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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation
This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy. Background: Approximately 10% of patients who receive dual antiplatelet therapy after percutaneous coronary intervention have an indication for oral anticoagulation and are thus treated with triple therapy. The standard adenosine diphosphate receptor blocker in this setting is clopidogrel. Data regarding prasugrel as part of triple therapy are not available. Methods: We analyzed a consecutive series of 377 patients who underwent drug-eluting stent implantation and had an indication for oral antico...
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Nikolaus Sarafoff, Amadea Martischnig, Jill Wealer, Katharina Mayer, Julinda Mehilli, Dirk Sibbing, Adnan Kastrati Tags: Interventional Cardiology Source Type: research

Triple Antithrombotic Therapy With Prasugrel in the Stented Patient: Concern for More Bleeding⁎
There is a large body of evidence, including results of prospective trials, that supports oral anticoagulation therapy (OAT) as the optimal strategy to prevent fibrin-centric thrombotic events (FCTEs). Examples of FCTEs include thromboembolism in patients with mechanical heart valves, deep vein thrombosis, and atrial fibrillation (AF) (). In a large prospective trial, warfarin was found to be superior to dual antiplatelet therapy (DAPT) with aspirin + clopidogrel in the prevention of vascular events in patients with AF plus 1 or more risk factors for stroke (). European and American guidelines include a Class I recommendat...
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Paul A. Gurbel, Udaya S. Tantry Tags: Interventional Cardiology: Editorial Comment Source Type: research

The Transaortic Approach for Transcatheter Aortic Valve Replacement: Initial Clinical Experience in the United States
Conclusions: TAVR via the TAO approach is technically feasible, seems to be associated with favorable outcomes, and expands the current alternative options for access sites in patients with inoperable aortic stenosis who are ineligible for TF TAVR.
Source: Journal of the American College of Cardiology - April 12, 2013 Category: Cardiology Authors: Joel A. Lardizabal, Brian P. O'Neill, Harit V. Desai, Conrad J. Macon, Alexis P. Rodriguez, Claudia A. Martinez, Carlos E. Alfonso, Martin S. Bilsker, Roger G. Carillo, Mauricio G. Cohen, Alan W. Heldman, William W. O'Neill, Donald B. Williams Tags: Interventional Cardiology Source Type: research

Platelet Responsiveness to Clopidogrel Treatment After Peripheral Endovascular Procedures: The PRECLOP Study: Clinical Impact and Optimal Cutoff Value of On-Treatment High Platelet Reactivity
This study aimed to assess the clinical implications and optimal cutoff value of high platelet reactivity (HPR) in patients receiving clopidogrel for peripheral endovascular procedures.Background: As noted in coronary studies, HPR could be related to increased adverse events.Methods: This prospective trial included patients receiving clopidogrel 75 mg daily, before and after infrainguinal angioplasty or stenting. Platelet inhibition was assessed with the VerifyNow P2Y12 point-of-care test. Primary endpoints were 1-year clinical events rate (composite endpoint of death, major stroke, major amputation, target vessel revascul...
Source: Journal of the American College of Cardiology - April 18, 2013 Category: Cardiology Authors: Stavros Spiliopoulos, Georgios Pastromas, Konstantinos Katsanos, Panagiotis Kitrou, Dimitrios Karnabatidis, Dimitrios Siablis Tags: Interventional Cardiology Source Type: research

Good Fat, Bad Fat: The Increasingly Complex Interplay of Adipose Tissue and the Cardiovascular System∗
Obesity is present in more than 30% of adults in the United States and is a known risk factor for a variety of cardiovascular problems, including coronary artery disease, atrial fibrillation, congestive heart failure, and stroke . Obesity is considered to be present when there is an excess mass of adipose tissue in the body. There is now widespread acceptance of the notion that regional fat stores might have specific local or systemic effects. The best-known example of a local fat depot with a specific effect is the case of excess fat within the abdominal cavity, which seems to contribute to insulin resistance, raised bloo...
Source: Journal of the American College of Cardiology - May 13, 2013 Category: Cardiology Authors: Sheldon E. Litwin Tags: Cardiometabolic Risk: Editorial Comment Source Type: research

Brief Episodes of Silent Atrial Fibrillation Predict Clinical Vascular Brain Disease in Type 2 Diabetic Patients
This study evaluated whether subclinical episodes of atrial fibrillation (AF) were associated with an increased risk of silent cerebral infarct (SCI) and stroke in diabetic patients younger than 60 years who did not have other clinical evidence of AF and cerebrovascular disease at baseline.Background: In type 2 diabetic patients, one-fourth of strokes are of unknown cause, and subclinical episodes of AF may be a common etiologic factor.Methods: A total of 464 type 2 diabetic patients younger than 60 years were included in a longitudinal observational study and matched to patients without diabetes. Patients underwent 48-h e...
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Raffaele Marfella, Ferdinando Carlo Sasso, Mario Siniscalchi, Mario Cirillo, Pasquale Paolisso, Celestino Sardu, Michelangela Barbieri, Maria Rosaria Rizzo, Ciro Mauro, Giuseppe Paolisso Tags: Heart Rhythm Disorders Source Type: research

Prevalence and Trends of Metabolic Syndrome in the Adult U.S. Population, 1999–2010
This study sought to characterize the prevalence of metabolic syndrome (MetS), its 5 components, and their pharmacological treatment in U.S. adults by sex and race/ethnicity over time.Background: MetS is a constellation of clinical risk factors for cardiovascular disease, stroke, kidney disease, and type 2 diabetes mellitus.Methods: Prevalence estimates were estimated in adults (≥20 years of age) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 (in 2-year survey waves). The biological thresholds, defined by the 2009 Joint Scientific Statement, were: 1) waist circumference ≥102 c...
Source: Journal of the American College of Cardiology - July 1, 2013 Category: Cardiology Authors: Hiram Beltrán-Sánchez, Michael O. Harhay, Meera M. Harhay, Sean McElligott Tags: Metabolic Syndrome Source Type: research

