High ‐risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?
This study included 68 patients within 24 hours of first acute inferior MI. Group 1 (n = 49) isolated inferior MI; group 2 (n = 19) inferior and RV MI. echocardiography for RV free wall longitudinal strain (FWLS), RV fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (MPI) and peak systolic velocity (S′). ResultsGroup 2 had higher MPI by tissue Doppler and 2D‐RV average FWLS, whereas RV FAC, S′, and TAPSE were lower (P
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Hisham Samir Roshdy, Ibtesam Ibrahim El ‐Dosouky, Mohammad Hassan Soliman Tags: CLINICAL INVESTIGATIONS Source Type: research
Electrophysiological characteristics and catheter ablation of symptomatic focal premature atrial contractions originating from pulmonary veins and non ‐pulmonary veins
BackgroundWe aimed to explore electrophysiological characteristics of premature atrial contractions (PACs) originating from pulmonary veins (PVs) and non‐PVs and to evaluate the effectiveness and safety of catheter ablation for PACs. HypothesisSymptomatic PACs originated from different positions and whether could be ablated. MethodsSymptomatic, frequent, and drug‐refractory PAC patients were enrolled in this study. All patients underwent electrophysiological study and catheter ablation. ResultsA total of 81 patients were enrolled: 45 patients with PACs originating from PVs (group A), 24 patients with PACs originating f...
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Xingfu Huang, Yanjia Chen, Junhui Xiao, Hongxin Zhao, Yizhen Chen, Shenrong Liu, Liwei He, Zheng Huang, Haobin Zhou, Dingli Xu, Jian Peng Tags: CLINICAL INVESTIGATIONS Source Type: research
Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200 –499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study
The objective of the randomized, double‐blind, placebo‐controlled EVAPORATE study is to evaluate the effects of icosapent ethyl 4 g/d on atherosclerotic plaque in a North American population of statin‐treated patients with coronary atherosclerosis, TG levels of 200 to 499 mg/dL, and low‐density lipoprotein cholesterol levels of 40 to 115 mg/dL. The primary endpoint is change in low‐attenuation plaque volume measured by multidetector computed tomography angiography. Secondary endpoints include incident plaque rates; quantitative changes in different plaque types and morphology; changes in mark...
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Matthew Budoff, J. Brent Muhlestein, Viet T. Le, Heidi T. May, Sion Roy, John R. Nelson Tags: TRIAL DESIGNS Source Type: research
Nutraceuticals in the management of patients with statin ‐associated muscle symptoms, with a note on real‐world experience
There is considerable evidence for the role of low‐density lipoprotein cholesterol (LDL‐C) in the development of atherosclerotic cardiovascular disease. Although statin therapy remains the most frequency prescribed medication to reduce LDL‐C and lower risk of cardiovascular disease, a considerable number of patients develop muscle‐related side affects. This review summarizes recent literature supporting the role of nutraceuticals as LDL‐C–lowering therapy in statin‐intolerant patients, with evidence from our own clinical practices. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Natalie C. Ward, Jing Pang, Jacqueline D.M. Ryan, Gerald F. Watts Tags: REVIEW Source Type: research
Long ‐term prognostic value of combined free triiodothyronine and late gadolinium enhancement in nonischemic dilated cardiomyopathy
BackgroundThyroid dysfunction and myocardial fibrosis are both associated with cardiovascular events in patients with dilated cardiomyopathy (DCM). HypothesisThe combination of thyroid hormone (TH) and myocardial fibrosis (detected by late gadolinium enhancement [LGE]) is an independent and incremental predictor of adverse events in DCM. MethodsWe consecutively enrolled 220 idiopathic DCM patients with thyroid function and LGE assessment at Fuwai Hospital (China) from January 2010 to October 2011 and followed up through December 2015. Patients were divided into 4 groups according to the presence or absence of LGE and FT3 v...
