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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG The SYNTAX Trial at 5-Year Follow-Up
ConclusionsSmoking is associated with poor clinical outcomes after revascularization in patients with complex CAD. This places further emphasis on efforts at smoking cessation to improve revascularization benefits. (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries; NCT00114972)
Source: Journal of the American College of Cardiology - March 16, 2015 Category: Cardiology Source Type: research

How Recent Data Have Impacted the Treatment of Internal Carotid Artery Stenosis
Carotid atherosclerosis accounts for approximately 10% of ischemic stroke cases. Multifaceted medical therapy reduces the risk of stroke in patients with carotid stenosis. Revascularization with endarterectomy or stenting can benefit select patients. In recent years, new information has been obtained regarding optimal selection of revascularization candidates. In addition, new concepts have been formulated regarding the relationship between carotid stenosis and vascular cognitive impairment. Finally, the declining rate of stroke with improved medical therapy has led to the launch of new clinical trials to determine the con...
Source: Journal of the American College of Cardiology - March 16, 2015 Category: Cardiology Source Type: research

Revisiting Sex Equality With Transcatheter Aortic Valve Replacement Outcomes A Collaborative, Patient-Level Meta-Analysis of 11,310 Patients
BackgroundThere has been conflicting clinical evidence as to the influence of female sex on outcomes after transcatheter aortic valve replacement.ObjectivesThe aim of this study was to evaluate the impact of sex on early and late mortality and safety end points after transcatheter aortic valve replacement using a collaborative meta-analysis of patient-level data.MethodsFrom the MEDLINE, Embase, and the Cochrane Library databases, data were obtained from 5 studies, and a database containing individual patient-level time-to-event data was generated from the registry of each selected study. The primary outcome of interest was...
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research

Carotid Stiffness and Cerebrovascular Disease The Physiology Beyond the Anatomy ∗
Stroke is a leading cause of morbidity, mortality, and disability worldwide, and the disease burden has progressively increased over the past decades. A rising interest in identifying risk factors for cerebrovascular disease may finally shift the focus to prevention of future events (1). Several studies have investigated carotid disease, and specifically carotid stiffness, as a risk factor for the development of cerebrovascular disease and incident stroke. These studies have been limited, however, by inconsistent results. Some reported a significant association between carotid stiffness and stroke, whereas others failed to...
Source: Journal of the American College of Cardiology - November 2, 2015 Category: Cardiology Source Type: research

Persistent but not Paroxysmal Atrial Fibrillation Is Independently Associated With Lower Cognitive Function ARIC Study
The association of atrial fibrillation (AF) with an increased risk of cognitive impairment or dementia is independent of clinical stroke (1) and may be mediated by subclinical cerebral infarcts (SCIs) (2). However, little is known about whether AF burden (i.e., the percentage of time a person is in AF) is related to cognitive function. Moreover, if such a relationship exists, whether it is mediated by clinical stroke or SCIs is unknown. We hypothesized that a higher AF burden would be independently associated with lower cognitive function after adjustment for clinical stroke but that this association would be attenuated af...
Source: Journal of the American College of Cardiology - March 15, 2016 Category: Cardiology Source Type: research

Morning Home Blood Pressure Is a Strong Predictor of Coronary Artery Disease The HONEST Study
BackgroundFew studies have evaluated out-of-office blood pressure (BP) measurements as predictors of coronary artery disease (CAD) events.ObjectivesThe aim of this study was to determine morning home blood pressure (HBP) as a predictor of CAD events.MethodsUsing data from the HONEST (Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study, we investigated the relationship between morning HBP and incidence of stroke and CAD events.ResultsIn 21,591 treated hypertensive patients (mean age 64.9 years; mean follow-up 2.02 years), 127 stroke events (2.92 per 1,000 patien...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research

Left Atrial Appendage Closure in Patients With Contraindications to Oral Anticoagulation
The PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) and PREVAIL (Prospective Randomized Evaluation of the Watchman LAA Closure Device In Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy) trials revealed that in atrial fibrillation (AF) patients suitable for oral anticoagulation (OAC), mechanical left atrial appendage closure (LAAC) with a catheter-delivered heart implant device (Watchman; Boston Scientific, Marlborough, Massachusetts) is effective for stroke prevention (1,2). Importantly, these patients received at least 6 weeks ...
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research

Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope
This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope. Background: Syncope is a common clinical event, but knowledge of prognosis is not fully elucidated in healthy individuals. Methods: Patients without previous comorbidity admitted for syncope in Denmark from 2001 to 2009 were identified in nationwide administrative registries and matched by sex and age with 5 control subjects from the Danish population. The risk of death or recurrent syncope, implantation of pacemaker or implantable cardioverter-defibrillat...
Source: Journal of the American College of Cardiology - December 17, 2012 Category: Cardiology Authors: Martin Huth Ruwald, Morten Lock Hansen, Morten Lamberts, Carolina Malta Hansen, Michael Vinther, Lars Køber, Christian Torp-Pedersen, Jim Hansen, Gunnar Hilmar Gislason Tags: Heart Rhythm Disorders Source Type: research

Treatment Targets in Atrial Fibrillation: “Is Feeling Better Good Enough?”⁎
Atrial fibrillation (AF) is the most common sustained arrhythmia necessitating medical therapy. The majority of AF patients have associated cardiovascular comorbidities that increase the risk of negative cardiovascular outcomes, including excess morbidity, hospitalizations, and mortality (). Data assessing a disease management strategy of rate versus rhythm control have produced clear variations when viewed from a real-world clinical perspective (). These data emphasize that the treatment of AF involves 3 nonmutually exclusive principles: 1) prevention of stroke and systemic embolism; 2) ventricular rate control during AF;...
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Michael H. Kim Tags: Heart Rhythm Disorders in Heart Failure: Editorial Comment Source Type: research

Strategies of Clopidogrel Load and Atorvastatin Reload to Prevent Ischemic Cerebral Events in Patients Undergoing Protected Carotid Stenting: Results of the Randomized ARMYDA-9 CAROTID (Clopidogrel and Atorvastatin Treatment During Carotid Artery Stenting) Study
Conclusions: In patients undergoing carotid stenting, a strategy using both a 600-mg clopidogrel load and a short-term reload with high-dose atorvastatin protects against early ischemic cerebral events. These results, obtained along with routine mechanical neuroprotection, provide new evidence of the optimization of drug therapy before percutaneous carotid intervention. (Clopidogrel and Atorvastatin Treatment During Carotid Artery Stenting [ARMYDA-9 CAROTID]; NCT01572623)
Source: Journal of the American College of Cardiology - March 14, 2013 Category: Cardiology Authors: Giuseppe Patti, Fabrizio Tomai, Rosetta Melfi, Elisabetta Ricottini, Michele Macrì, Pietro Sedati, Arianna Giardina, Cristina Aurigemma, Mario Leporace, Andrea D'Ambrosio, Germano Di Sciascio Tags: Interventional Cardiology Source Type: research

Efficacy and Safety of Dabigatran Etexilate and Warfarin in “Real-World” Patients With Atrial Fibrillation: A Prospective Nationwide Cohort Study
Conclusions: In this “everyday clinical practice” post-approval nationwide clinical cohort, there were similar stroke/systemic embolism and major bleeding rates with dabigatran (both doses) compared with warfarin. Mortality, intracranial bleeding, pulmonary embolism, and MI were lower with dabigatran, compared with warfarin. We found no evidence of an excess of bleeding events or MI among dabigatran-treated patients in this propensity-matched comparison against warfarin, even in the subgroup with ≥1-year follow-up.
Source: Journal of the American College of Cardiology - April 4, 2013 Category: Cardiology Authors: Torben Bjerregaard Larsen, Lars Hvilsted Rasmussen, Flemming Skjøth, Karen Margrete Due, Torbjörn Callréus, Mary Rosenzweig, Gregory Y.H. Lip Tags: Atrial Fibrillation Source Type: research

