Vascular Effects of Eplerenone in Coronary Artery Disease With Preserved Ejection Fraction: A Double‐Blind, Randomized, Placebo‐Controlled Trial
ConclusionsAdding low‐dose eplerenone to standard medical therapy did not improve important markers of vascular health in patients with CAD and preserved EF. Our results may help understand conflicting evidence from larger clinical trials on MRAs in patients with preserved EF. (Source: Clinical Cardiology)
Source: Clinical Cardiology - February 1, 2016 Category: Cardiology Authors: Isabella Sudano, Matthias Naegele, Susanne Roas, Daniel Périat, Michelle Frank, Alexey Kouroedov, Georg Noll, Thomas F. Lüscher, Frank Enseleit, Frank Ruschitzka, Andreas J. Flammer Tags: Clinical Investigations Source Type: research

Comparison of PCSK9 Inhibitor Evolocumab vs Ezetimibe in Statin‐Intolerant Patients: Design of the Goal Achievement After Utilizing an Anti‐PCSK9 Antibody in Statin‐Intolerant Subjects 3 (GAUSS‐3) Trial
We report the design of Goal Achievement After Utilizing an Anti‐PCSK9 Antibody in Statin‐Intolerant Subjects 3 (GAUSS‐3), a phase 3, multicenter, randomized, double‐blind, ezetimibe‐controlled study to compare effectiveness of 24 weeks of evolocumab 420 mg monthly vs ezetimibe 10 mg daily in hypercholesterolemic patients unable to tolerate an effective statin dose. The study incorporates a novel atorvastatin‐controlled, double‐blind, crossover phase to objectively identify statin intolerance. Eligible patients had LDL‐C above the National Cholesterol Education Project Adult Treatment Panel II...
Source: Clinical Cardiology - February 1, 2016 Category: Cardiology Authors: Steven E. Nissen, Ricardo E. Dent‐Acosta, Robert S. Rosenson, Erik Stroes, Naveed Sattar, David Preiss, G.B. John Mancini, Christie M. Ballantyne, Alberico Catapano, Ioanna Gouni‐Berthold, Evan A. Stein, Allen Xue, Scott M. Wasserman, Rob Scott, Paul Tags: Trial Designs Source Type: research

Effect of Remote Ischaemic Conditioning in Oncology Patients Undergoing Chemotherapy: Rationale and Design of the ERIC‐ONC Study—A Single‐Center, Blinded, Randomized Controlled Trial
ABSTRACT Cancer survival continues to improve, and thus cardiovascular consequences of chemotherapy are increasingly important determinants of long‐term morbidity and mortality. Conventional strategies to protect the heart from chemotherapy have important hemodynamic or myelosuppressive side effects. Remote ischemic conditioning (RIC) using intermittent limb ischemia‐reperfusion reduces myocardial injury in the setting of percutaneous coronary intervention. Anthracycline cardiotoxicity and ischemia‐reperfusion injury share common biochemical pathways in cardiomyocytes. The potential for RIC as a novel treatment to re...
Source: Clinical Cardiology - January 25, 2016 Category: Cardiology Authors: Robin Chung, Angshuman Maulik, Ashraf Hamarneh, Daniel Hochhauser, Derek J. Hausenloy, J. Malcolm Walker, Derek M. Yellon Tags: Trial Designs Source Type: research

Management Strategies and Outcomes of ST‐Segment Elevation Myocardial Infarction Patients Transferred After Receiving Fibrinolytic Therapy in the United States
ABSTRACT Fibrinolytic therapy is still used in patients with ST‐segment elevation myocardial infarction (STEMI) when the primary percutaneous coronary intervention cannot be provided in a timely fashion. Management strategies and outcomes in transferred fibrinolytic‐treated STEMI patients have not been well assessed in real‐world settings. Using the Nationwide Inpatient Sample from 2008 to 2012, we identified 18 814 patients with STEMI who received fibrinolytic therapy and were transferred to a different facility within 24 hours. The primary outcome was in‐hospital mortality. Secondary outcomes included gastrointes...
Source: Clinical Cardiology - January 19, 2016 Category: Cardiology Authors: Nish Patel, Nileshkumar J. Patel, Badal Thakkar, Vikas Singh, Shilpkumar Arora, Nilay Patel, Chirag Savani, Abhishek Deshmukh, Udho Thadani, Apurva O. Badheka, Carlos Alfonso, Gregg C. Fonarow, Mauricio G. Cohen Tags: Quality and Outcomes Source Type: research

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

Ticagrelor in Triple Antithrombotic Therapy: Predictors of Ischemic and Bleeding Complications
ConclusionsThe risk of bleeding and ischemic complications among patients on TT is similar between those on ticagrelor and clopidogrel. However, caution with use of bridging anticoagulation should be taken when using ticagrelor. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 8, 2016 Category: Cardiology Authors: Angel Fu, Kuljit Singh, Joseph Abunassar, Nikita Malhotra, Michel Le May, Marino Labinaz, Christopher Glover, Jean‐Francois Marquis, Michael Froeschl, Alexander Dick, Benjamin Hibbert, Aun‐Yeong Chong, Derek Y. F. So, Tags: Clinical Investigations Source Type: research

