Editorial Board
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Source Type: research

Contents
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Source Type: research

Incidence and Mortality trends of Atrial Fibrillation/Atrial Flutter in the United States 1990 to 2017
Atrial fibrillation (AF) is a heart rhythm disorder characterized by rapid disorganized electrical activity originating in the atrium which is associated with increased morbidity and mortality 1,2. The likelihood of developing AF is complex and influenced by biological factors, environmental factors, genetics, epigenetics, and social determinants 3-8. Studies have shown that the prevalence and incidence of AF have been increasing in North America and Europe from the 1970s to the beginning of the 21st century 9. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Authors: Augustin J. DeLago, Mohammed Essa, Alireza Ghajar, Matthew Hammond-Haley, Arshi Parvez, Isaiah Nawaz, Joseph Shalhoub, Dominic C. Marshall, Saman Nazarian, Hugh Calkins, Justin D. Salciccioli, Binu Philips Source Type: research

Meta-Analysis of Sex Disparities in In-hospital Care and Outcomes in Patients with ST-Segment Elevation Myocardial Infarction
Sex disparities in ST-segment elevation myocardial infarction (STEMI) outcomes continue to be reported worldwide; however, the magnitude of this gap remains unknown. To evaluate gender-based discrepancies in clinical outcomes and identify the primary driving factors a global meta-analysis was performed. Studies were selected if they included all comers with STEMI, reported sex specific patient characteristics, treatments, and outcomes, according to the registered PROSPERO protocol: CRD42020161469. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Authors: Tayyab Shah, Ido Haimi, Yiping Yang, Samantha Gaston, Roy Taoutel, Sameer Mehta, Hyon Jae Lee, Robaayah Zambahari, Andreas Baumbach, Timothy D Henry, Cindy L. Grines, Alexandra Lansky, Daniela Tirziu Source Type: research

Sex-Specific Differences in Etiology and Prognosis in Patients With Significant Tricuspid Regurgitation
The aim of this study was to assess differences in etiology, comorbidities, echocardiographic parameters and prognosis between men and women with significant TR. Clinical and echocardiographic characteristics of 1569 patients (age 71 (62-78) years) at first diagnosis of significant TR were compared between men and women. Patients with congenital heart disease or previous tricuspid valve surgery were excluded. TR etiologies were defined as primary, left valvular disease related, left ventricular (LV) dysfunction related, pulmonary hypertension related, or isolated. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Authors: Marlieke F. Dietz, Edgard A. Prihadi, Pieter van der Bijl, Federico Fortuni, Ana Isabel Marques, Nina Ajmone Marsan, Jeroen J. Bax, Victoria Delgado Source Type: research

COVID-19 and Gender Disparities in Pediatric Cardiologists with Dependent Care Responsibilities
This study aimed to acquire information regarding the gender-specific effects of the COVID-19 lockdown on aspects of professional and personal lives of a subset of pediatric cardiologists. We sent an online multiple-choice survey to a listserv of Pediatric Cardiologists. Data collected included demographics, dependent care details, work hours, leave from work, salary cut, childcare hours before and after the COVID-19 peak lockdown/stay at home mandate and partner involvement. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 24, 2021 Category: Cardiology Authors: Sunita J Ferns, Shiva Gautam, Mark L. Hudak Source Type: research

Six-Month Outcomes for COVID-19 Negative Patients with Acute Myocardial Infarction Before versus During the COVID-19 Pandemic
The Coronavirus disease 2019 (COVID-19) pandemic has changed the way patients seek medical attention and how medical services are provided. We sought to compare characteristics, clinical course, and outcomes of patients presenting with acute myocardial infarction (AMI) during the pandemic compared to before it. This is a multicenter, retrospective cohort study of consecutive COVID-19 negative patients with AMI in Lithuania from March 11, 2020 to April 20, 2020 compared to patients admitted with the same diagnosis during the same period in 2019. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 22, 2021 Category: Cardiology Authors: Ali Aldujeli, Anas Hamadeh, Kristen M. Tecson, Zilvinas Krivickas, Laurynas Maciulevicius, Simas Stiklioraitis, Marius Sukys, Kasparas Briedis, Montazar Aldujeili, Kamilija Briede, Rima Braukyliene, Andrius Pranculis, Ramunas Unikas, Diana Zaliaduonyte, P Source Type: research

“The Millionaire Next Door: Part I of II: General Points”
This and the next Editorial are a review of The Millionaire Next Door: The Surprising Secrets of America's Wealthy1. The book was published in 1996, so the statistics are a little dated, but the message is unchanged. No matter how much you make, if you spend it all, you have nothing. Live below your means. Thrift creates wealth. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 20, 2021 Category: Cardiology Authors: Robert M. Doroghazi Source Type: research

