A meta‐analysis of arrhythmia endpoints in randomized controlled trials of transendocardial stem cell injections for chronic ischemic heart disease

2019 ◽  
Vol 30 (11) ◽  
pp. 2492-2500
Author(s):  
Gilson C. Fernandes ◽  
Amanda D. F. Fernandes ◽  
Manuel Rivera ◽  
Aisha Khan ◽  
Ivonne H. Schulman ◽  
...  
Keyword(s):  
Stem Cell ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Chronic Ischemic Heart Disease ◽  
Randomized Controlled

scholarly journals Lessons Learnt from Recent Trials in Ischemic Heart Disease

2020 ◽  
Author(s):  
John M. Mandrola ◽  
Sanjay Kaul ◽  
Andrew Foy
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Patient Care ◽  
Critical Appraisal ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Stable Ischemic Heart Disease ◽  
Trial Evidence

AbstractFour recently published randomized controlled trials have informed the care of patients with stable ischemic heart disease. The purpose of this clinical focus article is to offer a summary and critical appraisal of the recent evidence. We aim to aid clinicians in the translation of the trial evidence to patient care.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

scholarly journals The efficacy of catheter ablation versus ICD for prevention of ventricular tachycardia in patients with ischemic heart disease: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Guolin Liu ◽  
Xin Xu ◽  
Qijian Yi ◽  
Tiewei Lv
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ischemic Heart Disease ◽  
Meta Analysis ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
All Cause Mortality ◽  
Icd Shock

Abstract Purpose Although implantable cardioverter defibrillator (ICD) could prevent the sudden death of ventricular tachycardia (VT) in patients with ischemic heart disease, it could not effectively prevent the recurrence of ventricular tachycardia. Several studies have suggested that catheter ablation may effectively decrease the incidence of ICD events, but relevant dates from randomized controlled trials were limited. Methods A systematic review and meta-analysis of randomized controlled trials were performed to evaluate the effect of catheter ablation for the prevention of VT in patients with ischemic heart disease. Random-effects model with inverse-variance weighting method was used to pool odds ratios. Egger method was performed to evaluate whether there was public bias in each outcome. Results Four studies enrolling a total of 605 patients were included in the present meta-analysis. Compared with the control group (ICD ± AAD), catheter ablation could significantly reduce the incidence of ICD therapy (OR, 0.49; 95% CI, 0.28 ~ 0.87), ICD shock (OR, 0.50; 95% CI, 0.28 ~ 0.87), VT storm (OR, 0.60; 95% CI, 0.40 ~ 0.90), and cardiovascular-related hospitalization (OR, 0.66; 95% CI, 0.45 ~ 0.9). But there was no significant difference among the risk of all-cause mortality (OR, 0.89; 95% CI, 0.59 ~ 1.34), cardiovascular mortality (OR, 0.76; 95% CI, 0.44 ~ 1.30), and complication (OR, 0.89; 95% CI, 0.30 ~ 2.67). Conclusion These results showed that catheter ablation combined with ICD could reduce ICD therapy, ICD shock, and VT storm in patients with ischemic heart disease, but there was no improvement in all-cause mortality. Meanwhile, it also provided a basic guidance for the design of larger clinical randomized trials with longer follow-up in the future.

Abstract 16655: Bone Marrow Cell Therapy in Patients With Ischemic Heart Disease: A Meta-analysis of Randomized Controlled Trials Using Cardiac MRI

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Muhammad R Afzal ◽  
Anweshan Samanta ◽  
Briha Ansari ◽  
Vinodh Jeevanantham ◽  
Buddhadeb Dawn
Keyword(s):  
Bone Marrow ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Bone Marrow Cell ◽  
Cardiac Mri ◽  
Marrow Cell ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

Introduction: The results from clinical trials of bone marrow cell (BMC) therapy in ischemic heart disease (IHD) have been discordant with regard to left ventricular (LV) functional improvement. This discrepancy has been attributed, in part, to the use of dissimilar cardiac imaging modalities. MRI is the gold standard for assessment of cardiac structure/function. Hypothesis: We hypothesized that BMC therapy will improve LV parameters in patients with IHD when assessed by cardiac MRI. Methods: We performed a systematic review and meta-analysis of data from randomized controlled trials (RCTs) of BMC therapy in patients with IHD that used cardiac MRI. Database searches through May 30, 2015 identified 27 eligible RCTs (enrolling 1826 patients). The MRI data on LV ejection fraction (EF), infarct size, LV end-systolic volume (LVESV), and LV end-diastolic volume (LVEDV) were analyzed with random-effects meta-analysis. Clinical outcomes were analyzed using Peto odds ratio (OR). Results: Compared with standard therapy, BMC therapy improved LVEF (1.62%; 95% confidence interval [CI]: 0.49 to 2.75; P=0.005) and reduced LVESV (-2.00 ml; 95% CI: -3.19 to -0.82; P=0.0009). The improvement in LVEF was similar in patients with acute myocardial infarction (MI) and chronic IHD. Perhaps more importantly, BMC therapy was associated with reduced incidence of recurrent MI (OR: 0.39; 95% CI: 0.20 to 0.78; P=0.007) along with substantial improvement in other outcome parameters, including mortality (Table). However, these changes did not reach statistical significance perhaps due to smaller patient numbers. Conclusions: These results from meta-analysis of RCTs using cardiac MRI indicate that BMC therapy improves LV function and outcomes in patients with IHD. These data may help resolve the controversy regarding whether the reported benefits of BMC therapy are dependent on the selection of imaging modalities.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

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