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https://www.readbyqxmd.com/read/28728744/serial-heart-rates-guideline-directed-beta-blocker-use-and-outcomes-in-patients-with-chronic-heart-failure-with-reduced-ejection-fraction
#1
Nasrien E Ibrahim, James L Januzzi, Dustin J Rabideau, Parul U Gandhi, Hanna K Gaggin
A single heart rate (HR) measurement may inform future prognosis in chronic heart failure with reduced ejection fraction (HFrEF). The importance of elevated HR across serial assessment is uncertain, particularly with well-applied guideline-directed medical therapy (GDMT) with beta blockers (BBs). In this post hoc analysis of 129 patients with chronic HFrEF in sinus rhythm, who had aggressive medication titration over 10.6 months, HR and BB use were assessed at each visit (average of 6 visits per patient). All-cause mortality was assessed...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#2
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28724651/hyperkalemia-after-initiating-renin-angiotensin-system-blockade-the-stockholm-creatinine-measurements-scream-project
#3
Ghassan Bandak, Yingying Sang, Alessandro Gasparini, Alex R Chang, Shoshana H Ballew, Marie Evans, Johan Arnlov, Lars H Lund, Lesley A Inker, Josef Coresh, Juan-Jesus Carrero, Morgan E Grams
BACKGROUND: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score. METHODS AND RESULTS: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter...
July 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28720639/angioedema-spotlight-a-closer-examination-of-sacubitril-valsartan-safety-results
#4
Ryan E Owens, Carrie S Oliphant
Incorporation of neprilysin inhibition into heart failure pharmacotherapy regimens has recently been recommended by U.S. guidelines, based on results from the PARADIGM-HF trial comparing sacubitril/valsartan to enalapril. While most of the discussion has focused on efficacy, a closer examination of the safety results, particularly the incidence of angioedema during the run-in and double-blind periods, is also warranted. Although no major safety concerns were identified, an angioedema risk comparable to enalapril was found, primarily in the black population...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28714810/advances-in-cardiovascular-health-in-women-over-the-past-decade-guideline-recommendations-for-practice
#5
Pejman Raeisi-Giglou, Annabelle Santos Volgman, Hena Patel, Susan Campbell, Amparo Villablanca, Eileen Hsich
Cardiovascular disease (CVD) remains the number one cause of death in women. It is estimated that 44 million women in the United States are either living with or at risk for heart disease. This article highlights the recent significant progress made in improving care, clinical decision-making, and policy implications for women with CVD. We provide our perspective supported by evidence-based advances in cardiovascular research and clinical care guidelines in seven areas: (1) primary CVD prevention and community heart care, (2) secondary prevention of CVD, (3) stroke, (4) heart failure and cardiomyopathies, (5) ischemia with nonobstructive coronary artery disease, (6) spontaneous coronary artery dissection, and (7) arrhythmias and device therapies...
July 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28714615/-arni-new-abbreviation-for-a-new-class-of-treatment-of-heart-failure
#6
Soran Karimzadeh, Hazrije Mustafić, Tomoe Stampfli Andres
ARNI (Angiontensin Receptor Neprilysin Inhibitor) are a new class of drug : the angiotensin and neprilysin inhibitors. This combined effect allows an optimisation of the heart failure treatment by acting on both pathways of the renin-angiotensin-aldosterone and of the natriuretic peptides. LCZ696 is a combined molecule of valsartan and sacubitril and is currently the only one on the market. Its efficacy has been shown in a large randomised trial in 2014, and LCZ696 is now part of the last 2016 European Society of Cardiology guidelines for the management of heart failure...
