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长效硝苯地平对稳定性心绞痛患者的死亡率及心血管发病率的影响:ACTION随机对照试验

世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 8-9页

作者： poole wilson p.p.a. Lubsen p.J. Kirwan B.-A. 王亭忠 Cardiac Medicine Imperial College London Dovehouse Str eet SW3 6LY London United Kingdom

Background Calcium antagonists are widely prescribed for angina pectoris but t heir effect on clinical outcome is controversial. We aimed to investigate the ef fect of the calcium antagonist nifedipine on long term outcome in patients with stable angina pectoris. Methods We randomly assigned 3825 patients with treated stable symptomatic coronary disease to double blind addition of nifedipine GIT S (gastrointestinal therapeutic system) 60 mg once daily and 3840 to placebo. Th e primary endpoint was the combination of death, acute myocardial infarction, re fractory angina, new overt heart failure, debilitating stroke, and peripheral re vascularisation. Mean follow up was 4.9 years (SD 1.1). Analysis was by intenti on to treat. Findings 310 patients allocated nifedipine died (1.64 per 100 patie nt years) compared with 291 people allocated placebo (1.53 per 100 patient yea rs; hazard ratio 1.07 [95%CI 0.91-1.25], p=0.41). primary endpoint rates wer e 4.60 per 100 patient years for nifedipine and 4.75 per 100 patient years for p lacebo (0.97 [0.88-1.07], p=0.54). With nifedipine, rate of death and any car di ovascular event or procedure was 9.32 per 100 patient years versus 10.50 per 10 0 patient years for placebo (0.89 [0.83-0.95], p=0.0012). The difference was m ainly attributable to a reduction in the need for coronary angiography and inter ventions in patients assigned nifedipine, despite an increase in peripheral reva scularisation. Nifedipine had no effect on the rate of myocardial infarction. In terpretation Addition of nifedipine GITS to conventional treatment of angina pec toris has no effect on major cardiovascular event free survival. Nifedipine GIT S is safe and reduces the need for coronary angiography and interventions.

关键词：心血管发病率稳定性心绞痛随机对照试验 ACTION 难治性心绞痛钙拮抗剂介入治疗心血管事件血管重建控释

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维普期刊数据库

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慢性稳定型心绞痛的治疗——近期试验的临床意义

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世界核心医学期刊文摘（心脏病学分册） 2005年第8期1卷 1-3页

作者： philip A.poole-wilson 世界心脏联盟

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与时俱进:冠心病治疗指南的新思考——明确长效钙通道阻滞剂在冠心病治疗中的地位

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世界核心医学期刊文摘（心脏病学分册） 2005年第7期1卷 1-3页

作者： philip A.poole wilson 世界心脏联盟

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维普期刊数据库

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非ST段抬高急性冠状动脉综合征介入治疗的5年结果:英国心脏基金会RITA3随机试验

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世界核心医学期刊文摘(心脏病学分册) 2006年第2期 22-23页

作者： Fox K. A. A. poole-wilson p. Clayton T. C. 孙凯 Centre for Cardiovascular Science Department of Medical and Radiological Sciences University of Edinburgh Edinburgh EH16 4SB United Kingdom Prof.

