Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - November 19, 2014 Category: Cardiology Tags: Issue Information Source Type: research

Sequential Analysis of Myeloperoxidase for Prediction of Adverse Events After Suspected Acute Coronary Ischemia
Abstract BackgroundMyeloperoxidase (MPO) plasma values predict major adverse cardiac events (MACE) in cases of acute coronary syndrome. The effect of serial testing in patients who are suspected for acute coronary ischemia is unclear. HypothesisWe hypothesize that sequential MPO measurement may improve prediction of MACE in patients with suspected acute coronary ischemia. MethodsThe present prospective observational study examined the prognostic significance of MPO in 917 patients with suspicion of acute coronary syndrome. Blood samples were taken at cardiac catheter laboratory admission and the day after coronary angiogra...
Source: Clinical Cardiology - November 17, 2014 Category: Cardiology Authors: Christian Koch, Michael Henrich, Martin Clemens Heidt Tags: Clinical Investigations Source Type: research

The Influence of Type 2 Diabetes on Left Atrial Remodeling
Abstract The influence of type 2 diabetes mellitus on cardiac remodeling has been evaluated for decades; however, the majority of investigations were focused only on the left ventricle. The impact of diabetes on the left atrial (LA) function is less researched. LA enlargement has been shown as an independent predictor of cardiovascular morbidity and mortality in the general and diabetic population; however, LA dysfunction has been proven to be an independent predictor only in the general population. There are not much follow‐up data about the influence of diabetes on LA function. New echocardiographic techniques, such as...
Source: Clinical Cardiology - November 17, 2014 Category: Cardiology Authors: Marijana Tadic, Cesare Cuspidi Tags: Reviews Source Type: research

Acute Heart Failure: Acute Cardiorenal Syndrome and Role of Aggressive Decongestion
Abstract Congestion and acute renal dysfunction are at the center of acute heart failure (HF) syndromes. Acute cardiorenal syndrome, which refers to worsening of renal function in a patient with acute HF syndrome, is partly related to venous congestion and high renal afterload. Aggressive decongestion improves renal and myocardial flow and ventricular loading conditions, potentially resulting in reduced HF progression, rehospitalization, and mortality. High‐dose diuretic therapy remains the mainstay therapy. Ultrafiltration and inotropic therapy are useful in the subgroup of patients with a low‐output state and diureti...
Source: Clinical Cardiology - November 17, 2014 Category: Cardiology Authors: Elias B. Hanna, Eliana Hanna Deschamps Tags: Reviews Source Type: research

FRAIL‐HF, a Study to Evaluate the Clinical Complexity of Heart Failure in Nondependent Older Patients: Rationale, Methods and Baseline Characteristics
ABSTRACT The clinical scenario of heart failure (HF) in older hospitalized patients is complex and influenced by acute and chronic comorbidities, coexistent geriatric syndromes, the patient's ability for self‐care after discharge, and degree of social support. The impact of all these factors on clinical outcomes or disability evolution is not sufficiently known. FRAIL‐HF is a prospective observational cohort study designed to evaluate clinical outcomes (mortality and readmission), functional evolution, quality of life, and use of social resources at 1, 3, 6, and 12 months after admission in nondependent elderly patient...
Source: Clinical Cardiology - November 1, 2014 Category: Cardiology Authors: María T. Vidán, Elísabet Sánchez, Francisco Fernández‐Avilés, José A. Serra‐Rexach, Javier Ortiz, Héctor Bueno Tags: Trial Designs Source Type: research

Racial Disparities in the Use of Catheter Ablation for Atrial Fibrillation and Flutter
Abstract BackgroundAtrial fibrillation (AF) is the most common arrhythmia seen in clinical practice. Catheter ablation is an expensive but potentially curable treatment of AF. We explored differences in the use of catheter ablation for AF in the state of Florida and compared the findings to ablation for atrial flutter. MethodsWe conducted a cross‐sectional analysis of all ambulatory and hospital discharge procedures between 2006 and 2009 in Florida. We identified all subjects with AF and atrial flutter, using International Classification of Diseases, 9th Revision codes along with the race/ethnicity of each individual. We...
Source: Clinical Cardiology - November 1, 2014 Category: Cardiology Authors: Leonardo Tamariz, Alexis Rodriguez, Ana Palacio, Hua Li, Robert Myerburg Tags: Clinical Investigations Source Type: research

