Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real ‐world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013
BackgroundThe past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS). HypothesisThe outcomes of ACS patients with atrial fibrillation (AF) has improved over the years. MethodsWe evaluated time‐dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013. We divided the surveys into early (2000–2006) and late (2008–2013) time periods. ResultsThe study population comprised 13 297 ACS patien...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Aharon Erez, Ilan Goldenberg, Avi Sabbag, Eyal Nof, Doron Zahger, Shaul Atar, Arthur Pollak, Idit Dobrecky ‐Merye, Roy Beigel, Shlomi Matetzky, Michael Glikson, Roy Beinart Tags: Clinical Investigations Source Type: research

Efficacy and safety of dabigatran, rivaroxaban, and warfarin for stroke prevention in Chinese patients with atrial fibrillation: the Hong Kong Atrial Fibrillation Project
BackgroundLittle is known about the comparative effectiveness and safety of non–vitamin K antagonist oral anticoagulants (NOAC) compared to warfarin in Chinese atrial fibrillation (AF) patients. Our aim was to compare the ischemic stroke risk reduction and incidence of intracranial hemorrhage (ICH) of warfarin in relation to quality of anticoagulation control (as reflected by time in therapeutic range [TTR]), and to dabigatran and rivaroxaban in a real‐world cohort of Chinese AF patients. HypothesisNOAC, rather than warfarin, is preferred in Chinese AF patients. MethodsOf 2099 patients studied (73.1 ± 12.3 y...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Wen ‐Hua Li, Duo Huang, Chern‐En Chiang, Chu‐Pak Lau, Hung‐Fat Tse, Esther W. Chan, Ian C.K. Wong, Gregory Y. H. Lip, Pak‐Hei Chan, Chung‐Wah Siu Tags: Clinical Investigations Source Type: research

Rationale and design of the BAYES (Interatrial Block and Yearly Events) registry
The prevalence of interatrial block (IAB) is high in the elderly, particularly in those with heart disease. Despite this high prevalence—and the association of IAB with the risk of atrial fibrillation (AF), stroke, and cognitive decline—little information exists about the prognosis of older patients with IAB. P‐wave duration and morphology are associated with risk of developing AF, stroke, and cognitive decline in elderly patients with structural heart disease. The aim of the Interatrial Block and Yearly Events (BAYES) registry is to assess the impact of IAB on the risk of AF and stroke during 3 years of foll...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Manuel Mart ínez‐Sellés, Adrian Baranchuk, Roberto Elosua, Antonio Bayés Luna Tags: Trial Designs Source Type: research

Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ‐5D questionnaire. From baseline to study...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: John Zarifis, Manolis Kallistratos, Apostolos Katsivas, Tags: Clinical Trial Updates Source Type: research

Trends in hospitalization for congestive heart failure, 1996 –2009
We present data on number of HF admissions, length of stay (LOS), and inpatient mortality in the United States, 1996–2009. HypothesisTo assess HF hospitalizations in a national sample of United States population. MethodsData were obtained from the National Hospital Discharge Survey (NHDS), a national probability sample survey of discharges conducted annually by the National Center for Health Statistics. Sampling weights are applied to raw NHDS data to produce national estimates. Hospitalizations with a primary diagnosis of HF were identified using ICD‐9‐CM codes. We excluded hospitalizations where HF was a second...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Muhammad Bilal Munir, Michael S. Sharbaugh, Floyd W. Thoma, Muhammad Umer Nisar, Amir S. Kamran, Andrew D. Althouse, Samir Saba Tags: Clinical Investigations Source Type: research

The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study
Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1‐ to 2‐week period at each site between April...
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Faraz Kureshi, Ali Shafiq, Suzanne V. Arnold, Kensey Gosch, Tracie Breeding, Ashwath S. Kumar, Philip G. Jones, John A. Spertus Tags: Quality and Outcomes Source Type: research