Long-Term Outcomes and Valve Performance in Patients Undergoing Transcatheter Aortic Valve Implantation
Transcatheter aortic valve implantation (TAVI) is an equal therapeutic strategy to surgery in patients with symptomatic severe aortic valve stenosis (AS) at low, medium and high surgical risk1-4. One of the few remaining issues with transcatheter heart valves is the long-term durability and valve performance. The aim of this study was to determine the long-term clinical outcomes and valve performance beyond 5 years with the first and second generation of a self-expanding bioprosthesis. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Konstantinos Stathogiannis, Andreas Synetos, George Latsios, Antonios Karanasos, George Trantalis, Pantelis Toskas, Maria Drakopoulou, Maria Xanthopoulou, Maria Karmpalioti, Chryssa Simopoulou, Stergios Soulaidopoulos, George Oikonomou, Georgios Benetos, Source Type: research

Usefulness of Rhythm Monitoring Following Acute Ischemic Stroke
Atrial fibrillation (AF) is a well-recognized risk factor for ischemic stroke, and AF-related strokes are typically severe.1,2 Recognizing AF as the underlying mechanism of stroke is important, as oral anticoagulation substantially reduces risk of recurrent stroke.3 –5 AF is frequently subclinical, however, and detected only after extended rhythm monitoring.6–8 As a result, current guidelines provide a Class IIa recommendation (moderate strength and good quality evidence) for extended rhythm monitoring (“∼ 30 days”) within six months following cryptog enic stroke (i.e., strokes with no apparent ...
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Shaan Khurshid, Xinye Li, Jeffrey M. Ashburner, Ana T. Trisini Lipsanopoulos, Priscilla R. Lee, Aimee K. Lin, Darae Ko, Patrick T. Ellinor, Lee H. Schwamm, Emelia J. Benjamin, Steven J. Atlas, Daniel E. Singer, Christopher D. Anderson, Ludovic Trinquart, Source Type: research

Relation of Decongestion and Time to Diuretics to Biomarker Changes and Outcomes in Acute Heart Failure
In patients with acute heart failure (AHF), prompt initiation of decongestive therapy may help mitigate the adverse effects of congestion and multi-organ injury in the early phase of hospitalization and result in improved outcomes. Several studies have examined the relationship between early initiation of diuretics and/or vasoactive agents and clinical outcomes 1-4. However, a pathophysiologic link between early treatment, decongestion, organ damage and clinical outcomes has not been fully assessed, especially from the viewpoint of biomarker trajectories. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Yu Horiuchi, Nicholas Wettersten, Dirk J. van Veldhuisen, Christian Mueller, Gerasimos Filippatos, Richard Nowak, Christopher Hogan, Michael C. Kontos, Chad M. Cannon, Gerhard A. M üeller, Robert Birkhahn, Pam Taub, Gary M. Vilke, Olga Barnett, Kenneth M Source Type: research

Comparison of Metoprolol versus Carvedilol After Acute Myocardial Infarction
Beta-blocker therapy after myocardial infarction (MI) improves survival and is a cornerstone of post-MI management. Multiple randomized clinical trials and observational studies supported the use of beta-blocker therapy post-MI, leading to the recommendation of beta-blocker therapy for the majority of patients following acute non-ST elevation MI and ST-elevation MI without any contraindication. The most prescribed beta-blocker post-MI varies from region to region, but the two most prescribed are metoprolol and carvedilol1-6. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Ghaith Zaatari, Dan J. Fintel, Haris Subacius, Joseph J Germano, Jacob Shani, Jeffrey J. Goldberger, Outcomes of Beta-blocker Therapy After myocardial INfarction (OBTAIN) Investigators Source Type: research

Sex-Based Differences in Prevalence and Outcomes of Common Acute Conditions Associated with Type 2 Myocardial Infarction
Little is known about the association between acute prevalent conditions in patients with type 2 Myocardial Infarction (T2MI) and clinical outcomes, particularly between sexes. Using the Nationwide Inpatient Sample (2015-2017), we examined outcomes of T2MI in patients stratified by prevalent associated conditions (renal failure, decompensated heart failure, infection, acute respiratory failure, cardiac arrhythmias, bleeding) and sex. Multivariable logistic regression was performed to assess the odds ratios (OR) of in-hospital all-cause mortality in each of the study groups. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Mohamed O. Mohamed, Tahmeed Contractor, Dmitry Abramov, Purvi Parwani, Erin D. Michos, David Fischman, M Chadi Alraies, Rodrigo Bagur, Mamas A. Mamas Source Type: research

