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coronary artery disease guidelines

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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
#1
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/28816537/evaluating-the-prescription-of-angiotensin-converting-enzyme-inhibitors-or-receptor-blockers-in-patients-with-diabetes-in-jordan
#2
Fadia Mayyas, Wa'ed Bataineh, Anan Jarab
OBJECTIVE: The angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are guideline-recommended agents to prevent development and progression of nephropathy and cardiovascular diseases in diabetic Mellitus (DM). The aim of this study was to evaluate the prescription of ACEIs/ARBs in DM patients with guideline indications. METHOD: electronic data files for diabetes patients were retrospectively reviewed at a primary care setting northern Jordan...
August 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28814233/statins-in-acute-coronary-syndromes
#3
Manolis Vavuranakis, Maria Kariori, Gerasimos Siasos, Konstantinos Kalogeras, Dimitris Tousoulis
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28807954/acetylsalicylic-acid-for-children-with-kawasaki-disease
#4
Teeranai Sakulchit, Susanne M Benseler, Ran D Goldman
Question A 7-year-old child in my office was recently discharged from the hospital after receiving intravenous immunoglobulin for Kawasaki disease. Should I continue treatment with acetylsalicylic acid (ASA), and if so, what is the appropriate dose? Answer The role of ASA for Kawasaki disease during the acute febrile phase has recently been called into question. According to several studies, ASA might reduce the duration of fever but it does not appear to directly reduce the incidence of coronary artery complications...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28801030/lipoprotein-a-screening-in-patients-with-controlled-traditional-risk-factors-undergoing-percutaneous-coronary-intervention
#5
Matthew C Weiss, Jeffrey S Berger, Eugenia Gianos, Edward Fisher, Arthur Schwartzbard, James Underberg, Howard Weintraub
BACKGROUND: Lipoprotein(a) [Lp(a)] is an inherited atherogenic lipoprotein and an independent risk factor for atherosclerotic cardiovascular disease; however, its clinical role remains limited. OBJECTIVE: We hypothesized that Lp(a) screening in high cardiovascular risk patients could provide insight into disease pathogenesis and modify physician behavior for treatment intensification targeting traditional risk factors when Lp(a)-related risk was identified. METHODS: We screened 113 patients presenting electively for percutaneous coronary intervention (PCI) for Lp(a) who met any of the following criteria: (1) premature coronary artery disease (male age <55 years, female age <65 years); (2) family history of premature coronary artery disease; (3) progression to PCI despite well-controlled traditional risk factors (blood pressure <140/90 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL, and HbA1c <7%, and nonsmoker); or (4) progression to PCI despite at least moderate intensity statin use (simvastatin 40, atorvastatin 40-80, or rosuvastatin 20-40 mg daily)...
July 22, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#6
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#7
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28797011/the-coronary-heart-team
#8
Bobby Yanagawa, John D Puskas, Deepak L Bhatt, Subodh Verma
PURPOSE OF REVIEW: The concept of a Coronary Heart Team has generated increased interest, including support from major practice guidelines. Here, we review the rationale and the published experience of Coronary Heart Teams. RECENT FINDINGS: A Coronary Heart Team should be led by both cardiology and cardiac surgery with a shared decision-making approach. The team should incorporate data from anatomic and clinical risk prediction models to offer individualized care...
September 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28792141/validation-of-a-newly-developed-equation-for-estimating-serum-apolipoprotein-b-associations-with-cardiovascular-disease-surrogate-markers-in-koreans
#9
Jong Dai Kim, You Cheol Hwang, Hong Yup Ahn, Cheol Young Park
PURPOSE: Many clinical guidelines recommend apolipoprotein B (apoB) measurement, particularly in subjects with metabolic syndrome or type 2 diabetes. Recently, we developed a new equation to estimate serum apoB (apoBE). We validated the clinical relevance of apoBE and compared the performance of the equation with conventional lipid measurements and direct measurement of apoB. MATERIALS AND METHODS: Study subjects were recruited from patients who visited the Health Screening Center at Kangbuk Samsung Hospital between January and December 2009 for routine medical examinations (n=78125)...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28782466/current-status-of-renal-artery-angioplasty-and-stenting-for-resistant-hypertension-a-case-series-and-review-of-the-literature
#10
Antonis S Manolis, Antonis A Manolis, Helen Melita
BACKGROUND: Renal artery stenosis (RAS) has a high prevalence in older patients, especially in the context of general atherosclerosis. It is frequently associated with resistant hypertension and impaired renal function and their attendant consequences. The issue whether revascularization via percutaneous renal angioplasty and stenting (PRA/S) can benefit these patients remains unsettled. OBJECTIVE: To present a case series of patients with refractory hypertension and RAS undergoing PRA/S and also to provide an extensive review of the literature on the current status of PRA/S for resistant hypertension...
