Meta-Analysis of the Efficacy and Safety of Genotype-Guided Strategy for Selection of P2Y12 Inhibitors in Coronary Artery Disease
Despite the development of newer and more potent antiplatelet medications, clopidogrel remained the most prescribed P2Y12 inhibitor after percutaneous coronary intervention (PCI) in the USA..1,2 Clopidogrel is a pro-drug, which requires activation through cytochrome P450 pathway (CYP2C19) to be effective. Due to genetic variation in the CYP2C19 gene, up to 30% of the U.S. population are poor metabolizers of clopidogrel, and are at higher risk of thrombotic complications after PCI.1 –3 Ticagrelor and prasugrel metabolism are not affected by these genetic polymorphisms. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 19, 2020 Category: Cardiology Authors: Salik Nazir, Keerat Rai Ahuja, Ahmed Elzanaty, Neha J. Patel, Muhammad Mahmood, Khalid Changal, Michael Macciocca, Rajesh Gupta Source Type: research

Meta-analysis of Aspirin Monotherapy versus Dual Antiplatelet Therapy after Transcatheter Aortic Valve Implantation
Transcatheter Aortic Valve Implantation (TAVI) is increasingly being performed in patients with severe aortic stenosis1. The current American guidelines recommend dual antiplatelet therapy (DAPT) for the first 3 to 6 months after TAVI in patients who are not on anticoagulation1. These recommendations have been established based on experts ’ opinions due to the lack of clinical trials investigating the optimal antithrombotic therapy in this population. More recently, multiple studies have questioned the benefit of DAPT in reducing thromboembolic outcomes and revealed high bleeding events in patients who received DAPT ...
Source: The American Journal of Cardiology - September 19, 2020 Category: Cardiology Authors: Mohammed Osman, Moinuddin Syed, Sudarshan Balla, Babikir Kheiri, Harsh Golwala, Firas Zahr Source Type: research

Predictors and Mechanisms of Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy
Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HC) is associated with significant symptomatic deterioration, heart failure and thromboembolic disease. There is a need for better mechanistic insight and improved identification of at risk patients. We used CMR to assess predictors of AF in HC, in particular the role of myocardial fibrosis. Consecutive patients with HC referred for CMR 2003-2013 were prospectively enrolled. CMR parameters including left ventricular volumes, presence and percentage of late gadolinium enhancement in the left ventricle (%LGE) and left atrial volume index (LAVi) were measured. (Source: ...
Source: The American Journal of Cardiology - September 16, 2020 Category: Cardiology Authors: Claire E Raphael, Alphonsus C Liew, Frances Mitchell, Gajen Sunthar Kanaganayagam, Elisa Di Pietro, Simon Newsome, Ruth Owen, John Gregson, Robert Cooper, Fouad R Amin, Peter Gatehouse, Vassilis Vassiliou, Sabine Ernst, Rory O'Hanlon, Michael Frenneaux, D Source Type: research

Relationship Between Anemia and Sudden Cardiac Death in Patients with Severe Aortic Stenosis
Aortic stenosis (AS) is the most prevalent valvular abnormality warranting treatment in the US 1,2. As AS progresses, impedance of blood flow results in increasing left ventricular pressure overload, hypertrophy, and decreased compliance which ultimately impairs cardiac output and coronary blood flow. As such, AS is associated with significant comorbidity and mortality including SCD. The onset of symptoms in AS is associated with a marked increase in mortality. Even asymptomatic patients with severe AS are at increased risk of SCD death events with an estimated even rate of 1% per year 1-3. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Allison Ducharme-Smith, C. Anwar A. Chahal, Hiroyiku Sawatari, Alex Podboy, Akil Sherif, Christopher G. Scott, Peter A. Brady, Bernard J. Gersh, Virend K. Somers, Vuyisile T. Nkomo, Patricia A. Pellikka Source Type: research

Timing of Ablation and Prognosis of Patients with Electrical Storm and Scar-Related Left Ventricular Dysfunction
Electrical storm (ES) is a very serious clinical syndrome. It is characterised by several episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) produced by a state of electrical instability1-3. Several works show that patients with ES present an increased risk of sudden arrhythmic or cardiac death in the midterm follow up4,5; however no reproducible data on acute mortality are available6. Radiofrequency catheter ablation (RFCA) for ES is safe and very effective in reducing the number of monomorphic VT episodes7,8. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Javier Jim énez Candil, Juan Carlos Castro, Jesús Hernández, Javier Fernández-Portales, Manuel Durán, Olga Durán, Jendri Pérez, Juliana Elices, José Luis Moríñigo, Francisco Martín, Carlos González-Juanatey, Pedro L Sánchez Source Type: research

