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Guidelines in cardiology

Matthew E Levy, Alan E Greenberg, Manya Magnus, Naji Younes, Amanda Castel
Statin coverage has been examined among HIV-infected patients using Adult Treatment Panel III (ATP III) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines, although not with newer National Lipid Association (NLA) guidelines. We investigated statin eligibility, prescribing practices, and therapeutic responses using these three guidelines. Sociodemographic, clinical, and laboratory data were collected between 2011 and 2016 for HIV-infected outpatients enrolled in the DC Cohort, a multi-center, prospective, observational study in Washington, DC...
February 2018: AIDS Patient Care and STDs
Lydia Chan, Harry McNaughton, Mark Weatherall
Objective: We aimed to estimate the level of physical activity undertaken by health care professionals and the proportion that achieved a daily target of 10,000 steps. Design: This was a prospective cohort study. Setting: Participants were recruited in Wellington Regional Hospital, a tertiary hospital in New Zealand. Participants: Neurology, Cardiology, and Endocrinology staff were invited to participate. Main outcome measures: Pedometer-measured step counts were recorded over seven days and the proportion that achieved a daily target of 10,000 steps was calculated...
January 2018: JRSM Cardiovascular Disease
Takayuki Warisawa, Christopher M Cook, Yoshihiro J Akashi, Justin E Davies
It is well known that the apparent significant coronary stenosis on angiography sometimes does not cause significant ischemia, and vice versa. For this reason, decision-making based on coronary physiology is becoming more and more important. Fractional flow reserve (FFR), which has emerged as a useful tool to determine which lesions need revascularization in the catheterization laboratory, now has a class IA indication in the European Society of Cardiology guidelines. More recently, the instantaneous wave-free ratio, which is considered easier to use than FFR, has been graded as equivalent to FFR...
March 15, 2018: Revista Española de Cardiología
Mehmet Özkan, Sabahattin Gündüz, Macit Kalçık, Mustafa Ozan Gürsoy
No abstract text is available yet for this article.
February 7, 2018: American Journal of Cardiology
Takuya Oikawa, Yasuhiko Sakata, Kotaro Nochioka, Masanobu Miura, Kanako Tsuji, Takeo Onose, Ruri Abe, Shintaro Kasahara, Masayuki Sato, Takashi Shiroto, Jun Takahashi, Satoshi Miyata, Hiroaki Shimokawa
BACKGROUND: The beneficial prognostic impact of statins has been established in patients with ischemic heart disease but not in those with heart failure (HF). In addition, it is still unclear whether patients benefit from statins regardless of low-density lipoprotein cholesterol levels. METHODS AND RESULTS: We examined 2444 consecutive stage C or D HF patients with ischemic heart disease registered in CHART-2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2), a multicenter, prospective, observational cohort study in Japan...
March 14, 2018: Journal of the American Heart Association
Hein Heidbuchel, Nikolaos Dagres, Matthias Antz, Karl-Heinz Kuck, Patrice Lazure, Suzanne Murray, Céline Carrera, Gerhard Hindricks, Alec Vahanian
Aims: Guideline-adherent treatment is associated with improved prognosis in atrial fibrillation (AF) patients but is insufficiently implemented in clinical practice. The European Society of Cardiology (ESC) performed a multinational educational needs assessment study among cardiologists, general practitioners/family physicians (GPs/FPs), and neurologists in order to evaluate knowledge and skills of physicians and system factors related to AF care delivery. Methods and results: A total of 561 physicians (294 cardiologists, 131 neurologists, and 136 GPs/FPs) from six European countries participated...
March 12, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
March 13, 2018: Drugs
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
Tasalak Thonghong, Ole De Backer, Lars Søndergaard
New European guidelines on the management of valvular heart disease-supported by the European Society of Cardiology (ESC) and European Association of CardioThoracic Surgery (EACTS)-were recently published. Although these guidelines are very comprehensive, these typically are not very inviting to read. In this document, we aimed to distil all the information about transcatheter aortic valve replacement (TAVR) in the new 2017 ESC/EACTS guidelines to the essential and give additional comments on the position of TAVR in 2017...
2018: Open Heart
Lee S Nguyen, Pierre Baudinaud, Alain Brusset, Florence Nicot, Louis Pechmajou, Joe-Elie Salem, Philippe Estagnasie, Pierre Squara
BACKGROUND: The prognostic role of heart failure with preserved ejection fraction (HFpEF) remains unclear. This study aimed to assess HFpEF prognostic value after cardiothoracic surgery, adjusting for European System for Cardiac Operative Risk (EuroSCORE II) criteria. METHODS: Patients with left ventricular ejection fraction (LVEF) ≥ 50% undergoing cardiothoracic surgery between 2012 and 2016 were included. Patients with HFpEF were compared to control patients with LVEF ≥ 50%...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Takashi Kuragaichi, Yuma Kurozumi, Shogo Ohishi, Yasuo Sugano, Akihiro Sakashita, Norihiko Kotooka, Makoto Suzuki, Taiki Higo, Dai Yumino, Yasuko Takada, Seiko Maeda, Saori Yamabe, Koichi Washida, Tomonori Takahashi, Tomohito Ohtani, Yasushi Sakata, Yukihito Sato
BACKGROUND: Palliative care for heart failure (HF) patients is recommended in Western guidelines, so this study aimed to clarify the current status of palliative care for HF patients in Japan.Methods and Results:A survey was sent to all Japanese Circulation Society-authorized cardiology training hospitals (n=1,004) in August 2016. A total of 544 institutions (54%) returned the questionnaire. Of them, 527 (98%) answered that palliative care is necessary for patients with HF. A total of 227 (42%) institutions held a palliative care conference for patients with HF, and 79% of the institutions had <10 cases per year...
