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American Heart Journal

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https://www.readbyqxmd.com/read/27892888/early-de-novo-atrial-fibrillation-after-coronary-artery-bypass-grafting-facts-and-features
#1
Ameeta Yaksh, Charles Kik, Paul Knops, Maarten J B van Ettinger, Ad J J C Bogers, Natasja M S de Groot
: Knowledge of the mechanism underlying post-operative atrial fibrillation (PoAF) is essential for development of preventive measures. The incidence and characteristics of both PoAF and supraventricular premature beats triggering PoAF, their interrelationship and alterations over time have never been examined. The goal of this study is therefore to examine the correlation between the incidence and characteristics of supraventricular premature beats (SVPBs) and PoAF episodes in patients undergoing CABG in the first five post-operative days...
November 10, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892891/atorvastatin-for-high-risk-statin-na%C3%A3-ve-patients-undergoing-noncardiac-surgery-the-lowering-the-risk-of-operative-complications-using-atorvastatin-loading-dose-load-randomized-trial
#2
Otavio Berwanger, Pedro G M de Barros E Silva, Roberto Ramos Barbosa, Dalton Bertolim Precoma, Estêvão Lanna Figueiredo, Ludhmila Abrahão Hajjar, Cleber Dario Pinto Kruel, Carolina Alboim, Adail Paixão Almeida, Marianna Deway Andrade Dracoulakis, Hugo Vargas Filho, Maria José Carvalho Carmona, Lília Nigro Maia, João Bosco de Oliveira Filho, Jose Francisco Kerr Saraiva, Rafael M Soares, Lucas Damiani, Denise Paisani, Alessandra A Kodama, Beatriz Gonzales, Dimas T Ikeoka, Philip J Devereaux, Renato D Lopes
: Preliminary evidence suggests that statins may prevent major perioperative vascular complications. METHODS: We randomized 648 statin-naïve patients who were scheduled for noncardiac surgery and were at risk for a major vascular complication. Patients were randomized to a loading dose of atorvastatin or placebo (80 mg anytime within 18hours before surgery), followed by a maintenance dose of 40 mg (or placebo), started at least 12hours after the surgery, and then 40 mg/d (or placebo) for 7days...
November 9, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892887/cardiorespiratory-fitness-and-nonfatalcardiovascular-events-a-population-based-follow-up-study
#3
Hassan Khan, Nabil Jaffar, Rainer Rauramaa, Sudhir Kurl, Kai Savonen, Jari A Laukkanen
BACKGROUND: To examine the prognostic value of cardiorespiratory fitness (CRF) with risk of first major nonfatal myocardial infarction (MI), stroke, and heart failure (HF) events. METHODS: Cardiorespiratory fitness, as measured by maximal oxygen uptake, was assessed at baseline in a prospective cohort of 2,089 men aged 42 to 61years. RESULTS: During a mean (SD) follow-up of 19.1(8.4) years, 522 nonfatal acute MI events, 198 acute all-cause nonfatal stroke events, and 221 nonfatal HF events were recorded...
November 2, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#4
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
October 31, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892882/clinical-and-angiographic-predictors-of-persistently-ischemic-fractional-flow-reserve-after-percutaneous-revascularization
#5
Shiv Kumar Agarwal, Srikanth Kasula, Ahmed Almomani, Yalcin Hacioglu, Zubair Ahmed, Barry F Uretsky, Abdul Hakeem
AIMS: Despite optimal angiographic results after percutaneous coronary intervention (PCI), some lesions may continue to produce ischemia under maximal hyperemia. We evaluated the factors associated with persistently ischemic fractional flow reserve (FFR) after angiographically successful PCI. METHODS AND RESULTS: A total of 574 consecutive patients with 664 lesions undergoing PCI who had FFR pre- and post-PCI were analyzed. Percutaneous coronary intervention led to effective ischemia reduction from pre-FFR (0...
October 29, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892889/the-impact-of-functional-vs-degenerative-mitral-regurgitation-on-clinical-outcomes-among-patients-undergoing-transcatheter-aortic-valve-implantation
#6
René Vollenbroich, Stefan Stortecky, Fabien Praz, Jonas Lanz, Anna Franzone, Katarzyna Zuk, Dik Heg, Marco Valgimigli, Crochan John O'Sullivan, Corinna Heinisch, Eva Roost, Peter Wenaweser, Stephan Windecker, Thomas Pilgrim
BACKGROUND: Among patients undergoing transcatheter aortic valve implantation (TAVI), concomitant mitral regurgitation (MR) has been associated with adverse prognosis. We aimed to assess long-term clinical outcomes according to MR etiology. METHODS: In a single-center registry of consecutive patients undergoing TAVI, we investigated the impact of functional (FMR) vs degenerative (DMR) MR on cardiovascular (CV) mortality throughout 2years of follow-up. RESULTS: Among 603 patients (mean age 82...