Interleukin ‐37 elevation in patients with atrial fibrillation
Conclusions IL‐37 is elevated in AF patients and its expression is closely associated with AF subgroups. Thus, IL‐37 may provide a novel research target for the pathogenesis and therapy of AF. This study is the first to document elevated IL‐37 in AF patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Weidong Li, Shijie Li, Xianjin Li, Shuzhong Jiang, Bing Han Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 19, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Relationship Among Risk Score Systems and Coronary Atherosclerosis Determined by Multislice Computed Tomography
ConclusionsRisk score systems have only moderate diagnostic value to predict presence of CA, without significant differences among them. Coronary artery disease is highly prevalent in patients considered low risk. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 5, 2016 Category: Cardiology Authors: Alberto Garc ía‐Lledó, José L. Moya‐Mur, Virginia Ponz‐Mir, Susana Novo‐Aparicio, Azucena Sanz‐Barrio, Concepción Álvarez‐Sanz, Ana de Santiago‐Nocito Tags: Clinical Investigations Source Type: research

Temporal trends in transcatheter aortic valve implantation, 2008 –2014: patient characteristics, procedural issues, and clinical outcome
ConclusionsTemporal trends accompanying TAVI evolution include its utilization in lower‐risk patients, procedural simplification, improved overall survival, decreased pacemaker obligation, and shorter hospital stay. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Uri Landes, Alon Barsheshet, Ariel Finkelstein, Victor Guetta, Abid Assali, Amir Halkin, Hanna Vaknin ‐Assa, Amit Segev, Tamir Bental, Jeremy Ben‐Shoshan, Israel M. Barbash, Ran Kornowski Tags: Clinical Investigations Source Type: research

Effect of remote ischemic preconditioning on electrophysiological and biomolecular parameters in nonvalvular paroxysmal atrial fibrillation (RIPPAF study): Rationale and study design of a randomized, controlled clinical trial
Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological‐ and thrombogenesis‐related parameters in the setting of paroxysmal nonvalvular AF has not been investigated. The aim of the study is to answer the following questions: (1) Does RIPC have impact on inducibility of AF in patients with known paroxysmal AF? If yes, what are the direct electrophysiological mechanisms of this phenomenon, a...
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Jedrzej Kosiuk, Romina Milani, Laura Ueberham, Tobias Uhe, Clara Stegmann, Gerhard Hindricks, Andreas Bollmann Tags: Trial Designs Source Type: research

Combined Post ‐ and Precapillary Pulmonary Hypertension in Patients With Heart Failure
ConclusionsHeart failure patients with CpcPH are associated with increased death rate 1 year post–cardiac catheterization, compared with patients without PH. They are a high‐risk PH group and should be evaluated and diagnosed earlier in the disease state. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Michael E. Rezaee, Elizabeth L. Nichols, Mandeep Sidhu, Jeremiah R. Brown Tags: Clinical Investigations Source Type: research

A prospective study of patients with refractory angina: outcomes and the role of high ‐sensitivity troponin T
BackgroundThe predictors of cardiovascular events in patients with chronic refractory angina are limited. High‐sensitivity cardiac troponin T (hs‐cTnT) assays are biomarkers that may be used to determine the prognosis of patients with stable coronary artery disease. HypothesisHs‐cTnT is a predictor of death and nonfatal myocardial infarction (MI) in patients with refractory angina. MethodsWe prospectively enrolled 117 consecutive patients in this study. A heart team ruled out myocardial revascularization feasibility after assessing recent coronary angiograms; evidence of myocardial ischemia served as an inclusion cri...
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Nilson T. Poppi, Lu ís H.W. Gowdak, Luciana O.C. Dourado, Eduardo L. Adam, Thiago N.P. Leite, Bruno M. Mioto, José E. Krieger, Luiz A.M. César, Alexandre C. Pereira Tags: Clinical Investigation Source Type: research

Long ‐term survival after acute myocardial infarction in patients with hypertrophic cardiomyopathy
ConclusionsAMI patients with HCM exhibited worse long‐term survival than did AMI patients without HCM. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Yin ‐Jian Yang, Chao‐Mei Fan, Jin‐Qing Yuan, Hai‐Bin Zhang, Fu‐Jian Duan, Zhi‐Min Wang, Xi‐Ying Guo, Shan‐Shan Zhai, Shuo‐Yan An, Fei Hang, Yi‐Shi Li Tags: Clinical Investigation Source Type: research

