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Total 262 results found since Jan 2013.

Cardiovascular highlights from non-cardiology journals
Transcatheter aortic valve implantation in intermediate risk patients Transcatheter aortic valve implantation (TAVI) has had a major impact on both morbidity and mortality in high-risk and inoperable patients with severe aortic stenosis. Robust evidence has supported widespread adoption in this patient group but uncertainty exists as to whether TAVI may also achieve clinical equipoise with surgical aortic valve replacement (AVR) in lower risk groups. In the industry sponsored PARTNER 2 trial, patients deemed at intermediate surgical risk (generally with an STS score between 4 and 8) were randomized to either TAVI with the ...
Source: Heart - July 25, 2016 Category: Cardiology Authors: McCabe, J. M. Tags: Journal scan Source Type: research

Cardiovascular disease risk assessment in HIV: navigating data-sparse zones
Persons with HIV are surviving longer than ever before due to effective antiretroviral therapy (ART) and are increasingly at risk for chronic, non-communicable diseases.1–3 Data from large cohorts in North America and Europe have demonstrated that HIV-infected persons have roughly 50% greater risks for myocardial infarction (MI) than uninfected persons, as well as greater risks for other cardiovascular diseases such as heart failure and stroke.4 5 These elevated risks for MI persist even after accounting for cardiovascular risk factors and ART regimens and are thought to result from HIV-associated inflammation, immun...
Source: Heart - July 10, 2016 Category: Cardiology Authors: Feinstein, M. J. Tags: Drugs: cardiovascular system, Acute coronary syndromes Editorials Source Type: research

Significance of apical cavity obliteration in apical hypertrophic cardiomyopathy
Conclusions The ratio of obliteration to cavity could provide useful information to predict the occurrence of adverse events in apical HCM.
Source: Heart - July 10, 2016 Category: Cardiology Authors: Kim, H., Park, J.-H., Won, K.-B., Yoon, H.-J., Park, H.-S., Cho, Y.-K., Nam, C.-W., Han, S., Hur, S.-H., Kim, Y.-N., Kim, K.-B. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Hypertension, Epidemiology Heart failure and cardiomyopathies Source Type: research

Effect of prior clopidogrel use on outcomes in medically managed acute coronary syndrome patients
Conclusions Patients receiving clopidogrel before admission for ACS and subsequently treated only medically are at higher risk for CV events versus those not previously receiving clopidogrel. More potent antiplatelet inhibition with prasugrel versus clopidogrel did not significantly reduce this risk. Trial registration number NCT00699998.
Source: Heart - July 10, 2016 Category: Cardiology Authors: Chin, C. T., Boden, W. E., Roe, M. T., Neely, B., Neely, M. L., Leiva-Pons, J. L., Corbalan, R., Gottlieb, S., Dalby, A. J., Armstrong, P. W., Prabhakaran, D., Fox, K. A. A., White, H. D., Ohman, E. M., Winters, K. J., Schiele, F. Tags: Drugs: cardiovascular system, Acute coronary syndromes Special populations Source Type: research

Heartbeat: Lonely Hearts
Loneliness and social isolation are associated with an increased risk of premature mortality. This association is related to several factors including behaviors (such as smoking or physical inactivity), reduced psychological well-being, and adverse physiological changes (such as altered immune function and hypertension). In order to better define the magnitude of risk for incident cardiovascular disease attributable to loneliness and social isolation, Valtorta and colleagues (see page 1009) performed a meta-analysis of 16 longitudinal databases with a total of 4628 coronary heart disease (CHD) events and 3002 strokes over ...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Otto, C. M. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Tobacco use Heartbeat Source Type: research

Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry
Loneliness and social isolation as risk factors for CVD A recent meta-analysis has shown that loneliness and social isolation are risk factors for coronary heart disease and stroke.1 These latest findings, specific to cardiovascular outcomes, are consistent with substantial research indicating broad health risks (eg, immune functioning, cardiovascular functioning, cognitive decline) associated with the quantity and quality of social relationships—including several meta-analyses documenting mortality risk.2 3 In the most comprehensive of these,3 the overall odds for mortality was 1.50, similar to the risk from light s...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Holt-Lunstad, J., Smith, T. B. Tags: Open access, Press releases, Drugs: cardiovascular system, Hypertension, Epidemiology, Tobacco use Editorials Source Type: research

Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies
Conclusions Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries. Study registration number CRD42014010225.
Source: Heart - June 9, 2016 Category: Cardiology Authors: Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., Hanratty, B. Tags: Open access, Editor's choice, Press releases, Drugs: cardiovascular system, Epidemiology Cardiac risk factors and prevention Source Type: research

Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban
Conclusions We found that patients with AF and AS on oral anticoagulants may have distinctly different efficacy and safety outcomes than patients with MR or AR or no SVD. Trial registration number NCT00403767; Post-results.
Source: Heart - June 9, 2016 Category: Cardiology Authors: Breithardt, G., Baumgartner, H., Berkowitz, S. D., Hellkamp, A. S., Piccini, J. P., Lokhnygina, Y., Halperin, J. L., Singer, D. E., Hankey, G. J., Hacke, W., Becker, R. C., Nessel, C. C., Mahaffey, K. W., Califf, R. M., Fox, K. A. A., Patel, M. R., for th Tags: Open access, Drugs: cardiovascular system, Interventional cardiology, Aortic valve disease, Mitral valve disease Valvular heart disease Source Type: research

Carotid artery stenting
Learning objectives After reading this article the reader should:Know the appropriate diagnostic workup for patients with carotid artery disease. Be able to put in perspective, based on strengths and limitations, the results of randomised trials comparing carotid artery stenting and carotid endarterectomy. Be able to identify patients that may benefit from carotid artery stenting. Introduction In western countries, stroke is the fourth leading cause of death, after heart disease, cancer and chronic respiratory diseases.1 Carotid artery disease may be responsible for 10–15% of all ischaemic strokes.2 Randomised contro...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Roffi, M., Kulcsar, Z., Carrera, E., Cremonesi, A. Tags: Education in Heart, Drugs: cardiovascular system, Interventional cardiology, Epidemiology, Tobacco use Source Type: research

Carotid artery stenting outcomes in dataset registries: a cause of concern or an opportunity for improvement?
Dear Editor, Roffi et al1 report that contemporary outcomes following carotid stenting (CAS) in large-scale registries were comparable to carotid endarterectomy (CEA). They also concluded that, over time, complication rates following CAS had decreased.1 We recently reviewed outcomes after >1 500 000 procedures in 21 administrative dataset registries where procedural death/stroke rates were reported for both CEA and CAS.2 One key finding was that CAS was associated with in-hospital/30-day death/stroke rates that exceeded the 3% American Heart Association (AHA) risk threshold for asymptomatic patients in 9/21 re...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Paraskevas, K. I., Naylor, A. R. Tags: Review articles PostScript Source Type: research

Heartbeat: Go with the flow in aortic stenosis?
Aortic valve stenosis (AS), at the simplest level, is mechanical obstruction to left ventricular (LV) outflow with severity best described by the high velocity or pressure gradient across the valve or the small valve opening area. More recently, the importance of adverse left ventricular (LV) changes in patients with aortic valve disease has led to a new classification of AS to include measures of LV function and volume flow rate as follows: (1) high gradient severe AS with a transvalvular velocity ≥4 m/s or mean gradient ≥40 mm Hg, (2) low-flow low-gradient severe AS with reduced ejection fraction (<50%), an...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Otto, C. M. Tags: Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Heartbeat Source Type: research

All types of atrial fibrillation in the setting of myocardial infarction are associated with impaired outcome
Conclusions AF is common in the setting of MI and is associated with a higher risk of composite cardiovascular outcome and the individual components; mortality, reinfarction and ischaemic stroke, respectively. No major difference in outcome was observed between AF subtypes. No difference in outcome for AF was observed between the NSTEMI and STEMI cohort.
Source: Heart - June 5, 2016 Category: Cardiology Authors: Batra, G., Svennblad, B., Held, C., Jernberg, T., Johanson, P., Wallentin, L., Oldgren, J. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Coronary artery disease Source Type: research

Echocardiographic predictors of outcomes in adults with aortic stenosis
Conclusions The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS.
Source: Heart - June 5, 2016 Category: Cardiology Authors: Capoulade, R., Le Ven, F., Clavel, M.-A., Dumesnil, J. G., Dahou, A., Thebault, C., Arsenault, M., O'Connor, K., Bedard, E., Beaudoin, J., Senechal, M., Bernier, M., Pibarot, P. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism
Learning objectives Understand the importance of venous thrombosis in cardiovascular medicine. Appreciate the mode of action of different oral anticoagulants. Recall the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulants. Introduction Thrombosis is the common pathophysiology responsible for ischaemic heart disease, ischaemic stroke and venous thromboembolism (VTE), and a major contributor to the global disease burden.1 This effect is markedly more pronounced by considering the view that cancer is also a thrombotic disease.2 3 Cardiovascular disease (CVD, manifesting as acute coronary syndromes, m...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Blann, A. D., Lip, G. Y. H. Tags: Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Source Type: research

Cardiovascular highlights from non-cardiology journals
Pre-operative aspirin does not influence CABG outcomes Aspirin is a common therapy for risk reduction among patients with coronary artery disease. However, among patients undergoing coronary artery bypass surgery, the benefits of aspirin on the risk of myocardial infarction and stroke may be outweighed by perioperative bleeding risk. To address this question, the ATACAS trial randomized 2100 patients to either receive 100 mg aspirin daily or matching placebo for 4 days immediately prior to the operation with all patients resuming aspirin within 24 hours of their bypass surgery. The primary outcome was a composite of d...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research