
Effectiveness and Cost-effectiveness of a VCoP to Empowerment of Patients With Ischaemic Heart Disease...
Ischemic Heart Disease ChronicObjective: to evaluate the effectiveness and estimate the costs of a Virtual Community of Practice in the improvement of the activation of patients with Ischemic Heart Disease in Primary Care . Methods: Design: pragmatic randomized controlled multicentric trial. Setting: health centres belonging to the Autonomous Communities of Catalonia, Madrid and the Canary Islands. Population: 246 patients with Ischemic Heart Disease in Primary Care. Randomization: randomization will be central and automatically performed by the online "e-mpodera" platform and the assigned group will be communicated to the patient once he or she has entered the platform and completed baseline assessment. Intervention: the intervention group will be offered participation for 6 months in a Virtual Community of Practice based on a web 2.0 platform in which there is interaction with other patients and with a multidisciplinary team of professionals. The intervention will be co-designed with a group of patients and a group of primary and specialized care professionals. The control group will receive usual care. Measurements: the main variable will be measured using the Patient Activation Measure questionnaire at baseline, 6, 12 and 18 months. Secondary variables: sociodemographic and clinical variables of the patients; knowledge test (questionnaire of risk cardiovascular factories , attitudes (Self-efficacy Managing Chronic Disease Scale ), adherence to Mediterranean diet (Mediterranean Diet), level of physical activity (International Physical Activity Questionnaire), medication adherence (Adherence Refill and Medication Scale (ARMS-e), depression (Patient Health Questionnaire), anxiety (Hospital Anxiety and Depression Scale), quality of life (EQ-5D-5L); variables related to the use of health resources; variables related to the use of the Virtual Community of Practice . Data will be collected from self-reported questionnaires and the electronic medical records. Analysis: a linear regression model of mixed effects will be estimated to estimate the effect of participating in the Virtual Community of Practice. In addition, subgroup analyses will be carried out and indicators of the functioning of the Virtual Community of Practice will be measured through techniques of Social Network Analysis and Control Charts. There will be an economic evaluation of the Virtual Community of Practice from the perspective of the National Health System and from the social perspective.

Cardiovascular Systems Inc. (CSI) pVAD First in Human Study
Coronary Artery DiseaseThis study will collect initial clinical data on the CSI pVAD system to inform device design and finalization.

Feasibility and Safety of the Routine Distal Transradial Approach
Vascular Access ComplicationRadial Artery3 moreThe distal transradial approach (dTRA) via the anatomical snuffbox is hypothesized to be more beneficial than the conventional transradial access (cTRA) in patients undergoing coronary procedures. This prospective single-center randomized trial was designed to investigate the safety, efficacy, and various ultrasound parameters of dTRA.

Cardiac Rehabilitation in Coronary Artery Diseases
Have a Diagnosis of Coronary Artery DiseaseCardiac rehabilitation is approaches that focus on accelerating the recovery process of patients after a cardiac event, improving their physical, psychological and social conditions, and controlling risk factors. Cardiac rehabilitation is known to be an effective and cost-effective approach in the secondary prevention of cardiovascular diseases, most of which are caused by preventable risks. Ischemic heart diseases, one of the cardiovascular diseases, are responsible for 16% of total deaths in the world and have increased significantly since 2000, causing 8.9 million deaths in 2019. When coronary artery diseases cannot be prevented, the basic approach should be to ensure the individual's compliance with treatment and healthy lifestyle behaviors, and to increase the quality of life and life span. For this reason, the aim of the study is to examine the effects of technology-based education structured according to the health promotion model in cardiac rehabilitation on healthy lifestyle behaviors, health fatalism and risk knowledge level. Question 1. Does technology-based education structured according to the health promotion model affect the healthy lifestyle behaviors score? Question 2. Does technology-based education structured according to the health promotion model affect the health fatalism score? Question 3. Does technology-based education structured according to the health promotion model affect the cardiovascular disease risk factors knowledge level score?