Relation of Statin Use Prior to Admission to Severity and Recovery Among COVID-19 Inpatients
The impact of statins, ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) on COVID-19 severity and recovery is important given their high prevalence of use among individuals at risk for severe COVID-19. We studied the association between use of statin/ACEi/ARB in the month before hospital admission, with risk of severe outcome, and with time to severe outcome or disease recovery, among patients hospitalized for COVID-19. We performed a retrospective single-center study of all patients hospitalized at UCSD Health between February 10-June 17, 2020 (n=170 hospitalized for COVID-19, n=5281 COVID-negative control...
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Lori B. Daniels, Amy M. Sitapati, Jing Zhang, Jingjing Zou, Quan M. Bui, Junting Ren, Christopher A. Longhurst, Michael H. Criqui, Karen Messer Source Type: research

Relation of Biomarkers of Cardiac Injury, Stress, and Fibrosis with Cardiac Mechanics in Individuals ≥ 65 Years of Age
High sensitivity cardiac troponin T (hscTnT), soluble ST2 (sST2), N-terminal B-type natriuretic peptide (NT-proBNP), and galectin-3 (gal-3) are biomarkers of cardiac injury, stress, myocardial stretch and fibrosis. Elevated levels are associated with poor outcomes. However, their association with cardiac mechanics in older persons is unknown. Associations between these biomarkers and cardiac mechanics derived from speckle tracking echocardiography, including left ventricular longitudinal strain (LVLS), early diastolic strain (LVEDSR) and left atrial reservoir strain (LARS) were evaluated using standardized beta coefficient...
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: John S. Gottdiener, Stephen Seliger, Christopher deFilippi, Robert Christenson, Abigail S. Baldridge, Jorge R. Kizer, Bruce M. Psaty, Sanjiv J. Shah Source Type: research

Cardiovascular Outcome of Pediatric Patients With Bi-Allelic (Homozygous) Familial Hypercholesterolemia Before and After Initiation of Multimodal Lipid Lowering Therapy Including Lipoprotein Apheresis
Twenty-four patients with bi-allelic familial hypercholesterolemia (FH) commencing chronic lipoprotein apheresis (LA) at a mean age of 8.5 ± 3.1 years were analysed retrospectively and in part prospectively with a mean follow-up of 17.2 ± 5.6 years. Mean age at diagnosis was 6.3 ± 3.4 years. Untreated mean LDL-C concentrations were 752 mg/dl ± 193 mg/dl (19.5 mmol/l ± 5.0 mmol/l). Multimodal lipid lowering therapy (LLT) including LA resulted in a mean LDL-C concentration of 184 mg/dl [4.8 mmol/l], which represents a 75.5% mean reduction. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Christina Taylan, Joenna Driemeyer, Claus P. Schmitt, Lars Pape, Rainer B üscher, Matthias Galiano, Jens König, Carsten Schürfeld, Ralf Spitthöver, Axel Versen, Michael Koziolek, Tobias A. Marsen, Holger Stein, Juergen R. Schaefer, Andreas Heibges, Re Source Type: research

Comparisons of Edoxaban versus Warfarin on Levels of Plasma Prothrombin Fragment in Patients with Non-Valvular Atrial Fibrillation
The effect of edoxaban on plasma prothrombin fragment 1+2 (PTF1+2), a sensitive maker of in vivo thrombin generation, has not been fully investigated in non-valvular atrial fibrillation (NVAF). We compared plasma PTF1+2 levels between 25 NVAF patients receiving warfarin and 100 NVAF patients receiving edoxaban and additionally analyzed the association between plasma PTF1+2 levels and the dose of edoxaban. Plasma PTF1+2 levels were significantly higher in patients receiving edoxaban than in those receiving warfarin (141.5 ± 50.0 pmol/l vs 93.1 ± 55.7 pmol/l, p (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Akira Tamura, Ena Yamamoto, Yoshiyuki Kawano Source Type: research

Relation of Interatrial Block to Cognitive Impairment in Patients ≥ 70 Years of Age (From the CAMBIAD Case-Control Study)
The association between atrial fibrillation, stroke, and interatrial block (IAB) (P-wave duration ≥120 ms) is well recognized, particularly in the case of advanced IAB. We aimed to assess the association of IAB with mild cognitive impairment. CAMBIAD (Advanced Characterization of Cognitive Impairment in Elderly with Interatrial Block) was a case-control multicenter study, conducted in subjects aged ≥70 years in sinus rhythm without significant structural heart disease. Diagnosis of mild cognitive impairment was performed by an expert geriatrician, internist, or neurologist in the presence of changes in cognitive func...
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Cristian Herrera, Vanesa Bru ña, Pedro Abizanda, Pablo Díez-Villanueva, Francesc Formiga, Rosa Torres, José Carreras, Rocio Ayala, F. Javier Martin-Sánchez, Antoni Bayés-Genis, Roberto Elosua, Antonio Bayés-de-Luna, Manuel Martínez-Sellés, CAMBIAD Source Type: research

