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Michael R Bristow, Jorge Silva Enciso, Bernard J Gersh, Christine Grady, Madeline Murguia Rice, Steven Singh, George Sopko, Robin Boineau, Yves Rosenberg, Barry H Greenberg
TOPCAT was a multinational clinical trial of 3,445 heart failure with preserved ejection fraction (HFpEF) patients that enrolled in 233 sites in six countries in North America, Eastern Europe and South America. Patients with a heart failure hospitalization in the last 12 months or an elevated B-type natriuretic peptide (BNP) were randomized to the mineralocorticoid receptor antagonist spironolactone vs. placebo. Sites in Russia and the Republic of Georgia provided the majority of early enrollment, primarily based on the hospitalization criterion since BNP levels were initially unavailable there...
April 2016: JACC. Basic to Translational Science
Mandeep Singh, Deepak L Bhatt, Gregg W Stone, Charanjit S Rihal, Bernard J Gersh, Ryan J Lennon, Jagat Narula, Valentin Fuster
It is estimated that in the United States, each year, approximately 620,000 persons will experience an acute coronary syndrome and approximately 70% of these will have non-ST-elevation acute coronary syndrome. Cardiovascular disease still accounts for 1 of every 3 deaths in the United States, and there is an urgent need to improve the prognosis of patients presenting with acute coronary syndrome. Cardiovascular mortality and ischemic complications are common after acute coronary syndrome, and the advent of newer antithrombotic therapies has reduced ischemic complications, but at the expense of greater bleeding...
October 2016: Mayo Clinic Proceedings
Arie Pieter Kappetein, Patrick W Serruys, Joseph F Sabik, Martin B Leon, David P Taggart, Marie-Claude Morice, Bernard J Gersh, Stuart J Pocock, David J Cohen, Lars Wallentin, Ori Ben-Yehuda, Gerrit-Anne van Es, Charles A Simonton, Gregg W Stone
AIMS: Coronary artery bypass graft (CABG) surgery is the standard of care for revascularisation of patients with left main coronary artery disease (LMCAD). Recent studies have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may provide comparable outcomes in selected patients with LMCAD without extensive CAD. We therefore designed a trial to investigate whether PCI with XIENCE cobalt-chromium everolimus-eluting stents (CoCr-EES) would result in non-inferior or superior clinical outcomes to CABG in selected patients with LMCAD...
September 18, 2016: EuroIntervention
Sean D Pokorney, DaJuanicia N Simon, Laine Thomas, Bernard J Gersh, Elaine M Hylek, Jonathan P Piccini, Eric D Peterson
No abstract text is available yet for this article.
August 9, 2016: JAMA: the Journal of the American Medical Association
Deepak L Bhatt, Bernard J Gersh
No abstract text is available yet for this article.
July 26, 2016: Circulation
Jonathan P Piccini, DaJuanicia N Simon, Benjamin A Steinberg, Laine Thomas, Larry A Allen, Gregg C Fonarow, Bernard Gersh, Elaine Hylek, Peter R Kowey, James A Reiffel, Gerald V Naccarelli, Paul S Chan, John A Spertus, Eric D Peterson
IMPORTANCE: Despite the frequency of atrial fibrillation (AF) in clinical practice, relatively little is known about sex differences in symptoms and quality of life and how they may affect treatment and outcomes. OBJECTIVE: To determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with AF. DESIGN, SETTING, AND PARTICIPANTS: This observational cohort study included 10 135 patients with AF. The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation is a prospective, nationwide, multicenter outpatient registry of patients with incident and prevalent AF enrolled at 176 sites between June 2010 and August 2011...
June 1, 2016: JAMA Cardiology
Alanna M Chamberlain, Robert D Brown, Alvaro Alonso, Bernard J Gersh, Jill M Killian, Susan A Weston, Véronique L Roger
BACKGROUND: While atrial fibrillation is a recognized risk factor for stroke, contemporary data on trends in stroke incidence after the diagnosis of atrial fibrillation are scarce. METHODS AND RESULTS: Olmsted County, MN residents with incident atrial fibrillation or atrial flutter (collectively referred to as AF) from 2000 to 2010 were identified. Cox regression determined associations of year of AF diagnosis with ischemic stroke and transient ischemic attack (TIA) occurring through 2013...
