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Clinical Cardiology

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https://www.readbyqxmd.com/read/28914973/comparison-of-mid-to-long-term-clinical-outcomes-between-anatomical-testing-and-usual-care-in-patients-with-suspected-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#1
In-Chang Hwang, Sol Ji Choi, Ji Eun Choi, Eun-Bi Ko, Jae Kyung Suh, Insun Choi, Hyun-Jae Kang, Yong-Jin Kim, Joo Youn Kim
BACKGROUND: Controversies remain regarding clinical outcomes following initial strategies of coronary computed tomography angiography (CCTA) vs usual care with functional testing in patients with suspected coronary artery disease (CAD). HYPOTHESIS: CCTA as initial diagnostic strategy results in better mid- to long-term outcomes than usual care in patients with suspected CAD. METHODS: We searched PubMed, Embase, and Cochrane Library for randomized controlled trials comparing clinical outcomes during ≥6 months' follow-up between initial anatomical testing by CCTA vs usual care with functional testing in patients with suspected CAD...
September 15, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28914972/seasonal-patterns-of-acute-and-recurrent-idiopathic-pericarditis
#2
Yoav Hammer, Jihad Bishara, Alon Eisen, Zaza Iakobishvili, Ran Kornowski, Aviv Mager
BACKGROUND: Idiopathic pericarditis is presumed to result from viral infection. The incidence rates of some viral infections have typical seasonal patterns. The data in the literature on a possible seasonal pattern of acute pericarditis are very limited. The mechanism and possible seasonality of recurrent episodes are not well established . HYPOTHESIS: The incidence of acute idiopathic pericarditis has a seasonal pattern. METHODS: The computerized database of a tertiary, university-affiliated hospital was searched for all patients admitted with a first episode of acute idiopathic pericarditis between January 1, 2010 and December 31, 2015...
September 15, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28902960/the-prognostic-significance-of-lung-function-in-stable-heart-failure-outpatients
#3
Louis Lind Plesner, Morten Dalsgaard, Morten Schou, Lars Køber, Jørgen Vestbo, Erik Kjøller, Kasper Iversen
BACKGROUND: This study investigated the impact on all-cause mortality of airflow limitation indicative of chronic obstructive pulmonary disease or restrictive spirometry pattern (RSP) in a stable systolic heart failure population. HYPOTHESIS: Decreased lung function indicates poor survival in heart failure. METHODS: Inclusion criteria: NYHA class II-IV and left ventricular ejection fraction (LVEF) < 45%. Prognosis was assessed with multivariate Cox proportional hazards models...
September 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28898433/changes-in-parameters-of-right-ventricular-function-with-cardiac-resynchronization-therapy
#4
Abhishek Sharma, Carl J Lavie, Ajay Vallakati, Akash Garg, Sunny Goel, Jason Lazar, Gregg C Fonarow
BACKGROUND: Studies have shown that cardiac resynchronization therapy (CRT) significantly improves right ventricle (RV) size and function in patients with heart failure (HF). HYPOTHESIS: CRT does not lead to improvement in RV function independent of baseline clinical variables. METHODS: A systematic search of studies published between 1966 to August 31, 2015 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases...
September 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28898432/hyperglycemia-on-admission-and-hospitalization-outcomes-in-patients-with-atrial-fibrillation
#5
Amit Akirov, Alon Grossman, Tzipora Shochat, Ilan Shimon
BACKGROUND: We evaluated the association of admission blood glucose (ABG) and mortality in patients with and without diabetes mellitus (DM) hospitalized for atrial fibrillation (AF). HYPOTHESIS: Hyperglycemia on admission is a bad prognostic marker in patients with AF. METHODS: Observational data were collected from electronic records of patients age ≥ 18 years hospitalized for AF in 2011-2013. Twelve-month data were available in all cases...
September 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28892227/dynamic-changes-of-qtc-interval-and-prognostic-significance-in-takotsubo-stress-cardiomyopathy
#6
Francesco Santoro, Natale Daniele Brunetti, Nicola Tarantino, Jorge Romero, Francesca Guastafierro, Armando Ferraretti, Luigi F M Di Martino, Riccardo Ieva, Pier Luigi Pellegrino, Matteo Di Biase, Luigi Di Biase
BACKGROUND: Prolonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high-risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role. HYPOTHESIS: Dynamic changes of QTc interval during hospitalization for TTC could be associated with outcome at follow-up. METHODS: Fifty-two consecutive patients hospitalized for TTC were enrolled...
