Hearts and Minds: Stress, Anxiety, and Depression: Unsung Risk Factors for Cardiovascular Disease
Anxiety, depression, and stress are exceedingly common in patients with cardiovascular disease (CVD). They increase the risk of cardiac events and are associated with much worse outcomes. A causal relationships exists between anxiety/depression and adverse cardiac events such as acute myocardial infarction and sudden cardiac death. Various treatments, including psychologic therapies and pharmacotherapy, can used to treat patients with these disorders. This review discusses the epidemiology, pathogenesis, and treatment options for patients with CVD who suffer from these conditions and argues that they should be treated as c...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Precardiogenic Shock: A New Clinical Entity
The pathogenesis of cardiogenic shock (CS) has evolved from an acute event due to a large myocardial infarction to a semiacute event due to rapid hemodynamic deterioration on a background of preexisting left ventricular systolic dysfunction. Pre-CS refers to the period of rapid hemodynamic deterioration that precedes overt CS with hypotension, inflammatory response, and end-organ failure. Mortality remains extremely high in CS and has not improved over the past decades. Pre-CS offers a unique opportunity to initiate early treatment that may result in better clinical outcomes. The present review addresses the definition, re...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Predictors of Adverse Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: A Meta-Analysis of Observational Studies
In conclusion, multiple risk factors have been associated with arrhythmic events in AC patients. However, larger studies are needed to discriminate those patients who will benefit from implantable cardioverter defibrillators. (Source: Cardiology in Review)
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Parathyroid Hormone and Cardiac Electrophysiology: A Review
Calcium has long been known to be essential to cardiac electrical activity. Parathyroid hormone (PTH) is the main regulator of serum calcium and is central to calcium homeostasis. Although there are significant data linking parathyroid disease states with changes in cardiac electrophysiology, most data have focused on how PTH modulates serum calcium to produce these effects. Close scrutiny of early literature demonstrates that the relationship between PTH and electrocardiographic changes is not straightforward, and numerous studies have linked PTH to arrhythmia. Basic science research has demonstrated that there is a basis...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Heart Transplantation for Hepatitis C Virus Non-Viremic Recipients From Hepatitis C Virus Viremic Donors
Multiple strategies have been implemented to increase the donor pool to avoid transplant wait-list mortality. The approval of highly effective direct-acting antiviral regimens for the treatment of hepatitis C virus (HCV) has enabled expansion of the donor pool by allowing the transplantation of organs from HCV-viremic donors to HCV-negative recipients. Multiple centers have recently published data on outcomes of heart transplantation from HCV-viremic heart donors to HCV-negative recipients, with acceptable posttransplant outcomes. However, areas of uncertainty remain, particularly in the long-term risks of intentional HCV ...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Drugs Used to Treat Attention-Deficit/Hyperactivity Disorder Part 2: Impact on Cardiovascular Events and Recommendations for Evaluation and Monitoring
A variety of psychostimulant and nonpsychostimulant medications have proven to be successful in reducing inattention, impulsivity, and hyperactivity in individuals with attention-deficit/hyperactivity disorder (ADHD). Psychostimulants used to treat ADHD include methylphenidate and related drugs and various amphetamine preparations. Nonpsychostimulant medications used to treat ADHD include atomoxetine and 2 α-2 adrenergic agonists: guanfacine extended-release and clonidine extended-release. The psychostimulants and atomoxetine have been shown, on average, to increase heart rate by 3–10 beats/min, systolic blood ...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Brain–Heart Connection and the Northridge Earthquake
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Editorial Source Type: research

Angiotensin II (Giapreza): A Distinct Mechanism for the Treatment of Vasodilatory Shock
Septic shock, a form of vasodilatory shock associated with high morbidity and mortality, requires early and effective therapy to improve patient outcomes. Current management of septic shock includes the use of intravenous fluids, catecholamines, and vasopressin for hemodynamic support to ensure adequate perfusion. Despite these interventions, hospital mortality rates are still greater than 40%. Practitioners are continuously faced with cases of refractory shock that are associated with poor clinical outcomes. In December of 2017, the Food and Drug Administration approved the first synthetic human angiotensin II, a potent v...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: New Therapy Update Source Type: research