June 2016: Journal of the American Heart Association
Partha Sardar, Saurav Chatterjee, Amartya Kundu, Habib Samady, Theophilus Owan, Jay Giri, Ramez Nairooz, Craig H Selzman, Gerd Heusch, Bernard J Gersh, J Dawn Abbott, Debabrata Mukherjee, James C Fang
BACKGROUND: Remote ischemic preconditioning (RIPC) has been associated with reduced risk of myocardial injury in patients undergoing cardiovascular surgery, but uncertainty about clinical outcomes remains, particularly in the light of 2 recent large randomized clinical trials (RCTs) which were neutral. We performed a meta-analysis to evaluate the efficacy of RIPC on clinically relevant outcomes in patients undergoing cardiovascular surgery. METHODS: We searched PubMed, Cochrane CENTRAL, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through November 30, 2015...
October 15, 2016: International Journal of Cardiology
Gerd Heusch, Bernard J Gersh
The incidence of ST segment elevation myocardial infarction (STEMI) has decreased over the last two decades in developed countries, but mortality from STEMI despite widespread access to reperfusion therapy is still substantial as is the development of heart failure, particularly among an expanding older population. In developing countries, the incidence of STEMI is increasing and interventional reperfusion is often not available. We here review the pathophysiology of acute myocardial infarction and reperfusion, notably the temporal and spatial evolution of ischaemic and reperfusion injury, the different modes of cell death, and the resulting coronary microvascular dysfunction...
June 26, 2016: European Heart Journal
Joana Delgado Silva, Marco Costa, Bernard J Gersh, Lino Gonçalves
The pathophysiological role of sympathetic overactivity in conditions such as hypertension has been well documented. Catheter-based renal denervation (RDN) is a minimally invasive percutaneous procedure which aims to disrupt sympathetic nerve afferent and efferent activity through the application of radiofrequency energy directly within the renal artery wall. This technique has emerged as a very promising treatment with dramatic effects on refractory hypertension but also in other conditions in which a sympathetic influence is present...
August 2016: Journal of the American Society of Hypertension: JASH
Nandan S Anavekar, Panithaya Chareonthaitawee, Jagat Narula, Bernard J Gersh
Myocardial viability assessment is typically reserved for patients with coronary artery disease and significant left ventricular dysfunction. In this setting, there is myocardial adaptation to an altered physiological state that is potentially reversible. Imaging can characterize different parameters of cardiac function; however, despite previously published appraisals of different imaging modalities, there is still uncertainty regarding the role of these tests in clinical practice. The purpose of this review is to reflect on the physiological basis of myocardial viability, discuss the imaging tests available that characterize myocardial viability, and summarize the current published reports on the use of these tests in clinical practice...
June 21, 2016: Journal of the American College of Cardiology
Ahmed D Abdalrhim, Tariq S Marroush, Erin E Austin, Bernard J Gersh, Nusret Solak, Syed A Rizvi, Kent R Bailey, Iftikhar J Kullo
Osteopontin (OPN) is a secreted glycophosphoprotein that has a role in inflammation, immune response and calcification. We hypothesized that plasma OPN levels are associated with adverse cardiovascular outcomes in patients with stable coronary artery disease (CAD) and preserved ejection fraction (EF) enrolled in the PEACE trial. We measured plasma OPN levels at baseline in 3567 CAD patients (mean age 64.5 ± 8.1 years, 81% men) by a sandwich chemiluminescent assay (coefficient of variation = 4.1%). OPN levels were natural log (Ln) transformed prior to analyses...