The Impact of Processes of Care on Myocardial Infarct Size in Patients With ST‐Segment Elevation Myocardial Infarction: Observations From the CRISP‐AMI Trial
ConclusionsIn CRISP‐AMI, reperfusion was accomplished in a timely fashion while incorporating informed consent and randomization among patients with anterior myocardial infarction. Further study of patients' comprehension and preferences during the informed‐consent process in STEMI patients is warranted so that innovative drugs and devices can be safely and ethically tested. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2014 Category: Cardiology Authors: W. Schuyler Jones, Robert M. Clare, Karen Chiswell, Divaka Perera, John K. French, A. Sreenivas Kumar, Jonathan Blaxill, Nico Pijls, James Mills, E. Magnus Ohman, Manesh R. Patel Tags: Clinical Investigations Source Type: research

Direct Myocardial Ischemia Imaging: a New Cardiovascular Nuclear Imaging Paradigm
This article describes recent studies using 18F‐fluorodeoxyglucose (18FDG) for myocardial ischemia imaging. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2014 Category: Cardiology Authors: Diwakar Jain, Zuo‐Xiang He, Vikram Lele, Wilbert S. Aronow Tags: Reviews Source Type: research

Efficacy and Safety of Dronedarone in Patients Previously Treated With Other Antiarrhythmic Agents
ABSTRACT BackgroundCurrently available antiarrhythmic drugs (AADs) for the prevention of atrial fibrillation (AF)/atrial flutter (AFL) suffer from incomplete efficacy and poor tolerability. HypothesisDronedarone could represent an effective and safe option in patients previously treated with AADs, especially class Ic AADs and sotalol. MethodsRetrospective analysis of 2 double‐blind, parallel‐group trials (EURIDIS [European Trial in Atrial Fibrillation or Flutter Patients Receiving Dronedarone for the Maintenance of Sinus Rhythm] and ADONIS [American–Australian–African Trial With Dronedarone in Atrial Fibril...
Source: Clinical Cardiology - November 1, 2014 Category: Cardiology Authors: Federico Guerra, Stefan H. Hohnloser, Peter R. Kowey, Harry J. G. M. Crijns, Etienne M. Aliot, David Radzik, Denis Roy, Stuart Connolly, Alessandro Capucci Tags: Clinical Trial Updates Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - October 21, 2014 Category: Cardiology Tags: Issue Information Source Type: research

Hospitalization Costs for Acute Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention in the United States Are Substantially Higher Than Medicare Payments
ABSTRACT BackgroundAcute coronary syndromes account for half of all deaths secondary to cardiovascular disease and represent a significant economic burden in the United States. Therefore, assessing hospitalization costs relative to Medicare reimbursement for these patients is important in understanding the impact of these patients on hospitals. We hypothesized that hospitalization costs for acute myocardial infarction patients treated with percutaneous coronary intervention (PCI) were higher than their associated Medicare payments. MethodsUsing the Nationwide Inpatient Sample, we evaluated hospitalization costs for patien...
Source: Clinical Cardiology - October 21, 2014 Category: Cardiology Authors: Majed Afana, Waleed Brinjikji, Harry Cloft, Samer Salka Tags: Clinical Investigations Source Type: research

Application of Appropriate Use Criteria to Cardiac Stress Testing in the Hospital Setting: Limitations of the Criteria and Areas for Improved Practice
ABSTRACT BackgroundImaging cardiac stress test use has risen significantly, leading to the development of appropriate use criteria. Prior studies have suggested the rate of inappropriate testing is 13% to 14%, but inappropriate testing in hospitalized patients has not been well studied. HypothesisAppropriate use of stress testing in hospitalized patients is not comparable to the ambulatory setting. MethodsWe studied 459 consecutive patients referred for imaging stress tests (nuclear imaging or stress echocardiography) at a single institution over a 6‐month period. Appropriate use was determined by research cardiologists ...
Source: Clinical Cardiology - October 21, 2014 Category: Cardiology Authors: Zachary M. Gertz, William O'Donnell, Amresh Raina, Andrew J. Litwack, Jessica R. Balderston, Lee R. Goldberg Tags: Clinical Investigations Source Type: research