August 4, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28766924/factors-associated-with-performing-urgent-coronary-angiography-in-out-of-hospital-cardiac-arrest-patients
#11
David H Lam, Lauren M Glassmoyer, Jordan B Strom, Roger B Davis, James M McCabe, Donald E Cutlip, Michael W Donnino, Michael N Cocchi, Duane S Pinto
OBJECTIVES: Factors associated with performing urgent coronary angiography (UCA) in patients with out-of-hospital cardiac arrest (OHCA) were identified. BACKGROUND: Current guidelines for resuscitated OHCA patients recommend UCA if there is ST-elevation on post-arrest electrocardiogram or high suspicion of acute myocardial infarction. Some have advocated for UCA in all OHCA regardless of suspected etiology. The reasons for variations in performing UCA are not well understood...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28765738/baseline-characteristics-of-a-retrospective-patient-cohort-in-the-korean-vascular-intervention-society-endovascular-therapy-in-lower-limb-artery-diseases-k-vis-ella-registry
#12
Young-Guk Ko, Chul-Min Ahn, Pil-Ki Min, Jae-Hwan Lee, Chang-Hwan Yoon, Cheol Woong Yu, Seung Whan Lee, Sang-Rok Lee, Seung Hyuk Choi, Yoon Seok Koh, In-Ho Chae, Donghoon Choi
BACKGROUND AND OBJECTIVES: The Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry is a multicenter observational study with retrospective and prospective cohorts of patients with lower extremity peripheral artery disease (PAD) undergoing endovascular treatment. In this study, we report the baseline characteristics of this retrospective cohort. SUBJECTS AND METHODS: In the present study we analyzed datasets of 3073 patients with 3972 target limbs from a retrospective cohort treated with endovascular therapy in 31 Korean hospitals...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28765182/a-vulnerable-plaque-identified-on-ct-coronary-angiography-when-should-we-act-in-stable-coronary-artery-disease
#13
Sarah R Blake, Thomas D Heseltine, Scott Murray, Balazs Ruzsics
CT coronary angiography (CTCA) is increasingly being used to diagnose coronary artery disease (CAD). Recent technological advancements, including dual energy CT and improved gantry times, have led to the ability to image coronary arteries with excellent spatial resolution at low radiation doses. Atheromatous plaques can be identified using CTCA and assessed to establish the risk of acute coronary syndrome from each individual plaque. If CTCA identifies CAD, it should then be used in conjunction with functional testing or invasive angiography with physiological assessment to establish the significance of coronary disease in an individual patient...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#14
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28760215/interventions-supporting-long-term-adherence-and-decreasing-cardiovascular-events-island-pragmatic-randomized-trial-protocol
#15
RANDOMIZED CONTROLLED TRIAL
Noah Ivers, J-D Schwalm, Holly O Witteman, Justin Presseau, Monica Taljaard, Tara McCready, Beth Bosiak, Jennifer Cunningham, Shelley Smarz, Laura Desveaux, Jack V Tu, Clare Atzema, Garth Oakes, Wanrudee Isaranuwatchai, Sherry L Grace, R Sacha Bhatia, Madhu Natarajan, Jeremy M Grimshaw
BACKGROUND: Guidelines recommend cardiac rehabilitation and long-term use of cardiac medications for most patients who have had a myocardial infarction (MI), but adherence to these secondary prevention treatments is suboptimal. METHODS: This is a multicenter, pragmatic, 3-arm randomized trial. Eligible patients (n = 2,742) with obstructive coronary artery disease are randomized post-MI to usual care or 1 of 2 intervention arms. Patients in the first intervention arm receive mail-outs sent on behalf of their cardiologist at 4, 8, 20, 32, and 44 weeks post-MI; content is designed to address determinants of adherence and facilitate discussion between the patient and their health care team...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28759470/percutaneous-coronary-intervention-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease
#16
Michael P Thomas, Eric R Bates
PURPOSE OF REVIEW: This review aims to summarize recent reports on percutaneous coronary intervention (PCI) strategies for patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). RECENT FINDINGS: Recent randomized clinical trials and meta-analyses have suggested that patients with STEMI and multivessel CAD may benefit more from multivessel PCI (either multivessel primary PCI or staged PCI before hospital discharge) than culprit vessel-only primary PCI...
