Betrixaban: A Novel Factor Xa Inhibitor for the Prevention of Venous Thromboembolism in Acutely Ill Medical Patients
This article provides an overview of betrixaban’s pharmacological profile, clinical trial results, and potential roles in therapy. (Source: Cardiology in Review)
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: New Therapy Update Source Type: research

Tocilizumab in Giant Cell Arteritis
Giant cell arteritis is a granulomatous immune-mediated vasculitis of medium and large vessels. It most commonly affects white females over the age of 50 and is the most common primary vasculitis in the United States. Treatment of this disease has classically been with high-dose corticosteroids, but this therapy has been associated with severe morbidity and mortality. Tocilizumab, a humanized monoclonal antibody targeting the interleukin-6 receptor, has been used with great efficacy and safety in rheumatoid arthritis and systemic-onset juvenile idiopathic arthritis. As interleukin-6 has been shown to be a key cytokine in g...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Sodium–Glucose Cotransporter-2 Inhibition in Type 2 Diabetes Mellitus: A Review of Large-Scale Cardiovascular Outcome Studies and Possible Mechanisms of Benefit
Cardiovascular (CV) disease remains the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). However, conventional antihyperglycemic medications seem to have minimal effect on lowering CV risk despite achieving excellent reductions in glycated hemoglobin A1c and associated reductions in microvascular risk. Sodium–glucose cotransporter 2 (SGLT2) inhibitors have emerged as noteworthy antihyperglycemic agents with concomitant CV and renal protection in T2DM patients. In this comprehensive review, we present the key CV findings from major large-scale outcome trials of SGLT2 inhibi...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Acromegalic Cardiomyopathy: An Overview of Risk Factors, Clinical Manifestations, and Therapeutic Options
Acromegaly is a rare endocrine disorder that carries a significant burden of cardiovascular morbidity and mortality. Abnormalities of the growth hormone/insulin-like growth factor-1 axis in acromegaly lead to the characteristic cardiovascular manifestations of this disease. One hallmark feature of the disease is acromegalic cardiomyopathy, a syndrome of progressive cardiac dysfunction characterized by left ventricular hypertrophy, diastolic dysfunction, and combined systolic and diastolic dysfunction in the very advanced stage. In this article, we review the current concepts regarding the pathophysiology of acromegalic car...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Risk-Adjusted Overall Mortality as a Quality Measure in the Cardiovascular Intensive Care Unit
Risk-adjusted mortality has been proposed as a quality of care indicator to gauge cardiovascular intensive care Unit (CICU) performance. Mortality is easily measured, readily understandable, and a meaningful outcome for the patient, provider, administrative agencies, and other key stakeholders. Disease-specific risk-adjusted mortality is commonly used in cardiovascular medicine as an indicator of care quality, for external accreditation, and to determine payer reimbursement. However, the evidence base for overall risk-adjusted mortality in the CICU is limited, with most available data coming from the general critical care ...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