Relation of Timing of Percutaneous Coronary Intervention on Outcomes in Patients with Non-ST Segment Elevation Myocardial Infarction
International guidelines suggest revascularization within 24 hours in non-ST segment elevation myocardial infarction (NSTEMI). Within a large population cohort study, we aimed to explore clinical practice regarding timing targets for percutaneous coronary intervention (PCI) in NSTEMI. The Victorian Cardiac Outcomes Registry was established in 2013 as a state-wide clinical quality registry, pooling data from public and private PCI capable centres. Data were collected on 11,852 PCIs performed for NSTEMI from 2014 to 2018. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Riley J Batchelor, Diem Dinh, Angela Brennan, Nathan Wong, Jeffrey Lefkovits, Christopher Reid, Stephen J Duffy, William Chan, Nicholas Cox, Danny Liew, Dion Stub, VCOR investigators Source Type: research

Cardiac Stress Testing After Coronary Revascularization
Unless prompted by symptoms or change in clinical status, the appropriate use criteria considers cardiac stress testing (CST) within two years of percutaneous coronary intervention (PCI) and five years of coronary artery bypass grafting (CABG) to be rarely appropriate. Little is known regarding use and yield of CST after PCI or CABG. We studied 39,648 patients treated with coronary revascularization (29,497 PCI; 10,151 CABG) between 04/2004 and 03/2012 in Alberta, Canada. Frequency of CST between 60 days and 2 years after revascularization was determined from linked provincial databases. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 15, 2020 Category: Cardiology Authors: Arti Dhoot, Shuangbo Liu, Anamaria Savu, Zain M. Cheema, Robert C. Welsh, Kevin R. Bainey, Dennis T. Ko, Sanjeev P. Bhavnani, Shaun G. Goodman, Padma Kaul, Akshay Bagai Source Type: research

Van Gogh and Digitalis
It has long been argued that digitalis is responsible for many of the dazzling colors in Van Gogh's painting. Several reports have made a convincing case that digitalis caused the blue-green scotomata that was often seen in Van Gogh's work.1,2 Van Gogh was a sad fellow, unrecognized in his lifetime as a great painter, unsuccessful in relationships with women, having to consistently borrow money from his brother and spurned by his dear (but one side) friend Gauguin. He was a troubled person who was being treated by a Dr. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: John C. Somberg Source Type: research

Usefulness of Semi-supervised Machine Learning-based Phenogrouping to Improve Risk Assessment for Patients Undergoing Transcatheter Aortic Valve Implantation
Semi-supervised machine learning methods are able to learn from fewer labeled patient data. We illustrate the potential use of a semi-supervised automated machine learning (AutoML) pipeline for phenotyping patients undergoing Transcatheter Aortic Valve Implantation (TAVI) and identifying patient groups with similar clinical outcome. Using the Transcatheter Valve Therapy registry (TVT) data we divided 344 patients into two sequential cohorts (Cohort 1, n= 211, Cohort 2, n=143). We investigated patient similarity analysis to identify unique phenogroups of patients in the first cohort. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Yasir Abdul Ghaffar, Mohammed Osman, Sirish Shrestha, Faizan Shaukat, Nobuyuki Kagiyama, Mohammed Alkhouli, Bryan Raybuck, Vinay Badhwar, Partho P. Sengupta Source Type: research

Usefulness of Lipoprotein (a) for Predicting Outcomes after Percutaneous Coronary Intervention for Stable Angina Pectoris in Patients on Hemodialysis
Serum lipoprotein (a) level is genetically determined and remains consistent during a person's life. Previous studies have reported that people with high lipoprotein (a) level are at a high risk of cardiac events. We investigated the association between lipoprotein (a) levels and clinical outcomes after percutaneous coronary intervention (PCI) for stable angina pectoris (SAP) in hemodialysis (HD) patients. Serum lipoprotein (a) levels were measured on admission in 410 consecutive HD patients who underwent successful PCI for SAP. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Keiichi Hishikari, Hiroyuki Hikita, Hiroshi Yoshikawa, Fumiyuki Abe, Shihoko Tsujihata, Naruhiko Ito, Yoshinori Kanno, Munehiro IIya, Tadashi Murai, Atsushi Takahashi, Taishi Yonetsu, Tetsuro Sasano Source Type: research

Relation of Absence of Coronary Artery Calcium to Cardiovascular Disease Mortality Risk among Individuals Meeting Criteria for Statin Therapy According to the 2018/2019 ACC/AHA Guidelines
The 2013 ACC/AHA guidelines resulted in broad recommendations for preventive statin therapy allocation among individuals without known cardiovascular disease (CVD). Subsequent studies demonstrated significant heterogeneity of atherosclerotic cardiovascular disease (ASCVD) risk across the primary prevention population. In 2018/2019, the guidelines were revised to optimize risk assessment and cholesterol management. We sought to evaluate the heterogeneity of risk among statin-recommended individuals, using coronary artery calcium (CAC) according to 2018/2019 ACC/AHA guidelines in a primary prevention cohort. (Source: The Ame...
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Tanuja Rajan, Alan Rozanski, Miguel Cainzos-Achirica, Gowtham R. Grandhi, Zeina A. Dardari, Mouaz H. Al-Mallah, Ron Blankstein, Michael D. Miedema, Leslee J. Shaw, John A. Rumberger, Matthew J. Budoff, Michael J. Blaha, Daniel Berman, Khurram Nasir Source Type: research

