49,261 results match your criteria risk stratification

Precision medicine in immunoglobulin A nephropathy: still a journey ahead.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):24-30

Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide and since its first description extensive research has identified a number of key central pathogenetic contributors, including genetic, immunological and environmental factors. Along with its multifaceted pathophysiology, the clinical presentation of IgAN varies, ranging from mild forms with only minor urinary findings and preserved renal function to cases that rapidly progress to end-stage renal disease. Because of this, early identification of patients at risk for a progressive course is urgently needed. Read More

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Consensus Statement for the Management and Treatment of Sturge-Weber Syndrome: Neurology, Neuroimaging, and Ophthalmology Recommendations.

Pediatr Neurol 2021 May 6;121:59-66. Epub 2021 May 6.

Department of Dermatology, University of California, Irvine School of Medicine, Irvine, California. Electronic address:

Background: Sturge-Weber syndrome (SWS) is a sporadic, neurocutaneous syndrome involving the skin, brain, and eyes. Because of the variability of the clinical manifestations and the lack of prospective studies, consensus recommendations for management and treatment of SWS have not been published.

Objective: This article consolidates the current literature with expert opinion to make recommendations to guide the neuroimaging evaluation and the management of the neurological and ophthalmologic features of SWS. Read More

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Agreement between ACR TI-RADS and EU TI-RADS scoring systems in the diagnosis of 473 thyroid nodules from a single-center in Brazil.

Endocr Pract 2021 Jun 18. Epub 2021 Jun 18.

Division of Surgery, Pathology and Endocrinology, Agamenon Magalhães Hospital, State Secretary of Health, Recife, Brazil; University of Pernambuco Medical School, Recife, Brazil.

Objectives: This study compares two ultrasound-based risk-stratification systems in malignancy risk assessment of thyroid nodules and the clinical applicability of these guidelines in Brazil.

Methods: We retrospectively reviewed the ultrasound findings of 314 patients (473 thyroid nodules) who underwent fine needle aspiration (FNA) biopsy and/or surgery between February 2018 and March 2019. All nodules were classified using two systems: The Thyroid Imaging, Reporting, and Data System of the American College of Radiology (ACR-TIRADS) and the TIRADS of the European Thyroid Association (EU-TIRADS). Read More

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Combination Biomarkers for Risk Stratification in Patients with Chronic Heart Failure Biomarkers Prognostication in HF.

J Card Fail 2021 Jun 18. Epub 2021 Jun 18.

Department of Medicine, UCLA Medical Center, Los Angeles, CA; UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Background: Current guidelines recommend measuring natriuretic peptide biomarkers to establish prognosis in patients with chronic heart failure with reduced ejection fraction (HFrEF). We assessed whether a combination biomarkers approach improve prognostication in stable HFrEF patients.

Methods: An observational cohort study recruited 202 stable HFrEF patients at a single center, tertiary care hospital undergoing elective cardiac resynchronization therapy device placement from 2013 to 2015. Read More

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Circulatory follicular helper T lymphocytes associate with lower incidence of CMV infection in kidney transplant recipients.

Am J Transplant 2021 Jun 21. Epub 2021 Jun 21.

Instituto de Investigación Biomédica Hospital, 12 de Octubre (imas12), Madrid, Spain.

Primary infection and/or reactivation of cytomegalovirus (CMV) in kidney transplant recipients (KTR) favour rejection and mortality. T follicular helper cells (TFH) could contribute to protection against CMV. Circulatory TFH (cTFH) were studied pre-transplantation and early post-transplantation in 90 CMV seropositive KTR not receiving antithymocyte globulin or antiviral prophylaxis, followed-up for one year. Read More

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Association of metabolic syndrome with cardiovascular outcomes in hypertensive patients: a systematic review and meta-analysis.

J Endocrinol Invest 2021 Jun 21. Epub 2021 Jun 21.

Department of General Practice, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Purpose: The association between metabolic syndrome (MetS) and cardiovascular outcomes in patients with hypertension is still controversial. This meta-analysis sought to evaluate the association of MetS with cardiovascular outcomes in hypertensive patients.