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28712629/the-prime-diabetes-model-novel-methods-for-estimating-long-term-clinical-and-cost-outcomes-in-type-1-diabetes-mellitus
#7
William J Valentine, Richard F Pollock, Rhodri Saunders, Jay Bae, Kirsi Norrbacka, Kristina Boye
BACKGROUND: Recent publications describing long-term follow-up from landmark trials and diabetes registries represent an opportunity to revisit modeling options in type 1 diabetes mellitus (T1DM). OBJECTIVES: To develop a new product-independent model capable of predicting long-term clinical and cost outcomes. METHODS: After a systematic literature review to identify clinical trial and registry data, a model was developed (the PRIME Diabetes Model) to simulate T1DM progression and complication onset...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28711453/a-roadmap-for-evaluating-the-use-and-value-of-durable-ventricular-assist-device-therapy
#8
EDITORIAL
Sarah T Ward, Qixing Liang, Francis D Pagani, Min Zhang, Robert L Kormos, Keith D Aaronson, Andrew D Althouse, Brahmajee K Nallamothu, Donald S Likosky
Heart failure is a disease characterized by profound human suffering with limitations in survival despite treatment with guideline-directed medical therapies. Patients with heart failure frequently progress to advanced stages and often require cardiac transplantation or implantation of left ventricular assist devices (LVADs) to extend survival and improve quality of life. As the number of suitable heart donors, number of experienced medical centers and patient comorbidities place restrictions on the feasibility of cardiac transplantation, implantation of LVADs has emerged as a more frequently applied treatment as either a bridge to transplantation or as permanent therapy...
June 23, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28707341/impact-of-hyperkalemia-and-worsening-renal-function-on-the-use-of-renin-angiotensin-aldosterone-system-inhibitors-in-chronic-heart-failure-with-reduced-ejection-fraction
#9
B Pitt, P Rossignol
Patients with heart failure (HF) and reduced ejection fraction (HFREF) are at increased risk of death and hospitalizations for HF. Numerous registries have reported a large and persistent gap between real-life practice in the use of life-saving evidence-based therapies, such as renin angiotensin system inhibitors, beta blockers, mineralocorticoid receptor antagonists (MRAs), and recommended practices in international guidelines. The fears of inducing hyperkalemia and/or worsening renal function are the main triggers of this underuse...
July 14, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28706597/an-infrequent-cause-of-apical-ventricular-aneurysm-in-the-united-states
#10
Mohammed M Taleb
Chronic Chagas cardiomyopathy (CCC) is a late complication of Chagas disease with various manifestations including arrhythmia, heart failure, thromboembolism, and stroke. In a patient with symptoms of heart failure and left ventricular apical aneurysm unexplained by structural heart or coronary vascular abnormalities, CCC should be strongly considered and inquiry made about exposure status. Typical electrocardiographic findings of bundle branch block, complete heart blocks, and ventricular arrhythmia are helpful clues...
April 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28701888/pharmacological-treatment-of-heart-failure-with-preserved-ejection-fraction
#11
REVIEW
Kazuhiro Yamamoto
Heart failure with preserved ejection fraction is a socioeconomic burden in Japan as well as other developed countries. Diuretics are widely used to attenuate symptoms and signs of congestion in both heart failure with preserved and reduced ejection fraction, although their effects on long-term prognosis of both phenotypes of heart failure have not been demonstrated because of an ethical difficulty in designing a randomized and prospective clinical trial. Guidelines do not provide any guidance on therapy choice, and physicians blindly choose furosemide among loop diuretics in current clinical settings...
June 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28701328/inpatient-mortality-risk-scores-and-postdischarge-events-in-hospitalized-heart-failure-patients-a-community-based-study
#12
Sithu Win, Imad Hussain, Virginia B Hebl, Shannon M Dunlay, Margaret M Redfield
BACKGROUND: The Acute Decompensated Heart Failure National Registry (ADHERE) and Get With The Guidelines (GWTG) registries have developed simple heart failure (HF) in-hospital mortality risk scores. We hypothesized that HF scores predictive of in-hospital mortality would perform as well for early postdischarge mortality risk stratification. METHODS AND RESULTS: In this single-center, community-based, retrospective study of all consecutive primary HF hospitalizations (6203 hospitalizations in 3745 patients) from 2000 to 2013, the ADHERE and GWTG risk scores were calculated from admission data...
July 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#13
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28699839/validated-low-volume-immunoassay-for-the-reliable-determination-of-direct-renin-especially-valuable-for-pediatric-investigations
#14
J Schaefer, B B Burckhardt, J Tins, A Bartel, S Laeer
INTRODUCTION: The pharmacotherapy of pediatric patients suffering from heart failure is extrapolated from adults due to missing data in children. OBJECTIVES: Development and validation of a low-volume immunoassay for the reliable determination of renin. EXPERIMENTAL: The immunoassay was validated according to international guidelines. RESULTS: The assay allows the reliable determination of renin in 40 μL plasma within a calibration range of 4 - 128 pg/mL...
