new randomized controlled trials designed for the evaluation of newer PAH drugs should stratify patients according to anticoagulant use. More studies are needed to answer previous questions related to patients’ selection and risk stratification, target INR, and role of new oral anticoagulants. price Telaprevir Conclusion Contemporary data from the COMPERA registry support the use of anticoagulant therapy in patients with idiopathic PAH, but not in other types of PAH. Importantly, the data substantiated the previously reported concern that anticoagulant therapy may be harmful in patients with scleroderma-associated PAH. Further research into the role of anticoagulation in PAH is needed to establish best practice recommendations.
The last fifty years have witnessed remarkable improvement in the morbidity and mortality trends of most cardiovascular diseases. However, heart failure (HF) remains a notable exception. HF is a growing global health problem in both industrialized and developing nations. In fact, HF is the second most common cause for hospital admissions; the first cause is normal delivery. 1 In the
United States, the number of people with HF is expected to rise 46 percent from 5 million in 2012 to 8 million in 2030. The rise in patient numbers will double the costs of HF treatment, from $31 billion in 2012, to a staggering $70 billion in 2030. 2 These facts have stimulated the search for new effective methods to combat HF. An attractive strategy is to integrate the early detection of high-risk patients at the primary care level with advanced
diagnostic and therapeutic strategies at the tertiary care level. The St Vincent’s Screening TO Prevent Heart Failure (STOP-HF) study is a recently published trial in the Journal of American Medical Association (JAMA) assessing the use of brain natriuretic peptide (BNP) as a screening tool for HF in an at-risk population in reducing newly-diagnosed heart failure and prevalence Cilengitide of significant left ventricular (LV) systolic and/or diastolic dysfunction. 3 STOP-HF trial design and results In this “first-of-its-type” study, the investigators recruited 1374 participants with various cardiovascular risk factors from a nurse-provided primary care cardiovascular screening program in the catchment area of St Vincent’s University Hospital, Dublin, Ireland, between January 2005 and December 2009.Eligibility criteria were age older than 40 years (mean age, 64.8 [SD, 10.2] years) and a history of one or more of the following; hypertension, hypercholesterolemia, obesity, vascular disease, diabetes mellitus, arrhythmias, moderate to severe valvular heart disease.