The Role of the Myocardial Microvasculature in Mental Stress–Induced Myocardial Ischemia
This study is a review of the literature discussing the prevalence and emerging mechanisms underlying MSIMI. We identified several aspects underlying MSIMI, including psychological, genetic, and physiological causes. Several sources suggested that dysfunctional cardiac microvasculature might be a contributing factor in the development of stress‐induced myocardial ischemia. The literature also suggested that although MSIMI has distinct features and pathophysiology, its occurrence might indicate an increased future risk of cardiovascular events. We found that dysfunctional cardiac microvasculature may be the key point of i...
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: Huan Ma, Lan Guo, Daozheng Huang, Lei Wang, Liheng Guo, Qingshan Geng, Minzhou Zhang Tags: Review Source Type: research

Impact of Awareness and Patterns of Nonhospitalized Atrial Fibrillation on the Risk of Mortality: The Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study
ConclusionsAsymptomatic, nonhospitalized AF is associated with an increased risk of mortality in the general population. Mortality is higher in those with ECG‐confirmed cases and among those who are unaware of their diagnosis. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: Wesley T. O'Neal, Jimmy T. Efird, Suzanne E. Judd, Leslie A. McClure, Virginia J. Howard, George Howard, Elsayed Z. Soliman Tags: Clinical Investigations Source Type: research

Comparison of Coronary Artery Disease Consortium 1 and 2 Scores and Duke Clinical Score to Predict Obstructive Coronary Disease by Invasive Coronary Angiography
ABSTRACT BackgroundThe first step in evaluating a patient with suspected stable coronary artery disease (CAD) is the determination of the pretest probability. The European Society of Cardiology guidelines recommend the use of the CAD Consortium 1 score (CAD1), which contrary to CAD Consortium 2 (CAD2) score and Duke Clinical Score (DCS), does not include modifiable cardiovascular risk factors. HypothesisUsing scores that include modifiable risk factors (DCS and CAD2) enhances prediction of CAD. MethodsWe retrospectively included all patients referred to invasive coronary angiography for suspected CAD from January/2008&ndas...
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: João Almeida, Paulo Fonseca, Tiago Dias, Ricardo Ladeiras‐Lopes, Nuno Bettencourt, José Ribeiro, Vasco Gama Tags: Clinical Investigations Source Type: research

Depression and Multiple Rehospitalizations in Patients With Heart Failure
ConclusionsDepression is an independent risk factor for multiple all‐cause readmissions in patients with HF. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: Kenneth E. Freedland, Robert M. Carney, Michael W. Rich, Brian C. Steinmeyer, Judith A. Skala, Victor G. Dávila‐Román Tags: Clinical Investigations Source Type: research

The Lewis Lead for Detection of Ventriculoatrial Conduction Type
ConclusionsCompared with standard‐lead ECG, modified Lewis‐lead ECG is associated with significantly improved detection of VA conduction type during fast ventricular pacing and thus may help improve ECG diagnosis. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: Martin Huemer, Henning Meloh, Philipp Attanasio, Alexander Wutzler, Abdul S. Parwani, Hisao Matsuda, Florian Blaschke, Leif‐Hendrik Boldt, Wilhelm Haverkamp Tags: Clinical Investigations Source Type: research

Gender, Racial, and Health Insurance Differences in the Trend of Implantable Cardioverter‐Defibrillator (ICD) Utilization: A United States Experience Over the Last Decade
ABSTRACT Prior studies have highlighted disparities in cardiac lifesaving procedure utilization, particularly among women and in minorities. Although there has been a significant increase in implantable cardioverter‐defibrillator (ICD) insertion, socioeconomic disparities still exist in the trend of ICD utilization. With the use of the Nationwide Inpatient Sample from 2003 through 2011, we identified subjects with ICD insertion (procedure code 37.94) and cardiac resynchronization defibrillator (procedure code 00.50, 00.51) as codified by the International Classification of Diseases, Ninth Revision, Clinical Modification....
Source: Clinical Cardiology - January 1, 2016 Category: Cardiology Authors: Nileshkumar J. Patel, Sushruth Edla, Abhishek Deshmukh, Nikhil Nalluri, Nilay Patel, Kanishk Agnihotri, Achint Patel, Chirag Savani, Nish Patel, Ronak Bhimani, Badal Thakkar, Shilpkumar Arora, Deepak Asti, Apurva O. Badheka, Valay Parikh, Raul D. Mitrani, Tags: Quality and Outcomes Source Type: research

