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Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Management of Atrial Fibrillation
Atrial fibrillation remains the most prevalent cardiac arrhythmia, and its incidence is increasing as the population ages. Common conditions associated with an increased incidence include advanced age, hypertension, heart failure, and valvular heart disease. Patients with atrial fibrillation may complain of palpitations, fatigue, and decreased exercise tolerance or may be completely asymptomatic. Options for treating patients who experience atrial fibrillation include rate-controlling drugs such as digoxin, β-blockers, and calcium channel blockers or a rhythm-controlling strategy with agents such as sodium channel blo...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Zamani, P., Verdino, R. J. Tags: Analytic Reviews Source Type: research

Cardiovascular Events of Electrical Cardioversion Under Optimal Anticoagulation in Atrial Fibrillation: The Multicenter Analysis.
CONCLUSION: Cardioversion appears as a safe procedure with a reasonably acceptable cardiovascular event rate. However, to prevent the cardiovascular events, several risk factors should be considered before cardioversion. PMID: 26446636 [PubMed - in process]
Source: Yonsei Medical Journal - October 9, 2015 Category: Universities & Medical Training Authors: Shin DG, Cho I, Hartaigh BÓ, Mun HS, Lee HY, Hwang ES, Park JK, Uhm JS, Pak HN, Lee MH, Joung B Tags: Yonsei Med J Source Type: research

{beta}-blockers in pulmonary arterial hypertension: evolving concepts of right heart failure
Current guidelines advise against the use of β-blockers in pulmonary arterial hypertension (PAH) to avoid systemic hypotension [1]. In addition, PAH patients have a fixed stroke volume, and are therefore highly dependent on heart rate to increase their cardiac output [2–4]. Indeed, Provencher et al. [5] showed that withdrawal of β-blockers significantly improved exercise capacity in portopulmonary hypertension. Peacock and Ross [6] described another case of portopulmonary hypertension, in which the use of a β-blocker to treat a supraventricular tachycardia in an already haemodynamically unstable patient was nearly fatal.
Source: European Respiratory Journal - August 31, 2015 Category: Respiratory Medicine Authors: de Man, F. S., Handoko, M. L. Tags: Pulmonary vascular disease Editorials Source Type: research

Antiplatelet therapy in Takotsubo cardiomyopathy: does it improve cardiovascular outcomes during index event?
Abstract Plasma catecholamines may play an important role in Takotsubo cardiomyopathy (TCM) pathophysiology. Patients with disproportionately high catecholamine responses to stressful events are prone to worse clinical outcomes. Catecholamines stimulate platelet activation and, therefore, may determine the clinical presentation and outcomes of TCM. We conducted a retrospective, descriptive study TCM patients admitted between 2003 and 2013 to Einstein Medical Center, Philadelphia, PA, USA and Danbury Hospital, Danbury, CT, USA. A total of 206 patients met Modified Mayo TCM criteria. Using a multiple logistic model,...
Source: Heart and Vessels - August 13, 2015 Category: Cardiology Source Type: research

Effects of blood pressure-lowering on outcome incidence in hypertension: 5. Head-to-head comparisons of various classes of antihypertensive drugs – overview and meta-analyses
Conclusions: The results of all available evidence from head-to-head drug class comparisons do not allow the formulation of a fixed paradigm of drug choice valuable for all hypertensive patients, but the differences found may suggest specific choices in specific conditions, or preferable combinations of drugs.
Source: Journal of Hypertension - June 5, 2015 Category: Cardiology Tags: Reviews Source Type: research

Abstract 118: Discharge Medications, Hospice Use and 30 Day Outcomes for Hospitalized Heart Failure Patients Session Title: Poster Session I
Conclusions: As heart failure progresses, transfer to palliative or hospice services is often appropriate. Including patients when death is imminent in outcome analyses could overestimate medication effects. Mechanisms for identifying such patients other than hospice use are limited but constitute an important goal for future research.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Stearns, S. C., Rodgers, J. E., Chang, P. P., Sueta, C. A. Tags: Session Title: Poster Session I Source Type: research

Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial
This study is registered at clinicaltrials.gov-NCT00417222.
Source: European Heart Journal - April 14, 2015 Category: Cardiology Authors: Sakata, Y., Shiba, N., Takahashi, J., Miyata, S., Nochioka, K., Miura, M., Takada, T., Saga, C., Shinozaki, T., Sugi, M., Nakagawa, M., Sekiguchi, N., Komaru, T., Kato, A., Fukuchi, M., Nozaki, E., Hiramoto, T., Inoue, K., Goto, T., Ohe, M., Tamaki, K., I Tags: Heart failure/cardiomyopathy Source Type: research