Special considerations for therapeutic choice of non –vitamin K antagonist oral anticoagulants for Japanese patients with nonvalvular atrial fibrillation
Nonvalvular atrial fibrillation (AF) is a risk factor for stroke in elderly patients. Although warfarin has been used to prevent AF‐associated stroke for more than 50 years, non–vitamin K antagonist oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban recently have been developed to overcome the disadvantages of warfarin. Based on the results of NOAC clinical trials, Savelieva and Camm made recommendations regarding selection of NOACs in patients with nonvalvular AF. Recent accumulating evidence indicates that NOACs work differently in Asian and non‐Asian individuals. In this revi...
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Ken Okumura, Masatsugu Hori, Norio Tanahashi, A. John Camm Tags: Reviews Source Type: research

Assessment of Respiratory Distress by the Roth Score
This study introduces the Roth score as a telemedicine tool that uses patient counting times to accurately risk‐stratify dyspnea severity in terms of hypoxia. HypothesisThe Roth score has correlation with dyspnea severity. MethodsThis is a prospective, controlled‐cohort study. Roth score index is measured by having the patient count from 1 to 30 in their native language, in a single breath, as rapidly as possible. The primary result of the Roth score is the duration of time and the highest number reached. ResultsThere was a strongly positive correlation between pulse oximetry and both maximal count achieved in 1 breath (r = 0.67; P
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Ehud Chorin, Allison Padegimas, Ofer Havakuk, Edo Y. Birati, Yacov Shacham, Anat Milman, Guy Topaz, Nir Flint, Gad Keren, Ori Rogowski Tags: Clinical Investigations Source Type: research

Different cardiometabolic effects of atorvastatin in men with normal vitamin D status and vitamin D insufficiency
ConclusionsThe obtained results indicate that the strength of pleiotropic effects of atorvastatin depends on vitamin D status. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Robert Krysiak, Ma łgorzata Gilowska, Bogusław Okopień Tags: Clinical Investigations Source Type: research

Meta ‐analysis of Vitamin D Deficiency and Risk of Atrial Fibrillation
ABSTRACT BackgroundThere are accumulating studies investigating the association between vitamin D status and the risk of atrial fibrillation (AF). However, the results in these studies were inconsistent in regard to the role of vitamin D deficiency in predicting the development of AF. HypothesisVitamin D deficiency is associated increased risk of AF. MethodsUsing PubMed and Embase databases, we searched for records published before March 2016. Additionally, a manual search was conducted using all review articles on this topic. Of the 587 initially identified records, 8 studies with a total of 27 307 patients were fina...
Source: Clinical Cardiology - August 23, 2016 Category: Cardiology Authors: Zhiwei Zhang, Yajuan Yang, Chee Yuan Ng, Dandan Wang, Jianlong Wang, Guangping Li, Tong Liu Tags: Clinical Investigations Source Type: research

Response to Giovanni Battista Morgagni and the Foundation of Modem Medicine
(Source: Clinical Cardiology)
Source: Clinical Cardiology - August 22, 2016 Category: Cardiology Authors: Fl ávia F. A. Vale, Paulo C. R. P. Corrêa Tags: Letter to the Editor Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - August 22, 2016 Category: Cardiology Tags: Issue Information Source Type: research

High incidence of ventricular arrhythmias in patients with left ventricular enlargement and moderate left ventricular dysfunction
This study retrospectively analyzed the data of 853 patients who have an implantable cardioverter‐defibrillator/cardiac resynchronization therapy cardioverter‐defibrillator equipped with home monitoring. The patients were divided into 4 groups: group A, 35%
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Shuang Zhao, Keping Chen, Yangang Su, Wei Hua, Jiefu Yang, Silin Chen, Zhaoguang Liang, Wei Xu, Shu Zhang Tags: Clinical Investigations Source Type: research

The Role of the Ratio of J ‐Point Elevation Magnitude and R‐Wave Amplitude on the Same ECG Lead in the Risk Stratification of Subjects With Early Repolarization Pattern
BackgroundJust as high‐risk populations for cardiac arrest exist in patients with Brugada syndrome or long QT syndrome, high‐risk and low‐risk populations for cardiac arrest also exist in patients with early repolarization pattern (ERP). HypothesisElectrocardiographic (ECG) characteristics can aid the risk stratification of patients with ERP. MethodsElectrocardiographic parameters such as magnitude of J‐point elevation and J/R ratio were measured. The magnitude of J‐point elevation, leads with J points elevated, J/R ratio, morphology of the ST segment, and QT/QTc interval were used in comparative analysis in 2 gr...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Xu ‐Miao Chen, Cheng‐Cheng Ji, Yun‐Jiu Cheng, Li‐juan Liu, Wei‐Qi Zhu, Ying Huang, Wei‐Ying Chen, Su‐Hua Wu Tags: Clinical Investigations Source Type: research