Relationship of Sedentary Behavior and Physical Activity to Incident Cardiovascular Disease: Results From the Women's Health Initiative
Objectives: The aim of this study was to examine the independent and joint associations of sitting time and physical activity with risk of incident cardiovascular disease (CVD).Background: Sedentary behavior is recognized as a distinct construct beyond lack of leisure-time physical activity, but limited data exist on the interrelationship between these 2 components of energy balance.Methods: Participants in the prospective Women’s Health Initiative Observational Study (n = 71,018), 50 to 79 years of age and free of CVD at baseline (1993 to 1998), provided information on sedentary behavior, defined as hours of sitting/d...
Source: Journal of the American College of Cardiology - April 12, 2013 Category: Cardiology Authors: Andrea K. Chomistek, JoAnn E. Manson, Marcia L. Stefanick, Bing Lu, Megan Sands-Lincoln, Scott B. Going, Lorena Garcia, Matthew A. Allison, Stacy T. Sims, Michael J. LaMonte, Karen C. Johnson, Charles B. Eaton Tags: Cardiovascular Risk Source Type: research

Comparison of Transcatheter and Surgical Aortic Valve Replacement in Severe Aortic Stenosis: A Longitudinal Study of Echocardiography Parameters in Cohort A of the PARTNER Trial (Placement of Aortic Transcatheter Valves)
This study sought to compare echocardiographic findings in patients with critical aortic stenosis following surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR).Background: The PARTNER (Placement of Aortic Transcatheter Valves) trial randomized patients 1:1 to SAVR or TAVR.Methods: Echocardiograms were obtained at baseline, discharge, 30 days, 6 months, 1 year, and 2 years after the procedure and analyzed in a core laboratory. For the analysis of post-implantation variables, the first interpretable study (≤6 months) was used.Results: Both groups showed a decrease in aortic valve grad...
Source: Journal of the American College of Cardiology - April 25, 2013 Category: Cardiology Authors: Rebecca T. Hahn, Philippe Pibarot, William J. Stewart, Neil J. Weissman, Deepika Gopalakrishnan, Martin G. Keane, Saif Anwaruddin, Zuyue Wang, Martin Bilsker, Brian R. Lindman, Howard C. Herrmann, Susheel K. Kodali, Raj Makkar, Vinod H. Thourani, Lars G. Tags: Catheter Versus Surgical Intervention Source Type: research

Percutaneous Left Atrial Appendage Closure With the AMPLATZER Cardiac Plug Device in Patients With Nonvalvular Atrial Fibrillation and Contraindications to Anticoagulation Therapy
Conclusions: In patients with nonvalvular atrial fibrillation at high risk of cardioembolic events and absolute contraindications to anticoagulation, LAAC using the ACP device followed by dual-/single-antiplatelet therapy was associated with a low rate of embolic and bleeding events after a mean follow-up of 20 months. No cases of severe residual leak or device thrombosis were observed at the 6-month follow-up.
Source: Journal of the American College of Cardiology - May 13, 2013 Category: Cardiology Authors: Marina Urena, Josep Rodés-Cabau, Xavier Freixa, Jacqueline Saw, John G. Webb, Mélanie Freeman, Eric Horlick, Mark Osten, Albert Chan, Jean-Francois Marquis, Jean Champagne, Réda Ibrahim Tags: Mini-Focus: Left Atrial Closure in Atrial Fibrillation Source Type: research

Percutaneous Left Atrial Appendage Suture Ligation Using the LARIAT Device in Patients With Atrial Fibrillation: Initial Clinical Experience
Conclusions: LAA closure with the LARIAT device can be performed effectively with acceptably low access complications and periprocedural adverse events in this observational study.
Source: Journal of the American College of Cardiology - October 16, 2012 Category: Cardiology Authors: Krzysztof Bartus, Frederick T. Han, Jacek Bednarek, Jacek Myc, Boguslaw Kapelak, Jerzy Sadowski, Jacek Lelakowski, Stanislaw Bartus, Steven J. Yakubov, Randall J. Lee Tags: Mini-Focus: Left Atrial Closure in Atrial Fibrillation Source Type: research