Aims: To investigate the effect on risk of major adverse cardiac events(MACE) of lipid lowering treatment with fluvastatin 80 mg/day after a first percutaneous coronary intervention in patientswith stable and unstable...Aims: To investigate the effect on risk of major adverse cardiac events(MACE) of lipid lowering treatment with fluvastatin 80 mg/day after a first percutaneous coronary intervention in patientswith stable and unstable angina. Method and results: This prespecified subgroup analysis of the LIPS(Lescol intervention prevention study) analysed 1658 patients with documented diagnosis; 824 had unstable angina(417 randomly assigned to fluvastatin, 407 to placebo) and 834 had stable angina(including silent ischaemia; fluvastatin, 418; placebo, 416). Median follow up was 3.9 years. There was no significant effect of anginal status on long term risk of MACE. Fluvastatin treatment reduced the risk ofMACE by 28%compared with placebo (p=0.03) among patients with unstable angina, with no difference between patients with stable and patients with unstable angina(relative risk 1.07, 95%confidence interval 0.87 to 1.30, p=0.53). Fluvastatin reduced coronary atherosclerotic events (MACE excluding restenosis) by 36%(p=0.006) among patients with unstable angina and 31%(p=0.02) among patients with stable angina. Fluvastatin caused similar reductions in total cholesterol and low density lipoprotein cholesterol concentrations in both patient groups. Conclusion: Treatment with fluvastatin 80 mg/day produced significant reductions inMACE and coronary atherosclerotic events after percutaneous coronary intervention in patientswith average cholesterol concentrations. The beneficial effects of fluvastatin are observed in patients with unstable or stable angina alike.展开更多
Objective: This study was undertaken to evaluate the validity of the pregnancy prolongation index (PPI) as a measure of preterm labor treatment success. Study design: Analysis of prospectively collected maternal and n...Objective: This study was undertaken to evaluate the validity of the pregnancy prolongation index (PPI) as a measure of preterm labor treatment success. Study design: Analysis of prospectively collected maternal and neonatal data from a national clinical database (Matria Healthcare). Included were patients with singleton, twin, and triplet pregnancies who had outpatient surveillance initiated between 18 and 34 weeks and delivered at 24 to 36 6/7 weeks’ gestation with NICU admission. Each patient’s PPI core was calculated with the following equation: [(gestational age at delivery- gestational age at start of treatment) / (37.0 gestational age at start of treatment)] × .100% . The impact of increasing PPI score was measured against NICU length of stay as a surrogate gauge of neonatal morbidity. Data were further stratified by gestational type and reason for delivery. Results: Pregnancy outcomes of 12,642 patients (6,642 singletons, 4,326 twins, and 1,674 triplets) were analyzed. The PPI score increased in a direct, inverse linear relationship with decreasing number of NICU days. Conclusion: The PPI is a sensitive measure for the evaluation of treatment success in the inhibition of preterm labor and delivery.展开更多
Background: Diabetes increases the risk of developing cardiovascular disease. Patients with diabetes undergoing percutaneous coronary intervention(PCI) show poorer outcomes compared with nondiabetic patients. The aim ...Background: Diabetes increases the risk of developing cardiovascular disease. Patients with diabetes undergoing percutaneous coronary intervention(PCI) show poorer outcomes compared with nondiabetic patients. The aim of this study was to determine the clinical benefit of long-term fluvastatin in patients with diabetes who had undergone a successful PCI. Methods: This subanalysis of a prospective, multicenter, randomized, double-blind, placebo-con-trolled trial of patients who had undergone PCI and were treated with fluvastatin determined the impact of fluvastatin on the survival-free period of major adverse cardiac events(MACE)(defined as cardiac death, nonfatal myocardial infarction, and reintervention procedure[coronary artery bypass grafting, repeat PCI, PCI for a new lesion]). Patients with baseline total cholesterol levels of 135 to 270 mg/dL(3.5-7.0 mmol/L) and triglyceride levels of 400 mg/dL(4.5 mmol/L) were randomized at discharge either to fluvastatin(n=844) or to placebo(n=833); follow-up was 3 to 4 years. Among these patients, there were 202 with diabetes(120 on fluvastatin, 82 placebo) and 1475 without diabetes(724 on fluvastatin, 751 on placebo). The primary clinical outcome was survival time free of MACE and MACE excluding restenosis. Results: The presence of diabetes increased the risk of MACE by almost 2-fold in placebo-treated patients(RR 1.78, 95%CI 1.20-2,64, P=.0045). In contrast, in diabetic patients treated with fluvastatin, the risk of MACE was not significantly different from that in patients without diabetes. Fluvastatin reduced the risk of MACE in diabetic patients by 51%(P=.0088). Conclusions: Diabetes is a consistent clinical predictor of cardiovascular complications and fluvastatin reduces the increased incidence of long-term adverse complications associated with the presence of diabetes.展开更多
