Effects of Cardiac Rehabilitation in Diabetic Patients: Both Cardiac and Noncardiac Factors Determine Improvement in Exercise Capacity
Abstract BackgroundDiabetic patients have a worse prognosis than nondiabetic patients after myocardial infarction. Although exercise improves risk factors, exercise capacity, and mortality, it is still unclear if these benefits are the same as in nondiabetics. Furthermore, although exercise tolerance is predicted by systolic and diastolic dysfunction in nondiabetics, its role as a predictor of exercise capacity in diabetics remains unclear. HypothesisDiabetics and nondiabetics see a similar improvement in their cardiac risk factors and exercise parameters from exercise‐based cardiac rehabilitation (CR). MethodsA series o...
Source: Clinical Cardiology - January 22, 2014 Category: Cardiology Authors: Mitchell St. Clair, Hardik Mehta, Matthew Sacrinty, Dominic Johnson, Killian Robinson Tags: Clinical Investigation Source Type: research

Quality of Care for Patients With Acute Coronary Syndromes as a Function of Hospital Revascularization Capability: Insights From Get With The Guidelines‐CAD
This study included 95 999 acute coronary syndrome patients admitted to 310 GWTG‐CAD hospitals. There were 89 000 patients admitted to 226 revascularization‐capable hospitals and 6999 patients admitted to 84 hospitals without revascularization capability included. Adjusted multivariate analysis demonstrated that 8 of the 19 measures were more frequently performed in the revascularization cohort: aspirin (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.04‐1.92), clopidogrel (OR: 2.31, 95% CI: 1.78‐3.00), lipid‐lowering therapies at discharge (OR: 1.39, 95% CI: 1.04‐1.87), lipid‐lowering th...
Source: Clinical Cardiology - January 22, 2014 Category: Cardiology Authors: Arun K. Thukkani, Gregg C. Fonarow, Christopher P. Cannon, Margueritte Cox, Adrian F. Hernandez, Eric D. Peterson, W. Frank Peacock, Warren K. Laskey, Lee H. Schwamm, Deepak L. Bhatt, Tags: Clinical Investigation Source Type: research

New Antithrombotics for Secondary Prevention of Acute Coronary Syndrome
This study was terminated early in patients with prior stroke owing to excess ICH, though an increased risk of ICH or fatal bleeding was not detected in patients with prior myocardial infarction. The Apixaban for Prevention of Acute Ischemic and Safety Events 2 (APPRAISE‐2) trial of standard‐dose apixaban added to standard care in patients with ACS was also stopped early owing to excess serious bleeding. However, in Rivaroxaban in Combination With Aspirin Alone or With Aspirin and a Thienopyridine in Patients With Acute Coronary Syndromes (ATLAS ACS 2 TIMI 51), fatal bleeding or fatal ICH did not increase with low‐do...
Source: Clinical Cardiology - January 22, 2014 Category: Cardiology Authors: Shinya Goto, Aiko Tomita Tags: Review Source Type: research

Clinical Implications and Correlates of Q Waves in Patients With ST‐Elevation Myocardial Infarction Treated With Fibrinolysis: Observations from the CLARITY‐TIMI 28 Trial
ConclusionsAmong STEMI patients treated with fibrinolysis, evaluating for Q waves prior to discharge is a simple method of assessing for less successful reperfusion and an increased risk of adverse 30‐day cardiovascular outcomes. The combination of Q waves and 90‐minute STRes allows additional risk refinement. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 22, 2014 Category: Cardiology Authors: Jonathan W. Waks, Marc S. Sabatine, Christopher P. Cannon, David A. Morrow, C. Michael Gibson, Stephen D. Wiviott, Robert P. Giugliano, Sarah Sloan, Benjamin M. Scirica Tags: Clinical Investigation Source Type: research

Prehospital Telemedicine Electrocardiogram Triage for a Regional Public Emergency Medical Service: Is It Worth It? A Preliminary Cost Analysis
ConclusionsPrehospital EMS triage with telemedicine ECG in patients with suspected acute cardiac disease may reduce health‐care costs. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 22, 2014 Category: Cardiology Authors: Natale Daniele Brunetti, Giulia Dellegrottaglie, Claudio Lopriore, Giuseppe Di Giuseppe, Luisa De Gennaro, Saverio Lanzone, Matteo Di Biase Tags: Quality and Outcome Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - January 13, 2014 Category: Cardiology Tags: Issue Information Source Type: research

