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Clinical Cardiology

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https://www.readbyqxmd.com/read/29774564/mortality-in-sepsis-comparison-of-outcomes-between-patients-with-demand-ischemia-acute-myocardial-infarction-and-neither-demand-ischemia-nor-acute-myocardial-infarction
#1
Mahek Shah, Soumya Patnaik, Obiora Maludum, Brijesh Patel, Byomesh Tripathi, Manyoo Agarwal, Lohit Garg, Sahil Agrawal, Ulrich P Jorde, Matthew W Martinez
INTRODUCTION: Elevation in cardiac troponins is common among septic patients. We sought to explore outcomes among those admitted with demand ischemia(DI), acute myocardial infarction(AMI) and neither DI nor AMI in sepsis. METHODS: We analyzed data from the 2011-2014 National Inpatient Sample among patients admitted for sepsis. We compared outcomes among sepsis patients with i)DI versus AMI and ii)DI versus neither DI nor AMI using separate propensity matched cohorts...
May 18, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29774566/influence-of-sex-and-pregnancy-on-survival-in-patients-admitted-with-heart-failure-data-from-a-prospective-multicenter-registry
#2
Manuel Martínez-Sellés, Pablo Díez-Villanueva, Jesús Álvarez-Gracía, Andreu Ferrero-Gregori, Miquel Vives-Borrás, Fernando Worner, Alfredo Bardají, Juan F Delgado, Rafael Vázquez, José R González-Juanatey, Francisco Fernández-Aviles, Juan Cinca
BACKGROUND: Female sex is an independent predictor of better survival in patients with heart failure but the mechanism of this association is unknown. On the other hand, pregnancies have a strong influence in the cardiovascular system. HYPOTHESIS: Sex and previous gestations might have a prognostic impact on one-year mortality in patients admitted with heart failure. METHODS: Observational prospective consecutive multicenter registry of 1831 patients (756 women [41...
May 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29766526/qtc-interval-in-takotsubo-cardiomyopathy-how-the-activation-of-insular-cortex-interact
#3
LETTER
Michiaki Nagai, Keigo Dote, Masaya Kato, Noboru Oda, Eiji Kunita
We read the interesting review article by Marafioti et al.,1 who reported that the association of prolonged QTc interval with Takotsubo cardiomyopathy (Tc) in relation to the right insular cortex (Ic) activity. Several points should be taken into account when interpreting the theory presented by Marafioti et al.1 First, in a dog model, adjusted QT interval at high parasympathetic or low sympathetic tone was significantly longer than that at the low parasympathetic or high sympathetic tone.2 In Tc, ST segment elevations were observed immediately after the onset...
May 15, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29761516/recurrence-rate-of-atrial-fibrillation-after-the-first-clinical-episode-a-prospective-evaluation-using-continuous-cardiac-rhythm-monitoring
#4
Emmanuel N Simantirakis, Panteleimon E Papakonstantinou, Emmanuel Kanoupakis, Gregory I Chlouverakis, Stylianos Tzeis, Panos E Vardas
BACKGROUND: Decision making regarding a patient who has experienced a first clinical episode of atrial fibrillation (AF) is challenging, and the AF recurrences should be a significant consideration. Continuous long-term rhythm monitoring via implantable loop recorders (ILRs) has enabled us to evaluate the AF recurrence profile after the first clinical episode and to investigate clinical parameters associated with the course of the arrhythmia. HYPOTHESIS: Continuous rhythm monitoring via ILRs in AF patients after the first clinical episode is of clinical significance and precisely evaluate the AF recurrence profile...
May 14, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29752816/relation-between-age-and-carotid-artery-intima-medial-thickness-a-systematic-review
#5
REVIEW
Inge C L van den Munckhof, Helen Jones, Maria T E Hopman, Jacqueline de Graaf, Jean Nyakayiru, Bart van Dijk, Thijs M H Eijsvogels, Dick H J Thijssen
Carotid artery intima-medial thickness (cIMT) represents a popular measure of atherosclerosis and is predictive of future cardiovascular and cerebrovascular events. Although older age is associated with a higher cIMT, little is known about whether this increase in cIMT follows a linear relationship with age or it is affected under influence of cardiovascular diseases (CVD) or CVD risk factors. We hypothesize that the relationship between cIMT and age is nonlinear and is affected by CVD or risk factors. A systematic review of studies that examined cIMT in the general population and human populations free from CVD/risk factors was undertaken...
