metcardio.org
 Meta-analysis and Evidence-based Medicine Training in Cardiology
The metcardio.org website is dedicated to meta-analysis and evidence-based medicine training in cardiology. It is sponsored by the Meta-analysis and Evidence-based medicine Training in Cardiology (METCARDIO) Group, currently headquartered in Turin, Italy, and formerly known as the Center for Overview, Meta-analysis, and Evidence-based Medicine Training (COMET). The focus of the metcardio.org website is on clinical research methods and evidence-based cardiovascular medicine with a specific interest in interventional cardiology and peripheral cardiovascular interventions. Nonetheless, there is plenty of training and research opportunities for other evidence-based endeavors, eg in anesthesiology, critical care medicine, and psychiatry.










  1. Basic science
  2. Critical care
  3. General cardiology
  4. Interactive cases
  5. Interventional cardiology
  6. Lezioni ed esercitazioni
  7. Peripheral interventions
  8. Scientific publishing
  9. Statistics

  10. Basic science
    1. Acute myocardial infarction: role of cardiac remodeling (4.4 Mb Ppt File, November 2008)
    2. Apoptosis: role in myocardial response to ischemia (6.3 Mb Ppt File, January 2008)
    3. Gender differences: relationship between female gender, myocardial remodelling and cardiac function (886 Kb Ppt file, August 2007)

  11. Critical care
    1. Beta-blockers in cardiac surgery (2.6 Mb Ppt file, May 2009)
    2. Catheter drainage of the pericardial space: pericardiocentesis (6.8 Mb Ppt file, May 2010)
    3. Peri-operative cardiac protection (8.6 Mb Ppt file, February 2010)
    4. Pharmacological pre-emptive strategies to reduce peri-operative risk (6.3 Mb Ppt file, February 2010)
    5. Principles of anesthesia for medical students (9.3 Mb Ppt file, February 2010)
    6. Protein C concentrates in paediatric septic patients (5.6 Mb Ppt file, February 2010)
    7. Protein C zymogen for severe sepsis in heart surgery (4.9 Mb Ppt file, February 2010)

  12. General cardiology
    1. Acute coronary syndromes
      1. 2007 European Society of Cardiology (ESC) guidelines on acute coronary syndromes (2.3 Mb Ppt file, October 2007)
      2. Antiplatelet agents in acute coronary syndromes (10.8 Mb Ppt file, October 2008)
      3. Antiplatelet therapy and percutaneous coronary intervention (5.1 Mb Ppt file, November 2006)
      4. Antithrombotic agents in acute coronary syndromes (9.4 Mb Ppt file, November 2008)
      5. Comparing ticagrelor versus prasugrel for acute coronary syndromes: a 32,983-patient adjusted indirect comparison meta-analysis (2.5 Mb Ppt file, May 2010)
      6. Focus sul recente “boxed warning” dell’FDA americana sul clopidogrel (1.3 Mb Ppt file, July 2010)
      7. Is prasugrel superior to ticagrelor for acute coronary syndromes? (1.14 Mb Ppt file, February 2010)
      8. Management of late comers with ST-elevation acute myocardial infarction (1.7 Mb Pdf file, September 2009)
      9. Rationale against early dual anti-platelet therapy discontinuation (3.5 Mb Ppt file, May 2009)
    2. Arrhythmias
      1. Anti-arrhythmic drugs (3.8 Mb Ppt file, January 2010)
      2. Pace-makers, defibrillators, and cardiac resynchronization therapy (27.9 Mb Ppt file, May 2010)
    3. Cardiomyopathy following anthracycline chemotherapy
      1. Prevention and therapy of anthracycline cardiotoxicity (2.6 Mb Ppt file, April 2010)
      2. Role of tissue Doppler imaging (424 Kb Ppt file, August 2007)
      3. The cardiologist's viewpoint (4.9 Mb Ppt file, February 2009)
    4. Coronary artery disease
      1. Aspirin discontinuation (874 Kb Ppt file, October 2006)
      2. Duration of antiplatelet therapy (4.9 Mb Ppt file, March 2008)
      3. Clopidogrel loading dose (7.8 Mb Ppt file, June 2008)
      4. Coronary risk factors (5.7 Mb Ppt file, March 2010)
      5. Impact of duration and intensity of antithrombotic therapy (6.7 Mb Ppt file, February 2009)
      6. Oral anticoagulants (2.1 Mb Ppt file, November 2008)
      7. Pathophysiology, diagnosis, and management - part 1 (16.3 Mb Ppt file, March 2007)
      8. Pathophysiology, diagnosis, and management - part 2 (7.8 Mb Ppt file, March 2007)
      9. Refractory angina pectoris (14.0 Mb Ppt file, December 2007)
      10. Treatment strategies for stable patients: COURAGE, OAT, SWISSI II, and VIAMI (8.3 Mb Ppt file, October 2007)
      11. Triple antithrombotic therapy in cardiology (4.9 Mb Ppt file, May 2009)
    5. Dislipidemias
      1. Dislipidemie familiari (1.9 Mb Ppt file, September 2009)
      2. Farmacologia delle statine (1.9 Mb Ppt file, September 2009)
      3. Linee guida sulle dislipidemie (3.8 Mb Ppt file, September 2009)
    6. Heart failure
      1. Basics of treatment (5.7 Mb Ppt file, April 2008)
      2. Current epidemiology - epidemiologia attuale dello scompenso cardiaco (8.0 Mb Ppt file, May 2009)
    7. Imaging
      1. Coronary computed tomography (19.1 Mb Ppt file, May 2007)
      2. Indications for myocardial purfusion nuclear scan imaging - SPECT miocardica di perfusione: indicazioni cliniche (406 Kb Ppt file, April 2008)
      3. Nuclear scintigraphy in heart failure - Ruolo della cardiologia nucleare nello scompenso cardiaco (2.37 Mb Ppt file, April 2008)
      4. Why coronary CT is inferior to invasive coronary angiography (2.9 Mb Ppt file, October 2009)
    8. Pulmonary embolism: prognostic role of brain natriuretic peptide (503 Kb Ppt file, December 2008)
    9. Stress ECG and stress echocardiography (6.2 Mb Ppt file, March 2010)

