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https://www.readbyqxmd.com/read/28823072/prevalence-and-predictors-of-digoxin-utilization-among-heart-failure-patients-with-reduced-ejection-fraction-in-qatar
#1
Alaa Abdullah Rahhal, Ahmed Awaisu, Kawthar M Tawengi, Safae AbuYousef, Lylia Mekideche
Background Digoxin is a cardiac glycoside that is recommended by clinical practice guidelines to be used in patients with heart failure with reduced ejection fraction (HFrEF) who still have persistent symptoms despite optimal medical therapy. However, this recommendation is based on limited and old trial data. Moreover, pharmacoepidemiologic studies are important in determining the prevalence of digoxin use and factors influencing this. Objective This study aimed to determine the prevalence and the predictors of digoxin utilization among patients with HFrEF with or without atrial fibrillation (AF) in Qatar...
August 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28823011/guidelines-versus-reality-is-coronary-stent-application-in-three-vessel-disease-standard-or-the-exception
#2
Roland Linder, J Zeidler, F Verheyen, J-M Graf von der Schulenburg, A Haverich, T Schilling
The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively...
August 19, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28822701/clinical-applications-of-biomarkers-in-atrial-fibrillation
#3
REVIEW
Kay-Won Chang, Jonathan C Hsu, Avinash Toomu, Sutton Fox, Alan S Maisel
While biomarkers have greatly impacted the diagnosis and management of myocardial infarction and heart failure, the use of biomarkers has been slow to permeate management of atrial fibrillation. Guideline recommendations on the use of biomarkers in atrial fibrillation were virtually non-existent until the 2016 European Society of Cardiology guidelines on atrial fibrillation offered a class IIb recommendation to consider using biomarkers such as high sensitivity troponin and natriuretic peptide to further refine stroke and bleeding risk in atrial fibrillation patients...
August 16, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28822512/implications-of-the-2013-acc-aha-cholesterol-guidelines-on-contemporary-clinical-practice-for-patients-with-atherosclerotic-coronary-and-peripheral-arterial-disease
#4
Prasad Gunasekaran, Vinodh Jeevanantham, Suresh Sharma, Rashmi Thapa, Kamal Gupta
BACKGROUND: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. METHODS: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28822511/comparison-of-different-cardiovascular-risk-score-calculators-for-cardiovascular-risk-prediction-and-guideline-recommended-statin-uses
#5
Naveen Garg, Subrat K Muduli, Aditya Kapoor, Satyendra Tewari, Sudeep Kumar, Roopali Khanna, Pravin Kumar Goel
OBJECTIVE: The accuracy of various 10-year cardiovascular disease (CVD) risk calculators in Indians may not be the same as in other populations. Present study was conducted to compare the various calculators for CVD risk assessment and statin eligibility according to different guidelines. METHODS: Consecutive 1110 patients who presented after their first myocardial infarction were included. Their CVD risk was calculated using Framingham Risk score- Coronary heart disease (FRS-CHD), Framingham Risk Score- Cardiovascular Disease (FRS-CVD), QRISK2, Joint British Society risk calculator 3 (JBS3), American College of Cardiology/American Heart Association (ACC/AHA), atherosclerotic cardiovascular disease (ASCVD) and WHO risk charts, assuming that they had presented one day before cardiac event for risk assessment...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821397/cardiac-metabolism-a-promising-therapeutic-target-for-heart-failure
#6
REVIEW
Hannah Noordali, Brodie L Loudon, Michael P Frenneaux, Melanie Madhani
Heart failure, with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF), is associated with high morbidity and mortality. Although many established pharmacological interventions exist for those patients with HFrEF, hospitalization and death rates remain high, and in those with HFpEF (over half of all heart failure patients), there are no effective therapies. Recently, the role of impaired cardiac energetic status in heart failure has gained increasing recognition with the identification of reduced metabolic capacity for carbohydrates and fatty acids, impaired function of the electron transport chain, reduced capacity to transfer ATP to the cytosol, and inefficient utilization of the energy produced...
