\n\nMethods and Results-We performed a post hoc analysis of the Clopidogrel for
the Reduction of Events During Observation (CREDO) study to compare the treatment effect of clopidogrel in patients on CCBs versus not on CCBs. In CREDO, 2116 patients were randomly assigned to pretreatment with 300 mg clopidogrel 3-24 hours before a planned percutaneous coronary intervention followed by 1 year of 75 mg/d clopidogrel, versus 75 mg clopidogrel at the time of the procedure and continued for 28 days only. The primary end points were a combined end point of death, myocardial infarction, and stroke at 28 days and 1 year. Among the 580 patients (27%) on CCBs at enrollment, at 28 days, the combined end point was reached in 17 patients (6%) on clopidogrel versus 28 (9%) on placebo (hazard Pitavastatin datasheet ratio [HR], 0.71; 95% confidence interval [CI], 0.39-1.29). At 1 year, the combined end Selleck LY2606368 point was reached in 27 patients (10%) on clopidogrel versus 46 (15%) on placebo (HR, 0.68; 95% CI, 0.42-1.09). The treatment effect of clopidogrel was similar in patients not on CCBs at 1 year (HR, 0.78; 95% CI, 0.56-1.09). After adjustment for differences
between patients on and not on CCB, there was still no evidence of an interaction between clopidogrel treatment and CCB (HR for patients not on CCBs, 0.87; 95% CI, 0.62-1.23; HR for patients on CCBs, 0.74; 95% CI, 0.45-1.21).\n\nConclusions-In CREDO, there was no evidence that CCBs decrease the efficacy of clopidogrel. (Circ Cardiovasc Interv. 2012;5:77-81.)”
“This paper presents a personal view of research into the exercise drive to breathe that can be observed to act immediately to increase breathing at the start of rhythmic exercise. It is based on a talk given at the Experimental Biology 2013 meeting in a session entitled Recent advances in understanding mechanisms regulating breathing during exercise’. This drive
to breathe has its origin in a combination of central command, whereby voluntary motor commands to the exercising muscles produce a concurrent respiratory drive, and afferent feedback, whereby afferent information from the exercising muscles selleck compound affects breathing. The drive at the start and end of rhythmic exercise is proportional to limb movement frequency, and its magnitude decays as exercise continues so that the immediate decrease of ventilation at the end of exercise is about 60% of the immediate increase at the start. With such evidence for the effect of this fast drive to breathe at the start and end of rhythmic exercise, its existence during exercise is hypothesised. Experiments to test this hypothesis have, however, provided debatable evidence. A fast drive to breathe during both ramp and sine wave changes in treadmill exercise speed and grade appears to be present in some individuals, but is not as evident in the general population.