The Physiological Rationale for Incorporating Pulsatility in Continuous-Flow Left Ventricular Assist Devices
Over the past few decades, left ventricular assist device (LVAD) support has extended the lives of many patients with end-stage heart failure. The most common devices are continuous-flow (CF) LVADs. The use of the CF-LVADs has required that clinicians learn the physiological and clinical consequences of long-term continuous blood flow. While this alteration in the normal physiology still offers advantages from mechanical circulatory support, the lack of pulsatility may also increase the likelihood of adverse events. However, it is currently unknown whether newly evolved devices should incorporate pulsatility. In this artic...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Overview of Link Between Inflammatory Bowel Disease and Cardiovascular Disease
Inflammation has been shown to play an increasingly important role in the pathogenesis of atherosclerosis and in precipitating thrombotic events. Inflammatory bowel disease (IBD) is a systemic inflammatory disorder with a wide range of extraintestinal manifestations including a clinically significant increase in the risk of venous thromboembolism compared to matched controls in several studies. The data for the association between IBD and ischemic heart disease are less clear; multiple population-based studies have shown both positive and negative associations between the 2 conditions. While the systemic inflammation shoul...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Long-Term Outcomes of Drug-Eluting Stents Versus Bare-Metal Stents in End-Stage Renal Disease Patients on Dialysis: A Systematic Review and Meta-Analysis
There are no dedicated data to guide drug-eluting stent (DES) versus bare-metal stent (BMS) selection in patients with end-stage renal disease undergoing dialysis (ESRD-D). It is unclear whether long-term benefits of a specific stent type outweigh risks in this population at high risk for both bleeding and ischemic events. We performed a meta-analysis of nonrandomized studies extracted from PubMed, Scopus, and EMBASE, assessing the safety and effectiveness of DES versus BMS in ESRD-D patients. Odds ratios (OR) and 95% confidence intervals (CI) were computed with the Mantel–Haenszel method. Random-effects model was us...
Source: Cardiology in Review - October 18, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Acute Coronary Artery Dissection: A Review of the Literature and Current Evidence
Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Hence, early detection is crucial to manage the dissection and reduce the mortality and morbidity rates. Most coronary dissections will heal spontaneously, and conservative treatment is recommended for uncomplicated cases. In the acute phase, primary percutaneous coronary intervention re...
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Interatrial Shunting, a Novel Device-Based Therapy for Patients With Heart Failure
Heart failure (HF) patients with either reduced ejection fraction or preserved ejection fraction experience a high mortality rate. The most recent pharmacologic advance for treating patients with HF with reduced ejection fraction has been with sacubitril/valsartan. Along with pharmaceutical research, there has been interest in device-based therapies as another treatment approach. One novel interventional device therapy that has shown promise in early tests and trials is the interatrial shunt device developed by Corvia Medical Inc. and the V-Wave device by V-Wave Ltd. Inserted between the atria in the atrial septum, both de...
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock
This article reviews the existing literature on short- and long-term predictors and risk stratification in MI complicated by CS. (Source: Cardiology in Review)
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Periprocedural Management of Direct Oral Anticoagulants Surrounding Cardioversion and Invasive Electrophysiological Procedures
As direct oral anticoagulants (DOACs) have demonstrated favorable efficacy and safety outcomes compared with vitamin K antagonists for the treatment and prevention of venous thromboembolism and the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, their role in the management of anticoagulation during electrophysiological procedures continues to evolve. At present, guidelines are limited regarding specific recommendations for the use of DOACs in these clinical settings. Here, we review available data regarding the risks and benefits associated with various periprocedural anticoagu...
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Novel Pharmacotherapy in Hypertrophic Cardiomyopathy
This article reviews the currently recommended and frequently used medications (beta-blockers, nondihydropyridine calcium channel blockers, and disopyramide) and emerging pharmacological treatment options in the management of HCM. The mechanism of action and latest clinical trials of the novel agents are discussed in greater detail. (Source: Cardiology in Review)
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Functional Mitral Regurgitation: An Interventional Cardiologist’s Perspective
Functional mitral regurgitation (FMR) is common in patients with heart failure and portends a poor prognosis. The etiology is secondary to nonischemic or ischemic (postmyocardial infarction) adverse remodeling. Treatment includes guideline-directed medical therapy, cardiac resynchronization therapy, and in some cases, surgical repair or replacement. Transcatheter mitral valve (MV) repair with the MitraClip device is approved in patients with degenerative MR and is currently under investigation for use in FMR, as are several transcatheter MV replacement devices. This review discusses the basis of FMR pathophysiology, classi...
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Left Main Disease: What Is the Correct Approach to Revascularization?
Percutaneous coronary intervention of the left main coronary artery has evolved through registries and meta analyses, supported by results from the EXCEL [Everolimus-Eluting Stents (EES) or Bypass Surgery for Left Main Coronary Artery Disease] and NOBLE (Percutaneous Coronary Angioplasty versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials as an acceptable alternative to coronary artery bypass grafting in patients with low and intermediate Syntax scores. Advances in stenting strategies and the availability of larger diameter drug-eluting stents improve patient safety and optimize pr...
Source: Cardiology in Review - August 21, 2018 Category: Cardiology Tags: Review Articles Source Type: research

