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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
Persistent but not Paroxysmal Atrial Fibrillation Is Independently Associated With Lower Cognitive Function ARIC Study
The association of atrial fibrillation (AF) with an increased risk of cognitive impairment or dementia is independent of clinical stroke (1) and may be mediated by subclinical cerebral infarcts (SCIs) (2). However, little is known about whether AF burden (i.e., the percentage of time a person is in AF) is related to cognitive function. Moreover, if such a relationship exists, whether it is mediated by clinical stroke or SCIs is unknown. We hypothesized that a higher AF burden would be independently associated with lower cognitive function after adjustment for clinical stroke but that this association would be attenuated af...
Source: Journal of the American College of Cardiology - March 15, 2016 Category: Cardiology Source Type: research
Reply Nitrites/Nitrates in Heart Failure With Preserved Ejection Fraction
We thank Dr. Weber and colleagues for their interest and thoughtful comments regarding our recent trial (1) demonstrating improvement in exercise hemodynamics and cardiac reserve following acute infusion of sodium nitrite in patients with heart failure and preserved ejection fraction (HFpEF). We agree with the authors’ speculation that part of the benefit from nitrite therapy may be related to reduction in arterial wave reflections, which are known to correlate with abnormal diastolic function and the clinical syndrome of HFpEF (2,3). Indeed, we have previously shown in a separate randomized trial (4) that aggressive ...
Source: Journal of the American College of Cardiology - March 15, 2016 Category: Cardiology Source Type: research
Initial Experience With Commercial Transcatheter Mitral Valve Repair in the United States
ConclusionsIn this study of the initial commercial U.S. experience, it was found that procedural success was achieved in approximately 91% of patients, and the majority of patients were discharged home with moderate or less MR. These data support the effectiveness of this therapy in appropriately selected high-risk patients in a commercial setting. Further study is required to determine the long-term impact of transcatheter MV repair in this patient population.
Source: Journal of the American College of Cardiology - March 7, 2016 Category: Cardiology Source Type: research
Subclinical Cardiovascular Disease and Death, Dementia, and Coronary Heart Disease in Patients 80+ Years
ConclusionsIn subjects 80+ years of age, there is a greater incidence of dementia than of CHD. CAC, as a marker of atherosclerosis, is a determinant of mortality, and risk of CHD and myocardial infarction. White women with low CAC scores had a significantly decreased risk of dementia. A very important unanswered question, especially in the very elderly, is whether prevention of atherosclerosis and its complications is associated with less Alzheimer disease pathology and dementia. (Cardiovascular Health Study [CHS]; NCT00005133)
Source: Journal of the American College of Cardiology - March 1, 2016 Category: Cardiology Source Type: research
Coronary Artery Calcification A Canary in the Cognitive Coalmine ∗
In this cognitive study cohort from the Cardiovascular Health Study (CHS) in this issue of the Journal, Kuller et al. (1) examine coronary artery calcification (CAC), a measure of subclinical cardiovascular disease, as a predictor of incident dementia and coronary events among individuals without a baseline history of clinical cardiovascular events who were predominantly 80+ years of age. The study extends previous findings by examining dementia incidence prospectively over a longer follow-up duration. The results suggest that for people who live into their 8th decade without a cardiovascular event, dementia is a more like...
Source: Journal of the American College of Cardiology - March 1, 2016 Category: Cardiology Source Type: research
Perioperative Cardiovascular Risk of Prior Coronary Stent Implantation Among Patients Undergoing Noncardiac Surgery
ConclusionsThis study found that prior coronary stent implantation is an independent risk factor for MACCE and bleeding when time from stenting to NCS is
Source: Journal of the American College of Cardiology - March 1, 2016 Category: Cardiology Source Type: research
Tracking Body Mass Index From Childhood to Adulthood for Subclinical Cardiovascular Diseases at Adulthood
Subclinical cardiovascular diseases (CVDs), including arterial stiffness measured with carotid-femoral pulse wave velocity (cfPWV), carotid atherosclerosis measured with carotid artery intima-media thickness (cIMT), and left ventricular hypertrophy measured with left ventricular mass index (LVMI), may serve as the surrogate indexes of CVD (mainly coronary heart diseases and stroke). Previous studies have examined the relationship between childhood body mass index (BMI) and adult CVD risk, as well as subclinical CVD (1,2). However, the effect of BMI change from childhood to adulthood has not been clearly established. Moreo...