Barthel Index as a Predictor of 1‐Year Mortality in Very Elderly Patients Who Underwent Percutaneous Coronary Intervention for Acute Coronary Syndrome: Better Activities of Daily Living, Longer Life
ABSTRACT BackgroundPercutaneous coronary intervention (PCI) is safe and effective in very elderly patients, defined as those who are age ≥85 years, with acute coronary syndrome (ACS). However, the prognostic factors remain unknown. The association between activities of daily living (ADL) and the prognosis after PCI has not yet been investigated. HypothesisBetter ADL is associated with better 1‐year prognosis. MethodsThis retrospective study included 91 consecutive very elderly patients with ACS. We calculated the Barthel Index (BI) as an indicator for ADL. Patients were classified into 2 groups according to BI:...
Source: Clinical Cardiology - December 31, 2015 Category: Cardiology Authors: Satoshi Higuchi, Yusuke Kabeya, Kenichi Matsushita, Hiroki Taguchi, Haruhisa Ishiguro, Hideyasu Kohshoh, Hideaki Yoshino Tags: Clinical Investigations Source Type: research

Sinus Node Dysfunction Is Associated With Higher Symptom Burden and Increased Comorbid Illness: Results From the ORBIT‐AF Registry
ConclusionsSinus node dysfunction is present in 1 of 6 patients with AF and is associated with increased comorbidities and higher symptom burden. However, SND is not associated with an increase in major risk‐adjusted outcomes. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 31, 2015 Category: Cardiology Authors: Larry R. Jackson, Sung Hee Kim, Jonathan P. Piccini, Bernard J. Gersh, Gerald V. Naccarelli, James A. Reiffel, James Freeman, Laine Thomas, Paul Chang, Gregg C. Fonarow, Alan S. Go, Kenneth W. Mahaffey, Eric D. Peterson, Peter R. Kowey Tags: Clinical Investigations Source Type: research

Nonsteroidal Anti‐inflammatory Drugs and Risk of Incident Heart Failure: A Systematic Review and Meta‐analysis of Observational Studies
ConclusionsA significantly elevated risk of incident HF was observed among users of NSAIDs. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 31, 2015 Category: Cardiology Authors: Patompong Ungprasert, Narat Srivali, Charat Thongprayoon Tags: Clinical Investigations Source Type: research

Duration of Triple Therapy: A Clinical Question Remains Unanswered
(Source: Clinical Cardiology)
Source: Clinical Cardiology - December 29, 2015 Category: Cardiology Authors: Karam Ayoub, Ramez Nairooz Tags: Letters to the Editor Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - December 29, 2015 Category: Cardiology Tags: Issue Information Source Type: research

Ankle‐Brachial Index Testing at the Time of Stress Testing in Patients Without Known Atherosclerosis
ConclusionsAnkle‐brachial index screening at rest just before stress testing detected low ABI in 2.0% of participants, all of whom had negative stress tests. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 22, 2015 Category: Cardiology Authors: Amar Narula, Ricardo J. Benenstein, Daisy Duan, David Zagha, Lilun Li, Alana Choy‐Shan, Matthew W. Konigsberg, Ginger Lau, Lawrence M. Phillips, Muhamed Saric, Lisa Vreeland, Harmony R. Reynolds Tags: Clinical Investigations Source Type: research

Angina in Coronary Artery Disease Patients With and Without Diabetes: US National Health and Nutrition Examination Survey 2001–2010
ABSTRACT BackgroundAngina pectoris (AP) is common in coronary artery disease (CAD), but whether those with diabetes mellitus (DM) experience AP as often as those without DM is unclear. HypothesisAP prevalence is similar in those with vs without DM in a community sample with CAD. MethodsIn adults with CAD in the US NHANES 2001–2010, AP was determined by self‐report and Rose questionnaire and compared by DM status. Physical functioning and medication use were also evaluated. ResultsOf 1957 adults with CAD, 619 (28.2%) had DM. Prevalence of AP was similar in those with vs without DM (48.9% vs 46.3%; P = ...
Source: Clinical Cardiology - December 22, 2015 Category: Cardiology Authors: Gavin Hui, Bruce Koch, Federico Calara, Nathan D. Wong Tags: Clinical Investigations Source Type: research

Statin Use and Aneurysm Risk in Patients With Bicuspid Aortic Valve Disease
ABSTRACT BackgroundNo medical therapy has been proven to prevent the progression of aortic dilatation in bicuspid aortic valve (BAV) disease, and prophylactic aortic surgery remains the mainstay of treatment. HypothesisAmong patients with BAV disease who are referred for surgery, preoperative statin use is associated with decreased odds of ascending aortic dilatation. MethodsWe reviewed all BAV patients who underwent aortic valve and/or aortic surgery at our center between April 2004 and December 2013. Aortic diameter (AD), defined as the maximum ascending aortic dimension, was determined by magnetic resonance imaging, com...
Source: Clinical Cardiology - December 22, 2015 Category: Cardiology Authors: Alexander P. Taylor, Ajay Yadlapati, Adin‐Cristian Andrei, Zhi Li, Colleen Clennon, Patrick M. McCarthy, James D. Thomas, S. Chris Malaisrie, Neil J. Stone, Robert O. Bonow, Paul W.M. Fedak, Jyothy J. Puthumana Tags: Clinical Investigations Source Type: research

