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Source: Journal of the American College of Cardiology
Condition: Stroke
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Total 258 results found since Jan 2013.
Alice in Lipidland The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol ∗
In the topsy-turvy world of Lewis Carroll’s Alice in Wonderland(1), the Cheshire Cat said, “only a few find the way, some don’t recognize it when they do—some … don’t ever want to.” Such was the status of many healthcare providers and patients in November 2013 at the issuance of the 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (2). This was coupled with the Guideline on the Assessment of Cardiovascular Risk (3), using a new risk assessment calculator, the Pooled Cohort Equations (4), to es...
Source: Journal of the American College of Cardiology - November 24, 2014 Category: Cardiology Source Type: research
President's Page: Heart Month and the American College of Cardiology: A Lesson in Partnerships, Member Values, and Patient Education
The global statistics surrounding cardiovascular disease speak for themselves. Not only is cardiovascular disease the number 1 cause of death globally, but this trend is also expected to continue well into the future. According to the World Health Organization, the number of deaths from cardiovascular diseases, mainly from heart disease and stroke, is expected to reach 23.3 million by 2030 .
Source: Journal of the American College of Cardiology - February 3, 2014 Category: Cardiology Authors: John Gordon Harold Tags: FROM THE ACC Source Type: research
Patent Foramen Ovale Closure Challenged by Left Atrial Chord
In a 22-year-old woman suffering from ischemic stroke affecting the posterior cerebral artery, clinical work-up ruled out cardiovascular and neurological pathologies except patent foramen ovale (PFO) with septal aneurysm and complete bubble filling of the left atrium as demonstrated by echocardiography. The patient was scheduled for transcatheter PFO closure. Peri-interventional 3-dimensional transesophageal echocardiography revealed a PFO tunnel and a left atrial chord keeping the PFO open, with consequent continuous left to right shunting (A to C; Online Video 1). Balloon sizing demonstrated a tunnel diameter of 16 mm (D...
Source: Journal of the American College of Cardiology - December 2, 2013 Category: Cardiology Authors: Smita R. Jategaonkar, Nikola Bogunovic, Dieter Horstkotte, Werner Scholtz Tags: IMAGES IN CARDIOLOGY Source Type: research
Reply: Effects of Habitual Coffee Consumption on Vascular Function
We thank Dr. Siasos and colleagues for pointing out that habitual coffee consumption has been associated with improved endothelial function in elderly inhabitants of Ikaria Island . The improvement in endothelial function may in part account for the associations of moderate coffee intake (about 2 to 4 cups daily) with lower risks for coronary heart disease and stroke . Indeed, even in the setting of endothelium damage, coffee has the ability to prevent arterial thrombus formation, a benefit that is independent of its caffeine content . Recent studies also indicate that moderate daily coffee intake may confer protection a...
Source: Journal of the American College of Cardiology - November 1, 2013 Category: Cardiology Authors: James J. DiNicolantonio, James H. O'Keefe, Carl J. Lavie Tags: Letters to the Editor Source Type: research
Heart Failure With Preserved Ejection Fraction: Comparison of Patients With and Without Angina Pectoris (From the Duke Databank for Cardiovascular Disease)
This study investigated the characteristics and outcomes of patients with heart failure with preserved ejection fraction (HFpEF) and angina pectoris (AP).Background: AP is a predictor of adverse events in patients with heart failure with reduced EF. The implications of AP in HFpEF are unknown.Methods: We analyzed HFpEF patients (EF ≥50%) who underwent coronary angiography at Duke University Medical Center from 2000 through 2010 with and without AP in the previous 6 weeks. Time to first event was examined using Kaplan-Meier methods for the primary endpoint of death/myocardial infarction (MI)/revascularization/stroke (...
Source: Journal of the American College of Cardiology - October 25, 2013 Category: Cardiology Authors: Robert J. Mentz, Samuel Broderick, Linda K. Shaw, Mona Fiuzat, Christopher M. O'Connor Tags: Heart Failure Source Type: research
“De-Risking” Risk Reduction: Should Coronary Artery Calcium Scoring Be the Gatekeeper to Preventive Pharmacotherapy With the Polypill?∗
The cardiovascular disease (CVD) epidemic remains the leading cause of death worldwide . Widespread adoption of the Western diet and lifestyle by populations in emergent countries with low or middle income has resulted in dramatic increases in the incidence of coronary heart disease and stroke. An overwhelming proportion of the cardiovascular risk is explained by the cumulative presence of classic and potentially modifiable risk factors, and this effect does not seem to be influenced by sex, ethnicity, or geography . Therefore, to effectively reduce risk and improve outcomes, prevention strategies should be conducted and i...
Source: Journal of the American College of Cardiology - October 25, 2013 Category: Cardiology Authors: William Wijns, Dan Rusinaru Tags: Cardiometabolic Risk: Editorial Comment Source Type: research
President's Page: An Urgent Call to Action: Graduate Medical Education Funding and the Future of Health Care
Cardiovascular medicine is experiencing a confluence of events that pose a significant threat to the future health of the nation. By 2030, it is predicted that more than 40% of adult Americans will have some form of cardiovascular disease. In addition, current projections indicate a 25% increase in the prevalence of both heart failure and stroke over the next 20 years—a result of an aging U.S. population . To make matters more complicated, an additional 30 million Americans will be seeking healthcare services beginning as early as next year as a result of the Affordable Care Act .
