131 research outputs found
Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy - a meta-analysis of 11 randomized controlled trials involving 21,295 participants
No full textThe available studies have reported the benefits of statins on all-cause and cardiovascular mortality in chronic kidney disease (CKD) patients. However studies in end-stage renal disease patients on dialysis yielded conflicting results. Therefore, we performed a meta-analysis and provide the most reliable trial data to date on the impact of statin therapy on cardiovascular events and death from all causes in CKD patients. Data from PubMed, Web of Science, Cochrane Library, and Scopus for the years 1966 to October 2012 were searched. The final meta-analysis included 11 randomized controlled trials involving 21,295 participants with CKD. Among them 6857 were on dialysis. The use of statins in subjects with non-dialysis-dependent CKD resulted in a marked reduction in death from all causes (relative risk [RR]: 0.66; 95% confidence interval [CI]: 0.55-0.79; p0.05), but had the effect of reducing death from cardiac causes (RR: 0.79; 95%CI: 0.64-0.98; p<0.05) and cardiovascular events (RR: 0.81; 95%CI: 0.7-0.94; p<0.05). In conclusion, the use of statins should be indicated in cardiovascular disease prevention especially in patients with non-dialysis-dependent CKD. According to the very limited data the obtained results suggest caution in expecting a reduction in cardiovascular events in patients on dialysis.Marcin Barylski, Shekoufeh Nikfar, Dimitri P. Mikhailidis, Peter P. Toth, Pooneh Salari, Kausik K. Ray, Michael J. Pencina, Manfredi Rizzoi, Jacek Rysz, Mohammad Abdollahi, Stephen J. Nicholls, Maciej Banach and Lipid and Blood Pressure Meta-Analysis Collaboration Grou
Effects of statins on lipid profile in chronic kidney disease patients: a meta-analysis of randomized controlled trials
No full textObjectiveThe available data on statin effects in chronic kidney disease (CKD) patients are still conflicting. We investigated the impact of short- and long-term statin therapy on lipid profiles in CKD patients requiring or not requiring dialysis.Research design and methodsData from Scopus, PubMed, Web of Science, and the Cochrane Library from 1966 to May 2012 were searched for studies that investigated this effect. We included all randomized controlled clinical trials that investigated the impact of statin therapy on lipids and lipoproteins.ResultsThe final analysis included 16 trials with 3594 subjects. In CKD patients, statin therapy significantly reduced total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) (p 3 months in CKD patients on dialysis, the magnitude of TC and LDL-C decreased (26.3 vs 25.9, and 42.2 vs 29.8 mg/dl, respectively, p > 0.05 for both), while TG increased modestly (4.5 vs 13.4 mg/dl). Short-term statin therapy increased high density lipoprotein cholesterol by a mean 0.7 mg/dl (p = 0.04), and long-term therapy was associated with a mean reduction of 2.4 mg/dL.ConclusionsStatin therapy significantly modifies the lipid profile in CKD patients not on dialysis therapy (with the trend to be more effective with longer therapy), and have less beneficial effect in patients on dialysis with the trend to be less effective with longer duration of therapy.Dragana Nikolic, Shekoufeh Nikfar, Pooneh Salari, Manfredi Rizzo, Kausik K. Ray, Michael J. Pencina, Dimitri P. Mikhailidis, Peter P. Toth, Stephen J. Nicholls, Jacek Rysz, Mohammad Abdollahi, Maciej Banach, Lipid and Blood Pressure Meta-Analysis Collaboration Grou
Health Technology Assessment of TNK-ase vs. Reteplase in the Treatment of Acute Myocardial Infarction in Iran
No full textBackground & Objectives: Due to the lack of evidence about the most cost-effective
thrombolytic drug in the treatment of acute myocardial infarction with the ascension of the ST
segment, this study was conducted to evaluate the cost effectiveness of tenecteplase, as a new
medicine, versus Reteplase in the treatment of acute myocardial infarction patients with the
ascension of the ST segment in Iran.
Methods: This study was a type of health technology assessment study. We searched the
MEDLINE, Cochrane Library (DARE-EED-HTA, Web of Science and EMBASE databases
(from March1980 to March 2017) by using related keywords for finding cost-effectiveness,
safety and economic studies. The qualities of studies were independently assessed by
STROBE checklist and data were extracted using Cochrane data extraction form.
Results: Three studies were eligible for inclusion and all three were of high quality. Mortality
had been compared between Tenecteplase and Reteplase. The results of two studies with 781
samples had showed the same efficacy for Tenecteplase and Reteplase in regard to mortality
rate. According to the cost-effectiveness analysis, Reteplase is more cost effective than TNKase
(250 ).
Conclusion: Reteplase, due to the same safety and effictiveness but lower cost, is preferred to
Tenecteplase and considering the current economic conditions of Iran, it is recommended to
be used in the treatment of acute myocardial infarction patients with the ascension of the ST
segment.
Keywords: Health Technology Assessment, Acute Myocardial Infarction, Tenecteplase,
Reteplase, Economic evaluation
Citation: Bashzar S, Tourani S, Nikfar S, Ravaghi H, Habibi M. Health Technology Assessment of TNK-ase
vs. Reteplase in the Treatment of Acute Myocardial Infarction in Iran. Journal of Health Based Research 2018;
4(1): 51-62
The Results on Vertex Domination in Fuzzy Graphs
No full textWe do fuzzification the concept of domination in crisp graph by using membership values of nodes, &alpha;-strong and arcs. In this paper, we introduce a new variation on the domination theme which we call vertex domination. We determine the vertex domination number &gamma;v for several classes of fuzzy graphs, specially complete fuzzy graph and complete bipartite fuzzy graphs. The bounds is obtained for the vertex domination number of fuzzy graphs. Also the relationship between M-strong arcs and &alpha;-strong is obtained. In fuzzy graphs, monotone decreasing property and monotone increasing property is introduced. We prove the vizing&rsquo;s conjecture is monotone decreasing fuzzy graph property for vertex domination. we prove also the Grarier-Khelladi&rsquo;s conjecture is monotone decreasing fuzzy graph property for it. We obtain Nordhaus-Gaddum (NG) type results for these parameters. The relationship between several classes of operations on fuzzy graphs with the vertex domination number of them is studied.</jats:p
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