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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
The Assault on the Left Atrial Appendage in Perspective∗
For patients with atrial fibrillation (AF) inappropriate for or refractory to ablation or cardioversion, the choices have been austere: treat with anticoagulation or expose the patient to a 5-fold or greater risk of embolic events including stroke. Anticoagulation remains the standard of care and has been studied extensively in multiple level I trials, most recently as part of the introduction of a new-generation polypharmacy for nonvalvular AF. Anticoagulation nevertheless remains an iatrogenically induced disease with significant associated morbidity and mortality to which patients may be exposed for decades. Mechanical ...
Source: Journal of the American College of Cardiology - May 13, 2013 Category: Cardiology Authors: Zoltan G. Turi Tags: Mini-Focus: Left Atrial Closure in Atrial Fibrillation: Editorial Comment Source Type: research
Subtle Post-Procedural Cognitive Dysfunction After Atrial Fibrillation Ablation
Conclusions: Ablation for AF is associated with a 13% to 20% prevalence of POCD in patients with AF at long-term follow-up. These results were seen in a patient population with predominant CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/transient ischemic attack) scores of 0 to 1, representing the majority of patients undergoing ablation for AF. The long-term implications of these subtle changes require further study.
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Caroline Medi, Lisbeth Evered, Brendan Silbert, Andrew Teh, Karen Halloran, Joseph Morton, Peter Kistler, Jonathan Kalman Tags: Heart Rhythm Disorders Source Type: research
The Year in Atherothrombosis
A number of studies have addressed the prevalence and significance of cardiovascular disease (CVD) worldwide. According to the Global Burden of Disease Study 2010, age-standardized death rates for CVD decreased by approximately 20% in the last 2 decades, but coronary heart disease (CHD) and stroke constitute the 2 leading causes of death in the world due to respective 35% and 26% increases in crude mortality () . Furthermore, when combining years of life lost and years lived with disability, CHD and stroke rank first and third, respectively . Amongst risk factors, arterial hypertension was identified as the main source of ...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: Javier Sanz, Pedro R. Moreno, Valentin Fuster Tags: YEAR IN CARDIOLOGY SERIES Source Type: research
Reply: Higher N-Terminal Pro–B-Type Natriuretic Peptide May Be Related to Very Different Conditions
We thank Dr. Balta and colleagues for their comments on our article concerning the use of N-terminal pro B-type natriuretic peptide (NT-proBNP) for atrial fibrillation (AF) in the ARISTOTLE (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation) trial . Of the 18,201 patients with AF in the ARISTOTLE trial, 14,892 comprised the population in whom baseline NT-proBNP plasma samples were analyzed. The results showed that NT-proBNP was strongly and independently related to stroke, cardiovascular events, and mortality.
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Ziad Hijazi, Christopher B. Granger, Lars Wallentin Tags: Letters to the Editor Source Type: research
Carotid Revascularization Before Open Heart Surgery: The Data-Driven Treatment Strategy∗
Optimal management of high-grade obstructive carotid artery disease at the time of open heart surgery (OHS) has never been addressed in a randomized clinical trial. Data suggest that the combined approach of carotid endarterectomy (CEA) and OHS leads to a higher risk of procedural stroke , and, therefore, staged carotid revascularization by CEA or carotid artery stenting (CAS) is often performed before OHS. Does the staged approach lead to an overall reduction in the rate of major adverse cardiovascular events (MACE = death, myocardial infarction, and stroke) for patients with concomitant coronary and cerebrovascular di...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: Ehtisham Mahmud, Ryan Reeves Tags: Coronary Artery Disease: Editorial Comment 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
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
Perioperative Beta Blockade in Noncardiac Surgery: A Systematic Review for the 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
ConclusionsPerioperative beta blockade started within 1 day or less before noncardiac surgery prevents nonfatal MI but increases risks of stroke, death, hypotension, and bradycardia. Without the controversial DECREASE studies, there are insufficient data on beta blockade started 2 or more days prior to surgery. Multicenter RCTs are needed to address this knowledge gap.
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research
Cardiovascular Disease in Asian Americans Unmasking Heterogeneity ∗
Heart disease is the leading cause of death in the United States, and stroke is the fourth leading cause of death (1). Together, heart disease and stroke accounted for more than $300 billion in health care expenditures and related expenses in 2010 alone (2). However, from 2000 to 2010, death rates attributable to cardiovascular disease (CVD) declined by 31.0%. In the same 10-year period, the actual number of annual deaths from CVD declined by 16.7% (2). Yet in 2010, CVD still accounted for 31.9% of all 2,468,435 deaths, or about 1 of every 3 deaths in the United States (2). Despite this decline, considerable data from th...
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research
Ischemic Brain Lesions After Carotid Artery Stenting Increase Future Cerebrovascular Risk
ConclusionsIschemic brain lesions discovered on DWI after CAS seem to be a marker of increased risk for recurrent cerebrovascular events. Patients with periprocedural DWI lesions might benefit from more aggressive and prolonged antiplatelet therapy after CAS. (A Randomised Comparison of the Risks, Benefits and Cost Effectiveness of Primary Carotid Stenting With Carotid Endarterectomy: International Carotid Stenting Study; ISRCTN25337470)
Source: Journal of the American College of Cardiology - February 9, 2015 Category: Cardiology Source Type: research
Duration of Triple Therapy in Patients Requiring Oral Anticoagulation After Drug-Eluting Stent Implantation The ISAR-TRIPLE Trial
ConclusionsSix weeks of triple therapy was not superior to 6 months with respect to net clinical outcomes. These results suggest that physicians should weigh the trade-off between ischemic and bleeding risk when choosing the shorter or longer duration of triple therapy. (Triple Therapy in Patients on Oral Anticoagulation After Drug Eluting Stent Implantation [ISAR-TRIPLE]; NCT00776633)
Source: Journal of the American College of Cardiology - April 20, 2015 Category: Cardiology Source Type: research
Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis 1-Year Results From the All-Comers NOTION Randomized Clinical Trial
ConclusionsIn the NOTION trial, no significant difference between TAVR and SAVR was found for the composite rate of death from any cause, stroke, or MI after 1 year. (Nordic Aortic Valve Intervention Trial [NOTION]; NCT01057173)
Source: Journal of the American College of Cardiology - May 18, 2015 Category: Cardiology Source Type: research
Randomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease 5-Year Outcomes of the PRECOMBAT Study
ConclusionsDuring 5 years of follow-up, our study did not show significant difference regarding the rate of MACCE between patients who underwent PCI with a sirolimus-eluting stent and those who underwent CABG. However, considering the limited power of our study, our results should be interpreted with caution. (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease [PRECOMBAT]; NCT00422968)
Source: Journal of the American College of Cardiology - May 18, 2015 Category: Cardiology Source Type: research
Prognostic and Bioepidemiologic Implications of Papillary Fibroelastomas
ConclusionsIn patients with echocardiographically suspected PFE who do not undergo surgical removal, rates of cerebrovascular accident and mortality are increased.
Source: Journal of the American College of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
