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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
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
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
Impact of the 2014 Expert Panel Recommendations for Management of High Blood Pressure on Contemporary Cardiovascular Practice Insights From the NCDR PINNACLE Registry
ConclusionsAmong U.S. ambulatory cardiology patients with hypertension, nearly 1 in 7 who did not meet JNC-7 recommendations would now meet the 2014 treatment goals. If the new recommendations are implemented in clinical practice, blood pressure target achievement and cardiovascular events will need careful monitoring, because many patients for whom the target blood pressure is now more permissive are at high cardiovascular risk.
Source: Journal of the American College of Cardiology - November 24, 2014 Category: Cardiology Source Type: research
New Transcatheter Aortic Valve Prosthesis Sets a New Standard ∗
When Cribier et al. (1) first described transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) in 2002, few envisioned the current widespread utilization of this novel technique. Initial randomized studies provided evidence for efficacy in patients not suitable for open surgical aortic valve replacement (2,3). Subsequent studies demonstrated noninferiority (4) and then superiority (5) to surgery for high-risk patients. Nonetheless, limitations of TAVR, particularly vascular complications, stroke, and paravalvular leaks (PVL) resulting in aortic regurgitation (AR), have combined to restrict TAVR to patients...
Source: Journal of the American College of Cardiology - November 24, 2014 Category: Cardiology Source Type: research
Near-Infrared Spectroscopy Predicts Cardiovascular Outcome in Patients With Coronary Artery Disease
ConclusionCAD patients with an LCBI equal to or above the median of 43.0, as assessed by NIRS in a nonculprit coronary artery, had a 4-fold risk of adverse cardiovascular events during 1-year follow-up. This observation warrants confirmation by larger studies with extended follow-up. (The European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis – Intravascular Ultrasound Study [AtheroRemoIVUS]; NCT01789411)
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research
Effect of Prasugrel Pre-Treatment Strategy in Patients Undergoing Percutaneous Coronary Intervention for NSTEMI The ACCOAST-PCI Study
ConclusionsThese findings support deferring treatment with prasugrel until a decision is made about revascularization in patients with NSTEMI undergoing angiography within 48 h of admission. (A Comparison of prasugrel at the time of percutaneous Coronary intervention Or as pre-treatment At the time of diagnosis in patients with non—ST-segment elevation myocardial infarction [ACCOAST]; NCT01015287)
Source: Journal of the American College of Cardiology - December 15, 2014 Category: Cardiology Source Type: research
Proximal Aortic Distensibility Is an Independent Predictor of All-Cause Mortality and Incident CV Events The MESA Study
ConclusionsDecreased proximal aorta distensibility significantly predicted all-cause mortality and hard CV events among individuals without overt CVD. AAD may help refine risk stratification, especially among asymptomatic, low- to intermediate-risk individuals.
Source: Journal of the American College of Cardiology - December 15, 2014 Category: Cardiology Source Type: research
Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials
BackgroundIn the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial, 3,602 patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) treated with bivalirudin had lower bleeding and mortality rates, but higher acute stent thrombosis rates compared with heparin + a glycoprotein IIb/IIIa inhibitor (GPI). Subsequent changes in primary PCI, including the use of potent P2Y12 inhibitors, frequent radial intervention, and pre-hospital medication administration, were incorporated into the EUROMAX (European Ambu...
Source: Journal of the American College of Cardiology - January 5, 2015 Category: Cardiology Source Type: research
Low-Gradient, Low-Flow Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction Characteristics, Outcome, and Implications for Surgery
ConclusionsIn this study, the outcome of severe LG/LF aortic stenosis with preserved EF was similar to that of mild-to-moderate aortic stenosis and was not favorably influenced by aortic surgery. Further research is needed to better understand the natural history and the progression of LG/LF aortic stenosis.
