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Incidence of Bleeding-Related Complications During Primary Implantation and Replacement of Cardiac Implantable Electronic Devices [Arrhythmia and Electrophysiology]
This study identified 42 606 patients who had a primary or replacement CIED procedure and met all inclusion criteria. Incidence of bleeding ranged from 0.58% to 2.81% by type of pharmaceutical therapy. Incidence of infection during days 31 to 365 of follow‐up was significantly higher among patients with a bleeding complication in the first 30 days versus those without (6.56% vs 1.24%, P (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 22, 2017 Category: Cardiology Authors: Nichols, C. I., Vose, J. G. Tags: Electrophysiology, Pacemaker, Complications, Quality and Outcomes Original Research Source Type: research

Diffuse Myocardial Fibrosis Reduces Electrocardiographic Voltage Measures of Left Ventricular Hypertrophy Independent of Left Ventricular Mass [Imaging]
BackgroundMyocardial fibrosis quantified by myocardial extracellular volume fraction (ECV) and left ventricular mass (LVM) index (LVMI) measured by cardiovascular magnetic resonance might represent independent and opposing contributors to ECG voltage measures of left ventricular hypertrophy (LVH). Diffuse myocardial fibrosis can occur in LVH and interfere with ECG voltage measures. This phenomenon could explain the decreased sensitivity of LVH detectable by ECG, a fundamental diagnostic tool in cardiology.Methods and ResultsWe identified 77 patients (median age, 53 [interquartile range, 26–60] years; 49% female) referred...
Source: JAHA:Journal of the American Heart Association - January 22, 2017 Category: Cardiology Authors: Maanja, M., Wieslander, B., Schlegel, T. T., Bacharova, L., Abu Daya, H., Fridman, Y., Wong, T. C., Schelbert, E. B., Ugander, M. Tags: Hypertrophy, Electrocardiology (ECG), Magnetic Resonance Imaging (MRI) Original Research Source Type: research

Carotid Intima-Media Thickness and Prediction of Cardiovascular Disease [Editorials]
(Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 21, 2017 Category: Cardiology Authors: Oygarden, H. Tags: Cardiovascular Disease, Risk Factors, Diagnostic Testing, Ultrasound Editorial Source Type: research

Carotid Intima-Media Thickness Score, Positive Coronary Artery Calcium Score, and Incident Coronary Heart Disease: The Multi-Ethnic Study of Atherosclerosis [Epidemiology]
ConclusionsA carotid IMT score based on normative data incrementally adds to Framingham risk factors and a positive calcium score in predicting first‐time CHD in an ethnically diverse cohort. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 21, 2017 Category: Cardiology Authors: Polak, J. F., Szklo, M., O'Leary, D. H. Tags: Biomarkers, Cardiovascular Disease, Risk Factors, Diagnostic Testing, Ultrasound Original Research Source Type: research

Impact of an Expanded Hospital Recognition Program for Stroke Quality of Care [Stroke]
We examined hospital‐level performance on 6 quality of care (process) measures and 1 defect‐free composite quality measure for stroke following expansion of the existing performance measure recognition program. Compliance with all measures improved following launch of the expanded program, and this rate increased significantly for all 9 measures. When evaluated as the relative rate of increase in use over time, process improvement slowed significantly (P (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 21, 2017 Category: Cardiology Authors: Heidenreich, P. A., Zhao, X., Hernandez, A. F., Schwamm, L. H., Smith, E., Reeves, M., Peterson, E. D., Fonarow, G. C. Tags: Quality and Outcomes Original Research Source Type: research

Post-Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke [Stroke]
This study aimed to estimate the association between post–glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke.Methods and ResultsData were derived from the ACROSS‐China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry. Patients with ischemic stroke without a history of diabetes mellitus were included. Two post–glucose load measures of insulin sensitivity, the insulin sensitivity indices ISI(composite) and the ISI0,120, were calculated. Outcomes included stroke recurrence, all‐cause death, and poor functional outcome at 12 months. A...
Source: JAHA:Journal of the American Heart Association - January 20, 2017 Category: Cardiology Authors: Pan, Y., Jing, J., Chen, W., Zheng, H., Jia, Q., Mi, D., Li, H., Zhao, X., Liu, L., Wang, C., Gaisano, H. Y., He, Y., Wang, Y., Tags: Ischemic Stroke Original Research Source Type: research