August 15, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28819824/-update-pulmonary-arterial-hypertension-definitions-diagnosis-therapy
#7
N Sommer, M J Richter, K Tello, F Grimminger, W Seeger, H A Ghofrani, H Gall
The term pulmonary arterial hypertension comprises a group of pulmonary vascular diseases of different etiologies that are characterized by similar precapillary vascular remodeling processes and result in exertional dyspnea and right heart insufficiency. The specific pharmacological treatment approach considers the risk of mortality and phenotypical properties and includes treatment with phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostanoids, as well as with more novel substances, such as a soluble guanylyl cyclase stimulator and an oral prostacyclin receptor agonist...
August 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#8
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28818058/evaluation-of-therapy-management-and-outcome-in-takotsubo-syndrome
#9
Nadine Abanador-Kamper, Lars Kamper, Judith Wolfertz, Witali Pomjanski, Anamaria Wolf-Pütz, Melchior Seyfarth
BACKGROUND: To date there is no validated evidence for standardized treatment of patients with Takotsubo syndrome (TTS). Medication therapy after final TTS diagnosis remains unclear. Previous data on patient outcome is ambivalent. Aim of this study was to evaluate medication therapy in TTS and to analyze patient outcome. METHODS: Within an observational retrospective cohort study we analyzed our medical records and included 72 patients with TTS that underwent cardiovascular magnetic resonance imaging (CMR) after a median of 2 days interquartile range (IQR 1-3...
August 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#10
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28816774/practitioner-gender-and-quality-of-care-in-ambulatory-cardiology-practices-a-report-from-the-national-cardiovascular-data-practice-innovation-and-clinical-excellence-pinnacle-registry
#11
Dipti Gupta, Fengming Tang, Frederick A Masoudi, Philip G Jones, Paul S Chan, Stacie L Daugherty
BACKGROUND: Some studies suggest that female practitioners are more likely to provide guideline-concordant care than male practitioners; however, little is known about the role of practitioner gender in cardiology. OBJECTIVE: The aim of the study was to measure the association between practitioner gender and adherence to the cardiovascular performance measures in the American College of Cardiology's ambulatory Practice Innovation and Clinical Excellence Registry...
August 15, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28815597/cardiac-action-potential-repolarization-re-visited-early-repolarization-shows-all-or-none-behaviour
#12
Beatriz Trenor, Karen Cardona, Javier Saiz, Denis Noble, Wayne Giles
In healthy mammalian hearts the action potential (AP) waveform initiates and modulates each contraction, or heartbeat. As a result, action potential height and duration are key physiological variables. In addition, rate-dependent changes in ventricular action potential duration (APD), and variations in APD at a fixed heart rate, are both reliable biomarkers of electrophysiological stability. Present guidelines for the likelihood that candidate drugs will increase arrhythmias rely on small changes in APD and Q-T intervals as criteria for Safety Pharmacology decisions...
August 17, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28814664/pulmonary-arterial-hypertension-treatment-with-carvedilol-for-heart-failure-a-randomized-controlled-trial
#13
Samar Farha, Didem Saygin, Margaret M Park, Hoi I Cheong, Kewal Asosingh, Suzy Aa Comhair, Olivia R Stephens, Emir C Roach, Jacqueline Sharp, Kristin B Highland, Frank P DiFilippo, Donald R Neumann, W H Wilson Tang, Serpil C Erzurum
BACKGROUND: Right-sided heart failure is the leading cause of death in pulmonary arterial hypertension (PAH). Similar to left heart failure, sympathetic overactivation and β-adrenoreceptor (βAR) abnormalities are found in PAH. Based on successful therapy of left heart failure with β-blockade, the safety and benefits of the nonselective β-blocker/vasodilator carvedilol were evaluated in PAH. METHODS: PAH Treatment with Carvedilol for Heart Failure (PAHTCH) is a single-center, double-blind, randomized, controlled trial...