Methods: Two authors comprehensively searched PubMed and Embase databases from their inception to April 18, 2020 for the longitudinal studies that evaluated the association of MetS with cardiovascular outcomes in patients with hypertension. Read More

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Reduced hepatic steatosis is associated with higher risk of hepatocellular carcinoma in chronic hepatitis B infection.

Hepatol Int 2021 Jun 21. Epub 2021 Jun 21.

Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road 102, Hong Kong, China.

Background: Concomitant chronic hepatitis B infection (CHB) and non-alcoholic fatty liver disease (NAFLD) is common, but the implications of NAFLD on clinical outcomes of CHB, including hepatocellular carcinoma (HCC), are not well-investigated.

Methods: CHB patients were recruited for transient elastography assessment for liver stiffness (LS), and controlled attenuation parameter (CAP), a non-invasive quantification of hepatic steatosis, and were prospectively followed up for development of HCC. Steatosis and severe steatosis were diagnosed by CAP ≥ 248 dB/m and ≥ 280 dB/m respectively, and advanced fibrosis/cirrhosis was diagnosed by LS ≥ 9 kPa. Read More

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Performance evaluation of four prediction models for risk stratification in gastric cancer screening among a high-risk population in China.

Gastric Cancer 2021 Jun 21. Epub 2021 Jun 21.

Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, China.

Objective: Early detection of gastric cancer (GC) is a critical step for decreasing mortality. The aim of this study was to evaluate the performance of four prediction models for risk stratification in the screening of GC and precancerous lesions among a large, high-risk population in China.

Design: This study was a retrospective analysis of data from the Provincial Gastric Cancer Screening Program (Zhejiang, China) spanning the period between October 2016 and April 2019, in which 97,541 individuals from the urban areas of 10 cities in Zhejiang province, China participated in this program. Read More

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Use of Multiprognostic Index Domain Scores, Clinical Data, and Machine Learning to Improve 12-Month Mortality Risk Prediction in Older Hospitalized Patients: Prospective Cohort Study.

J Med Internet Res 2021 Jun 21;23(6):e26139. Epub 2021 Jun 21.

College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Background: The Multidimensional Prognostic Index (MPI) is an aggregate, comprehensive, geriatric assessment scoring system derived from eight domains that predict adverse outcomes, including 12-month mortality. However, the prediction accuracy of using the three MPI categories (mild, moderate, and severe risk) was relatively poor in a study of older hospitalized Australian patients. Prediction modeling using the component domains of the MPI together with additional clinical features and machine learning (ML) algorithms might improve prediction accuracy. Read More

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CD34-negative Solitary Fibrous Tumor: A Clinicopathologic Study of 25 Cases and Comparison With Their CD34-positive Counterparts.

Am J Surg Pathol 2021 Apr 7. Epub 2021 Apr 7.

Department of Pathology, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.

CD34-negative solitary fibrous tumors (SFTs) are rare and have not been comprehensively studied. We retrospectively reviewed all cases of SFT confirmed with STAT6 immunohistochemistry and/or STAT6 gene fusion between 2013 and 2020 and collected pertinent clinicopathologic parameters. Of a total of 244 cases, 25 (10%) lacked CD34 expression by immunohistochemistry. Read More

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Current and new imaging techniques in risk stratification of asymptomatic severe aortic stenosis.

Acta Cardiol 2021 Jun 21:1-9. Epub 2021 Jun 21.

Cardiology Department, Abderrahmane Mami's Hospital, Ariana, Tunisia.

Aortic stenosis (AS) is one of the most common valvular diseases in clinical practice. The prevalence of calcified AS with moderate or severe stenosis exceeds 2% after 75 years. The optimal timing of intervention for asymptomatic severe AS is uncertain and controversial. Read More

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Postoperative Myocardial Injury in Patients Classified as Low Risk Preoperatively Is Associated With a Particularly Increased Risk of Long-Term Mortality After Noncardiac Surgery.

J Am Heart Assoc 2021 Jun 19:e019379. Epub 2021 Jun 19.

Department of Medicine Heart and Vascular Center MetroHealth Medical Center Case Western Reserve University School of Medicine Cleveland OH.

