Clinical Trial Service Unit

About: Clinical Trial Service Unit is a based out in . It is known for research contribution in the topics: Population & Stroke. The organization has 428 authors who have published 1387 publications receiving 181920 citations.

Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials.

Abstract: Objectives: Most randomised trials of anticoagulant therapy for suspected acute myocardial infarction have been small and, in some, aspirin and fibrinolytic therapy were not used routinely. A systematic overview (meta-analysis) of their results is needed, in particular to assess the clinical effects of adding heparin to aspirin. Design: Computer aided searches, scrutiny of reference lists, and inquiry of investigators and companies were used to identify potentially eligible studies. On central review, 26 studies were found to involve unconfounded randomised comparisons of anticoagulant therapy versus control in suspected acute myocardial infarction. Additional information on study design and outcome was sought by correspondence with study investigators. Subjects: Patients with suspected acute myocardial infarction. Interventions: No routine aspirin was used among about 5000 patients in 21 trials (including half of one small trial) that assessed heparin alone or heparin plus oral anticoagulants, and aspirin was used routinely among 68 000 patients in six trials (including the other half of one small trial) that assessed the addition of intravenous or high dose subcutaneous heparin. Main outcome measurements: Death, reinfarction, stroke, pulmonary embolism, and major bleeds (average follow up of about 10 days). Results: In the absence of aspirin, anticoagulant therapy reduced mortality by 25% (SD 8%; 95% confidence interval 10% to 38%; 2P = 0.002), representing 35 (11) fewer deaths per 1000. There were also 10 (4) fewer strokes per 1000 (2P = 0.01), 19 (5) fewer pulmonary emboli per 1000 (2P Conclusions: The clinical evidence from randomised trials does not justify the routine addition of either intravenous or subcutaneous heparin to aspirin in the treatment of acute myocardial infarction (irrespective of whether any type of fibrinolytic therapy is used). Key messages Heparin seemed to be useful among patients with suspected acute myocardial infarction who, in the past, had received neither aspirin nor fibrinolytic therapy The available evidence from clinical trials does not justify the routine addition of intravenous or subcutaneous heparin to aspirin in the treatment of acute myo- cardial infarction (whether or not any type of fibrinolytic therapy is used)

Genome-Wide Association Study of Susceptibility to Idiopathic Pulmonary Fibrosis.

Abstract: Rationale: Idiopathic pulmonary fibrosis (IPF) is a complex lung disease characterized by scarring of the lung that is believed to result from an atypical response to injury of the epithelium. Geno...

Seasonal variation in blood pressure and its relationship with outdoor temperature in 10 diverse regions of China: the China Kadoorie Biobank.

Abstract: OBJECTIVES Mean blood pressure varies moderately with outdoor air temperature in many western populations. Substantial uncertainty exists, however, about the strength of the relationship in other populations and its relevance to age, adiposity, medical treatment, climate and housing conditions. METHODS To investigate the relationship of blood pressure with season and outdoor temperature, we analysed cross-sectional data from the China Kadoorie Biobank study of 506,673 adults aged 30-79 years recruited from 10 diverse urban and rural regions in China. Analyses related mean blood pressure - overall and in various subgroups - to mean local outdoor temperature. RESULTS The mean difference in SBP between summer (June-August) and winter (December-February) was 10 mmHg overall, and was more extreme, on average, in rural than in urban areas (12 vs. 8 mmHg; P for interaction <0.0001). Above 5°C, SBP was strongly inversely associated with outdoor temperature in all 10 areas studied, with 5.7 (SE 0.04) mmHg higher SBP per 10°C lower outdoor temperature. The association was stronger in older people and in those with lower BMI. At lower temperatures, there was no evidence of an association among participants who reported having central heating in their homes. CONCLUSION Blood pressure was strongly inversely associated with outdoor temperature in Chinese adults across a range of climatic conditions, although access to home central heating appeared to remove much of the association during the winter months. Seasonal variation in blood pressure should be considered in the clinical management of hypertension.