July 29, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28756079/-exercise-testing-new-guidelines
#17
Dany Michel Marcadet
The GERS (Exercise Rehabilitation and Sports Group of the French Society of Cardiology) has decided to update current guidelines regarding the practice of EKG stress tests. Since the last update dates from 1997, the GERS judged it necessary to integrate data from new works and advancements made in the last 20 years. Good clinical practices and safety conditions are better defined regarding the structure, location, material, staff competency, as well as convention with hospital structures. The diagnosis of coronary artery disease remains the principal indication for a stress test...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28754397/contemporary-atrial-fibrillation-management-a-comparison-of-the-current-aha-acc-hrs-ccs-and-esc-guidelines
#18
REVIEW
Jason G Andrade, Laurent Macle, Stanley Nattel, Atul Verma, John Cairns
In this article we compare and contrast the current recommendations, and highlight the important differences, in the American College of Cardiology/American Heart Association/Heart Rhythm Society, European Society of Cardiology, and Canadian Cardiovascular Society atrial fibrillation (AF) guidelines. Although many of the recommendations of the various societies are similar, there are important differences in the methodologies underlying their development and the specific content. Specifically, key differences can be observed in: (1) the definition of nonvalvular AF, which subsequently affects anticoagulation choices and candidacy for non-vitamin K antagonist oral anticoagulants; (2) the symptom score used to guide management decisions and longitudinal patient profiling; (3) the stroke risk stratification algorithm used to determine indications for oral anticoagulant therapy; (4) the role of acetylsalicylic acid in stroke prevention in AF; (5) the antithrombotic regimens used in the context of coronary artery disease, acute coronary syndromes, and percutaneous coronary intervention; (6) the rate control target and medications recommended to achieve the target; and (7) the role of "first-line" catheter ablation, open surgical ablation, and left atrial appendage exclusion...
August 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28754155/magnetic-resonance-adenosine-perfusion-imaging-as-gatekeeper-of-invasive-coronary-intervention-magnet-study-protocol-for-a-randomized-controlled-trial
#19
Dominik Buckert, Simon Witzel, Maciej Cieslik, Raid Tibi, Wolfgang Rottbauer, Peter Bernhardt
BACKGROUND: Current guidelines for the diagnosis and management of patients with stable coronary artery disease (CAD) recommend functional stress testing for risk stratification prior to revascularization procedures. Cardiac magnetic resonance imaging (CMR) is a modality of choice for stress testing because of its capability to detect myocardial ischemia sensitively and specifically. Nevertheless, evidence from randomized trials evaluating a CMR-based management of stable CAD patients in comparison to a more common angiography-based approach still is limited...
July 28, 2017: Trials
https://www.readbyqxmd.com/read/28751537/management-of-kawasaki-disease-in-adults
#20
REVIEW
Kara J Denby, Daniel E Clark, Larry W Markham
Kawasaki disease is the most common childhood vasculitis in the USA and the most common cause of acquired cardiac disease in children in developed countries. Since the vast majority of Kawasaki disease initially presents at <5 years of age, many adult cardiologists are unfamiliar with the pathophysiology of this disease. This vasculitis has a predilection for coronary arteries with a high complication rate across the lifespan for those with medium to large coronary artery aneurysms. An inflammatory cascade produces endothelial dysfunction and damage to the vascular wall, leading to aneurysmal dilatation...
July 27, 2017: Heart: Official Journal of the British Cardiac Society
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