Author's Reply
(Source: Clinical Cardiology)
Source: Clinical Cardiology - May 22, 2016 Category: Cardiology Authors: Ajay Yadlapati, Alexander P. Taylor, Neil J. Stone, Robert O. Bonow, Jyothy J. Puthumana Tags: Letter to the Editor Source Type: research

Association Between Sedentary Lifestyle and Diastolic Dysfunction Among Outpatients With Normal Left Ventricular Systolic Function Presenting to a Tertiary Referral Center in the Middle East
ABSTRACT BackgroundSedentary lifestyle has become prevalent in our community. Recent data showed controversy on the effect of regular exercise on left ventricular compliance and myocardial relaxation. HypothesisWe sought to assess whether physical inactivity is an independent predictor of diastolic dysfunction in or community, after adjustment for several covariates. MethodsConsecutive outpatients presenting to the echocardiography laboratory between July 2013 and June 2014 were prospectively enrolled. Clinical variables were collected prospectively at enrollment. Patients were considered physically active if they exercise...
Source: Clinical Cardiology - May 22, 2016 Category: Cardiology Authors: Stephanie Matta, Elie Chammas, Chadi Alraies, Antoine Abchee, Wael AlJaroudi Tags: Clinical Investigations Source Type: research

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

Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta ‐Analysis
In conclusion, published literature supports that a higher level of physical fitness is associated with a lower risk of AF. Further studies should be performed to confirm these findings. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Wengen Zhu, Yang Shen, Qiongqiong Zhou, Zhenyan Xu, Lin Huang, Qi Chen, Kui Hong Tags: Reviews Source Type: research

Neutrophil Gelatinase –Associated Lipocalin as an Early Marker of Contrast‐Induced Nephropathy After Elective Invasive Cardiac Procedures
ConclusionsUrine NGAL is potentially superior compared with conventional nephropathy markers in early CIN diagnosis after elective invasive cardiac procedures. Definition of clinically significant uNGAL changes with reference change value is probably a valuable supplement to statistically defined significant variations. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Nikolaos Kafkas, Charalampos Liakos, Filitsa Zoubouloglou, Ourania Dagadaki, Stylianos Dragasis, Konstantinos Makris Tags: Clinical Investigations Source Type: research

In Hypertrophic Cardiomyopathy, the Spatial Peaks QRS ‐T Angle Identifies Those With Sustained Ventricular Arrhythmias
ABSTRACT BackgroundThe spatial peaks QRS‐T (SPQRS‐T) angle differentiates hypertrophic cardiomyopathy (HCM) patients from controls. Increased angle confers arrhythmia risk in other populations. HypothesisWe predict that the SPQRS‐T angle will identify HCM patients with sustained ventricular arrhythmias (VAs) and those with New York Heart Association class III/IV heart failure. MethodsCorrected QT interval, QRS duration, and SPQRS‐T angle were assessed in HCM patients with VAs (>30 seconds) and those without VAs. ResultsOne hundred HCM patients (mean age, 32.7 ± 17.2 years) were...
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Daniel Cortez, Sharon Graw, Luisa Mestroni Tags: Clinical Investigations Source Type: research

Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta‐Analysis
In conclusion, published literature supports that a higher level of physical fitness is associated with a lower risk of AF. Further studies should be performed to confirm these findings. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Wengen Zhu, Yang Shen, Qiongqiong Zhou, Zhenyan Xu, Lin Huang, Qi Chen, Kui Hong Tags: Review Source Type: research

Neutrophil Gelatinase–Associated Lipocalin as an Early Marker of Contrast‐Induced Nephropathy After Elective Invasive Cardiac Procedures
ConclusionsUrine NGAL is potentially superior compared with conventional nephropathy markers in early CIN diagnosis after elective invasive cardiac procedures. Definition of clinically significant uNGAL changes with reference change value is probably a valuable supplement to statistically defined significant variations. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Nikolaos Kafkas, Charalampos Liakos, Filitsa Zoubouloglou, Ourania Dagadaki, Stylianos Dragasis, Konstantinos Makris Tags: Clinical Investigations Source Type: research