Atrial Fibrillation and Incident Myocardial Infarction in the Elderly
ConclusionsAF is associated with an increased risk of MI in a population of older adults. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2014 Category: Cardiology Authors: Wesley T. O'Neal, Kunal Sangal, Zhu‐Ming Zhang, Elsayed Z. Soliman Tags: Clinical Investigations Source Type: research

Stroke After Transcatheter Aortic Valve Replacement: Incidence, Risk Factors, Prognosis, and Preventive Strategies
Abstract The first transcatheter aortisc valve replacement (TAVR) was performed in 2002, and has been proven beneficial in inoperable and high‐risk patients for open heart surgery. Stroke occurrence after TAVR, both periprocedure and at follow‐up, has not been well described. We sought to review incidence, pathophysiology, predictors, prognosis, and current preventive strategies of cerebrovascular accidents (CVAs) after TAVR. Studies were selected from a Medline search if they contained clinical outcomes data after TAVR. Acute and subacute CVAs after TAVR have been reported in 3% to 6% of patients. Approximately 45% of...
Source: Clinical Cardiology - October 1, 2014 Category: Cardiology Authors: Ioannis Mastoris, Mikkel M. Schoos, George D. Dangas, Roxana Mehran Tags: Reviews Source Type: research

Efficacy and Safety of Alirocumab as Add‐on Therapy in High–Cardiovascular‐Risk Patients With Hypercholesterolemia Not Adequately Controlled With Atorvastatin (20 or 40 mg) or Rosuvastatin (10 or 20 mg): Design and Rationale of the ODYSSEY OPTIONS Studies
Abstract The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double‐blind, active‐comparator, 24‐week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add‐on therapy in ∼ 650 high‐cardiovascular (CV)‐risk patients whose low‐density lipoprotein cholesterol (LDL‐C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV‐risk category, high and very high CV risk, respectively, with atorvastatin (20–40 mg/d) or rosuv...
Source: Clinical Cardiology - September 30, 2014 Category: Cardiology Authors: Jennifer G. Robinson, Helen M. Colhoun, Harold E. Bays, Peter H. Jones, Yunling Du, Corinne Hanotin, Stephen Donahue Tags: Trial Designs Source Type: research

Predictors and Outcome of Sustained Improvement in Left Ventricular Function in Dilated Cardiomyopathy
Abstract BackgroundImprovement in the left ventricular ejection fraction (LVEF) may occur in patients with dilated cardiomyopathy (DCM). HypothesisThere are different implications of persistent versus transient improvement in LVEF among DCM patients receiving contemporary therapy. MethodsWe studied 188 patients with nonischemic DCM. Persistent improvement in LVEF (PIEF) was defined as LVEF increase by at least 10% compared to baseline, and found in 2 separate echo‐Doppler exams performed at least 12 months apart. Increased LVEF in echo 2, which was not sustained in echo 3, was defined as transient improvement in LVEF (TI...
Source: Clinical Cardiology - September 18, 2014 Category: Cardiology Authors: Ido Blechman, Michael Arad, Tamar Nussbaum, Ilan Goldenberg, Dov Freimark Tags: Clinical Investigations Source Type: research

Evaluation of Ascending Aorta Wall in Rheumatoid Arthritis by Tissue and Strain Doppler Imaging During Anti–Tumor Necrosis Factor‐α Therapy
Abstract BackgroundPatients with rheumatoid arthritis (RA) are at increased risk of vascular events. Data on the effects of tumor necrosis factor‐α (TNF‐α) blocking agents on aortic vascular function are still debated. HypothesisTo evaluate the effects of anti–TNF‐α treatment on elastic properties of the ascending aorta (distensibility, stiffness, and tissue Doppler imaging [TDI] strain) in RA patients. MethodsWe prospectively followed 13 patients affected by RA without cardiovascular risk factors for 1 year during anti–TNF‐α treatment. Every subject received an echocardiographic...
Source: Clinical Cardiology - September 18, 2014 Category: Cardiology Authors: Enrico Vizzardi, Ilaria Cavazzana, Edoardo Sciatti, Ivano Bonadei, Antonio D'Aloia, Angela Tincani, Franco Franceschini, Marco Metra Tags: Clinical Investigations Source Type: research