Background: The long-term outcome of an interventional strategy in patients with non-ST-elevation acute coronary syndrome is unknown. We tested whether an interventional strategy(routine angiography followed by revascularisation) was better than a conservative strategy(ischaemia-driven or symptom-driven angiography) over 5 years' follow-up. Methods: In a multicentre randomised trial, 1810 patients(from 45 hospitals in England and Scotland, UK) with non-ST-elevation acute coronary syndrome were randomly assigned to receive an early intervention(n=895) or a conservative strategy(n=915)within 48 h of the index episode of cardiac pain. In each group, the aim was to provide the best medical treatment, and also to undertake coronary arteriography within 72 h in the interventional strategy with subsequent management guided by the angiographic findings. Analysis was by intention to treat and the primary outcome(composite of death or non-fatal myocardial infarction) had masked independent adjudication. RITA 3 has been assigned the International Standard Randomised Control Trial Number ISRCTN07752711. Findings: At 1-year follow-up, rates of death or non-fatal myocardial infarction were similar. However, at a median of 5 years' follow-up(IQR 4.6-5.0), 142(16.6% ) patients with intervention treatment and 178(20.0% ) with conservative treatment died or had non-fatal myocardial infarction(odds ratio 0.78, 95% CI 0.61-0.99, p=0.044), with a similar benefit for cardiovascular death or myocardial infarction(0.74, 0.56-0.97, p=0.030). 234(102 12% intervention, 132 15% conservative) patients died during follow-up(0.76, 0.58-1.00, p=0.054). The benefits of an intervention strategy were mainly seen in patients at high risk of death or myocardial infarction(p=0.004), and for the highest risk group, the odds ratio of death or non-fatal myocardial infarction was 0.44(0.25-0.76). Interpretation: In patients with non-ST elevation acute coronary syndrome, a routine invasive strategy leads to

关键词：急性冠状动脉综合征患者 RITA3 介入治疗 ST 随机试验概率试验

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氯沙坦心衰生存研究(ELITEⅡ):氯沙坦和卡托普利对心衰相关预后和症状的作用比较

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 27-28页

作者： Konstam M. A. Neaton J. D. poole-wilson p. A. 宁宁 Dr. Tufts-New England Medical Center Box 108 750 Washington St Boston MA02111 United States

Background: Blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors improves outcomes and symptoms in patients with heart failure(HF). We compared effects of losartan to captopril on mortality, morbidity, and functional status for patients in the ELITE II study. Methods and results: A total of 3152 patients, aged 60 years or older, with New York Heart Association(NYHA) classes II to IV HF and ejection fraction ≤40%were assigned to receive losartan 50 mg once daily or captopril 50 mg 3 times daily. Outcome measures included all-cause and HF-related mortality, hospitalizations, and discontinuations; change in NYHA class; and quality of life(QoL). HF-related outcomes were not significantly different between therapies. Similar improvements from baseline(pps. Among 1856 QoL participants, 1343 patients survived at least 1 year; the QoL for 1-year survivors improved in both treatment groups(pps. Conclusions: In ELITE II, the effects of losartan on HF-related outcomes, NYHA class, and QoL were not superior to those of captopril. Although angiotensin-converting enzyme inhibitors remain the treatment of choice for patients with HF, the similarity of the findings in the present analysis supports a role for angiotensin-receptor antagonists in this patient population.

关键词：心衰患者判断预后卡托普利氯沙坦生存研究症状阻断肾素-血管紧张素系统血管紧张素转换酶抑制剂 NYHA分级心功能分级

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维普期刊数据库

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卡维地洛比酒石酸美托洛尔更能有效降低慢性心力衰竭病人的死亡率

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英国医学杂志中文版 2004年第5期7卷 304-305页

作者： poole-wilson pA Swedberg K Cleland JG Curt D Furberg Bruce M psaty 王琳 F Hoffman La Roche and Glaxo Smith Kline professor p A National Heart and Lung Institute London UK Curt D Furberg MD PhD Wake Forest University School of Medicine Winston-Salem North Carolina USA Bruce M Psaty MD PhD University of Washington Seattle Washington USA

poole-wilson p A,Swedberg K Cleland JG,et al.卡维地洛和酒石酸美托洛尔欧洲试验(COMET)中卡维地咨和酒石酸美托洛尔对慢性心力衰竭(CHF)病人的临床疗效的比较。

关键词：美托洛尔卡维地洛慢性心力衰竭病人死亡率随机对照试验降低和酒欧洲

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维普期刊数据库

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基于一个大型随机试验预测稳定性心绞痛队列患者死亡、心肌梗死和卒中的危险评分