  13. Interactive cases
    1. Peripheral case: antegrade femoral access despite ostial superficial femoral artery occlusion (1.5 Mb Pdf file, October 2007)
    2. Peripheral case: antegrade femoral access with stent puncture (1.1 Mb Pdf file, October 2007)
    3. Peripheral case: superficial femoral artery intervention (1.1 Mb Pdf file, October 2007)

  14. Interventional cardiology
    1. A meta-analysis of percutaneous versus surgical closure of ostium secundum atrial septal defects (3.6 Mb Ppt file, August 2007)
    2. An overview of coronary drug-eluting stents: the meta-analytic approach (9.3 Mb Ppt file, November 2007)
    3. Applications of bivalirudin in interventional cardiology (1.6 Kb Ppt file, April 2010)
    4. Benefits of clopidogrel in patients undergoing coronary stenting depend on loading dose: meta-regression (366 Kb file, November 2007)
    5. Bifurcations
      1. Devaxx Axxess stent (24.2 Mb Ppt file, May 2007)
      2. Role of intravascular ultrasound for coronary bifurcations (800 Kb Ppt file, February 2010)
      3. Simple versus complex drug-eluting stenting strategies (422 Kb Ppt file, July 2008)
      4. Treatment with percutaneous coronary stenting (6.5 Mb Ppt file, October 2008)
    6. Chronic total occlusions
      1. Clinical evidence in support of revascularization in 2007 (18.1 Mb Ppt file, May 2007)
      2. Clinical evidence in support of revascularization in 2008 (12.6 Mb Ppt file, October 2008)
      3. Is it useful to re-open a chronic coronary occlusion? (1.8 Mb Ppt file, December 2006)
      4. Late percutaneous coronary intervention after myocardial infarction: a meta-analysis (302 Kb Ppt file, March 2007)
      5. Retrograde recanalization of coronary chronic total occlusions: outcomes and tips & tricks (1.9 Mb ppt file, October 2007)
      6. What is known and what is unknown (4.7 Mb Ppt file, February 2009)
    7. Diabetes mellitus
      1. Diabetes mellitus in patients undergoing percutaneous drug-eluting stent implantation: short and long-term results (970 Kb Ppt file, May 2010)
    8. Drug-eluting stents
      1. Comparison of sirolimus- versus paclitaxel-eluting stents (517 Kb Ppt file, March 2006)
      2. Incidence and outcome of coronary dissections left untreated after drug-eluting stent implantation (2.5 Mb Ppt file, September 2005)
      3. Late drug-eluting stent thrombosis: should we be worried? (6.2 Mb Ppt file, March 2007)
      4. Long-term follow-up of high-risk subsets (12.0 Mb Ppt file, February 2007)
      5. Off-label use (5.2 Mb Ppt file, December 2008)
      6. Sirolimus-eluting stents for in-stent restenosis in 278 patients: long-term outcomes (272 Kb Ppt file, August 2007)
      7. Sirolimus-eluting stents for the treatment of bare-metal in-stent restenosis (14.6 Mb Ppt file,April 2008)
      8. Sirolimus-eluting stents in saphenous vein grafts: 6-month intravascular ultrasound results of the RRISC trial (1.7 Mb Ppt file, October 2006)
      9. The case for postdilation (8.5 Mb Ppt file, December 2008)
      10. Use in challenging lesions (9.9 Mb Ppt file, June 2007)
      11. Which and to whom? (8.1 Mb Ppt file, November 2007)
    9. Elective stenting vs balloon angioplasty for small vessel coronary artery disease: evidence from a meta-analysis (2.4 Mb Ppt file, September 2004)
    10. Efficacy of anti-inflammatory drug-eluting balloon coated with genistein before stenting in porcine coronary arteries (1.9 Mb Ppt file, August 2008)
    11. High clopidogrel loading is superior to a standard dose for percutaneous coronary intervention: a meta-analysis (323 Kb Ppt file, August 2007)
    12. Imaging
      1. Coronary angiographic presentation and plaque characteristics (17.3 Mb Ppt file, May 2009)
      2. Intravascular ultrasound (IVUS) does not provide any significant clinical benefit for percutaneous coronary intervention of bifurcation lesions (394 Kb Ppt file, May 2010)
      3. Late luminal loss: clinically meaningful surrogate or insignificant angiographic parameter? (11.1 Mb Ppt file, October 2007)