July 12, 2017: Journal of Immunoassay & Immunochemistry
https://www.readbyqxmd.com/read/28698289/mechanism-and-implications-of-the-tricuspid-regurgitation-from-the-pathophysiology-to-the-current-and-future-therapeutic-options
#15
REVIEW
Antonio Mangieri, Claudio Montalto, Matteo Pagnesi, Richard J Jabbour, Josep Rodés-Cabau, Neil Moat, Antonio Colombo, Azeem Latib
The tricuspid valve was virtually ignored for a long time in the past. However, significant tricuspid regurgitation (TR) often accompanies left-side heart valve pathology and does not always reverse with its correction. If left untreated, TR can progress and result in progressive right ventricular failure. Current guideline recommendations still hold minor differences. Nevertheless, there is a consensus to operate on patients with severe TR undergoing left-sided valve surgery (class I) or those with mild to moderate TR with a dilated annulus (≥40 or ≥21 mm(2), Class IIa)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28695558/rehabilitation-in-patients-with-pulmonary-arterial-hypertension
#16
Stephan Keusch, Alexander Turk, Stéphanie Saxer, Nicola Ehlken, Ekkehard Grunig, Silvia Ulrich, On Behalf Of The Swiss Society Of Pulmonary Hypertension
Exertional dyspnoea is a leading symptom in patients with pulmonary arterial hypertension (PAH). Patients suffering from PAH report poor quality of life, have skeletal muscle dysfunction and in the absence of advanced medical therapy deteriorate progressively due to right heart failure which can lead to death. For decades, patients with PAH were advised to avoid exercise in fear of exacerbated right heart failure. Recently, it has been shown that a highly supervised rehabilitation programme in expert centres leads to significant improvements in symptoms, quality of life, exercise capacity and may even enhance haemodynamics in selected stable patients treated with advanced regimens of PAH-targeted drugs...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28695549/iron-substitution-in-the-treatment-of-chronic-heart-failure
#17
Christine Gstrein, Matthias Meyer, Pablo Anabitarte
Iron deficiency is a prevalent and clinically relevant comorbidity in up to 50% of patients with chronic heart failure (CHF). Iron deficiency in CHF patients is associated with impaired quality of life, reduced exercise capacity and increased mortality, irrespective of the presence of anaemia. It is diagnosed by determining circulating ferritin levels and transferrin saturation. Three randomised trials (CONFIRM-HF, FAIR-HF, and EFFECT-HF) of intravenous ferric carboxymaltose in the treatment of iron deficiency in CHF patients with reduced left ventricular ejection fraction demonstrated improvement of symptoms, functional capacity and quality of life...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692216/-digoxin-and-atrial-fibrillation-in-2016
#18
Sarah Théone, Sebastian Carballo, David Carballo, Christophe Marti
Various properties of digoxin have been exploited for decades, amongst which are its positive inotropy used in the treatment of heart failure, and its vagotonic effect used to slow ventricular response to atrial fibrillation. Pharmacologic properties of digoxin are however characterised by a narrow therapeutic interval, and recent observational studies suggest a potential association with increased mortality in patients with atrial fibrillation. As a result and because of available alternative therapeutic strategies, current guidelines do not recommend digoxin as first line treatment of atrial fibrillation...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28692214/-iron-deficiency-a-new-target-in-treating-chronic-heart-failure
#19
Maxime Borgeaud, Arnaud Perrier
Iron deficiency is now recognized as an independent predictor of poor outcome in patients with chronic heart failure and reduced left ventricular ejection fraction. In randomized controlled trials, treatment with ferric carboxymaltose results in improvement in functional capacity, symptoms and quality of life, and might reduce hospitalizations. Thus, the recent European Society of Cardiology guidelines on heart failure recommend treating these patients with intravenous ferric carboxymaltose, whether or not anemic...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28689185/patients-experiences-of-person-centred-integrated-heart-failure-care-and-palliative-care-at-home-an-interview-study
#20
Naghada Talabani, Karin Hellström Ängerud, Kurt Boman, Margareta Brännström
OBJECTIVES: Patients with severe heart failure (HF) suffer from a high symptom burden and high mortality. European and Swedish guidelines for HF care recommend palliative care for these patients. Different models for integrated palliative care and HF care have been described in the literature. No studies were found that qualitatively evaluated these models. The purpose of this study is to describe patients' experiences of a new model of person-centred integrated HF and palliative care at home...
July 7, 2017: BMJ Supportive & Palliative Care
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