September 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28873233/seasonal-variation-in-hospitalization-outcomes-in-patients-admitted-for-heart-failure-in-the-united-states
#7
Emmanuel Akintoye, Alexandros Briasoulis, Alexander Egbe, Oluwole Adegbala, Samson Alliu, Muhammad Sheikh, Manmohan Singh, Abdelrahman Ahmed, Sagar Mallikethi-Reddy, Diane Levine
BACKGROUND: There is lack of evidence of the impact of varying season on heart failure (HF) hospitalization outcomes in the U.S. HYPOTHESIS: HF hospitalization outcomes exhibit significant seasonal variation in the U.S. METHODS: Using data from the National Inpatient Sample (2011-2013), seasonal variation was classified based on meteorological classification of Northern Hemisphere-Spring, Summer, Fall, & Winter-and analysis was conducted via multivariable-adjusted mixed-effect model...
September 5, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28873222/uremic-pericarditis-pericardial-effusion-and-constrictive-pericarditis-in-end-stage-renal-disease-insights-and-pathophysiology
#8
REVIEW
Karim Abdur Rehman, Jorge Betancor, Bo Xu, Arnav Kumar, Carlos Godoy Rivas, Kimi Sato, Leslie P Wong, Craig R Asher, Allan L Klein
A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis...
September 5, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28850679/hemodynamic-parameters-predict-the-risk-of-atrial-fibrillation-after-cardiac-surgery-in-adults
#9
Rongxin Lu, Nan Ma, Zhaolei Jiang, Ju Mei
BACKGROUND: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery and is associated with poorer prognosis. This study attempted to evaluate whether hemodynamic parameters determined by a right heart catheter predict the occurrence of POAF. HYPOTHESIS: We hypothesized that atrial fibrillation after cardiac surgery can be predicted by hemodynamic parameters determined by a right heart catheter. METHODS: Between October 2015 and January 2017, 126 patients with preoperative sinus rhythm undergoing coronary artery bypass grafting and/or aortic valve replacement were enrolled in this study...
August 29, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846809/relation-of-premature-atrial-complexes-with-stroke-and-death-systematic-review-and-meta-analysis
#10
REVIEW
Bao-Tao Huang, Fang-Yang Huang, Yong Peng, Yan-Biao Liao, Fei Chen, Tian-Li Xia, Xiao-Bo Pu, Mao Chen
Frequent premature atrial complexes (PACs) are universal in the general population; however, their clinical significance is unclear. We hypothesize that frequent PACs are associated with increased risk of stroke and death. The PubMed (from 1966 to April 2017) and Embase (from 1974 to April 2017) databases were searched for longitudinal studies that reported the relation of PACs with incidence of stroke and death with various etiologies. Study quality was evaluated, and the relative risks (RR) of unfavorable outcomes in subjects with frequent PACs vs those without were calculated...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846808/dna-methylation-dysregulations-in-valvular-atrial-fibrillation
#11
Kangjun Shen, Tao Tu, Zhaoshun Yuan, Jiangfeng Yi, Yangzhao Zhou, Xiaobo Liao, Qiming Liu, Xinmin Zhou
BACKGROUND: The epigenetic changes underlying the development of atrial fibrillation (AF) remain incompletely understood. Limited evidence suggests that abnormal DNA methylation might be involved in the pathogenesis of AF. In the present study, we evaluated the methylation status of genomic DNA from myocardial tissue in AF patients and sinus rhythm (SR) patients systematically. HYPOTHESIS: DNA methylation dysregulations will be associated with valvular AF. METHODS: Right atrial myocardial tissue was obtained from rheumatic valvular patients who had undergone valve replacement surgery (SR group, n = 10; AF group, n = 10)...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846806/apixaban-rivaroxaban-and-dabigatran-use-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-using-the-second-generation-cryoballoon
#12
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. HYPOTHESIS: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. METHODS: In 200 consecutive patients (mean age, 64...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846805/an-exploration-of-the-association-between-ischemic-etiology-and-the-likelihood-of-heart-failure-hospitalization-following-cardiac-resynchronization-therapy
#13
Adam C Powell, Teresa L Rogstad, Uday U Deshmukh, Stephen E Price, Jeffrey D Simmons
BACKGROUND: Myocardial scarring resulting from cardiomyopathy with ischemic etiology may interfere with effective lead placement during implantation of multi-lead cardioverter-defibrillators for cardiac resynchronization therapy (CRT-D). Extensive scarring is known to be associated with poorer physiological and survival outcomes in patients who undergo CRT-D. HYPOTHESIS: Ischemic CRT-D recipients respond as well as nonischemic recipients, using hospital admission for heart failure (HF) as a measure of response...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846803/comprehensive-primary-prevention-of-cardiovascular-disease-in-women
#14
REVIEW
Suegene K Lee, Jay Khambhati, Tina Varghese, Eric P Stahl, Sonali Kumar, Pratik B Sandesara, Nanette K Wenger, Laurence S Sperling
