One-year follow-up after primary coronary intervention for acute myocardial infarction in diabetic patients: a substudy of the STENT PAMI trial

OBJECTIVE - This analysis was undertaken to determine the composite incidence of cumulative adverse events (death, reinfarction, disabling stroke, and target vessel revascularization) at the end of the first year after acute myocardial infarction, in diabetic patients who underwent coronary stenting or primary coronary balloon angioplasty. METHODS - From the STENT PAMI trial, we analyzed the 6-month angiographic and 1-year clinical outcomes of 135 diabetic (112, noninsulin dependent) patients who underwent the randomization process of the trial and compared them with 758 nondiabetic patients. RESULTS - Coronary stenting did not significantly reduce the primary composite clinical end point when compared with PTCA (20 vs. 30%, p=0.2). A significant benefit from stenting was observed in patients with noninsulin dependent diabetes, with a trend toward a lesser need for new revascularization procedures (10 vs. 21%, p<.001), with a significant reduction in the primary composite clinical end point at 1 year (12 vs. 28%, p=. 04). At 6 months, the restenosis rate were significantly reduced only in nondiabetic patients (18 vs. 33%, p<. 001). Diabetic patients had the same restenosis rate (38%) either with stenting or balloon PTCA. CONCLUSIONS - Coronary Stenting in diabetics noninsulin dependent offered a significant reduction in the composite incidence of major clinical adverse events compared with balloon PTCA.

Species muscorum frondosorum : descriptae et tabulis aeneis lxxvii coloratis illustratae / Joannis Hedwig ; opus posthumum, editum a Friderico Schwaegrichen.

1801

Species muscorum frondosorum : descriptae et tabulis aeneis lxxvii coloratis illustratae / Joannis Hedwig ; opus posthumum, editum a Friderico Schwaegrichen.

suppl.1:v.1 (1816)

Species muscorum frondosorum : descriptae et tabulis aeneis lxxvii coloratis illustratae / Joannis Hedwig ; opus posthumum, editum a Friderico Schwaegrichen.

suppl.1:v.2 (1816)

Flora Pyrenaea per ordines naturales gradatim digesta /P. Bubani ; opus posthumum editum O. Penzig.

v.1 (1897)

Historia naturalis palmarum :opus tripartium / Carol. Frid. Phil. de Martius.

vol. 1

Historia naturalis palmarum :opus tripartium / Carol. Frid. Phil. de Martius.

vol. 2

Historia naturalis palmarum :opus tripartium / Carol. Frid. Phil. de Martius.

vol. 3

Horti medici amstelodamensis rariorum tam Orientalis :quàm Occidentalis Indiæ, aliarumque peregrinarum plantarum, magno studio ac labore, sumptibus Civitatis amstelodamensis, longâ annorum serie collectarum, descriptio et icones ad vivum æri incisæ /auctore Joanne Commelino. Opus posthumum, latinitate donatum, notisque & observationibus illustratum, à Frederico Ruyschio & Francisco Kiggelario.

v.1

Horti medici amstelodamensis rariorum tam Orientalis :quàm Occidentalis Indiæ, aliarumque peregrinarum plantarum, magno studio ac labore, sumptibus Civitatis amstelodamensis, longâ annorum serie collectarum, descriptio et icones ad vivum æri incisæ /auctore Joanne Commelino. Opus posthumum, latinitate donatum, notisque & observationibus illustratum, à Frederico Ruyschio & Francisco Kiggelario.

v.2

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

Background:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

Storing Data in the Trial of Complex Technical Products

The article considers the ways of organization of databases for the storage of the results obtained during testing. A new variant of the organization of the data to ensure the ability to write to the database different sets of parameters in the form of chronological series. The required set of parameters depends on the modification of the tested technical installation.