Prognostic Role of Incidental Pleural Effusion Diagnosed During Echocardiographic Evaluation
Abstract BackgroundThe purpose of this study was to determine the long‐term prognostic implications of incidental pleural effusion (PE) detected during echocardiographic examination and its relationship with concomitant diseases. HypothesisThe study hypothesis is to test whether incidental pleural PE detected during echocardiographic examination be used as a prognostic marker. MethodsThe study was performed by evaluating patient records (N = 251) in whom PE was incidentally detected during echocardiographic examination in a tertiary hospital between 1999 and 2012. The patients were classified into 4 major g...
Source: Clinical Cardiology - January 7, 2014 Category: Cardiology Authors: Suleyman Ercan, Vedat Davutoglu, Gokhan Altunbas, Ibrahim Halil Inanc, Mehmet Kaplan, Muhammed Oylumlu, Ibrahim Koç, Murat Yuce, Orhan Ozer, Serdar Soydinc Tags: Clinical Investigations Source Type: research

Coronary Arterial Development: A Review of Normal and Congenitally Anomalous Patterns
Abstract Coronary artery development is a delicate, complex, and finely tuned process that includes multiple interactions among many pathways, especially in the pericardium and the developing myocardium. There still exists some controversy on the exact origin of certain cellular components. Nevertheless, an understanding of this extremely important developmental process is paramount in identifying some of the causes of anomalous coronary development. There are different patterns of anomalous coronary arteries, with variable risk of myocardial ischemia, malignant arrhythmias, and sudden cardiac death. These anomalies can be...
Source: Clinical Cardiology - January 7, 2014 Category: Cardiology Authors: Gentian Lluri, Jamil Aboulhosn Tags: Review Source Type: research

Independent Effects of Body Fat and Inflammatory Markers on Ventricular Geometry, Midwall Function, and Atrial Remodeling
Abstract BackgroundThe effect of body fat distribution on left ventricular (LV) mass and geometry has been recently recognized. However, data regarding circulating inflammatory markers in relation to regional visceral fat deposits, which are metabolically active tissues that can impact cardiac structural remodeling, remain sparse. HypothesisWe hypothesized that obesity has adverse effects on cardiac function and structure. MethodsWe consecutively studied 1071 asymptomatic subjects (age 49.5 ± 10.5 years, 39.4% female) free from significant valvular disorders, chronic lung disease, or renal disease. Echocardiography...
Source: Clinical Cardiology - January 7, 2014 Category: Cardiology Authors: Yau‐Huei Lai, Chuan‐Chuan Liu, Jen‐Yuan Kuo, Ta‐Chuan Hung, Yih‐Jer Wu, Hung‐I Yeh, Bernard E. Bulwer, Chung‐Lieh Hung Tags: Clinical Investigations Source Type: research

Doppler‐Detected Valve Movement in Aortic Stenosis: A Predictor of Adverse Outcome
Abstract BackgroundThe absence of auscultatory aortic valve closure sound is associated with severe aortic stenosis. The absence of Doppler‐derived aortic opening (Aop) or closing (Acl) may be a sign of advanced severe aortic stenosis. HypothesisAbsent Doppler‐detected Aop or Acl transient is indicative of very severe aortic stenosis and is associated with adverse outcome. MethodsA total of 118 consecutive patients with moderate (n = 63) or severe aortic stenosis (n = 55) were included. Aop and Acl signals were identified in a blinded fashion by continuous‐wave Doppler. Patients with and w...
Source: Clinical Cardiology - January 7, 2014 Category: Cardiology Authors: Xiushui Ren, Nader M. Banki, Richard E. Shaw, Edward J. McNulty, Sherry C. Williams, Michael Pencina, Nelson B. Schiller Tags: Clinical Investigations Source Type: research

Catheterization Therapy vs Surgical Closure in Pediatric Patients With Patent Ductus Arteriosus: A Meta‐Analysis
ConclusionsCatheterization therapy in pediatric PDA patients did not show a significant advantage in primary success rate, total complications, or blood transfusion, but it was associated with increase in residual shunts and reduction in length of hospital stay. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 6, 2014 Category: Cardiology Authors: Kai Wang, Xuanren Pan, Qiaoyun Tang, Yusheng Pang Tags: Review Source Type: research

Recurrence of Left Ventricular Dysfunction in Patients With Restored Idiopathic Dilated Cardiomyopathy
ConclusionsThe recurrence of LV dysfunction was significantly correlated with age, presence of diabetes, and LVEDD at initial presentation. Clinicians should consider maintenance of intensive care to patients who recovered from DCM with these factors. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 1, 2014 Category: Cardiology Authors: Jin‐Sun Park, Jin‐Woo Kim, Kyoung‐Woo Seo, Byoung‐Joo Choi, So‐Yeon Choi, Myeong‐Ho Yoon, Gyo‐Seung Hwang, Seung‐Jea Tahk, Joon‐Han Shin Tags: Clinical Investigation Source Type: research