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Kuo Zhang, Wenyao Wang, Shihua Zhao, Stuart D. Katz, Giorgio Iervasi, A. Martin Gerdes, Yi ‐Da Tang Tags: CLINICAL INVESTIGATIONS Source Type: research
Effect of body mass index on survival after sudden cardiac arrest
BackgroundAlthough elevated body mass index (BMI) is a risk factor for cardiac disease, patients with elevated BMI have better survival in the context of severe illness, a phenomenon termed the “obesity paradox.” HypothesisHigher BMI is associated with lower mortality in sudden cardiac arrest (SCA) survivors. MethodsData were collected on 1433 post‐SCA patients, discharged alive from the hospitals of the University of Pittsburgh Medical Center between 2002 and 2012. Of those, 1298 patients with documented BMI during the index hospitalization and follow‐up data constituted the study cohort. ResultsIn the ove...
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Sayna Matinrazm, Adetola Ladejobi, Deepak Kumar Pasupula, Awais Javed, Asad Durrani, Shahzad Ahmad, Muhammad Bilal Munir, Evan Adelstein, Sandeep K. Jain, Samir Saba Tags: CLINICAL INVESTIGATIONS Source Type: research
Skin aging parameters: A window to heart block
ConclusionsAny population with a total intrinsic skin aging score of>6 is at high risk for developing advanced‐degree AV block and should undergo periodic ECG follow‐up for early detection of any conduction disturbance in the early asymptomatic stages to minimize sudden cardiac death. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 23, 2017 Category: Cardiology Authors: Hisham Samir Roshdy, Mohammad Hassan Soliman, Ibtesam Ibrahim El ‐Dosouky, Soheir Ghonemy Tags: CLINICAL INVESTIGATIONS Source Type: research
Association between diet quality and measures of body adiposity using the Rate Your Plate survey in patients presenting for coronary angiography
BackgroundDiet is a modifiable risk factor for cardiovascular disease; however, dietary patterns are historically difficult to capture in the clinical setting. Healthcare providers need assessment tools that can quickly summarize dietary patterns. Research should evaluate the effectiveness of these tools, such as Rate Your Plate (RYP), in the clinical setting. HypothesisRYP diet quality scores are associated with measures of body adiposity in patients referred for coronary angiography. MethodsPatients without a history of coronary revascularization (n = 400) were prospectively approached at a tertiary medical...
Source: Clinical Cardiology - November 23, 2017 Category: Cardiology Authors: Lisa Ganguzza, Calvin Ngai, Laura Flink, Kathleen Woolf, Yu Guo, Eugenia Gianos, Joseph Burdowski, James Slater, Victor Acosta, Tamsin Shephard, Binita Shah Tags: CLINICAL INVESTIGATION Source Type: research
Transcatheter vs surgical aortic ‐valve replacement in low‐ to intermediate‐surgical‐risk candidates: A meta‐analysis and systematic review
The American and European expert documents recommend transcatheter aortic valve replacement (TAVR) for inoperable or high‐surgical‐risk patients with severe aortic stenosis. In comparison, efficacy of TAVR is relatively less studied in low‐ to intermediate‐surgical‐risk patients. We sought to discover whether TAVR can be as effective as surgical aortic valve replacement (SAVR) in low‐ to intermediate‐surgical‐risk candidates. Four randomized clinical trials (RCTs) and 8 prospective matched studies were selected using PubMed/MEDLINE, Embase, and Cochrane Library (inception: March 2017). Results were reported...
