BACKGROUND: Patients with severe aortic stenosis present frequently (∼50%) with concomitant obstructive coronary artery disease. Current guidelines recommend combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) as the preferred treatment. Transcatheter aortic valve implantation (TAVI) and fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) represent a valid treatment alternative. We aimed to test the non-inferiority of FFR-guided PCI plus TAVI versus SAVR plus CABG in patients with severe aortic stenosis and complex coronary artery disease. METHODS: This international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial was conducted at 18 tertiary medical centres across Europe. Patients (aged ≥70 years) with severe aortic stenosis and complex coronary artery disease, deemed feasible for percutaneous or surgical treatment according to the on-site Heart Team, were randomly assigned (1:1) to FFR-guided PCI plus TAVI or SAVR plus CABG according to a computer-generated sequence with random permuted blocks sizes stratified by site. The primary endpoint was a composite of all-cause mortality, myocardial infarction, disabling stroke, clinically driven target-vessel revascularisation, valve reintervention, and life-threatening or disabling bleeding at 1 year post-treatment. The trial was powered for non-inferiority (with a margin of 15%) and if met, for superiority. The primary and safety analyses were done per an intention-to-treat principle. This trial is registered with ClinicalTrials.gov (NCT03424941) and is closed. FINDINGS: Between May 31, 2018, and June 30, 2023, 172 patients were enrolled, of whom 91 were assigned to the FFR-guided PCI plus TAVI group and 81 to the SAVR plus CABG group. The mean age of patients was 76·5 years (SD 3·9). 118 (69%) of 172 patients were male and 54 (31%) patients were female. FFR-guided PCI plus TAVI resulted in favourable outcomes for the primary endpoint (four [4%] of 91 patients) versus SAVR plus CABG (17 [23%] of 77 patients; risk difference -18·5 [90% CI -27·8 to -9·7]), which was below the 15% prespecified non-inferiority margin (pnon-inferiority<0·001). FFR-guided PCI plus TAVI was superior to SAVR plus CABG (hazard ratio 0·17 [95% CI 0·06-0·51]; psuperiority<0·001), which was driven mainly by all-cause mortality (none [0%] of 91 patients vs seven (10%) of 77 patients; p=0·0025) and life-threatening bleeding (two [2%] vs nine [12%]; p=0·010). INTERPRETATION: The TCW trial is the first trial to compare percutaneous treatment versus surgical treatment in patients with severe aortic stenosis and complex coronary artery disease, showing favourable primary endpoint and mortality outcomes with percutaneous treatment. FUNDING: Isala Heart Centre and Medtronic.
- MeSH
- aortální stenóza * chirurgie komplikace MeSH
- chirurgická náhrada chlopně metody MeSH
- frakční průtoková rezerva myokardu * MeSH
- koronární angioplastika * metody MeSH
- koronární bypass * metody MeSH
- lidé MeSH
- nemoci koronárních tepen * chirurgie komplikace terapie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- transkatetrální implantace aortální chlopně * metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnocení ekvivalence MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
OBJECTIVES: This cross-sectional analysis from the CZecking Heart Failure in patients with advanced Chronic Kidney Disease trial (ISRCTN18275480) examined pulmonary hypertension and right ventricular-pulmonary arterial coupling in patients on chronic hemodialysis. The aims of this analysis were: 1. To analyze relations between pulmonary hypertension and right ventricular-pulmonary arterial coupling with dialysis access flow and current hydration; 2. To analyze structural heart changes associated with right ventricular-pulmonary arterial uncoupling; 3. To reveal the prevalence, etiology and severity of pulmonary hypertension in the Czech hemodialysis population. METHODS: We performed expert echocardiography, vascular access flow measurements, bioimpedance analysis, and laboratory testing in 336 hemodialysis patients. RESULTS: Pulmonary hypertension was present in 34% (114/336) patients and right ventricular-pulmonary arterial uncoupling was present in 25% of patients with pulmonary hypertension. Only weak associations between the flow of the dialysis arteriovenous access and estimated pulmonary arterial systolic pressure and right ventricular-pulmonary arterial coupling was proved. There was a strong association between hydration status assessed by estimated central venous pressure with pulmonary arterial systolic pressure (Rho 0.6, p < 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.52, p < 0.0001) and association between overhydration to extracellular water ratio with pulmonary arterial systolic pressure (Rho 0.31, p = 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.29, p = 0.002). The prevalence of heart failure was significantly higher in patients with right ventricular-pulmonary arterial uncoupling (88% vs. 52%, p = 0.0003). CONCLUSION: These findings suggest that optimizing volume status and treating heart failure should be prioritized in hemodialysis patients to prevent pulmonary hypertension progression and right ventricular-pulmonary arterial uncoupling.
