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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Mode of Death Prevention by Serelaxin
We read with interest the article by Felker et al. (1) regarding the effect of serelaxin on the mode of death prevention in acute heart failure. This paper was a subgroup analysis of the RELAX-AHF (Efficacy and Safety of Relaxin for the Treatment of Acute Heart Failure) study intended to assess the effect of serelaxin on the specific mode of death in acute heart failure patients enrolled in the trial. The RELAX-AHF study demonstrated a reduction in the secondary endpoint of 180-day mortality in patients receiving a 48-h continuous infusion of 30 μg/kg/day serelaxin compared with placebo (2). Although designed for the tre...
Source: Journal of the American College of Cardiology - June 29, 2015 Category: Cardiology Source Type: research

Duration of Triple Therapy in Patients Requiring Oral Anticoagulation After Drug-Eluting Stent Implantation
We read with much interest the paper and editorial by Fiedler et al. (1) and Bhatt et al. (2) regarding the optimal duration of dual antiplatelet therapy (DAPT) in patients on systemic anticoagulation in a recent issue of the Journal. In this randomized, open-label trial, 614 patients underwent drug-eluting stent (DES) implantation and were randomized to either 6 weeks or 6 months of clopidogrel therapy. They found no difference in the primary endpoint (composite of death, myocardial infarction, definite stent thrombosis, stroke, or TIMI [Thrombolysis In Myocardial Infarction] major bleeding) between the 2 groups (9.8...
Source: Journal of the American College of Cardiology - August 24, 2015 Category: Cardiology Source Type: research

Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitor-Based Treatment on Cardiovascular Outcomes in Hypertensive Blacks Versus Whites
This study evaluated the comparative effectiveness of an ACE inhibitor–based regimen on a composite outcome of all-cause mortality, stroke, and acute myocardial infarction (AMI) in hypertensive blacks compared with whites.MethodsWe conducted a retrospective cohort study of 434,646 patients in a municipal health care system. Four exposure groups (Black-ACE, Black-NoACE, White-ACE, White-NoACE) were created based on race and treatment exposure (ACE or NoACE). Risk of the composite outcome and its components was compared across treatment groups and race using weighted Cox proportional hazard models.ResultsOur analysis inclu...
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research

PFO “Please Figure Out,” or Now “Potentially Figured Out?” ∗
In 2001, one of us (B.A.L.) was asked to give medicine grand rounds on the topic of patent foramen ovale (PFO) closure for cryptogenic stroke. The copresenting neurologist creatively titled it “PFO = Please Figure Out.” Fifteen years and 3 randomized trials later, the witty title still resonates. The recurrent theme of the 3 trials comparing medical management and transcatheter device closure of PFO to prevent recurrent cryptogenic stroke has favored device closure but fallen short of the “holy grail” of statistical significance (p 
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research

Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel
ConclusionsCYP2C19 metabolizer status is not associated with the composite outcome of cardiovascular death, MI, or stroke in medically managed ACS patients treated with clopidogrel or prasugrel. Our findings do not support routine CYP2C19 genetic testing in this population. (A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects [TRILOGY ACS]; NCT00699998)
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research

Reply Nitrites/Nitrates in Heart Failure With Preserved Ejection Fraction
We thank Dr. Weber and colleagues for their interest and thoughtful comments regarding our recent trial (1) demonstrating improvement in exercise hemodynamics and cardiac reserve following acute infusion of sodium nitrite in patients with heart failure and preserved ejection fraction (HFpEF). We agree with the authors’ speculation that part of the benefit from nitrite therapy may be related to reduction in arterial wave reflections, which are known to correlate with abnormal diastolic function and the clinical syndrome of HFpEF (2,3). Indeed, we have previously shown in a separate randomized trial (4) that aggressive ...
Source: Journal of the American College of Cardiology - March 15, 2016 Category: Cardiology Source Type: research

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Myocardial Infarction Patients With Renal Dysfunction
ConclusionsTreatment with ACEI/ARB after AMI was associated with improved long-term survival, regardless of underlying renal function, and was accompanied by low rates of adverse renal events.
Source: Journal of the American College of Cardiology - April 4, 2016 Category: Cardiology Source Type: research

3-Year Outcomes in High-Risk Patients Who Underwent Surgical or Transcatheter Aortic Valve Replacement
This study sought to determine whether this clinical benefit was sustained over time.MethodsPatients with severe aortic stenosis deemed at increased risk for surgery by a multidisciplinary heart team were randomized 1:1 to TAVR or open surgical valve replacement (SAVR). Three-year clinical and echocardiographic outcomes were obtained in those patients with an attempted procedure.ResultsA total of 797 patients underwent randomization at 45 U.S. centers; 750 patients underwent an attempted procedure. Three-year all-cause mortality or stroke was significantly lower in TAVR patients (37.3% vs. 46.7% in SAVR; p = 0.006). Adver...
Source: Journal of the American College of Cardiology - May 30, 2016 Category: Cardiology Source Type: research