Source: Clinical Cardiology - November 23, 2017 Category: Cardiology Authors: Safi U. Khan, Ahmad N. Lone, Muhammad A. Saleem, Edo Kaluski Tags: REVIEW Source Type: research
Occurrence of primarily noninducible atrioventricular nodal reentry tachycardia after radiofrequency delivery in the slow pathway region during empirical slow pathway modulation
ConclusionsOut of 149 initially noninducible patients, a considerable number (9%) exhibited AVNRT during or after RF delivery. These patients crossed over from empirical to controlled slow pathway modulation resulting in a good clinical outcome. Our observations should encourage electrophysiologists to repeat programmed stimulation even after initial empirical RF delivery to retest for inducibility. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 22, 2017 Category: Cardiology Authors: Felix Konrad Wegner, Nils B ögeholz, Patrick Leitz, Gerrit Frommeyer, Dirk Georg Dechering, Simon Kochhäuser, Philipp Sebastian Lange, Julia Köbe, Kristina Wasmer, Gerold Mönnig, Lars Eckardt, Christian Pott Tags: CLINICAL INVESTIGATIONS Source Type: research
Clinical investigation of left ventricular pacing using coronary sinus in patients with mechanical prosthetic tricuspid valve replacement
ConclusionsLV lead implantation through the CS appears safe and efficacious in patients with inaccessibility for RV pacing. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 22, 2017 Category: Cardiology Authors: Kelan Zha, Kaijun Cui, Xingbin Liu, Yuan Fang Tags: CLINICAL INVESTIGATIONS Source Type: research
The effect of fasting status on lipids, lipoproteins, and inflammatory biomarkers assessed after hospitalization for an acute coronary syndrome: Insights from PROVE IT –TIMI 22
ConclusionsAlthough fasting does impact lipid measurements, the effect on LDL‐C is small (about 4 mg/dL), both early after ACS and during follow‐up. These data provide support for recent guidelines that no longer advocate for fasting lipid samples, including in the setting of ACS. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Dylan L. Steen, Amarachi A. Umez ‐Eronini, Jianping Guo, Naseer Khan, Christopher P. Cannon Tags: CLINICAL INVESTIGATIONS Source Type: research
Association between ideal cardiovascular health metrics and risk of cardiovascular events or mortality: A meta ‐analysis of prospective studies
ConclusionsIdeal CVH status, or even 1 point increase in CVH metrics, can result in substantial reductions in the risk of CVD, stroke, and mortality. Improving metrics of smoking, diet, physical activity, plasma glucose levels, and blood pressure will achieve the highest benefits. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Leilei Guo, Shangshu Zhang Tags: CLINICAL INVESTIGATIONS Source Type: research
Acute kidney injury requiring dialysis and in ‐hospital mortality in patients with chronic kidney disease and non–ST‐segment elevation acute coronary syndrome undergoing early vs delayed percutaneous coronary intervention: A nationwide analysis
ConclusionsThe incidence of AKI‐D and in‐hospital mortality among patients with CKD and NSTE‐ACS were not significantly affected by the timing of PCI. However, delayed PCI added significant cost and length of stay. A prospective randomized study is required to validate this concept. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Brijesh Patel, Philip Carson, Mahek Shah, Lohit Garg, Manyoo Agarwal, Sahil Agrawal, Shilpkumar Arora, Susan Steigerwalt, Anthony Bavry, Raman Dusaj, Nainesh Patel, Bruce Feldman Tags: CLINICAL INVESTIGATIONS Source Type: research
Incidence of thromboembolic and bleeding events in patients with newly diagnosed nonvalvular atrial fibrillation: An Asian multicenter retrospective cohort study in Singapore
ConclusionsSAPT and DAPT are less effective than warfarin in NVAF patients. DOACs may be considered in view of lower risk of overall bleed. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Xue Ting Wee, Lih Maan Ho, Han Kiat Ho, Joyce Yu ‐Chia Lee, Chun Wei Yap, Henry William, Linus Chong En Chan, Hooi Ching Tay, Cynthia Eei Mei Goh, Doreen Su‐Yin Tan Tags: CLINICAL INVESTIGATIONS Source Type: research
Laboratory characteristics of ischemic stroke patients with atrial fibrillation on or off therapeutic warfarin
ConclusionsAF patients who presented with IS on therapeutic warfarin had higher average serum creatinine and blood urea nitrogen, and lower glomerular filtration rates, compared with others. Impaired renal function may be a factor contributing to occurrence of IS in AF patients despite adequate anticoagulation. Larger, targeted studies are needed to confirm these findings. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Raghav V. Aachi, Lee A. Birnbaum, Christopher H. Topel, Ali Seifi, Shaheryar Hafeez, R éza Behrouz Tags: CLINICAL INVESTIGATIONS Source Type: research
Real ‐world incidence of efficacy and safety outcomes in patients on direct oral anticoagulants with left ventricular systolic dysfunction at a tertiary referral center
ConclusionsOur findings are largely compatible with the results of LVSD or HF subgroups in RE‐LY, ROCKET‐AF, and ARISTOTLE trials and add to increasing confidence that DOACs can be safely used for stroke and systemic embolism prevention in patients with LVSD. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Andrew S. Tseng, J. William Schleifer, Win ‐Kuang Shen, Robert McBane, Sunil Mankad, Heidi Esser, Darko Vucicevic, Fadi E. Shamoun Tags: CLINICAL INVESTIGATIONS Source Type: research
Clinical outcomes according to symptom presentation in patients with acute myocardial infarction: Results from the FAST ‐MI 2010 registry
BackgroundAtypical clinical presentation in acute myocardial infarction (AMI) patients is not uncommon; most studies suggest that it is associated with unfavorable prognosis. HypothesisLong‐term clinical impact differs according to predominant symptom presentation (typical chest pain, atypical chest pain, syncope, cardiac arrest, or dyspnea) in AMI patients. MethodsFAST‐MI 2010, a nationwide French registry, included 4169 patients with AMI in 213 centers at the end of 2010 (76% of active centers). Demographics, medical history, hospital management, and outcomes were compared according to predominant symptom presentatio...