October 28, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892881/comparison-of-visual-assessment-of-coronary-stenosis-with-independent-quantitative-coronary-angiography-findings-from-the-prospective-multicenter-imaging-study-for-evaluation-of-chest-pain-promise-trial
#7
Rohan Shah, Eric Yow, William Schuyler Jones, Louis P Kohl, Andrzej S Kosinski, Udo Hoffmann, Kerry L Lee, Christopher B Fordyce, Daniel B Mark, Alicia Lowe, Pamela S Douglas, Manesh R Patel
: The outcomes in patients by visual assessment and quantitative coronary angiography (QCA) for obstructive coronary artery disease (CAD) are not known. Our objectives were to compare visual and QCA estimates of obstructive CAD and to assess their relationship to outcomes in stable patients with symptoms of CAD. METHODS: The PROMISE trial randomized 10,003 patients with CAD symptoms to anatomical or functional testing. Site reports of invasive angiography detailing visual stenosis and independent, blinded QCA were performed for obstructive CAD (≥50% stenosis)...
October 26, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892884/%C3%AE-blocker-dosage-and-outcomes-after-acute-coronary-syndrome
#8
Jason E Allen, Stacey Knight, Raymond O McCubrey, Tami Bair, Joseph Brent Muhlestein, Jeffrey J Goldberger, Jeffrey L Anderson
BACKGROUND: Although β-blockers increase survival in acute coronary syndrome (ACS) patients, the doses used in trials were higher than doses used in practice, and recent data do not support an advantage of higher doses. We hypothesized that rates of major adverse cardiac events (MACE), all-cause death, myocardial infarction, and stroke are equivalent for patients on low-dose and high-dose β-blocker. METHODS: Patients admitted to Intermountain Healthcare with ACS and diagnosed with ≥70% coronary stenosis between 1994 and 2013 were studied (N = 7,834)...
October 22, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892886/safety-profile-and-utility-of-treadmill-exercise-in-patients-with-high-gradient-hypertrophic-cardiomyopathy
#9
Lars Lindholm Sorensen, Hsin-Yueh Liang, Aurelio Pinheiro, Alex Hilser, Veronica Dimaano, Niels Thue Olsen, Thomas Fritz Hansen, Peter Sogaard, Alexandra Nowbar, Chiara Pisanello, Iraklis Pozios, Susan Phillip, Xun Zhou, Roselle Abraham, Theodore P Abraham
: Exercise echocardiography in the evaluation of hypertrophic cardiomyopathy (HCM) provides valuable information for risk stratification, selection of optimal treatment, and prognostication. However, HCM patients with left ventricular outflow tract gradients ≥30mm Hg are often excluded from exercise testing because of safety considerations. We examined the safety and utility of exercise testing in patients with high-gradient HCM. METHODS: We evaluated clinical characteristics, hemodynamics, and imaging variables in 499 consecutive patients with HCM who performed 959 exercise tests...
October 20, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892883/predicting-long-term-prognosis-in-stable-peripheral-artery-disease-with-baseline-functional-capacity-estimated-by-the-duke-activity-status-index
#10
Vichai Senthong, Yuping Wu, Stanley L Hazen, W H Wilson Tang
BACKGROUND: The ability of a simple self-assessment tool for estimated functional capacity to predict long-term prognosis in patients with established peripheral artery disease (PAD) is unknown. We investigate whether subjective measurement of functional capacity estimated by using the Duke Activity Status Index (DASI) questionnaire predicts long-term prognosis in patients with established PAD. METHODS: We administered the DASI questionnaire to 771 stable patients with established PAD who underwent elective diagnostic coronary angiography with 5-year follow-up all-cause mortality...