Rationale and Design of LAPLACE‐2: A Phase 3, Randomized, Double‐Blind, Placebo‐ and Ezetimibe‐Controlled Trial Evaluating the Efficacy and Safety of Evolocumab in Subjects With Hypercholesterolemia on Background Statin Therapy
This study will also provide comparative efficacy, safety, and tolerability data between evolocumab and ezetimibe when added to background atorvastatin therapy. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 1, 2014 Category: Cardiology Authors: Jennifer G. Robinson, William J. Rogers, Bettina S. Nedergaard, Jonathan Fialkow, Joel M. Neutel, David Ramstad, Ransi Somaratne, Jason C. Legg, Patric Nelson, Rob Scott, Scott M. Wasserman, Robert Weiss Tags: Trial Designs Source Type: research

Resistant Hypertension Optimal Treatment Trial: A Randomized Controlled Trial
Abstract The prevalence of resistant hypertension (ReHy) is not well established. Furthermore, diuretics, angiotensin‐converting enzyme inhibitors or angiotensin‐receptor blockers, and calcium channel blockers are largely used as the first 3‐drug combinations for treating ReHy. However, the fourth drug to be added to the triple regimen is still controversial and guided by empirical choices. We sought (1) to determine the prevalence of ReHy in patients with stage II hypertension; (2) to compare the effects of spironolactone vs clonidine, when added to the triple regimen; and (3) to evaluate the role of measuring sympa...
Source: Clinical Cardiology - December 11, 2013 Category: Cardiology Tags: Trial Designs Source Type: research

Erratum
(Source: Clinical Cardiology)
Source: Clinical Cardiology - December 6, 2013 Category: Cardiology Tags: Erratum Source Type: research

Utilization Patterns of Single‐Photon Emission Cardiac Tomography Myocardial Perfusion Imaging Studies in a Rural Tertiary Care Setting
ConclusionsWe found that a majority of MPI studies are performed for appropriate indications regardless of ordering provider specialty. Few common scenarios accounted for the majority of the inappropriate or uncertain studies. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 1, 2013 Category: Cardiology Authors: Maninder Singh, Zaruhi Babayan, Kishore J. Harjai, Paras Dedhia, Sudhakar Sattur, Dinesh H. Jagasia Tags: Quality and Outcomes Source Type: research

Management of Postoperative Atrial Fibrillation and Subsequent Outcomes in Contemporary Patients Undergoing Cardiac Surgery: Insights From the Society of Thoracic Surgeons CAPS‐Care Atrial Fibrillation Registry
Abstract BackgroundPostoperative atrial fibrillation (POAF) is a well‐recognized complication of cardiac surgery; however, its management remains a challenge, and the implementation and outcomes of various strategies in clinical practice remain unclear. HypothesisWe hypothesize that treatment for POAF is variable, and that it is associated with particular morbidity and mortality following cardiac surgery. MethodsWe compared patient characteristics, operative procedures, postoperative management, and outcomes between patients with and without POAF following coronary artery bypass grafting (CABG) in the Society of Thoracic...
Source: Clinical Cardiology - December 1, 2013 Category: Cardiology Authors: Benjamin A. Steinberg, Yue Zhao, Xia He, Adrian F. Hernandez, David A. Fullerton, Kevin L. Thomas, Roger Mills, Winslow Klaskala, Eric D. Peterson, Jonathan P. Piccini Tags: Quality and Outcomes Source Type: research

Combined Use of Warfarin and Oral P2Y12 Inhibitors in Patients With Atrial Fibrillation and Acute Coronary Syndrome
ConclusionsAmong Medicare beneficiaries with AF and ACS, combination therapy with warfarin and P2Y12 inhibitor was uncommon during the 90‐day ascertainment period, and more than one‐quarter of patients had no claims for warfarin or P2Y12 inhibitors. Rates of all‐cause readmission and mortality within 1 year of hospitalization for ACS were high. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 1, 2013 Category: Cardiology Authors: W. Schuyler Jones, Xiaojuan Mi, Manesh R. Patel, Roger Mills, Adrian F. Hernandez, Lesley H. Curtis Tags: Clinical Investigation Source Type: research

Evolving Antithrombotic Strategies in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: Results From a Survey Among US Cardiologists
ConclusionsThe survey highlights an interest in the new strategy of dropping aspirin, but the lack of concrete evidence triggers undesired diversity in clinical approaches. High‐quality data on the efficacy and safety of such interventions are needed to further consolidate these approaches. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 25, 2013 Category: Cardiology Authors: Moshe Vardi, Marcella Debidda, Deepak L. Bhatt, Laura Mauri, Christopher P. Cannon Tags: Clinical Investigation Source Type: research