Impact of Implantable Cardioverter-Defibrillator Interventions on All-Cause Mortality in Heart Failure Patients: A Meta-Analysis
Implantable cardioverter-defibrillators (ICDs) have a unique role in the primary and secondary prevention of sudden cardiac death. However, appropriate and inappropriate ICD interventions [antitachycardia pacing (ATP) or shocks] can result in deleterious effects. The aim of our study was to systematically review the existing data about the impact of ICD interventions on all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF). We systematically searched MEDLINE (by using PubMed Web-based search engine) without any limits until September 30, 2017. After screening 17,752 records, a total of 17 stu...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Evolving Use of Biomarkers in the Management of Heart Failure
Objective, noninvasive, clinical assessment of patients with heart failure can be made using biomarker measurements, including natriuretic peptides, cardiac troponins, soluble suppression of tumorigenicity 2, and galectin-3. The aim of this review is to provide clinicians with guidance on the use of heart failure biomarkers in clinical practice. The authors provide a didactic narrative based on current literature, an exemplary case study, and their clinical experience. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Searching for the Genetic Determinants of Peripheral Arterial Disease: A Review of the Literature and Future Directions
Peripheral arterial disease (PAD) is a significant but under-recognized disease that is poorly understood despite population-scale genetic studies. To address this morbid disease, clinicians need additional tools to identify, prevent, and treat patients at risk for PAD. Genetic studies of coronary artery disease have yielded promising results for clinical application, which have thus far been lacking in PAD. In this article, we review recent findings, discuss limitations, and propose future directions of genomic study and clinical application. However, despite many studies, we still lack definitive genetic markers for PAD....
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Thermodilution Cardiac Output: A Concept Over 250 Years in the Making
The need to quantify blood flow through the heart has led to the development of different techniques for its measurement. The 3 main approaches are the Fick method, dye dilution, and thermodilution techniques. The latter 2 are based on the use of indicators that indirectly quantify blood flow. These have slowly been developed over centuries, from the concept of measuring blood flow, to a technique, and its clinical utility. Thermodilution is the most popular dilution method used for measuring cardiac output (CO) in the clinical setting. The information obtained during this procedure is relevant in the process of clinical d...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Manifestations in Idiopathic Inflammatory Myopathies: An Overview
Idiopathic inflammatory myopathies are a group of autoimmune diseases that are characterized by muscle inflammation resulting in elevated muscle enzyme release and distinctive biopsy findings. This group of conditions includes polymyositis, dermatomyositis, inclusion body myositis, and necrotizing autoimmune myopathy. Although they have many similarities, the inflammatory myopathies differ in their clinical, pathological, and treatment realms. Extramuscular manifestations may involve many organs that include the skin, joints, heart, lungs, and gastrointestinal tract. Cardiovascular involvement is one of the leading causes ...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Mediterranean Diet and Cardiovascular Disease: Gaps in the Evidence and Research Challenges
In conclusion, the evidence indicates that the MD prevents CVD. There is a need for RCTs that test the effectiveness of the MD for preventing CVD. Key design features for such a study are proposed. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Effects of Spaceflight on Cardiovascular Physiology and Health
This article reviews the knowledge gained in human experiments in the past half century of spaceflight, and summarizes our knowledge on the effects of short- and long-duration microgravity exposure on cardiovascular physiology and functioning, including fluid redistribution, autonomic reflexes, cardiac parameters, orthostatic intolerance, arrhythmias, aerobic capacity, and cardiac atrophy. This review also discusses current countermeasures for risk reduction during spaceflight, as well as future directions in cardiovascular research in space. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Drugs Used to Treat Attention-Deficit/Hyperactivity Disorder: Part 1: Epidemiology, Pharmacology, and Impact on Hemodynamics and Ventricular Repolarization