Comparison of Outcomes in Patients with Takotsubo Syndrome with-vs-without Cardiogenic Shock
Takotsubo syndrome (TS) is a neurologically mediated acute heart failure syndrome characterized by transient reversible left ventricular dysfunction affecting more than one coronary artery territory in a circumferential distribution.1,2 The syndrome is classically associated with a lack of culprit lesion on coronary angiography and is often triggered by physical or emotional stress.2 TS is variably referred to as stress cardiomyopathy, apical ballooning syndrome or broken heart syndrome and is increasingly recognized in approximately 2% of patients initially presenting with acute coronary syndromes. (Source: The American J...
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Moinuddin Syed, Muhammad Zia Khan, Mohammed Osman, Anas Alharbi, Muhammad Usman Khan, Muhammad Bilal Munir, Sudarshan Balla Source Type: research

Relevance of Functional Mitral Regurgitation in Aortic Valve Stenosis
The clinical relevance of functional-mitral-regurgitation (FMR) in patients with aortic-valve-stenosis (AS) has been poorly studied using a quantitative approach. In addition, FMR prognostic value has mostly been analyzed after aortic valve replacement. Between 2010-2014 the echocardiograms of consecutive AS patients were retrospectively reviewed. Inclusion criteria were calcified aortic valve with transaortic-velocity>2.5 m/sec and calculated mitral effective-regurgitant-orifice area (ERO) in the presence of mitral regurgitation. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Giovanni Benfari, Martina Setti, Stefano Nistri, Diego Fanti, Caterina Maffeis, Elvin Tafciu, Michele Pighi, Mariantonietta Cicoira, Flavio Luciano Ribichini, Andrea Rossi Source Type: research

Comparison in Patients < 75 Years of Age - vs – Those > 75 Years on One-Year-Events with Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry)
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared to younger patients, they benefit from optimal anticoagulation. The sub-analysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients ( ≥ 75 years) compared to younger ( (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Aref El Nasasra, Johannes Brachmann, Thorsten Lewalter, Ibrahim Akin, Horst Sievert, Christoph A. Nienaber, Christian Wei ß, Sven T. Pleger, Hüseyin Ince, Jens Maier, Stephan Achenbach, Holger H. Sigusch, Matthias Hochadel, Steffen Schneider, Jochen Sen Source Type: research

Comparison of Outcomes After Ablation of Atrial Fibrillation in Patients With Heart Failure with Preserved Versus Reduced Ejection Fraction
Catheter ablation improves outcomes in atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). We sought to evaluate the efficacy and safety of catheter ablation of AF in HF patients with a preserved ejection fraction (HFpEF). We performed a retrospective study of all patients who underwent de novo radiofrequency catheter ablation enrolled in the UC San Diego AF Ablation Registry. The primary outcome was recurrence of all atrial arrhythmias on or off antiarrhythmic drugs (AAD). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Omar M. Aldaas, Chaitanya L. Malladi, Praneet S. Mylavarapu, Florentino Lupercio, Douglas Darden, Frederick T. Han, Kurt S. Hoffmayer, David Krummen, Gordon Ho, Farshad Raissi, Gregory K. Feld, Jonathan C. Hsu Source Type: research

Relation of High-Sensitivity Cardiac Troponin I Elevation with Exercise to Major Adverse Cardiovascular Events in Patients with Coronary Artery Disease
High sensitive cardiac troponin I (hs-cTnI) increases with inducible myocardial ischemia in patients with coronary artery disease (CAD). We aimed to assess if the change in hs-cTnI levels with exercise stress testing is associated with major adverse cardiac events (MACE). A cohort of 365 (age 62 ± 9 years, 77% men) patients with stable CAD underwent 99mTc sestamibi myocardial perfusion imaging with treadmill testing. Plasma hs-cTnI level was measured at rest and at 45 min after stress. Multivariable Fine& Gray's sub-distribution hazards models (sHR) were used to determine the association between the change in hs...
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Bruno B. Lima, Muhammad Hammadah, Jeong Hwan Kim, Irina Uphoff, Amit Shah, Oleksiy Levantsevych, Zakaria Almuwaqqat, Kasra Moazzami, Samaah Sullivan, Laura Ward, Yan Sun, Michael Kutner, Yi-An Ko, David S Sheps, Agim Beshiri, Gillian Murtagh, J Douglas Br Source Type: research