Impact of Clinical and Therapeutic Factors on Incident Cardiovascular and Cerebrovascular Events in a Population‐Based Cohort of HIV‐Infected and Non–HIV‐Infected Adults
ConclusionsAfter adjusting for traditional risk factors and sociodemographic differences, there is higher risk of incident cardiovascular events among HIV‐infected individuals exposed to combined antiretroviral medications compared to the general population. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 15, 2014 Category: Cardiology Authors: Avnish Tripathi, Angela D. Liese, Michael D. Winniford, Jeanette M. Jerrell, Helmut Albrecht, Ali A. Rizvi, Jiajia Zhang, Wayne A. Duffus Tags: Quality and Outcomes Source Type: research

Noninvasive Testing in Women With Suspected Ischemic Heart Disease: Ten Highlights to Guide Quality Clinical Care
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 15, 2014 Category: Cardiology Authors: Jennifer H. Mieres, Leslee J. Shaw, Nanette K. Wenger Tags: Editorials Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 15, 2014 Category: Cardiology Tags: Issue Information Source Type: research

Noncardiac Surgery in Patients With Aortic Stenosis: A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System
ABSTRACT BackgroundPast research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30‐day major adverse cardiovascular event (MACE) and all‐cause mortality were investigated in a contemporary Danish cohort. HypothesisAS is not an independent risk factor for adverse outcomes in noncardiac surgery. MethodsAll patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through nationwide administrative r...
Source: Clinical Cardiology - September 15, 2014 Category: Cardiology Authors: Charlotte Andersson, Mads Emil Jørgensen, Andreas Martinsson, Peter Wæde Hansen, J. Gustav Smith, Per Føge Jensen, Gunnar H. Gislason, Lars Køber, Christian Torp‐Pedersen Tags: Clinical Investigation Source Type: research

The Relationship Between Gamma‐Glutamyl Transferase Levels and Coronary Plaque Burdens and Plaque Structures in Young Adults With Coronary Atherosclerosis
ABSTRACT BackgroundElevated gamma‐glutamyl transferase (GGT) levels have been demonstrated to be associated with poor prognoses in patients with coronary artery disease. Coronary computed tomography angiography (CCTA) is a noninvasive imaging modality that may differentiate the structure of coronary plaques. Elevated plaque burdens and noncalcified plaques, detected by CCTA, are important predictors of atherosclerosis in young adults. HypothesisThe present study investigated the possible relationship between GGT levels and coronary plaque burdens/structures in young adults with coronary atherosclerosis. MethodsCCTA image...
Source: Clinical Cardiology - September 5, 2014 Category: Cardiology Authors: Omer Celik, Huseyin Altug Cakmak, Seckin Satilmis, Baris Gungor, Fatih Akin, Derya Ozturk, Ahmet Arif Yalcin, Burak Ayca, Mehmet Erturk, Mehmet Mahir Atasoy, Nevzat Uslu Tags: Clinical Investigations Source Type: research

Statins in the Elderly: A Patient‐Focused Approach
ABSTRACT Individuals age>65 years represent the fastest‐growing subpopulation in the United States. Although these individuals with the highest cardiovascular risk profile would be anticipated to be the most aggressively treated, paradoxically, treatment and baseline risk are inversely related. Presumably, the elderly population would benefit from high‐intensity statin therapy; however, as per the 2013 American College of Cardiology/American Heart Association guidelines, given the scarcity of evidence in patients age>75, there are only sufficient data from randomized controlled trials to support use of mod...
Source: Clinical Cardiology - September 1, 2014 Category: Cardiology Authors: Kobina A. Wilmot, Abdullah Khan, Sandeep Krishnan, Danny J. Eapen, Laurence Sperling Tags: Reviews Source Type: research