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Etienne Puymirat, Nadia Aissaoui, Laurent Bonello, Guillaume Cayla, Jean ‐Noel Labèque, Olivier Nallet, Pascal Motreff, Olivier Varenne, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin, Tags: CLINICAL INVESTIGATIONS Source Type: research
Long ‐term use of continuous positive airway pressure therapy in coronary artery disease patients with nonsleepy obstructive sleep apnea
BackgroundExcessive daytime sleepiness is a frequent symptom of obstructive sleep apnea (OSA) and has been proposed as a motivator for adherence to continuous positive airway pressure (CPAP) therapy. However, excessive daytime sleepiness is absent in many patients with coronary artery disease (CAD) and concomitant OSA. We evaluated long‐term use of CPAP and predictors of CPAP use in nonsleepy and sleepy OSA patients from a CAD cohort. HypothesisLong‐term CPAP use is lower in CAD patients with nonsleepy OSA vs sleepy OSA. MethodsNonsleepy (Epworth Sleepiness Scale [ESS] score
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Faith S. Luyster, Patrick J. Strollo, Erik Thunstr öm, Yüksel Peker Tags: CLINICAL INVESTIGATIONS Source Type: research
Administrative billing codes accurately identified occurrence of electrical cardioversion and ablation/maze procedures in a prospective cohort study of atrial fibrillation patients
ConclusionsAdministrative billing data accurately identified electrical cardioversion and ablation/maze procedures and can be used instead of medical record review. Our findings apply to healthcare settings with available administrative billing databases. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2017 Category: Cardiology Authors: Alexa N. Ehlert, Susan R. Heckbert, Kerri L. Wiggins, Evan L. Thacker Tags: CLINICAL INVESTIGATIONS Source Type: research
Predictors of an abnormal postexercise ankle brachial index: Importance of the lowest ankle pressure in calculating the resting ankle brachial index
BackgroundThe postexercise ankle‐brachial index (ABI) is useful in patients with suspected peripheral arterial disease (PAD) and a normal resting ABI. Our objective was to determine the independent predictors of an abnormal postexercise ABI. HypothesisWe hypothesized that the lowest ankle systolic pressure to calculate the resting ABI would be associated with an abnormal post‐exercise ABI. MethodsAmong 619 consecutive patients referred for suspected PAD, we calculated the postexercise ABI in patients with a normal resting ABI. An ABI 20% reduction compared with rest. ResultsUsing multivariate analysis, the lowest ABI (...
Source: Clinical Cardiology - October 1, 2017 Category: Cardiology Authors: David W.J. Armstrong, Colleen Tobin, Murray F. Matangi Tags: CLINICAL INVESTIGATIONS Source Type: research
Reverse cascade screening for familial hypercholesterolemia in high ‐risk Chinese families
ConclusionsReverse cascade screening is a highly effective method for diagnosing new cases of FH in parents, siblings, and second‐degree relatives of index children with severe FH. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 1, 2017 Category: Cardiology Authors: Xue Wu, Jing Pang, Xumin Wang, Jie Peng, Yan Chen, Shilong Wang, Gerald F. Watts, Jie Lin Tags: CLINICAL INVESTIGATIONS Source Type: research
Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score –matched analysis
BackgroundTranscatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HypothesisTAVR is associated with better in‐hospital outcomes compared with SAVR in patients with advanced kidney disease. MethodsWe identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We included patients with chronic kidney disease s...