Nonvitamin K Anticoagulant Agents in Patients With Advanced Chronic Kidney Disease or on Dialysis With AF
Nonvitamin K-dependent oral anticoagulant agents (NOACs) are currently recommended for patients with atrial fibrillation at risk for stroke. As a group, NOACs significantly reduce stroke, intracranial hemorrhage, and mortality, with lower to similar major bleeding rates compared with warfarin. All NOACs are dependent on the kidney for elimination, such that patients with creatinine clearance 
Source: Journal of the American College of Cardiology - June 14, 2016 Category: Cardiology Source Type: research

Hybrid Coronary Revascularization for the Treatment of Multivessel Coronary Artery Disease A Multicenter Observational Study
ConclusionsThese observational data from this first multicenter study of HCR suggest that there is no significant difference in MACCE rates over 12 months between patients treated with multivessel PCI or HCR, an emerging modality. A randomized trial with long-term outcomes is needed to definitively compare the effectiveness of these 2 revascularization strategies. (Hybrid Revascularization Observational Study; NCT01121263)
Source: Journal of the American College of Cardiology - July 18, 2016 Category: Cardiology Source Type: research

Hybrid Coronary Revascularization for  the Treatment of Multivessel Coronary Artery Disease A Multicenter Observational Study
Conclusions These observational data from this first multicenter study of HCR suggest that there is no significant difference in MACCE rates over 12 months between patients treated with multivessel PCI or HCR, an emerging modality. A randomized trial with long-term outcomes is needed to definitively compare the effectiveness of these 2 revascularization strategies. (Hybrid Revascularization Observational Study; NCT01121263)
Source: Journal of the American College of Cardiology - July 21, 2016 Category: Cardiology Source Type: research

Low-Dose Colchicine for Secondary Prevention of Cardiovascular Disease
The objective of this study was to determine whether colchicine 0.5 mg/day can reduce the risk of cardiovascular events in patients with clinically stable coronary disease. Background: The presence of activated neutrophils in culprit atherosclerotic plaques of patients with unstable coronary disease raises the possibility that inhibition of neutrophil function with colchicine may reduce the risk of plaque instability and thereby improve clinical outcomes in patients with stable coronary disease. Methods: In a clinical trial with a prospective, randomized, observer-blinded endpoint design, 532 patients with stable coron...
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Stefan M. Nidorf, John W. Eikelboom, Charley A. Budgeon, Peter L. Thompson Tags: Clinical Trial Source Type: research

Remnant Cholesterol: “Non-(HDL-C + LDL-C)” as a Coronary Artery Disease Risk Factor⁎
In this issue the Journal, Varbo et al. () demonstrate that irrespective of the fasting state, the cholesterol transported by remnant lipoproteins is a robust predictor of coronary artery disease (CAD) risk. Their findings provide clarification to the debate regarding triglyceride-rich lipoproteins and atherosclerosis (). Overall, a consensus is emerging on the basis of clinical and population data and genetic studies that fasting and nonfasting plasma triglycerides are predictive of both CAD and stroke risk, although the relationship is attenuated after correction for associated variables, including high-density lipoprote...
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Ruth McPherson Tags: Cardiometabolic Risk: Editorial Comment Source Type: research

The Current State of Niacin in Cardiovascular Disease Prevention: A Systematic Review and Meta-Regression
Conclusions: The consensus perspective derived from available clinical data supports that niacin reduces CVD events and, further, that this may occur through a mechanism not reflected by changes in high-density lipoprotein cholesterol concentration.
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Paul M. Lavigne, Richard H. Karas Tags: Cardiometabolic Risk Source Type: research

Association Between Cardiovascular Autonomic Neuropathy and Left Ventricular Dysfunction: DCCT/EDIC Study (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications)
Objectives: The goal of these studies was to determine the association between cardiovascular autonomic neuropathy (CAN) and indices of left ventricle (LV) structure and function in patients with type 1 diabetes (T1DM) in the DCCT/EDIC (Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications) study. Background: The pathophysiology of LV dysfunction in T1DM remains unclear, especially when the LV ejection fraction (EF) is preserved. Whether CAN is associated with LV dysfunction is unclear. Methods: Indices of LV structure and function were obtained by cardiac magnetic resonanc...
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Rodica Pop-Busui, Patricia A. Cleary, Barbara H. Braffett, Catherine L. Martin, William H. Herman, Phillip A. Low, Joao A.C. Lima, David A. Bluemke, DCCT/EDIC Research Group Tags: Heart Failure Source Type: research