Residual Ischemic Risk and Its Determinants in Patients With Previous Myocardial Infarction and Without Prior Stroke or TIA: Insights From the REACH Registry
BackgroundAlthough the rate of in‐hospital ischemic events after myocardial infarction (MI) has dramatically decreased, long‐term residual risk may remain substantial. However, most of the information on current residual risk is derived from highly selected randomized trials. HypothesisIn patients with previous MI and no prior ischemic stroke/transient ischemic attack (TIA), residual ischemic risk increases over time. MethodsUsing the international Reduction of Atherothrombosis for Continued Health (REACH) registry, we analyzed baseline characteristics and 4‐year follow‐up of patients with previous MI and no histor...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: J érémie Abtan, Deepak L. Bhatt, Yedid Elbez, Emmanuel Sorbets, Kim Eagle, Yasuo Ikeda, David Wu, Mary E. Hanson, Hakima Hannachi, Puneet K. Singhal, Philippe Gabriel Steg, Gregory Ducrocq, Tags: Clinical Investigations Source Type: research

Design and Rationale of the RE ‐DUAL PCI Trial: A Prospective, Randomized, Phase 3b Study Comparing the Safety and Efficacy of Dual Antithrombotic Therapy With Dabigatran Etexilate Versus Warfarin Triple Therapy in Patients With Nonvalvular Atrial Fibrillation Who Have Undergone Percutaneous Coronary Intervention With Stenting
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest‐sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking. The RE‐DUAL PCI trial (NCT...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Christopher P. Cannon, Savion Gropper, Deepak L. Bhatt, Stephen G. Ellis, Takeshi Kimura, Gregory Y.H. Lip, Ph. Gabriel Steg, Jurri ën M. Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M. Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll Tags: Trial Designs Source Type: research

Percutaneous Coronary Intervention for Bifurcation: How Can We Outperform the Provisional Strategy?
In the era of drug‐eluting stents, the provisional stenting strategy has been established as the default strategy in percutaneous coronary intervention for bifurcation lesions. However, emerging evidence shows that, in selected situations, the complex strategy of stenting both vessels regardless could reduce side‐branch restenosis without penalty. In particular, the double kissing crush technique has been proven to outperform the provisional strategy and other complex strategies in randomized trials. In this review, we present the evidence comparing the 2 strategies and individual stenting techniques and discuss the ro...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Andrew Kei ‐Yan Ng, Man‐Hong Jim Tags: Reviews Source Type: research

Electrocardiographic Time to Intrinsicoid Deflection and Heart Failure: The Multi ‐Ethnic Study of Atherosclerosis
ConclusionsDelayed time to ID is able to identify individuals at risk for developing HF before major ventricular conduction delays (eg, bundle branch block) are evident. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Wesley T. O'Neal, Waqas T. Qureshi, Saman Nazarian, Nadine Kawel ‐Boehm, David A. Bluemke, Joao A.C. Lima, Elsayed Z. Soliman Tags: Clinical Investigations Source Type: research

Prognostic Role of Right Ventricular Function in Patients With Heart Failure Undergoing Cardiac Resynchronization Therapy
BackgroundBecause 20% to 40% of patients undergoing cardiac resynchronization therapy (CRT) do not respond to it, identification of potential factors predicting response is a relevant research topic. HypothesisThere is a possible association between right ventricular function and response to CRT. MethodsWe analyzed 227 patients from the Cardiac Resynchronization Therapy Modular Registry (CRT‐MORE) who received CRT according to current guidelines from March to December 2013. Response to therapy was defined as a decrease of ≥15% in left ventricular end‐systolic volume (LVESV) at 6 months. ResultsThe tricuspid annular ...
Source: Clinical Cardiology - July 27, 2016 Category: Cardiology Authors: Antonio Rapacciuolo, Stefano Maff è, Pietro Palmisano, Anna Ferraro, Antonella Cecchetto, Antonio D'Onofrio, Francesco Solimene, Paola Musatti, Paola Paffoni, Francesca Esposito, Umberto Parravicini, Alessia Agresta, Giovanni Luca Botto, Maurizio Malacri Tags: Clinical Investigations Source Type: research