Is High‐Intensity Statin Therapy Associated With Lower Statin Adherence Compared With Low‐ to Moderate‐Intensity Statin Therapy? Implications of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guidelines
ABSTRACT BackgroundThe recent cholesterol guideline recommends high‐intensity statins in cardiovascular disease (CVD) patients. High‐intensity statins are associated with more frequent side effects. Therefore, it may be of concern that these recommendations might reduce statin adherence. HypothesisHigh‐intensity statins are associated with lower adherence compared with low‐ to moderate‐intensity statins. MethodsIn a national database of 972 532 CVD patients from the Veterans Health Administration, we identified patients receiving statins between October 1, 2010, and September 30, 2011. We assessed statin a...
Source: Clinical Cardiology - September 1, 2014 Category: Cardiology Authors: Salim S. Virani, LeChauncy D. Woodard, Julia M. Akeroyd, David J. Ramsey, Christie M. Ballantyne, Laura A. Petersen Tags: Quality and Outcomes Source Type: research

Gender Differences in Coronary Artery Diameter Are Not Related to Body Habitus or Left Ventricular Mass
Abstract BackgroundSmaller coronary artery diameter portends worse outcomes after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The suggestion that women have smaller coronary artery diameters than men has not been validated by a large‐scale study. HypothesisWe sought to confirm a gender difference with respect to coronary artery diameter, even after accounting for body habitus and left ventricular mass (LVM). MethodsFrom 4200 subjects evaluated for cardiovascular disease by computed tomography angiography, we selected 710 subjects (383 males, 327 females) with coronary artery calcium (CAC) scores
Source: Clinical Cardiology - September 1, 2014 Category: Cardiology Authors: Amit K. Hiteshi, Dong Li, Yanlin Gao, Andy Chen, Ferdinand Flores, Song Shou Mao, Matthew J. Budoff Tags: Clinical Investigations Source Type: research

Authors' Reply
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2014 Category: Cardiology Authors: Germaine Loo, Chi‐Hang Lee, Junjie Zhang, Rishi Sethi, Ruogu Li, Luciano F. Drager, Hee‐Hwa Ho, Thet Hein, Man‐Hong Jim Tags: Letter to the Editor Source Type: research

Culprit Vessel Only vs Immediate Complete Revascularization in Patients With Acute ST‐Segment Elevation Myocardial Infarction: Systematic Review and Meta‐Analysis
The objective of this review was to determine the benefits and harms of culprit vessel only vs immediate complete percutaneous coronary intervention (PCI) in patients with acute STEMI. We searched MEDLINE, EMBASE, the Cochrane Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for randomized controlled trials (RCTs). Teams of 2 reviewers, independently and in duplicate, screened titles and abstracts, completed full‐text reviews, and abstracted data. We calculated pooled risk ratios (RRs) and associated 95% confidence intervals (CIs) using random‐effect models for no...
Source: Clinical Cardiology - September 1, 2014 Category: Cardiology Authors: Nigar Sekercioglu, Frederick A. Spencer, Luciane Cruz Lopes, Gordon H. Guyatt Tags: Reviews Source Type: research

Rosuvastatin Reduces Ischemia‐Reperfusion Injury in Patients With Acute Coronary Syndrome Treated With Percutaneous Coronary Intervention
ConclusionsRosuvastatin before PCI reduced ischemia‐reperfusion injury in patients with acute coronary syndrome, which suggests the importance of application of rosuvastatin before PCI for early intervention. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 25, 2014 Category: Cardiology Authors: Fangyong Jiang, Jin Yang, Linchao Zhang, Rongshan Li, Liuan Zhuo, Liping Sun, Qin Zhao Tags: Clinical Investigations Source Type: research

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis
Abstract Cardiac resynchronization therapy (CRT) is a well‐established therapy for patients with heart failure (HF) and wide QRS configuration, especially for those in sinus rhythm. However, for those with permanent AF, atrioventricular nodal (AVN) ablation use remains under debate. Our objective was to evaluate clinical outcomes and mortality of AVN ablation in HF patients with permanent AF receiving CRT. Electronic publication database and reference lists through October 1, 2013 were searched. Observational cohort studies comparing CRT patients with AF who received either AVN ablation or medical therapy were selected. ...
Source: Clinical Cardiology - August 25, 2014 Category: Cardiology Authors: Jie Yin, Hesheng Hu, Ye Wang, Mei Xue, Xiaolu Li, Wenjuan Cheng, Xinran Li, Suhua Yan Tags: Reviews Source Type: research