- Klíčová slova
- Right ventricular-pulmonary arterial coupling, arteriovenous access flow, chronic hemodialysis, fluid overload, heart failure, pulmonary hypertension,
- MeSH
- arteria pulmonalis * patofyziologie MeSH
- chronické selhání ledvin * terapie komplikace patofyziologie MeSH
- dialýza ledvin * škodlivé účinky MeSH
- echokardiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- plicní hypertenze * etiologie patofyziologie MeSH
- průřezové studie MeSH
- senioři MeSH
- srdeční komory patofyziologie diagnostické zobrazování MeSH
- srdeční selhání patofyziologie komplikace etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: This study examines the perspectives of individuals with coronary heart disease (CHD) on a nurse-led eHealth cardiac rehabilitation (NeCR) program, which included a website, tele-monitoring device, and social media chatroom. METHODS: Using a descriptive qualitative approach, semi-structured interviews were conducted with 18 participants to capture their feedback and experiences with the NeCR program. RESULTS: Participants found the NeCR program valuable in addressing gaps in cardiac rehabilitation services in China, empowering them to make behavioral changes and enhancing their social motivation. However, they also highlighted the need for a more user-friendly website, better symptom management during exercise, and stronger privacy protections in the peer networking chatroom. The study concludes that the NeCR program is feasible in providing accessible rehabilitative services at home post-discharge. Recommendations include improving the self-monitoring platform for ease of use, incorporating immediate symptom management guidance during exercise, and ensuring a secure environment for online peer support. CONCLUSIONS: These findings offer crucial insights for developing patient-centered eHealth cardiac rehabilitation services, emphasizing the importance of user-friendly design, effective symptom management features, and privacy protection in promoting participant engagement with e-platforms. TRIAL REGISTRATION: ChiCTR1800020411 (http://www.chictr.org.cn/showprojen.aspx?proj=33906).
- Klíčová slova
- behavioral change, cardiac rehabilitation, coronary heart disease, eHealth, patient‐centered care,
- MeSH
- dospělí MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc rehabilitace ošetřování MeSH
- kvalitativní výzkum * MeSH
- lidé středního věku MeSH
- lidé MeSH
- rozhovory jako téma MeSH
- senioři MeSH
- telemedicína * MeSH
- zpětná vazba MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Čína MeSH
Infective endocarditis (IE) is a life-threatening disease, with its mortality rate varying depending on the infectious agent. Streptococci are among the most common causes of infective endocarditis. However, Streptococcus vestibularis has rarely been associated with human infections, typically affecting patients with underlying conditions such as immunosuppressive diseases, valve replacement, rheumatic heart disease, and hemodialysis. We present the case of a 26-year-old man who presented with fever, unanticipated weight loss, and fatigue. Although no typical risk factors for infective endocarditis were identified at admission, transesophageal echocardiography revealed a bicuspid aortic valve with calcification, paravalvular aortic abscess formation, and vegetations on the anterior leaflet of the mitral valve. Blood cultures grew S. vestibularis, which was initially sensitive to benzylpenicillin but developed emergent resistance on the third day of the antibiotic treatment. Subsequently, ceftriaxone therapy was initiated, and blood cultures became sterile on day 10. The patient eventually underwent aortic valve replacement. We report the first known case of native aortic and mitral valve endocarditis caused by S. vestibularis, accompanied by a paravalvular abscess around the native aortic valve, in a patient who had no typical risk factors for infective endocarditis, except for a bicuspid aortic valve.