Background Prior studies have shown an association between myocardial injury after noncardiac surgery (MINS) and all-cause mortality in patients following noncardiac surgery. However, the association between preoperative risk assessments, Revised Cardiac Risk Index and American College of Surgeons National Surgical Quality Improvement Program, and postoperative troponin elevations and long-term mortality is unknown. Methods and Results A retrospective chart review identified 548 patients who had a troponin I level drawn within 14 days of noncardiac surgery that required an overnight hospital stay. Read More

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Congenital Long QT Syndrome: A Clinician's Guide.

Intern Med J 2021 Jun 20. Epub 2021 Jun 20.

Division of Cardiology, Alfred Health, Melbourne, Australia.

Congenital long QT syndrome (LQTS) is a familial cardiac ion channelopathy first described over sixty years ago. It is characterised by prolonged ventricular repolarization (long QT on ECG), ventricular arrhythmias and associated syncope or sudden cardiac death. As the most closely studied cardiac channelopathy, over the decades we have gained a deep appreciation of the complex genetic model of LQTS. Read More

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Impact of YTHDF1 gene polymorphisms on Wilms tumor susceptibility: A five-center case-control study.

J Clin Lab Anal 2021 Jun 21:e23875. Epub 2021 Jun 21.

Department of General Surgery, Xi'an Children's Hospital, Xi'an Jiaotong University Affiliated Children's Hospital, Xi'an, China.

Background: Wilms tumor is the most frequent renal malignancy in children. YTHDF1 is associated with the development of several kinds of cancers, yet whether common variants of the YTHDF1 gene influence Wilms tumor risk is unknown. We present, here, a hospital-based case-control study specifically designed to investigate the role of YTHDF1 genetic variants on Wilms tumor. Read More

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Arrhythmic risk stratification in arrhythmogenic cardiomyopathy: new predictors for left-sided variants?

Eur Heart J 2021 Jun 21. Epub 2021 Jun 21.

Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Italy.

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Assessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency Department.

Crit Care Explor 2021 Jun 15;3(6):e0460. Epub 2021 Jun 15.

Louisiana State University Health Sciences Center, Baton Rouge, LA.

Objectives: Sepsis is a common cause of morbidity and mortality. A reliable, rapid, and early indicator can help improve efficiency of care and outcomes. To assess the IntelliSep test, a novel in vitro diagnostic that quantifies the state of immune activation by measuring the biophysical properties of leukocytes, as a rapid diagnostic for sepsis and a measure of severity of illness, as defined by Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation-II scores and the need for hospitalization. Read More

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Prediction of Impending Septic Shock in Children With Sepsis.

Crit Care Explor 2021 Jun 15;3(6):e0442. Epub 2021 Jun 15.

Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD.

Objectives: Sepsis and septic shock are leading causes of in-hospital mortality. Timely treatment is crucial in improving patient outcome, yet treatment delays remain common. Early prediction of those patients with sepsis who will progress to its most severe form, septic shock, can increase the actionable window for interventions. Read More

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F-RGD PET/CT and Systemic Inflammatory Biomarkers Predict Outcomes of Patients With Advanced NSCLC Receiving Combined Antiangiogenic Treatment.

Front Oncol 2021 4;11:671912. Epub 2021 Jun 4.

Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.

Background: The aim of this study was to evaluate F-AlF-NOTA-PRGD2 positron emission tomography/computed tomography (F-RGD PET/CT) and serum inflammation biomarkers for predicting outcomes of patients receiving combined antiangiogenic treatment for advanced non-small cell lung cancer (NSCLC).

Methods: Patients with advanced NSCLC underwent F-RGD PET/CT examination and provided blood samples before treatments commenced. PET/CT parameters included maximum standard uptake value (SUVmax) and mean standard uptake value (SUVmean), peak standard uptake value (SUVpeak) and metabolic tumor volume (MTV) for all contoured lesions. Read More

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A Nomogram for Predicting Survival in Patients With Breast Cancer Liver Metastasis: A Population-Based Study.

Front Oncol 2021 2;11:600768. Epub 2021 Jun 2.