Objectives and Design of the Russian Acute Coronary Syndrome Registry (RusACSR)
ABSTRACT The Russian Acute Coronary Syndrome Registry (RusACSR) is a retrospective, continuous, nationwide, Web‐based registry of patients with acute coronary syndromes (ACS). The RusACSR is a database that uses a secure Web‐based interface for data entry by individual users. Participation in the RusACSR is voluntary. Any clinical center that provides health care to ACS patients can take part in the RusACSR. The RusACSR enrolls ACS patients who have undergone care in Russian hospitals from February 2008 to the present. Key data elements and methods of data analysis in the RusACSR are presented in this article. Up to 20...
Source: Clinical Cardiology - December 22, 2015 Category: Cardiology Authors: Vladimir I. Gridnev, Anton R. Kiselev, Olga M. Posnenkova, Yulia V. Popova, Viktor A. Dmitriev, Mikhail D. Prokhorov, Pavel Ya. Dovgalevsky, Elena V. Oschepkova, Tags: Trial Designs Source Type: research

The Effects of Free‐Living Physical Activity on Mortality After Coronary Artery Disease Diagnosis
ConclusionsFree‐living objectively measured physical activity is associated with greater survival among CAD patients in the United States. If confirmed by future research, development of strategies to not only increase participation in supervised cardiac rehabilitation, but also increase participation in free‐living physical activity, are needed. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 1, 2015 Category: Cardiology Authors: Paul D. Loprinzi, Ovuokerie Addoh Tags: Clinical Investigations Source Type: research

Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function
ConclusionsAlterations in lifestyle and emotional state are frequent in AAD survivors. Clinicians should screen for unfounded fears or beliefs after dissection that may reduce function and/or quality of life for AAD survivors. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 20, 2015 Category: Cardiology Authors: Ashish Chaddha, Eva Kline‐Rogers, Alan C. Braverman, Steven R. Erickson, Elizabeth A. Jackson, Barry A. Franklin, Elise M. Woznicki, Justin T. Jabara, Daniel G. Montgomery, Kim A. Eagle Tags: Clinical Investigations Source Type: research

Exercise and Physical Activity for the Post–Aortic Dissection Patient: The Clinician's Conundrum
ABSTRACT Despite the paucity of evidence, it is often presumed, and is physiologically plausible, that sudden, acute elevations in blood pressure may transiently increase the risk of recurrent aortic dissection (AD) or rupture in patients with a prior AD, because a post‐dissection aorta is almost invariably dilated and may thus experience greater associated wall stress as compared with a nondilated aorta. Few data are available regarding the specific types and intensities of exercise that may be both safe and beneficial for this escalating patient population. The purpose of this editorial/commentary is to further explore...
Source: Clinical Cardiology - November 20, 2015 Category: Cardiology Authors: Ashish Chaddha, Kim A. Eagle, Alan C. Braverman, Eva Kline‐Rogers, Alan T. Hirsch, Robert Brook, Elizabeth A. Jackson, Elise M. Woznicki, Susan Housholder‐Hughes, Linda Pitler, Barry A. Franklin Tags: Commentary Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - November 20, 2015 Category: Cardiology Tags: Issue Information Source Type: research

Sweating: A Specific Predictor of ST‐Segment Elevation Myocardial Infarction Among the Symptoms of Acute Coronary Syndrome: Sweating In Myocardial Infarction (SWIMI) Study Group
ABSTRACT BackgroundToday, cardiologists seek to minimize time from symptom onset to interventional treatment for the most favorable results. HypothesisIn the acute coronary syndrome (ACS) symptom complex, sweating can differentiate ST‐segment elevation myocardial infarction (STEMI) from non–ST‐segment elevation ACS (NSTE‐ACS) during early hours of infarction. MethodsThis single‐center, prospective, observational study compared symptoms of STEMI and NSTE‐ACS patients admitted from August 2012 to July 2014. ResultsOf 12 913 patients, 90.56% met ACS criteria. Among these, 22.51% had STEMI. Typical angina was t...
Source: Clinical Cardiology - November 1, 2015 Category: Cardiology Authors: Rajendra K. Gokhroo, Bhanwar L. Ranwa, Kamal Kishor, Kumari Priti, Avinash Ananthraj, Sajal Gupta, Devendra Bisht Tags: Clinical Investigations Source Type: research