Attention-deficit/hyperactivity disorder (ADHD) is a clinical syndrome characterized by persistent inattention, impulsivity, and hyperactivity. It is most commonly encountered in children and adolescents but may persist into adulthood. A variety of psychostimulant and nonpsychostimulant medications have proven to be successful in reducing inattention, impulsivity, and hyperactivity in those with ADHD. Psychostimulants used to treat ADHD include methylphenidate and related drugs and various amphetamine preparations. Non-psychostimulant medications used to treat ADHD include atomoxetine and two alpha-2 adrenergic agonists: g...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Racial Disparities in the Cardiac Computed Tomography Assessment of Coronary Artery Disease: Does Gender Matter: Erratum
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Erratum Source Type: research

Andexanet Alfa for Reversing Factor Xa Inhibition
The direct oral anticoagulants (DOACs) have gained popularity recently among both patients and providers for their comparable or better efficacy and safety profiles compared with warfarin and the lack of need for routine monitoring of anticoagulant effect. One obstacle for the more widespread use of the DOACs in clinical practice has been the lack of a reversal agent. Most DOACs act by directly binding to and inhibiting the effects of factor Xa. Andexanet alfa (Andexxa, Portola Pharmaceuticals, San Francisco, CA) is a modified form of factor Xa that acts as a decoy binding entity for DOACs, thereby allowing endogenous fact...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Immune-Related Adverse Events in Immune Checkpoint Inhibition Therapy
Immune checkpoint inhibitors present clinicians with both an exciting step forward in cancer treatment and the unknown possibilities of an unshackled immune system. The latter phenomena, known as immune-related adverse events (irAEs), are of particular interest because they may affect any organ system with autoimmune-like pathologies, such as hepatitis and colitis. Within the cardiovascular system, irAEs associated with immune checkpoint blockade exist as a broad clinical spectrum, with autoimmune myocarditis being the best-characterized entity at this time. In general, irAEs are often reversible with immunosuppression. Ho...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Chemotherapy Used in the Treatment of Breast Cancers
This article will discuss the epidemiology, mechanisms, diagnostic methods, and management of cardiotoxicity from systemic chemotherapy used to treat breast cancer. (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Review on Factors Influencing Physician Guideline Adherence in Cardiology
Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applica...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Involvement in Systemic Sclerosis: Diagnostic Tools and Evaluation Methods
The heart is one of the major organs commonly involved in systemic sclerosis (SSc). Myocardial fibrosis has been identified in a high percentage of these patients. Most SSc patients with cardiac involvement (CI) are subclinical, especially early on in the course of their disease. To accurately identify CI and improve diagnosis and treatment, imaging techniques should be implemented on a regular basis following diagnosis. In this review, we discuss the up-to-date pathophysiologic basis of CI, the cardiac manifestations, and the diagnostic methods that have been published in the literature. Recent studies have shown that tis...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Obesity in Kidney Transplantation: Impact on Transplant Candidates, Recipients, and Donors
Obesity is now common among children and adults who are kidney transplant candidates and recipients. It is associated with an increased risk of cardiovascular disease and kidney failure. This also pertains to potential living kidney donors with obesity. Obese patients with end-stage renal disease benefit from transplantation as do nonobese patients, but obesity is also associated with more risk. A complicating factor is that obesity is also associated with increased survival on maintenance dialysis in adults, but not in children. The assessment of obesity and body habitus should be individualized. Body mass index is a comm...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Clinical Value of Heart Rate Monitoring Using an Apple Watch
Public interest in health monitoring devices has increased with the availability of wearable technologies or wearables such as the Apple Watch. These devices are collecting health data that may be useful to health professionals. Most studies to date have been conducted with a limited sample size and with healthy subjects. Recent studies have suggested the usefulness of long-term cardiac monitoring to reveal atrial fibrillation and prevent cryptogenic stroke. Wearable devices may become useful in cardiac monitoring, and further studies are needed. (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Michael E. DeBakey, Surgeon, Scientist, Innovator, and Administrator (1908–2008)