Rationale and Design of the Henry Ford ExercIse Testing Project (The FIT Project)
ABSTRACT Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population‐based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low‐cost, epidemiologic studies leveraging electronic medical record (EMR) data, we describe the rationale and design of the Henry Ford ExercIse Testing Project (The FIT Project). The FIT Project is unique in its combined use of directly measured clinical exercise data retrospective collection of medical history and medication treatment dat...
Source: Clinical Cardiology - August 19, 2014 Category: Cardiology Authors: Mouaz H. Al‐Mallah, Steven J. Keteyian, Clinton A. Brawner, Seamus Whelton, Michael J. Blaha Tags: Trial Designs Source Type: research

New Section Launched in Clinical Cardiology!
(Source: Clinical Cardiology)
Source: Clinical Cardiology - August 19, 2014 Category: Cardiology Authors: Deepak L. Bhatt Tags: Editorials Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - August 19, 2014 Category: Cardiology Tags: Issue Information Source Type: research

One‐Year Outcomes Associated With Using Observation Services in Triaging Patients With Nonspecific Chest Pain
ConclusionsPatients who had observation services had similar outcomes and 1‐year costs compared to patients admitted to inpatient wards. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 11, 2014 Category: Cardiology Authors: Ibrahim M. Abbass, Salim S. Virani, J. Michael Swint, Wenyaw Chan, Luisa Franzini Tags: Quality and Outcomes Source Type: research

The Ratio of High‐Density Lipoprotein Cholesterol to Apolipoprotein A‐I Predicts Myocardial Injury Following Elective Percutaneous Coronary Intervention
ConclusionsThere was a U‐shaped association between HDL‐C/apoA‐I ratio and myocardial injury following PCI. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 11, 2014 Category: Cardiology Authors: Xiao‐Lin Li, Jian‐Jun Li, Yuan‐Lin Guo, Cheng‐Gang Zhu, Ping Qing, Na‐Qiong Wu, Bo Xu, Run‐Lin Gao Tags: Clinical Investigation Source Type: research

Modern Obesity Pharmacotherapy: Weighing Cardiovascular Risk and Benefit
Abstract Obesity is a major correlate of cardiovascular disease. Weight loss improves cardiovascular risk factors and has the potential to improve outcomes. Two drugs, phentermine plus topiramate and lorcaserin, have recently been approved by the US Food and Drug Administration for the indication of obesity; a third, bupropion plus naltrexone, is under consideration for approval. In clinical trials, these drugs cause weight loss and improve glucose tolerance, lipid profile, and, with the exception of bupropion plus naltrexone, blood pressure. However, their effect on cardiovascular outcomes is unknown. In defining appropri...
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Jonathan W. Cunningham, Stephen D. Wiviott Tags: Reviews Source Type: research

Major Electrocardiographic Abnormalities and 25‐Hydroxy Vitamin D Deficiency: Insights from National Health and Nutrition Examination Survey‐III
ConclusionsVDD is associated with increased prevalence of major ECG abnormalities. Well‐structured trials are needed to assess progression/resolution of mECG abnormalities with vitamin D supplementation in deficient individuals. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Tushar A. Tuliani, Maithili Shenoy, Abhishek Deshmukh, Ankit Rathod, Sadip Pant, Apurva O. Badheka, Diane Levine, Luis Afonso Tags: Clinical Investigations Source Type: research

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature
ConclusionsCAG remains the gold standard for detection of CPFs. An adjuvant technique using MDCT provides full anatomical details of the fistulas. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Salah A. M. Said, Rogier L. G. Nijhuis, Jeroen W. op den Akker, Masaki Takechi, Riemer H. J. A. Slart, Johannes S. Bos, Caspar R. Hoorntje, K. Gert van Houwelingen, Mirjam Bakker‐de Boo, Richard L. Braam, Thijs M. W. J. Vet Tags: Clinical Investigations Source Type: research