Intra‐abdominal Hypertension: An Important Consideration for Diuretic Resistance in Acute Decompensated Heart Failure
ABSTRACT Fluid accumulation is the hallmark of heart failure decompensation. Fluid overload and congestion are associated with recurrent hospitalizations, poor quality of life, and increased mortality in heart failure. Despite the use of high‐dose intravenous loop diuretic therapy, acutely decompensated heart failure patients may develop diuretic resistance. Diuretic refractoriness can be a result of elevated intra‐abdominal pressure (IAP) in acutely decompensated heart failure. Increased renal venous and interstitial pressures in patients with elevated IAP may lead to renal impairment and diuretic resistance. Routine ...
Source: Clinical Cardiology - November 1, 2015 Category: Cardiology Authors: Vinh Q. Nguyen, Taraka V. Gadiraju, Hiren Patel, Minnsun Park, Thierry H. Le Jemtel, Abhishek Jaiswal Tags: Clinical Investigations Source Type: research

Comparison of Time Trends of Cardiovascular Disease Risk Factors and Framingham Risk Score Between Patients With and Without Acute Coronary Syndrome Undergoing Percutaneous Intervention Over the Last 17 Years: From the Mayo Clinic Percutaneous Coronary Intervention Registry
This study was a time‐trend analysis from 1994 to 2010 within the Mayo Clinic PCI registry. Outcome measures were incidence and prevalence of cvRF, including the Framingham Risk Score (FRS), at the time of admission for PCI. ResultsAge of non‐ACS patients was higher than that of ACS patients, and age distribution slightly shifted toward older age in both groups (P for trend
Source: Clinical Cardiology - November 1, 2015 Category: Cardiology Authors: Moo‐Sik Lee, Andreas J. Flammer, Jing Li, Ryan J. Lennon, Sinny Delacroix, Hyunsoo Kim, Amir Lerman Tags: Clinical Investigations Source Type: research

Assessment of Short‐term Blood Pressure Variability in Patients With Ascending Aortic Dilatation
ABSTRACT BackgroundBlood pressure variability (BPV) is a novel parameter related to adverse cardiovascular findings and events, especially in hypertensive patients. The aim of the present study was to investigate the relationship between short‐term BPV and ascending aortic dilatation (AAD). HypothesisHypertensive patients with AAD may exhibit higher short‐term BPV compared to hypertensive patients with normal diameter ascending aorta and BPV may be correlated with aortic sizes. MethodsSeventy‐six hypertensive patients with AAD and 181 hypertensive patients with a normal‐diameter ascending aorta were retrospectively...
Source: Clinical Cardiology - November 1, 2015 Category: Cardiology Authors: Mehmet Baran Karataş, Göktürk İpek, Yiğit Çanga, Barış Güngör, Kazim Serhan Özcan, Emre Arugaslan, Zeki Yüksel Günaydin, Gündüz Durmuş, Tolga Onuk, Koray Kalenderoğlu, Evliya Akdeniz, Osman Bolca Tags: Clinical Investigations Source Type: research

Effects of Anxiety and Depression on Arterial Elasticity of Subjects With Suboptimal Physical Health
ABSTRACT BackgroundThe authors investigated the effects of suboptimal health status (SHS; high‐normal blood pressure, blood glucose, and blood lipids) on arterial elasticity in subjects with or without anxiety or depression. HypothesisSuboptimal physical health status and anxiety or depression increase the risk of cardiovascular diseases. MethodsThis was a cross‐sectional, observational, multicenter study. Among 1520 subjects who underwent physical examination between May 2009 and December 2012 in Beijing and Chongqing, China, 955 were included. All subjects completed anxiety and depression questionnaires. Systemic vas...
Source: Clinical Cardiology - October 28, 2015 Category: Cardiology Authors: Ningling Sun, Yang Xi, Zhiming Zhu, Huijun Yin, Qiushan Tao, Hongyi Wang, Luyan Wang, Zhiyi Ma, Yuanyuan Chen, Dan Yao Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - October 28, 2015 Category: Cardiology Tags: Issue Information Source Type: research

The Contemporary Use of Angiography and Revascularization Among Patients With Non–ST‐Segment Elevation Myocardial Infarction in the United States Compared With South Korea
ConclusionsThe profile, characteristics, and use of angiography and revascularization for NSTEMI patients in the U.S. vs South Korea differed substantially from 2007–2010, underscoring the heterogeneity of NSTEMI patients and treatment selection among different countries. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 8, 2015 Category: Cardiology Authors: Hyun‐Jae Kang, DaJuanicia Simon, Tracy Y. Wang, Karen P. Alexander, Myung Ho Jeong, Hyo‐Soo Kim, Eric R. Bates, Timothy D. Henry, Eric D. Peterson, Matthew T. Roe, Tags: Clinical Investigations Source Type: research

