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American Heart Journal

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https://www.readbyqxmd.com/read/28760218/growth-differentiation-factor-15-and-risk-of-major-bleeding-in-atrial-fibrillation-insights-from-the-randomized-evaluation-of-long-term-anticoagulation-therapy-re-ly-trial
#1
RANDOMIZED CONTROLLED TRIAL
Ziad Hijazi, Jonas Oldgren, Ulrika Andersson, Stuart J Connolly, John W Eikelboom, Michael D Ezekowitz, Paul A Reilly, Salim Yusuf, Agneta Siegbahn, Lars Wallentin
OBJECTIVE: To evaluate and validate the prognostic value of growth-differentiation factor 15 (GDF-15) beyond clinical characteristics and other biomarkers concerning bleeding and stroke outcomes in patients with atrial fibrillation in the RE-LY trial. METHODS: GDF-15 was measured in samples collected at randomization in 8,474 patients with a median follow-up time of 1.9 years. Patients were stratified based on predefined GDF-15 cutoffs: group 1, <1,200 ng/L (the 90th percentile in healthy individuals); group 2, 1,200-1,800; and group 3, >1,800 ng/L (high-risk individuals)...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760217/time-in-therapeutic-range-and-major-adverse-outcomes-in-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-the-atrial-fibrillation-undergoing-coronary-artery-stenting-afcas-registry
#2
MULTICENTER STUDY
Marco Proietti, K E Juhani Airaksinen, Andrea Rubboli, Axel Schlitt, Tuomas Kiviniemi, Pasi P Karjalainen, Gregory Yh Lip
BACKGROUND: Combination of oral anticoagulation (OAC) and antiplatelets is used in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention and stent (PCI-S) procedure but is associated with increased bleeding when triple antithrombotic therapy (TAT) is used. Our aim was to analyze the impact of time in therapeutic range (TTR) on outcomes, in patients prescribed with TAT. METHODS: Ancillary analysis from the AFCAS registry in patients assigned to TAT...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760216/use-of-endpoint-adjudication-to-improve-the-quality-and-validity-of-endpoint-assessment-for-medical-device-development-and-post-marketing-evaluation-rationale-and-best-practices-a-report-from-the-cardiac-safety-research-consortium
#3
REVIEW
Jonathan H Seltzer, Ted Heise, Peter Carson, Daniel Canos, Jo Carol Hiatt, Pascal Vranckx, Thomas Christen, Donald E Cutlip
This white paper provides a summary of presentations, discussions and conclusions of a Thinktank entitled "The Role of Endpoint Adjudication in Medical Device Clinical Trials". The think tank was cosponsored by the Cardiac Safety Research Committee, MDEpiNet and the US Food and Drug Administration (FDA) and was convened at the FDA's White Oak headquarters on March 11, 2016. Attention was focused on tailoring best practices for evaluation of endpoints in medical device clinical trials, practical issues in endpoint adjudication of therapeutic, diagnostic, biomarker and drug-device combinations, and the role of adjudication in regulatory and reimbursement issues throughout the device lifecycle...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760215/interventions-supporting-long-term-adherence-and-decreasing-cardiovascular-events-island-pragmatic-randomized-trial-protocol
#4
RANDOMIZED CONTROLLED TRIAL
Noah Ivers, J-D Schwalm, Holly O Witteman, Justin Presseau, Monica Taljaard, Tara McCready, Beth Bosiak, Jennifer Cunningham, Shelley Smarz, Laura Desveaux, Jack V Tu, Clare Atzema, Garth Oakes, Wanrudee Isaranuwatchai, Sherry L Grace, R Sacha Bhatia, Madhu Natarajan, Jeremy M Grimshaw
BACKGROUND: Guidelines recommend cardiac rehabilitation and long-term use of cardiac medications for most patients who have had a myocardial infarction (MI), but adherence to these secondary prevention treatments is suboptimal. METHODS: This is a multicenter, pragmatic, 3-arm randomized trial. Eligible patients (n = 2,742) with obstructive coronary artery disease are randomized post-MI to usual care or 1 of 2 intervention arms. Patients in the first intervention arm receive mail-outs sent on behalf of their cardiologist at 4, 8, 20, 32, and 44 weeks post-MI; content is designed to address determinants of adherence and facilitate discussion between the patient and their health care team...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760214/clinical-outcomes-with-percutaneous-coronary-revascularization-vs-coronary-artery-bypass-grafting-surgery-in-patients-with-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-6-randomized-trials-and-4-686-patients
#5
REVIEW
Tullio Palmerini, Patrick Serruys, Arie Pieter Kappetein, Philippe Genereux, Diego Della Riva, Letizia Bacchi Reggiani, Evald Christiansen, Niels R Holm, Leif Thuesen, Timo Makikallio, Marie Claude Morice, Jung-Min Ahn, Seung-Jung Park, Holger Thiele, Enno Boudriot, Mario Sabatino, Mattia Romanello, Giuseppe Biondi-Zoccai, Raphael Cavalcante, Joseph F Sabik, Gregg W Stone
Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT. METHODS: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760213/retained-cardiac-implantable-electronic-device-fragments-are-not-associated-with-magnetic-resonance-imaging-safety-issues-morbidity-or-mortality-after-orthotopic-heart-transplant
#6
Christopher O Austin, Kevin Landolfo, Pragnesh P Parikh, Parag C Patel, K L Venkatachalam, Fred M Kusumoto
BACKGROUND: Cardiac implantable electronic device therapy (CIED) has revolutionized treatment for advanced heart failure. Most patients considered for orthotopic heart transplantation (OHT) are treated with implantable cardioverter defibrillators, cardiac resynchronization therapy, or both. These CIEDs are surgically extracted at the time of transplant. Occasionally, CIEDs are incompletely removed. Little is known about the outcomes of post-OHT patients with retained CIED fragments. METHODS: We identified 200 consecutive patients that underwent OHT at our institution between April 2006 and December 2014 and performed a retrospective analysis of available radiographic images and clinical records...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760212/brain-derived-neurotrophic-factor-rs6265-val66met-polymorphism-is-associated-with-disease-severity-and-incidence-of-cardiovascular-events-in-a-patient-cohort
#7
Rong Jiang, Michael A Babyak, Beverly H Brummett, Elizabeth R Hauser, Svati H Shah, Richard C Becker, Ilene C Siegler, Abanish Singh, Carol Haynes, Megan Chryst-Ladd, Damian M Craig, Redford B Williams
BACKGROUND: The rs6265 (Val66Met) single-nucleotide polymorphism in the BDNF gene has been related to a number of endophenotypes that have in turn been shown to confer risk for atherosclerotic cardiovascular disease (CVD). To date, however, very few studies have examined the association of the Val66Met single-nucleotide polymorphism with CVD clinical outcomes. METHODS: In a cohort of 5,510 Caucasian patients enrolled in the CATHeterization GENetics (CATHGEN) study at Duke University Hospital between 2001 and 2011, we determined the severity of coronary artery disease (CAD) and CVD event incidence through up to 11...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760211/implantable-cardiac-monitors-in-high-risk-post-infarction-patients-with-cardiac-autonomic-dysfunction-and-moderately-reduced-left-ventricular-ejection-fraction-design-and-rationale-of-the-smart-mi-trial
#8
RANDOMIZED CONTROLLED TRIAL
Wolfgang Hamm, Konstantinos D Rizas, Lukas von Stülpnagel, Nikolay Vdovin, Steffen Massberg, Stefan Kääb, Axel Bauer
BACKGROUND: Most deaths after myocardial infarction (MI) occur in patients with left ventricular ejection fraction (LVEF) >35%, for whom no specific prophylactic strategies exist. Deceleration capacity (DC) of heart rate and periodic repolarization dynamics (PRD) are noninvasive electrophysiological markers depending on the vagal and sympathetic tone. The combination of abnormal DC and/or PRD identifies a new high-risk group among postinfarction patients with LVEF 36%-50%. This new high-risk group has similar characteristics with respect to prognosis and patient numbers to those of the established high-risk group identified by LVEF ≤ 35%...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760210/a-randomized-trial-of-a-1-hour-troponin-t-protocol-in-suspected-acute-coronary-syndromes-design-of-the-rapid-assessment-of-possible-acs-in-the-emergency-department-with-high-sensitivity-troponin-t-rapid-tnt-study
#9
RANDOMIZED CONTROLLED TRIAL
Cynthia Papendick, Andrew Blyth, Anil Seshadri, Michael J R Edmonds, Tom Briffa, Louise Cullen, Stephen Quinn, Jon Karnon, Anthony Chuang, Adam J Nelson, Matthew Horsfall, Erin Morton, Derek P Chew
BACKGROUND: Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency department before being deemed safe for discharge. In an era of limited health service resources, a protocol that could discharge patients safely within an hour of presentation is extremely attractive...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760209/stroke-of-known-cause-and-underlying-atrial-fibrillation-stroke-af-randomized-trial-design-and-rationale
#10
RANDOMIZED CONTROLLED TRIAL
Richard A Bernstein, Hooman Kamel, Christopher B Granger, Robert C Kowal, Paul D Ziegler, Lee H Schwamm