March 10, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Subir Bhatia, Shilpkumar Arora, Sravya M Bhatia, Mohammed Al-Hijji, Yogesh N V Reddy, Parshva Patel, Charanjit S Rihal, Bernard J Gersh, Abhishek Deshmukh
BACKGROUND: Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS: Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD...
March 10, 2018: Journal of the American Heart Association
Robert A Phillips, Jiaqiong Xu, Leif E Peterson, Ryan M Arnold, Joseph A Diamond, Adam E Schussheim
BACKGROUND: The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology and American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment...
March 2, 2018: Journal of the American College of Cardiology
Petar M Seferović, Mark C Petrie, Gerasimos S Filippatos, Stefan D Anker, Giuseppe Rosano, Johann Bauersachs, Walter J Paulus, Michel Komajda, Francesco Cosentino, Rudolf A de Boer, Dimitrios Farmakis, Wolfram Doehner, Ekaterini Lambrinou, Yuri Lopatin, Massimo F Piepoli, Michael J Theodorakis, Henrik Wiggers, John Lekakis, Alexandre Mebazaa, Mamas A Mamas, Carsten Tschöpe, Arno W Hoes, Jelena P Seferović, Jennifer Logue, Theresa McDonagh, Jillian P Riley, Ivan Milinković, Marija Polovina, Dirk J van Veldhuisen, Mitja Lainscak, Aldo P Maggioni, Frank Ruschitzka, John J V McMurray
The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30-40% of patients) and associated with a higher risk of HF hospitalization, all-cause and cardiovascular (CV) mortality. The most important causes of HF in T2DM are coronary artery disease, arterial hypertension and a direct detrimental effect of T2DM on the myocardium. T2DM is often unrecognized in HF patients, and vice versa, which emphasizes the importance of an active search for both disorders in the clinical practice...
March 8, 2018: European Journal of Heart Failure
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Carlos D Davila, James E Udelson
Among all patients referred for stress myocardial perfusion imaging (MPI), a substantial proportion in contemporary practice cannot exercise. Another group of patients are those who are thought to be able to achieve an adequate workload with treadmill (or bicycle) exercise but do not achieve at least 85% of maximum predicted heart rate without developing symptoms. There has been substantial interest and literature on the adjunctive use of vasodilator stress during the same visit to generate best-quality results for patients who do not exercise adequately...
March 2018: JACC. Cardiovascular Imaging
Tom Kai Ming Wang, Kok-Lam Chow, Aaron Lin, Alexei Chataline, Harvey White, Matthew Dawes, Greg Gamble, Chris Ellis
AIMS: To review the number, characteristics and clinical management of suspected ACS patients admitted to cardiology and non-cardiology services at Auckland City Hospital, to assess differences between these services and to assess the number who would potentially be enrolled in the All New Zealand Acute Coronary Syndrome (ACS) Quality Improvement Programme (ANZACS-QI) database. METHODS: Auckland City Hospital patient data was extracted from the Australia and New Zealand ACS 'SNAPSHOT' audit, performed over 14 days in May 2012...
March 9, 2018: New Zealand Medical Journal
Yochai Schonmann, Oz Bleich, Andre Matalon, Hanny Yeshua
Aims The aim of this study was to evaluate the performance of the US Preventive Services Task Force (USPSTF) cholesterol recommendations in a contemporary non-US cohort. Methods and results This is a historical cohort analysis of electronic records from Israel's largest health provider. All patients in the Tel Aviv district eligible for primary cardiovascular prevention were followed between January 2005 and December 2015. Risk was estimated by the pooled cohort equations. Statin eligibility was determined by USPSTF and American College of Cardiology and American Heart Association (ACC/AHA) recommendations...
January 1, 2018: European Journal of Preventive Cardiology
Cori Russell, Samip Sheth, Douglas Jacoby
PURPOSE OF REVIEW: We provide an overview of our current understanding of combination lipid-lowering therapies intended for dyslipidemia treatment and cardiovascular disease prevention. First, we analyze recent statin and non-statin combination therapy guidelines and clinical studies since the publication of 2013 American College of Cardiology Cholesterol Guidelines. Second, we examine the clinical utility of non-statin agents alone and in combination in terms of LDL-C lowering and ASCVD risk reduction...
March 7, 2018: Current Atherosclerosis Reports
Erman Öztürk, Ferit Onur Mutluer
In cardiology practice, anticoagulation and antiplatelet therapies are essential for most patients. As of yet, there is no high quality evidence regarding these treatments in thrombocytopenic patients, which continues to be an issue. Thrombocytopenia is defined as a platelet count of <150x109/L and is classified as severe when the platelet count is <50x109/L. Pseudothrombocytopenia, drug-induced thrombocytopenia, immune thrombocytopenia, heparin-induced thrombocytopenia, and thrombotic thrombocytopenic purpura are some of the main causes of thrombocytopenia...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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