Correlation of the New York Heart Association Classification and the 6‐Minute Walk Distance: A Systematic Review
ABSTRACT BackgroundFunctional status assessment is the cornerstone of heart failure management and trials. The New York Heart Association (NYHA) classification and 6‐minute walk distance (6MWD) are commonly used tools; however, the correlation between them is not well understood. HypothesisWe hypothesised that the relationship between the NYHA classification and 6MWD might vary across studies. MethodsA systematic literature search was performed to identify all studies reporting both NYHA class and 6MWD. Two reviewers independently assessed study eligibility and extracted data. Thirty‐seven studies involving 5678 patie...
Source: Clinical Cardiology - October 7, 2015 Category: Cardiology Authors: Jonathan Yap, Fang Yi Lim, Fei Gao, Ling Li Teo, Carolyn Su Ping Lam, Khung Keong Yeo Tags: Clinical Investigations Source Type: research

Natural History and Implantable Cardioverter‐Defibrillator Implantation After Revascularization for Stable Coronary Artery Disease With Depressed Ejection Fraction
ConclusionsFollowing revascularization for stable CAD with depressed LVEF, ≥50% of patients' ventricular function improved enough to make ICD implantation unnecessary. A waiting period after revascularization prior to ICD implantation appears appropriate and does not significantly negatively impact follow‐up or the rate of appropriate ICD implantation. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 7, 2015 Category: Cardiology Authors: Geoffrey F. Lewis, Adam C. Harless, Lauren Vazquez, Freddy M. Abi‐Samra, Michael L. Bernard, Sammy Khatib, Glenn M. Polin, Daniel P. Morin Tags: Clinical Investigations Source Type: research

Treatment of Stable Angina Pectoris With Ivabradine in Everyday Practice: A Pan‐Hellenic, Prospective, Noninterventional Study
This study's purpose was to evaluate in CAD patients the antianginal efficacy of 4‐month treatment with ivabradine plus a β‐blocker and to record patient compliance and the effect of treatment on QOL. MethodsIn this noninterventional study, 2403 patients with chronic stable angina were prospectively studied from 245 private cardiology offices. Data were recorded at baseline and at 1 and 4 months after inclusion. Patient quality of life was assessed using the EuroQol 5 dimensions (EQ‐5D) questionnaire. ResultsFrom baseline to study completion, mean heart rate decreased from 81.5 ± 9.7 bpm to 63.9 ± 6.0 bpm (P
Source: Clinical Cardiology - October 1, 2015 Category: Cardiology Authors: John Zarifis, Violetta Grammatikou, Manolis Kallistratos, Apostolos Katsivas, Tags: Clinical Trial Updates Source Type: research

Clinical Practice Patterns in Constrictive Pericarditis Patients With Heart Failure: A Retrospective Cohort Study Using a National Inpatient Database in Japan
ABSTRACT BackgroundPrevious studies on constrictive pericarditis (CP) mainly concerned patients undergoing pericardiectomy. The reported perioperative mortality of CP patients remained high. Data on medically treated CP patients without pericardiectomy have been scarce. HypothesisConstrictive pericarditis patients with more comorbidities are less likely to undergo pericardiectomy. MethodsUsing the Diagnosis Procedure Combination database from 2007 to 2013, we retrospectively identified CP patients admitted with heart failure of New York Heart Association (NYHA) class II to IV. We compared clinical characteristics between p...
Source: Clinical Cardiology - October 1, 2015 Category: Cardiology Authors: Toshiaki Isogai, Hideo Yasunaga, Hiroki Matsui, Hiroyuki Tanaka, Motoyuki Hisagi, Kiyohide Fushimi Tags: Clinical Investigations Source Type: research

The Association of Transfer Rate From Hospitals Without Revascularization Capabilities and Mortality Risk for Older Non–ST‐Segment Elevation Myocardial Infarction Patients
ConclusionsTransfer rates for older NSTEMI patients vary widely among non–revascularization‐capable hospitals. Despite lower predicted mortality risk and higher rates of post‐transfer revascularization, patients from high–transfer‐out hospitals had a similar risk for short‐ and long‐term mortality compared with those from low–transfer‐out hospitals. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2015 Category: Cardiology Authors: Lan Shen, Bimal R. Shah, Shuang Li, Laine Thomas, Tracy Y. Wang, Karen P. Alexander, Eric D. Peterson, Ben He, Matthew T. Roe Tags: Clinical Investigations Source Type: research

Assessing Bleeding Risk With the HAS‐BLED Score: Balancing Simplicity, Practicality, and Predictive Value in Bleeding‐Risk Assessment
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 29, 2015 Category: Cardiology Authors: Gregory Y. H. Lip Tags: Editorials Source Type: research