Monitoring of Daily Body Weight and Intrathoracic Impedance in Heart Failure Patients With a High Risk of Volume Overload Decompensation
ABSTRACT BackgroundDecompensation is frequent in heart failure (HF) patients and predicts poor prognosis. HypothesisVolume‐overload events in HF patients are preceded by changes in intrathoracic impedance (Z) and body weight (BW); monitoring these parameters may be useful to predict decompensation. MethodsForty‐three HF patients (LVEF 25% ± 12%) with a recent HF event and an implantable cardioverter‐defibrillator providing daily Z were equipped with telemonitoring scales submitting daily BW. Changes in BW and Z 30 days prior to major (HF hospitalization) and minor (ambulatory adjustment of diuret...
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Kristjan Gudmundsson, Patrik Lyngå, Mårten Rosenqvist, Frieder Braunschweig Tags: Clinical Investigations Source Type: research

In Hypertrophic Cardiomyopathy, the Spatial Peaks QRS‐T Angle Identifies Those With Sustained Ventricular Arrhythmias
ABSTRACT BackgroundThe spatial peaks QRS‐T (SPQRS‐T) angle differentiates hypertrophic cardiomyopathy (HCM) patients from controls. Increased angle confers arrhythmia risk in other populations. HypothesisWe predict that the SPQRS‐T angle will identify HCM patients with sustained ventricular arrhythmias (VAs) and those with New York Heart Association class III/IV heart failure. MethodsCorrected QT interval, QRS duration, and SPQRS‐T angle were assessed in HCM patients with VAs (>30 seconds) and those without VAs. ResultsOne hundred HCM patients (mean age, 32.7 ± 17.2 years) were...
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Daniel Cortez, Sharon Graw, Luisa Mestroni Tags: Clinical Investigations Source Type: research

Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low‐density Lipoprotein Cholesterol Levels in Older High‐risk Adults
ABSTRACT BackgroundThe value of lipoprotein(a) (Lp[a]) for predicting cardiovascular disease (CVD) across low‐density lipoprotein cholesterol (LDL‐C) is uncertain. HypothesisIn older high‐risk adults, higher LDL and Lp(a) combined would be associated with higher CVD risk and more healthcare costs. MethodsWe included 3251 high‐risk subjects (prior CVD, diabetes, or 10‐year Framingham CVD risk>20%) age ≥65 years from the Cardiovascular Health Study and examined the relation of Lp(a) tertiles with incident CVD, coronary heart disease (CHD), and all‐cause mortality within LDL‐C strata (spanning
Source: Clinical Cardiology - May 12, 2016 Category: Cardiology Authors: Yanglu Zhao, Joseph A. Delaney, Ruben G.W. Quek, Julius M. Gardin, Calvin H. Hirsch, Shravanthi R. Gandra, Nathan D. Wong Tags: Clinical Investigations Source Type: research

Left Atrial Sphericity Index Predicts Early Recurrence of Atrial Fibrillation After Direct ‐Current Cardioversion: An Echocardiographic Study
ConclusionsIn conclusion, baseline LASI>0.9 was associated with significantly greater AF recurrence throughout the 12‐month follow‐up period. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 9, 2016 Category: Cardiology Authors: Armin Osmanagic, S ören Möller, Azra Osmanagic, Hussam M. Sheta, Kristina H. Vinther, Kenneth Egstrup Tags: Clinical Investigations Source Type: research

Left Atrial Sphericity Index Predicts Early Recurrence of Atrial Fibrillation After Direct‐Current Cardioversion: An Echocardiographic Study
ConclusionsIn conclusion, baseline LASI>0.9 was associated with significantly greater AF recurrence throughout the 12‐month follow‐up period. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 9, 2016 Category: Cardiology Authors: Armin Osmanagic, Sören Möller, Azra Osmanagic, Hussam M. Sheta, Kristina H. Vinther, Kenneth Egstrup Tags: Clinical Investigations Source Type: research

Prasugrel Use in Real Life: A Report From the Outpatient Setting in France
The objective of this study was to provide descriptive statistics on patterns of prasugrel usage in the outpatient setting in France. This retrospective study was conducted to describe treatment patterns for prasugrel in the outpatient setting in France using the Intercontinental Marketing Services (IMS) Disease Analyzer database, which collates electronic medical records updated by a nationally representative database of 1200 French general practitioners (GPs). Anonymous data were collected prospectively at each follow‐up visit. The study population consisted of patients with ≥1 prescription for prasugrel in the outp...
Source: Clinical Cardiology - April 30, 2016 Category: Cardiology Authors: Pierre Sabouret, Magali Taiel‐Sartral, Florence Chartier, Sabine Akiki, Thomas Cuisset Tags: Quality and Outcomes Source Type: research

Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome
ConclusionsLower serum calcium level on admission is a possible indicator of increased risk of in‐hospital mortality in ACS patients. Inclusion of serum calcium in the GRACE score may lead to a more accurate prediction of this risk. Large prospective studies are needed to confirm this finding. (Source: Clinical Cardiology)
Source: Clinical Cardiology - April 30, 2016 Category: Cardiology Authors: Shao‐di Yan, Xiao‐jing Liu, Yong Peng, Tian‐li Xia, Wei Liu, Jiay‐yu Tsauo, Yuan‐ning Xu, Hua Chai, Fang‐yang Huang, Mao Chen, De‐jia Huang 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 - April 30, 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

The Association Between Complementary and Alternative Medicine and Health Status Following Acute Myocardial Infarction
ConclusionsThere was no association between CAM use and health‐status recovery after AMI. Until randomized trials suggest otherwise, these findings underscore the importance of focusing on therapies with proven effectiveness after AMI. (Source: Clinical Cardiology)
Source: Clinical Cardiology - April 30, 2016 Category: Cardiology Authors: Ali Shafiq, Natalie Jayaram, Kensey L. Gosch, John A. Spertus, Donna M. Buchanan, Carole Decker, Mikhail Kosiborod, Suzanne V. Arnold Tags: Quality and Outcomes Source Type: research

Postoperative Strokes and Intracranial Bleeds in Patients With Atrial Fibrillation: The FibStroke Study
ConclusionsPerioperative interruption of OAC is common in patients who suffer a postoperative stroke, even in patients with low‐bleeding‐risk procedures. Postoperative intracranial bleeding is frequently preceded by perioperative heparin bridging. (Source: Clinical Cardiology)
Source: Clinical Cardiology - April 30, 2016 Category: Cardiology Authors: Antti Palomäki, Tuomas Kiviniemi, Juha E.K. Hartikainen, Pirjo Mustonen, Antti Ylitalo, Ilpo Nuotio, Päivi Hartikainen, Jussi Jaakkola, Riho Luite, K.E. Juhani Airaksinen Tags: Clinical Investigations Source Type: research

Response to Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function; and Exercise and Physical Activity for the Post–Aortic Dissection Patient: The Clinician's Conundrum
Chaddha A et al. Clin Cardiol. 2015;38:652–659. Chaddha A et al. Clin Cardiol. 2015;38:647–651. (Source: Clinical Cardiology)
Source: Clinical Cardiology - April 20, 2016 Category: Cardiology Authors: María Martín, Jesús de la Hera, José Rozado, Daniel García Iglesias, César Morís, Juan Calvo, Rubén Alvarez Cabo Tags: Letter to the Editor Source Type: research

High Plasma Levels of Gremlin‐1 and Macrophage Migration Inhibitory Factor, but Not Their Ratio, Indicate an Increased Risk for Acute Coronary Syndrome in Patients With Type 2 Diabetes Mellitus
Abstract BackgroundChronic inflammation promotes atherosclerosis and is a prognostic factor in coronary artery disease (CAD). Patients with type 2 diabetes mellitus (DM2) are at risk for progressive atherosclerosis. Macrophage migration inhibitory factor (MIF) is a key player in atherosclerosis, mediating pro‐inflammatory responses. Its endogenous antagonist Gremlin‐1 inhibits foam‐cell formation and atheroprogression by binding MIF, neutralizing its proatherosclerotic functions. HypothesisPlasma levels of MIF and Gremlin‐1 correlate with the stability of CAD in patients with DM2. MethodWe assessed plasma levels of...
Source: Clinical Cardiology - April 20, 2016 Category: Cardiology Authors: Karin A.L. Müller, Dominik Rath, Martina Schmid, Heiko Schoenleber, Meinrad Gawaz, Tobias Geisler, Iris I. Müller Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - April 20, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Trends in the Burden of Adult Congenital Heart Disease in US Emergency Departments
ABSTRACT BackgroundWe assessed trends in incidence, in‐hospital mortality, and admission among patients with adult congenital heart disease (ACHD) presenting to the emergency department (ED) from 2006 to 2012. HypothesisThere is a considerable burden of ACHD in the US EDs. MethodsWe used the 2006–2012 US Nationwide Emergency Department Sample. All ED visits with ACHD were identified using standard International Classification of Diseases, Ninth Edition, Clinical Modification codes. ResultsThe number of patients presenting to the ED with simple (40.6%) as well as complex (37.6%) ACHD across 2006–2012 increased...
Source: Clinical Cardiology - April 14, 2016 Category: Cardiology Authors: Shikhar Agarwal, Karan Sud, Sahil Khera, Dhaval Kolte, Gregg C. Fonarow, Julio A. Panza, Venu Menon Tags: Clinical Investigations Source Type: research