Lower Extremity Peripheral Artery Disease and Quality of Life Among Older Individuals in the Community [Epidemiology]
BackgroundEvidence regarding the association of lower extremity peripheral arterial disease with quality of life (QOL) is mainly from selected clinical populations or relatively small clinical cohorts. Thus, we investigated this association in community‐derived populations.Methods and ResultsUsing data of 5115 participants aged 66 to 90 years from visit 5 (2011‐2013) of the Atherosclerosis Risk in Communities Study, we quantified the associations of ankle‐brachial index (ABI) with several QOL parameters, including 12‐item Short‐Form Health Survey (SF‐12), after accounting for potential confounders using linear...
Source: JAHA:Journal of the American Heart Association - January 20, 2017 Category: Cardiology Authors: Wu, A., Coresh, J., Selvin, E., Tanaka, H., Heiss, G., Hirsch, A. T., Jaar, B. G., Matsushita, K. Tags: Aging, Epidemiology, Mental Health, Quality and Outcomes, Peripheral Vascular Disease Original Research Source Type: research

Outcomes of Women and Men With Acute Coronary Syndrome Treated With and Without Percutaneous Coronary Revascularization [Health Services and Outcomes Research]
ConclusionsAn increased risk of adverse clinical outcomes was observed for women with ACS undergoing an early invasive strategy and coronary revascularization compared with men. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 20, 2017 Category: Cardiology Authors: Udell, J. A., Koh, M., Qiu, F., Austin, P. C., Wijeysundera, H. C., Bagai, A., Yan, A. T., Goodman, S. G., Tu, J. V., Ko, D. T. Tags: Secondary Prevention, Women, Percutaneous Coronary Intervention, Health Services, Acute Coronary Syndromes Original Research Source Type: research

Mechanisms of Vasovagal Syncope in the Young: Reduced Systemic Vascular Resistance Versus Reduced Cardiac Output [Arrhythmia and Electrophysiology]
ConclusionsBoth ↓CO and ↓SVR occur in young VVS patients. ↓SVR is predominant in VVS and is caused by impaired splanchnic vasoconstriction. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 18, 2017 Category: Cardiology Authors: Stewart, J. M., Medow, M. S., Sutton, R., Visintainer, P., Jardine, D. L., Wieling, W. Tags: Clinical Studies, Hemodynamics, Physiology Original Research Source Type: research

Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation and Peripheral Artery Disease: Insights From the ARISTOTLE Trial [Arrhythmia and Electrophysiology]
ConclusionsPatients with PAD in ARISTOTLE had a higher crude risk of stroke or systemic embolism compared with patients without PAD that was not present after adjustment. The benefits of apixaban versus warfarin for stroke and systemic embolism were similar in patients with and without PAD. These findings highlight the need to optimize the treatment of patients with atrial fibrillation and PAD.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 17, 2017 Category: Cardiology Authors: Hu, P. T., Lopes, R. D., Stevens, S. R., Wallentin, L., Thomas, L., Alexander, J. H., Hanna, M., Lewis, B. S., Verheugt, F. W. A., Granger, C. B., Jones, W. S. Tags: Arrhythmias, Atrial Fibrillation, Anticoagulants, Peripheral Vascular Disease Original Research Source Type: research

Avoiding Untimely Implantable Cardioverter/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter/Defibrillator—The PROLONG Study [Arrhythmia and Electrophysiology]
ConclusionsA relevant proportion of patients with newly diagnosed heart failure shows recovery of LVEF>35% beyond 3 months after initiation of heart failure therapy. To avoid untimely ICD implantation, prolongation of WCD period should be considered in these patients to prevent sudden cardiac death while allowing left ventricular reverse remodeling during intensified drug therapy. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 17, 2017 Category: Cardiology Authors: Duncker, D., Konig, T., Hohmann, S., Bauersachs, J., Veltmann, C. Tags: Arrhythmias, Sudden Cardiac Death, Cardiomyopathy, Heart Failure Original Research Source Type: research