The HAS‐BLED Score for Predicting Major Bleeding Risk in Anticoagulated Patients With Atrial Fibrillation: A Systematic Review and Meta‐analysis
ABSTRACT Our objective was to compare the diagnostic accuracy between the HAS‐BLED score and any of HEMORR2HAGES, ATRIA, CHADS2, or CHA2DS2‐VASc scores in anticoagulated patients with atrial fibrillation. We systematically searched the Cochrane Library, MEDLINE, PubMed, and Embase databases for relevant studies. Data were extracted and analyzed according to predefined clinical endpoints. Eleven studies were identified. Discrimination analysis demonstrates that HAS‐BLED has no significant C‐statistic differences for bleeding risk prediction compared with ATRIA or HEMORR2HAGES, but it has significant differences comp...
Source: Clinical Cardiology - September 29, 2015 Category: Cardiology Authors: Wengen Zhu, Wenfeng He, Linjuan Guo, Xixing Wang, Kui Hong Tags: Review Source Type: research

Validation of the Canada Acute Coronary Syndrome Risk Score for Hospital Mortality in the Gulf Registry of Acute Coronary Events‐2
ConclusionsThe new C‐ACS score performed well in predicting hospital mortality in a contemporary ACS population outside North America. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 29, 2015 Category: Cardiology Authors: Hussam F. AlFaleh, Alawi A. Alsheikh‐Ali, Anhar Ullah, Khalid F. AlHabib, Ahmad Hersi, Jassim Al Suwaidi, Kadhim Sulaiman, Shukri Al Saif, Wael Almahmeed, Nidal Asaad, Haitham Amin, Ahmed Al‐Motarreb, Tarek Kashour Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 29, 2015 Category: Cardiology Tags: Issue Information Source Type: research

Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?
BackgroundShortness of breath (SOB) is common among healthy women with normal pregnancies. However, when no overt cardiac or extra cardiac etiology is found, a subtle cardiac source must be excluded. HypothesisPregnancy may induce or unmask myocardial dysfunction that may cause SOB. MethodsHealthy pregnant women with significant SOB were recruited for this study. We performed a comprehensive echocardiographic assessment including tissue Doppler imaging (TDI) and 2‐ dimensional strain imaging (2DS). The echocardiographic data obtained were compared with that of a control group of pregnant women without SOB. ResultsThirty ...
Source: Clinical Cardiology - September 28, 2015 Category: Cardiology Authors: Sorel Goland, Sharon Perelman, Nardin Asalih, Sara Shimoni, Osnat Walfish, Mordechai Hallak, Zion Hagay, Jacob George, Avraham Shotan, David S. Blondheim Tags: Clinical Investigations Source Type: research

The Safety and Efficacy of Absorb Bioresorbable Vascular Scaffold: A Systematic Review
ABSTRACT Bioresorbable stents are novel devices designed to overcome the long‐term limitations of permanent stent implantation. The Absorb bioresorbable vascular scaffold (BVS; Abbott Vascular, Santa Clara, CA) was the first bioresorbable stent with Conformité Européenne mark approval in coronary vessels and has been the subject of multiple clinical studies. Despite its potential advantages, the safety and efficacy of BVS remain unclear. To address this, we conducted a systematic review to examine the safety and efficacy of BVS. The MEDLINE, Embase, Current Index to Nursing & Allied Health Literature (C...
Source: Clinical Cardiology - September 23, 2015 Category: Cardiology Authors: Chang Lu, Kristian B. Filion, Mark J. Eisenberg Tags: Review Source Type: research

Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber
ABSTRACT The right atrium (RA) plays a pivotal role in electromechanical and endocrine regulation of the heart. Its peculiar anatomical features and phasic mechanical function make it distinct from ventricles. Various invasive and noninvasive techniques have been used to elucidate RA structure and function. Of these modalities, echocardiography has distinct advantages over others. Several conventional measures of RA function through echocardiography have been described in the literature, but they are load dependent. A relatively new technique is speckle tracking–derived strain, which is relatively less dependent on l...
Source: Clinical Cardiology - September 10, 2015 Category: Cardiology Authors: Aitzaz Bin Sultan Rai, Eduardo Lima, Farrukh Munir, Anum Faisal Khan, Ahmed Waqas, Sara Bughio, Ehtesham ul Haq, Hassan Bin Attique, Zia Ur Rahman Tags: Review Source Type: research

Association Between Preinfarction Angina and Angiographic Findings in Non–ST‐Segment Elevation Myocardial Infarction
ABSTRACT BackgroundThe association between preinfarction angina and angiographic findings has not been elucidated in patients with non–ST‐segment elevation myocardial infarction (NSTEMI). HypothesisPatients with preinfarction angina have favorable angiographic findings. MethodsThis retrospective study analyzed 481 patients who underwent coronary angiography within 5 days of presenting NSTEMI. Preinfarction angina was defined as experiencing ≥1 chest‐pain episode within 7 days prior to admission. Infarct size was measured as the peak cardiac troponin I (cTnI) level, and large myocardial infarction (MI) was defi...
Source: Clinical Cardiology - September 7, 2015 Category: Cardiology Authors: Naoki Misumida, Akihiro Kobayashi, Madeeha Saeed, John T. Fox, Yumiko Kanei Tags: Clinical Investigations Source Type: research

