization for chest pain was significantly higher (P 1 compared to patients with SHR ≤1. These findings were confirmed by multivariable analyses (adjusting for potential confounders, including age, BMI, blood pressure, heart rate, chronic kidney disease, and cholesterol), propensity score matching, and inverse probability of treatment weighting. Conclusions: Our data indicate, to our knowledge for the first time, that SHR on hospital admission significantly and independently increases the risk of rehospitalization for chest pain in INOCA patients
Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure
No full textCurrent therapeutic strategies for acute heart failure (AHF) are based on traditional inotropic agents that are often associated with untoward effects; therefore, finding new effective approaches with a safer profile is dramatically needed. Istaroxime is a novel compound, chemically unrelated to cardiac glycosides, that is currently being studied for the treatment of AHF. Its effects are essentially related to its inotropic and lusitropic positive properties exerted through a dual mechanism of action: activation of the sarcoplasmic reticulum Ca2+ ATPase isoform 2a (SERCA2a) and inhibition of the Na+/K+-ATPase (NKA) activity. The advantages of istaroxime over the available inotropic agents include its lower arrhythmogenic action combined with its capability of increasing systolic blood pressure without augmenting heart rate. However, it has a limited half-life (1 hour) and is associated with adverse effects including pain at the injection site and gastrointestinal issues. Herein, we describe the main mechanism of action of istaroxime and we present a systematic overview of both clinical and preclinical trials testing this drug, underlining the latest insights regarding its adoption in clinical practice for AHF
The selective aldosterone synthase inhibitor Baxdrostat significantly lowers blood pressure in patients with resistant hypertension
Get PDFAchieving a Systolic Blood Pressure Below 130 mmHg Reduces the Incidence of Cardiovascular Events in Hypertensive Patients with Echocardiographic Left Ventricular Hypertrophy
No full text: Background: Recent reports have evidenced an increased mortality rate in hypertensive patients with electrocardiographic left ventricular hypertrophy (ECG-LVH) achieving systolic blood pressure (SBP) 130mmHg, reaching the highest rate in the Echo-LVH group with SBP{greater than or equal to}140mmHg. By separate Cox multivariable regressions, after adjusting for potential confounders, both primary and secondary endpoints were significantly associated with SBP{greater than or equal to}140mmHg and Echo-LVH. Instead, DBP reduction {less than or equal to}80mmHg was associated with a significant increased rate of secondary events. Conclusions: In hypertensive patients with Echo-LVH, achieving an average in-treatment SBP target {less than or equal to}130mmHg has a beneficial prognostic impact on incidence of cardiovascular events. Significance Statement In contrast with recent reports, achieving in-treatment SBP≤130mmHg reduces the incidence of CV events in hypertensive patients with Echo-LVH. Reducing DBP≤80mmHg is instead associated with a higher rate of CV complications. By Cox multivariable regression models, adjusting for potential confounders, the rate of hard and soft CV events was significantly associated with Echo-LVH and SBP≥140mmHg. Our data indicate that therapeutic strategies in patients with Echo-LVH should aim at reducing SBP≤130mmHg paying attention to not reducing DBP≤80mmHg
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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