Coronary Artery Calcium Testing in Patients with Chest Pain: Alive and Kicking
AbstractPurpose of ReviewWe review the potential role of coronary artery calcium (CAC) scoring in the initial evaluation and risk stratification of patients with low- to moderate-risk, stable and acute, chest pain.Recent FindingsA negative CAC score (CAC  = 0) has a negative predictive value of 94–99% in symptomatic patients with a low to moderate pretest probability of coronary artery stenosis. The sensitivity is superior to that of stress testing, and the risks, costs, and need for expertise are less than that of coronary CT angiography. Addit ionally, patients with CAC = 0 have an extremely low risk of future adve...
Source: Current Cardiovascular Risk Reports - April 26, 2017 Category: Cardiology Source Type: research

Transthyretin Cardiac Amyloidosis in Older Adults: Optimizing Cardiac Imaging to the Corresponding Diagnostic and Management Goal
AbstractPurpose of ReviewTransthyretin cardiac amyloidosis is increasingly recognized as an important cause of heart failure in older adults. Many cardiac imaging modalities have evolved to evaluate transthyretin cardiac amyloidosis and include 2D echocardiography with tissue Doppler and speckle-strain imaging, nuclear scintigraphy, cardiac magnetic resonance imaging, and positron emission tomography. The purpose of this review is to highlight the optimal selection of advanced cardiac imaging techniques with corresponding diagnostic goals including raising suspicion, making an early diagnosis, and subtyping transthyretin c...
Source: Current Cardiovascular Risk Reports - April 25, 2017 Category: Cardiology Source Type: research

Health Status After Hospitalization: A New Target for Geriatric Cardiology
Abstractᅟ (Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - April 20, 2017 Category: Cardiology Source Type: research

Alcohol Septal Ablation for Treatment of Symptomatic Hypertrophic Obstructive Cardiomyopathy
AbstractPurpose of ReviewTo provide a contemporary review of data regarding patient selection and outcomes for patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM) undergoing septal reduction therapy with alcohol septal ablation (ASA).Recent FindingsThis review focuses on recent guideline updates from the USA and Europe, multiple recently published large multicenter, multinational registries of patients being treated with ASA, and a recent review of “real world” outcomes of ASA and surgical myectomy (SM) treated in hospitals in the USA.SummaryRecent data have demonstrated that ASA is a safe procedure...
Source: Current Cardiovascular Risk Reports - March 19, 2017 Category: Cardiology Source Type: research

Frailty and Advanced Heart Failure in Older Adults
AbstractPurpose of ReviewAdvances in medical therapy have resulted in a growing population of older adults with advanced heart failure. Frailty is a clinical syndrome that increases in prevalence with age and is highly prevalent in patients with heart failure. This paper reviews the complex relationship between frailty and advanced systolic heart failure in older adults, including the potential for reversal of frailty following advanced cardiac interventions.Recent FindingsFrailty is predictive of adverse outcomes, including rehospitalization and mortality, in heart failure patients. Several small studies have shown that m...
Source: Current Cardiovascular Risk Reports - March 17, 2017 Category: Cardiology Source Type: research

Cardiovascular Health Awareness and Promotion in Women: AHA ’s Life’s Simple 7™ and Go Red for Women™
AbstractPurpose of ReviewThis review will discuss the incidence of and trends in cardiovascular disease (CVD), including coronary heart disease (CHD), stroke, and associated risk factors among women by ethnic groups, and the recent AHA efforts to increase awareness among women.Recent FindingsCVD mortality among women in the USA accounts for approximately half (49.7%) of total CVD deaths. CHD, as the predominant form of CVD, is the leading cause of death for women in the USA. The general indicators of risk associated with CHD in women include high blood cholesterol and triglyceride levels, high blood pressure, diabetes and ...
Source: Current Cardiovascular Risk Reports - March 6, 2017 Category: Cardiology Source Type: research

Novel Immune Mechanisms in Hypertension and Cardiovascular Risk
AbstractPurpose of ReviewHypertension is a common disorder with substantial impact on public health due to highly elevated cardiovascular risk. The mechanisms still remain unclear and treatments are not sufficient to reduce risk in majority of patients. Inflammatory mechanisms may provide an important mechanism linking hypertension and cardiovascular risk. We aim to review newly identified immune and inflammatory mechanisms of hypertension with focus on their potential therapeutic impact.Recent FindingsIn addition to the established role of the vasculature, kidneys and central nervous system in pathogenesis of hypertension...
Source: Current Cardiovascular Risk Reports - March 5, 2017 Category: Cardiology Source Type: research

Role of PAI-1 in Pediatric Obesity and Nonalcoholic Fatty Liver Disease
AbstractPurpose of ReviewThe purpose of this study is to review the role of plasminogen activator inhibitor-1 (PAI-1) in pediatric obesity and nonalcoholic fatty liver disease (NAFLD).Recent FindingsOngoing evidence supports that patients with insulin resistance, obesity, NAFLD, and cardiovascular disease have higher levels of PAI-1. The role of PAI-1 in NAFLD has been further delineated and both experimental models and human studies strongly support an independent role of PAI-1 in the pathophysiology of NAFLD.SummaryGrowing evidence supports a mechanistic role of PAI-1 in obesity associated metabolic abnormalities includi...
Source: Current Cardiovascular Risk Reports - February 28, 2017 Category: Cardiology Source Type: research

