ABSTRACT
AIM: To compare the impact of cardiac resynchronization therapy (CRT) on survival in patients with ischemic and non-ischemic cardiomyopathy (CMP) in clinical practice. SUBJECTS AND METHODS: The study enrolled 206 patients with NYHA Functional Class II-IV chronic heart failure (CHF) and a left ventricular ejection fraction of < or = 35, including 107 patients implanted with CRT devices in combination with continuous drug therapy (DT). Among the 107 patients, 48 were diagnosed as having non-ischemic CMP (NCMP), 59 as coronary heart disease (CHD). The other 99 patients (12 with NCMP and 87 with CHD) were on DT only. Later on the patients from both groups were divided into subgroups according to the treatment policy of CHF: CRT + DT or DT only. The mean follow-up period was 24 +/- 18.1 months. RESULTS: The Kaplan-Meier survival analysis revealed that overall survival in the patients on CRT + DT was significantly higher than in those on DT (70 and 49%, respectively; p = 0.004). Analysis of the chosen treatment policy in the NCMP subgroup showed no significant differences in survival rates in the patients receiving CRT + DT or DT (74 versus 78%, respectively; p = 0.5). At the same time, the survival rates in the CHD patients on CRT + DT were significantly higher than those in the DT subgroup (68 versus 44%; p = 0.04). CONCLUSION: CRT significantly reduces overall mortality in patients with CHF in clinical practice. Our findings indicated that this effect was achieved mainly in patients with CHD, rather than in those with NCMP.
Subject(s)
Cardiac Resynchronization Therapy/mortality , Cardiomyopathies/therapy , Ischemia/therapy , Adult , Cardiac Resynchronization Therapy Devices/statistics & numerical data , Cardiomyopathies/drug therapy , Cardiomyopathies/mortality , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Ischemia/drug therapy , Ischemia/mortality , Kaplan-Meier Estimate , Male , Middle Aged , Treatment OutcomeSubject(s)
Gene Expression Profiling/methods , Prostatic Neoplasms/genetics , Databases, Factual , Gene Expression , Gene Expression Profiling/statistics & numerical data , Gene Library , Humans , Male , Oligonucleotide Array Sequence Analysis , Pathology, Clinical/methods , Polymorphism, Single NucleotideABSTRACT
The study is devoted to research of the selective screening possibilities for revealing of hormonodependent tumours of the reproductive system organs in women (endometrial carcinoma, ovarian and breast cancer). The detection of risk factors of cervix uteri cancer, endometrial carcinoma, ovarian and breast cancer has been carried out with the help of a case-control study (311 patients with cancer and 14,872 controls). On the basis of the established risk factors by means of mathematical methods the optimized calculation programmes of individual risks and models in the formation of risk groups of hormonodependent tumours (control 0.32%) have been detected. Through this approach the practical significance of hormonedependent tumours of the selective screening of the reproductive system organs in women has been augmented.
Subject(s)
Genital Neoplasms, Female/diagnosis , Neoplasms, Hormone-Dependent/diagnosis , Precancerous Conditions/diagnosis , Adolescent , Adult , Case-Control Studies , Contraception , Female , Genital Neoplasms, Female/etiology , Humans , Middle Aged , Models, Biological , Neoplasms, Hormone-Dependent/etiology , Precancerous Conditions/etiology , Risk Factors , Sexual BehaviorABSTRACT
The review of references and data on endometrial and cervical cancer incidence in five continents (1970, 1976, 1982, 1987) are presented. The increase in cervical cancer rates in the developing countries of Asia, Africa and Latin America has been recorded. The hormonedependent tumours (endometrial, breast cancer) prevail in the economically developed countries of Europe and North America. They have shown a tendency to increase since the end of the 70's. The possible causes of peculiarities in oncogynecological incidence have been discussed.