Stroke and Bleeding Risk in Atrial Fibrillation: Navigating the Alphabet Soup of Risk‐Score Acronyms (CHADS2, CHA2DS2‐VASc, R2CHADS2, HAS‐BLED, ATRIA, and More)
ABSTRACT Stroke prevention is central to the management of patients with atrial fibrillation (AF). As effective stroke prophylaxis essentially requires oral anticoagulants, an understanding of the risks and benefits of oral anticoagulant therapy is needed. Although AF increases stroke risk 5‐fold, this risk is not homogeneous. Many stroke risk factors also confer an increased risk of bleeding. Various stroke and bleeding risk‐stratification schemes have been developed to help inform clinical decision‐making. These scores were derived and validated in different study cohorts, ranging from highly selected clinical‐tr...
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Mikhail S. Dzeshka, Deirdre A. Lane, Gregory Y. H. Lip Tags: Reviews Source Type: research

Outcome in Patients With Left‐Sided Native‐Valve Infective Endocarditis and Isolated Large Vegetations
ConclusionsSurgical treatment in patients with left‐sided native‐valve IE and isolated large vegetations without any other indication for surgery seems to be associated with excess mortality. A randomized controlled trial of surgery vs conservative treatment in this subset of patients is justified. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Steffen Desch, Anne Freund, Suzanne de Waha, Ingo Eitel, Philipp Lurz, Thomas Stiermaier, Georg Fuernau, Gerhard Schuler, Holger Thiele Tags: Clinical Investigations Source Type: research

Response to Impact of Obstructive Sleep Apnea on Cardiovascular Outcomes in Patients Treated With Percutaneous Coronary Intervention: Rationale and Design of the Sleep and Stent Study
Loo G et al. Clin Cardiol. 2014;37:261–269. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2014 Category: Cardiology Authors: Meltem Refiker Ege Tags: Letter to the Editor Source Type: research

Cardiac Repolarization Abnormalities Among Patients With Various Stages of Chronic Kidney Disease
This study aims to explore the relationship of cardiac repolarization in patients with CKD and worsening kidney function. HypothesisThere is cardiac repolarization abnormalities among patients with chronic kidney disease. MethodsThis was a retrospective, chart‐review study of admissions or clinic visits to a university hospital between 2005 and 2010 by patients with a diagnosis of CKD. Inclusion criteria selected patients who had 12‐lead surface electrocardiography (ECG), renal function tests within 24 hours, and transthoracic echocardiography within 6 months. Cases with a documented etiology for the corrected Qt (Qtc)...
Source: Clinical Cardiology - July 18, 2014 Category: Cardiology Authors: Khaled A. Sherif, Elsayed Abo‐Salem, Ragesh Panikkath, Musab Nusrat, Meryem Tuncel Tags: Clinical Investigation Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 18, 2014 Category: Cardiology Tags: Issue Information Source Type: research

Response to An Expanding Role of Biomarkers in Acute Aortic Syndromes
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 18, 2014 Category: Cardiology Authors: Fernando Cabrera‐Bueno, Maria Jesus Alvarez‐Cubero, Francisco Fernandez‐Rosado, Esther Martinez‐Espin, Carmen Entrala‐Bernal Tags: Letters to the Editor Source Type: research

The Relationship Between Revascularization Extent and the Long‐term Prognosis of Patients With Stable Angina Pectoris and Three‐Vessel Disease Treated by Percutaneous Coronary Intervention in the Era of Drug‐Eluting Stents
ABSTRACT BackgroundThe effects of revascularization extent (RE) on the long‐term prognosis of patients with stable angina pectoris and 3‐vessel disease who underwent percutaneous coronary intervention were unknown. HypothesisThe study was aimed at evaluating whether there was an effect of RE on patients presenting with stable angina pectoris and 3‐vessel disease. MethodsRE, which was calculated by baseline SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score minus residue SYNTAX score divided by baseline SYNTAX score, was initially used in our study. Five hundred fifty‐ei...
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Quan Li, Xianpeng Yu, Jiqiang He, Yuechun Gao, Xiaoling Zhang, Changyan Wu, Yawei Luo, Yuchen Zhang, Xuejun Ren, Shuzheng Lv, Fang Chen Tags: Clinical Investigations Source Type: research