Safety and Efficacy of Oral Anticoagulants for Atrial Fibrillation in Patients After Bariatric Surgery
Bariatric surgery is a mainstay of treatment for obesity, and results in anatomic changes which may influence pharmacokinetic properties of medications.1 –3 Atrial fibrillation (AF) is a common comorbidity among the bariatric surgery population as obesity itself increases the risk of developing AF and often requires anticoagulation. To date there is limited evidence describing the efficacy and safety of oral anticoagulants in patients with bariatri c surgery, and even less to guide agent selection when therapy is warranted. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Abby K. Hendricks, Joseph J. Zieminski, Xiaoxi Yao, Shannon M. Dunlay, Lindsey R. Sangaralingham, John G. O'Meara, Theocles R. Herrin, Scott D. Nei Source Type: research

Cardiovascular Risk Among Patients ≥ 65 Years of Age with Parkinson's Disease (From the National Inpatient Sample)
In this study, we aimed to investigate the relationship between PD and vascular disease and risk factors using a nationally representative sample. The National Inpatient Sample (NIS) was queried for all patients aged ≥ 65 who were diagnosed with PD during the year 2016. Patients were identified using the International Classification of Diseases—Tenth Revision (ICD-10) diagnosis code: "G20". Each patient diagnosed with PD was frequency-matched to controls at a 1:4 ratio by age and gender. Study outcomes were hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease and stroke. (Source: The ...
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Ashraf Abugroun, Ahmed Taha, Manar Abdel-Rahman, Pragnesh Patel, Ibtisam Ali, Lloyd W Klein Source Type: research

Prognostic Implications of Increased Right Ventricular Wall Tension in Secondary Tricuspid Regurgitation
Secondary tricuspid regurgitation (TR) imposes a chronic volume overload on the right ventricle (RV) which can increase RV wall tension (RVWT). The aim of this study was to investigate the prognostic implications of increased RVWT in patients with significant secondary TR. A total of 1142 patients with moderate-to-severe secondary TR were included. Based on the simplified Laplace-Young's law, RVWT was defined as the product between pulmonary artery systolic pressure (PASP) and RV base-to-apex length. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Federico Fortuni, Marlieke F. Dietz, Steele C. Butcher, Edgard A. Prihadi, Pieter van der Bijl, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax Source Type: research

“Private Equity and the Private Practice of Medicine”
Physicians now have 3 general options to practice Medicine. The first is traditional private practice. Over the last few decades, many physicians have chosen to become hospital employees. They may have an MD behind their name, but are lumped together as “providers”, just one more cost center to be controlled, no different than an X-Ray tech, or how much it costs to repave the parking lot. Many find out, invariably the hard way, that they can also be fired and unemployed if they do not please the hospital CEO. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 14, 2020 Category: Cardiology Authors: Robert M. Doroghazi Source Type: research

Effect of Acute Pulmonary Embolism on the Hospitalization Rates in Patients with Heart Failure (From a Nationwide Cohort Sample)
Patients with heart failure (HF) experience high rates of hospitalization, account for over 1 million admissions annually, and place a large economic burden on the US health system.1 HF complicated by acute pulmonary embolism (PE) is associated with even worse outcomes.2 Prior studies demonstrated a bidirectional relationship whereby both conditions increase the risk of hospitalization and mortality for the other.3,4 Further understanding the inter-relationship between PE and HF, particularly across types of HF (HF with reduced (HFrEF) and preserved (HFpEF) ejection fraction), may help guide more tailored treatment strateg...
Source: The American Journal of Cardiology - September 11, 2020 Category: Cardiology Authors: Ahmed Elkaryoni, Karim R. Merchant, Yevgeniy Brailovsky, Matthew C. Bunte, Brett W. Sperry, Amir Darki Source Type: research

In-Hospital Survival after Out of Hospital Cardiac Arrest
We read with keen interest the description of etiology and determinants of in-hospital survival after an out of hospital cardiac arrest (OHCA) (1). Among the non-cardiac causes, pulmonary embolism is reported to be the most common. It is particularly challenging to diagnose pulmonary (PE) as a cause of OHCA, but it often presents as a non-shockable rhythm, which was predictive for non-survival. The emergence of mobile-application based ultrasound systems where the ubiquitous smartphones can be transformed into an ultrasound by plugging in a transducer or through a Bluetooth will facilitate the diagnosis of PE in OHCA (2). ...
Source: The American Journal of Cardiology - September 11, 2020 Category: Cardiology Authors: Boban Thomas, Imad Hassan, Carla Nobre Source Type: research

Editorial Board
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 9, 2020 Category: Cardiology Source Type: research

Contents
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 9, 2020 Category: Cardiology Source Type: research

Corrigendum to “Meta-Analysis Comparing Outcomes of Therapies for Patients with Central Sleep Apnea and Heart Failure With Reduced Ejection Fraction”
The authors regret that the disclosure information was omitted in this article. Please find here the following disclosure information: (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 9, 2020 Category: Cardiology Authors: Jeffrey Voigt, Sitaramesh Emani, Sanjaya Gupta, Robin Germany, Rami Khayat Source Type: research