Race and Sex Differences in Management and Outcomes of Patients After ST ‐Elevation and Non–ST‐Elevation Myocardial Infarct: Results From the NCDR
ConclusionsIn this contemporary cohort, although there are differences by race in presentation and management of MI, heavily protocol‐driven processes seem to show fewer racial disparities. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 27, 2016 Category: Cardiology Authors: D. Edmund Anstey, Shuang Li, Laine Thomas, Tracy Y. Wang, Stephen D. Wiviott Tags: Clinical Investigations Source Type: research

Similar Impact of Clopidogrel or Ticagrelor on Carotid Atherosclerotic Plaque Inflammation
BackgroundPlatelets play an important role in inflammation. Inhibitors of the P2Y12 receptor, which is involved in platelet activation, may have a direct effect on carotid atherosclerotic plaque inflammation. HypothesisWe compared the effects of clopidogrel and ticagrelor therapy for carotid atherosclerotic plaque inflammation using 18F‐fluorodeoxyglucose ( 18FDG) positron emission tomography (PET) imaging. MethodsFifty patients with acute coronary syndrome and ≥1 18FDG uptake in the carotid artery (target‐to‐background ratio [TBR] ≥1.6) were randomized to either clopidogrel or ticagrelor groups. Of these, 4...
Source: Clinical Cardiology - July 25, 2016 Category: Cardiology Authors: Minyoung Oh, Cheol Whan Lee, Hyo Sang Lee, Mineok Chang, Jung ‐Min Ahn, Duk‐Woo Park, Soo‐Jin Kang, Seung‐Whan Lee, Young‐Hak Kim, Dae Hyuk Moon, Seong‐Wook Park, Seung‐Jung Park Tags: Clinical Investigations Source Type: research

Association Between Body Mass Index and Age of Presentation With Symptomatic Coronary Artery Disease
BackgroundObesity is increasingly recognized as an important risk factor for coronary artery disease (CAD). HypothesisPatients with increased body mass index (BMI) present at a younger age with symptomatic CAD. MethodsWe analyzed data on 2137 consecutive patients admitted for treatment of CAD proven on angiography from 2010 to 2013, excluding those with prior coronary intervention or bypass surgery. ResultsMean age was 64.1 ± 12.4 years; 75% were male; 43.6% were overweight (BMI 25–29.9 kg/m2) and 31.6% were obese (BMI ≥30 kg/m2). Patients with BMI ≥25 kg/m2 compared with
Source: Clinical Cardiology - July 18, 2016 Category: Cardiology Authors: Syed M. Atique, Bruce Shadbolt, Paul Marley, Ahmad Farshid Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 14, 2016 Category: Cardiology Tags: Issue Information Source Type: research

The Risk of Atrial Fibrillation With Ivabradine Treatment: A Meta ‐analysis With Trial Sequential Analysis of More Than 40000 Patients
Recent trials reported that risk of atrial fibrillation (AF) is increased in patients using ivabradine compared with controls. We performed this meta‐analysis to investigate the risk of AF association with ivabradine treatment on the basis of data obtained from randomized controlled trials (RCTs). We searched PubMed, EMBASE, Scopus, and the Cochrane Library for RCTs that comprised>100 patients. The incidence of AF was assessed. We obtained data from European Medicines Agency (EMA) scientific reports for the RCTs in which the incidence of AF was not reported. We used trial sequential analysis (TSA) to provide informati...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: İbrahim Halil Tanboğa, Selim Topçu, Enbiya Aksakal, Oktay Gulcu, Emrah Aksakal, Uğur Aksu, Vecih Oduncu, Fatih Rıfat Ulusoy, Serdar Sevimli, Cihangir Kaymaz Tags: Reviews Source Type: research