May 12, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29750433/absence-of-a-primary-role-for-ttn-missense-variants-in-arrhythmogenic-cardiomyopathy-from-a-clinical-and-pathological-perspective
#6
Kai Chen, Jiangping Song, Zhen Wang, Man Rao, Liang Chen, Shengshou Hu
BACKGROUND: Arrhythmogenic cardiomyopathy (ACM) is an inheritable heart disease characterized by fibro-fatty replacement of the myocardium. TTN missense variants were previously reported as a pathogenic factor for ACM. HYPOTHESIS: TTN missense variants are commonly identified in ACM, but have limited effect on the phenotype of ACM. METHODS: We sequenced 15 ACM-related genes in 35 patients who had a heart transplantation and quantified myocardium, and fibrous and adipose tissue in blocks of the explanted heart...
May 11, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29749621/the-short-and-long-term-outcomes-of-percutaneous-intervention-with-drug-eluting-stent-vs-bare-metal-stent-in-saphenous-vein-graft-disease-an-updated-meta-analysis-of-all-randomized-clinical-trials
#7
REVIEW
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Sahar Ahmed, Ghassan Bachuwa, Mustafa Hassan
The use of drug-eluting stents (DES) vs bare-metal stents (BMS) in saphenous vein graft (SVG) lesions remains controversial. We conducted a meta-analysis of all randomized clinical trials comparing the outcomes of DES with BMS in SVG percutaneous coronary interventions. A search of PubMed, Embase, the Cochrane Register of Controlled Trials, and Clinicaltrials.gov was performed for all randomized clinical trials. We evaluated the short- and long-term clinical outcomes of the following: all-cause mortality, major adverse cardiovascular events (MACE), definite/probable stent thrombosis, target lesion revascularization (TLR), and target-vessel revascularization (TVR)...
May 11, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29749620/peripartum-cardiomyopathy-a-systematic-review-of-the-literature
#8
REVIEW
Zain Ul Abideen Asad, Mirwais Maiwand, Fahmi Farah, Tarun W Dasari
Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure. It is defined as cardiomyopathy that develops in the last month of pregnancy or within 5 months of the postpartum period without an identifiable cause. We conducted a systematic review of literature of prospective studies with a focus on echocardiographic and long-term clinical outcomes in PPCM. We searched MEDLINE and Embase up to October 1, 2017. Prospective studies (sample size ≥20) reporting all-cause mortality and follow-up duration of ≥1 year were included...
May 11, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29749101/understanding-patient-adherence-and-concerns-with-statins-and-medication-discussions-with-physicians-action-a-survey-on-the-patient-perspective-of-dialogue-with-healthcare-providers-regarding-statin-therapy
#9
Eliot A Brinton
BACKGROUND: Statin therapy is used first-line for cholesterol lowering and prevention of atherosclerotic cardiovascular disease (CVD), but side effects and the potential for drug-drug interactions may complicate its use. Provider-patient communication is essential for shared decision-making, which, in turn, is recommended by guidelines to reduce or overcome these challenges. Unfortunately, relatively little is known about provider-patient communication surrounding statin use. METHOD: We conducted an online survey of 5,014 patients, U...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29746005/the-art-of-cardiovascular-risk-assessment
#10
REVIEW
Jay Khambhati, Marc Allard-Ratick, Devinder Dhindsa, Suegene Lee, John Chen, Pratik B Sandesara, Wesley O'Neal, Arshed A Quyyumi, Nathan D Wong, Roger S Blumenthal, Laurence S Sperling
Cardiovascular disease (CVD) remains the leading cause of death in the United States. Healthcare expenditures have been principally allocated toward treatment of CVD at the end of the health/disease continuum, rather than toward health promotion and disease prevention. A focused effort on both primordial and primary prevention can promote cardiovascular health and reduce the burden of CVD. Risk-factor assessment for predicting atherosclerotic CVD events serves as the foundation of preventive cardiology and has been driven by population-based scoring algorithms based on traditional risk factors...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29746000/pericarditis-among-giant-cell-arteritis-patients-from-myth-to-reality