Personalized Drug Therapy Key Laboratory of Sichuan Province, Department of Pharmacy, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Objective: The prognosis of patients with breast cancer liver metastasis (BCLM) was poor. We aimed at constructing a nomogram to predict overall survival (OS) for BCLM patients using the SEER (Surveillance Epidemiology and End Results) database, thus choosing an optimized therapeutic regimen to treat.

Methods: We identified 1173 patients with BCLM from the SEER database and randomly divided them into training (n=824) and testing (n=349) cohorts. Read More

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Multi-Omics Marker Analysis Enables Early Prediction of Breast Tumor Progression.

Front Genet 2021 3;12:670749. Epub 2021 Jun 3.

Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.

Ductal carcinoma (DCIS) is a preinvasive form of breast cancer with a highly variable potential of becoming invasive and affecting mortality of the patients. Due to the lack of accurate markers of disease progression, many women with detected DCIS are currently overtreated. To distinguish those DCIS cases who are likely to require therapy from those who should be left untreated, there is a need for robust and predictive biomarkers extracted from molecular or genetic profiles. Read More

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Tuberculosis Risk Stratification of Psoriatic Patients Before Anti-TNF-α Treatment.

Front Immunol 2021 3;12:672894. Epub 2021 Jun 3.

Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.

Psoriasis is a skin inflammatory condition for which significant progress has been made in its management by the use of targeted biological drugs. Detection of latent infection (LTBI) is mandatory before starting biotherapy that is associated with reactivation risk. Together with evaluation of TB risk factors and chest radiographs, tuberculin skin tests (TST) and/or blood interferon-γ-release assays (IGRA), like the QuantiFERON (QFT), are usually performed to diagnose infection. Read More

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High Prevalence of Right Ventricular/Left Ventricular Ratio ≥1 Among Patients Undergoing Computed Tomography Pulmonary Angiography.

J Thorac Imaging 2021 Jul;36(4):231-235

Departments of Radiology.

Aim: Increased ratio between the right and left ventricular (RV/LV) diameters ≥1 is considered an important imaging marker for risk stratification among patients diagnosed with acute pulmonary embolism (PE). Our goal was to assess the prevalence of RV/LV≥1 among consecutive patients undergoing computed tomography pulmonary angiography, and to compare the prevalence of RV/LV≥1 between patients with and without PE.

Methods: Retrospective analysis of consecutive patients who underwent computed tomography pulmonary angiography due to clinical suspicion of PE between January 1, 2014 and December 31, 2014. Read More

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Assessment of patient mobility improves the risk stratification of triage with the Emergency Severity Index: a prospective cohort study.

Eur J Emerg Med 2021 Jun 18. Epub 2021 Jun 18.

Emergency Department, University Hospital Basel, Basel, Switzerland Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg Department of Emergency Medicine, Odense University Hospital, Odense, Denmark Department of Clinical Research, University of Basel, Basel, Switzerland.

Background And Importance: Formal triage may assign a low acuity to patients at high risk of deterioration and mortality. A patient's mobility can be easily assessed at triage.

Objective: To investigate if a simple assessment of mobility at triage can improve the Emergency Severity Index's (ESI) prediction of adverse outcomes. Read More

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Growing use of home enteral nutrition: a great tool in nutrition practice toolbox.

Curr Opin Clin Nutr Metab Care 2021 Jun 18. Epub 2021 Jun 18.

Division of Endocrinology, Diabetes, Metabolism and Nutrition Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Purpose Of Review: Home enteral nutrition (HEN) is a well-established practical nutrition therapy tool that is typically managed by an interdisciplinary team. Prevalence of HEN is increasing across the globe given significant evidence for utility, feasibility, efficacy, safety, and reliability of HEN in helping patients meeting their nutrition needs. The current review highlights the growing use of HEN in the context of what is novel in the field including trends in HEN practice with regards to tubes and connectors, feeding formula and real food blends, and common complications. Read More

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Risk factors for anastomotic stricture after hepaticojejunostomy for bile duct injury-A systematic review and meta-analysis.