Coronary Artery Disease as the Cause of Sudden Cardiac Death Among Victims < 50 Years of Age
Coronary artery disease (CAD) is the leading cause of sudden cardiac death (SCD) 1, resulting from either acute coronary syndrome or fatal arrhythmias due to myocardial fibrosis/scarring. Among young, non-ischemic structural diseases and arrhythmia disorders are more prevalent 2. While CAD is prevalent in older population, the magnitude of CAD as cause for SCD in younger individuals has also been acknowledged 3, 4. Nevertheless, there are very little data on CAD in young populations since it is uncommon in these age groups. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Juha V ähätalo, Lauri Holmström, Lasse Pakanen, Kari Kaikkonen, Juha Perkiömäki, Heikki Huikuri, Juhani Junttila Source Type: research

Racial and Socioeconomic Disparities in Cardiotoxicity among Women with HER2-Positive Breast Cancer
Breast cancer and cardiovascular-specific mortality are higher among blacks compared with whites, but disparities in cancer therapy-related adverse cardiovascular outcomes have not been well studied. We assessed for the contribution of race and socioeconomic status on cardiotoxicity among women with HER2-positive breast cancer. This retrospective cohort analysis studied women diagnosed with stage I-III HER2-positive breast cancer from 2004-2013. All underwent left ventricular ejection fraction (LVEF) assessment at baseline and at least one follow-up after beginning trastuzumab. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Mohammed Al-Sadawi, Yasin Hussain, Robert S. Copeland-Halperin, Jonathan N. Tobin, Chaya S. Moskowitz, Chau T. Dang, Jennifer E. Liu, Richard M. Steingart, Michelle N. Johnson, Anthony F. Yu Source Type: research

Blood Coagulation Changes With or Without Direct Oral Anticoagulant Therapy Following Transcatheter Aortic Valve Implantation
Thromboembolic events remain clinically unresolved after transcatheter aortic valve implantation (TAVI).1, 2 The mechanism of thromboembolic events after TAVI is multifactorial. The activation of the coagulation pathway induced by valve implantation may stimulate thrombus formation. 1, 3 However, blood coagulation change following TAVI was not fully investigated. The incidence of preexisting atrial fibrillation in patients with severe aortic valve stenosis is as high as 20% –30%.4 Although the use of direct oral anticoagulant (DOAC) for stroke prevention has increased, DOAC use to reduce thrombosis associated with TA...
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Taiga Katayama, Naoyuki Yokoyama, Yusuke Watanabe, Shinji Takahashi, Hirofumi Hioki, Kazuo Kawasugi, Ken Kozuma Source Type: research

Hospital Volume and Outcomes of Coronary Atherectomy
We examined the association between atherectomy volume and in-hospital mortality after atherectomy-facilitated PCI in a large inpatient registry. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Ayman Elbadawi, Islam Y. Elgendy, Alexander Dang, Michael Megaly, Sachin S. Goel, Yader Sandoval, Hend I. Shahin, Ahmed K. Abdel-Latif, Subhash Banerjee, Emmanouil S. Brilakis Source Type: research

Meta-Analysis of the Effect of Colchicine on Mortality and Mechanical Ventilation in COVID-19
Due to the significant healthcare and economic burdens of the coronavirus disease 2019 (COVID-19) and the lack of effective treatment, repurposing of existing medications based on plausible mechanism of action have been used. Colchicine, an anti-inflammatory medication, has been proposed as a possible treatment option for COVID-19. Colchicine exerts its anti-inflammatory effects via inhibition of neutrophil chemotaxis, adhesion, and mobilization; suppression of superoxide production; and reduction of tumor necrosis factor (TNF)- α generation and activity. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Husam M. Salah, Jawahar L. Mehta Source Type: research

Economic Evaluation of an N-terminal pro B-type Natriuretic Peptide-supported Diagnostic Strategy among Dyspneic Patients Suspected of Acute Heart Failure in the Emergency Department
Dyspnea is a frequent reason for emergency department (ED) admission in the United States (US).1 Its underlying cause may be acute heart failure (AHF) or a respiratory condition that requires different management.2-4 Effective differentiation of AHF from other causes of dyspnea at the time of diagnostic work-up is important as uncertainty in assessment increases the likelihood of hospital admission, longer hospital stays, and higher rates of one-year morbidity and mortality.2 Among available diagnostic tools, echocardiography demonstrated the highest accuracy in evaluating patients for AHF5; however, it requires specialize...
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Uwe Siebert, Sandra Milev, Denise Zou, Michal Litkiewicz, Hannah K. Gaggin, Linda Tirapelle, Serge Masson, James L. Januzzi Source Type: research