文摘Aims: To investigate the effect on risk of major adverse cardiac events(MACE) of lipid lowering treatment with fluvastatin 80 mg/day after a first percutaneous coronary intervention in patientswith stable and unstable angina. Method and results: This prespecified subgroup analysis of the LIPS(Lescol intervention prevention study) analysed 1658 patients with documented diagnosis; 824 had unstable angina(417 randomly assigned to fluvastatin, 407 to placebo) and 834 had stable angina(including silent ischaemia; fluvastatin, 418; placebo, 416). Median follow up was 3.9 years. There was no significant effect of anginal status on long term risk of MACE. Fluvastatin treatment reduced the risk ofMACE by 28%compared with placebo (p=0.03) among patients with unstable angina, with no difference between patients with stable and patients with unstable angina(relative risk 1.07, 95%confidence interval 0.87 to 1.30, p=0.53). Fluvastatin reduced coronary atherosclerotic events (MACE excluding restenosis) by 36%(p=0.006) among patients with unstable angina and 31%(p=0.02) among patients with stable angina. Fluvastatin caused similar reductions in total cholesterol and low density lipoprotein cholesterol concentrations in both patient groups. Conclusion: Treatment with fluvastatin 80 mg/day produced significant reductions inMACE and coronary atherosclerotic events after percutaneous coronary intervention in patientswith average cholesterol concentrations. The beneficial effects of fluvastatin are observed in patients with unstable or stable angina alike.
文摘Objective: This study was undertaken to evaluate the validity of the pregnancy prolongation index (PPI) as a measure of preterm labor treatment success. Study design: Analysis of prospectively collected maternal and neonatal data from a national clinical database (Matria Healthcare). Included were patients with singleton, twin, and triplet pregnancies who had outpatient surveillance initiated between 18 and 34 weeks and delivered at 24 to 36 6/7 weeks’ gestation with NICU admission. Each patient’s PPI core was calculated with the following equation: [(gestational age at delivery- gestational age at start of treatment) / (37.0 gestational age at start of treatment)] × .100% . The impact of increasing PPI score was measured against NICU length of stay as a surrogate gauge of neonatal morbidity. Data were further stratified by gestational type and reason for delivery. Results: Pregnancy outcomes of 12,642 patients (6,642 singletons, 4,326 twins, and 1,674 triplets) were analyzed. The PPI score increased in a direct, inverse linear relationship with decreasing number of NICU days. Conclusion: The PPI is a sensitive measure for the evaluation of treatment success in the inhibition of preterm labor and delivery.
文摘Background: Diabetes increases the risk of developing cardiovascular disease. Patients with diabetes undergoing percutaneous coronary intervention(PCI) show poorer outcomes compared with nondiabetic patients. The aim of this study was to determine the clinical benefit of long-term fluvastatin in patients with diabetes who had undergone a successful PCI. Methods: This subanalysis of a prospective, multicenter, randomized, double-blind, placebo-con-trolled trial of patients who had undergone PCI and were treated with fluvastatin determined the impact of fluvastatin on the survival-free period of major adverse cardiac events(MACE)(defined as cardiac death, nonfatal myocardial infarction, and reintervention procedure[coronary artery bypass grafting, repeat PCI, PCI for a new lesion]). Patients with baseline total cholesterol levels of 135 to 270 mg/dL(3.5-7.0 mmol/L) and triglyceride levels of 400 mg/dL(4.5 mmol/L) were randomized at discharge either to fluvastatin(n=844) or to placebo(n=833); follow-up was 3 to 4 years. Among these patients, there were 202 with diabetes(120 on fluvastatin, 82 placebo) and 1475 without diabetes(724 on fluvastatin, 751 on placebo). The primary clinical outcome was survival time free of MACE and MACE excluding restenosis. Results: The presence of diabetes increased the risk of MACE by almost 2-fold in placebo-treated patients(RR 1.78, 95%CI 1.20-2,64, P=.0045). In contrast, in diabetic patients treated with fluvastatin, the risk of MACE was not significantly different from that in patients without diabetes. Fluvastatin reduced the risk of MACE in diabetic patients by 51%(P=.0088). Conclusions: Diabetes is a consistent clinical predictor of cardiovascular complications and fluvastatin reduces the increased incidence of long-term adverse complications associated with the presence of diabetes.