The Effects of Continuous Positive Airways Pressure Therapy on Cardiovascular End Points in Patients With Sleep‐Disordered Breathing and Heart Failure: A Meta‐Analysis of Randomized Controlled Trials
Abstract In patients with sleep‐disordered breathing and heart failure, continuous positive airway pressure has been found to be associated with an improvement in cardiovascular end points. We conducted a systematic review of the current literature and a meta‐analysis to pool data from 15 published randomized controlled trials. End points analyzed were left ventricular ejection fraction, diastolic blood pressure, systolic blood pressure, heart rate, and mortality. A fixed effects model was used for end points demonstrating homogeneity among included studies, whereas a random effects model was used for end points demons...
Source: Clinical Cardiology - November 25, 2013 Category: Cardiology Authors: Saurabh Aggarwal, Rashid Nadeem, Rohit S. Loomba, Mahwish Nida, Dorice Vieira Tags: Reviews Source Type: research

Practical Considerations for Using Novel Oral Anticoagulants in Patients With Atrial Fibrillation
Abstract Novel oral anticoagulants, including dabigatran, rivaroxaban, and apixaban, represent new options for preventing stroke in patients with atrial fibrillation, as shown by the results from large, randomized phase III trials. Because of their greater specificity, rapid onset of action, and predictable pharmacokinetics, the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) address several limitations of warfarin or other vitamin K antagonists in day‐to‐day clinical practice. However, a range of practical questions relating to the novel oral anticoagulants has emerged, including topics such as patie...
Source: Clinical Cardiology - November 19, 2013 Category: Cardiology Authors: Irene Savelieva, A. John Camm Tags: Review Source Type: research

Retraction
(Source: Clinical Cardiology)
Source: Clinical Cardiology - November 11, 2013 Category: Cardiology Tags: Retraction Source Type: research

Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study: Objectives, Methods, and Cohort Description
ConclusionsThe MASALA study will provide novel data on the prevalence and associations of cardiovascular risk factors and subclinical atherosclerosis in South Asians living in the United States. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 5, 2013 Category: Cardiology Authors: Alka M. Kanaya, Namratha Kandula, David Herrington, Matthew J. Budoff, Stephen Hulley, Eric Vittinghoff, Kiang Liu Tags: Trial Design Source Type: research

Familial Hypercholesterolemia: An Under‐recognized but Significant Concern in Cardiology Practice
Familial hypercholesterolemia (FH) is a common disorder in which genetic mutations in at least 1 of several genes lead to significantly increased levels of lipoproteins, in particular, low‐density lipoprotein cholesterol. Most commonly, mutations in the low‐density lipoprotein receptor gene result in high plasma levels of apolipoprotein B‐containing lipoproteins (eg, low‐density lipoprotein and lipoprotein(a)). High plasma levels of lipoproteins increase the risk of cardiovascular events by as much as 20‐fold if left untreated. A 2011 survey of cardiologists performed by the American College of Cardiology (ACC) s...
Source: Clinical Cardiology - November 5, 2013 Category: Cardiology Authors: JoAnne M. Foody Tags: Review Source Type: research

Addition of N‐Acetyl Cysteine to Carvedilol Decreases the Incidence of Acute Renal Injury After Cardiac Surgery
ConclusionsCombined carvedilol and NAC decreased ARI incidence as compared with carvedilol or metoprolol. No difference was detected between carvedilol and metoprolol. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2013 Category: Cardiology Authors: Mehmet Ozaydin, Tulay Peker, Selahaddin Akcay, Bayram A. Uysal, Habil Yucel, Atilla Icli, Dogan Erdogan, Ercan Varol, Abdullah Dogan, Huseyin Okutan Tags: Clinical Investigation Source Type: research

Impact of Clinical Predictors and Routine Coronary Artery Disease Testing on Outcome of Patients Admitted to Chest Pain Decision Unit
ConclusionsClinical risk stratification allows identification of patients at low risk of adverse outcome over an intermediate period of follow‐up. Noninvasive testing is not warranted in such patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2013 Category: Cardiology Authors: Vlad Cotarlan, David Ho, John Pineda, Anwer Qureshi, Jamshid Shirani Tags: Clinical Investigation Source Type: research

Response to Reduced Diurnal Variation of Heart Rate Is Associated With Increased Plasma B‐Type Natriuretic Peptide Level in Patients With Atrial Fibrillation
Kamikawa S et al. Clin Cardiol. 2013;36:394–400 (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 17, 2013 Category: Cardiology Authors: Emre Yalcinkaya, Murat Celik, Erkan Yildirim, Salim Yasar, Baris Bugan Tags: Letters to the Editor Source Type: research