Source: Journal of the American College of Cardiology - October 2, 2013 Category: Cardiology Authors: John Gordon Harold, Patrick T. O'Gara, Joseph A. Hill, Marvin A. Konstam Tags: FROM THE ACC Source Type: research
The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)
Objectives: The goal of this study was to analyze the impact of dabigatran plasma concentrations, patient demographics, and aspirin (ASA) use on frequencies of ischemic strokes/systemic emboli and major bleeds in atrial fibrillation patients.Background: The efficacy and safety of dabigatran etexilate were demonstrated in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, but a therapeutic concentration range has not been defined.Methods: In a pre-specified analysis of RE-LY, plasma concentrations of dabigatran were determined in patients treated with dabigatran etexilate 110 mg twice daily (bid) ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: Paul A. Reilly, Thorsten Lehr, Sebastian Haertter, Stuart J. Connolly, Salim Yusuf, John W. Eikelboom, Michael D. Ezekowitz, Gerhard Nehmiz, Susan Wang, Lars Wallentin, RE-LY Investigators Tags: Antithrombotic Therapy Source Type: research
Left Atrial Appendage Occlusion: Opportunities and Challenges
Stroke prevention in patients with atrial fibrillation is a growing clinical dilemma as the incidence of the arrhythmia increases and risk profiles worsen. Strategies in patients with nonvalvular atrial fibrillation have included anticoagulation with a variety of drugs. Knowledge that stroke in this setting typically results from thrombus in the left atrial appendage has led to the development of mechanical approaches, both catheter-based and surgical, to occlude that structure. Such a device, if it were safe and effective, might avoid the need for anticoagulation and prevent stroke in the large number of patients who are ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: David R. Holmes, Dhanunjaya R. Lakkireddy, Richard P. Whitlock, Ron Waksman, Michael J. Mack Tags: STATE-OF-THE-ART PAPER Source Type: research
Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome: Results From the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On Contrast-Induced Acute Kidney Injury and Myocardial Damage in Patients With Acute Coronary Syndrome)
Conclusions: High-dose rosuvastatin given on admission to statin-naïve patients with ACS who are scheduled for an early invasive procedure can prevent CI-AKI and improve short-term clinical outcome. (Statin Contrast Induced Nephropathy Prevention [PRATO-ACS]; NCT01185938)
Source: Journal of the American College of Cardiology - September 27, 2013 Category: Cardiology Authors: Mario Leoncini, Anna Toso, Mauro Maioli, Francesco Tropeano, Simona Villani, Francesco Bellandi Tags: Cardiac Imaging Source Type: research
High-Sensitivity Troponin T and Risk Stratification in Patients With Atrial Fibrillation During Treatment With Apixaban or Warfarin
Objectives: The aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) risk score in patients with atrial fibrillation (AF).Background: The level of troponin is a powerful predictor of cardiovascular events and mortality.Methods: A total of 14,897 patients with AF were randomized to treatment with apixaban or warfarin in the ARISTOTLE (Apixaban for...
Source: Journal of the American College of Cardiology - September 23, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, John H. Alexander, Dan Atar, Bernard J. Gersh, Michael Hanna, Veli Pekka Harjola, John D. Horowitz, Steen Husted, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Granger, Tags: Heart Rhythm Disorders Source Type: research
The HAS-BLED Score Has Better Prediction Accuracy for Major Bleeding Than CHADS2 or CHA2DS2-VASc Scores in Anticoagulated Patients With Atrial Fibrillation
Objectives: The aim of this study was to test the hypothesis that a specific bleeding risk score, HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), was better at predicting major bleeding compared with CHADS2 (congestive heart failure, hypertension, 75 years of age or older, diabetes mellitus, and previous stroke or transient ischemic attack) and CHA2DS2-VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular...
Source: Journal of the American College of Cardiology - September 20, 2013 Category: Cardiology Authors: Vanessa Roldán, Francisco Marín, Sergio Manzano-Fernández, Pilar Gallego, Juan Antonio Vílchez, Mariano Valdés, Vicente Vicente, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research
Effect of Percutaneous Closure of Patent Foramen Ovale on Post-Procedural Arrhythmias
Atrial arrhythmias after percutaneous patent foramen ovale (PFO) closure, including atrial fibrillation (AF), has been consistently reported in different series suggesting a causal link between mechanical closure of PFO and the new onset of post-procedural arrhythmias . We have systematically assessed the effect of percutaneous PFO closure upon the development of post-procedural arrhythmias in 221 consecutive patients (144 women; mean age 48 ± 13 years) undergoing percutaneous PFO closure. At clinical evaluation, no patient had symptoms indicative or suggestive of arrhythmias. Indications for closure were the presence of ...
Source: Journal of the American College of Cardiology - September 13, 2013 Category: Cardiology Authors: Achille Gaspardone, Arianna Giardina, Maria Iamele, Gaetano Gioffrè, Mauro Polzoni, Filippo Lamberti, Romolo Remoli, Gregory A. Sgueglia, Marco Papa, Cesare Iani Tags: Research Correspondence Source Type: research
Correction
Hiratzka LF, Bakris GL, Beckman JA, et al., “2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine” (J Am Coll Cardiol...
Source: Journal of the American College of Cardiology - September 4, 2013 Category: Cardiology Tags: CORRECTIONS Source Type: research
Left Ventricular Scar in Atrial Fibrillation: Cause or Effect?∗
Atrial fibrillation (AF) is the most common clinical arrhythmia and is associated with increased risk for stroke, heart failure, and all-cause mortality . The mortality rate of patients with AF is about double that of patients in normal sinus rhythm, and data from the Framingham Heart Study show an AF-associated mortality risk even after adjusting for preexisting cardiovascular conditions . Although some of the mortality risk, such as stroke-related death and worsening heart failure, could be traced back to AF, the fact remains that in most cases, AF is viewed merely an association .
Source: Journal of the American College of Cardiology - August 30, 2013 Category: Cardiology Authors: Zhiyu Ling, Harikrishna Tandri Tags: Cardiac Imaging: Editorial Comment Source Type: research