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Editorial Source Type: research

Bempedoic Acid (ETC-1002): ATP Citrate Lyase InhibitorReview of a First-in-Class Medication with Potential Benefit in Statin-Refractory Cases
Bempedoic acid (BA; ETC-1002) is a new agent that reduces cholesterol synthesis through inhibition of adenosine triphosphate citrate lyase, an enzyme upstream from 3-hydroxy-3-methylglutaryl-coenzyme A. In animal models, BA also influences fatty acid synthesis, but in humans, its role is limited primarily to lowering low-density lipoprotein cholesterol (LDL-C). In early clinical trials, BA was well tolerated and without major side effects. Alone or in various combinations with atorvastatin and/or ezetimibe, LDL-C lowering ranged from 17% to 64%. In addition, BA lowers levels of non–high-density lipoprotein cholestero...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: New Therapy Update Source Type: research

Exercise for Preventing Hospitalization and Readmission in Adults With Congestive Heart Failure
We critically appraised all available evidence regarding exercise interventions for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). We searched 4 databases up to April 2018 and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation working group approach. We reviewed 7 meta-analyses and the publications of 48 randomized controlled trials (RCTs). In HF with reduced ejection fraction, low-quality evidence suggests that exercise prevents all-cause hospitalizations [Relative risk (RR), 0.77; 95% confidence interval...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Patent Foramen Ovale and Hypoxemia
Patent foramen ovale (PFO), an embryonic remnant of the fetal circulation, is present in 20–25% of adults. Although recent observational studies and clinical trials have established the link between PFO-mediated right-to-left shunting with cryptogenic stroke and migraine with aura, the role of a PFO in exacerbating hypoxemic medical conditions (ie, sleep apnea, chronic obstructive pulmonary disease, pulmonary hypertension, platypnea–orthodeoxia, pulmonary arteriovenous malformation, high-altitude pulmonary edema, and exercise desaturation) remains less understood. PFO-mediated hypoxemia occurs when deoxygenated...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Emerging Implications of Genetic Testing in Inherited Primary Arrhythmia Syndromes
Inherited primary arrhythmia syndromes are genetically determined disorders of cardiac ion channels or ion channel macromolecular complexes usually associated with a higher risk of sudden cardiac death. These conditions have a very broad spectrum of clinical manifestations, ranging from an asymptomatic course to syncope, atrial and ventricular arrhythmias, and conduction disturbances, but may produce sudden infant death syndrome and unexplained sudden cardiac death in apparently healthy individuals. During the last 20 years, the evolving knowledge on the genetic basis of inherited arrhythmia syndromes has dramatically resh...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Racial Disparities in the Cardiac Computed Tomography Assessment of Coronary Artery Disease: Does Gender Matter
Coronary heart disease (CHD) represents a significant healthcare burden in terms of hospital resources, morbidity, and mortality. Primary prevention and early detection of risk factors for the development of CHD are pivotal to successful intervention programs and prognostication. Yet, there remains a paucity of evidence regarding differences in the assessment of these risk factors and the tools of assessment among different ethnicities. We conducted a narrative review to assess the utility of cardiac computed tomography, particularly coronary artery calcification (CAC), in different ethnicities. We also looked to see wheth...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Gastrointestinal Bleeding During Continuous-Flow Left Ventricular Assist Device Support: State of the Field
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly used for the management of advanced heart failure refractory to optimal medical therapy. Despite the encouraging outcomes with CF-LVADs, gastrointestinal bleeding (GIB) continues to be a rather concerning complication resulting in increased rates of readmission and increased morbidity. The exact pathophysiology of CF-LVAD-associated GIB remains poorly understood, and this lack of knowledge limits our ability to control this morbid complication. What is clear, however, is that the majority of GIB episodes in LVAD patients are due to fragile GI arter...
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Ten Trials of a Cardiovascular Clinical Trialist
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 7, 2018 Category: Cardiology Tags: Editorial Source Type: research

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