A Nonsurgical Approach to Mesenteric Vascular Disease: Erratum
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Erratum Source Type: research

Are Shorter Durations of Dual Antiplatelet Therapy Acceptable Following Percutaneous Coronary Intervention?
Much debate has centered on whether or not the standard 12-month duration of dual antiplatelet therapy (DAPT) is still necessary postpercutaneous coronary intervention, given recent improvements in stent technology. The benefits of shorter (3–6 months) durations of DAPT include a potential lower risk for bleeding and less patient drug cost and pill burden. Although randomized clinical trials have shown noninferiority for shorter versus longer DAPT regimens in many regards, some endpoints (e.g., myocardial infarction) may still occur less frequently with longer DAPT regimens, particularly in higher risk populations (e...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

Xenon: An Emerging Neuroprotectant With Potential Application for Cardiac Arrest Care
Xenon is an inert, highly polarizable noble gas with demonstrated safety and application in general anesthesia for over 50 years. A potent inhibitor of the N-methyl-D-aspartate subtype of glutamate receptors, xenon has a well-documented ameliorating effect on excitotoxic neuronal injury in numerous cellular and animal models of hypoxic-ischemic brain injury. The most important determinant of overall survival and morbidity in out-of-hospital cardiac arrest is the severity of neurological injury. The only approved neuroprotective strategy in this setting is mild therapeutic hypothermia, which has demonstrated significant, al...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

His Bundle Pacing: Hemodynamics and Clinical Outcomes
From 1993 to 2009, nearly 2.9 million pacemakers were implanted in the United States; the majority of which were dual-chamber pacemakers. One of the major physiologic advantages of dual-chamber pacing over single-chamber ventricular pacing is atrioventricular synchrony, which prevents the pacemaker syndrome. However, patients who are pacemaker dependent or use right ventricle (RV) apical pacing more than 40% of the time are at a risk of developing heart failure from electromechanical dyssynchrony. Studies have also shown that RV pacing results in nonphysiological activation of the left ventricle, leading to adverse clinica...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Was the Enalapril Dose Too Low in the PARADIGM-HF Trial?
In conclusion, based on current evidence, it is unclear whether a maximum recommended enalapril dose would promote improved patient outcomes compared with an intermediate dose. However, no prospective study to date comparing ACE inhibitor doses has documented that higher doses result in significant mortality reduction, although the data suggest that there may be a decrease in HF hospitalizations when compared with lower doses. (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Medical Management of Rheumatic Heart Disease: A Systematic Review of the Evidence
Rheumatic heart disease (RHD) is an important cause of heart disease globally. Its management can encompass medical and procedural (catheter and surgical) interventions. Literature pertaining to the medical management of RHD from PubMed 1990–2016 and via selected article reference lists was reviewed. Areas included symptom management, left ventricular dysfunction, rate control in mitral stenosis, atrial fibrillation, anticoagulation, infective endocarditis prophylaxis, and management in pregnancy. Diuretics, angiotensin blockade and beta-blockers for left ventricular dysfunction, and beta-blockers and If inhibitors f...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Antithrombotic Management of Patients With Prosthetic Heart Valves
Valvular heart disease is a major public health issue. The prevalence of valvular heart disease is expected to increase due to an aging population. Valve dysfunction manifests as valve stenosis, regurgitation, or both due to various etiologies. Valve repair and replacement are the main treatment options for severe valve dysfunction. Valve replacement is achieved by using either a mechanical or a bioprosthetic valve. Mechanical valves are more durable but require lifelong anticoagulation with associated complications. Bioprosthetic valves usually require anticoagulation only transiently after implantation but are less durab...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Diagnosis, Treatment, and Management of Orthotopic Liver Transplant Candidates With Portopulmonary Hypertension
Portopulmonary hypertension (POPH) is seen in 5–8% of orthotopic liver transplantation (OLT) candidates and has significant implications for clinical outcomes. POPH is characterized by vasoconstriction and remodeling of the pulmonary vasculature. It is exacerbated by the hyperdynamic circulation that is common in advanced liver disease. Screening all OLT candidates with transthoracic echocardiography to assess pulmonary pressures and right ventricular function is crucial, as clinical symptoms alone are not reliable. Any significant right ventricular dysfunction or dilatation along with an elevation in estimated pulmo...
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Frank Cole Spencer, MD—Surgeon, Innovator, and Educator
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2018 Category: Cardiology Tags: Editorial Source Type: research