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.
CONCLUSIONS: Several class IA, IC and III drugs, as well as class II drugs (beta-blockers), are moderately effective in maintaining sinus rhythm after conversion of atrial fibrillation. However, they increase adverse events, including pro-arrhythmia, and some of them (disopyramide, quinidine and sotalol) may increase mortality. Possible benefits on clinically relevant outcomes (stroke, embolism, heart failure) remain to be established. PMID: 25820938 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - April 2, 2015 Category: Journals (General) Authors: Lafuente-Lafuente C, Valembois L, Bergmann JF, Belmin J Tags: Cochrane Database Syst Rev Source Type: research

Predictors of long-term outcomes in hypertrophic cardiomyopathy patients undergoing cardiopulmonary stress testing and echocardiography
Conclusions In HCM patients undergoing CPT, a higher % of achieved age-gender predicted V02 and surgical relief of LVOT obstruction were associated with better outcomes, while abnormal HRR, atrial fibrillation and lower LVEF were associated with worse outcomes.
Source: American Heart Journal - February 25, 2015 Category: Cardiology Source Type: research

Myocardial infarction in older than 75 years: An increasing population. CASTUO study
Conclusions Patients older than 75 years with acute myocardial infarction had lower survival and were treated with fewer beta-blockers, statins and angioplasty, indications that are associated with lower mortality.
Source: Revista Clinica Espanola - January 16, 2015 Category: Internal Medicine Source Type: research

First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension.
CONCLUSIONS: We found predominantly moderate quality evidence that all-cause mortality is similar when first-line RAS inhibitors are compared to other first-line antihypertensive agents. First-line thiazides caused less HF and stroke than first-line RAS inhibitors. The quality of the evidence comparing first-line beta-blockers and first-line RAS inhibitors was low and the lower risk of total CV events and stroke seen with RAS inhibitors may change with the publication of additional trials. Compared with first-line CCBs, first-line RAS inhibitors reduced HF but increased stroke. The magnitude of the reduction in HF exceeded...
Source: Cochrane Database of Systematic Reviews - January 11, 2015 Category: Journals (General) Authors: Xue H, Lu Z, Tang WL, Pang LW, Wang GM, Wong GW, Wright JM Tags: Cochrane Database Syst Rev Source Type: research

Effects of blood pressure lowering on outcome incidence in hypertension: 4. Effects of various classes of antihypertensive drugs – Overview and meta-analyses
Conclusion: BP lowering by all classes of antihypertensive drugs is accompanied by significant reductions of stroke and major cardiovascular events. This supports the concept that reduction of these events is because of BP lowering per se rather than specific drug properties. However, evidence of risk reduction of other events and particularly mortality was obtained so far with some drug classes only. As a result of marked differences in the trial design, total cardiovascular risk, SBP/DBP differences and statistical power, comparisons of meta-analyses of different drug-specific placebo-controlled RCTs appear unwarranted.
Source: Journal of Hypertension - January 6, 2015 Category: Cardiology Tags: Reviews and Meta-Analyses Source Type: research

{beta}-Blockers and Cardiovascular Events in Patients With and Without Myocardial Infarction: Post Hoc Analysis From the CHARISMA Trial Original Articles
Conclusions— β-blocker use in patients with prior MI but no heart failure was associated with a lower composite cardiovascular outcome driven by lower risk of recurrent MI with no difference in mortality. However, β-blocker use was not associated with lower cardiovascular events in those without MI, with a suggestion of inferior outcome with regard to stroke risk. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00050817.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Bangalore, S., Bhatt, D. L., Steg, P. G., Weber, M. A., Boden, W. E., Hamm, C. W., Montalescot, G., Hsu, A., Fox, K. A. A., Lincoff, A. M. Tags: Secondary prevention Original Articles Source Type: research

Beta-blocker Use for Toxicity From “Bath Salts”
We appreciate the review of synthetic cathinones (“bath salts”) by Dr. Banks and colleagues (1). The long half-lives of these drugs are similar to methamphetamine, and persistent tachycardia and hypertension are problems that may lead to secondary injury such as acute coronary syndrome, heart failure, arterial dissection, and stroke (2–6). Indeed, the authors recognize this and write, “What is evident in these case reports is that tachycardia is more severe and more prevalent than hypertension; heart rates are commonly reported> 150 beats/min, whereas concomitant blood pressure (BP) might be normal or only mildly (systolic BP 
Source: The Journal of Emergency Medicine - November 18, 2014 Category: Emergency Medicine Authors: John R. Richards, Erik G. Laurin, Timothy E. Albertson Tags: Letter to the Editor Source Type: research

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