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in women. Historically, medical research has focused on male patients, and subsequently, there has been decreased awareness of the burden of ASCVD in females until recent years. The biological differences between sexes and differences in societal expectations defined by gender roles contribute to gender differences in ASCVD risk factors. With these differing risk profiles, risk assessment, risk stratification, and primary preventive measures of ASCVD are different in women and men...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846802/deceleration-capacity-of-heart-rate-predicts-1-year-mortality-of-patients-undergoing-transcatheter-aortic-valve-implantation
#15
Martin Duckheim, Charlotte Bensch, Linn Kittlitz, Nin Götz, Katharina Klee, Patrick Groga-Bada, Lars Mizera, Meinrad Gawaz, Christine Zuern, Christian Eick
BACKGROUND: Risk prediction in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is challenging. Development of novel markers for patient risk assessment is of great clinical value. Deceleration capacity (DC) of heart rate is a strong risk predictor in post-infarction patients. HYPOTHESIS: DC provides prognostic information in patients undergoing TAVI. METHODS: We enrolled 374 consecutive patients with severe AS undergoing TAVI...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28841246/facility-level-variation-in-diabetes-and-blood-pressure-control-in-patients-with-diabetes-findings-from-the-veterans-affairs-national-database
#16
Hasan Rehman, Julia M Akeroyd, David Ramsey, Sarah T Ahmed, Anwar T Merchant, Sankar D Navaneethan, Laura A Petersen, Salim S Virani
BACKGROUND: Intensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes. HYPOTHESIS: We hypothesized that there is suboptimal glycemic and BP control with significant facility-level variation in patients with diabetes. METHODS: We identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. We assessed facility-level rates of glycemic (hemoglobin [Hb]A1c <7%), BP (BP <140/90 mmHg), and combined glycemic and BP control (HbA1c <7% and BP <140/90 mmHg), and their facility-level variation in using median rate ratios (MRR)...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28841233/patients-without-comorbidities-at-the-time-of-diagnosis-of-atrial-fibrillation-causes-of-death-during-long-term-follow-up-compared-to-matched-controls
#17
Tommy Andersson, Anders Magnuson, Ing-Liss Bryngelsson, Ole Frøbert, Karin M Henriksson, Nils Edvardsson, Dritan Poçi
BACKGROUND: Little is known about the long-term, cause-specific mortality risk in patients without comorbidities at the time of diagnosis of atrial fibrillation (AF). METHODS: From a nation-wide registry of patients hospitalized with incident AF between 1995 and 2008 we identified 9 519 patients with a first diagnosed AF and no comorbidities at the time of AF diagnosis. They were matched with 12 468 controls. The follow-up continued until December 2008. Causes of death were classified according to the ICD-10 codes...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28841230/rationale-and-design-of-the-drug-eluting-stents-vs-bare-metal-stents-in-saphenous-vein-graft-angioplasty-diva-trial
#18
Emmanouil S Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R Holmes, Deepak L Bhatt, Sunil V Rao, Mark W Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V Rangan, Beverly Ventura, Ying Lu, Mark Holodniy, Mei-Chiung Shih
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28841228/the-shifting-paradigm-in-the-treatment-of-type-2-diabetes-mellitus-a-cardiologist-s-perspective
#19
REVIEW
Saeeda Fatima, Ayesha Jameel, Fnu Ayesha, Dhananjai J Menzies
In patients with diabetes mellitus, cardiovascular (CV) disease is the leading cause of morbidity and mortality. A multitude of contemporary antidiabetic agents presents different CV safety profiles. Metformin forms the cornerstone agent to reduce CV events. Newer agents, such as glucagon-like peptide-1 agonists and sodium-glucose cotransporter-2 inhibitors, have appealing CV benefits. Insulin, dipeptidyl peptidase-4 inhibitors, and sulfonylureas have neutral CV effects. Cardiologists should familiarize themselves with these agents to promote comprehensive CV care in patients with diabetes mellitus...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28833291/association-between-modifiable-lifestyle-and-the-prevalence-of-atrial-fibrillation-in-a-chinese-population-based-on-the-cardiovascular-health-score
#20
Yiheng Yang, Xu Han, Yue Chen, Lianjun Gao, Xiaomeng Yin, Huihua Li, Jing Qiu, Youxin Wang, Yong Zhou, Yunlong Xia
BACKGROUND: The Cardiovascular Health (CVH) Score was comprised of a series of modifiable lifestyle and health factors, which was published by American Heart Association in 2010. Its relationship with atrial fibrillation (AF) remains unclear. HYPOTHESIS: Individuals with a higher CVH Score had a lower risk of AF. METHODS: Participants ≥40 years of age were recruited from the Jidong community. Information regarding the following 7 CVH metrics, including smoking, body mass index, diet, physical activity, total cholesterol, and fasting blood glucose, were collected...
August 21, 2017: Clinical Cardiology
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