Through the Decades: β-Blocker Use and Outcomes in Acute Coronary Syndromes
This article provides a review of the landmark clinical trials of β-blockers in ACS and highlights the chronology and evolution of guideline recommendations through the decades. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

Effects of Anti-Inflammatory Medications in Patients With Coronary Artery Disease: A Focus on Losmapimod
Inflammation plays an integral role in atherogenesis and the pathogenesis of coronary artery disease (CAD). The question remains as to whether targeted inhibition of specific pathways of inflammation will have any clinical benefits in CAD. In this article, we will review p38 mitogen-activated protein kinase, one of the key sensors of cellular stress that plays an important role in the inflammatory cascade. In addition, we will review losmapimod, a reversible competitive inhibitor of the α and β isoforms of p38 mitogen-activated protein kinase, and its efficacy when added to standard of care in patients hospitali...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium and is most often caused by mutations in sarcomere genes. The structural and functional abnormalities are not explained by flow-limiting coronary artery disease or loading conditions. The disease affects at least 0.2% of the population worldwide and is the most common cause of sudden cardiac death in young people and competitive athletes because of fatal ventricular arrhythmia. In some patients, however, HCM has a benign course. Therefore, it is of utmost importance to properly evaluate patients and single o...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Aorto-Atrial Fistulas: A Contemporary Review
Aorto-atrial fistulas (AAFs) are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. AAFs are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Secondary causes incite local deterioration of cardiac wall integrity leading to formation of fistulous connections, whereas iatrogenic causes are more traumatic in nature. Signs and symptoms include those of...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy: Current and Future Perspectives
Two-dimensional speckle tracking echocardiography represents a novel, simple, and reproducible technique for the estimation of left ventricular myocardial deformation (strain) and the evaluation of left ventricular twist mechanics. During the last few years, its clinical and prognostic implications in cardiomyopathies and hypertrophic cardiomyopathy (HCM), in particular, have been rapidly increasing. Reduced global longitudinal strain is associated with more severe disease and confers an increased risk for major cardiac events, independently of other clinical and echocardiographic risk factors. Left ventricular dyssynchron...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Complications of Proteasome Inhibitors Used in Multiple Myeloma
The use of proteasome inhibitors (PI) as targeted chemotherapeutics have significantly improved survival in patients with multiple myeloma (MM). However, rare and serious cardiovascular complications have occurred as a result of their use, most commonly congestive heart failure, hypertension, and arrhythmias. MM occurs in an aged population with many concurrent cardiovascular risk factors. The primary disease process also contributes to cardiovascular complications. Furthermore, many MM patients have prior exposure to cardiotoxic chemotherapy such as anthracyclines. Because of these occurrences, the identification, prevent...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Cardioprotection in the Modern Era of Cancer Chemotherapy
The current arsenal of cancer chemotherapy is broad and rapidly expanding and includes conventional cytotoxic agents and targeted and immune-based therapies. As cancer survival rates have improved, the acute and latent cardiotoxicities of chemotherapy have emerged as important contributors to morbidity and mortality in cancer survivors. All chemotherapeutic agents have the potential for cardiac complications, with manifestations ranging from subclinical left ventricular dysfunction and asymptomatic QT prolongation, to congestive heart failure, myocardial ischemia, myocarditis, arrhythmia, and sudden cardiac death. Efforts ...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Switching From Ticagrelor or Prasugrel to Clopidogrel
Ticagrelor and prasugrel are newer antiplatelet drugs which, like clopidogrel, block the P2Y12 platelet receptor to inhibit platelet aggregation. Compared with clopidogrel, both ticagrelor and prasugrel have greater clinical efficacy but also have a higher risk of bleeding and are much more costly. Therefore, some institutions and providers switch patients from ticagrelor or prasugrel to clopidogrel in an effort to lower bleeding risk, stem costs, or otherwise ensure that patients can safely adhere to long-term P2Y12 inhibitor therapy. From a pharmacodynamic perspective, switching patients from ticagrelor or prasugrel to c...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