- Klíčová slova
- Bicuspid aortic valves, Infective endocarditis, Periannular abscesses, Streptococcus vestibularis,
- MeSH
- aortální chlopeň * MeSH
- bakteriální endokarditida * diagnóza mikrobiologie komplikace MeSH
- dospělí MeSH
- lidé MeSH
- mitrální chlopeň * MeSH
- Streptococcus * izolace a purifikace MeSH
- streptokokové infekce * diagnóza komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
BACKGROUND AND AIMS: Myocardial infarction (MI) in multivessel disease (MVD) and chronic total occlusion (CTO) is associated with high mortality. However, all-cause mortality of matched cohort without a CTO is unclear. Our aim was to analyse clinical characteristics, presenting symptoms, and survival of patients with MI in MVD and the possible impact of CTO on 1-year mortality. METHODS: All MI patients with MVD (two or three vessel disease) hospitalized in our center from January 2020 to September 2022 (1309 patients) were selected. We conducted a propensity score matching (PSM) analysis based on age, gender, type of MI, and compared patients with CTO (CTO group, n = 90) and without CTO (Control group, n = 90). RESULTS: We observed no difference in presenting clinical symptoms and initial heart rhythm between the groups. 1-year follow-up shows all-cause mortality rate of 23.3 % (n = 21) in the CTO group (Mean survival [MS] = 292.1 days, 95 % CI = 263.8 to 320.4) and 18.9 % (n = 17) in the Control group (MS = 310.2 days, 95 % CI = 285.3 to 335.2), p = 0.44. PCI alone was performed in 64.4 % (n = 58) in both groups, CABG in 18.8 % (n = 17) and 24.4 % (n = 22) (CTO vs. Control group respectively). Combination of PCI and CABG occurred in 8.8 % (n = 8) in both groups. Conservative treatment was chosen for 7 CTO and 2 Control group patients. CONCLUSION: We observed no 1-year mortality difference in patients with MI, MVD and a CTO compared to a matched cohort of patients with MI, MVD without CTO. Excellent 1-year survival was observed in patients treated by CABG, irrespective of CTO presence.
- Klíčová slova
- Chronic total occlusion, Multivessel disease, Myocardial infarction, Percutaneous coronary intervention,
- MeSH
- chronická nemoc MeSH
- infarkt myokardu * mortalita diagnóza MeSH
- kohortové studie MeSH
- koronární angioplastika metody MeSH
- koronární okluze * diagnóza mortalita chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- nemoci koronárních tepen mortalita diagnóza chirurgie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- tendenční skóre MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: To analyze the prevalence and severity of fetal aortic regurgitation (AR) after undergoing successful fetal aortic valvuloplasty (FAV) and to evaluate its effects on fetal circulation and left ventricular (LV) growth. METHODS: This was a retrospective review of all fetuses with critical aortic stenosis who underwent successful FAV at our center between 2010 and 2024 for whom postnatal echocardiograms were available in digital format. Fetal and postnatal echocardiographic examinations were analyzed for ventricular and valvular dimensions and characteristics, and Z-scores were calculated for middle cerebral artery (MCA) pulsatility index (PI), umbilical artery (UA) PI and cerebroplacental ratio. AR severity was classified into no/mild AR or significant (moderate/severe) AR. The balloon-to-aortic valve ratio (BVR) was calculated as the ratio between the maximum actual balloon diameter and the aortic valve (AV) annulus diameter. The primary endpoints of this study were the prevalence, severity and risk factors for fetal AR following successful FAV. RESULTS: Ninety-nine fetuses who underwent successful FAV were included. Immediate post-FAV echocardiograms showed that 87% of fetuses developed some degree of AR, including 45% of all fetuses with significant AR. BVR was significantly higher in fetuses with significant AR compared to those with no/mild AR (mean, 1.09 (95% CI, 1.06-1.12) vs 1.02 (95% CI, 0.99-1.04); P < 0.001). In a subgroup of 66/99 fetuses with available postnatal echocardiograms, the prevalence of AR decreased significantly from 86% before birth to 58% after birth (P < 0.001), with the proportion of fetuses with significant AR reducing from 47% before birth to 17% after birth (P < 0.001). In the overall cohort of fetuses, AV maximum velocity (Vmax) increased significantly from post-FAV to after birth (mean, 1.93 (95% CI, 1.75-2.11) m/s vs 3.21 (95% CI, 2.89-3.55) m/s; P < 0.001), regardless of AR severity, but Vmax after birth was lower in the significant-AR group compared with the no/mild-AR group (mean, 2.85 m/s vs 3.55 m/s; P = 0.020). Fetuses with significant AR exhibited higher relative LV length increases from immediately post-FAV to after birth than did those with no/mild AR (25% (95% CI, 16-33%) vs 14% (95% CI, 6-21%); P = 0.044), although there was no significant difference in mean LV length Z-score after birth between the two groups. FAV led to significant short-term increases in MCA-PI and UA-PI Z-scores, with greater increases observed in fetuses with significant AR. CONCLUSIONS: FAV is associated with a high prevalence of fetal AR, which lessens in severity over the course of gestation. Significant fetal AR had the largest association with greater BVR and had significant impact on fetal hemodynamics. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