Amlodipine Freeze-Dried Powder for Oral Solution 5 mg
HypertensionCoronary Artery DiseaseThe goal of this clinical study is to assess the relative bioavailability of Amlodipine for Oral Solution 5 mg of Brillian Pharma Inc. under fasting and fed conditions versus reference product Norvasc 5 mg tablets of Pfizer Labs under fasting in normal, healthy, adult, male, Primary Objective: To compare the relative bioavailability. To assess the food effect in Test product (T1) (Fast) vs Test product (T2) (Fed) Amlodipine Oral Solution 5 mg of Brillian Pharma Inc. Secondary Objective: To monitor the safety and tolerability of a single oral dose of investigational medicinal products (IMPs).

Effects of Ticagrelor Versus Prasugrel on Coronary Microcirculation in Patients Undergoing Elective...
Coronary Artery DiseaseBesides being at least as effective as prasugrel in inhibiting platelet aggregation, ticagrelor has been shown to have additional properties potentially affecting coronary microcirculation. We sought to compare the effects of ticagrelor and prasugrel on absolute coronary blood flow (Q) and microvascular resistance (R) in patients with stable coronary artery disease (CAD) undergoing elective percutaneous coronary intervention (PCI). The PROMICRO-3 study shows that in patients with stable CAD undergoing PCI pre-treatment with a loading dose of ticagrelor compared with prasugrel improves post-procedural coronary flow and microvascular function and seems to reduce the related myocardial injury.

Comparative Effectiveness of Decision Aids for Stable Chest Discomfort
Coronary Artery DiseaseStable AnginaThe purpose of the study is to compare two different types of decision support materials for patients considering treatment for chest pain or chest discomfort from heart disease.

Improving Quality by Maintaining Accurate Problems in the EHR
AsthmaAtrial Fibrillation11 moreThe overall goal of the IQ-MAPLE project is to improve the quality of care provided to patients with several heart, lung and blood conditions by facilitating more accurate and complete problem list documentation. In the first aim, the investigators will design and validate a series of problem inference algorithms, using rule-based techniques on structured data in the electronic health record (EHR) and natural language processing on unstructured data. Both of these techniques will yield candidate problems that the patient is likely to have, and the results will be integrated. In Aim 2, the investigators will design clinical decision support interventions in the EHRs of the four study sites to alert physicians when a candidate problem is detected that is missing from the patient's problem list - the clinician will then be able to accept the alert and add the problem, override the alert, or ignore it entirely. In Aim 3, the investigators will conduct a randomized trial and evaluate the effect of the problem list alert on three endpoints: alert acceptance, problem list addition rate and clinical quality.

Analysis of Surface EKG Signals to Identify Myocardial Dysfunction in Patients at Risk for Coronary...
Coronary Artery DiseaseThe MyoVista device is capable of detecting surface electrocardiogram signals and sensitive in detecting coronary artery disease compared to traditional computed tomography angiography (CTA) Electrophysiological signals at the cellular level of myocardium are related to specific patterns on the MyoVista device Changes in MyoVista device output and can indicative of future CAD outcomes and need for revascularization

Study to Evaluate the Effect of Nicotinamide Riboside on Immunity
AtherosclerosisDiabetes1 moreBackground: The immune system controls how the body responds to infection or injury. Researchers want to see what effect a dietary supplement called nicotinamide riboside (NR) has on the immune system. A study showed that fasting has a good effect on immune cell health in healthy people. And when immune cells were exposed to NR they had a similar positive response as with fasting. Researchers want to see if healthy people have the same effects from NR and fasting, and if those effects last. Objectives: To see if taking nicotinamide riboside will have the same healthy immune system effects as fasting. To see if these good effects continue even after eating again. Eligibility: Healthy volunteers ages 18 - 39 years Design: Participants will be screened with medical history, physical exam, and blood tests. Women will have a urine pregnancy test. Participants will take 4 pills of either NR or a placebo once a day for 1 week. On day 6, they will not eat or drink anything. On day 7, they will have a study visit to give a blood sample before and after eating a meal at the clinic. They will also give a urine sample. Participants will stop taking the pills for 1 2 weeks. Participants will take either NR or a placebo once a day for 1 week. They will repeat day 6 and day 7 of the first week. Participants will get NR once and placebo once, but will not know which they are taking.