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Journal of the American Heart Association

Amit P Amin, Samantha Miller, Brandon Rahn, Mary Caruso, Andrew Pierce, Katrine Sorensen, Howard Kurz, Alan Zajarias, Richard Bach, Jasvindar Singh, John M Lasala, Hemant Kulkarni, Patricia Crimmins-Reda
Background Bleeding is a common, morbid, and costly complication of percutaneous coronary intervention. While bleeding avoidance strategies ( BAS ) are effective, they are used paradoxically less in patients at high risk of bleeding. Whether a patient-centered approach to specifically increase the risk-concordant use of BAS and, thus, reverse the risk-treatment paradox is associated with reduced bleeding and costs is unknown. Methods and Results We implemented an intervention to reverse the bleeding risk-treatment paradox at Barnes-Jewish Hospital, St...
November 6, 2018: Journal of the American Heart Association
Juwon Kim, Kyu Tae Park, Mi Ja Jang, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Sang-Hoon Lee, Kyung Pyo Hong, Joo-Yong Hahn
Background Whether use of high-intensity statins is more important than achieving low-density lipoprotein cholesterol ( LDL -C) target remains controversial in patients with coronary artery disease. We sought to investigate the association between statin intensity and long-term clinical outcomes in patients achieving treatment target for LDL -C after percutaneous coronary intervention. Methods and Results Between February 2003 and December 2014, 1746 patients who underwent percutaneous coronary intervention and achieved treatment target for LDL -C (<70 mg/dL or >50% reduction from baseline level) were studied...
November 6, 2018: Journal of the American Heart Association
Steven R Messé, Michael T Mullen, Margueritte Cox, Gregg C Fonarow, Eric E Smith, Jeffrey L Saver, Mathew J Reeves, Deepak L Bhatt, Roland Matsouaka, Lee H Schwamm
Background Patients presenting to hospitals during non-weekday hours experience worse outcomes, often attributed to reduced staffing. The American Heart Association International Stroke Conference ( ISC ) is well attended by stroke clinicians. We sought to determine whether patients with acute ischemic stroke ( AIS ) admitted during the ISC receive less guideline-adherent care and experience worse outcomes. Methods and Results We performed a retrospective cohort study of US hospitals participating in Get With The Guidelines-Stroke and assessed use of intravenous tissue plasminogen activator, other quality measures, and outcomes for patients with AIS admitted during the ISC compared with those admitted the weeks before and after the conference...
November 6, 2018: Journal of the American Heart Association
Michael A Wewege, Dohee Ahn, Jennifer Yu, Kevin Liou, Andrew Keech
Background Cardiac rehabilitation ( CR ) for patients with cardiovascular disease has traditionally involved low- to moderate-intensity continuous aerobic exercise training ( MICT ). There is growing and robust evidence that high-intensity interval training ( HIIT ) shows similar or greater efficacy compared with MICT across a range of cardiovascular and metabolic measures, in both healthy populations and populations with a chronic illness. However, there is understandable concern about the safety aspects of applying HIIT in CR settings...
November 6, 2018: Journal of the American Heart Association
Carole H Sudre, Lorna Smith, David Atkinson, Nish Chaturvedi, Sébastien Ourselin, Frederik Barkhof, Alun D Hughes, H Rolf Jäger, M Jorge Cardoso
Background Cardiovascular risk factors vary between ethnicities but little is known about their differential effects on white matter hyperintensities ( WMH ), an indicator of brain aging and burden of cerebrovascular disease. Methods and Results Brain magnetic resonance imaging scans from 213 people of South Asian and 256 of European ethnicity (total=469) were analyzed for global and regional WMH load. Associations with cardiovascular risk factors and a composite cardiovascular risk score (National Cholesterol Education Programme Adult Treatment Panel III) were compared by ethnicity, diabetes mellitus, smoking, and hypertension status...
November 6, 2018: Journal of the American Heart Association
Ambarish Pandey, Jarett D Berry, Mark H Drazner, James C Fang, W H Wilson Tang, Justin L Grodin
Background The prognostic interrelationship between natriuretic peptide ( NP ) levels and body mass index ( BMI ) among patients with chronic stable heart failure with preserved ejection fraction is not well characterized. Methods and Results Participants from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial enrolled in the Americas meeting inclusion by the NP stratum were stratified into 4 data-derived categories by BMI and standardized NP -z score. Adjusted Cox-proportional models determined the independent association of BMI , NP -z score, and BMI / NP categories with composite primary end point, heart failure hospitalization, and all-cause mortality...