Antiplatelet Therapy for Percutaneous Coronary Intervention: Something Old and Something New
AbstractPurpose of ReviewAntiplatelet therapy for patients undergoing percutaneous coronary intervention has rapidly evolved over the last 10  years, often outpacing clinical guidelines. This review appraises recent clinical trials within the context of landmark trials in interventional cardiology, and offers a framework for the integration of recent trials into clinical practice.Recent FindingsThis review interprets recent evidence regarding the following: (1) aspirin and the most effective dose; (2) the role of the newer, more potent P2Y12 inhibitors prasugrel, ticagrelor, and cangrelor; (3) an appraisal of the evolving...
Source: Current Cardiovascular Risk Reports - February 9, 2017 Category: Cardiology Source Type: research

Pulmonary Hypertension in Women: What Does the Cardiologist Need to Know?
AbstractPurpose of ReviewOur goal is to review the epidemiology, diagnosis, and management of PH focusing on how this condition affects women.Recent FindingsPH is a broad term used to describe a group of medical conditions presenting with elevated pressures in the pulmonary circulation. A subgroup, PAH, is of great importance as many medical therapies have been developed and clinical outcomes have improved substantially when compared with historical data. PAH is more predominant in women and is an under recognized medical condition.SummaryPAH is a progressive condition for which many medical therapies are now available. Fu...
Source: Current Cardiovascular Risk Reports - February 9, 2017 Category: Cardiology Source Type: research

Geriatric Insights on Elderly Women and Heart Disease
AbstractPurpose of ReviewThe prevalence of heart diseases is growing in recent years and will further rise because of the increased longevity of elderly population, mainly reported for the female gender.Recent FindingsSeveral studies have demonstrated the presence of a large sex-specific variability on physiopathology, presentation, and overall prognosis of cardiovascular diseases (CVD). Women, in particular, tend to present heart diseases generally later than men, have a higher number of comorbidities, and report worse outcomes. Moreover, atypical symptomatology of heart diseases in older women constitutes a potential sou...
Source: Current Cardiovascular Risk Reports - February 5, 2017 Category: Cardiology Source Type: research

Optimizing Coronary Angioplasty with FFR and Intravascular Imaging
AbstractPurpose of ReviewPercutaneous coronary intervention has changed the approach to coronary artery disease management, but angiography remains the principal method for determining the severity of disease. Because an angiogram only identifies the outline of the lumen, angiography is not the most sensitive or accurate instrument. This leads to significant inter-observer variation in interpretation of intermediate lesions. Additional technologies have been developed to better evaluate the extent of disease and identify potential high risk lesions. This paper reviews the strengths and deficits of these techniques.Recent F...
Source: Current Cardiovascular Risk Reports - January 31, 2017 Category: Cardiology Source Type: research

Palliative Care in Older Adults with Cardiovascular Disease: Addressing Misconceptions to Advance Care
AbstractPurpose of ReviewThe prevalence of cardiovascular disease (CVD) increases with increasing age, and most patients with CVD are older. Death is more common in older than that in younger patients with CVD.CVD is responsible for significant disability, particularly in older patients.FindingsOlder persons have many comorbidities that complicate palliative care. We summarize available information about palliative care in CVD and specifically in heart failure. We address many misconceptions about palliative care in patients with CVD, including the notion that palliative care and hospice are synonymous, that palliative car...
Source: Current Cardiovascular Risk Reports - January 31, 2017 Category: Cardiology Source Type: research

Screening for Hypercholesterolemia in Children: What Strategies Can Be Employed
AbstractPurpose of ReviewFamilial hypercholesterolemia (FH) is an important, treatable cause of elevated LDL cholesterol that can be remediated to lower risk of premature coronary artery disease.Recent FindingsStrategies for identification include universal screening, cascade screening of relatives of persons found with either early cardiovascular disease (CVD) or LDL-C consistent with FH, and big data approaches to identify persons with high cholesterol and premature CVD.SummaryUniversal screening of children is advocated to find FH at an early age with still asymptomatic parents and negative family history. (Source: Curr...
Source: Current Cardiovascular Risk Reports - January 31, 2017 Category: Cardiology Source Type: research

Population-Based Surveillance for Cardiovascular Disease in the Caribbean: Challenges and Opportunities for Regional Approaches
AbstractPurpose of ReviewNon-communicable diseases (NCDs), including cardiovascular disease (CVD), are the leading causes of morbidity and mortality in the Caribbean. In response to this growing epidemic, regional and global organizations mandated the collection of real-time and accurate population health data to address surveillance health data gaps. The purpose of this review was to assess surveillance activities implemented in the Caribbean region from 2006 to 2016 and the availability of widely disseminated CVD surveillance data.Recent FindingsA review of surveillance activities in the region in 2011 showed modest prog...
Source: Current Cardiovascular Risk Reports - January 25, 2017 Category: Cardiology Source Type: research