      4. New techniques for the “invasive diagnosis” of the vulnerable plaque (8.7 Mb Ppt file, March 2006)
      5. Quantitative coronary angiography (QCA) (2.9 Mb Ppt file, September 2008)
      6. Rotational and 3-dimensional coronary angiography (27.4 Mb Ppt file, March 2006)
      7. Vulnerable plaque assessment (7.6 Mb Ppt file, May 2006)
    13. Introduzione al LUCAS in sala di emodinamica (21.5 Mb Ppt file, September 2007)
    14. Invasive and interventional cardiology: key-steps (3.9 Mb Ppt file, October 2008)
    15. Multivessel coronary disease
      1. Complete revascularization in elderly: contraindications (11.6 Mb Ppt file, January 2008)
      2. Culprit-only versus multivessel percutaneous coronary intervention for multivessel disease in ST-elevation myocardial infarction (1.0 Mb Ppt file, May 2010)
      3. Multivessel vs culprit-only percutaneous coronary intervention? Counterpoint (1.7 Mb Ppt file, April 2007)
      4. PCI vs. CABG: Review of the evidence and suggestions (6.4 Mb Ppt file, October 2009)
      5. The best strategy for the patient with multivessel coronary artery disease (10.9 Mb Ppt file, November 2008)
    16. Oral cilostazol prevents restenosis and repeat revascularization after drug-eluting stenting (325 Kb Ppt file, October 2008)
    17. Oral cilostazol prevents restenosis and repeat revascularization after percutaneous coronary stenting (604 Kb Ppt file, July 2008)
    18. Percutaneous coronary intervention in diabetics and diffuse disease: role of glycoprotein IIb/IIIa inhibitors (8.2 Mb Ppt file, December 2006)
    19. Practical recommendations on anti-thrombotic treatment in patients treated with drug-eluting stents (2.8 Mb Ppt file, September 2007)
    20. Radial versus femoral access for acute coronary syndromes: a meta-analysis (345 Kb Ppt file, October 2008)
    21. Radial versus femoral approach for percutaneous coronary procedures: a meta-analysis of randomized trials (1.1 Mb Pptfile, June 2005)
    22. Results of drug-eluting stent randomized trials: separating gold from fool's gold with the statisticians's help (5.2 Mb Ppt file, February 2007)
    23. Saphenous vein grafts
      1. Increased late mortality after sirolimus-eluting stents versus bare metal stents in diseased saphenous vein grafts (1.2 Mb Ppt file, September 2007)
      2. Saphenous vein grafts: role of drug eluting stents (1.7 Mb Ppt file, September 2007)
    24. Significant benefits of cilostazol on restenosis and revascularization after percutaneous coronary intervention: a meta-analysis (693 Kb Ppt file, October 2007)
    25. Single versus multiple vessel stenting in patients with ST-elevation myocardial infarction (900 Kb Ppt file, February 2010)
    26. Small vessel, diffuse coronary disease, and tortuous lesions (20.6 Mb Ppt file, August 2008)
    27. Stent safety update and endothelial progenitor cell capturing stents (13.9 Mb Ppt file, February 2010)
    28. Stent thrombosis: which impact in real clinical practice? (2.9 Mb Ppt file, June 2010)
    29. Thrombectomy
      1. ATTEMPT individual patient meta-analysis on coronary thrombectomy (1.7 Mb Ppt file, September 2008)
      2. Thrombectomy is beneficial (if ever) only in highly selected patients (2.6 Mb Ppt file, October 2009)
    30. Unprotected left main disease
      1. A comprehensive meta-analysis on drug-eluting stenting (1.7 Mb Ppt file, October 2008)
      2. Impact of diabetes on percutaneous drug-eluting stent implantation for unprotected left main disease (462 Kb Ppt file, October 2007)
      3. Meta-analysis on 1,274 patients undergoing percutaneous drug-eluting stenting (464 Kb Ppt file, August 2007)
      4. Predictors of events after drug-eluting stenting (208 Kb Ppt file, August 2007)
      5. Restenosis after treatment with drug-eluting stents (2.3 Mb Ppt file, May 2009)
      6. When PCI? When surgery? (5.6 Mb Ppt file, October 2008)
    31. What matters in the eyes of interventional cardiologists (6.1 Mb Ppt file, January 2010)