Source: Journal of the American College of Cardiology - January 5, 2015 Category: Cardiology Source Type: research
Management of Paradoxical Low-Flow, Low-Gradient Aortic Stenosis Need for an Integrated Approach, Including Assessment of Symptoms, Hypertension, and Stenosis Severity ∗
In 2007, we reported that a substantial proportion of patients with severe aortic stenosis may have a low flow (LF) (i.e., reduced stroke volume), and thus, often have a low transvalvular pressure gradient (LG), despite a preserved left ventricular ejection fraction (LVEF) (1). The 2014 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines (2) classified this “paradoxical” LF/LG entity as a D3 stage of aortic stenosis, which is defined as an aortic valve area (AVA) of
Source: Journal of the American College of Cardiology - January 5, 2015 Category: Cardiology Source Type: research
Affinity Proteomics for Phosphatase Interactions in Atrial Fibrillation ∗
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, with an estimated 30 million individuals affected worldwide (1). AF constitutes a major risk factor for stroke and heart failure, resulting in significant morbidity and mortality. Remodeling of the atria is a consequence as well as a substrate for perpetuation of AF. The remodeling process occurs at various levels, including atrial fibrosis, cardiomyocyte contractibility, and electrical coupling. During electrical remodeling, an unbalanced calcium (Ca2+) transport exposes cardiomyocytes locally to increased Ca2+ levels. Ca2+ overload i...
Source: Journal of the American College of Cardiology - January 12, 2015 Category: Cardiology Source Type: research
Patent Foramen Ovale and Paradoxical Systemic Embolism Can We Determine High-Risk Characteristics by Echocardiography?
We read with interest the review paper on paradoxical embolism by Windecker et al. (1). It was suggested, on the basis of available evidence from published reports, that device closure of patent foramen ovale (PFO) should be considered in patients with first-time cryptogenic stroke, particularly in those with high-risk criteria, such as presence of an atrial septal aneurysm (ASA), large PFO, Eustachian valve, or Chiari network. The viewpoints of Windecker et al. on those with high-risk criteria should be discussed and clarified.
Source: Journal of the American College of Cardiology - January 12, 2015 Category: Cardiology Source Type: research
Systemic Vascular Load in Calcific Degenerative Aortic Valve Stenosis Insight From Percutaneous Valve Replacement
This study sought to characterize the interaction between valvular and vascular functions in patients with AS by using transcatheter aortic valve replacement (TAVR) as a clinical model of isolated intervention.MethodsAortic pressure and flow were measured simultaneously using high-fidelity sensors in 23 patients (mean 79 ± 7 years of age) before and after TAVR. Blood pressure and clinical response were registered at 6-month follow-up.ResultsSystolic and pulse arterial pressures, as well as indices of vascular function (vascular resistance, aortic input impedance, compliance, and arterial elastance), were significantly mo...
Source: Journal of the American College of Cardiology - February 2, 2015 Category: Cardiology Source Type: research
Data Strengthen to Support Recommending Anticoagulant Therapy for All Atrial Fibrillation Patients With a CHA 2 DS 2 -VASc Score ≥1 ∗
Management of patients with atrial fibrillation (AF) can be considered a 3-legged stool. Physicians caring for AF patients must consider the issues of rate control, rhythm control, and stroke prevention and then make specific recommendations to their patients that address each of these issues.
Source: Journal of the American College of Cardiology - February 16, 2015 Category: Cardiology Source Type: research
All Aortic Stenoses Are Not Created Equal ∗
With the advent and success of transcatheter aortic valve replacement (TAVR), new emphasis is being placed on patient selection to ensure successful outcomes after aortic valve replacement (AVR). In this regard, clinicians must appreciate that aortic stenosis (AS) is not a simple obstruction but involves a complex pathological interaction among the left ventricle (LV), aortic valve (AV), and peripheral vasculature (1). The most typical form of AS is normal flow high-gradient aortic stenosis (NFHGAS), which is characterized by patients with a normal left ventricular ejection fraction (EF), normal flow (left ventricular stro...
Source: Journal of the American College of Cardiology - February 16, 2015 Category: Cardiology Source Type: research
