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Study design of Dal-GenE, a pharmacogenetic trial targeting reduction of cardiovascular events with dalcetrapib
We describe below the design of dal-GenE, a precision medicine, placebo-controlled clinical outcome trial of dalcetrapib in patients with a recent acute myocardial infarction with the unique feature of selecting only those with the AA genotype at rs1967309 in the ADCY9 gene.
Source: American Heart Journal - January 19, 2020 Category: Cardiology Source Type: research

Risk of Major Cardiovascular and Neurologic Events with Obstructive Sleep Apnea among Patients with Atrial Fibrillation
ConclusionAmong patients with AF, OSA is an independent risk factor for MACNE and, more specifically, stroke/SE.Graphical Abstract
Source: American Heart Journal - January 7, 2020 Category: Cardiology Source Type: research

Low-density lipoprotein cholesterol treatment and outcomes in patients with type 2 diabetes and established cardiovascular disease: Insights from TECOS
ConclusionsAlthough most high-risk patients with T2D and CV disease were on lipid-lowering therapy, only 1:3 had LDL-C < 70 mg/dL and 1:6 had LDL-C < 55 mg/dL. Each 10 mg/dL higher LDL-C value was associated with a 5% and 6% higher 5-year incidence of MACE and CV death, respectively. (TECOS, NCT00790205).
Source: American Heart Journal - November 14, 2019 Category: Cardiology Source Type: research

Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials
ConclusionsClaims- versus site-based (+CEC) follow-up identified similar overall cardiovascular event rates despite meaningful differences in the events detected. Randomized treatment effects were similar using the 2 methods, suggesting claims data could be used to support clinical research leveraging routinely collected data. This approach may lead to more effective evidence generation, synthesis, and appraisal of medical products and inform the strategic approaches toward the National Evaluation System for Health Technology.
Source: American Heart Journal - November 12, 2019 Category: Cardiology Source Type: research

The effect of low-dose colchicine in patients with stable coronary artery disease: The LoDoCo2 trial rationale, design, and baseline characteristics
ConclusionThe LoDoCo2 Trial will provide information on the efficacy and safety of low-dose colchicine for secondary prevention in patients with stable coronary artery disease.
Source: American Heart Journal - November 7, 2019 Category: Cardiology Source Type: research

Outcome impact of different tranexamic acid regimens in cardiac surgery with cardiopulmonary bypass (OPTIMAL): Rationale, design, and study protocol of a multi-center randomized controlled trial
ConclusionsThe study is designed to identify a TxA dose with maximal efficacy and minimal complications. We hypothesize that the high dose has superior efficacy and non-inferior safety to the low dose.
Source: American Heart Journal - October 22, 2019 Category: Cardiology Source Type: research

Association of obesity with cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease: Insights from TECOS
ConclusionsThe majority of TECOS participants with ASCVD and T2D were overweight or obese, yet overweight or obese class I individuals had lower CV risk than those who were under/normal weight. These results suggest the presence of an obesity paradox, but this paradox may reflect an epidemiological artifact rather than a true negative association between normal weight and clinical outcomes.
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

T effect of low dose colchicine in patients with stable coronary artery disease: The LoDoCo2 trial rationale, design and baseline characteristics
ConclusionThe LoDoCo2 Trial will provide information on the efficacy and safety of low dose colchicine for secondary prevention in patients with stable coronary artery disease.
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

Claims-based cardiovascular outcome identification for clinical research: Results from seven large randomized cardiovascular clinical trials
ConclusionsClaims- vs. site-based (+CEC) follow-up identified similar overall cardiovascular event rates, despite meaningful differences in the events detected. Randomized treatment effects were similar using the two methods, suggesting claims data could be used to support clinical research leveraging routinely-collected data. This approach may lead to more effective evidence generation, synthesis, and appraisal of medical products and inform the strategic approaches toward the National Evaluation System for Health Technology.
Source: American Heart Journal - September 12, 2019 Category: Cardiology Source Type: research