  15. Lezioni ed esercitazioni
    1. ECG normale (13.0 Mb Ppt file, March 2010)
    2. ECG patologico (12.4 Mb Ppt file, April 2010)
    3. Esercitazione sull'approccio clinico al dolore toracico (5.3 MB Ppt file and 31 Kb Doc file, February 2007)
    4. Esercitazione sull'approccio all'auscultazione cardiaca e all'ECG (7.5 Mb Ppt file, March 2007)
    5. Lezione di emodinamica e cardiologia interventistica - parte 1 (15.5 Mb Ppt file, March 2007)
    6. Lezione di emodinamica e cardiologia interventistica - parte 2 (27.2 Mb Ppt file, March 2007)
    7. Lezione di ricerca clinica cardiologica - parte 1 (3.2 Mb Ppt file, March 2008)
    8. Lezione di ricerca clinica cardiologica - parte 2 (7.1 Mb Ppt file, March 2008)
    9. Lezione di ricerca clinica cardiologica - parte 3 (2.8 Mb Ppt file, March 2008)
    10. Lezione di ricerca clinica cardiologica - parte 4 (1.2 Mb Ppt file, March 2008)
    11. Lezione di ricerca clinica cardiologica - parte 5 (2.5 Mb Ppt file, March 2008)
    12. Lezione di ricerca clinica cardiologica - parte 6 (1.7 Mb Ppt file, March 2008)
    13. Lezione di ricerca clinica cardiologica - parte 7 (2.5 Mb Ppt file, March 2008)
    14. Lezione di ricerca clinica cardiologica - parte 8 (2.0 Mb Ppt file, March 2008)

  16. Peripheral interventions
    1. Basic principles of peripheral interventions (4.1 Mb Ppt file, October 2009)
    2. Complications of superficial femoral artery and popliteal artery interventions (2.3 Pdf file, October 2007)
    3. Drug-eluting or absorbable stents versus bare-metal stents in peripheral artery disease (2.8 Mb Ppt file, December 2009)
    4. Drug-eluting stents, bare-metal stents, or balloon-only angioplasty for below-the-knee disease (3.5 Mb Ppt file, June 2010)
    5. Endovascular challenges for the next decade (10.4 Mb Ppt file, September 2007)
    6. Epidemiology, pathophysiology and natural history of arteriopathy of the lower limb and ischemic diabetic foot (12.3 Mb Ppt file, October 2007)
    7. Percutaneous below-the-knee stent implantation in patients with critical limb ischemia (393 Kb Ppt file, August 2008)
    8. Post-procedural management and follow-up after lower limb interventions (1.4 Mb Pdf file, October 2007)
    9. Standard techniques and materials for diagnostic arteriography of the lower limb and ischemic diabetic foot (26.5 Mb Ppt file, October 2007)