Association Between Atrial Fibrillation and Costs After Myocardial Infarction: A Community Study
ABSTRACT BackgroundThe authors sought to estimate incremental economic impact of atrial fibrillation (AF) and the timing of its onset in myocardial infarction (MI) patients. HypothesisConcurrent AF and its timing are associated with higher costs in MI patients. MethodsThis retrospective cohort study included incident MI patients from Olmsted County, Minnesota, treated between November 1, 2002, and December 31, 2010. We compared inflation‐adjusted standardized costs accumulated between incident MI and end of follow‐up among 3 groups by AF status and timing: no AF, new‐onset AF (within 30 days after index MI), and prio...
Source: Clinical Cardiology - September 7, 2015 Category: Cardiology Authors: Bijan J. Borah, Véronique L. Roger, Roger M. Mills, Susan A. Weston, Stephanie S. Anderson, Alanna M. Chamberlain Tags: Clinical Investigations Source Type: research

Rationale, Design, and Methodological Aspects of the BUDAPEST‐GLOBAL Study (Burden of Atherosclerotic Plaques Study in Twins—Genetic Loci and the Burden of Atherosclerotic Lesions)
ABSTRACT The heritability of coronary atherosclerotic plaque burden, coronary geometry, and phenotypes associated with increased cardiometabolic risk are largely unknown. The primary aim of the Burden of Atherosclerotic Plaques Study in Twins—Genetic Loci and the Burden of Atherosclerotic Lesions (BUDAPEST‐GLOBAL) study is to evaluate the influence of genetic and environmental factors on the burden of coronary artery disease. By design this is a prospective, single‐center, classical twin study. In total, 202 twins (61 monozygotic pairs, 40 dizygotic same‐sex pairs) were enrolled from the Hungarian Twin Registry...
Source: Clinical Cardiology - September 1, 2015 Category: Cardiology Authors: Pál Maurovich‐Horvat, Dávid L. Tárnoki, Ádám D. Tárnoki, Tamás Horváth, Ádám L. Jermendy, Márton Kolossváry, Bálint Szilveszter, Viktor Voros, Attila Kovács, Andrea Á. Molnár, Levente Littvay, Hildo J. Lamb, Szilard Voros, György Jermen Tags: Trial Designs Source Type: research

Initial Experience With Novel Oral Anticoagulants During the First 45 Days After Left Atrial Appendage Closure With the Watchman Device
ConclusionsOur pilot study suggests that NOAC therapy within the first 45 days after interventional LAA closure is safe and effective. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2015 Category: Cardiology Authors: Leif I. Bösche, Faegheh Afshari, Dominik Schöne, Aydan Ewers, Andreas Mügge, Michael Gotzmann Tags: Clinical Investigations Source Type: research

Ranolazine in Cardiac Arrhythmia
ABSTRACT Ranolazine utilization in the management of refractory angina has been established by multiple randomized clinical studies. However, there is growing evidence showing an evolving role in the field of cardiac arrhythmias. Multiple experimental and clinical studies have evaluated the role of ranolazine in prevention and management of atrial fibrillation, with ongoing studies on its role in ventricular arrhythmias. In this review, we will discuss the pharmacological, experimental, and clinical evidence behind ranolazine use in the management of various cardiac arrhythmias. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2015 Category: Cardiology Authors: Marwan Saad, Ahmed Mahmoud, Islam Y Elgendy, C. Richard Conti Tags: Review Source Type: research

Remnant Lipoprotein Cholesterol and Mortality After Acute Myocardial Infarction: Further Evidence for a Hypercholesterolemia Paradox From the TRIUMPH Registry
We examined 2465 AMI survivors in a prospective, 24‐center US study of AMI outcomes. Lipoprotein cholesterol subfractions were directly measured by ultracentrifugation. RLP‐C was defined as intermediate‐density lipoprotein cholesterol (IDL‐C) + very‐low‐density lipoprotein cholesterol subfraction 3 (VLDL3‐C). Given a linear relationship between RLP‐C and mortality, we examined RLP‐C by tertiles and continuously. Cox regression hazard ratios (HRs) were adjusted for the Global Registry of Acute Coronary Events (GRACE) score and 23 other covariates. ResultsParticipants were age 58 ± 12 years (mean &pl...
Source: Clinical Cardiology - September 1, 2015 Category: Cardiology Authors: Seth S. Martin, Kamil F. Faridi, Parag H. Joshi, Michael J. Blaha, Krishnaji R. Kulkarni, Arif A. Khokhar, Thomas M. Maddox, Edward P. Havranek, Peter P. Toth, Fengming Tang, John A. Spertus, Steven R. Jones Tags: Clinical Investigations Source Type: research