Lower Admission Hemoglobin Levels Are Associated With Longer Symptom Duration in Acute ST‐Elevation Myocardial Infarction
Abstract BackgroundAn acute‐phase response in patients with acute myocardial infarction could contribute to the development of anemia. HypothesisAn association may exist between symptom duration, hemoglobin (Hb) concentration and serum C‐reactive protein (CRP) values in patients presenting to an emergency department (ED) with acute ST‐segment elevation myocardial infarction (STEMI). MethodsA retrospective analysis was conducted on consecutive male STEMI patients who were admitted to our medical center's ED from January 2008 to November 2012 and had presented within the first 12 hours after the onset of chest pain. He...
Source: Clinical Cardiology - October 7, 2013 Category: Cardiology Authors: Yacov Shacham, Eran Leshem‐Rubinow, Eyal Ben‐Assa, Arie Roth, Arie Steinvil Tags: Clinical Investigation Source Type: research

Safe‐Dose Thrombolysis Plus Rivaroxaban for Moderate and Severe Pulmonary Embolism: Drip, Drug, and Discharge
Abstract BackgroundThrombolysis, though very effective, has not been embraced as routine therapy for symptomatic pulmonary embolism (PE) except in very severe cases. Rivaroxaban recently has been approved for the treatment of venous thromboembolism (VTE). There are no data on the combined use of thrombolysis and rivaroxaban in PE. Hypothesis“Safe dose” thrombolysis (SDT) plus new oral anticoagulants are expected to become an appealing, safe and effective approach in the treatment of moderate and severe PE in the near future, thereby drastically reducing hospitalization time. MethodsOver a 12‐month period, 98 ...
Source: Clinical Cardiology - October 7, 2013 Category: Cardiology Authors: Mohsen Sharifi, Curt Bay, Frederic Schwartz, Laura Skrocki Tags: Clinical Investigation Source Type: research

Impact of Atherosclerosis Detection by Carotid Ultrasound on Physician Behavior and Risk‐Factor Management in Asymptomatic Hypertensive Subjects
BackgroundThere are limited data regarding the impact of atherosclerosis detection by carotid ultrasound (CUS) on physician prevention efforts and risk‐factor management for cardiovascular disease. HypothesisAtherosclerosis detection by CUS in asymptomatic hypertensive patients would lead to physician prevention efforts, including target low‐density lipoprotein cholesterol (LDL‐C) level and prescription. Also, it may improve risk‐factor management. MethodsA total of 347 asymptomatic hypertensive subjects (age 61 ± 8 years, 189 men) were prospectively recruited from 22 hospitals. Prior to CUS, physicians were...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Sung‐Jin Hong, Hyuk‐Jae Chang, Kijun Song, Geu‐Ru Hong, Seung Woo Park, Hyun‐Jae Kang, Eung Ju Kim, Dong‐Soo Kim, Myung‐Ho Jeong Tags: Clinical Investigation Source Type: research

Therapeutic Hypothermia‐Induced Electrocardiographic Changes and Relations to In‐hospital Mortality
BackgroundTherapeutic hypothermia improves survival for selected patients who remain comatose after cardiac arrest. Hypothermia triggers changes in electrocardiographic (ECG) parameters; however, the association of these changes to in‐hospital mortality remains unclear. HypothesisQT interval changes induced by therapeutic hypothermia are not associated with in‐hospital mortality. MethodsWe retrospectively compared precooling ECG parameters to ECG parameters during hypothermia on all consecutive patients with available information who received hypothermia at our academic medical center between December 2006 and July 201...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: David H. Lam, Ravi Dhingra, Sheila M. Conley, Alan T. Kono Tags: Clinical Investigation Source Type: research

Aortic Stiffness Is Associated With Left Ventricular Diastolic Dysfunction in Systemic Lupus Erythematosus: A Controlled Transesophageal Echocardiographic Study
Abstract BackgroundAortic stiffness and left ventricular (LV) diastolic dysfunction are common and associated with increased morbidity and mortality in systemic lupus erythematosus (SLE). HypothesisIn SLE, aortic stiffness and LV diastolic dysfunction may be associated. MethodsThis 6‐year‐duration, cross‐sectional, and controlled study was conducted in 76 SLE patients (69 women; mean age, 37 ± 12 years) and 26 age‐ and sex‐matched healthy controls. All subjects underwent clinical and laboratory evaluations and transesophageal echocardiography (TEE) to assess LV diastolic function and stiffnes...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Carlos A. Roldan, Ihab B. Alomari, Khaled Awad, Nathan M. Boyer, Clifford R. Qualls, Ernest R. Greene, Wilmer L. Sibbitt Jr Tags: Clinical Investigation Source Type: research