Age, Gender, and Race‐Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)
ConclusionsIn our sample of the Brazilian population, we observed significant differences in CAC by sex, age, and race. Adjusted for age and sex, low‐risk individuals from the Brazilian population present with significantly lower CAC prevalence and burden compared with other low‐risk individuals from other worldwide populations. Using US‐derived percentiles in Brazilian individuals may lead to overestimating relative CAC burden in men and underestimating relative CAC burden in women. (Source: Clinical Cardiology)
Source: Clinical Cardiology - April 14, 2016 Category: Cardiology Authors: Alexandre C. Pereira, Luz M. Gomez, Marcio Sommer Bittencourt, Henrique Lane Staniak, Rodolfo Sharovsky, Murilo Foppa, Michael J. Blaha, Isabela M. Bensenor, Paulo A. Lotufo Tags: Clinical Investigations Source Type: research

Association Between Very Low Levels of High‐Density Lipoprotein Cholesterol and Long‐term Outcomes of Patients With Acute Coronary Syndrome Treated Without Revascularization: Insights From the TRILOGY ACS Trial
ABSTRACT BackgroundLow levels of high‐density lipoprotein cholesterol (HDL‐C;
Source: Clinical Cardiology - March 31, 2016 Category: Cardiology Authors: Emil Hagström, Matthew T. Roe, Gail Hafley, Megan L. Neely, Mandeep S. Sidhu, Kenneth J. Winters, Dorairaj Prabhakaran, Harvey D. White, Paul W. Armstrong, Keith A.A. Fox, E. Magnus Ohman, William E. Boden, Tags: Clinical Investigations Source Type: research

Resting Myocardial Contrast Echocardiography for the Evaluation of Coronary Microcirculation Dysfunction in Patients With Early Coronary Artery Disease
ABSTRACT BackgroundCoronary microcirculation dysfunction can occur in patients with chest pain suggestive of coronary artery disease (CAD). The present study aimed to determine the diagnostic value of resting myocardial contrast echocardiography (MCE) for early CAD with myocardial microcirculation dysfunction by evaluating the continuous imaging time, peak time, and peak intensity. HypothesisResting MCE is an effective and noninvasive method for evaluation of coronary microcirculation dysfunction in patients with early coronary artery disease. MethodsThe present study included 20 consecutive patients without obvious clinic...
Source: Clinical Cardiology - March 31, 2016 Category: Cardiology Authors: Xin Li, Sheng He, Yun‐Shan Zhang, Yu Chen, Jiang‐Chun He Tags: Clinical Investigations Source Type: research

Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients With Implantable Cardioverter‐Defibrillators
ABSTRACT BackgroundImplantable cardioverter‐defibrillators (ICD) have provided effective therapy for fatal arrhythmia. However, ICD patients are known to develop psychological problems, such as posttraumatic stress disorder (PTSD), if they have experienced potentially fatal arrhythmia and ICD shocks. Little is known about the factors influencing PTSD in ICD patients. HypothesisEchocardiographic cardiac‐function parameters might relate to psychological problems, especially PTSD, in ICD patients. MethodsA total of 128 outpatients with ICD implantation completed the Impact of Event Scale Revised (IES‐R) questionnaire as...
Source: Clinical Cardiology - March 31, 2016 Category: Cardiology Authors: Hiroyuki Sawatari, Tomoko Ohkusa, Anita Rahamawati, Katsuhiko Ishikawa, Miyuki Tsuchihashi‐Makaya, Yuko Ohtsuka, Mori Nakai, Mami Miyazono, Nobuko Hashiguchi, Hiroaki Chishaki, Harumizu Sakurada, Yasushi Mukai, Shujiro Inoue, Kenji Sunagawa, Akiko Chish Tags: Clinical Investigations Source Type: research

Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)
ABSTRACT BackgroundThe association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. HypothesisAmong multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. MethodsAfter excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi‐Ethnic Study of Atherosclerosis (MESA) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ...
Source: Clinical Cardiology - March 31, 2016 Category: Cardiology Authors: David I. Feldman, Miguel Cainzos‐Achirica, Kevin L. Billups, Andrew P. DeFilippis, Kanchan Chitaley, Philip Greenland, James H. Stein, Matthew J. Budoff, Zeina Dardari, Martin Miner, Roger S. Blumenthal, Khurram Nasir, Michael J. Blaha Tags: Clinical Investigations Source Type: research

Cardioversion of Atrial Fibrillation in ENGAGE AF‐TIMI 48
(Source: Clinical Cardiology)
Source: Clinical Cardiology - March 29, 2016 Category: Cardiology Authors: Anna Plitt, Michael D. Ezekowitz, Raffaele De Caterina, Francesco Nordio, Nancy Peterson, Robert P. Giugliano, Tags: Clinical Investigations Source Type: research

Endothelial Dysfunction and Racial Disparities in Mortality and Adverse Cardiovascular Disease Outcomes
ConclusionBlack race is associated with increased risk of CVD events and mortality independent of its associations with ED, as measured by PAT. (Source: Clinical Cardiology)
Source: Clinical Cardiology - March 29, 2016 Category: Cardiology Authors: Sebhat Erqou, Kevin E. Kip, Suresh R. Mulukutla, Aryan N. Aiyer, Steven E. Reis Tags: Clinical Investigations Source Type: research

Stroke and Systemic Embolism After Successful Ablation of Typical Atrial Flutter
ConclusionsPatients with AFL who undergo successful ablation are by no means free from embolic complications during long‐term follow‐up, mainly due to a high rate of AF development. Given the difficulties in detecting AF and the uncertainty about the temporal relation of AF and stroke, oral anticoagulation may need to be continued in those patients with underlying stroke risk factors. (Source: Clinical Cardiology)
Source: Clinical Cardiology - March 29, 2016 Category: Cardiology Authors: Víctor Expósito, Felipe Rodríguez‐Entem, Susana González‐Enríquez, Gabriela Veiga, Iván Olavarri, Juan J. Olalla Tags: Clinical Investigations Source Type: research

Two‐Year Safety and Efficacy of Biodegradable Polymer Drug‐Eluting Stent Versus Second‐Generation Durable Polymer Drug‐Eluting Stent in Patients With Acute Myocardial Infarction: Data from the Korea Acute Myocardial Infarction Registry (KAMIR)
ConclusionsBP‐DES and 2G‐DP‐DES appear to have comparable 2‐year safety and efficacy for the treatment of AMI. However, longer‐term follow‐up is needed. (Source: Clinical Cardiology)
Source: Clinical Cardiology - March 29, 2016 Category: Cardiology Authors: Seung‐Ho Hur, In‐Cheol Kim, Ki‐Bum Won, Yun‐Kyeong Cho, Hyuck‐Jun Yoon, Chang‐Wook Nam, Kwon‐Bae Kim, Min‐Seok Kim, Jincheol Park, Seung‐Woon Rha, Shung‐Chull Chae, Young‐Jo Kim, Chong‐Jin Kim, Myeong‐Chan Cho, Myung‐Ho Jeong, Tags: Clinical Investigations Source Type: research

Effects of High Salt Intake on Blood Pressure and Cardiovascular Disease: The Role of COX Inhibitors
ABSTRACT Sodium has a bidirectional effect on blood pressure (BP) and cardiovascular disease (CVD). High sodium intake increases both BP and CVD, whereas low sodium intake decreases them. The significance of this association has been debated for years, mostly due to the inconsistency of data, but recently it has been revived due to new evidence about the harmful effects of sodium. Recent studies have indicated that high sodium intake was associated with an increase in BP and CVD, which in 2010 was estimated to have accounted for 1.65 million deaths worldwide. Based on this evidence, the American Heart Association has issue...
Source: Clinical Cardiology - March 21, 2016 Category: Cardiology Authors: Steven G. Chrysant Tags: Commentary Source Type: research