Spontaneous Coronary Artery Dissection and Menopause
Spontaneous coronary artery dissection (SCAD) is a relatively uncommon, though increasingly recognized cause of acute coronary syndrome (ACS), especially in women.1-4 This entity, defined as a spontaneous separation of the coronary artery wall layers non-iatrogenic and not related to trauma, has been classically associated to young women, especially during pregnancy and peripartum.4,5 Recent data from larger and prospective registries on SCAD have allowed to improve our knowledge on this entity, thus providing relevant information about the pathophysiology, diagnosis, management and prognosis of SCAD. (Source: The American...
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Pablo D íez-Villanueva, Marcos Manuel García-Guimaraes, Fernando Macaya, Mónica Masotti, Juan Manuel Nogales, Marcelo Jimenez-Kockar, Maite Velázquez, Íñigo Lozano, Jose Moreu, Pablo Avanzas, Jorge Salamanca, Fernando Alfonso Source Type: research

Impact and Determinants of High-Sensitivity Cardiac Troponin-T Concentration in Patients With COVID-19 Admitted to Critical Care
Cardiac Troponin (hs-TnT) elevation has been reported in unselected patients hospitalised with COVID-19 however the mechanism and relationship with mortality remain unclear. Consecutive patients admitted to a high-volume intensive care unit (ICU) in London with severe COVID-19 pneumonitis were included if hs-TnT concentration at admission was known. Kaplan-Meier survival analysis performed, with cohorts classified a priori by multiples of the upper limit of normal (ULN). 277 patients were admitted during a 7-week period in 2020; 176 were included (90% received invasive ventilation). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Ozan M. Demir, Matthew Ryan, Chiara Cirillo, Nishita Desai, Ana Pericao, Hannah Sinclair, Vasileios Stylianidis, Kelly Victor, Bashir Alaour, Andrew Jones, Antonis N. Pavlidis, Andrew Retter, Gerald Carr-White, Luigi Camporota, Nicholas Barrett, Michael M Source Type: research

Frequency of Atrial Arrhythmia in Hospitalized Patients with COVID-19
There is growing evidence that COVID-19 can cause cardiovascular complications. However, there are limited data on the characteristics and importance of atrial arrhythmia (AA) in patients hospitalized with COVID-19. Data from 1029 patients diagnosed with of COVID-19 and admitted to Columbia University Medical Center between March 1st and April 15th 2020 were analyzed. The diagnosis of AA was confirmed by 12 lead electrocardiographic recordings, 24hour telemetry recordings and implantable device interrogations. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Hirad Yarmohammadi, John P. Morrow, Jose Dizon, Angelo Biviano, Frederick Ehlert, Deepak Saluja, Marc Waase, Pierre Elias, Timothy J. Poterucha, Jeremy Berman, Alexander Kushnir, Mark P. Abrams, Geoffrey A. Rubin, Stephanie Jou, Jessica Hennessey, Nir Uri Source Type: research

Bicuspid Aortopathy and Sports Clearance
Bicuspid aortic valve is the most common congenital heart defect, with a population prevalence estimated at 1-2%1. This condition has a variable clinical course – while many have mild disease, longitudinal studies have shown that up to 50% of patients will have some degree of aortic dilatation by age 182,3. Within this setting, sports clearance is a common scenario faced by pediatric cardiologists. Traditionally, a conservative, risk-averse approach has p redominated, given the magnitude of incorrectly clearing those with truly pre-morbid disease. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Camden Hebson, Glen Iannucci Source Type: research

Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Hypertensive Patients with COVID-19 (COVIDECA Study)
Effect of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) among hypertensive patients with coronavirus disease 2019 (COVID-19) is debated. The aim of the COVIDECA study was to assess the outcome of ACEI and ARB among hypertensive patients presenting with COVID-19.We reviewed from the Assistance Publique-H ôpitaux de Parishealthcare record database all patients presenting with confirmed COVID-19 by RT-PCR. We compared hypertensive patients with ACEI or ARB and hypertensive patients without ACEI and ARB. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Hazrije Mustafic, Abdallah Fayssoil, Lo ïc Josseran, Mounir Ouadahi, Lamiae Grimaldi-Bensouda, Olivier Dubourg, Djillali Annane, Nicolas Mansencal Source Type: research

Editorial Board
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 10, 2021 Category: Cardiology Source Type: research

Contents
(Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 10, 2021 Category: Cardiology Source Type: research

Meta-Analysis of Prospective Studies of Risk stratification by Syntax Score for Unprotected Left Main Coronary Artery Revascularization
Current guidelines for the treatment of left main coronary artery disease (ULMCD) with percutaneous or surgical revascularization is debatable. The syntax score, established based on the results of the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial, is a well-respected risk stratification method for choosing the optimal revascularization strategy.1 However, the trial had limitations including inadequate power due to very small number of ULMCD patients incorporated. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 9, 2021 Category: Cardiology Authors: Waqas T. Qureshi, Tanveer Mir, Mohammad M. Uddin, Usama Nasir Source Type: research