A Nonsurgical Approach to Mesenteric Vascular Disease
Mesenteric ischemia is a rare disorder, with considerably high morbidity and mortality rates. It can manifest in several ways, including acute mesenteric ischemia, chronic mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric venous thrombosis, and colonic ischemia. Of these, acute mesenteric ischemia is the most severe form of intestinal ischemia, with a high mortality rate. The mainstay of therapy for mesenteric ischemia is surgical exploration and resection of infarcted bowel; however, medical therapy can play an important adjunctive role. When diagnosed early, before bowel infarction, endovascular therapy c...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Acupuncture and Cardiovascular Disease: Focus on Heart Failure
This article serves to examine recent evidence supporting the long-loop pathway as the physiologic mechanism of acupuncture and the sympatholytic, vasodilatory, and cardioprotective effects of acupuncture that could specifically improve cardiac function and quality of life measures in the management of congestive heart failure. (Source: Cardiology in Review)
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Genetic Origins of Tetralogy of Fallot
Due to improved survival and clinical outcomes, congenital heart disease (CHD) is an area of growing importance within the medical community. As these patients reach adulthood and have children, there has been a growing appreciation for the increased risk of CHD among their offspring, strongly implying a genetic element. Given the growing wealth of genetic data available and these clinical implications, this review serves to reexamine the role of genetics within CHD, using Tetralogy of Fallot as a model pathology. Tetralogy of Fallot (TOF) is one of the oldest documented CHDs, with a growing prevalence of adult patients, a...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Impact of Improved Survival in Congenital Heart Disease on Incidence of Disease
Survival rates and life expectancies for patients with congenital heart disease (CHD) have dramatically increased, and these patients are now reaching reproductive age. As they reproduce, questions pertaining to recurrent risk of disease and the impact on incidence rates have emerged. Recurrence rates for CHD have been estimated at 3% to 5%, although, due to the complex genetics underlying CHD, this range may represent an underestimation of the true risk. Debate still exists on whether the impact of recurrence of disease has been reflected in incidence rates. Although incidence rates have undoubtedly increased, the mechani...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: A Review of the Literature
Transcatheter aortic valve replacement (TAVR) is a safe and effective therapy for aortic valve replacement in patients ineligible for or at high risk for surgery. However, outcomes after TAVR based on an individual’s sex remain to be fully elucidated. We searched PUBMED and EMBASE using the keywords: “transcatheter aortic valve replacement,” “transcatheter aortic valve implantation,” “sex differences,” “gender,” “sex characteristics” and collected information on baseline features, procedural characteristics, and postprocedural outcomes in women. Inclusion/ex...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Chronic Thromboembolic Pulmonary Hypertension: Epidemiology, Diagnosis, and Management
Chronic thromboembolic pulmonary hypertension (CTEPH), classified as World Health Organization (WHO) group 4 pulmonary hypertension (PH), is an interesting and rare pulmonary vascular disorder secondary to mechanical obstruction of the pulmonary vasculature from thromboembolism resulting in PH. The pathophysiology is complex, beginning with mechanical obstruction of the pulmonary arteries, which eventually leads to arteriopathic changes and vascular remodeling in the nonoccluded arteries and in the distal segments of the occluded arteries mediated by thrombus nonresolution, abnormal angiogenesis, endothelial dysfunction, a...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Implications of the New National Guidelines for Hypertension
Automated validated devices should be used for measuring blood pressure (BP). A systolic BP between 120 and 129 mm Hg with a diastolic BP (Source: Cardiology in Review)
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole
Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Maintaining high-risk patients on low-dose aspirin therapy is a fundamental component of management. However, poor adherence, secondary to the drug’s gastrointestinal side effects, has been associated with negative cardi...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: New Therapy Update Source Type: research