Association of Body Mass Index With Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair
Obesity is a major independent risk factor for premature death due to cardiovascular diseases. Several studies have reported a better prognosis for obese patients who underwent transcatheter aortic valve replacement, coronary artery bypass grafting, hypertension, and heart failure compared with their leaner counterparts.1,2 This counterintuitive phenomenon has been described as an “obesity paradox,” and the exact pathophysiological mechanism of this association is not fully understood. Mitral regurgitation (MR) is the most frequent form of valvular heart disease in the United States. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 8, 2020 Category: Cardiology Authors: Salik Nazir, Keerat Rai Ahuja, Michael Macciocca, Khalid Changal, Carson Oostra, Muhammad Asif Mangi, Muhammad Mahmood, Asad Inayat, Eric E. Elgin, Ehab Eltahawy Source Type: research

Relation of Body Mass Index to Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair
Obesity is a major independent risk factor for premature death due to cardiovascular diseases. Several studies have reported a better prognosis for obese patients undergoing transcatheter aortic valve replacement, coronary artery bypass grafting, hypertension, and heart failure compared to their leaner counterparts.1,2 This counterintuitive phenomenon has been described as an “obesity paradox”, and the exact pathophysiological mechanism of this association is not fully understood. Mitral regurgitation (MR) is the most frequent form of valvular heart disease in the United States. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 8, 2020 Category: Cardiology Authors: Salik Nazir, Keerat Rai Ahuja, Michael Macciocca, Khalid Changal, Carson Oostra, Muhammad Asif Mangi, Muhammad Mahmood, Asad Inayat, Eric E. Elgin, Ehab Eltahawy Source Type: research

Meta-Analysis Comparing Angiography-Guided versus FFR-Guided Coronary Artery Bypass Grafting
Fractional flow reserve (FFR) is the ratio of mean distal coronary artery pressure to the simultaneous mean aortic pressure at maximal hyperemia. FFR provides an objective assessment of the flow in a coronary artery and is the gold standard for physiological stenosis severity assessment. An FFR cut-off of ≤ 0.80, indicating the mean hyperemic coronary pressure is reduced by at least 20% from the theoretical maximum value, is used in contemporary practice to define a physiologically significant stenosis. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 8, 2020 Category: Cardiology Authors: Khalid Changal, Mitra Patel, FNU Salman, Salik Nazir, Rajesh Gupta Source Type: research

Network Meta-analysis Comparing Apixaban versus Rivaroxaban in Morbidly Obese Patients with Atrial Fibrillation
The efficacy and safety of DOACs in morbidly obese patients have been well investigated over the last few years.1-4 Our recent meta-analysis showed that the DOAC group did not increase stroke or systemic embolism (SE) event rate compared to the warfarin group and the DOAC use was significantly associated with a lower major bleeding event rate compared to the warfarin group.5 However, it is still unknown which DOAC is more appropriate than others. Apixaban and rivaroxaban are the two most common DOACs prescribed in the U.S but there is no guidance on which agent should be selected in morbidly obese patients with AF. (Source...
Source: The American Journal of Cardiology - September 8, 2020 Category: Cardiology Authors: Kazuhiko Kido, Mikiko Shimizu, Tsuyoshi Shiga, Masayuki Hashiguchi Source Type: research

Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors Versus Non-survivors in Patients With COVID-19
Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the 2 groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Saeed Shoar, Fatemeh Hosseini, Mohammad Naderan, Jawahar L. Mehta Source Type: research

Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors vs. Non-survivors in Patients with COVID-19
Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the two groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Saeed Shoar, Fatemeh Hosseini, Mohammad Naderan, Jawahar L. Mehta Source Type: research

Relation of Low Normal Left Ventricular Ejection Fraction to Heart Failure Hospitalization in Blacks (From the Jackson Heart Study)
Reduced left ventricular (LV) systolic function is associated with incident heart failure (HF).1 A LV ejection fraction (EF) of (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Daisuke Kamimura, Karen A. Valle, Chad Blackshear, Robert J. Mentz, Joseph Yeboah, Carlos J. Rodriguez, David M. Herrington, Takeki Suzuki, Ⅲ Donald Clark, Ervin R. Fox, Amil M. Shah, Richard B. Stacey, William G. Hundley, Adolfo Correa, Javed Butler, M Source Type: research

Outcomes of Patients With Acute Myocardial Infarction Who Recovered from Severe In-Hospital Complications
Acute myocardial infarction (AMI) would sometimes raise severe in-hospital complications such as cardiopulmonary arrest, shock, stroke, atrioventricular block, and respiratory failure. The purpose of this retrospective study was to compare the clinical outcomes of AMI patients who recovered from severe in-hospital complications with those who did not have in-hospital complications. We included 494 AMI patients, and divided those into the in-hospital complications group (n=166) and non-complications group (n=328). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 29, 2020 Category: Cardiology Authors: Shinnosuke Sawano, Kenichi Sakakura, Yousuke Taniguchi, Kei Yamamoto, Takunori Tsukui, Masaru Seguchi, Hiroyuki Jinnouchi, Hiroshi Wada, Hideo Fujita Source Type: research