The Impact of Environmental Factors on the Mortality of Patients with Chronic Heart Failure
Heart failure (HF) affects an estimated 6.2 million individuals in the United States (US).1 Acute HF requiring hospitalization is more common during the winter in the US2,3 and the prognosis of a HF-related hospitalization is worse during this season compared to the rest of the year.2,4 Several large studies have confirmed this pattern in various countries throughout the world, including Japan,5,6 Nigeria,7 Italy,8 and Brazil.9 A similar pattern has been described in patients with chronic HF,10,11 however, the data are more limited. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 8, 2021 Category: Cardiology Authors: Persio D. Lopez, Eder H. Cativo-Calderon, Diana Otero, Mahjabeen Rashid, Steven Atlas, Clive Rosendorff Source Type: research

Coronary Sinus Reducers and Internal Mammary Artery Occlusion: Giambattista Vico's Recurring Cycles within the History of Civilization
With great interest, I read the article by D'Amico et al1 reporting on the usefulness of a coronary sinus (CS) reducer, a percutaneous endo-luminal stent, for treating refractory angina. The principle behind implanting this device is focal narrowing in the lumen of the CS, which activates a short cascade of events. First, it creates a pressure gradient across the device, including an increase in backward pressure in venules and capillaries. Secondly, it causes microvascular blood redistribution from the less ischemic sub-epicardium to more ischemic endocardium, thereby adjusting the normal blood flow ratio between the hear...
Source: The American Journal of Cardiology - February 5, 2021 Category: Cardiology Authors: Marco Picich è Source Type: research

Hospitalization Rates Before and After Palliative Care Utilization for Heart Failure Patients (From a Nationwide Sample)
Despite the advancement in heart failure (HF) management, HF remains a progressive disease with substantial morbidity, mortality and considerable burden on the health care system.1 Palliative care (PC) is an under-utilized, non-pharmacological modality that improves quality of life for HF patients and their families.2 Previous studies showed a potential reduction in the hospitalization rates with integration of PC; however, the rates remain relatively high ( ∼30%) over six months.2 To better understand the effect of PC on hospitalizations and to put these readmissions into context, we queried the Nationwide Readmission...
Source: The American Journal of Cardiology - February 5, 2021 Category: Cardiology Authors: Ahmed Elkaryoni, Brett W Sperry, Anna Royce, Kevin Walsh, Elizabeth Bruno, Subir Shah, Amir Darki, Islam Elgendy Source Type: research

National Trends in Mechanical and Bioprosthetic Valve Replacement Among Women of Childbearing Age
Prosthesis choice among women of childbearing age needing valve replacement surgery remains a clinical conundrum1. The durability advantage of mechanical valves is often offset by the considerable burden and morbidity of anticoagulation management during planned or unanticipated pregnancy. Indeed,>1/3 of women with mechanical valves have a serious maternal or fetal complication during pregnancy1. In addition, the emergence of transcatheter valve in valve therapies might contribute to the preference of bioprosthetic valves in this age group2,3. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 5, 2021 Category: Cardiology Authors: Mohammed Osman, Akram Kawsara, Mohamad Alkhouli Source Type: research

Meta-Analysis of Usefulness of Cerebral Embolic Protection During Transcatheter Aortic Valve Implantation
One of the most feared complications of transcatheter aortic valve implantation (TAVI) is stroke, with increased mortality and disability observed in patients suffering a stroke after TAVI. There has been no significant decline in stroke rates seen over the last 5 years; attention has therefore been given to strategies for cerebral embolic protection. With the emergence of new randomized trial data, we sought to perform an updated systematic review and meta-analysis to examine the effect of cerebral embolic protection during TAVI both on clinical outcomes and on neuroimaging parameters. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 4, 2021 Category: Cardiology Authors: Dr Yousif Ahmad, James P. Howard Source Type: research

Is Regression of Left Ventricular Hypertrophy Really a Good Thing for Patients with Hypertrophic Cardiomyopathy?: The Emerging Mavacamten Story
The 60-year history of hypertrophic cardiomyopathy has been periodically encumbered by uncertainties regarding its very nature and pathophysiology, including popular myths about the disease, some of which have persisted to this day.1 One such example is the belief that the clinical course of hypertrophic cardiomyopathy can be reversed by eliminating or substantially reducing left ventricular (LV) hypertrophy itself, the sine qua non and primary diagnostic and pathophysiologic feature of this complex inherited disease. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 4, 2021 Category: Cardiology Authors: Barry J. Maron, Ethan J Rowin, Martin S. Maron Source Type: research