The ATLAS ACS 2–TIMI 51 Trial and the Burden of Missing Data: (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects With Acute Coronary Syndrome ACS 2–Thrombolysis In Myocardial Infarction 51)
Rivaroxaban is a factor Xa inhibitor that was recently reviewed by the Food and Drug Administration as a potential therapy to reduce the risk of recurrent atherothrombotic events in patients with acute coronary syndromes. Approval of this drug would represent a paradigm shift away from dual antiplatelet therapy toward long-term triple antithrombotic therapy. However, to date, no other experimental anticoagulant agent has demonstrated a favorable risk-benefit profile in this population, in part because of the expected increased risk in major bleeding by combining aspirin, a P2Y12 receptor inhibitor, and an anticoagulant. Ap...
Source: Journal of the American College of Cardiology - June 10, 2013 Category: Cardiology Authors: Mori J. Krantz, Sanjay Kaul Tags: VIEWPOINT Source Type: research

Impact of Low Flow on the Outcome of High-Risk Patients Undergoing Transcatheter Aortic Valve Replacement
This study sought to assess the impact of baseline left ventricular (LV) outflow, LV ejection fraction (LVEF), and transvalvular gradient on outcomes following transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS).Background: Low flow (i.e., reduced stroke volume index [SVi]) can occur with both reduced and preserved LVEF. Low flow is often associated with low gradient despite severe stenosis and with worse outcomes following surgical aortic valve replacement. However, there are few data about the impact of low flow on outcomes following TAVR.Methods: We retrospectively analyzed the cli...
Source: Journal of the American College of Cardiology - June 14, 2013 Category: Cardiology Authors: Florent Le Ven, Mélanie Freeman, John Webb, Marie-Annick Clavel, Miriam Wheeler, Éric Dumont, Chris Thompson, Robert De Larochellière, Robert Moss, Daniel Doyle, Henrique B. Ribeiro, Marina Urena, Luis Nombela-Franco, Josep Rodés-Cabau, Philippe Pibar Tags: Transcatheter Aortic Valve Replacement Source Type: research

In Vivo Evaluation of Atherosclerotic Plaque Inflammation and of Anti-Inflammatory Effects of Statins by 18F-Fluorodeoxyglucose Positron Emission Tomography∗
Atherosclerosis is currently no longer considered merely a cholesterol storage disease, but rather a complex process of vascular inflammation . Indeed, various inflammatory cells and, in particular, monocytes and macrophages play a major role in the development, progression, and rupture of atherosclerotic plaques . Atherosclerosis is initiated when blood monocytes and T lymphocytes are attracted by chemokinesis to oxidized apo-B rich lipoproteins in the vessel wall. Expression of vascular cell adhesion molecule-1 and E- and P-selectin by the endothelium allows their adherence and entry into the subendothelial space. Monocy...
Source: Journal of the American College of Cardiology - June 3, 2013 Category: Cardiology Authors: Bernhard L. Gerber Tags: Cardiac Imaging: Editorial Comment Source Type: research

Antithrombotic Regimens in Patients With Atrial Fibrillation and Coronary Disease: Optimizing Efficacy and Safety∗
Clear evidence supports the value of oral anticoagulation (OAC) with vitamin K antagonists in preventing stroke and thromboembolism in patients with atrial fibrillation (AF) who have well-established risk factors. For this indication, vitamin K antagonists have been shown to be superior to single or dual antiplatelet agents in reducing thromboembolic complications . Yet, up to 30% of patients with AF also have indications for antiplatelet therapy because of coronary artery disease . Dual antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor (e.g., clopidogrel) is usually recommended after stent implantation or a...
Source: Journal of the American College of Cardiology - June 10, 2013 Category: Cardiology Authors: Steven M. Markowitz Tags: Coronary Artery Disease: Editorial Comment 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

Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health, and All-Cause Mortality
Coffee, after water, is the most widely consumed beverage in the United States, and is the principal source of caffeine intake among adults. The biological effects of coffee may be substantial and are not limited to the actions of caffeine. Coffee is a complex beverage containing hundreds of biologically active compounds, and the health effects of chronic coffee intake are wide ranging. From a cardiovascular (CV) standpoint, coffee consumption may reduce the risk of type 2 diabetes mellitus and hypertension, as well as other conditions associated with CV risk such as obesity and depression; but it may adversely affect lipi...
Source: Journal of the American College of Cardiology - July 19, 2013 Category: Cardiology Authors: James H. O'Keefe, Salman K. Bhatti, Harshal R. Patil, James J. DiNicolantonio, Sean C. Lucan, Carl J. Lavie Tags: STATE-OF-THE-ART PAPER Source Type: research

Thromboembolic Complications After Cardioversion of Acute Atrial Fibrillation: The FinCV (Finnish CardioVersion) Study
This study sought to explore the incidence and risk factors of thromboembolic complications after cardioversion of acute atrial fibrillation.Background: Anticoagulation therapy is currently recommended after cardioversion of acute atrial fibrillation in patients with risk factors for stroke, but the implementation of these new consensus-based guidelines has been slow.Methods: A total of 7,660 cardioversions were performed in 3,143 consecutive patients with atrial fibrillation lasting 
Source: Journal of the American College of Cardiology - July 12, 2013 Category: Cardiology Authors: K. E. Juhani Airaksinen, Toni Grönberg, Ilpo Nuotio, Marko Nikkinen, Antti Ylitalo, Fausto Biancari, Juha E.K. Hartikainen Tags: Heart Rhythm Disorders Source Type: research