Cardiogenic Shock: Failure of Oxygen Delivery and Oxygen Utilization
ABSTRACT Cardiogenic shock remains a highly lethal condition. Conventional therapy including revascularization and mechanical circulatory support aims to improve cardiac output and oxygen delivery, but increasing basic and clinical observations indicate wider circulatory and cellular abnormalities, particularly at the advanced stages of shock. Progressive cardiogenic shock is associated with microcirculatory and cellular abnormalities. Cardiogenic shock is initially characterized by a failure to maintain global oxygen delivery; however, progressive cardiogenic shock is associated with the release of pro‐inflammatory cyto...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Hoong Sern Lim Tags: Reviews Source Type: research

Prevalence and Factors Associated With Statin Use Among a Nationally Representative Sample of US Adults: National Health and Nutrition Examination Survey, 2011 –2012
The 2013 American College of Cardiology/American Heart Association guidelines recommend statins for adults age ≤75 years who have clinical atherosclerotic cardiovascular disease (IA) and adults age 40 to 75 years with diabetes mellitus and LDL‐C 70–189 mg/dl (IA). Our aim was to estimate the prevalence and likelihood of statin use among selected statin benefit groups. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2012, we examined 5319 adults age ≥20 years. We estimated weighted frequencies and prevalence of statin use for adults with diabetes mellitu...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Demilade Adedinsewo, Nchang Taka, Pradyumna Agasthi, Rajesh Sachdeva, George Rust, Anekwe Onwuanyi Tags: Quality and Outcomes Source Type: research

Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: Rationale and Study Design of a Prospective Randomized Controlled Trial
Abstract Heart failure with preserved ejection fraction (HFpEF) has become the most prevalent form of heart failure in developed countries. Regrettably, there is no evidence‐based effective therapy for HFpEF. We seek to evaluate whether inspiratory muscle training, functional electrical stimulation, or a combination of both can improve exercise capacity as well as left ventricular diastolic function, biomarker profile, quality of life (QoL), and prognosis in patients with HFpEF. A total of 60 stable symptomatic patients with HFpEF (New York Heart Association class II–III/IV) will be randomized (1:1:1:1) to receive ...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Patricia Palau, Eloy Dom ínguez, Laura López, Raquel Heredia, Jessika González, Jose María Ramón, Pilar Serra, Enrique Santas, Vicente Bodi, Juan Sanchis, Francisco J. Chorro, Julio Núñez Tags: Trial Designs Source Type: research

Dual Antiplatelet Therapy and Outcomes in Patients With Atrial Fibrillation and Acute Coronary Syndromes Managed Medically Without Revascularization: Insights From the TRILOGY ACS Trial
We examined these associations for medically managed ACS patients randomized to dual antiplatelet therapy (DAPT) using patient data from the TRILOGY ACS trial. DAPT included aspirin plus clopidogrel 75 mg/d or prasugrel 10 mg/d (5 mg/d for those
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Larry R. Jackson, Jonathan P. Piccini, Derek D. Cyr, Matthew T. Roe, Megan L. Neely, Felipe Martinez, Thomas F. L üscher, Renato D. Lopes, Kenneth J. Winters, Harvey D. White, Paul W. Armstrong, Keith A.A. Fox, Dorairaj Prabhakaran, Deepak L. Bhatt, E. M Tags: Clinical Trial Updates Source Type: research

Stress Cardiac MRI in Women With Myocardial Infarction and Nonobstructive Coronary Artery Disease
ConclusionsAbnormal perfusion on sCMR is common among women with MINOCA. Abnormal perfusion usually co‐localized with LGE and/or T2+ when present. Variability in LGE pattern leads to uncertainty about whether the finding of abnormal perfusion was cause or consequence of the tissue state leading to LGE. Low MPRI, possibly indicating diffuse microvascular disease, was observed with and without LGE and T2+. Multiple mechanisms may lead to abnormal perfusion on sCMR. Microvascular dysfunction may contribute to the pathogenesis of and coexist with other causes of MINOCA. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Rina Mauricio, Monvadi B. Srichai, Leon Axel, Judith S. Hochman, Harmony R. Reynolds Tags: Clinical Investigations Source Type: research

The Prognostic Impact of New ‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis
ABSTRACT New‐onset persistent left bundle branch block (NOP‐LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP‐LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP‐LBBB patients after TAVI were included. The random‐effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals. Adjusted HRs were utilized over unadjusted ...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Tomo Ando, Hisato Takagi, Tags: Review Source Type: research

