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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
Ticagrelor for Prevention of Ischemic Events After Myocardial Infarction in Patients With Peripheral Artery Disease
This study evaluated the efficacy and safety of ticagrelor on major cardiovascular (CV) events and major adverse limb events in patients with PAD and a prior MI.MethodsPEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin—Thrombolysis In Myocardial Infarction 54) randomized 21,162 patients with prior MI (1 to 3 years) to ticagrelor 90 mg twice daily, ticagrelor 60 mg twice daily, or placebo, all on a background of low-dose aspirin. History of PAD was obtained at baseline. Occurrences of major adverse cardiovascular events (...
Source: Journal of the American College of Cardiology - June 7, 2016 Category: Cardiology Source Type: research
The Development of Therapeutics for Peripheral Artery Disease A Unique Cardiovascular Risk Population ∗
Peripheral artery disease (PAD) primarily manifests as occlusive atherosclerosis in the peripheral circulation to the lower extremities (1). Symptomatic patients have either a profound exercise limitation or develop critical limb ischemia, and all of these patients are at heightened risk for major cardiovascular and ischemic limb events (2). Despite a severe morbidity and mortality risk, historically, little attention has been paid to developing targeted therapies to reduce this risk in patients with PAD (3). However, there were early signals that PAD may be responsive to potent antiplatelet therapy in the CAPRIE (Clopidog...
Source: Journal of the American College of Cardiology - June 7, 2016 Category: Cardiology Source Type: research
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
Level of Blood Pressure Control and Cardiovascular Events SPRINT Criteria Versus the 2014 Hypertension Recommendations
BackgroundBlood pressure (BP) targets from the SPRINT (Systolic Blood Pressure Intervention Trial) differ from targets of the 2014 hypertension (HTN) recommendations of the Eighth Joint National Committee.ObjectivesThe goal of this study was to estimate the proportion of hypertensive adults with who would meet BP goals under the SPRINT criteria and under the 2014 recommendations, and to determine related effects on cardiovascular morbidity and mortality.MethodsWe used data from the Korean National Health and Nutrition Examination Survey of 2008 to 2013 (n = 13,346), as well as the Korean National Health Insurance Service...
Source: Journal of the American College of Cardiology - June 14, 2016 Category: Cardiology Source Type: research
Aspirin in Atrial Fibrillation The Clot Thickens ∗
Aspirin is the original “wonder drug,” used in various forms for thousands of years for its analgesic, antipyretic, and anti-inflammatory properties (1), and more recently, for its ability to inhibit platelet aggregation, reducing the risk for occlusive vascular events associated with acute coronary syndromes, transient cerebral ischemic attacks and stroke, and peripheral vascular disease (2).
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research
Treatment of Chronic Functional Mitral Valve Regurgitation With a Percutaneous Annuloplasty System
ConclusionsPercutaneous direct annuloplasty is feasible and safe in high-risk FMR patients. This treatment initiates LV reverse remodeling, and provides clinical improvement during 6 months after treatment. (Mitralign Percutaneous Annuloplasty First in Man Study; NCT01852149).
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research
Reply Adding Ezetimibe to Simvastatin for the Secondary Prevention of Cardiovascular Disease: Is it Useful?
In response to Drs. Mascitelli and Goldstein, we previously reported in the primary publication of IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) that there was no difference between ezetimibe plus simvastatin as compared with simvastatin alone with respect to cardiovascular death or all-cause mortality (1). Because the focus of the present paper is total cardiovascular events (2), we did not re-report all-cause mortality because the data were previously published, and a subject can only die once. This lack of difference was expected in IMPROVE-IT because prior trials of intensive-dose ve...
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research
Hybrid Coronary Revascularization The Best of 2 Worlds? ∗
As early as 1997, Michael Mack’s essay discussed the outlook for the possibility of hybrid revascularization with the emergence of minimally invasive coronary surgery combining the off-pump and minimally invasive direct coronary artery bypass (MIDCAB) techniques with percutaneous coronary intervention (PCI) to a non-left anterior descending (LAD) artery target (1). Since that time, coronary surgery and PCI technology have evolved even more. Off-pump coronary artery bypass surgery and MIDCAB surgery have been established in clinical practice and, with the development of drug-eluting stents, a new era of PCI was born. Desp...