Predictors of Long‐term Adherence to Evidence‐based Cardiovascular Disease Medications in Outpatients With Stable Atherothrombotic Disease: Findings From the REACH Registry
ConclusionsUsing a large international registry of outpatients with atherothrombotic disease, we found that age, region, race/ethnicity, and incident cardiovascular events were predictive of long‐term guideline adherence for secondary prevention, suggesting that certain patient groups may benefit from targeted interventions to improve adherence. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Fátima Rodriguez, Christopher P. Cannon, Ph. Gabriel Steg, Dharam J. Kumbhani, Shinya Goto, Sidney C. Smith, Kim A. Eagle, E. Magnus Ohman, Amarachi A. Umez‐Eronini, Elaine Hoffman, Deepak L. Bhatt, Tags: Quality and Outcome Source Type: research

Response to Fibromuscular Dysplasia Affecting a Two‐Branched Renal Artery in a Patient With a Solitary Kidney: Case Presentation
An et al. Clin Cardiol. 2013;36:E7–E10. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Antonio Bozzani, Alessia Moia, Marianna Carlino, Marco Caldana, Franco Ragni Tags: Letters to the Editor Source Type: research

Impact of Frailty and Functional Status on Outcomes in Elderly Patients With ST‐Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Rationale and Design of the IFFANIAM Study
Abstract The IFFANIAM study (Impact of frailty and functional status in elderly patients with ST segment elevation myocardial infarction undergoing primary angioplasty) is an observational multicenter registry to assess the impact of frailty and functional status on outcomes of elderly patients with ST‐segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. STEMI patients age 75 years or older undergoing primary angioplasty will be extensively studied during admission in 4 tertiary care Hospitals in Spain, assessing their baseline functional status (Barthel index, Lawton‐Brody index), frailty (F...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Albert Ariza‐Solé, Francesc Formiga, Maria T. Vidán, Héctor Bueno, Antoni Curós, Jaime Aboal, Cinta Llibre, Ferran Rueda, Eva Bernal, Angel Cequier Tags: Trial Design Source Type: research

Postdischarge International Normalized Ratio Testing and Long‐term Clinical Outcomes of Patients With Heart Failure Receiving Warfarin: Findings From the ADHERE Registry Linked to Medicare Claims
Abstract BackgroundEffective warfarin thromboprophylaxis requires maintaining anticoagulation within the recommended international normalized ratio (INR) range. INR testing rates and associations between testing and outcomes are not well understood. HypothesisINR testing rates after hospitalization for acute decompensated heart failure are suboptimal, and testing is associated with lower risks of mortality and adverse clinical events. MethodsWe conducted a retrospective cohort study of patients who were long‐term warfarin users and were hospitalized for heart failure, had a medical history of atrial fibrillation or valvu...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Laura G. Qualls, Melissa A. Greiner, Zubin J. Eapen, Gregg C. Fonarow, Roger M. Mills, Winslow Klaskala, Adrian F. Hernandez, Lesley H. Curtis Tags: Clinical Investigation Source Type: research

Very Large Database of Lipids: Rationale and Design
Abstract Blood lipids have major cardiovascular and public health implications. Lipid‐lowering drugs are prescribed based in part on categorization of patients into normal or abnormal lipid metabolism, yet relatively little emphasis has been placed on: (1) the accuracy of current lipid measures used in clinical practice, (2) the reliability of current categorizations of dyslipidemia states, and (3) the relationship of advanced lipid characterization to other cardiovascular disease biomarkers. To these ends, we developed the Very Large Database of Lipids (NCT01698489), an ongoing database protocol that harnesses deidentif...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Seth S. Martin, Michael J. Blaha, Peter P. Toth, Parag H. Joshi, John W. McEvoy, Haitham M. Ahmed, Mohamed B. Elshazly, Kristopher J. Swiger, Erin D. Michos, Peter O. Kwiterovich, Krishnaji R. Kulkarni, Joseph Chimera, Christopher P. Cannon, Roger S. Blum Tags: Trial Design Source Type: research

Projected Costs and Consequences of Computed Tomography‐Determined Fractional Flow Reserve
ConclusionsA strategy of using FFRCT to guide the selection of patients for ICA and PCI might reduce costs and improve clinical outcomes in patients with suspected coronary artery disease. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Mark A. Hlatky, Akshay Saxena, Bon‐Kwon Koo, Andrejs Erglis, Christopher K. Zarins, James K. Min Tags: Clinical Investigation Source Type: research

Adiponectin Levels Are Elevated in Patients With Pulmonary Arterial Hypertension
Abstract BackgroundIn addition to insulin‐sensitizing effects, adiponectin influences several mechanisms involved in pulmonary arterial hypertension (PAH) pathobiology. Insulin resistance has been associated with PAH, and elevated adiponectin levels have been described in left heart failure (HF) as a response to the increased metabolic stress. No studies have been performed in right HF or PAH patients. HypothesisCompared to healthy controls, PAH patients have a different plasma adipocytokine profile, higher insulin resistance, and higher inflammatory systemic activation. MethodsA case–control study was conducted in...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Mário Santos, Abílio Reis, Fabienne Gonçalves, Manuel J. Ferreira‐Pinto, Sofia Cabral, Severo Torres, Adelino F. Leite‐Moreira, Tiago Henriques‐Coelho Tags: Clinical Investigation Source Type: research