  17. Scientific publishing
    1. Clinical writing for interventional cardiologists
      1. Sections 1 and 2 - introduction and basics (8.2 Mb Ppt file, February 2009)
      2. Section 3 - techniques (4.4 Mb Ppt file, February 2009)
      3. Section 4 - 1st exercise (1.8 Mb Ppt file, February 2009)
      4. Section 5 - title and abstract (2.7 Mb Ppt file, February 2009)
      5. Section 6 - literature searching and introduction (8.3 Mb Ppt file, February 2009)
      6. Section 7 - methods (3.6 Mb Ppt file, February 2009)
      7. Section 8 - abstract (1.6 Mb Ppt file, February 2009)
      8. Sections 9 and 10 - results and discussion (3.1 Mb Ppt file, February 2009)
      9. Section 11 - tables (10.4 Mb Ppt file, February 2009)
      10. Section 12 - peer-review (1.2 Mb Ppt file, February 2009)
      11. Section 13 - grant submission (3.3 Mb Ppt file, February 2009)
      12. Section 14 - writing at a glance (700 Kb Ppt file, February 2009)
      13. Section 15 - conclusions (6.0 Mb Ppt file, February 2009)
    2. Clinical writing for surgeons
      1. Introduction (A) (700 Kb Ppt file, February 2008)
      2. General principles (4.2 Mb Ppt file, February 2008)
      3. Techniques (2.2 Mb Ppt file, February 2008)
      4. Title & abstract (6.3 Mb Ppt file, February 2008)
      5. Search & introduction (8.5 Ppt file, February 2008)
      6. Statistics & methods (5.7 Mb Ppt file, February 2008)
      7. 1st exercise (2.2 Mb Ppt file, February 2008)
      8. Introduction (B) (480 Kb Ppt file, February 2008)
      9. 2nd exercise (1.3 Mb Ppt file, February 2008)
      10. Results (2.1 Mb file, February 2008)
      11. Discussion (2.5 Mb Ppt file, February 2008)
      12. Tables and figures (6.7 Mb Ppt file, February 2008)
      13. Example (1.3 Mb Ppt file, February 2008)
    3. Peer review
      1. First aid for the peer review process (2.8 Mb Ppt file, October 2009)
      2. Surviving the peer review process (3.0 Mb Ppt file, September 2009)
    4. Current publication trends in interventional cardiology (8.5 Mb Ppt file, September 2009)
    5. Publishing trends in cardiology (4.4 Mb Ppt file, October 2009)

  18. Statistics
    1. Advanced statistics for interventional cardiologists
      1. Section 1 - introduction (2.3 Mb Ppt file, March 2009)
      2. Section 2 - basics of modeling (540 Kb Ppt file, March 2009)
      3. Section 3 - linear regression (10.9 Mb Ppt file, March 2009)
      4. Section 4 - Bayesian methods (10.3 Mb Ppt file, March 2009)
      5. Section 5 - logistic regression (2.9 Mb Ppt file, March 2009)
      6. Section 6 - resampling methods (4.9 Mb Ppt file, March 2009)
      7. Section 7 - meta-analysis (7.0 Mb Ppt file, March 2009)
      8. Section 8 - analysis of variance (8.5 Mb Ppt file, March 2009)
      9. Section 9 - Cox proportional hazard analysis (2.9 Mb Ppt file, March 2009)
      10. Section 10 - propensity analysis (2.0 Mb Ppt file, March 2009)
      11. Section 11 - statistical programs (2.9 Mb Ppt file, March 2009)
      12. Section 12 - conclusions (4.0 Mb Ppt file, March 2009)
    2. Meta-analysis
      1. A focused 2008 update on methods for Cochrane systematic reviews and meta-analyses (2.8 Mb Ppt file, June 2008)
      2. Failures of meta-analyses: the evidence against the evidences (6.4 Mb Ppt file, April 2009)
      3. Principles and practice in cardiovascular research (6.5 Mb Ppt file, September 2006)
      4. Tips and tricks for performing standard meta-regression analysis with SPSS (603 Kb Ppt file, April 2009)
      5. Value and limitations of meta-analysis in the era of evidence-based medicine (5.2 Mb Ppt file, March 2009)
    3. Nuts and bolts of biostatistics for cardiologists (1.3 Mb Pdf file, March 2005)
    4. Primer on statistics for interventional cardiologists
      1. Sections 1 & 2 - introduction and basics (6.8 Mb Ppt file, December 2008)
      2. Sections 3 - descriptive statistics (3.9 Mb Ppt file, December 2008)
      3. Section 4 - probability distributions (1.7 Mb Ppt file, December 2008)
      4. Section 5 - inferential statistics (6.9 Mb Ppt file, December 2008)
      5. Section 6 & 7 - differences between continuous variables (3.8 Mb Ppt file, December 2008)
      6. Section 8 - regression and correlation (3.2 Mb Ppt file, December 2008)
      7. Section 9 - differences between categorical variables (2.8 Mb Ppt file, December 2008)
      8. Section 10 - survival analysis (2.4 Mb Ppt file, December 2008)
      9. Section 11 - advanced statistics at a glance (5.9 Mb Ppt file, December 2008)
      10. Section 12 - conclusions (332 Kb Ppt file, December 2008)
    5. What the clinician needs to know about statistics: when is biostatistics not to be trusted? (2.4 Mb Ppt file, September 2009)


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