- Klíčová slova
- aortic regurgitation, critical aortic stenosis, evolving hypoplastic left heart syndrome, fetal cardiac intervention, fetal circulation,
- MeSH
- aortální chlopeň diagnostické zobrazování embryologie MeSH
- aortální insuficience * diagnostické zobrazování epidemiologie patofyziologie MeSH
- aortální stenóza diagnostické zobrazování embryologie epidemiologie patofyziologie MeSH
- balónková valvuloplastika * MeSH
- dospělí MeSH
- echokardiografie metody MeSH
- fetální srdce diagnostické zobrazování patofyziologie MeSH
- gestační stáří MeSH
- lidé MeSH
- nemoci plodu epidemiologie diagnostické zobrazování MeSH
- novorozenec MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- stupeň závažnosti nemoci MeSH
- těhotenství MeSH
- ultrasonografie prenatální * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease (CAD) that is characterized by concentric fibrous intimal hyperplasia along the length of coronary vessels, and is recognized as long-term complication after heart transplantation. The chromosomal loci 9p21, 6q25.1, and 2q36.3, represented by their respective leading variants rs10757274, rs6922269 and rs2943634, have been linked with a history of CAD by genome-wide association studies. We aimed to investigate the associations of genetic variants at the loci 9p21, 6q25.1, and 2q36.3 with CAV as genetic risk factors for early prediction. METHODS: Genomic DNA was extracted from paired aortic samples of 727 heart recipients (average age 50.8 ± 12.2 years; 21.3% women) and corresponding donors (average age 39.7 ± 12.0 years; 26.1% women). The variants within the loci 9p21, 6q25.1, and 2q36.3 were genotyped using PCR-RFLP. RESULTS: The recipients' variants of 9p21 (OR 1.97; 95% CI, 1.21-3.19 for GG vs. +A comparison, p = 0.0056) and 2q36.3 (OR 2.46; 95% CI, 1.12-6.17 for +C vs. AA comparison, p = 0.0186) were associated with higher incidence of CAV during the first year following heart transplantation. No such association was found for donor genotypes. CONCLUSIONS: Our data suggest that variants at the locus 9p21 (rs10757274) and 2q36.3 (rs2943634) are associated with early CAV development.
- Klíčová slova
- SNPs, cardiac allograft vasculopathy, transplantation,
- MeSH
- alografty * MeSH
- celogenomová asociační studie MeSH
- dospělí MeSH
- genetická predispozice k nemoci MeSH
- jednonukleotidový polymorfismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidské chromozomy, pár 2 genetika MeSH
- lidské chromozomy, pár 6 genetika MeSH
- lidské chromozomy, pár 9 genetika MeSH
- nemoci koronárních tepen * genetika patologie etiologie MeSH
- transplantace srdce * škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Diet, stress, genetics, and a sedentary lifestyle may all contribute to heart disease rates. Although recent studies propose comprehensive automated diagnostic systems, these systems tend to focus on one aspect, such as feature selection, prioritization, or predictive accuracy. A more complete approach that considers all of these factors can improve the efficiency of a cardiac prediction system. This study uses an appropriate strategy to overcome potential network design problems, design challenges, overfitting, and lack of robustness that can interfere with system performance. The research introduces an ideally designed deep trust network called ID-DTN to improve system performance. The Ruzzo-Tompa method is used to eliminate noncontributory features. The Seagull Optimization Algorithm (SOA) is introduced to optimize the trust depth network to achieve optimal network design. The study scrutinizes the deep trust network (ID-DTN) and the restricted Boltzmann machine (RBM) and sheds light on the system's operation. This proposal can optimize both network architecture and feature selection, which is the main novelty. The proposed method is analyzed using the below-mentioned metrics: Matthew's correlation coefficient, F1 score, accuracy, sensitivity, specificity, and accuracy. ID-DTN performs well compared to other state-of-the-art methods. The validation results confirm that the proposed method improves the prediction accuracy to 97.11% and provides reliable recommendations for patients with cardiovascular disease.