Source: Clinical Cardiology - October 1, 2017 Category: Cardiology Authors: Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj Tags: CLINICAL INVESTIGATIONS Source Type: research
Seasonal patterns of acute and recurrent idiopathic pericarditis
ConclusionsAcute idiopathic pericarditis appears to have a seasonal pattern with a distinct late winter peak. No seasonal pattern was identified for recurrent episodes. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 15, 2017 Category: Cardiology Authors: Yoav Hammer, Jihad Bishara, Alon Eisen, Zaza Iakobishvili, Ran Kornowski, Aviv Mager Tags: CLINICAL INVESTIGATIONS Source Type: research
Hyperglycemia on admission and hospitalization outcomes in patients with atrial fibrillation
BackgroundWe evaluated the association of admission blood glucose (ABG) and mortality in patients with and without diabetes mellitus (DM) hospitalized for atrial fibrillation (AF). HypothesisHyperglycemia on admission is a bad prognostic marker in patients with AF. MethodsObservational data were collected from electronic records of patients age ≥ 18 years hospitalized for AF in 2011–2013. Twelve‐month data were available in all cases. ABG levels were classified as follows: 70 to 110 mg/dL, normal; 111 to 140 mg/dL, mildly elevated; 141 to 199 mg/dL, moderately elevated; ...
Source: Clinical Cardiology - September 12, 2017 Category: Cardiology Authors: Amit Akirov, Alon Grossman, Tzipora Shochat, Ilan Shimon Tags: CLINICAL INVESTIGATIONS Source Type: research
Seasonal variation in hospitalization outcomes in patients admitted for heart failure in the United States
ConclusionsAmong HF patients in the U.S., hospitalization outcomes were worse in Winter but better in Summer. (Source: Clinical Cardiology)
Source: Clinical Cardiology - September 5, 2017 Category: Cardiology Authors: Emmanuel Akintoye, Alexandros Briasoulis, Alexander Egbe, Oluwole Adegbala, Samson Alliu, Muhammad Sheikh, Manmohan Singh, Abdelrahman Ahmed, Sagar Mallikethi ‐Reddy, Diane Levine Tags: CLINICAL INVESTIGATIONS Source Type: research
Relation of premature atrial complexes with stroke and death: Systematic review and meta ‐analysis
Frequent premature atrial complexes (PACs) are universal in the general population; however, their clinical significance is unclear. We hypothesize that frequent PACs are associated with increased risk of stroke and death. The PubMed (from 1966 to April 2017) and Embase (from 1974 to April 2017) databases were searched for longitudinal studies that reported the relation of PACs with incidence of stroke and death with various etiologies. Study quality was evaluated, and the relative risks (RR) of unfavorable outcomes in subjects with frequent PACs vs those without were calculated. Eleven studies with overall high quality we...
Source: Clinical Cardiology - August 28, 2017 Category: Cardiology Authors: Bao ‐tao Huang, Fang‐yang Huang, Yong Peng, Yan‐biao Liao, Fei Chen, Tian‐li Xia, Xiao‐bo Pu, Mao Chen Tags: REVIEW Source Type: research
Apixaban, rivaroxaban, and dabigatran use in patients undergoing catheter ablation for atrial fibrillation using the second ‐generation cryoballoon
BackgroundData are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second‐generation cryoballoon (CB) for the treatment of atrial fibrillation. HypothesisWe hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. MethodsIn 200 consecutive patients (mean age, 64.3 _ 10.6 years; female, n = 83) with symptomatic atrial fibrillation, PVI using the second‐generation 28‐mm CB was performed. In patients treat...
Source: Clinical Cardiology - August 28, 2017 Category: Cardiology Authors: Verena Tscholl, Abdullah Khaled ‐A. Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig Tags: CLINICAL INVESTIGATIONS Source Type: research
DNA methylation dysregulations in valvular atrial fibrillation
BackgroundThe epigenetic changes underlying the development of atrial fibrillation (AF) remain incompletely understood. Limited evidence suggests that abnormal DNA methylation might be involved in the pathogenesis of AF. In the present study, we evaluated the methylation status of genomic DNA from myocardial tissue in AF patients and sinus rhythm (SR) patients systematically. HypothesisDNA methylation dysregulations will be associated with valvular AF. MethodsRight atrial myocardial tissue was obtained from rheumatic valvular patients who had undergone valve replacement surgery (SR group, n = 10; AF group, n = 10). The glo...