#11
Shmuel Tiosano, Yehuda Adler, Shir Azrielant, Yarden Yavne, Omer Gendelman, Dana Ben-Ami Shor, Doron Comaneshter, Guy Shalom, Arnon D Cohen, Howard Amital
BACKGROUND: Giant cell arteritis (GCA) is an inflammatory disease of unknown etiology affecting adults age > 50 years. GCA (also known as temporal arteritis) is a vasculitis of large and medium-size vessels that involves the extracranial branches of the carotid artery. Common manifestations include constitutional symptoms, headache, jaw claudication, scalp tenderness, and vision loss. Cardiac involvement in GCA is considered to be as low as 5%, and < 30 cases of pericarditis among GCA patients have been reported in the literature...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29745996/how-do-anticoagulated-atrial-fibrillation-patients-who-suffer-ischemic-stroke-or-spontaneous-intracerebral-hemorrhage-differ
#12
Heidi Lehtola, Juha Hartikainen, Päivi Hartikainen, Tuomas Kiviniemi, Ilpo Nuotio, Antti Palomäki, Antti Ylitalo, K E Juhani Airaksinen, Pirjo Mustonen
BACKGROUND: Atrial fibrillation (AF) increases risk of ischemic stroke, and oral anticoagulation (OAC) increases risk of intracerebral hemorrhage (ICH). This study aimed to compare OAC-treated AF patients with an ischemic stroke/transient ischemic attack (TIA) or spontaneous ICH as their first lifetime cerebrovascular event, especially focusing on patients with therapeutic international normalized ratio (INR). HYPOTHESIS: We assumed that in AF patients suffering ischemic stroke/TIA or ICH, patient characteristics could be different in patients with therapeutic INR than in patients with warfarin...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29745979/trends-etiologies-and-predictors-of-90-day-readmission-after-percutaneous-ventricular-assist-device-implantation-a-national-population-based-cohort-study
#13
Hafeez Ul Hassan Virk, Byomesh Tripathi, Shuchita Gupta, Akanksha Agrawal, Sandeep Dayanand, Faisal Inayat, Chayakrit Krittanawong, Ali Raza Ghani, Mohammad Nour Zabad, Parasuram Melarcode Krishnamoorthy, Aman Amanullah, Gregg Pressman, Christian Witzke, Sean Janzer, Jon George, Sanjog Kalra, Vincent Figueredo
Percutaneous ventricular assist devices (pVADs) are indicated to provide hemodynamic support in high-risk percutaneous interventions and cardiogenic shock. However, there is a paucity of published data regarding the etiologies and predictors of 90-day readmissions following pVAD use. We studied the data from the US Nationwide Readmissions Database (NRD) for the years 2013 and 2014. Patients with a primary discharge diagnosis of pVAD use were collected by searching the database for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural code 37...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29745973/the-prevalence-of-obstructive-sleep-apnea-in-patients-with-atrial-fibrillation
#14
Asmaa M Abumuamar, Paul Dorian, David Newman, Colin M Shapiro
BACKGROUND: Obstructive sleep apnea (OSA) is a systemic disorder associated with significant cardiovascular complications. OSA may play a role in the initiation and worsening of atrial fibrillation (AF). This study aimed to determine the prevalence and clinical predictors of OSA in patients with AF. HYPOTHESIS: OSA is underdiagnosed in a large number of patients with AF and may not be predicted by conventional clinical indices. METHODS: Consecutive nonselected patients with AF were recruited from different arrhythmia clinics in Toronto, Ontario, Canada...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29726021/etiologies-predictors-and-economic-impact-of-readmission-within-one-month-among-patients-with-takotsubo-cardiomyopathy
#15
Mahek Shah, Pradhum Ram, Kevin Bryan U Lo, Natee Sirinvaravong, Brijesh Patel, Byomesh Tripathi, Shantanu Patil, Vincent M Figueredo
BACKGROUND: Limited data exists on readmission among patients with takotsubo cardiomyopathy [TC], a commonly reversible cause of heart failure. We sought to identify etiologies and predictors for readmission among TC patients. METHODS: We queried the National Readmissions Database for 2013-2014 to identify patients with primary admission for TC using ICD-9CM code 429.83. Patients who were readmitted to the hospital within 1-month post-discharge were further evaluated to identify etiologies, predictors and the resultant economic burden of readmission...
