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Review of the 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: What is New and Why?
Abstract In September 2014, the 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes (NSTE-ACS) was released electronically; it was published in print 3 months later, in December 2014. The management of NSTE-ACS has evolved significantly in recent years, and a number of novel agents are now available for use (e.g., prasugrel, ticagrelor). In addition, several key diagnostic and therapeutic agents that were formerly considered hallmarks in the treatment of acute coronary syndrome have fallen out of favor (e.g., glycoprotein inhibitors, CK-MB). The 2014 AHA...
Source: Current Cardiovascular Risk Reports - March 27, 2016 Category: Cardiology Source Type: research

Heart Failure and Inflammatory Arthritis: the Relationship of Systemic Inflammation
Abstract Significant research over the past decade has provided compelling evidence that inflammatory activation is an important pathway in disease progression in both heart failure (HF) and inflammatory arthritides. The impact of these inflammatory pathways on the prognosis of HF, however, is unknown. Furthermore, the chronic low-grade inflammation observed in patients with inflammatory arthritis such as rheumatoid arthritis (RA) or psoriatic arthritis (PsA) has been recognized as an important risk factor for the development of ischemic heart disease and, more recently, for the development of heart fai...
Source: Current Cardiovascular Risk Reports - March 10, 2016 Category: Cardiology Source Type: research

Reducing Heart Failure Risks in Obese Patients
Abstract Heart failure (HF) and obesity have both become major epidemics and recognized as public health problems. Obesity has known adverse effects on cardiac structure and function; therefore, it is not surprising that there is an increased prevalence and incidence of HF in obese patients. Additionally, numerous cardiovascular (CV) risk factors associated with obesity, such as hypertension, coronary heart disease, dyslipidemia, atrial fibrillation, and depression, are also known to play a role in the development of HF. Numerous studies have suggested the presence of an “obesity paradox,” where obe...
Source: Current Cardiovascular Risk Reports - February 27, 2016 Category: Cardiology Source Type: research

Risk Stratification for Older Adults with Myocardial Infarction
Abstract Older adults presenting with an acute myocardial infarction (MI) have an increased morbidity and mortality as compared to younger adults. The management of MI in older adults is dependent on accurate risk stratification incorporating the vast patient heterogeneity characteristic of this population. Traditional risk stratification methods differ in their predictive validity as age increases and important geriatric risk factors such as multimorbidity and geriatric syndromes (e.g., frailty) are often not taken into consideration when developing patient-centered care plans. The dearth of specific c...
Source: Current Cardiovascular Risk Reports - February 26, 2016 Category: Cardiology Source Type: research

Athlete Screening for Cardiomyopathies: Recent Insights and Latest Guidelines
Abstract The benefits of regular moderate exercise to improve health are undisputed. However, in individuals harboring underlying cardiac disorders, there is an increased risk of adverse cardiac events during exertion, including sudden cardiac death (SCD). Subclinical cardiomyopathies are amongst the most common causes of SCD in young athletes and, importantly, SCD may be the initial presentation of a cardiomyopathy. While these tragic events are rare, the emotional effect on the athlete’s family and the community at large is profound and devastating. Therefore, pre-participation screening programs to...
Source: Current Cardiovascular Risk Reports - February 17, 2016 Category: Cardiology Source Type: research

The Impact of Bariatric Surgery on Depression: a Review
Abstract More than half of patients with obesity who present for medical or surgical management meet the criteria for a psychiatric illness, commonly a mood disorder. Bariatric surgery leads to significant improvement in depression symptomology and a reduction in the overall prevalence of depression. Studies generally report short-term overall reduction in depression rates between approximately 55 to 65 % within the first two years following surgery. It appears that there is a dose response relationship between weight loss and resolution of depression. There are some conflicting reports in the literatu...
Source: Current Cardiovascular Risk Reports - February 15, 2016 Category: Cardiology Source Type: research

Does Treating Sleep Apnea Reduce Heart Failure Risks?
Abstract Sleep-disordered breathing (SDB) is the most common comorbidity in heart failure (HF) patients. SDB, including both central sleep apnea (CSA) and obstructive sleep apnea (OSA), affects up to 70 % of all heart patients. Numerous studies have identified intermittent hypoxia, oxidative stress, and sympathetic activation as the main pathways through which SDB exerts its negative cardiovascular consequences. The etiological relation between SDB and HF is complex and multi-layered. On one level, SDB contributes to the progression of cardiovascular disease (CVD) into HF; on another level, SDB is a co...
Source: Current Cardiovascular Risk Reports - February 11, 2016 Category: Cardiology Source Type: research

Assessing Risks of Glucose Lowering Therapy in Heart Failure: Should We Rely on Post-hoc Analyses?
Abstract Diabetes mellitus (DM) is common among patients with heart failure (HF), and each disease process likely potentiates the progression of the other. A number of recent clinical trials have brought significant attention to a possible association between glucose lowering therapy, particularly thiazolidinediones (TZDs) and dipeptidyl peptidase-4 (DPP-4) inhibitors, and increased HF hospitalizations. While several of these studies have been well powered for major adverse cardiovascular events, none of them have included HF outcomes as part of their primary endpoints. Numerous post hoc analyses of the...
Source: Current Cardiovascular Risk Reports - February 5, 2016 Category: Cardiology Source Type: research