October 20, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#11
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914506/use-of-high-intensity-statins-for-patients-with-atherosclerotic-cardiovascular-disease-in-the-veterans-affairs-health-system-practice-impact-of-the-new-cholesterol-guidelines
#12
Fatima Rodriguez, Shoutzu Lin, David J Maron, Joshua W Knowles, Salim S Virani, Paul A Heidenreich
BACKGROUND: The November 2013 American College of Cardiology/American Heart Association cholesterol guidelines recommend the use of high-intensity statins for patients with atherosclerotic cardiovascular disease (ASCVD). We sought to determine how these guidelines are being adopted at the Veterans Affairs (VA) Health System and identify treatment gaps. METHODS: We examined administrative data from the VA 12 months prior to the index dates of April 1, 2013, and after April 1, 2014, to identify patients ≤75 years of age with ≥2 codes for ASCVD...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914505/temporal-trends-and-factors-associated-with-diabetes-mellitus-among-patients-hospitalized-with-heart-failure-findings-from-get-with-the-guidelines-heart-failure-registry
#13
Justin B Echouffo-Tcheugui, Haolin Xu, Adam D DeVore, Phillip J Schulte, Javed Butler, Clyde W Yancy, Deepak L Bhatt, Adrian F Hernandez, Paul A Heidenreich, Gregg C Fonarow
BACKGROUND: The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden. METHODS: Using data from the Get With the Guidelines-Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40%≤EF <50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914504/on-treatment-analysis-of-the-improved-reduction-of-outcomes-vytorin-efficacy-international-trial-improve-it
#14
Michael A Blazing, Robert P Giugliano, James A de Lemos, Christopher P Cannon, Andrew Tonkin, Christie M Ballantyne, Basil S Lewis, Thomas A Musliner, Andrew M Tershakovec, Yuliya Lokhnygina, Jennifer A White, Craig Reist, Amy McCagg, Eugene Braunwald
BACKGROUND: We aimed to determine the efficacy and safety of adding ezetimibe (Ez) to simvastatin (S) in a post-acute coronary syndrome (ACS) population in a prespecified on-treatment analysis. METHODS: We evaluated 17,706 post-ACS patients from the IMPROVE-IT trial who had low-density lipoprotein cholesterol values between 50 and 125 mg/dL and who received Ez 10 mg/d with S 40 mg/d (Ez/S) or placebo with simvastatin 40 mg/d (P/S). The primary composite end point was cardiovascular death, myocardial infarction, unstable angina, coronary revascularization ≥30 days postrandomization, or stroke...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#15
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914502/rationale-and-design-of-the-progression-of-atherosclerotic-plaque-determined-by-computed-tomographic-angiography-imaging-paradigm-registry-a-comprehensive-exploration-of-plaque-progression-and-its-impact-on-clinical-outcomes-from-a-multicenter-serial-coronary
#16
Sang-Eun Lee, Hyuk-Jae Chang, Asim Rizvi, Martin Hadamitzky, Yong-Jin Kim, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Valentina Volpato, Matthew J Budoff, Ilan Gottlieb, Byoung Kwon Lee, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Jonathon A Leipsic, Sanghoon Shin, Jung Hyun Choi, Namsik Chung, James K Min
BACKGROUND: The natural history of coronary artery disease (CAD) in patients with low-to-intermediate risk is not well characterized. Although earlier invasive serial studies have documented the progression of atherosclerotic burden, most were focused on high-risk patients only. The PARADIGM registry is a large, prospective, multinational dynamic observational registry of patients undergoing serial coronary computed tomographic angiography (CCTA). The primary aim of PARADIGM is to characterize the natural history of CAD in relation to clinical and laboratory data...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#17
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914500/effect-of-l-arginine-asymmetric-dimethylarginine-and-symmetric-dimethylarginine-on-ischemic-heart-disease-risk-a-mendelian-randomization-study
#18
Shiu Lun Au Yeung, Shi Lin Lin, Hung San Hugh Simon Lam, Catherine Mary Schooling
BACKGROUND: l-arginine is a commonly consumed dietary conditional essential amino acid found in food items and supplements, which is closely related to asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). l-arginine is thought to increase nitric oxide and be cardioprotective, whereas ADMA and SDMA may inhibit nitric oxide synthesis and increase cardiovascular disease risk. Unexpectedly, l-arginine increased mortality in a small trial. To clarify the effects of these potential targets of intervention, we assessed the risk of ischemic heart disease (IHD) by genetically determined l-arginine, ADMA, and SDMA...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914499/exercise-training-improves-exercise-capacity-and-quality-of-life-after-transcatheter-aortic-valve-implantation-a-randomized-pilot-trial
#19
Axel Pressler, Jeffrey W Christle, Benjamin Lechner, Viola Grabs, Bernhard Haller, Ina Hettich, David Jochheim, Julinda Mehilli, Rüdiger Lange, Sabine Bleiziffer, Martin Halle
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly applied for aortic stenosis in elderly patients with impaired mobility and reduced quality of life. These patients may particularly benefit from postinterventional exercise programs, but no randomized study has evaluated the safety and efficacy of exercise in this population. METHODS: In a prospective pilot study, 30 patients after TAVI (mean age, 81±6 years, 44% female, 83±34 days postintervention) were randomly allocated 1:1 to a training group (TG) performing 8 weeks of supervised combined endurance and resistance exercise or to usual care...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914498/infective-endocarditis-in-patients-receiving-chronic-hemodialysis-a-21-year-observational-cohort-study-in-denmark
#20
Lene Ugilt Pagter Ludvigsen, Lars Skov Dalgaard, Henrik Wiggers, Søren Jensen-Fangel, Bente Jespersen, Svend Ellermann-Eriksen, Lars Østergaard, Ole Schmeltz Søgaard
BACKGROUND: Chronic hemodialysis is a risk factor for invasive bacterial infections. We conducted a nationwide study of risk and mortality of infective endocarditis (IE) among patients undergoing chronic hemodialysis. METHODS: In this observational cohort study, patients with end-stage renal disease who initiated hemodialysis in Denmark during 1990 to 2010 were matched on age, gender, and municipality with up to 19 population controls. We extracted information on first admissions with IE, comorbidity, and arteriovenous fistula surgery from medical administrative databases...
December 2016: American Heart Journal
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