Sex Differences in the Association Between Regular Physical Activity and Incident Atrial Fibrillation: A Meta‐analysis of 13 Prospective Studies
ABSTRACT Several studies investigated the role of physical activity in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical activity and incident AF, as well as to determine whether a sex difference existed. We systematically retrieved relevant studies from Cochrane Library, PubMed, and ScienceDirect through December 1, 2015. Data were abstracted from eligible studies and effect estimates pooled using a random‐effects model. Thirteen prospective studies fulfilled inclusion criteria. For primary analysis, neither total physical activity exposure (relative ri...
Source: Clinical Cardiology - March 21, 2016 Category: Cardiology Authors: Wen‐Gen Zhu, Rong Wan, Ying Din, Zhenyan Xu, Xiaohui Yang, Kui Hong Tags: Review Source Type: research

Author's Reply
(Source: Clinical Cardiology)
Source: Clinical Cardiology - March 17, 2016 Category: Cardiology Authors: Naoki Misumida, Yumiko Kanei Tags: Letter to the Editor Source Type: research

Coronary Artery Calcium as an Independent Surrogate Marker in the Risk Assessment of Patients With Atrial Fibrillation and an Intermediate Pretest Likelihood for Coronary Artery Disease Admitted to a German Chest Pain Unit
Abstract BackgroundAbout 10% of patients admitted to a chest pain unit (CPU) exhibit atrial fibrillation (AF). HypothesisTo determine whether calcium scores (CS) are superior over common risk scores for coronary artery disease (CAD) in patients presenting with atypical chest pain, newly diagnosed AF, and intermediate pretest probability for CAD within the CPU. MethodsIn 73 subjects, CS was related to the following risk scores: Global Registry of Acute Coronary Events (GRACE) score, including a new model of a frequency‐normalized approach; Thrombolysis In Myocardial Infarction score; European Society of Cardiology Systema...
Source: Clinical Cardiology - March 17, 2016 Category: Cardiology Authors: Frank Breuckmann, Jan Olligs, Liane Hinrichs, Matthias Koopmann, Michael Lichtenberg, Dirk Böse, Dieter Fischer, Lars Eckardt, Johannes Waltenberger, J. Lee Garvey Tags: Clinical Investigations Source Type: research

Shape of the Pulmonary Artery Doppler‐Flow Profile Predicts the Hemodynamics of Pulmonary Hypertension Caused by Left‐Sided Heart Disease
ConclusionsAbsence of PA Doppler‐flow notching was highly associated with PVH, and a notching pattern indicated PVH with PVD in the PH‐LHD cohort. (Source: Clinical Cardiology)
Source: Clinical Cardiology - March 17, 2016 Category: Cardiology Authors: Shailendra P. Kushwaha, Qin‐Hua Zhao, Qian‐Qian Liu, Wen‐Hui Wu, Lan Wang, Ping Yuan, Rui Zhang, Zhi‐Cheng Jing Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - March 17, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Fatty Liver, Insulin Resistance, and Obesity: Relationships With Increase in Coronary Artery Calcium Over Time
ABSTRACT BackgroundNonalcoholic fatty liver disease, insulin resistance (IR), and obesity frequently coexist with type 2 diabetes mellitus (DM), but it is uncertain whether these risk factors for vascular disease contribute to a change in atherosclerosis over time, independently of DM status. HypothesisWe hypothesized that the combination of fatty liver, IR, and obesity would be associated with an increase in coronary artery calcium (CAC) score over time, independently of DM status, other cardiovascular risk factors, and medications. MethodsData were analyzed from a South Korean occupational cohort of 2175 people. The outc...
Source: Clinical Cardiology - March 1, 2016 Category: Cardiology Authors: Ki‐Chul Sung, Seungho Ryu, Jong‐Young Lee, Sung Ho Lee, Eun Sun Cheong, Sarah H. Wild, Christopher D. Byrne Tags: Clinical Investigations Source Type: research