Source: Journal of the American College of Cardiology - July 18, 2016 Category: Cardiology Source Type: research
Cerebral Embolism During Transcatheter Aortic Valve Replacement The BRAVO-3 MRI Study
ConclusionsThis study documented cerebral embolization in nearly two-thirds of patients during contemporary TAVR. There were no significant differences in cerebral embolization for bivalirudin versus heparin anticoagulation during TAVR. (Open-Label, Randomized Trial in Patients Undergoing TAVR to Determine Safety and Efficacy of Bivalrudin vs. UFH [BRAVO-2/3]; NCT01651780)
Source: Journal of the American College of Cardiology - August 2, 2016 Category: Cardiology Source Type: research
Cerebrovascular Events With Transcatheter Aortic Valve Replacement Can We Identify Those Who Are at Risk? ∗
As interventional technologies evolve, careful assessment of the benefits and risks is urged (1,2). Stroke remains one of the most feared complications of percutaneous interventions(3), but has generally been a rare complication for percutaneous coronary intervention (
Source: Journal of the American College of Cardiology - August 9, 2016 Category: Cardiology Source Type: research
The Challenge of Timing Surgery in Degenerative Mitral Regurgitation Is B-Type Natriuretic Peptide the Solution? ∗
Degenerative mitral regurgitation (MR) with prolapse or flail of mitral leaflets has become the most frequent cause of severe primary MR in Europe and North America (1,2). In its chronic stage, even severe MR is tolerated very well for a surprisingly long time, and patients may remain asymptomatic for years. During this compensated stage of disease, pre-load, afterload, and both contractility and ejection fraction of the left ventricle (LV) remain normal, and the total stroke volume is increased as a result of the compensatory enlargement of the end-diastolic LV volume, which is enabled by an adaptive process of the LV myo...
Source: Journal of the American College of Cardiology - September 13, 2016 Category: Cardiology Source Type: research
Thrombotic and Embolic Complications Associated With Atrial Arrhythmia After Fontan Operation Role of Prophylactic Therapy
This study sought to determine the risk of TEC in this population and the role of anticoagulation therapy in TEC prevention.MethodsThis was a retrospective review of adults with atrial arrhythmia after Fontan operation who were evaluated at the Mayo Clinic between 1994 to 2014. TEC was classified into 2 groups: systemic TEC, defined as intracardiac thrombus, ischemic stroke, or systemic arterial embolus; and nonsystemic TEC, defined as Fontan conduit/right atrial thrombus or pulmonary embolus. Patients were divided into 3 groups: anticoagulation, antiplatelet, and no therapy cohorts.ResultsWe followed 278 patients, mean ag...
Source: Journal of the American College of Cardiology - September 13, 2016 Category: Cardiology Source Type: research
Fontan Anticoagulation A Never-Ending Debate? ∗
Thrombus formation is a significant cause of morbidity and mortality after Fontan operations. Intracardiac thrombus formation can lead to chronic pulmonary embolism (e.g., from system veins or subpulmonary ventricle) or stroke (e.g., from pulmonary veins or the systemic ventricle). Those “right-sided” embolisms may result in a ventilation/perfusion mismatch or an elevation of pulmonary vascular resistance, both of which may seriously hamper the cavopulmonary circulation. Preventing thromboembolism after the Fontan procedure and the role of a proper prophylaxis remains an ongoing discussion. The published reports are fr...
Source: Journal of the American College of Cardiology - September 13, 2016 Category: Cardiology Source Type: research
Association of Systolic Blood Pressure Variability With Mortality, Coronary Heart Disease, Stroke, and Renal Disease
This study investigated the association of increased visit-to-visit variability and all-cause mortality, cardiovascular events, and end-stage renal disease (ESRD) in a large cohort of U.S. veterans.MethodsFrom among 3,285,684 U.S. veterans with and without hypertension and normal estimated glomerular filtration rates (eGFR) during 2005 and 2006, we identified 2,865,157 patients who had 8 or more outpatient BP measurements. Systolic blood pressure variability (SBPV) was measured using the SD of all SBP values (normally distributed) in 1 individual. Associations of SD quartiles (
Source: Journal of the American College of Cardiology - September 20, 2016 Category: Cardiology Source Type: research
Thromboembolic, Bleeding, and Mortality Risks of Rivaroxaban and Dabigatran in Asians With Nonvalvular Atrial Fibrillation
BackgroundIt is unclear whether the non –vitamin K antagonist oral anticoagulant agents rivaroxaban and dabigatran are superior to warfarin for efficacy and safety outcomes in Asians with nonvalvular atrial fibrillation (NVAF).ObjectivesThe aim of this study was to compare the risk for thromboembolic events, bleeding, and mortality associated with rivaroxaban and dabigatran versus warfarin in Asians with NVAF.MethodsA nationwide retrospective cohort study was conducted of consecutive patients with NVAF taking rivaroxaban (n = 3,916), dabigatran (n = 5,921), or warfarin (n = 5,251) using data collected from the Taiwan...
Source: Journal of the American College of Cardiology - September 20, 2016 Category: Cardiology Source Type: research