Comparison of Outcomes and Mortality in Patients Having Left Ventricular Assist Device Implanted Early -vs- Late After Diagnosis of Cardiomyopathy
LVAD implantation in patients with a recently diagnosed cardiomyopathy has been poorly investigated. This work aims at describing the characteristics and outcomes of patients receiving a LVAD within 30 days following the diagnosis of cardiomyopathy. Patients from the ASSIST-ICD study were divided into recently and remotely diagnosed cardiomyopathy based on the time from initial diagnosis of cardiomyopathy to LVAD implantation using the cut point of 30 days. The primary endpoint of the study was all-cause mortality at 30-days and during follow-up. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 3, 2021 Category: Cardiology Authors: Elisabeth Chen, Nicolas Nesseler, Rapha ël P. Martins, Céline Goéminne, André Vincentelli, Clément Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Tam Hoang Minh, Philippe Gaudard, Philippe Rouvière, Magali Michel, Thomas Sénage Source Type: research

Hustles: Part III of Many
A scam is when someone purposefully and dishonestly takes something from you. A hustle is more nuanced. It is more commonly due to naivet é and lack of knowledge, with some seduction added in to exploit your ego. This is not high finance, its real life. Avoiding a hustle will save you money and embarrassment. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 3, 2021 Category: Cardiology Authors: Robert M. Doroghazi Source Type: research

The Mechanism of Balloon Impact in Percutaneous Transluminal Coronary Angioplasty in Eccentric Coronary Artery Narrowings
In the early days of percutaneous transluminal coronary angioplasty (PTCA) and in particular before the stent era, the selection of the appropriate balloon diameter was crucial for risk and success of the intervention. With larger balloon diameters the risk of vessel wall dissection was increased but the rate of restenosis was much higher when smaller balloons were used. In retrospect, it is surprising how few histopathological studies have been performed during this time period to study the mechanism of PTCA. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 2, 2021 Category: Cardiology Authors: Hugo Saner, Brigitte Saner, Bernhard Meier Tags: A historical perspective Source Type: research

Acute Chylopericardium With Tamponade and Cardiac Arrest With Pseudomyxoma Peritonei
In conclusion, this case demonstrates that chylopericardium may be life-threatening and underlines the importance of acute echocardiography in critical management of patients with unexplained shock. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 2, 2021 Category: Cardiology Authors: Nikolaj Milandt, Thomas Birkelund, Morten Engholm Source Type: research

Soluble Angiotensin-Converting Enzyme 2, Cardiac Biomarkers, Structure, and Function, and Cardiovascular Events (From the Atherosclerosis Risk in Communities Study)
Membrane-bound angiotensin-converting enzyme 2 (ACE2) is important in regulation of the renin-angiotensin-aldosterone system, but the association of cleaved soluble ACE2 (sACE2) with cardiovascular disease (CVD) is unclear. We evaluated the association of sACE2 with cardiac biomarkers, structure, and function and cardiovascular events in the Atherosclerosis Risk in Communities Study. sACE2 was measured in a subset of 497 participants (mean age 78 ±5.4 years, 53% men, 27% black); Cox regression analyses assessed prospective associations of sACE2 with time to first CVD event at median 6.1-year follow-up. (Source: The ...
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Aliza Hussain, Olive Tang, Caroline Sun, Xiaoming Jia, Elizabeth Selvin, Vijay Nambi, Aaron Folsom, Gerardo Heiss, Faiez Zannad, Thomas Mosley, Salim S. Virani, Josef Coresh, Eric Boerwinkle, Bing Yu, Jonathan W. Cunningham, Amil M. Shah, Scott D. Solomon Source Type: research

Comparison of Patients With Nonobstructive Coronary Artery Disease With Versus Without Myocardial Infarction (From the VA Clinical Assessment Reporting and Tracking [CART] Program)
Nonobstructive coronary artery disease is identified in 5-15% of patients presenting with myocardial infarction and is associated with mortality rates up to 5% at one year 1-5. Proposed causes of myocardial infarction with nonobstructive coronary artery disease (MINOCA) are diverse and include both epicardial and microvascular etiologies 5-9. Prior studies suggest that traditional cardiovascular risk factors are less prevalent in patients with MINOCA as compared to those with MI due to obstructive coronary artery disease (MI-CAD) 5,7,10,11. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Christopher P. Kovach, Annika Hebbe, Colin I. O'Donnell, Mary E. Plomondon, Paul L. Hess, Aref Rahman, Suresh Mulukutla, Stephen W. Waldo, Javier A. Valle Source Type: research