Comparison of Bivalirudin Versus Heparin(s) During Percutaneous Coronary Interventions in Patients Receiving Prasugrel: A Propensity‐Matched Study
Abstract BackgroundSeveral percutaneous coronary intervention (PCI) trials have established that the use of bivalirudin (BIV) is associated with improved patient outcomes and substantial hospital cost savings, relative to heparin (HEP)‐based regimens ± glycoprotein IIb/IIIa inhibitors (GPIs). Whether these benefits persist with the use of prasugrel, a new third‐generation oral thienopyridine, has not been previously evaluated. MethodsUsing the Premier hospital database, 6986 patients treated with prasugrel who underwent elective, urgent, or primary PCI between quarter 3, 2009 and quarter 4, 2010 from 166 US hosp...
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Martial Hamon, Laurent Bonello, Steven Marso, Sunil V. Rao, Marco Valgimigli, Freek Verheugt, Anthony Gershlick, Yamei Wang, Jayne Prats, Gabriel P. Steg, Efthymios Deliargyris Tags: Clinical Investigation Source Type: research

Pharmacogenetics in Cardiovascular Disease: The Challenge of Moving From Promise to Realization
Abstract Pharmacogenetics in cardiovascular medicine brings the potential for personalized therapeutic strategies that improve efficacy and reduce harm. Studies evaluating the impact of genetic variation on pharmacologic effects have been undertaken for most major cardiovascular drugs, including antithrombotic agents, β‐adrenergic receptor blockers, statins, and angiotensin‐converting enzyme inhibitors. Across these drug classes, many polymorphisms associated with pharmacodynamic, pharmacokinetic, or surrogate outcomes have been identified. However, their impact on clinical outcomes and their ability to improve cl...
Source: Clinical Cardiology - September 17, 2013 Category: Cardiology Authors: Philip G. Joseph, Guillaume Pare, Stephanie Ross, Robert Roberts, Sonia S. Anand Tags: Review Source Type: research

Heart Failure in Patients With Atrial Fibrillation Is Associated With a High Symptom and Hospitalization Burden: The RealiseAF Survey
Abstract BackgroundAtrial fibrillation (AF) and heart failure (HF) often coexist; the consequences of such coexistence are unclear. HypothesisHF in patients with AF is associated with poor outcomes. MethodsThis post hoc analysis of RealiseAF, a survey of AF patients, compared symptoms, hospitalizations, management, and AF control in patients with vs without HF. A total of 10,523 AF patients were analyzed according to presence/absence of HF. ResultsHistory of HF was present in 45.8%, and in more patients with permanent vs persistent, paroxysmal, or first‐episode AF (55.6%, 44.3%, 32.9%, and 29.8%, respectively; P 
Source: Clinical Cardiology - September 17, 2013 Category: Cardiology Authors: José Silva‐Cardoso, Oleg J. Zharinov, Piotr Ponikowski, Lisa Naditch‐Brûlé, Thorsten Lewalter, Sandrine Brette, P. Gabriel Steg, Tags: Clinical Investigations Source Type: research

Have We Given Up on Intra‐aortic Balloon Counterpulsation in Post–Myocardial Infarction Cardiogenic Shock?
Abstract The recently published Intra‐aortic Balloon Pump in Cardiogenic Shock II (IABP‐SHOCK II) trial concluded that intra‐aortic counterpulsation (IACP) does not reduce 30‐day mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI) for whom early revascularization strategy was planned. The study resulted in downgrading IACP in post‐AMI CS patients by certain professional organizations like the European Society of Cardiology. Although this is the largest and most important CS study of this decade, it suffers from considerable shortcomings: (1) time intervals from chest...
Source: Clinical Cardiology - September 17, 2013 Category: Cardiology Authors: Subasit Acharji, Atish Mathur, Umashankar Lakshmanadoss, Hari Prasad, Maninder Singh, Edo Kaluski Tags: Commentary Source Type: research

Gender‐Related Safety and Efficacy of Cardiac Resynchronization Therapy
Abstract BackgroundCardiac resynchronization therapy (CRT) is an established therapy for patients with chronic heart failure (CHF) and a broad QRS complex. Gender‐related safety and efficacy data are necessary for informed patient decision‐making for female patients with CHF. The aim of the study was to assess the effects of gender on the outcome of CRT in highly symptomatic heart failure patients. HypothesisGender may have an effect on the outcome of heart failure patients undergoing cardiac resynchronisation therapy. MethodsThe study analyzed the 2‐year follow‐up of 393 New York Heart Association (NYHA) class III...
Source: Clinical Cardiology - September 17, 2013 Category: Cardiology Authors: Andreas Schuchert, Carmine Muto, Themistoklis Maounis, Robert Frank, Rita Omega Ella, Alexander Polauck, Luigi Padeletti, Tags: Clinical Investigation Source Type: research