Long-Term (10-Year) Outcomes of Stenting or Bypass Surgery for Acute Coronary Syndromes and Stable Ischemic Heart Disease With Unprotected Left Main Coronary Artery Disease
ConclusionsIn patients with LMCA disease, we have identified no significant interaction between the acuity of clinical indication and the relative treatment effect of PCI versus CABG on 10-year clinical outcomes.
Source: American Heart Journal - August 22, 2019 Category: Cardiology Source Type: research

Expanding opportunities to understand quality and outcomes of peripheral vascular interventions: The ACC NCDR PVI registry
Publication date: Available online 22 July 2019Source: American Heart JournalAuthor(s): W. Schuyler Jones, Kevin F. Kennedy, Beau M. Hawkins, Robert R. Attaran, Eric A. Secemsky, Faisal Latif, Nicolas W. Shammas, Dmitriy N. Feldman, Herbert D. Aronow, Bruce Gray, Ehrin J. Armstrong, P. Michael Grossman, Kalon K.L. Ho, Anand Prasad, Michael R. Jaff, Kenneth Rosenfield, Thomas T. TsaiAbstractLower extremity peripheral artery disease (PAD) and cerebrovascular disease (CeVD) are prevalent conditions in the United States, and both are associated with significant morbidity (e.g. stroke, myocardial infarction and limb loss) and i...
Source: American Heart Journal - July 24, 2019 Category: Cardiology Source Type: research

Premorbid levels of high-sensitivity cardiac troponin T and natriuretic peptide and prognosis after incident myocardial infarction
ConclusionsPremorbid levels of hs-cTnT and NT-proBNP assessed on average six years prior to incident MI were associated with adverse outcomes after incident MI. These results further highlight the importance of cardiac health at an earlier stage of life.
Source: American Heart Journal - July 13, 2019 Category: Cardiology Source Type: research

Contemporary invasive management and in-hospital outcomes of patients with non–ST-segment elevation myocardial infarction in China: Findings from China Acute Myocardial Infarction (CAMI) Registry
ConclusionInvasive management was underused and profoundly deferred among patients with NSTEMI in China. The risk-treatment paradox, procedure deferral and medical resources distribution imbalance may represent opportunities for improvement.
Source: American Heart Journal - June 29, 2019 Category: Cardiology Source Type: research

Long-term follow-up and safety assessment of angiogenic gene therapy trial VIF-CAD: Transcatheter intramyocardial administration of a bicistronic plasmid expressing VEGF-A165/bFGF cDNA for the treatment of refractory coronary artery disease
This study presents the results of over 10-year (median 133 months, range 95–149) safety follow-up of VIF-CAD patients. Overall, 12 (36.4%) patients died in VIF and 8 (42.1%) in Placebo group (P = .68). Cardiovascular mortality was 12/33 (36.4%) in the VIF group and 6/19 (31.6%) in Placebo group (P = .73). Two Placebo patients died due to malignancies, but no VIF patients (P = .17). The Kaplan–Meier curves of combined endpoint: cardiovascular mortality, myocardial infarction and stroke were similar for both patient groups (P = .71). Odds ratio of Placebo group increasing (re...
Source: American Heart Journal - June 20, 2019 Category: Cardiology Source Type: research

Lessons learned about stress and the heart after major earthquakes
Publication date: Available online 6 June 2019Source: American Heart JournalAuthor(s): Robert A. KlonerAbstractThere is evidence that certain stressors can trigger cardiovascular events. Several studies have now demonstrated an increase in major adverse cardiac events associated with natural disasters such as an earthquake. The purpose of this paper is to review the literature on earthquakes and cardiovascular events. Reports from 13 major quakes were reported. Earthquakes have been associated with a number of cardiac events including sudden cardiac death, fatal myocardial infarction (MI), myocardial infarction, stress car...
Source: American Heart Journal - June 6, 2019 Category: Cardiology Source Type: research

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