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10.1016/j.jacc.2015.07.047 http://scihub22266oqcxt.onion/10.1016/j.jacc.2015.07.047 C4583654!4583654!26403339     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Am+Coll+Cardiol 2015 ; 66 (13): 1431-41 Nephropedia Template TP {{tp|p=26403339|t=2015. Effect of Beta-Blocker Dose on Survival after Acute Myocardial Infarction |pdf=|usr=}}{{26403339}} gab.com Text Effect of Beta-Blocker Dose on Survival after Acute Myocardial Infarction JO: J Am Coll Cardiol http://www.kidney.de/pget.php?&tw=1&pmid=26403339 #FOAvip Background: Beta-blocker therapy after acute myocardial infarction (MI) improves survival. Beta-blocker doses used in clinical practice are often substantially lower than those used in the randomized trials establishing their efficacy. Objective: This study evaluated the association of beta-blocker dose with survival after acute MI, hypothesizing that higher dose beta-blocker therapy will be associated with increased survival. Methods: A multicenter registry enrolled 7,057 consecutive patients with acute MI. Discharge beta-blocker dose was indexed to the target beta-blocker doses used in randomized clinical trials, grouped as >0% to 12.5%, >12.5% to 25%, >25% to 50%, and >50% of target dose. Follow-up vital status was assessed, with the primary endpoint of time-to-death right-censored at 2 years. Multivariable and propensity score analyses were used to account for group differences. Results: Of 6,682 with follow-up (median 2.1 years), 91.5% were discharged on beta-blocker (mean dose 38.1%). Lower mortality was observed with all beta-blocker doses (p < 0.0002) versus no beta-blocker therapy. After multivariable adjustment, hazard ratios (HRs) for 2-year mortality compared with the >50% dose were 0.862 (95% confidence interval [CI]: 0.677 to 1.098), 0.799 (95% CI: 0.635 to 1.005), and 0.963 (95% CI: 0.765 to 1.213) for the >0% to 12.5%, >12.5% to 25%, and >25% to 50% of target dose, respectively. Multivariable analysis with an extended set of covariates and propensity score analysis also demonstrated that higher doses were not associated with better outcome. Conclusions: These data do not demonstrate increased survival in patients treated with beta-blocker doses approximating those used in prior randomized clinical trials compared with lower doses. These findings provide the rationale to re-engage in research to establish appropriate beta-blocker dosing following MI to derive optimal benefit from this therapy.(The PACE-MI Registry Study - Outcomes of Beta-blocker Therapy After Myocardial Infarction [OBTAIN]: NCT00430612) Twit Text FOAVip Effect of Beta-Blocker Dose on Survival after Acute Myocardial Infarction ????J Am Coll Cardiol http://www.kidney.de/pget.php?&tw=1&pmid=26403339 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26403339 #FOAvip English Wikipedia <ref>{{Cite pmid|26403339}}</ref> Effect of Beta-Blocker Dose on Survival after Acute Myocardial Infarction #MMPMID26403339 Goldberger JJ; Bonow RO; Cuffe M; Liu L; Rosenberg Y; Shah PK; Smith SC; Suba?ius H J Am Coll Cardiol 2015[Sep]; 66 (13): 1431-41 PMID26403339show ga Background: Beta-blocker therapy after acute myocardial infarction (MI) improves survival. Beta-blocker doses used in clinical practice are often substantially lower than those used in the randomized trials establishing their efficacy. Objective: This study evaluated the association of beta-blocker dose with survival after acute MI, hypothesizing that higher dose beta-blocker therapy will be associated with increased survival. Methods: A multicenter registry enrolled 7,057 consecutive patients with acute MI. Discharge beta-blocker dose was indexed to the target beta-blocker doses used in randomized clinical trials, grouped as >0% to 12.5%, >12.5% to 25%, >25% to 50%, and >50% of target dose. Follow-up vital status was assessed, with the primary endpoint of time-to-death right-censored at 2 years. Multivariable and propensity score analyses were used to account for group differences. Results: Of 6,682 with follow-up (median 2.1 years), 91.5% were discharged on beta-blocker (mean dose 38.1%). Lower mortality was observed with all beta-blocker doses (p < 0.0002) versus no beta-blocker therapy. After multivariable adjustment, hazard ratios (HRs) for 2-year mortality compared with the >50% dose were 0.862 (95% confidence interval [CI]: 0.677 to 1.098), 0.799 (95% CI: 0.635 to 1.005), and 0.963 (95% CI: 0.765 to 1.213) for the >0% to 12.5%, >12.5% to 25%, and >25% to 50% of target dose, respectively. Multivariable analysis with an extended set of covariates and propensity score analysis also demonstrated that higher doses were not associated with better outcome. Conclusions: These data do not demonstrate increased survival in patients treated with beta-blocker doses approximating those used in prior randomized clinical trials compared with lower doses. These findings provide the rationale to re-engage in research to establish appropriate beta-blocker dosing following MI to derive optimal benefit from this therapy.(The PACE-MI Registry Study - Outcomes of Beta-blocker Therapy After Myocardial Infarction [OBTAIN]: NCT00430612) äEffect of Beta-Blocker Dose on Survival after Acute Myocardial Infarct(epmc).pdf DeepDyve Pubget Overpricing