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Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial

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Stroke & Vascular Neurology 2021年第2期6卷 180-186页

作者： Lucy Beishon Lisa J Woodhouse Daniel Bereczki Hanne K Christensen Ronan Collins John Gommans Christina Kruuse George Ntaios Serefnur Ozturk Stephen Phillips stuart pocock Szabolcs Szatmari Joanna Wardlaw Nikola Sprigg Philip M Bath Stroke Trials Unit Division of Clinical NeuroscienceUniversity of NottinghamNottinghamUK Department of Neurology Semmelweis UniversityBudapestHungary Bispebjerg Hospital and University of Copenhagen University of CopenhagenCopenhagenDenmark Department of Geriatric and Stroke Medicine Adelaide and Meath HospitalDublinIreland Department of Medicine Hawke's Bay HospitalCamberleyNew Zealand Department of Neurology Herlev Gentofte HospitalUniversity of CopenhagenCopenhagenDenmark Department of Medicine Larissa University HospitalUniversity of ThessalyVolosGreece Department of Neurology Selcuk University Medical FacultyKonyaTurkey Department of Neurology Queen Elizabeth II Health Sciences CentreHalifaxNova ScotiaCanada Medical Statistics Unit London School of Hygiene&Tropical MedicineLondonUK Department of Neurology George Emil Palade University of MedicinePharmacyScience and Technology of Târgu MureșTargu MuresRomania Centre for Clinical Brain Sciences University of EdinburghEdinburghUK Stroke Nottingham University Hospitals NHS TrustNottinghamUK

Introduction Nitrate-induced headache is common and may signify responsive cerebral *** assessed the relationship between nitrate headache and outcome in patients with acute *** and methods Patients were those randomised to glyceryl trinitrate(GTN)versus no GTN in the efficacy of nitric oxide in stroke *** of headache by end of treatment(day 7),and functional outcome(modified Rankin Scale,primary outcome)at day 90,were *** are adjusted for baseline prognostic factors and give OR and mean difference(MD)with 95%*** In 4011 patients,headache was more common in GTN than control(360,18.0% vs 170,8.5%;p<0.001).Nitrate-related headache was associated with:younger age,female sex,higher diastolic blood pressure,non-total anterior circulation syndrome,milder stroke and absence of dysphasia(p<0.05).Nitrate headache was not associated with improved functional outcome(OR 0.90,95% CI 0.73 to 1.10,p=0.30)or death(day 90)(HR 0.64,95% CI 0.40 to 1.02,p=0.062),but reduced death or deterioration(day 7)(OR 0.45,95% CI 0.25 to 0.82),death in hospital(OR 0.44,95% CI 0.22 to 0.88)and improved activities of daily living(Barthel index,MD 3.7,95% CI 0.3 to 7.1)and cognition(telephone interview cognitive screen,MD 2.0,95% CI 0.7 to 3.3)(day 90).Non-nitrate headache was not associated with death,disability or *** and conclusion Development of a nitrate headache by day 7 after stroke may be associated with improved activities of daily living and cognitive impairment at day 90,which was not seen with non-nitrate headache.

关键词： headache patients nitrate

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利拉鲁肽对糖尿病的影响和作用:心血管预后结果的评估(LEADER(?))试验的原理与研究设计

利拉鲁肽对糖尿病的影响和作用:心血管预后结果的评估(LEADER(?))...

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中华医学会糖尿病学分会第十六次全国学术会议

作者：罗小夫 Richard Bergenstal Gilbert Daniels Johannes Mann Steven Nissen stuart pocock Bernard Zinman John Buse Alan Moses Marcin Zychma Steven Marso University of Toronto International Diabetes Center MinneapolisMNUSA Massachusetts General Hospital BostonMAUSA Friedrich Alexander University of Erlangen MunichGermany Cleveland Clinic Foundation ClevelandOHUSA London School of Hygiene and Tropical Medicine LondonUK University of North Carolina at Chapel Hill School of Medicine Chapel HillNCUSA Novo Nordisk Inc PrincetonNJUSA Novo Nordisk CopenhagenDenmark Saint Luke’s Mid America Heart and Vascular Institute Kansas CityMOUSA

目的利拉鲁肽是1 d1次注射的人胰高糖素样肽-1类似物,已被批准用于治疗T2DM患者。尽管利拉鲁肽能显著降低空腹血糖、HbA1c、体重和收缩压,但其对心血管(CV)预后的影响尚未明确。LEADER是一项国际化、多中心、随机、双盲、安慰剂对照试验...