Long-term Implications of Post-Procedural Left Ventricular End-Diastolic Pressure in Patients Undergoing Transcatheter Aortic Valve Implantation
Left ventricular end diastolic pressure (LVEDP) has evolved as the gold standard of left ventricular diastolic function.1 Elevated LVEDP has been shown to be associated with worse short- and long-term prognosis following ST-segment elevation myocardial infarction (STEMI).2,3 The use of LVEDP as a guide for fluid administration after cardiac catheterization was found to be safe and effective in preventing contrast-induced nephropathy.4 Measurement of LVEDP is readily obtainable in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVI). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Yishay Szekely, Ariel Borohovitz, Aviram Hochstadt, Yan Topilsky, Maayan Konigstein, Amir Halkin, Samuel Bazan, Shmuel Banai, Ariel Finkelstein, Yaron Arbel Source Type: research

Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients with Coronavirus Disease 2019 (From the Yale COVID-19 Cardiovascular Registry)
Individuals with established cardiovascular disease or a high burden of cardiovascular risk factors may be particularly vulnerable to develop complications from coronavirus disease 2019 (COVID-19). We conducted a prospective cohort study at a tertiary care center to identify risk factors for in-hospital mortality and major adverse cardiovascular events (MACE; a composite of myocardial infarction, stroke, new acute decompensated heart failure, venous thromboembolism, ventricular or atrial arrhythmia, pericardial effusion, or aborted cardiac arrest) among consecutively hospitalized adults with COVID-19, using multivariable b...
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Manan Pareek, Avinainder Singh, Lina Vadlamani, Maxwell Eder, Justin Pacor, Jakob Park, Zaniar Ghazizadeh, Alex Heard, Ana Sofia Cruz-Solbes, Roozbeh Nikooie, Chad Gier, Zain V. Ahmed, James V. Freeman, Judith Meadows, Kim G.E. Smolderen, Rachel Lampert, Source Type: research

Usefulness of Beta-Blockers to Control Symptoms in Patients with Pericarditis
Conventional therapy of pericarditis includes anti-inflammatory drugs (e.g. non-steroidal anti-inflammatory drugs, colchicine, corticosteroids) for pain control and relief.1,2 Exercise restriction is a non-pharmacologic component of medical therapy and it is recommended by contemporary guidelines.2,3 Pericardial pain is triggered and worsened by friction of inflamed pericardial layers. A plausible hypothesis is that a reduction of heart rate could be helpful to achieve a better control of symptoms in pericarditis by reducing the friction of inflamed pericardial layers, and thus mechanical inflammation. (Source: The America...
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Massimo Imazio, Alessandro Andreis, Alessandra Agosti, Francesco Piroli, Stefano Avondo, Matteo Casula, Elena Paneva, Gabriele Barberi Squarotti, Carla Giustetto, Gaetano Maria De Ferrari Source Type: research

Usefulness of the Duke Activity Status Index to Select an Optimal Cardiovascular Exercise Stress Test Protocol
Exercise testing represents the preferred stress modality for individuals undergoing evaluation of suspected myocardial ischemia. Individuals with limited functional status may be unable to achieve an adequate exercise stress, thus influencing the diagnostic sensitivity of the results. The Duke Activity Status Index (DASI) is a clinically applicable tool to estimate exercise capacity. The purpose of the current study was to assess the utility of the DASI to identify individuals unable to achieve an adequate exercise stress result. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 31, 2021 Category: Cardiology Authors: Justin M. Canada, Mary Ann Reynolds, Rachel Myers, Josh West, Katey Sweat, Colton Powell, Virginia McGhee, Michael C. Kontos, Hem Bhardwaj, Antonio Abbate, Ross Arena, W. Gregory Hundley Tags: Full Length Article Source Type: research

Meta-analysis of Population Characteristics and Outcomes of Patients Undergoing Pericardiectomy for Constrictive Pericarditis
We sought to systematically describe the epidemiology, etiology, clinical and operative characteristics as well as outcomes of patients undergoing pericardiectomy for constrictive pericarditis in the contemporary era. We conducted a systematic search of the MEDLINE, Embase and Cochrane databases from their inception to April 1, 2020 for studies assessing the outcomes of pericardiectomy in patients with constrictive pericarditis. Studies with patients enrolled before 1985, pediatric patients or studies including>10% tuberculous pericarditis were excluded. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 31, 2021 Category: Cardiology Authors: Aspasia Tzani, Ilias P. Doulamis, Andreas Tzoumas, Dimitrios V. Avgerinos, Dimitrios Koudoumas, Gerasimos Siasos, Manolis Vavuranakis, Allan Klein, Polydoros N. Kampaktsis Source Type: research