BACKGROUND: Approximately 20% of ischemic strokes are associated with clinically apparent atrial fibrillation (AF). Regardless of stroke etiology, detection of AF in patients with ischemic strokes often changes antithrombotic treatment from anti-platelet to oral anticoagulation therapy. The role and the optimum duration of cardiac monitoring to detect AF in patients with strokes presumed due to large vessel atherosclerosis or small vessel disease is unknown. This manuscript describes the design and rationale of the STROKE-AF trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760208/use-of-troponin-assay-99th-percentile-as-the-decision-level-for-myocardial-infarction-diagnosis
#11
MULTICENTER STUDY
Akshay Bagai, Karen P Alexander, Jeffrey S Berger, Roxy Senior, Chakkanalil Sajeev, Radoslaw Pracon, Kreton Mavromatis, Jose Luis Lopez-Sendón, Gilbert Gosselin, Ariel Diaz, Gian Perna, Jarozlaw Drozdz, Dennis Humen, Birute Petrauskiene, Asim N Cheema, Denis Phaneuf, Subhash Banerjee, Todd D Miller, Sasko Kedev, Herwig Schuchlenz, Gregg W Stone, Shaun G Goodman, Kenneth W Mahaffey, Allan S Jaffe, Yves D Rosenberg, Sripal Bangalore, L Kristin Newby, David J Maron, Judith S Hochman, Bernard R Chaitman
BACKGROUND: The Universal Definition of Myocardial Infarction recommends the 99th percentile concentration of cardiac troponin in a normal reference population as part of the decision threshold to diagnose type 1 spontaneous myocardial infarction. Adoption of this recommendation in contemporary worldwide practice is not well known. METHODS: We performed a cohort study of 276 hospital laboratories in 31 countries participating in the National Heart, Lung, and Blood Institute-sponsored International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760207/the-troponin-decision-point-dilemma-the-99th-percentile-solution-do-the-best-you-can-with-cardiac-troponin-until-you-know-better-then-when-you-know-better-do-better-maya-angelou-poet-dancer-producer-playwright-director-author
#12
EDITORIAL
https://www.readbyqxmd.com/read/28760206/prevention-of-sudden-cardiac-death-in-the-young-developing-a-rational-reliable-and-sustainable-national-health-care-resource-a-report-from-the-cardiac-safety-research-consortium
#13
REVIEW
Salim F Idriss, Stuart Berger, Kimberly G Harmon, Allen Kindman, Robert Kleiman, Martha Lopez-Anderson, Silvana Molossi, Tess Elizabeth Saarel, Colette Strnadova, Thomas Todaro, Kaori Shinagawa, Valarie Morrow, Mitchell Krucoff, Victoria Vetter, Theressa J Wright
This White Paper, prepared by members of the Cardiac Safety Research Consortium, discusses important issues regarding sudden cardiac death in the young (SCDY), a problem that does not discriminate by gender, race, ethnicity, education, socioeconomic level, or athletic status. The occurrence of SCDY has devastating impact on families and communities. Sudden cardiac death in the young is a matter of national and international public health, and its prevention has generated deep interest from multiple stakeholders, including families who have lost children, advocacy groups, academicians, regulators, and the medical industry...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760205/probing-oral-anticoagulation-in-patients-with-atrial-high-rate-episodes-rationale-and-design-of-the-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-high-rate-episodes-noah-afnet-6-trial
#14
RANDOMIZED CONTROLLED TRIAL
Paulus Kirchhof, Benjamin F Blank, Melanie Calvert, A John Camm, Gregory Chlouverakis, Hans-Christoph Diener, Andreas Goette, Andrea Huening, Gregory Y H Lip, Emmanuel Simantirakis, Panos Vardas
Oral anticoagulation prevents ischemic strokes in patients with atrial fibrillation (AF). Early detection of AF and subsequent initiation of oral anticoagulation help to prevent strokes in AF patients. Implanted cardiac pacemakers and defibrillators allow seamless detection of atrial high rate episodes (AHRE), but the best antithrombotic therapy in patients with AHRE is not known. RATIONALE: Stroke risk is higher in pacemaker patients with AHRE than in those without, but the available data also show that stroke risk in patients with AHRE is lower than in patients with AF...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760204/effects-of-serelaxin-on-the-outcome-of-patients-with-or-without-substantial-peripheral-edema-a-subgroup-analysis-from-the-relax-ahf-trial
#15
RANDOMIZED CONTROLLED TRIAL
Claudio Gimpelewicz, Marco Metra, John G F Cleland, Peter Szecsödy, Chuan-Chuan Chang Wun, Leandro Boer-Martins, Gad Cotter, Beth A Davison, Gary Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Peter Pang, Piotr Ponikowski, Thomas Severin, Adrian A Voors, John R Teerlink
BACKGROUND: Acute heart failure (AHF) is a heterogeneous disorder, with most of the patients presenting with breathlessness along with varying degrees of peripheral edema. The presence of peripheral edema suggests that volume overload is the cause of decompensation leading to AHF, whereas breathlessness in the absence of edema may reflect a "vascular phenotype." This analysis investigated the characteristics, therapeutic response, and outcome of patients with AHF, with and without overt peripheral edema in the RELAX-AHF trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760203/county-socioeconomic-characteristics-and-heart-transplant-outcomes-in-the-united-states