High-Saturated-Fat Diet Increases Circulating Angiotensin-Converting Enzyme, Which Is Enhanced by the rs4343 Polymorphism Defining Persons at Risk of Nutrient-Dependent Increases of Blood Pressure [Hypertension]
ConclusionsThe HF‐diet‐induced increase of ACE serum concentrations reveals ACE to be a potential molecular link between dietary fat intake and hypertension and cardiovascular disease (CVD). The GG genotype of the ACE rs4343 polymorphism represents a robust nutrigenetic marker for an unfavorable response to high‐saturated‐fat diets.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01631123. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - January 17, 2017 Category: Cardiology Authors: Schuler, R., Osterhoff, M. A., Frahnow, T., Seltmann, A.–C., Busȷahn, A., Kabisch, S., Xu, L., Mosig, A. S., Spranger, J., Mohlig, M., Hornemann, S., Kruse, M., Pfeiffer, A. F. H. Tags: ACE/Angiotensin Receptors/Renin Angiotensin System, Clinical Studies, Diet and Nutrition, Genetic, Association Studies, High Blood Pressure Original Research Source Type: research

Use of Both Serum Cystatin C and Creatinine as Diagnostic Criteria for Contrast-Induced Acute Kidney Inȷury and Its Clinical Implications [Kidney in Cardiovascular Disease]
BackgroundContrast‐induced acute kidney injury (CI‐AKI) was traditionally defined as an increase in serum creatinine (sCr) after contrast media exposure. Recently, serum cystatin C (sCyC) has been proposed as an alternative to detect acute changes in renal function. The clinical implications of combining sCyC and sCr to diagnose CI‐AKI remain unknown.Methods and ResultsOne thousand seventy‐one consecutive patients undergoing coronary angiography/intervention were prospectively enrolled. SCyC and sCr were assessed at baseline and 24 to 48 hours after contrast media exposure. CI‐AKI determined by sCr (CI‐AKIsCr)...
Source: JAHA:Journal of the American Heart Association - January 13, 2017 Category: Cardiology Authors: Zhang, W.-f., Zhang, T., Ding, D., Sun, S.-q., Wang, X.-l., Chu, S.-c., Shen, L.-h., He, B. Tags: Nephrology and Kidney Original Research Source Type: research

International Variation in Outcomes Among People with Cardiovascular Disease or Cardiovascular Risk Factors and Impaired Glucose Tolerance: Insights from the NAVIGATOR Trial [Epidemiology]
BackgroundRegional differences in risk of diabetes mellitus and cardiovascular outcomes in people with impaired glucose tolerance are poorly characterized. Our objective was to evaluate regional variation in risk of new‐onset diabetes mellitus, cardiovascular outcomes, and treatment effects in participants from the NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research) trial.Methods and ResultsNAVIGATOR randomized people with impaired glucose tolerance and cardiovascular risk factors or with established cardiovascular disease to valsartan (or placebo) and to nateglinide (or placebo) with a ...
Source: JAHA:Journal of the American Heart Association - January 13, 2017 Category: Cardiology Authors: Harumi Higuchi dos Santos, M., Sharma, A., Sun, J.-L., Pieper, K., McMurray, J. J. V., Holman, R. R., Lopes, R. D. Tags: Cardiovascular Disease, Diabetes, Type 2, Risk Factors Original Research Source Type: research

Hypertension Severity Is Associated With Impaired Cognitive Performance [Hypertension]
BackgroundMost evidence of target‐organ damage in hypertension (HTN) is related to the kidneys and heart. Cerebrovascular and cognitive impairment are less well studied. Therefore, this study analyzed changes in cognitive function in patients with different stages of hypertension compared to nonhypertensive controls.Methods and ResultsIn a cross‐sectional study, 221 (71 normotensive and 150 hypertensive) patients were compared. Patients with hypertension were divided into 2 stages according to blood pressure (BP) levels or medication use (HTN‐1: BP, 140–159/90–99 or use of 1 or 2 antihypertensive drugs; HTN‐2: ...
Source: JAHA:Journal of the American Heart Association - January 11, 2017 Category: Cardiology Authors: Muela, H. C. S., Costa-Hong, V. A., Yassuda, M. S., Moraes, N. C., Memoria, C. M., Machado, M. F., Macedo, T. A., Shu, E. B. S., Massaro, A. R., Nitrini, R., Mansur, A. J., Bortolotto, L. A. Tags: High Blood Pressure, Hypertension, Cognitive Impairment Original Research Source Type: research