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英国医学杂志中文版 2006年第1期9卷 16-19页

作者： Tim C Clayton Stuart J pocock Jacobus Lubsen Zoltán Vokó Bridget-Anne Kirwan Keith A A Fox philip A poole-wilson Department ofEpidemiology andpopulation Health London School of Hygiene andTropical MedicineLondon Department of Epidemiology and Biostatistics Erasmus Medical Centre 3000 DR Rotterdam Netherlandsprofessor School of public Health University of Debrecen H-4028 Debrecen Hungary assistant professor SOCAR Research SA PO Box 2564 CH-1260 Nyon 2 Switzerland director Cardiovascular Research Unit EdinburghUniversityEdinburghEH16 4SBprofessor CardiovascularSciences NationalHeart and LungInstitute ImperialCollege LondonLondon SW3 6LYprofessor

目的对需要抗心绞痛治疗并且左心室功能代偿症状稳定的心绞痛患者建立预测全因死亡、心肌梗死和导致致残性卒中的复合危险评分。设计大型多中心临床试验数据的多变量Cox回归分析。背景西欧、以色列、加拿大、澳大利亚和新西兰的心脏专... 详细信息

目的对需要抗心绞痛治疗并且左心室功能代偿症状稳定的心绞痛患者建立预测全因死亡、心肌梗死和导致致残性卒中的复合危险评分。设计大型多中心临床试验数据的多变量Cox回归分析。背景西欧、以色列、加拿大、澳大利亚和新西兰的心脏专科门诊患者。入选者7311例具有全部需要资料的患者被入选。主要结局的测量指标平均随访4.9年时间内所有原因的死亡、心肌梗死或者致残性卒中。结果1063例患者发生任何原因死亡或者持久性心肌梗死或者致残性卒中。这些复合终点的5年危险性在危险性最低的十分位患者为4%,而在危险性最高的十分位患者为35%。危险评分结合16项临床常规变量的降序排序是:年龄、左心室射血分数、吸烟、白细胞计数、糖尿病、随机血糖浓度、肌酐浓度、既往卒中病史、1周至少1次心绞痛发作、冠状动脉造影发现(如果能够获得)、降脂治疗、QT间期、收缩期血压≥150mmHg、抗心绞痛药物数量、陈旧性心肌梗死以及性别。把这个模型分别应用于任何原因所致的死亡、心肌梗死和卒中进行预测评估,所得的结果相似。危险评分似乎不能预测事件性质(39%的死亡、46%心肌梗死以及15%致残性卒中)或者冠状动脉造影或血管重建率(占29%的患者)。结论该危险评分对客观地决定稳定性心绞痛患者进一步治疗措施以减少重要预后事件发生是有帮助的。该危险评分同样可以用于将来的计划性试验。

关键词：陈旧性心肌梗死心绞痛患者稳定性心绞痛冠状动脉造影危险评分随机试验血管重建治疗措施卒中预测

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维普期刊数据库

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美托洛尔和卡维地洛对慢性心衰患者病因特异性死亡率和发病率的影响:COMET研究

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世界核心医学期刊文摘（心脏病学分册） 2005年第9期1卷 29-29页

作者： Torp-pedersen C. poole-wilson p.A. Swedberg K. et al. 武敏 Dr. Department of Cardiology Bispebjerg University Hospital 2400 Copenhagen NV Denmark