Impact of Prior Coronary Artery Bypass Grafting in Patients ≥75 Years Old Presenting With Acute Myocardial Infarction (From the National Readmission Database)
Patients ≥75 years old presenting with acute myocardial infarction (AMI) have complex coronary anatomy in part due to prior coronary artery bypass grafting (CABG), percutaneous coronary interventions (PCI), calcific and valvular disease. Using the National Readmission Database from January 2016 to November 2017, we identified hospital admissions for acute myocardial infarction in patients ≥75 years old and divided them based on a history of CABG. We evaluated in-hospital outcomes, 30-day mortality, 30-day readmission and predictors of PCI in cohorts. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Alejandro Lemor, Gabriel A. Hernandez, Mir B Basir, Sati Patel, Pedro A. Villablanca, Khaldoon Alaswad, William O'Neill Source Type: research

Meta-Analysis of Complete Versus Culprit-Only Revascularization in Patients with ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Disease
Approximately half of patients with ST-segment elevation myocardial infarction (STEMI) present with non-infarct related multivessel coronary artery disease (CAD) during primary percutaneous coronary intervention (PCI). However, questions remain concerning whether patients with STEMI and multivessel CAD should routinely undergo complete revascularization. Our objective was to compare the risks of major cardiovascular outcomes and procedural complications in patients with STEMI and multivessel CAD randomized to complete revascularization versus culprit-only PCI. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Jeremy Y. Levett, Sarah B. Windle, Kristian B. Filion, Josselin Cabaussel, Mark J. Eisenberg Source Type: research

Ventricular Fibrillation Storm in Coronavirus 2019
Cardiac arrhythmia is a known manifestation of novel coronavirus 2019 (COVID-19) infection. Herein, we describe the clinical course of an otherwise healthy patient who experienced persistent ventricular tachycardia and fibrillation which is believed to be directly related to inflammation, as opposed to acute myocardial injury or medications that can prolong the QT interval. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Ossama Elsaid, Peter A. McCullough, Kristen M. Tecson, Ryan S Williams, Anthony Yoon Source Type: research

Outcomes After ST-segment Versus Non-ST-segment Elevation Myocardial Infarction Revascularized By Coronary Artery Bypass Grafting
The objectives of this study were to investigate the outcome differences between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) patients treated with coronary artery bypass grafting surgery (CABG). We conducted a multicenter, retrospective cohort follow-up study of consecutive patients with STEMI (surgery ≤48 hours of admission; n=348) or NSTEMI (n=1160) revascularized with first-time isolated CABG in Finland using nationwide registries (median age 68 years, 24% women). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Markus Malmberg, Jussi Sipil ä, Päivi Rautava, Jarmo Gunn, Ville Kytö Source Type: research

Familial LEOPARD Syndrome With Hypertrophic Cardiomyopathy
Multiple lentigines syndrome, also known as LEOPARD syndrome, is an autosomal dominant cardiocutaneous syndrome that has high penetrance with variable expressivity.1 In 1968, Moynahan and Polani initially described a neuroectodermal association between hypertrophic cardiomyopathy phenotype and lentiginosis.2 Subsequently, Gorlin et al. in 1969 coined the term “LEOPARD” as an acronym for lentigines, electrocardiographic conduction defects, ocular hypertelorism, pulmonary valve stenosis, abnormalities of genitalia, retardation of growth, and deafness. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Patrycja Galazka, Renuka Jain, Lakshmi Muthukumar, Heather Sanders, Michelle Bush, M. Fuad Jan, Arshad Jahangir, Bijoy K. Khandheria, A. Jamil Tajik Source Type: research

Procedural Characteristics and Outcomes of Patients Undergoing Percutaneous Coronary Intervention During Normal Work Hours versus Non-Work Hours
Historical data in the early years of treating ST-elevation myocardial infarction (STEMI) demonstrated that circadian variations had an effect on the practice of primary angioplasty, resulting in a higher incidence of failed angioplasty and worse clinical outcomes during off hours1,2. In contrast, a recent study in a contemporary organized network of hospitals demonstrated that STEMI patients admitted during on hours or off hours have similar management and outcomes3. The timing of PCI in patients with non-ST-elevation myocardial infarction (NSTEMI) has also been studied. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Brian C. Case, Charan T. Yerasi, Brian J. Forrestal, Anees Musallam, Yuefeng Chen, Toby Rogers, Lowell F. Satler, Itsik Ben-Dor, Hayder Hashim, Nelson Bernardo, Jason P. Wermers, Cheng Zhang, Rebecca Torguson, William S. Weintraub, Ron Waksman Source Type: research