Devices for Autonomic Regulation Therapy in Heart Failure With Reduced Ejection Fraction
Heart failure (HF) is associated with significant morbidity and mortality and an increasing economic burden. The persistence of HF’s risk factors, coupled with an aging population, also leads to an increase in its incidence and prevalence. It is well established that sympathetic hyperactivity and parasympathetic withdrawal are instrumental in the development and worsening of HF. Therefore, restoring autonomic balance to the cardiovascular system is an attractive therapeutic approach. The following is a review of current clinical trials of device-based autonomic regulation therapy in the management of HF with a reduce...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Milrinone Dosing and a Culture of Caution in Clinical Practice
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion. D...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Ability of Nonstrain Diastolic Parameters to Predict Doxorubicin-Induced Cardiomyopathy: A Systematic Review With Meta-Analysis
Doxorubicin is an important cause of chemotherapy-induced cardiomyopathy. Prior studies have found conflicting results of whether nonstrain diastolic parameters can predict doxorubicin-induced cardiotoxicity. We performed a systematic review of English written publications using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were applied: cancer subjects, echo-derived nonstrain diastolic profile, and patients compared before and after treatment to predict systolic dysfunction. The following exclusion criteria were applied: other cardiotoxic agents, n...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Mitral Valve and Subvalvular Repair for Secondary Mitral Regurgitation: Rationale and Clinical Outcomes of the Papillary Muscle Sling
We present a comprehensive review of the pathophysiology of secondary MR, and the rationale and clinical outcomes of MV repair with papillary muscle sling placement for the treatment of secondary MR. (Source: Cardiology in Review)
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Cardiosphere-Derived Cells and Ischemic Heart Failure
After a myocardial infarction, heart tissue becomes irreversibly damaged, leading to scar formation and inevitably ischemic heart failure. Of the many available interventions after a myocardial infarction, such as percutaneous intervention or pharmacological optimization, none can reverse the ischemic insult on the heart and restore cardiac function. Thus, the only available cure for patients with scarred myocardium is allogeneic heart transplantation, which comes with extensive costs, risks, and complications. However, multiple studies have shown that the heart is, in fact, not an end-stage organ and that there are endoge...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Five Presidents and a Secretary
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Editorial Source Type: research

Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole
Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Maintaining high-risk patients on low-dose aspirin therapy is a fundamental component of management. However, poor adherence, secondary to the drug’s gastrointestinal side effects, has been associated with negative cardi...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: New Therapy Update Source Type: research

Devices for Autonomic Regulation Therapy in Heart Failure With Reduced Ejection Fraction
Heart failure (HF) is associated with significant morbidity and mortality and an increasing economic burden. The persistence of HF’s risk factors, coupled with an aging population, also leads to an increase in its incidence and prevalence. It is well established that sympathetic hyperactivity and parasympathetic withdrawal are instrumental in the development and worsening of HF. Therefore, restoring autonomic balance to the cardiovascular system is an attractive therapeutic approach. The following is a review of current clinical trials of device-based autonomic regulation therapy in the management of HF with a reduce...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Milrinone Dosing and a Culture of Caution in Clinical Practice
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion. D...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Ability of Nonstrain Diastolic Parameters to Predict Doxorubicin-Induced Cardiomyopathy: A Systematic Review With Meta-Analysis
Doxorubicin is an important cause of chemotherapy-induced cardiomyopathy. Prior studies have found conflicting results of whether nonstrain diastolic parameters can predict doxorubicin-induced cardiotoxicity. We performed a systematic review of English written publications using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were applied: cancer subjects, echo-derived nonstrain diastolic profile, and patients compared before and after treatment to predict systolic dysfunction. The following exclusion criteria were applied: other cardiotoxic agents, n...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research