Multimedia Library
Review of Eligibility for Cardiac Resynchronization Therapy
Cardiac resynchronization therapy (CRT) is underused. Recent guidelines have expanded indications for CRT to include less severe symptoms but now favor left bundle branch block morphology in patients with moderate QRS prolongation. The prevalence of CRT eligibility according to historical and current guidelines is uncertain. The aim of this review was to identify and synthesize all existing published research reporting the prevalence of CRT eligibility. A systematic review of electronic databases including MEDLINE, Embase, and the Cochrane Library was performed.Meta-Analysis of Large-Scale Randomized Trials to Determine the Effectiveness of Inhibition of the Renin-Angiotensin Aldosterone System in Heart Failure
Renin-angiotensin-aldosterone system (RAAS) inhibition is 1 of the most effective strategies for the management of heart failure with reduced systolic function. However, trials that included patients with preserved systolic function have not shown a clear beneficial effect. Pooling evidence from several heart failure trials provides the opportunity to better assess the differential effects of RAAS inhibition across the continuum of systolic function. The authors searched MEDLINE for large-scale trials published from 1966 to March 2014 that compared RAAS inhibitors against placebos.Meta-Analysis of the Effects of Lifestyle Modifications on Coronary and Carotid Atherosclerotic Burden
Lifestyle modifications are the crux of atherosclerotic disease management. The goal of this study was to determine the effectiveness of diet and exercise in decreasing coronary and carotid atherosclerotic burden. Randomized controlled trials examining the effects of intensive lifestyle measures on atherosclerotic progression in coronary and carotid arteries as measured by baseline and follow-up quantitative coronary angiogram and ultrasonographic carotid intimal-medial thickness (CIMT), respectively, were included.A Systematic Review and Collaborative Meta-Analysis to Determine the Incremental Value of Copeptin for Rapid Rule-Out of Acute Myocardial Infarction
Multiple studies have evaluated copeptin, a surrogate for arginine vasopressin, in the diagnosis of acute myocardial infarction (AMI) with mixed results. A systematic review and collaborative meta-analysis were performed for diagnosis of AMI and assessment of prognosis in patients presenting to the emergency department with chest pain. MEDLINE/PubMed, Cochrane CENTRAL, and EMBASE were searched for studies assessing copeptin in such patients. Study investigators were contacted, and many provided previously unpublished data.Impact of Sugar-Sweetened Beverages on Blood Pressure
The impact of sugar-sweetened beverages (SSBs) on blood pressure (BP) has been debated, with some evidence suggesting that their increased intake is related to higher risk of developing hypertension. We conducted a systematic review exploring the relation between consumption of SSB and BP. A comprehensive search in 5 electronic databases along with a bibliography search was performed. The keywords “sugar sweetened beverages,” “sugary drinks,” “added sugars,” “blood pressure,” and “hypertension” were indexed in all combinations.Meta-Analysis of Clinical Correlates of Acute Mortality in Takotsubo Cardiomyopathy
The incidence and clinical correlates of acute in-hospital mortality of takotsubo cardiomyopathy (TTC) are not clear. We performed a systematic review and meta-analysis to consolidate the current evidence on acute mortality in TTC. We then assessed the impact of “secondary” TTC, male gender, advancing age, and catecholamine use on mortality. A comprehensive search of 4 major databases (EMBASE, Ovid MEDLINE, PubMed, and Google Scholar) was performed from their inception to the first week of July 2013.Meta-Analysis of Randomized Controlled Trials on the Risk of Bleeding With Dabigatran
Dabigatran is a univalent low-molecular-weight direct thrombin inhibitor that has been developed as an alternative to vitamin K antagonists (VKAs). However, uncertainty remains regarding dabigatran's safety profile with respect to bleeding. Our objective was to compare the risk of bleeding and all-cause mortality of dabigatran with that of VKAs in a systematic review and meta-analysis of randomized controlled trials (RCTs). We systematically searched MEDLINE, Embase, and the Cochrane Library of clinical trials to identify RCTs comparing the bleeding risk of dabigatran (150 mg twice daily) with that of VKAs.Meta-Analysis of the Effectiveness and Safety of Catheter Ablation of Atrial Fibrillation in Patients With Versus Without Left Ventricular Systolic Dysfunction
Catheter ablation is a promising therapy for atrial fibrillation (AF), but its utility in patients with left ventricular systolic dysfunction (LVSD) is uncertain. The objectives of this study were to perform a systematic review and meta-analysis of randomized and observational studies comparing the rates of recurrent AF, atrial tachycardia (AT), and complications after AF catheter ablation in those with versus without LVSD and to summarize the impact of catheter ablation on the left ventricular ejection fraction.Intravascular Ultrasound Imaging for Assessing Regression and Progression in Coronary Artery Disease
New imaging techniques have been used as surrogate markers of atherosclerotic burden to determine the effects of pharmacologic intervention. The aim of this study was to better determine potential utility and limitations of intravascular ultrasound (IVUS) imaging for assessing regression and progression in coronary artery disease. Medline was searched for randomized trials using IVUS for assessing regression and progression in coronary artery disease (through September 2009). A comparison of IVUS studies with large trials evaluating the same issue with clinical end points was performed.