Background: β-Blockers with different receptor bindings reduce mortality in patients with chronic heart failure. We compared the effects of the β1-blocker metoprolol tartrate and the β1-, β2-, and α1-blocker carvedilol. Methods: In a randomized double-blind design, 3029 patients with chronic congestive heart failure requiring diuretic therapy and with left ventricular dysfunction were randomized to treatment with carvedilol(n=1511) or metoprolol tartrate(n=1518) and titrated to target doses of 25 mg of carvedilol twice daily or 50 mg of metoprolol tartrate twice daily. The main outcome measures were total mortality and the combination of mortality or hospitalization for any cause. Secondary end points were cardiovascular death, combinations of morbidity and mortality, New York Heart Association class, worsening of heart failure, hospitalizations, and discontinuation of study therapy. Results: A total of 512 and 600 patients in the carvedilol group and metoprolol group, respectively, died(hazard ratio[HR] 0.83, 95%CI 0.74-0.93, p=.0017). Cardiovascular death was reduced by carvedilol(HR 0.80, 95%CI 0.70-0.90, p=.0004). There were fewer sudden deaths and deaths caused by circulatory failure or by stroke in the carvedilol group. There was no difference in all-cause hospitalizations or in worsening heart failure between treatment groups. The incidence of fatal or nonfatal acute myocardial infarction was significantly lower in the carvedilol group(HR 0.71, 95%CI 0.52-0.97, p=.03). Discontinuations of study therapy were similar in the 2 groups. Conclusion: Compared with metoprolol tartrate, carvedilol reduced cardiovascular mortality, sudden death, death caused by circulatory failure, death caused by stroke, as well as fatal and nonfatal myocardial infarctions.

关键词： COMET 慢性心衰利尿治疗受体阻断剂慢性充血性心衰左心室功能不全特异性全因死亡住院率随机双盲

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维普期刊数据库

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Medium-term mortality after hip fractures and COVID-19:A prospective multicentre UK study

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Chinese Journal of Traumatology 2022年第3期25卷 161-165页

作者： Gareth Chan Ashish Narang Arash Aframian Zaid Ali Joseph Bridgeman Alastair Carr Laura Chapman Henry Goodier Catrin Morgan Chang park Sarah Sexton Kapil Sugand Thomas Walton Michael wilson Ajay Belgaumkar Kieran Gallagher Koushik Ghosh Charles Gibbons Joshua Jacob Andrew Keightley Zuhair Nawaz Khaled Sarraf Christopher Wakeling William Kieffer Benedict Rogers Brighton&Sussex University Hospitals NHS Trust Brighton&Sussex Medical SchoolFainter CampusBrighton UK Surrey&Sussex Healthcare NHS Trust Canada&venueRedhillUK Chelsea&Westminster Hospital NHS Foundation Trust LondonUK Ashford&St frier's Hospital NHS Foundation TrustChertseyUK Western Sussex Hospitals NHS Foundation Trust(Sr Richard's Hospital)ChichesterUK poole General Hospital&the Royal Bournemouth Hospital froleUK Imperial College Healthcare NHS Trust LondonUK Western Sussex Hospitals NHS Foundation Trust(Worthing Hospital) WorthingUK Royal Surrey Hospital NHS Foundation Trust GuildfordUK Frimley Health NHS Foundation Trust FrimleyUK

purpose:The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 ***,death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms,but this period can extend up to 8 *** study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip ***:A multi-centre prospective study across 10 hospitals treating 8%of the annual burden of hip fractures in England between 1st March and 30th April,2020 was *** whose surgical treatment was payable through the National Health Service Best practice Tariff mechanism for"fragility hip fractures"were included in the ***'120-day mortality was assessed relative to their perioperative COVID-19 *** analysis was performed using SpSS version ***:A total of 746 patients were included in this study,of which 87(11.7%)were COVID-19 *** rates at 30-and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients(pp=0.107),16.1%and 9.4%respectively for COVID-19 positive and negative patients,odds ratio 1.855(95%CI 0.865-3.978).Conclusion:Hip fracture patients with concurrent COVID-19 infection,provided that they are alive at day-31 after injury,have no significant difference in 120-day *** the growing awareness and concern of "long-COVID"and its widespread prevalence,this does not appear to increase mediumterm mortality rates after a hip fracture.

关键词： Hip fractures Femoral fractures COVID-19 Coronavirus Mortality

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