Source: Clinical Cardiology - August 28, 2017 Category: Cardiology Authors: Kangjun Shen, Tao Tu, Zhaoshun Yuan, Jiangfeng Yi, Yangzhao Zhou, Xiaobo Liao, Qiming Liu, Xinmin Zhou Tags: CLINICAL INVESTIGATIONS Source Type: research
An exploration of the association between ischemic etiology and the likelihood of heart failure hospitalization following cardiac resynchronization therapy
ConclusionsPatients with nonischemic etiology were significantly less likely to experience a HF admission after CRT‐D, but the risk of HF admission improved significantly in all groups after CRT‐D. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 28, 2017 Category: Cardiology Authors: Adam C. Powell, Teresa L. Rogstad, Uday U. Deshmukh, Stephen E. Price, Jeffrey D. Simmons Tags: CLINICAL INVESTIGATIONS Source Type: research
Comprehensive primary prevention of cardiovascular disease in women
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in women. Historically, medical research has focused on male patients, and subsequently, there has been decreased awareness of the burden of ASCVD in females until recent years. The biological differences between sexes and differences in societal expectations defined by gender roles contribute to gender differences in ASCVD risk factors. With these differing risk profiles, risk assessment, risk stratification, and primary preventive measures of ASCVD are different in women and men. In this review article, clinicians will understand the ri...
Source: Clinical Cardiology - August 28, 2017 Category: Cardiology Authors: Suegene K. Lee, Jay Khambhati, Tina Varghese, Eric P. Stahl, Sonali Kumar, Pratik B. Sandesara, Nanette K. Wenger, Laurence S. Sperling Tags: REVIEW Source Type: research
Facility ‐level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database
BackgroundIntensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes. HypothesisWe hypothesized that there is suboptimal glycemic and BP control with significant facility‐level variation in patients with diabetes. MethodsWe identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. We assessed facility‐level rates of glycemic (hemoglobin [Hb]A1c
Source: Clinical Cardiology - August 25, 2017 Category: Cardiology Authors: Hasan Rehman, Julia M. Akeroyd, David Ramsey, Sarah T. Ahmed, Anwar T. Merchant, Sankar D. Navaneethan, Laura A. Petersen, Salim S. Virani Tags: CLINICAL INVESTIGATIONS Source Type: research
Patients without comorbidities at the time of diagnosis of atrial fibrillation: causes of death during long ‐term follow‐up compared to matched controls
ConclusionsIn patients with incident AF and no known comorbidities at the time of AF diagnosis, only cardiovascular diseases were more often causes of death as compared to controls. Women carried a significantly higher relative risk than men. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 25, 2017 Category: Cardiology Authors: Tommy Andersson, Anders Magnuson, Ing ‐Liss Bryngelsson, Ole Frøbert, Karin M. Henriksson, Nils Edvardsson, Dritan Poçi Tags: CLINICAL INVESTIGATIONS Source Type: research
Rationale and design of the Drug ‐Eluting Stents vs Bare‐Metal Stents in Saphenous Vein Graft Angioplasty (DIVA) Trial
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug‐eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare‐metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site. At sites that did not routinely administer 12‐months of dual antipl...
Source: Clinical Cardiology - August 25, 2017 Category: Cardiology Authors: Emmanouil S. Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R. Holmes, Deepak L. Bhatt, Sunil V. Rao, Mark W. Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V. Rangan, Bever Tags: TRIAL DESIGNS Source Type: research
Home monitoring after ambulatory implanted primary cardiac implantable electronic devices: The home ambulance pilot study
BackgroundThe Home Monitoring (HM) system of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias or device system failures. The aim of this pilot study was to examine how the safety and efficacy of the HM system in patients after ambulatory implanted primary CIEDs compare to patients with a standard procedure and hospitalization. HypothesisWe hypothesized that HM and their modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs. MethodsThis retrospective analysis evaluates telemetric data obtained from 364 patients in an ambulatory single center ove...