Significance of Aortic Valve Calcification in Patients With Low‐Gradient Low‐Flow Aortic Stenosis
Abstract BackgroundAssessment of patients with aortic stenosis (AS) and impaired left ventricular function remains challenging. Aortic valve calcium (AVC) scoring with computed tomography (CT) and fluoroscopy has been proposed as means of diagnosing and predicting outcomes in patients with severe AS. HypothesisSeverity of aortic valve calcification correlates with the diagnosis of true severe AS and outcomes in patients with low‐gradient low‐flow AS. MethodsEchocardiography and CT database records from January 1, 2000 to September 26, 2009 were reviewed. Patients with aortic valve area (AVA) 
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Olcay Aksoy, Akin Cam, Shikhar Agarwal, Mobolaji Ige, Rayan Yousefzai, Dhssraj Singh, Brian P. Griffin, Paul Schoenhagen, Samir R. Kapadia, Murat E. Tuzcu Tags: Clinical Investigation Source Type: research

Associations Between Sleep Duration and Prevalence of Cardiovascular Events
Abstract BackgroundData regarding the associations between sleep duration and clinical cardiovascular (CV) events are limited. We aimed to analyze any associations between self‐reported sleep duration and CV events. Hypothesis MethodsThis is a cross‐sectional analysis of nationally representative population of noninstitutionalized US civilians recruited in the 2007 to 2008 National Health and Nutrition Examination Survey. This is a questionnaire‐based study including only those subjects who answered questions on sleep duration and CV events. The main outcome measures were prevalence of congestive heart failure, myoca...
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Saurabh Aggarwal, Rohit Seth Loomba, Rohit Romesh Arora, Janos Molnar Tags: Clinical Investigation Source Type: research

Relationship of Race/Ethnicity With Door‐to‐Balloon Time and Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Elevation Myocardial Infarction: Findings From Get With the Guidelines–Coronary Artery Disease
ConclusionsIn GWTG‐Coronary Artery Disease, small differences in DTB times persist among different races/ethnicities. However, the proportion achieving DTB times ≤90 minutes has increased substantially for all patients over time, and there was no association between race/ethnicity and in‐hospital mortality. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Matthew A. Cavender, Andrew N. Rassi, Gregg C. Fonarow, Christopher P. Cannon, W. Frank Peacock, Warren K. Laskey, Adrian F. Hernandez, Eric D. Peterson, Margueritte Cox, Marie Grau‐Sepulveda, Lee H. Schwamm, Deepak L. Bhatt Tags: Clinical Investigation Source Type: research

Remote Monitoring of Implantable Pacemakers: In‐Office Setup Significantly Improves Successful Data Transmission
Abstract BackgroundRemote wireless follow‐up of implanted pacemakers (PM) has become an attractive method of follow‐up. Although wireless PM follow‐up has several advantages compared with transtelephonic and office‐based follow‐up, its utility depends on successful transmission. HypothesisInitial in‐office setup of wireless PM will improve transmission rate as compared with home setup. MethodsA total of 202 consecutive patients from 2 medical centers were included in this retrospective study. Patients in the home setup group (N = 101) had traditional home setup of wireless PM, whereas patients in the in‐offic...
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Xiushui Ren, Christina Apostolakos, Thuy Hong Vo, Richard E. Shaw, Korey Shields, Nader M. Banki, Douglas W. Zuckermann, Alexander C. Flint, Richard H. Hongo, Nora F. Goldschlager Tags: Clinical Investigation Source Type: research

Response to Improvement of Arterial Stiffness in the Transition From Acute Decompensated Heart Failure to Chronic Compensated Heart Failure
Kim DB et al. Clin Cardiol. 2013;36:358–362. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Sait Demirkol, Sevket Balta, Ugur Kucuk, Murat Unlu, Mustafa Cakar, Mustafa Dinc Tags: Letter to the Editor Source Type: research

Response to Relation Between Time of Symptom Onset of ST‐Segment Elevation Myocardial Infarction and Patient Baseline Characteristics: From the National Cardiovascular Data Registry
(Source: Clinical Cardiology)
Source: Clinical Cardiology - September 1, 2013 Category: Cardiology Authors: Murat Celik, Baris Bugan, Emre Yalcinkaya, Uygar Cagdas Yuksel, Turgay Celik Tags: Letter to the Editor Source Type: research