Effect of High-Density Lipoprotein Cholesterol Levels on Overall Survival and Major Adverse Cardiovascular and Cerebrovascular Events
In this study, we report the effect of HDL-C levels on overall survival outcomes and rates of MACCE following percutaneous coronary intervention (PCI). We reviewed patients who underwent PCI at the Cleveland Clinic from 2005 through 2017 and followed them through the end of 2018. Restricted cubic splines incorporated into Cox proportional hazard regression models were used to assess the outcomes. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Manpreet Kaur, Keerat Rai Ahuja, Shameer Khubber, Leon Zhou, Beni Rai Verma, Chandramohan Meenakshisundaram, Mohamed M Gad, Anas Saad, Kamalpreet Dhaliwal, Toshiaki Isogai, Jeevanatham Rajeswaran, Andrew Toth, Johnny Chahine, Leslie Cho, Rishi Puri, Samir Source Type: research

Meta-analysis of Valve-in-valve Transcatheter Aortic Valve Implantation Versus Redo-surgical Aortic Valve Replacement in Failed Bioprosthetic Aortic Valve
This meta-analysis was conducted to compare clinical outcomes of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-surgical aortic valve replacement (Redo-SAVR) in failed bioprosthetic aortic valves. We conducted a comprehensive review of previous publications of all relevant studies through August 2020. Twelve observational studies were included with a total of 8,430 patients, and a median-weighted follow-up period of 1.74 years. A pooled analysis of the data showed no significant difference in all-cause mortality (OR 1.15; 95% CI 0.93 – 1.43; p=0.21), cardiovascular mortality, myocardial...
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Abdullah Al-abcha, Yehia Saleh, Manel Boumegouas, Rohan Prasad, Khader Herzallah, Zulfiqar Qutrio Baloch, Ola Abdelkarim, Supratik Rayamajhi, George S Abela Source Type: research

Meta-Analysis of Efficacy of Sacubitril/Valsartan in Heart Failure with Preserved Ejection Fraction
Randomized controlled trials (RCTs) of sacubitril/valsartan have suggested possible clinical benefit among patients with heart failure with preserved ejection fraction (HFpEF). The phase II PARAMOUNT (Prospective comparison of ARNI with ARB [angiotensin-receptor blockers] on Management Of HFpEF) trial found sacubitril/valsartan to significantly reduce natriuretic peptide concentrations and left atrial size, compared with valsartan.1 In the PARAGON-HF (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in HFpEF) trial, although sacubitril/valsartan did not meet the primary endpoint of a statisti...
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Husam M. Salah, Marat Fudim, Subhi J. Al'Aref, Muhammad Shahzeb Khan, Zaid I. Almarzooq, Subodh R. Devabhaktuni, Robert J. Mentz, Javed Butler, Stephen J. Greene Source Type: research

Comparison of Direct Oral Anticoagulants versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves
The objectives of this study were to evaluate the ambulatory utilization of DOACs and to compare the effectiveness and safety of DOACs versus warfarin in patients with AF and BHVs. We conducted a retrospective cohort study at a large integrated health care delivery system in California. Patients with BHVs and AF treated with warfarin, dabigatran, rivaroxaban or apixaban between September 12, 2011 and June 18, 2020 were identified. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Lewei Duan, Jason N Doctor, John L Adams, John A Romley, Leigh-Anh Nguyen, Jaejin An, Ming-Sum Lee Source Type: research

Effect of Obesity on Response to Spironolactone in Patients with Heart Failure with Preserved Ejection Fraction
Obesity is common in heart failure with preserved ejection fraction (HFpEF). Whether obesity modifies the response to spironolactone in patients with HFpEF remains unclear. We aimed to investigate the effect of obesity, defined by body mass index (BMI) and waist circumference (WC), on response to spironolactone in patients with HFpEF enrolled in TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. This was a post-hoc, exploratory analysis of the Americas cohort of TOPCAT. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Khaled Elkholey, Lampros Papadimitriou, Javed Butler, Udho Thadani, Stavros Stavrakis Source Type: research

Frequency, Trend, Predictors, and Impact of Gastrointestinal Bleeding in Atrial Fibrillation Hospitalizations
Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke 1. Anticoagulation alone or in combination with other treatment strategies are implemented to reduce the risk of stroke in patients with AF. Gastrointestinal bleeding (GIB) is a common complication of oral anticoagulation (OAC) with a prevalence of 1%-3% in patients on long term OAC2. GIB in AF patients leads to discontinuation of anticoagulation, which can increase the risk of ischemic stroke, subject patients to endoscopic procedures, blood transfusions, and related side effects. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Mihir Dav, Ashish Kumar, Monil Majmundar, Devina Adalja, Mariam Shariff, Palak Shah, Rupak Desai, Krunalkumar Patel, Gowthami Sai Kogilathota Jagirdhar, Saraschandra Vallabhajosyula, Nageshwara Gullapalli, Rajkumar Doshi Source Type: research