Source: Clinical Cardiology - August 21, 2017 Category: Cardiology Authors: Mariana S. Parahuleva, Nedim Soydan, Dimitar Divchev, Ulrich L üsebrink, Bernhard Schieffer, Ali Erdogan Tags: CLINICAL INVESTIGATIONS Source Type: research
Study of young patients with myocardial infarction: Design and rationale of the YOUNG ‐MI Registry
The YOUNG‐MI registry is a retrospective study examining a cohort of young adults age ≤ 50 years with a first‐time myocardial infarction. The study will use the robust electronic health records of 2 large academic medical centers, as well as detailed chart review of all patients, to generate high‐quality longitudinal data regarding the clinical characteristics, management, and outcomes of patients who experience a myocardial infarction at a young age. Our findings will provide important insights regarding prevention, risk stratification, treatment, and outcomes of cardiovascular disease in thi...
Source: Clinical Cardiology - August 14, 2017 Category: Cardiology Authors: Avinainder Singh, Bradley Collins, Arman Qamar, Ankur Gupta, Amber Fatima, Sanjay Divakaran, Josh Klein, Jon Hainer, Petr Jarolim, Ravi V. Shah, Khurram Nasir, Marcelo F. Di Carli, Deepak L. Bhatt, Ron Blankstein Tags: TRIAL DESIGNS Source Type: research
Prognostic value of exercise capacity among men undergoing pharmacologic treatment for erectile dysfunction: The FIT Project
ConclusionsHigher baseline fitness is associated with improved cardiovascular prognosis in a population of middle‐aged men treated for ED. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 14, 2017 Category: Cardiology Authors: Robert V. Same, Mahmoud Al Rifai, David I Feldman, Kevin L. Billups, Clinton A. Brawner, Zeina A. Dardari, Jonathan K. Ehrman, Steven J. Keteyian, Mouaz H. Al ‐Mallah, Michael J. Blaha Tags: CLINICAL INVESTIGATIONS Source Type: research
Edoxaban Use in Nonvalvular Atrial Fibrillation With Valvular Heart Disease —Insights from ENGAGE AF‐TIMI 48
(Source: Clinical Cardiology)
Source: Clinical Cardiology - August 11, 2017 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: LETTER TO THE EDITOR Source Type: research
Comparison of mid ‐ to long‐term clinical outcomes between anatomical testing and usual care in patients with suspected coronary artery disease: A meta‐analysis of randomized trials
ConclusionsAnatomical testing with CCTA as the initial noninvasive diagnostic modality in patients with suspected CAD resulted in lower risk of nonfatal MI than usual care with functional testing, at the expense of more frequent use of invasive procedures. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: In ‐Chang Hwang, Sol Ji Choi, Ji Eun Choi, Eun‐Bi Ko, Jae Kyung Suh, Insun Choi, Hyun‐Jae Kang, Yong‐Jin Kim, Joo Youn Kim Tags: CLINICAL INVESTIGATIONS Source Type: research
The prognostic significance of lung function in stable heart failure outpatients
This study investigated the impact on all‐cause mortality of airflow limitation indicative of chronic obstructive pulmonary disease or restrictive spirometry pattern (RSP) in a stable systolic heart failure population. HypothesisDecreased lung function indicates poor survival in heart failure. MethodsInclusion criteria: NYHA class II‐IV and left ventricular ejection fraction (LVEF)
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Louis Lind Plesner, Morten Dalsgaard, Morten Schou, Lars K øber, Jørgen Vestbo, Erik Kjøller, Kasper Iversen Tags: CLINICAL INVESTIGATIONS Source Type: research
Changes in parameters of right ventricular function with cardiac resynchronization therapy
BackgroundStudies have shown that cardiac resynchronization therapy (CRT) significantly improves right ventricle (RV) size and function in patients with heart failure (HF). HypothesisCRT does not lead to improvement in RV function independent of baseline clinical variables. MethodsA systematic search of studies published between 1966 to August 31, 2015 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases. Studies reporting tricuspid annular plane systolic excursion (TAPSE) or RV basal strain or RV long axis diameter or RV short axis diameter or RV fractional area change (FAC), before and a...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Abhishek Sharma, Carl J. Lavie, Ajay Vallakati, Akash Garg, Sunny Goel, Jason Lazar, Gregg C. Fonarow Tags: CLINICAL INVESTIGATIONS Source Type: research