2016: PloS One
Elon Gersh, Carol A Hulbert, Ben McKechnie, Reem Ramadan, Tamara Worotniuk, Andrew M Chanen
OBJECTIVES: This study aimed to investigate alliance rupture and repair processes in psychotherapy for youth with borderline personality disorder. It sought to examine whether alliance processes differ between treatments, across the phases of therapy, and what associations these processes might have with therapeutic outcomes. DESIGN: The study involves repeated measurement of both process and outcome measures. Hypotheses were addressed using within- and between-subjects analyses...
May 30, 2016: Psychology and Psychotherapy
Anna Gundlund, Emil Loldrup Fosbøl, Sunghee Kim, Gregg C Fonarow, Bernard J Gersh, Peter R Kowey, Elaine Hylek, Kenneth W Mahaffey, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: We addressed whether patients with a family history of atrial fibrillation (AF) were diagnosed as having AF earlier in life, were more symptomatic, and had worse outcomes compared with those without a family history of AF. METHODS: Using the ORBIT-AF, we compared symptoms and disease characteristics in those with and without a family history of AF. A family history of AF was defined as AF in a first-degree family member and obtained by patient self-reporting...
May 2016: American Heart Journal
Rajiv Gulati, Bernard J Gersh
No abstract text is available yet for this article.
May 31, 2016: Circulation
Emily C O'Brien, Sunghee Kim, Laine Thomas, Gregg C Fonarow, Peter R Kowey, Kenneth W Mahaffey, Bernard J Gersh, Jonathan P Piccini, Eric D Peterson
BACKGROUND: Whereas insurance status has been previously associated with care patterns, little is currently known about the association between Medicaid insurance and the clinical characteristics, treatment, or outcomes of patients with atrial fibrillation (AF). METHODS AND RESULTS: We used data from adults with AF enrolled in the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF), a national outpatient registry conducted at 176 community, multispecialty sites...
May 2016: Journal of the American Heart Association
Konstantinos C Siontis, Gregory W Barsness, Ryan J Lennon, Jody L Holmen, R Scott Wright, Malcolm R Bell, Bernard J Gersh
The effectiveness of a pharmacoinvasive strategy consisting of fibrinolysis and transfer for percutaneous coronary intervention (PCI) compared to primary PCI (PPCI) in patients presenting to non-PCI-capable hospitals with ST-elevation myocardial infarction (STEMI) is not well defined. We analyzed data from the Mayo Clinic STEMI database of patients treated with a pharmacoinvasive strategy (favored in those presenting early after symptom onset) or PPCI in a regional STEMI network from 2004 to 2012. A total of 364 and 1,337 patients were included in the pharmacoinvasive and PPCI groups, respectively...
June 15, 2016: American Journal of Cardiology
Christopher J McLeod, Bernard J Gersh
No abstract text is available yet for this article.
May 9, 2016: JACC. Cardiovascular Interventions
Megha Prasad, Jeffrey B Geske, Paul Sorajja, Steve R Ommen, Hartzell V Schaff, Bernard J Gersh, Rick A Nishimura
OBJECTIVES: We aimed to assess the utility of changes in systolic and diastolic function by isoproterenol challenge in predicting symptom resolution post-myectomy in selected patients with hypertrophic cardiomyopathy (HCM) and labile obstruction. BACKGROUND: In a subset of symptomatic HCM patients without resting/provocable obstruction on noninvasive assessment, isoproterenol challenge during hemodynamic catheterization may elicit labile left ventricular outflow tract (LVOT) obstruction, and demonstrate the effect of obstruction on diastolic function...
April 6, 2016: Catheterization and Cardiovascular Interventions
Karen Sliwa, Letitia Acquah, Bernard J Gersh, Ana Olga Mocumbi
Africa is a continent characterized by marked ethnic, sociodemographic, and economic diversity, with profound changes in many regions over the past 2 decades. This diversity has an impact on cardiovascular disease presentation and outcomes. Within Africa and within the individual countries, one can find regions having predominantly communicable diseases such as rheumatic heart disease, tuberculous pericarditis, or cardiomyopathy and others having a marked increase in noncommunicable disease such as hypertension and hypertensive heart disease...
March 22, 2016: Circulation
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