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis
ABSTRACT New‐onset persistent left bundle branch block (NOP‐LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP‐LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP‐LBBB patients after TAVI were included. The random‐effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals. Adjusted HRs were utilized over unadjusted ...
Source: Clinical Cardiology - June 30, 2016 Category: Cardiology Authors: Tomo Ando, Hisato Takagi, Tags: Review Source Type: research

Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS‐ACTS Substudy
ABSTRACT BackgroundThe efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation‐treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs). HypothesisTransitioning from a VKA to rivaroxaban improves treatment satisfaction in routine practice. MethodsXarelto for Prevention of Stroke in Patients With Atrial Fibrillation (XANTUS) is a prospective, noninterventional study in patients with NVAF prescribed rivaroxaban for prevention of stroke in routine practice. Patients receiving a VKA 4 weeks prior to the initial XANTUS study visit a...
Source: Clinical Cardiology - June 29, 2016 Category: Cardiology Authors: Craig I. Coleman, Sylvia Haas, Alexander G.G. Turpie, Silvia Kuhls, Susanne Hess, Thomas Evers, Pierre Amarenco, Paulus Kirchhof, A. John Camm, Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - June 19, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Novel Approach to the Detection of Left Ventricular Hypertrophy Using Body Mass Index –Corrected Electrocardiographic Voltage Criteria in a Group of African Ancestry
Abstract BackgroundElectrocardiographic (ECG) QRS voltages used to generate criteria for left ventricular hypertrophy (LVH) detection are considerably attenuated by obesity. This effect renders the utility of ECG criteria to detect LVH in obese individuals of African ancestry to be of limited value. HypothesisA novel approach to correcting QRS voltages for the attenuating effect of body mass index (BMI) will improve the ability of ECG criteria to detect LVH in a group of African descent. MethodsLeft ventricular mass was determined from echocardiography in 661 randomly selected participants (43.0% obese) of black African an...
Source: Clinical Cardiology - June 8, 2016 Category: Cardiology Authors: Chanel Robinson, Angela J. Woodiwiss, Carlos D. Libhaber, Gavin R. Norton Tags: Clinical Investigations Source Type: research

Novel Approach to the Detection of Left Ventricular Hypertrophy Using Body Mass Index–Corrected Electrocardiographic Voltage Criteria in a Group of African Ancestry
Abstract BackgroundElectrocardiographic (ECG) QRS voltages used to generate criteria for left ventricular hypertrophy (LVH) detection are considerably attenuated by obesity. This effect renders the utility of ECG criteria to detect LVH in obese individuals of African ancestry to be of limited value. HypothesisA novel approach to correcting QRS voltages for the attenuating effect of body mass index (BMI) will improve the ability of ECG criteria to detect LVH in a group of African descent. MethodsLeft ventricular mass was determined from echocardiography in 661 randomly selected participants (43.0% obese) of black African an...
Source: Clinical Cardiology - June 8, 2016 Category: Cardiology Authors: Chanel Robinson, Angela J. Woodiwiss, Carlos D. Libhaber, Gavin R. Norton Tags: Clinical Investigations Source Type: research

Comparison of Risk Prediction With the CKD ‐EPI and MDRD Equations in Non–ST‐Segment Elevation Acute Coronary Syndrome
ABSTRACT BackgroundChronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations estimate glomerular filtration rate (GFR) more accurately than the Modification of Diet in Renal Disease (MDRD) equation. HypothesisNew CKD‐EPI equations improve risk stratification in patients with non‐ST‐segment elevation acute coronary syndrome (NSTE‐ACS) and provide complementary information to the Global Registry of Acute Coronary Events (GRACE) risk score. MethodsWe studied 350 subjects (mean age, 68 ± 12 years; 70% male) with NSTE‐ACS. Estimated GFR was calculated using the MDRD and new CKD‐EPI...
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: Pedro J. Flores ‐Blanco, Ángel López‐Cuenca, James L. Januzzi, Francisco Marín, Marianela Sánchez‐Martínez, Miriam Quintana‐Giner, Ana I. Romero‐Aniorte, Mariano Valdés, Sergio Manzano‐Fernández Tags: Clinical Investigations Source Type: research

Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis
ConclusionsCardiac ischemia leads to reduced circulating MP levels under cardiac stress. Changes of endothelial MP uptake capacities could be one possible mechanism. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: Jan‐Malte Sinning, Felix Jansen, Christoph Hammerstingl, Arne Meier, Jan Losch, Katharina Rohwer, Theresa Schmitz, Kathrin Paul, Alexander Sedaghat, Robert Schueler, Mariuca Vasa‐Nicotera, Cornelius Müller, Georg Nickenig, Nikos Werner Tags: Clinical Investigations Source Type: research

Percutaneous Closure of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation: A Systematic Review
ABSTRACT Paravalvular regurgitation (PVR) remains one of the drawbacks of transcatheter aortic valve implantation (TAVI). Details of percutaneous closure (PCC) of PVR after TAVI remain obscure. We aimed to explore the patient characteristics, procedural details, closure devices used, and outcomes of PCC after TAVI. A systematic search of the MEDLINE/PubMed and Embase databases from January 2002 to September 2015 was conducted. Reports considered to include same patient were excluded and only the studies with largest cohorts were included. A total of 14 studies including 58 patients (61 cases) were included in the study. A...
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: Tomo Ando, Hisato Takagi, Tags: Review Source Type: research

Impact of Frailty and Other Geriatric Syndromes on Clinical Management and Outcomes in Elderly Patients With Non–ST‐Segment Elevation Acute Coronary Syndromes: Rationale and Design of the LONGEVO‐SCA Registry
ABSTRACT The incidence of acute coronary syndromes (ACS) is high in the elderly. Despite a high prevalence of frailty and other aging‐related variables, little information exists about the optimal clinical management in patients with coexisting geriatric syndromes. The aim of the LONGEVO‐SCA registry (Impacto de la Fragilidad y Otros Síndromes Geriátricos en el Manejo y Pronóstico Vital del Anciano con Síndrome Coronario Agudo sin Elevación de Segmento ST) is to assess the impact of aging‐related variables on clinical management, prognosis, and functional status in elderly patients ...
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: Oriol Alegre, Albert Ariza‐Solé, María T. Vidán, Francesc Formiga, Manuel Martínez‐Sellés, Héctor Bueno, Juan Sanchís, Ramón López‐Palop, Emad Abu‐Assi, Àngel Cequier Tags: Trial Designs Source Type: research

Validation of Three Platelet Function Tests for Bleeding Risk Stratification During Dual Antiplatelet Therapy Following Coronary Interventions
ABSTRACT BackgroundAlthough low platelet reactivity (LPR) is commonly detected during bleeding, a validated threshold for reliable DAPT bleeding risk stratification is lacking. We tested the diagnostic utility of 3 conventional platelet‐activity assays to define the predictive value (if any) of LPR for bleeding. HypothesisWe hypothesized whether one of these tests be better than any others for predicting bleeding events. MethodsPatients (n = 800) following drug‐eluting stent implantation received DAPT. Bleeding was assessed by Bleeding Academic Research Consortium (BARC) classification and events were col...
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: Moo Hyun Kim, Sun Young Choi, Soo Yeon An, Victor Serebruany Tags: Clinical Investigations Source Type: research

Frequency and Implications of Ischemia Prior to Ventricular Tachyarrhythmia in Patients Treated With a Wearable Cardioverter Defibrillator Following Myocardial Infarction
ConclusionsIschemia is an infrequent cause of VT/VF following MI, contradicting previous study conclusions that recurrent MI is responsible for most post‐MI sudden death. Etiology of VT/VF, however, did not influence defibrillation success or survival, which was high for both groups. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 31, 2016 Category: Cardiology Authors: David E. Kandzari, Ramu Perumal, Deepak L. Bhatt Tags: Clinical Investigations Source Type: research

Response to Statin Use and Aneurysm Risk in Patients With Bicuspid Aortic Valve Disease
(Source: Clinical Cardiology)
Source: Clinical Cardiology - May 22, 2016 Category: Cardiology Authors: Rodica Toganel, Theodora Benedek, Monica Chitu Tags: Letter to the Editor Source Type: research