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Reduction in Ischemic Events With Ticagrelor in Diabetic Patients With Prior Myocardial Infarction in PEGASUS–TIMI 54
ConclusionsIn patients with diabetes with prior MI, adding ticagrelor to aspirin significantly reduces the risk of recurrent ischemic events, including cardiovascular and coronary heart disease death. (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin [PEGASUS]; NCT01225562)
Source: Journal of the American College of Cardiology - June 7, 2016 Category: Cardiology Source Type: research

Adherence to Medical Therapy and the Global Burden of Cardiovascular Disease ∗
Ischemic heart disease and cerebrovascular disease account for>20% of worldwide mortality and are the 2 leading causes of death on a global basis (1). Although mortality from ischemic heart disease is greater than that from stroke worldwide, the mortality from stroke is actually higher than from ischemic heart disease in 39% of countries. For example, mortality from stroke is generally higher than that for ischemic heart disease in China, Africa, and South America. In addition, stroke disability–adjusted life-year loss rates exceed ischemic heart disease-related disability in 32% of countries (2). Because of this, strate...
Source: Journal of the American College of Cardiology - March 29, 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

Annual Outcomes With Transcatheter Valve Therapy From the STS/ACC TVT Registry
ConclusionsThe TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.
Source: Journal of the American College of Cardiology - December 21, 2015 Category: Cardiology Source Type: research

Selecting Patients for Statin Therapy in Primary Prevention If We Could Only Predict the Future ∗
Statins are effective in the primary and secondary prevention of coronary heart disease and stroke. Although many would agree that primary prevention of atherosclerotic cardiovascular disease (ASCVD) is preferable to secondary prevention, no consensus exists on how to best identify individuals at risk for the disease, when to commence screening and risk assessment, at what age to start (or stop) treatment, how to treat, and how intensively to treat. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines concluded that net benefit was sufficient to recommend statin treatment for ...
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Carotid Stiffness Is Associated With Incident Stroke A Systematic Review and Individual Participant Data Meta-Analysis
ConclusionsCarotid stiffness is associated with incident stroke independently of CV factors and aortic stiffness. In addition, carotid stiffness improves stroke risk prediction beyond Framingham and aortic stiffness.
Source: Journal of the American College of Cardiology - November 2, 2015 Category: Cardiology Source Type: research

Treatment of Dyslipidemia in Elderly Patients With Coronary Heart Disease There Are Miles to Go Before We Sleep ∗
The treatment of dyslipidemia with statin therapy is a cornerstone in the management of patients in both the primary and secondary prevention settings. Dyslipidemia is widely prevalent in its various forms (1). The lowering of low-density lipoprotein cholesterol (LDL-C) with a statin in patients with established coronary heart disease (CHD) has shown unequivocal capacity to safely reduce risk for clinical sequelae such as nonfatal myocardial infarction, ischemic stroke, cardiovascular and all-cause mortality, as well as the need for revascularization (2,3). The American College of Cardiology/American Heart Association Guid...
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

Next Steps in Primary Prevention of Coronary Heart Disease Rationale for and Design of the ECAD Trial
Atherosclerotic cardiovascular disease (ASCVD) events, including coronary heart disease and stroke, are the most frequent cause of death and major disability in the world. Current American College of Cardiology/American Heart Association primary prevention guidelines are mainly on the basis of randomized controlled trials of statin-based low-density lipoprotein cholesterol (LDL-C)–lowering therapy for primary prevention of ASCVD events. Despite the clear demonstration of statin-based LDL-C lowering, substantial 10-year and lifetime risks of incident ASCVD continue. Although the 10-year risk is low in young and middle-age...
Source: Journal of the American College of Cardiology - October 12, 2015 Category: Cardiology Source Type: research

Coronary Calcium Score and the New Guidelines Back to Square One? ∗
Previous guidelines for cardiovascular risk assessment recommended the use of a modified Framingham score to estimate the 10-year risk of hard coronary heart disease (CHD) events, defined as myocardial infarction and CHD death (1). Coronary artery calcium (CAC) scoring for refined stratification received Class IIa or IIb recommendations for those at intermediate (10% to 20%) or low to intermediate (6% to 10%) risk, respectively (2). In 2013, the American College of Cardiology (ACC) and American Heart Association (AHA) released guidelines (3,4) endorsing new sex- and race-specific predictive equations derived from 5 large p...
Source: Journal of the American College of Cardiology - October 5, 2015 Category: Cardiology Source Type: research

Measuring Blood microRNAs to Provide Personalized Advice to Sleep Apnea Patients With Resistant Hypertension Dreaming the Future ∗
Obstructive sleep apnea (OSA; defined as>15 episodes of obstructive apnea and hypopnea per hour of sleep) was recently estimated to affect 13% of men and 6% of women (1), the prevalence having increased substantially over the last 2 decades in parallel with rising rates of obesity. OSA is associated with a 2- to 3-fold increase in the risk of stroke, ischemic heart disease, heart failure, and sudden death (2). One of the main putative mechanisms for increased OSA-related cardiovascular risk is systemic hypertension. Epidemiological studies have shown an independent association between OSA and prevalent and incident hyper...
Source: Journal of the American College of Cardiology - August 24, 2015 Category: Cardiology Source Type: research

Orthostatic Hypotension Epidemiology, Prognosis, and Treatment
Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 70 years of age. OH may complicate treatment of hypertension, heart failure, and coronary heart disease; cause disabling symptoms, faints, and traumatic injuries; and substantially reduce quality of life. Despite being largely asymptomatic or with minimal symptoms, the pres...
Source: Journal of the American College of Cardiology - August 10, 2015 Category: Cardiology Source Type: research

Glycemic Control in Type 1 Diabetes and Long-Term Risk of Cardiovascular Events or Death After Coronary Artery Bypass Grafting
ConclusionsIn patients with T1DM, poor glycemic control before CABG was associated with increased long-term risk of death or MACE. (HeAlth-data Register sTudies of Risk and Outcomes in Cardiac Surgery [HARTROCS]; NCT02276950)
Source: Journal of the American College of Cardiology - July 27, 2015 Category: Cardiology Source Type: research

Relationship of Oxidized Phospholipids on Apolipoprotein B-100 to Cardiovascular Outcomes in Patients Treated With Intensive Versus Moderate Atorvastatin Therapy The TNT Trial
ConclusionsElevated OxPL-apoB levels predict secondary MACE in patients with stable CHD, a risk that is mitigated by atorvastatin 80 mg. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691)
Source: Journal of the American College of Cardiology - March 30, 2015 Category: Cardiology Source Type: research

Cardiovascular Disease Mortality in Asian Americans
ConclusionsThe heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population.
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research

Cardiovascular Disease in Asian Americans Unmasking Heterogeneity ∗
Heart disease is the leading cause of death in the United States, and stroke is the fourth leading cause of death (1). Together, heart disease and stroke accounted for more than $300 billion in health care expenditures and related expenses in 2010 alone (2). However, from 2000 to 2010, death rates attributable to cardiovascular disease (CVD) declined by 31.0%. In the same 10-year period, the actual number of annual deaths from CVD declined by 16.7% (2). Yet in 2010, CVD still accounted for 31.9% of all 2,468,435 deaths, or about 1 of every 3 deaths in the United States (2). Despite this decline, considerable data from th...
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research

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