- Klíčová slova
- Artificial Intelligence, Boltzmann machine, Deep learning, Heart disease prediction, Ruzzo-Tompa, Seagull optimization,
- MeSH
- algoritmy * MeSH
- lidé MeSH
- nemoci srdce * diagnóza MeSH
- neuronové sítě (počítačové) MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Fibroblast growth factor 21 (FGF21), a metabolic hormone with pleiotropic effects, is beneficial for various cardiac disorders. However, FGF21's role in heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we show that elevated circulating FGF21 levels are negatively associated with cardiac diastolic function in patients with HFpEF. Global or adipose FGF21 deficiency exacerbates cardiac diastolic dysfunction and damage in high-fat diet (HFD) plus N[w]-nitro-L-arginine methyl ester (L-NAME)-induced HFpEF mice, whereas these effects are notably reversed by FGF21 replenishment. Mechanistically, FGF21 enhances the production of adiponectin (APN), which in turn indirectly acts on cardiomyocytes, or FGF21 directly targets cardiomyocytes, to negatively regulate pyruvate dehydrogenase kinase 4 (PDK4) production by activating PI3K/AKT signals, then promoting mitochondrial bioenergetics. Additionally, APN deletion strikingly abrogates FGF21's protective effects against HFpEF, while genetic PDK4 inactivation markedly mitigates HFpEF in mice. Thus, FGF21 protects against HFpEF via fine-tuning the multiorgan crosstalk among the adipose, liver, and heart.
- MeSH
- adiponektin * metabolismus genetika MeSH
- dieta s vysokým obsahem tuků * škodlivé účinky MeSH
- energetický metabolismus * účinky léků MeSH
- fibroblastové růstové faktory * metabolismus genetika MeSH
- fosfatidylinositol-3-kinasy metabolismus MeSH
- kardiomyocyty * metabolismus účinky léků MeSH
- lidé MeSH
- myši inbrední C57BL MeSH
- myši knockoutované MeSH
- myši MeSH
- PDH-kinasa * metabolismus genetika MeSH
- protoonkogenní proteiny c-akt metabolismus MeSH
- signální transdukce MeSH
- srdeční mitochondrie * metabolismus účinky léků MeSH
- srdeční selhání * metabolismus prevence a kontrola genetika MeSH
- tepový objem účinky léků MeSH
- tuková tkáň metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- adiponektin * MeSH
- FGF21 protein, human MeSH Prohlížeč
- fibroblast growth factor 21 MeSH Prohlížeč
- fibroblastové růstové faktory * MeSH
- fosfatidylinositol-3-kinasy MeSH
- PDH-kinasa * MeSH
- Pdk4 protein, mouse MeSH Prohlížeč
- protoonkogenní proteiny c-akt MeSH
BACKGROUND: Inflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of cardiovascular events. METHODS: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients who had myocardial infarction to receive either colchicine or placebo and either spironolactone or placebo. The results of the colchicine trial are reported here. The primary efficacy outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization, evaluated in a time-to-event analysis. C-reactive protein was measured at 3 months in a subgroup of patients, and safety was also assessed. RESULTS: A total of 7062 patients at 104 centers in 14 countries underwent randomization; at the time of analysis, the vital status was unknown for 45 patients (0.6%), and this information was most likely missing at random. A primary-outcome event occurred in 322 of 3528 patients (9.1%) in the colchicine group and 327 of 3534 patients (9.3%) in the placebo group over a median follow-up period of 3 years (hazard ratio, 0.99; 95% confidence interval [CI], 0.85 to 1.16; P = 0.93). The incidence of individual components of the primary outcome appeared to be similar in the two groups. The least-squares mean difference in C-reactive protein levels between the colchicine group and the placebo group at 3 months, adjusted according to the baseline values, was -1.28 mg per liter (95% CI, -1.81 to -0.75). Diarrhea occurred in a higher percentage of patients with colchicine than with placebo (10.2% vs. 6.6%; P<0.001), but the incidence of serious infections did not differ between groups. CONCLUSIONS: Among patients who had myocardial infarction, treatment with colchicine, when started soon after myocardial infarction and continued for a median of 3 years, did not reduce the incidence of the composite primary outcome (death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization). (Funded by the Canadian Institutes of Health Research and others; CLEAR ClinicalTrials.gov number, NCT03048825.).
- MeSH
- C-reaktivní protein * analýza MeSH
- cévní mozková příhoda prevence a kontrola MeSH
- dvojitá slepá metoda MeSH
- infarkt myokardu * prevence a kontrola mortalita MeSH
- Kaplanův-Meierův odhad MeSH
- kolchicin * terapeutické užití škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- recidiva MeSH
- sekundární prevence MeSH
- senioři MeSH
- spironolakton terapeutické užití škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- C-reaktivní protein * MeSH
- kolchicin * MeSH
- spironolakton MeSH