November 6, 2018: Journal of the American Heart Association
Umesh N Khot, Michael J Johnson, Newton B Wiggins, Ashley M Lowry, Jeevanantham Rajeswaran, Samir Kapadia, Venu Menon, Stephen G Ellis, Pamela Goepfarth, Eugene H Blackstone
Background Readmission after myocardial infarction ( MI ) is a publicly reported quality metric with hospital reimbursement linked to readmission rates. We describe the timing and pattern of readmission by cause within the first year after MI in consecutive patients, regardless of revascularization strategy, payer status, or age. Methods and Results We identified patients discharged after an MI from April 2008 to June 2012. Readmission within 12 months was the primary end point. Readmissions were classified into 4 groups: MI related, other cardiovascular, noncardiovascular, and planned...
November 6, 2018: Journal of the American Heart Association
Mercedes Sotos-Prieto, Josiemer Mattei, Nancy R Cook, Frank B Hu, Walter C Willett, Stephanie E Chiuve, Eric B Rimm, Howard D Sesso
Background The previously validated Healthy Heart Score effectively predicted the 20-year risk of cardiovascular disease (CVD). We examine whether the Healthy Heart Score may extend to an association with total and cause-specific mortality. Methods and results The prospective cohort study investigated 58 319 women (mean age 50.2 years) in the Nurses' Health Study (1984-2010) and 29 854 in men (mean age 52.7 years) in the Health Professionals' Follow-up Study (1986-2010) free of cancer and CVD at baseline...
November 6, 2018: Journal of the American Heart Association
Andrew E Levy, Larry A Allen
See Article by Khot et al.
November 6, 2018: Journal of the American Heart Association
Arnaud Bisson, Julien Pucheux, Clémentine Andre, Anne Bernard, Bertrand Pierre, Dominique Babuty, Laurent Fauchier, Nicolas Clementy
Background The efficacy of cardiac resynchronization therapy may be reduced in the event of pacing within myocardial fibrosis. We aimed to develop a method to determine the anatomical relationships between the left ventricular ( LV ) lead and myocardial fibrosis. Methods and Results In consecutive patients indicated for cardiac resynchronization therapy, cardiovascular magnetic resonance imaging with late gadolinium enhancement assessment was performed before implantation. After implantation, an injected computed tomography scanner ( CT scan) was performed...
November 6, 2018: Journal of the American Heart Association
Harold L Lazar
See Article by Gaudino et al .
November 6, 2018: Journal of the American Heart Association
Mohd Shahid, Erin L Hermes, David Chandra, Mohammad Tauseef, M Rizwan Siddiqui, M Hafeez Faridi, Mei X Wu
No abstract text is available yet for this article.
November 6, 2018: Journal of the American Heart Association
Rui Shi, Zhong Chen, Andrianos Kontogeorgis, Frederic Sacher, Paolo Della Bella, Caterina Bisceglia, Ruairidh Martin, Christian Meyer, Stephan Willems, Vias Markides, Philippe Maury, Tom Wong
Background Mapping using a multipolar catheter with small and closely spaced electrodes has been shown to improve the validity of electrograms to identify endocardial critical sites of reentry isthmus and foci of earliest activation. However, the feasibility, safety, and clinical outcome of using such technology to guide epicardial ventricular tachycardia (VT) ablation has not been reported. Methods and Results Thirty-three consecutive patients from 5 high-volume centers were studied. These patients had 43 epicardial maps using a novel 64-pole mini-basket catheter to guide VT ablation...
November 6, 2018: Journal of the American Heart Association
Mario Gaudino, Umberto Benedetto, Faisal Bakaeen, Mohamed Rahouma, Derrick Y Tam, Ahmed Abouarab, Antonino Di Franco, Jeremy Leonard, Adham Elmously, John D Puskas, Gianni D Angelini, Leonard N Girardi, Stephen E Fremes, David P Taggart
Background The debate on the relative benefits of off-pump and on-pump coronary artery bypass surgery ( OPCABG and ONCABG ) is still open. We aimed to provide an updated and complete summary of the evidence on the differences between OPCABG and ONCABG and to explore whether the length of the follow-up and the surgeons' experience in OPCABG modify the comparative results. Methods and Results All randomized clinical trials comparing OPCABG and ONCABG were included. Primary outcome was follow-up mortality. Secondary outcomes were operative mortality, perioperative stroke, perioperative myocardial infarction, and late repeated revascularization...