Cost‐Effectiveness of LDL‐C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States
ABSTRACT Randomized trials have shown marked reductions in low‐density lipoprotein cholesterol (LDL‐C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost‐effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL‐C>100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population‐specific trial‐based mean risk fact...
Source: Clinical Cardiology - February 29, 2016 Category: Cardiology Authors: Shravanthi R. Gandra, Guillermo Villa, Gregg C. Fonarow, Mickael Lothgren, Peter Lindgren, Ransi Somaratne, Ben van Hout Tags: Quality and Outcomes Source Type: research

Long‐term Cost‐Effectiveness of Diagnostic Tests for Assessing Stable Chest Pain: Modeled Analysis of Anatomical and Functional Strategies
ABSTRACT Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost‐effectiveness information to aid physicians and decision‐makers in selecting the most appropriate testing strategy. We used the state‐transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex‐ECG), stress echocardiography (ECHO), single‐photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C...
Source: Clinical Cardiology - February 29, 2016 Category: Cardiology Authors: Eduardo G. Bertoldi, Steffan F. Stella, Luis E. Rohde, Carisi A. Polanczyk Tags: Quality and Outcomes Source Type: research

Statin Use and Its Facility‐Level Variation in Patients With Diabetes: Insight From the Veterans Affairs National Database
We examined frequency and facility‐level variation in use of any or at least moderate‐intensity statin therapy (mean daily dose associated with ≥30% low‐density lipoprotein cholesterol lowering). In 911 444 patients with DM, 68.3% and 58.4% were receiving any and moderate‐ to high‐intensity statin therapy, respectively. Patients receiving statin had higher burden of cardiovascular disease, were more likely to be on nonstatin lipid‐lowering therapy and to receive care at a teaching facility, and had more frequent primary‐care visits. Median facility‐level uses of any and at least moderate‐intensi...
Source: Clinical Cardiology - February 29, 2016 Category: Cardiology Authors: Yashashwi Pokharel, Julia M. Akeroyd, David J. Ramsey, Ravi S. Hira, Vijay Nambi, Tina Shah, LeChauncy D. Woodard, David E. Winchester, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani Tags: Quality and Outcomes Source Type: research

Racial and Ethnic Differences in Acute Coronary Syndrome and Myocardial Infarction Within the United States: From Demographics to Outcomes
ABSTRACT In the United States, different races, ethnicities, and their subgroups experience disparities regarding acute coronary syndrome (ACS) and myocardial infarction (MI). This review highlights these differences across 4 stages that comprise the ACS/MI narrative: (1) patient demographics, (2) patient comorbidities and health risks, (3) treatments and their delays, and (4) outcomes. Overall, black and Hispanic ACS/MI patients are more likely to present with comorbidities, experience longer delays before treatment, and suffer worse outcomes when compared with non‐Hispanic white patients. More specifically, across the ...
Source: Clinical Cardiology - February 29, 2016 Category: Cardiology Authors: Garth Graham Tags: Review Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - February 24, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Clinical Outcome of First‐ vs Second‐Generation DES According to DAPT Duration: Results of ARCTIC‐Generation
ABSTRACT There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug‐eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring‐Guided Strategy for Drug‐Eluting Stent Implantation, and of Treatment Interruption vs Continuation One Year After Stenting (ARCTIC)‐Generation assessed whether there is a difference of outcome between first‐ vs second‐generation DES and if there is an interaction with DAPT duration in the ARCTIC‐Interruption study. ARCTIC‐Interruption randomly allocated 1259 patients...
Source: Clinical Cardiology - February 16, 2016 Category: Cardiology Authors: Jean‐Philippe Collet, Johanne Silvain, Mathieu Kerneis, Thomas Cuisset, Nicolas Meneveau, Ziad Boueri, Olivier Barthélémy, Grégoire Rangé, Guillaume Cayla, Eric Van Belle, Simon Elhadad, Didier Carrié, Christophe Caussin, Hélène Rousseau, Pierre Tags: Clinical Trial Updates Source Type: research

Guideline‐Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program
This study is an initial step toward improving adherence to GDMT in India and highlights the feasibility of examining quality of care in HFrEF in a resource‐limited setting. (Source: Clinical Cardiology)
Source: Clinical Cardiology - February 16, 2016 Category: Cardiology Authors: Yashashwi Pokharel, Jessica Wei, Ravi S. Hira, Ankur Kalra, Supriya Shore, Prafulla G. Kerkar, Ganesh Kumar, Samantha Risch, Veronique Vicera, William J. Oetgen, Anita Deswal, Mintu P. Turakhia, Nathan Glusenkamp, Salim S. Virani Tags: Quality and Outcomes Source Type: research