Total Serum Transforming Growth Factor‐β1 Is Elevated in the Entire Spectrum of Genetic Aortic Syndromes
ConclusionstsTGF‐β1 is elevated in the entire spectrum of genetic aortic syndromes. However, gradual differences in the increases of tsTGF‐β1 levels may mirror different degrees of alteration of tsTGF‐β1 signaling in different genetic aortic syndromes. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Mathias Hillebrand, Nathalie Millot, Sara Sheikhzadeh, Meike Rybczynski, Sabine Gerth, Tilo Kölbel, Britta Keyser, Kerstin Kutsche, Peter N. Robinson, Jürgen Berger, Thomas S. Mir, Tanja Zeller, Stefan Blankenberg, Yskert von Kodolitsch, Britta Goldmann Tags: Clinical Investigations Source Type: research

Nonatherosclerotic Obstructive Vascular Diseases of the Mesenteric and Renal Arteries
Abstract Nonatherosclerotic vascular diseases of the mesenteric and renal arteries are considered to occur less frequently than those caused by occlusive atherosclerotic disease. However, when present, they pose a significant diagnostic and therapeutic challenge. Such disorders include fibromuscular dysplasia, median arcuate ligament syndrome, the renal nutcracker syndrome, and some forms of acute and chronic mesenteric ischemia (embolic and thrombotic). This is a heterogeneous group of disorders with substantial differences in the pathogenesis and diagnostic approaches to these diseases. We provide an overview of the path...
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Ricardo O. Escárcega, Moses Mathur, Joseph J. Franco, Mohamad Alkhouli, Chirdeep Patel, Kanwar Singh, Riyaz Bashir, Pravin Patil Tags: Reviews Source Type: research

Outcomes and Predictors of Mortality Among Octogenarians and Older With ST‐Segment Elevation Myocardial Infarction Treated With Primary Coronary Angioplasty
BackgroundElderly patients are at high risk of mortality when they present with ST‐elevation myocardial infarction (STEMI). However, few data exist about prognostic factors in this sub‐group when treated with primary percutaneous coronary intervention (pPCI). HypothesisTo assess outcome and predictors of mortality among patients aged>80 years treated with pPCI. MethodsWe evaluated 139 consecutive patients (age 85.1 ± 3.9 years, 43.2% males) who underwent pPCI for STEMI. ResultsMale patients were younger and were more likely to have a history of coronary artery disease. Overall 30...
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Giorgio Caretta, Enrico Passamonti, Paolo Nicola Pedroni, Bianca Maria Fadin, Gian Luca Galeazzi, Salvatore Pirelli Tags: Quality and Outcomes Source Type: research

Transfemoral Aortic Valve Implantation of Edwards SAPIEN XT Without Predilatation Is Feasible
ABSTRACT BackgroundTranscatheter aortic valve implantation (TAVI) without predilatation has fewer procedural steps and thereby potentially fewer complications. This has been demonstrated for the antegrade transapical access; however, whether TAVI can be safely performed without predilatation using the retrograde transfemoral route is unknown. HypothesisWe postulated that TAVI is feasible with a balloon‐expandable device without predilatation using the retrograde transfemoral route. MethodsTwenty‐six consecutive patients with stenosis of the native aortic valve (AV) undergoing transfemoral TAVI with the Edwards SAPIEN X...
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Helge Möllmann, Won‐Keun Kim, Jörg Kempfert, Johannes Blumenstein, Christoph Liebetrau, Holger Nef, Arnaud Van Linden, Thomas Walther, Christian Hamm Tags: Clinical Investigations Source Type: research

Outcomes Associated With Fractional Flow‐Guided Revascularization: A Meta‐analysis
Abstract BackgroundDeferral of revascularization for abnormal but nonischemic lesions is usually recommended; however, the long‐term outcome of this approach is not well known. HypothesisDeferral of nonischemic lesions will be associated with a low frequency of adverse events. MethodsA PubMed search of the MEDLINE database identified studies that reported clinical outcomes among patients who had fractional flow reserve‐guided revascularization. We further categorized studies into 2 subgroups: left main and non–left main coronary artery lesions. Baseline demographics and clinical outcome data were extracted by 3 i...
Source: Clinical Cardiology - July 1, 2014 Category: Cardiology Authors: Anthony A. Bavry, Islam Y. Elgendy, John W. Petersen Tags: Clinical Investigation Source Type: research

Erratum
(Source: Clinical Cardiology)
Source: Clinical Cardiology - June 13, 2014 Category: Cardiology Tags: Erratum Source Type: research