Dynamic changes of QTc interval and prognostic significance in takotsubo (stress) cardiomyopathy
BackgroundProlonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high‐risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role. HypothesisDynamic changes of QTc interval during hospitalization for TTC could be associated with outcome at follow‐up. MethodsFifty‐two consecutive patients hospitalized for TTC were enrolled. Twelve‐lead electrocardiogram (ECG) was performed within 3 h after admission and repeated after 3, 5, and 7 days. Patients were classifi...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Francesco Santoro, Natale Daniele Brunetti, Nicola Tarantino, Jorge Romero, Francesca Guastafierro, Armando Ferraretti, Luigi F. M. Di Martino, Riccardo Ieva, Pier Luigi Pellegrino, Matteo Di Biase, Luigi Di Biase Tags: CLINICAL INVESTIGATIONS Source Type: research
Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end ‐stage renal disease: Insights and pathophysiology
A rising prevalence of end‐stage renal disease (ESRD) has led to a rise in ESRD‐related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti‐inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis. Constrictive pericarditis is also well documented in this populatio...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Karim Abdur Rehman, Jorge Betancor, Bo Xu, Arnav Kumar, Carlos Godoy Rivas, Kimi Sato, Leslie P. Wong, Craig R. Asher, Allan L. Klein Tags: REVIEW Source Type: research
Hemodynamic parameters predict the risk of atrial fibrillation after cardiac surgery in adults
ConclusionsThe present study suggested that LAD, PCWP, and PASP were robust predictors of POAF. These parameters may indicate a patient's susceptibility toward developing POAF and help to identify patients who need preventive treatment. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Rongxin Lu, Nan Ma, Zhaolei Jiang, Ju Mei Tags: CLINICAL INVESTIGATIONS Source Type: research
Deceleration capacity of heart rate predicts 1 ‐year mortality of patients undergoing transcatheter aortic valve implantation
BackgroundRisk prediction in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is challenging. Development of novel markers for patient risk assessment is of great clinical value. Deceleration capacity (DC) of heart rate is a strong risk predictor in post‐infarction patients. HypothesisDC provides prognostic information in patients undergoing TAVI. MethodsWe enrolled 374 consecutive patients with severe AS undergoing TAVI. All patients received 24‐hour Holter recording or continuous heart‐rate monitoring to assess DC before intervention. Primary endpoint was all‐cau...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Martin Duckheim, Charlotte Bensch, Linn Kittlitz, Nin G ötz, Katharina Klee, Patrick Groga‐Bada, Lars Mizera, Meinrad Gawaz, Christine Zuern, Christian Eick Tags: CLINICAL INVESTIGATIONS Source Type: research
The shifting paradigm in the treatment of type 2 diabetes mellitus —A cardiologist's perspective
In patients with diabetes mellitus, cardiovascular (CV) disease is the leading cause of morbidity and mortality. A multitude of contemporary antidiabetic agents presents different CV safety profiles. Metformin forms the cornerstone agent to reduce CV events. Newer agents, such as glucagon‐like peptide‐1 agonists and sodium‐glucose cotransporter‐2 inhibitors, have appealing CV benefits. Insulin, dipeptidyl peptidase‐4 inhibitors, and sulfonylureas have neutral CV effects. Cardiologists should familiarize themselves with these agents to promote comprehensive CV care in patients with diabetes mellitus. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Saeeda Fatima, Ayesha Jameel, Ayesha FNU Jalil, Dhananjai J. Menzies Tags: Reviews Source Type: research
Association between modifiable lifestyle and the prevalence of atrial fibrillation in a Chinese population: Based on the cardiovascular health score
ConclusionsIdeal health behavior and factors are associated with lower prevalence of AF in a community‐based population. Improving healthy behavior and these factors may be beneficial to decrease the prevalence of AF. (Source: Clinical Cardiology)
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Yiheng Yang, Xu Han, Yue Chen, Lianjun Gao, Xiaomeng Yin, Huihua Li, Jing Qiu, Youxin Wang, Yong Zhou, Yunlong Xia Tags: CLINICAL INVESTIGATIONS Source Type: research