May 3, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29726013/effect-of-comprehensive-remote-ischemic-conditioning-in-anterior-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-design-and-rationale-of-the-coric-mi-randomized-trial
#16
Li Song, Hongbing Yan, Peng Zhou, Hanjun Zhao, Chen Liu, Zhaoxue Sheng, Yu Tan, Yi Chen, Jiannan Li, Jinying Zhou
BACKGROUND: Remote ischemic conditioning (RIC) applied during or after an ST-segment elevation myocardial infarction (STEMI) is currently the most promising adjuvant therapy to reduce reperfusion injury. Recent animal studies showed that RIC may help the myocardium recover if applied daily during the month after an STEMI. METHODS: The CORIC-MI trial is a single-center, randomized controlled study. 200 patients undergoing primary percutaneous coronary intervention (PPCI) for anterior STEMI will be randomized in a 1:1 ratio into comprehensive RIC (CORIC) or no intervention (control)...
May 3, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29717509/impact-of-delirium-on-patients-hospitalized-for-myocardial-infarction-a-propensity-score-analysis-of-the-national-inpatient-sample
#17
Abdullah Abdullah, George Eigbire, Amr Salama, Abdul Wahab, Mohanad Awadalla, Ryan Hoefen, Richard Alweis
BACKGROUND: Delirium is associated with worse outcomes in critically ill patients. In the subset of patients with myocardial infarction (MI), the impact on clinical outcomes of delirium is not as well elucidated. HYPOTHESIS: Delirium is associated with increased mortality in patients hospitalized for MI METHODS: The study used data from the National Inpatient Sample (NIS) 2012 - 2014, Healthcare Cost and Utilization Project (HCUP). We included discharges associated with the primary diagnosis of MI using the relevant ICD-9-CM codes...
May 1, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29697870/long-term-results-of-combined-cardiac-contractility-modulation-and-subcutaneous-defibrillator-therapy-in-patients-with-heart-failure-and-reduced-ejection-fraction
#18
Susanne Röger, Boris Rudic, Ibrahim Akin, Tetyana Shchetynska-Marinova, Fabian Fastenrath, Erol Tülümen, Volker Liebe, Ibrahim El-Battrawy, Stefan Baumann, Jürgen Kuschyk, Martin Borggrefe
BACKGROUND: Cardiac contractility modulation (CCM) is an electrical-device therapy for patients with heart failure with reduced ejection fraction (HFrEF). Patients with left ventricular ejection fraction (LVEF) ≤35% also have indication for an implantable cardioverter-defibrillator (ICD), and in some cases subcutaneous ICD (S-ICD) is selected. HYPOTHESIS: CCM and S-ICD can be combined to work efficaciously and safely. METHODS: We report on 20 patients with HFrEF and LVEF ≤35% who received CCM and S-ICD...
April 26, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29697866/etiologies-and-predictors-of-30-day-readmissions-in-patients-undergoing-percutaneous-mechanical-circulatory-support-assisted-percutaneous-coronary-intervention-in-the-united-states-insights-from-the-nationwide-readmissions-database
#19
Chirag Bavishi, Alejandro Lemor, Vrinda Trivedi, Saurav Chatterjee, Pedro Moreno, John Lasala, Herbert D Aronow, J Dawn Abbott
BACKGROUND: Patients undergoing percutaneous mechanical circulatory support (pMCS)-assisted percutaneous coronary intervention (PCI) represent a high-risk group vulnerable to complications and readmissions. HYPOTHESIS: Thirty-day readmissions after pMCS-assisted PCI are common among patients with comorbidities and account for a significant amount of healthcare spending. METHODS: Patients undergoing PCI and pMCS (Impella, TandemHeart, or intra-aortic balloon pump) for any indication between January 1, 2012, and November 30, 2014, were selected from the Nationwide Readmissions Database...
April 26, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29696672/brain-heart-pathway-to-injury-in-takotsubo-syndrome
#20
LETTER
John E Madias
I enjoyed immensely reading the review by Marafioti et al,1 on the pathophysiology of takotsubo syndrome (TTS), and the primacy of the role of the insular cortex and the autonomic sympathetic nervous system in mediating an injury to the cardiomyocytes.
April 25, 2018: Clinical Cardiology
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