Surgery 2021 Jun 17. Epub 2021 Jun 17.

Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, United Kingdom; College of Medical and Dental Sciences, University of Birmingham, United Kingdom. Electronic address:

Background: After major bile duct injury, hepaticojejunostomy can result in good long-term patency, but anastomotic stricture is a common cause of long-term morbidity. There is a need to assimilate high-level evidence to establish risk factors for development of anastomotic stricture after hepaticojejunostomy for bile duct injury.

Methods: A systematic review of studies reporting the rate of anastomotic stricture after hepaticojejunostomy for bile duct injury was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Read More

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A Prospective Evaluation of Clinical HEART Score Agreement, Accuracy, and Adherence in Emergency Department Chest Pain Patients.

Ann Emerg Med 2021 Jun 17. Epub 2021 Jun 17.

Institute of Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA; Department of Emergency Medicine, University of Massachusetts Medical School‒Baystate, Springfield, MA.

Study Objective: The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. We compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events. Read More

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Field carcinogenesis for risk stratification of colorectal cancer.

Adv Cancer Res 2021 31;151:305-344. Epub 2021 Mar 31.

Department of Gastroenterology, Boston University Medical Center, Boston, MA, United States; Department of Internal Medicine, Baylor College of Medicine, Houston, TX, United States. Electronic address:

Colorectal cancer (CRC) is characterized by genetic-environmental interplay leading to diffuse changes in the entire colonic mucosa (field carcinogenesis or field of injury) and to a pro-neoplastic genetic/epigenetic/physiological milieu. The clinical consequences are increased risk of synchronous and metachronous neoplasia. Factors such as genetics, race, ethnicity, age, and socioeconomic status are thought to influence neoplasia development. Read More

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In-hospital acute kidney injury and atrial fibrillation: incidence, risk factors, and outcome.

Ren Fail 2021 Dec;43(1):949-957

Division of Nepphrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Background: The incidence and the risk factors of in-hospitalized acute kidney injury (AKI) in patients hospitalized for atrial fibrillation (AF) were unclear.

Methods: The Improving Care for Cardiovascular Disease in China-AF (CCC-AF) project is an ongoing registry and quality improvement project, with 240 hospitals recruited across China. We selected 4527 patients hospitalized for AF registered in the CCC-AF from January 2015 to January 2019. Read More

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December 2021

External validation of integrated genetic-epigenetic biomarkers for predicting incident coronary heart disease.

Epigenomics 2021 Jun 21. Epub 2021 Jun 21.

Cardio Diagnostics, Inc., Coralville, IA 52241, USA.

The Framingham Risk Score (FRS) and ASCVD Pooled Cohort Equation (PCE) for predicting risk for incident coronary heart disease (CHD) work poorly. To improve risk stratification for CHD, we developed a novel integrated genetic-epigenetic tool. Using machine learning techniques and datasets from the Framingham Heart Study (FHS) and Intermountain Healthcare (IM), we developed and validated an integrated genetic-epigenetic model for predicting 3-year incident CHD. Read More

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Monotherapy Anticoagulation to Expedite Home Treatment of Patients Diagnosed With Venous Thromboembolism in the Emergency Department: A Pragmatic Effectiveness Trial.

Circ Cardiovasc Qual Outcomes 2021 Jun 21:CIRCOUTCOMES120007600. Epub 2021 Jun 21.

Department of Internal Medicine, Division of Emergency Medicine, Louisiana State University, New Orleans (C.B.W.).

Background: The objective was to test if low-risk emergency department patients with vitamin K antagonist (venous thromboembolism [VTE]; including venous thrombosis and pulmonary embolism [PE]) can be safely and effectively treated at home with direct acting oral (monotherapy) anticoagulation in a large-scale, real-world pragmatic effectiveness trial.

Methods: This was a single-arm trial, conducted from 2016 to 2019 in accordance with the Standards for Reporting Implementation Studies guideline in 33 emergency departments in the United States. Participants had newly diagnosed VTE with low risk of death based upon either the modified Hestia criteria, or physician judgment plus the simplified PE severity index score of zero, together with nonhigh bleeding risk were eligible. Read More

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