Comparison of Frequency of Atrial Fibrillation in Blacks versus Whites and the Utilization of Race in a Novel Risk Score
Atrial fibrillation (AF) is the most prevalent sustained arrhythmia in the world, with over 30 million people affected as of 2010.1 The number of patients projected to develop AF will double over the next decade.2 AF is independently associated with an increased risk of stroke,3 heart failure (HF),4 and mortality.5 It is not surprising, thus, that AF assumes a sizeable share of health care expenditure and its magnitude is reaching epidemic proportions.6 Blacks despite having a higher prevalence of traditional risk factors for AF, such as HF, hypertension, and diabetes mellitus, have been shown to have a lower incidence of ...
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Gurukripa N. Kowlgi, Sampath Gunda, Santosh K. Padala, Jayanthi N. Koneru, Abhishek J. Deshmukh, Kenneth A. Ellenbogen Source Type: research

Worth Remembering: Cardiac Memory Presenting as Deep Anterior T-wave Inversions Explained by Intermittent Left Bundle Branch Block
Cardiac memory is a common cause of deep T-wave inversions (TWI) in the anterior precordial leads and can be difficult to distinguish from alternative causes of TWI such as myocardial ischemia. Cardiac memory is generally a benign condition except in the setting of prolonged QT when it can contribute to the precipitation of torsades de pointes. Herein, we describe the presentation and clinical course of a case of cardiac memory due to intermittent left bundle branch block (LBBB) that presented asymptomatically to our outpatient cardiology clinic with deep anterior TWI. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Jacob B. Pierce, James Rosenthal, Neil J. Stone Source Type: research

Prognostic Implications of Significant Isolated Tricuspid Regurgitation in Patients With Atrial Fibrillation Without Left-Sided Heart Disease or Pulmonary Hypertension
The prognostic impact of isolated tricuspid regurgitation (TR) in patients with atrial fibrillation (AF) has not been investigated. The purpose of this study was to investigate the prognostic implications of significant isolated TR in AF patients without left-sided heart disease, pulmonary hypertension or primary structural abnormalities of the tricuspid valve.A total of 63 AF patients with moderate and severe TR were matched for age and gender to 116 AF patients without significant TR. Patients were followed for the occurrhttps://doi.org/10.13039/100006520ence of all-cause mortality, hospitalization for heart failure and ...
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Marlieke F Dietz, Laurien Goedemans, N Mai Vo, Edgard A Prihadi, Pieter van der Bijl, Bernard J Gersh, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax Source Type: research

Comparison of Economic Self-sufficiency and Educational Attainment  in Adults with Congenital Heart Disease vs Siblings without Heart Disease and to General Population
Among children with congenital heart disease (CHD), there is often neurodevelopmental and behavioral impairment with unclear implications regarding adult socioeconomic achievements. We aimed to compare economic self-sufficiency and educational attainment in CHD adults with sibling and general population controls. Using Danish population-based nationwide registries this cohort study aimed to include all CHD subjects greater than 13 years born between 1963-1993. Comparison cohorts included: 1) sibling cohort, and 2) general population cohort matched 10:1 on birth year and gender. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Nicolas L. Madsen, Bradley S. Marino, Jessica G. Woo, Morten Olsen Source Type: research

Impact of Prior Coronary Artery Bypass Grafting in Patients ≥ 75 Years old Presenting with Acute Myocardial Infarction (From the National Readmission Database)
Patients ≥ 75 years old presenting with acute myocardial infarction (AMI) have complex coronary anatomy in part due to prior coronary artery bypass grafting (CABG), percutaneous coronary interventions (PCI), calcific and valvular disease. Using the National Readmission Database from January 2016 to Novembe r 2017, we identified hospital admissions for acute myocardial infarction in patients ≥ 75 years old and divided them based on a history of CABG. We evaluated in-hospital outcomes, 30-day mortality, 30-day readmission and predictors of PCI among cohorts. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Alejandro Lemor, Gabriel A. Hernandez, Mir B Basir, Sati Patel, Pedro A. Villablanca, Khaldoon Alaswad, William O'Neill Source Type: research

Barriers and Facilitators of Palliative Care and Advance Care Planning in Adults with Congenital Heart Disease
Honoring patients ’ care preferences surrounding quality of life drives high-quality medical care.1 This is especially important for patients with adult congenital heart disease (ACHD) who live with chronic illness. Life expectancy has markedly increased with medical and surgical advancements, but many continue to face disability, multimorbidity, and early death.2 Palliative care improves patients’ quality of life through the early identification, assessment, and treatment of pain and other problems that cause suffering. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 28, 2020 Category: Cardiology Authors: Jill M. Steiner, Alysha Dhami, Crystal E. Brown, Karen K. Stout, J. Randall Curtis, Ruth A. Engelberg, James N. Kirkpatrick Source Type: research