#16
MULTICENTER STUDY
Dmitry Tumin, Jessica Horan, Emily A Shrider, Sakima A Smith, Joseph D Tobias, Don Hayes, Randi E Foraker
BACKGROUND: Geographic disparities in survival after heart transplantation have received mixed support in prior studies, and specific geographic characteristics that might be responsible for these differences are unclear. We tested for differences in heart transplant outcomes across United States (US) counties after adjustment for individual-level covariates. Our secondary aim was to evaluate whether specific county-level socioeconomic characteristics explained geographic disparities in survival...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28760202/high-sensitivity-c-reactive-protein-is-an-independent-marker-of-abnormal-coronary-vasoreactivity-in-patients-with-non-obstructive-coronary-artery-disease
#17
Jaskanwal D S Sara, Megha Prasad, Ming Zhang, Ryan J Lennon, Joerg Herrmann, Lilach O Lerman, Amir Lerman
BACKGROUND: Coronary endothelial dysfunction (CED) is an early stage of atherosclerosis and is associated with adverse cardiovascular events. Inflammation may play a role in the development of endothelial dysfunction. To date no study has evaluated the relationship between C-reactive protein and CED. We aimed to determine if C-reactive protein is associated with CED. METHODS: In 1016 patients (mean age 50.7±12.3 years, 34% male) presenting to the catheterization laboratory with chest pain and non-obstructive coronary artery disease, coronary vasoreactivity was assessed by measuring the percent change in coronary blood flow (%ΔCBF) and coronary artery diameter (%ΔCAD) in response to intracoronary acetylcholine...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625387/design-and-rationale-for-the-influenza-vaccination-after-myocardial-infarction-iami-trial-a-registry-based-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Ole Fröbert, Matthias Götberg, Oskar Angerås, Lena Jonasson, David Erlinge, Thomas Engstrøm, Jonas Persson, Svend E Jensen, Elmir Omerovic, Stefan K James, Bo Lagerqvist, Johan Nilsson, Amra Kåregren, Rasmus Moer, Cao Yang, David B Agus, Andrejs Erglis, Lisette O Jensen, Lars Jakobsen, Evald H Christiansen, John Pernow
BACKGROUND: Registry studies and case-control studies have demonstrated that the risk of acute myocardial infarction (AMI) is increased following influenza infection. Small randomized trials, underpowered for clinical end points, indicate that future cardiovascular events can be reduced following influenza vaccination in patients with established cardiovascular disease. Influenza vaccination is recommended by international guidelines for patients with cardiovascular disease, but uptake is varying and vaccination is rarely prioritized during hospitalization for AMI...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625386/hemodynamic-determinants-of-mortality-after-fontan-operation
#19
Hideo Ohuchi, Aya Miyazaki, Jun Negishi, Yosuke Hayama, Michikazu Nakai, Kunihiro Nishimura, Hajime Ichikawa, Isao Shiraishi, Osamu Yamada
BACKGROUND: Elevated central venous pressure (CVP), low cardiac output, and mild hypoxia are common early and late after Fontan operations. However, the association of these characteristics with late mortality is unclear. We aimed to elucidate the hemodynamic determinants of mortality after Fontan operation. METHOD: We evaluated early (group early; 0.5-5years postoperatively, n=387) and late (group late; ≥15years postoperatively, n=161) Fontan hemodynamics that included CVP (mm Hg), cardiac index (CI; L/min per m(2)), systemic ventricular end-diastolic volume index (mL/m(2)), ejection fraction (EF; %), and arterial blood oxygen saturation (%)...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625385/seasonal-and-circadian-variations-of-acute-myocardial-infarction-findings-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#20
MULTICENTER STUDY
Vijaiganesh Nagarajan, Gregg C Fonarow, Christine Ju, Michael Pencina, Warren K Laskey, Thomas M Maddox, Adrian Hernandez, Deepak L Bhatt
BACKGROUND: Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and circadian variations are equally present in warmer and colder regions. We investigated whether seasonal and circadian variations in acute myocardial infarction (AMI) are more prominent in colder northern states compared with warmer southern states...
July 2017: American Heart Journal
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