November 6, 2018: Journal of the American Heart Association
Wen-Hui Zhang, Qi-Na Zhou, Yan-Mei Lu, Yao-Dong Li, Ling Zhang, Jiang-Hua Zhang, Qiang Xing, Wen-Kui Lv, Xin-Chun Cheng, Ge-Ge Zhang, Xue-Sheng Wang, Qi Gu, Xue Lou, Buajier Guli, Bao-Peng Tang, Xian-Hui Zhou
Background Ventricular arrhythmia after myocardial infarction is the most important risk factor for sudden cardiac death, which poses a serious threat to human health. As the correlation between autonomic nervous systemic dysfunction and heart rhythm abnormality has been gradually revealed, remedies targeting autonomic nervous system dysfunction, especially the sympathetic nerve, have emerged. Among them, renal denervation is noted for its powerful effect on the inhibition of sympathetic nerve activity. We aim to investigate whether renal denervation can reduce ventricular arrhythmia after myocardial infarction and thus decrease the risk of sudden cardiac death...
October 16, 2018: Journal of the American Heart Association
Sean van Diepen, Colleen M Norris, Yinggan Zheng, Jayan Nagendran, Michelle M Graham, Damaris Gaete Ortega, Derek R Townsend, Justin A Ezekowitz, Sean M Bagshaw
Background Postoperative clinical outcomes associated with the preoperative continuation or discontinuation of angiotensin-converting enzyme inhibitors ( ACEIs ) or angiotensin receptor blockers ( ARBs ) before cardiac surgery remain unclear. Methods and Results In a single-center, open-label, randomized, registry-based clinical trial, patients undergoing nonemergent cardiac surgery were assigned to ACEI / ARB continuation or discontinuation 2 days before surgery. Among the 584 patients screened, 261 met study criteria and 126 (48...
October 16, 2018: Journal of the American Heart Association
Federica Latta, Christopher de Filippi
No abstract text is available yet for this article.
October 16, 2018: Journal of the American Heart Association
Runqi Wangqin, Daniel T Laskowitz, Yongjun Wang, Zixiao Li, Yilong Wang, Liping Liu, Li Liang, Roland A Matsouaka, Jeffrey L Saver, Gregg C Fonarow, Deepak L Bhatt, Eric E Smith, Lee H Schwamm, Janet Prvu Bettger, Adrian F Hernandez, Eric D Peterson, Ying Xian
Background Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results We analyzed 19 604 patients with acute ischemic stroke in the China National Stroke Registry and 194 876 patients in the Get With The Guidelines--Stroke registry in the United States from June 2012 to January 2013. Compared with their US counterparts, Chinese patients were younger, had a lower prevalence of comorbidities, and had similar median, lower mean, and less variability in National Institutes of Health Stroke Scale (median 4 [25th percentile-75th percentile, 2-7], mean 5...
October 16, 2018: Journal of the American Heart Association
Toshiro Kitagawa, Hideya Yamamoto, Yumiko Nakamoto, Ko Sasaki, Shinya Toshimitsu, Fuminari Tatsugami, Kazuo Awai, Yutaka Hirokawa, Yasuki Kihara
Background Application of 18 F-sodium fluoride (18 F-NaF) positron emission tomography ( PET ) to coronary artery disease has attracted interest. We investigated the utility of 18 F-NaF uptake for predicting coronary events and evaluated the combined use of coronary computed tomography (CT) angiography ( CCTA ) and 18 F-NaF PET /CT in coronary artery disease risk assessment. Methods and Results This study included patients with ≥1 coronary atherosclerotic lesion detected on CCTA who underwent 18 F-NaF PET / CT ...
October 16, 2018: Journal of the American Heart Association
Can Gollmann-Tepeköylü, Daniela Lobenwein, Markus Theurl, Uwe Primessnig, Daniela Lener, Elke Kirchmair, Wolfgang Mathes, Michael Graber, Leo Pölzl, Angela An, Katarzyna Koziel, Elisabeth Pechriggl, Jakob Voelkl, Patrick Paulus, Wolfgang Schaden, Michael Grimm, Rudolf Kirchmair, Johannes Holfeld
Background Mechanical stimulation of acute ischemic myocardium by shock wave therapy ( SWT ) is known to improve cardiac function by induction of angiogenesis. However, SWT in chronic heart failure is poorly understood. We aimed to study whether mechanical stimulation upon SWT improves heart function in chronic ischemic heart failure by induction of angiogenesis and postnatal vasculogenesis and to dissect underlying mechanisms. Methods and Results SWT was applied in a mouse model of chronic myocardial ischemia...
October 16, 2018: Journal of the American Heart Association
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