Heart Failure Prevention: Special Considerations for Women
Abstract Heart failure (HF) is a growing epidemic in the USA, and the American Heart Association estimates there are 550,000 new cases of HF in men and women annually. Despite advances in evidence-based cardiovascular care including improved awareness of women’s cardiovascular disease, important gender discrepancies persist in the diagnosis and management of HF. Coronary heart disease (CHD) is a leading cause of HF in the USA, and despite advancing therapies for acute coronary syndromes, young women (age < 55) are the only population with increasing mortality from CHD. Women stand to greatly be...
Source: Current Cardiovascular Risk Reports - February 5, 2016 Category: Cardiology Source Type: research

Does Limiting Salt Intake Prevent Heart Failure? A Critical Appraisal
Abstract Reducing the incidence of heart failure (HF) and its associated morbidity is a major goal for public health authorities. In this review, we evaluate the evidence supporting sodium restriction as a means to prevent HF. High dietary sodium intake is associated with several factors that promote the development of HF including systemic hypertension, ventricular hypertrophy, diastolic dysfunction, vascular stiffness, and endothelial dysfunction. Some argue that sodium restriction actually may contribute to the development of HF through increased neurohormonal activation. The effect of sodium intake ...
Source: Current Cardiovascular Risk Reports - February 5, 2016 Category: Cardiology Source Type: research

Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention
Abstract Animals interact with humans in multiple ways, including as therapy and service animals, commercially as livestock, as wildlife, and in zoos. But the most common interaction is as companion animals in our homes, with an estimated 180 million cats and dogs living in US households. While pet ownership has been reported to have many health benefits, the findings are inconsistent. Cardiovascular risk factors such as lipids, glucose, obesity, and heart rate variability have improved, worsened, or remained the same in the limited number of studies considering companion animals. Physical activity incr...
Source: Current Cardiovascular Risk Reports - February 5, 2016 Category: Cardiology Source Type: research

Management of Moderate Hypertriglyceridemia in Childhood and Adolescence
Abstract In youth, high triglycerides(TGs) usually occur with low HDL-cholesterol(HDL-C) as combined dyslipidemia(CD) in the context of obesity. This is now the predominant dyslipidemic pattern in childhood, seen in 30 to 60 % of obese individuals. In adults, CD is the most common lipid pattern seen with premature coronary disease. At the lipid subpopulation level, hypertriglyceridemia and CD are represented as increased LDL particles and small, dense LDL plus reduced total HDL-C and large HDL, a highly atherogenic pattern. Hypertriglyceridemia and CD in childhood predict vascular dysfunction and patho...
Source: Current Cardiovascular Risk Reports - February 4, 2016 Category: Cardiology Source Type: research

Sedentary Behavior and Cardiovascular Risk in Older Adults: a Scoping Review
Abstract Sedentary behavior is an emerging risk factor for cardiovascular disease (CVD) and may be particularly relevant to the cardiovascular health of older adults. This scoping review describes the existing literature examining the prevalence of sedentary time in older adults with CVD and the association of sedentary behavior with cardiovascular risk in older adults. We found that older adults with CVD spend >75 % of their waking day sedentary, and that sedentary time is higher among older adults with CVD than among older adults without CVD. High sedentary behavior is consistently associated with...
Source: Current Cardiovascular Risk Reports - January 29, 2016 Category: Cardiology Source Type: research

Multimorbidity in Older Patients with Cardiovascular Disease
Abstract Multimorbidity affects more than two thirds of older individuals and the vast majority of patients with chronic cardiovascular disease. Patients with multimorbidity have high resource utilization, poor mobility, and poor health status and are at an increased risk for death. The presence of multimorbidity imposes numerous management challenges in caring for patients with chronic cardiovascular disease. It complicates decision-making, promotes fragmented care, and imposes an immense burden on the patient and their social support system. Novel models of care, such as the cardiovascular patient-cen...
Source: Current Cardiovascular Risk Reports - January 26, 2016 Category: Cardiology Source Type: research

Pregnancy Weight Gain, Postpartum Weight Retention, and Obesity
Abstract Obesity is a significant health problem associated with specific risks during pregnancy. Overweight and obese women are at increased risk for gaining weight in excess of pregnancy weight gain guidelines. Excessive gestational weight gain (EGWG) is associated with postpartum weight retention (PPWR) and can negatively impact the health of developing offspring, including increasing the risk of future obesity and diabetes. For all women, pregnancy may serve as an inciting factor that leads to increased body weight 15 to 20 years postpartum. Decreased exercise, increased consumption of unhealthy fo...
Source: Current Cardiovascular Risk Reports - January 26, 2016 Category: Cardiology Source Type: research