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Cardiovascular disease (CVD) is highly prevalent in women resulting in 398,086 deaths annually. Even as women participate in traditional CR programs, data specificity and subsequent research have yet to emerge in a meaningful way so that women-centered CR can be better customized and their outcomes properly assessed. Aerobic fitness is a powerful predictor of prognosis in individuals with CVD yet there is evidence that women do not improve their peak VO2 as much as men during CR. We have designed a training program for women based upon past research with a goal of optimizing their training potential in CR. This program combines the utilization of a training technique termed high intensity interval training along with specific strength training exercises of the upper legs. We hypothesize that women, irrespective of age, would be capable of high intensity interval training to improve peak aerobic capacity in the CR setting. Furthermore, since women often have a deficit of thigh strength entering CR, and thigh strength correlates with endurance walking,strength training will also be included. The purpose of this study is to examine the value of high intensity interval training and strength training to maximize aerobic training response in CR for women. This may contribute to establishing specific protocols and training guidelines for future program design for women in CR. Since a set of comprehensive CR guidelines pertaining to women is lacking, it is hoped that the results of this study will help us develop exercise protocols and regimen to better structure and modulate CR programs for optimal benefit to women.
The purpose of the study is to assess the feasibility of Cardiac Shock Wave Treatment in patients with anginal chest pain and evidence of abnormal myocardial perfusion under stress in the absence of significant stenoses of the epicardial coronary arteries.
Background /objectives: Despite preoperative screening, technical improvements and increased patient monitoring, myocardial infarction remains the first cause of morbidity and mortality within 30 days after surgery. Moreover, the available evidence further indicates worrying elevation of risk in postoperative patients with only elevated troponins reflecting cardiac injury, but without a conventional clinical diagnosis of myocardial infarction according to current definition. We have defined MINS (myocardial injury after noncardiac surgery) as a prognostically relevant increase of a troponin T peak of 0.03 ng/ml or greater. Non-cardiac surgery patients suffer MINS frequently (8.0%) and the majority do not have fulfilled the universal definition of myocardial infarction. MINS patients rarely experience ischemic symptoms and the prognosis is very poor (1 out of 10 die at 30 days). Objectives: 1) To implement troponin monitoring as a routine perioperative care; 2) To determine the preoperative and postoperative hscTnT thresholds to predict death; 3) To evaluate the cost-effectiveness of troponin monitoring, and; 4) To elucidate the mechanisms of perioperative myocardial events. Methodology: We will include 2000 patients with high cardiovascular risk undergoing major non-cardiac surgery. Three determinations of hs-cTnT for each patient will be obtained. We will determine the proportion of patients with MINS and calculate the pre- and post-operative troponin thresholds. We will undertake a cost-effectiveness analysis of screening of troponins compared with usual care. Finally using coronary CT-angiography and magnetic resonance imaging we will determine whether MINS is due to plaque rupture, supply-demand mismatch, non-ischemic cardiac cause, non-cardiac cause. Expected results: Our study will evaluate the feasibility and impact of implementing a hs-cTnT monitoring program in our center and will evaluate its cost-effectiveness in Spain. We will produce new knowledge about hs-cTnT thresholds, and with minimally invasive diagnostic tools we will inform the perioperative field about the underlying mechanisms involved in perioperative ischemic events.
This study investigates the effectiveness of a Finnish Tulppa outpatient rehabilitation program. Tulppa is a group-based secondary prevention program for patients with vascular diseases. The program is developed by the Finnish Heart Association. The intervention is implemented at the local primary health care centers in 12 health districts in Finland. A longitudinal controlled study is used to investigate the effects of the intervention on participants' level of cardiovascular risk factors (e.g. lipids, blood pressure, body mass index), functional capacity (e.g. 6 minute walk test), life style as well as psychosocial factors (e.g. smoking, diet, physical activity, health-related quality of life and depression). The data will be collected at baseline (i.e. before the intervention), and 6 and 12 months after the intervention started. The participants (n = 300) are patients diagnosed with coronary heart disease. The study group (n = 150) is recruited from participants of Tulppa rehabilitation in two health care districts (Pirkanmaa and Southern Karelia). The control group (n = 150) is recruited from two health care districts (Turku and Hyvinkää) that do not provide Tulppa rehabilitation.
To date there is very little PD and pharmacokinetic (PK) data on the ticagrelor 60 mg bid dosing regimen. In particular, there is no prospective PK/PD study on this dosing regimen in patients with DM who are known to have impaired response to clopidogrel therapy. Since DM patients frequently require elective PCI due to chronic progression of CAD (and not solely because of an acute thrombotic complication), and clopidogrel remains the guideline recommended P2Y12 inhibiting therapy for these patients, understanding the PD effects of the ticagrelor 60 mg bid regimen in this setting is an unmet clinical need. This is also in light of the ongoing THEMIS trial which is specifically evaluating the impact of the ticagrelor 60 mg bid dosing regimen in type 2 DM patients without a prior major CV event.
The present study is aimed to investigate whether oral L-arginine supplementation reduces the adverse cardiovascular effects of exposure to traffic-related air pollution among a group of non-smoking adults with elevated blood pressure.
To determine the efficacy of HS-25 (20mg) in reducing low density lipoprotein-cholesterol (LDL-C) levels after a 12-week period of treatment in combination with Atorvastatin in subjects with hypercholesterolemia and coronary heart diseases; To determine the safety of HS-25 (20mg) combination with Atorvastatin in subjects with hypercholesterolemia and coronary heart diseases
Objective of the study is to clarify humanin-like peptide concentration in myocard tissue and in blood and to study if its concentration level is related to early complication occurrence and frequency after cardiac operation. Hypothesis of the study is that previously described elements are related to each other.
The DynamX stent study is a consecutive enrolling, prospective, multicenter clinical trial recruiting up to 50 patients at up to 10 international sites. Patients that require treatment of a single de novo lesion equal to or less than 14mm in length located in a coronary artery >2.5 mm and < 3.5 mm in diameter and meet all eligibility criteria will be invited to participate. After the stent implantation patients will be followed up clinically at 30 days, 180 days and annually for 3 years All patients will have an imaging follow up at either 6 months or 9 months
To compare the immediate and long-term clinical outcomes between Balloon-Stent Kissing Technique (BSKT) and Jailed Wire Technique (JWT) for the interventional treatment of coronary bifurcation lesions.