Lipoprotein(a) and Increased Cardiovascular Risk in Women
Abstract BackgroundApproximately 20% of the population has elevated circulating levels of lipoprotein(a) (Lp[a]), one of the most robust predictors of cardiovascular disease risk. This is particularly true for women. HypothesisMany female patients with “normal” traditional risk factors or low atherosclerotic cardiovascular disease (ASCVD) risk scores may harbor high risk related to elevated levels of Lp(a). MethodsA retrospective, cross‐sectional study of consecutive female patients presenting to Heart Centers for Women was performed. Discordance between low‐density lipoprotein cholesterol (LDL‐C) and Lp(...
Source: Clinical Cardiology - February 16, 2016 Category: Cardiology Authors: Briana T. Costello, Eric R. Silverman, Rami Doukky, Lynne T. Braun, Neelum T. Aggarwal, Youping Deng, Yan Li, Gina Lundberg, Kim A. Williams, Annabelle S. Volgman Tags: Clinical Investigations Source Type: research

Response to Association Between Preinfarction Angina and Angiographic Findings in Non–ST‐Segment Elevation Myocardial Infarction
Misumida N et al. Clin Cardiol. 2015;38:535–541. (Source: Clinical Cardiology)
Source: Clinical Cardiology - February 16, 2016 Category: Cardiology Authors: Balazs Bajka, Theodora Benedek, Călin Molnar Tags: Letter to the Editor Source Type: research

Predictors of Medical Management in Patients Undergoing Elective Cardiac Catheterization for Chronic Ischemic Heart Disease
ConclusionsFor patients undergoing cardiac catheterization for stable angina, the decision to proceed to PCI vs medical management appears to depend largely on patient and angiographic characteristics, but not on symptoms or ischemia. Distal and high‐risk lesions (ACC/AHA type C) are more often referred for medical therapy. (Source: Clinical Cardiology)
Source: Clinical Cardiology - February 5, 2016 Category: Cardiology Authors: Auras R. Atreya, Senthil K. Sivalingam, Sonali Arora, Mohammad Amin Kashef, Janice Fitzgerald, Paul Visintainer, Amir Lotfi, Michael B. Rothberg Tags: Clinical Investigations Source Type: research

Implications of the New US Cholesterol Guidelines in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)
ABSTRACT BackgroundThe new US guidelines for the primary prevention of cardiovascular disease have substantially changed the approach to hyperlipidemia treatment. However, the impact of those recommendations in other populations is limited. In the present study, we evaluated the potential implications of those recommendations in the Brazilian population. HypothesisThe new U.S. recommendations may increase the proportion of individuals who are candidates for statin therapy. MethodsWe included all participants of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) without known cardiovascular disease. We calcula...
Source: Clinical Cardiology - February 5, 2016 Category: Cardiology Authors: Marcio Sommer Bittencourt, Henrique Lane Staniak, Alexandre Costa Pereira, Itamar S. Santos, Bruce B. Duncan, Raul D. Santos, Michael J. Blaha, Steve R. Jones, Peter P. Toth, Isabela M. Bensenor, Paulo A. Lotufo Tags: Clinical Investigations Source Type: research

Where There's Smoke, There's Fire? Significance of Atrial Fibrillation in Young Patients
ConclusionsAtrial fibrillation occurs in young patients with and without structural heart disease. Young AF patients without comorbidities rarely develop CVD during the first years after diagnosis. Yet, an SVT is found in a high proportion of young AF patients; AF may be first manifestation of SVT. Therefore, young patients should undergo further evaluation for SVT (Source: Clinical Cardiology)
Source: Clinical Cardiology - February 5, 2016 Category: Cardiology Authors: Alexander Wutzler, Sophie von Ulmenstein, Philipp Attanasio, Martin Huemer, Abdul Shokor Parwani, Katharina Völk, Florian Blaschke, Leif‐Hendrik Boldt, Wilhelm Haverkamp Tags: Clinical Investigations Source Type: research