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research
Device Closure of Patent Foramen Ovale After Stroke Pooled Analysis of Completed Randomized Trials
ConclusionsAmong patients with PFO and cryptogenic stroke, closure reduced recurrent stroke and had a statistically significant effect on the composite of stroke, transient ischemic attack, and death in adjusted but not unadjusted analyses.
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research
PFO “Please Figure Out,” or Now “Potentially Figured Out?” ∗
In 2001, one of us (B.A.L.) was asked to give medicine grand rounds on the topic of patent foramen ovale (PFO) closure for cryptogenic stroke. The copresenting neurologist creatively titled it “PFO = Please Figure Out.” Fifteen years and 3 randomized trials later, the witty title still resonates. The recurrent theme of the 3 trials comparing medical management and transcatheter device closure of PFO to prevent recurrent cryptogenic stroke has favored device closure but fallen short of the “holy grail” of statistical significance (p
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research
Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel
ConclusionsCYP2C19 metabolizer status is not associated with the composite outcome of cardiovascular death, MI, or stroke in medically managed ACS patients treated with clopidogrel or prasugrel. Our findings do not support routine CYP2C19 genetic testing in this population. (A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects [TRILOGY ACS]; NCT00699998)
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research
Acute Pulmonary Embolism With an Emphasis on an Interventional Approach
Compared with recent advances in treatment of serious cardiovascular diseases, such as myocardial infarction and stroke, the treatment and outcome of acute pulmonary embolism (PE) have remained relatively unchanged over the last few decades. This has prompted several experts to call for the formation of multidisciplinary PE response teams with a more proactive approach to the treatment of PE. In the current document, we discuss the formation of such teams and describe the available treatment options beyond anticoagulation, with a focus on the interventional approach. Acknowledging the paucity of data to support widespread ...
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research
Testosterone and Cardiovascular Disease
Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in t...
Source: Journal of the American College of Cardiology - February 2, 2016 Category: Cardiology Source Type: research
Effect of Diabetes and Glycemic Control on Ischemic Stroke Risk in AF Patients ATRIA Study
BackgroundDiagnosed diabetes mellitus (DM) is a consistently documented risk factor for ischemic stroke in patients with atrial fibrillation (AF).ObjectivesThe purpose of this study was to assess the association between duration of diabetes and elevated hemoglobin A1c (HbA1c) with risk of stroke among diabetic patients with AF.MethodsWe assessed this association in the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) California community-based cohort of AF patients (study years 1996 to 2003) where all events were clinician adjudicated. We used Cox proportional hazards regression to estimate the rate of isc...
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research
A Diabetes-Atrial Fibrillation Conundrum Does Duration Trump Glycemia? ∗
The disease and cost burden of atrial fibrillation (AF) is expected to double over the next 25 years (1). With availability of newer therapies, efforts to refine the triage of who receives therapies, when, and for how long have assumed center stage. Over the last few years, a host of new scores such as CHADS-VASc (congestive heart failure [or Left ventricular systolic dysfunction], hypertension, age≥75 years, diabetes, prior Stroke, TIA, or thromboembolism, vascular disease [e.g. peripheral artery disease, myocardial infarction, aortic plaque], age 65–74 years, sex category) and ATRIA (Anticoagulation and Risk Factors...
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research
Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients The SMILE Trial
ConclusionsIn multivessel non–ST-segment elevation myocardial infarction patients, complete 1-stage coronary revascularization is superior to multistage PCI in terms of major adverse cardiovascular and cerebrovascular events. (Impact of Different Treatment in Multivessel Non ST Elevation Myocardial Infarction [NSTEMI] Patients: One Stage Versus Multistaged Percutaneous Coronary Intervention [PCI] [SMILE]: NCT01478984)
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research