目的利拉鲁肽是1 d1次注射的人胰高糖素样肽-1类似物,已被批准用于治疗T2DM患者。尽管利拉鲁肽能显著降低空腹血糖、HbA1c、体重和收缩压,但其对心血管(CV)预后的影响尚未明确。LEADER是一项国际化、多中心、随机、双盲、安慰剂对照试验,旨在探讨以下假设:在T2DM患者中,利拉鲁肽联合标准治疗非劣于安慰剂与联合标准治疗,以主要不良CV事件为复合终点。

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研究方法学如何解读临床试验报告中的统计图

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英国医学杂志中文版 2008年第4期11卷 231-236页

作者： stuart J pocock Thomas G Travison Lisa M Wruck 王淳秀(译) 单广良(校) Medical Statistics Unit London School of Hygiene and Tropical Medicine London WCIE 7HT 不详

一个统计图可能会胜过千言万语，但在医学研究中。

关键词：临床试验报告统计图研究方法学解读医学研究

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Heart‘omicsin’AGEing (HOMAGE):design,research objectives and characteristics of the common database

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The Journal of Biomedical Research 2014年第5期28卷 349-359页

作者： Lotte Jacobs Lutgarde Thijs Yu Jin Faiez Zannad Alexandre Mebazaa Philippe Rouet Florence Pinet Christophe Bauters Burkert Pieske Andreas Tomaschitz Mamas Mamas Javier Diez Kenneth McDonald John G F Cleland Hans-Peter Brunner-La Rocca Stephane Heymans Roberto Latini Serge Masson Peter Sever Christian Delles stuart pocock Timothy Collier Tatiana Kuznetsova Jan A Staessen Studies Coordinating Centre Research Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular Sciences University of Leuven Centre d'Investigation Clinique Pierre Drouin and U 961 Hypertension and Heart Failure UnitInstitut Lourrain du Coeur etdes VaisseauxInsermNancyFrance Department of Anesthesiology and Critical Care Medicine InsermUMR-S942Hopital LariboisiereUniversite Paris Diderot Equipe obesite et insuffisance cardiaque Universite UPSInserm I2MCUMR 1048ToulouseFrance Inserm U744CHRULilleFrance Department of Cardiology Medical University Graz Cardiovascular Institute University of ManchesterManchesterUK Division of Cardiovascular Sciences Foundation for Applied Medical ResearchUniversity of Navarra Heart Failure Unit St Vincent's University Hospital University College Dublin Department of Cardiology University of HullUK Department of Cardiology Maastricht University Medical CentreNetherlands Center for Heart Failure Research Department of CardiologyMaastricht UniversityNetherlands Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" International Center for Circulatory Health Imperial College Institute of Cardiovascular and Medical Sciences BHF Glasgow Cardiovascular Research CenterUniversity of Glasgow London School of Hygiene and Tropical Medicine

Heart failure is common in older people and its prevalence is *** Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on（1） prospective population studies or（2） cross-sectional,prospective studies or randomized controlled trials（RCTs） of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ＇omics＇-based biomarkers to identify the risk of developing heart failure and/or *** studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk ***,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy（n = 7,124）,patients with heart failure（n = 4,312） from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease（n = 31,629） in 13 *** is anticipated that more partners will join the consortium and enlarge the pooled *** large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.

关键词： left ventricle heart failure heart failure with reduced ejection fraction heart failure with preserved ejection fraction population science morbidity mortality

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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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