August 17, 2017: JCI Insight
https://www.readbyqxmd.com/read/28814378/mhealth-technologies-for-palliative-care-patients-at-the-interface-of-in-patient-to-outpatient-care-protocol-of-feasibility-study-aiming-to-early-predict-deterioration-of-patient-s-health-status
#14
Gudrun Theile, Vanessa Klaas, Gerhard Tröster, Matthias Guckenberger
BACKGROUND: Palliative care patients are a particularly vulnerable population and one of the critical phases in patients' trajectories is discharge from specialized in-patient palliative care into outpatient care, where availability of a palliative care infrastructure is highly variable. A relevant number of potentially avoidable readmissions and emergency visits of palliative patients is observed due to rapid exacerbation of symptoms indicating the need for a closer patient monitoring...
August 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28814290/predicted-impact-of-lipid-lowering-therapy-on-cardiovascular-and-economic-outcomes-of-swedish-atherosclerotic-cardiovascular-disease-guideline
#15
Gunilla Journath, Kristina Hambraeus, Emil Hagström, Billie Pettersson, Mickael Löthgren
BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and possible avoided economic costs, in post myocardial infarction (MI) patients, if target LDL-C levels of ≤1.8 mmol/L would be achieved. METHODS: All patients registered in the Swedish Secondary Prevention after Heart Intensive care Admission register, with one-year post-MI follow-up during 2013 were selected...
August 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28812208/genetic-testing-in-inherited-heart-diseases-practical-considerations-for-clinicians
#16
REVIEW
Melanie Care, Vijay Chauhan, Danna Spears
PURPOSE OF REVIEW: Genetic testing has become an important element in the care of patients with inherited cardiac conditions (ICCs). The purpose of this review is to provide clinicians with insights into the utility of genetic testing as well as challenges associated with interpreting results. RECENT FINDINGS: Genetic testing may be indicated for individuals who are affected with or who have family histories of various ICCs. Various testing options are available and determining the most appropriate test for any given clinical scenario is key when interpreting results...
August 16, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#17
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28810904/antiarrhythmic-drug-therapy-among-patients-presenting-to-emergency-department-with-symptomatic-atrial-fibrillation-a-prospective-nationwide-cohort
#18
Tero Penttilä, Heikki Mäkynen, Juha Hartikainen, Harri Hyppölä, Timo Lauri, Mika Lehto, Juha Lund, M J Pekka Raatikainen
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia that causes numerous visits to emergency departments (ED). The aim of the FinFib2 study was to evaluate whether treatment of patients with AF in ED is consistent with the contemporary European Society of Cardiology (ESC) management guidelines. Here we report the results of antiarrhythmic drug therapy (AAD) in ED. METHODS: All patients within the two-week study period whose primary reason for the ED visit was symptomatic AF were included into this prospective multicentre study...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28809190/design-thinking-for-mhealth-application-co-design-to-support-heart-failure-self-management
#19
Leanna Woods, Elizabeth Cummings, Jed Duff, Kim Walker
Heart failure is a prevalent, progressive chronic disease costing in excess of $1billion per year in Australia alone. Disease self-management has positive implications for the patient and decreases healthcare usage. However, adherence to recommended guidelines is challenging and existing literature reports sub-optimal adherence. mHealth applications in chronic disease education have the potential to facilitate patient enablement for disease self-management. To the best of our knowledge no heart failure self-management application is available for safe use by our patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28807986/a-turbine-driven-ventilator-improves-adherence-to-advanced-cardiac-life-support-guidelines-during-a-cardiopulmonary-resuscitation-simulation
#20
Scott G Allen, Lara Brewer, Erik S Gillis, Nathan L Pace, Derek J Sakata, Joseph A Orr
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8 -10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines...
August 14, 2017: Respiratory Care
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