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COAG Trial: Dose of warfarin and Pharmacogenetics

COAG Trial: Dose of warfarin and Pharmacogenetics

Observational studies identified two genes that influence the dose of warfarin (CYP2C9 and VKORC1). The clinical utility of dose adjustment by genetics has been tested only in small studies with conflicting results. In this multicenter, double-blind randomized 1015 patients comparing strategy initiation of therapy using only clinical information versus using patient’s genotype. The primary endpoint

CORAL: Angioplasty versus medical treatment of renal artery stenosis

Atherosclerotic stenosis of the renal artery is common in the elderly population. Previous clinical trials showed no benefit with angioplasty in relation to renal function but their use for preventing cardiovascular events was still uncertain. A total of 947 patients with atherosclerotic renal artery and systolic hypertension (need two or more drugs) or renal dysfunction

STREAM Trial: Pharmacological-invasive strategy versus primary angioplasty

The STREAM study (Strategic Reperfusion Early After Myocardial Infarction) that included 1891 patients gave support to the fibrinolytic infusion strategy in the ambulance in patients treated within 3 hours of stroke and who cannot receive primary angioplasty within the hour versus primary angioplasty. The primary end point was a composite of death from any cause,

ENGAGE AF-TIMI 48: Endoxaban versus warfarin in atrial fibrillation

The endoxaban is an oral direct inhibitor of factor Xa with a rapid onset of action and a half-life of 8-10 hours. Endoxaban efficacy and safety for long-term versus warfarinin patients with atrial fibrillation was not studied. This was a randomized, double-blind study that compares two different regimes of endoxaban with warfarin in 21105 patients

EU-PACT: Warfarin dose guided by genotype

Anticoagulation level in response to a fixed dose of warfarin is difficult to predict at the start of therapy. The CYP2C9 gene polymorphism (involved in the metabolism of warfarin) and VKORC1 (involved in the vitamin K cycle) with the age and the body surface are responsible for about 50% of the individual variability in dose.

RADAR AF: High-frequency ablation versus pulmonary vein isolation to treat atrial fibrillation

Atrial fibrillation is initiated by focal triggers and maintained by an atrial substrate called fractioned complex of atrial electrograms. Isolating the pulmonary veins (triggers) through a circumferential ablation is the choice treatment in refractory atrial fibrillation but with suboptimal results. This work tested the hypothesis that don’t only isolate the pulmonary veins but also the

ERASE: Endovascular treatment plus exercise versus exercise alone to treat claudication

Initial therapy for intermittent claudication has been historically the gear train, however, especially in recent years; the number of peripheral angioplasties has increased, proving highly effective for this condition. The aim of this study was to compare the clinical effectiveness of endovascular revascularization plus exercise versus exercise alone in patients with intermittent claudication. The study

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