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https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#1
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29330214/statins-have-a-dose-dependent-effect-on-amputation-and-survival-in-peripheral-artery-disease-patients
#2
Shipra Arya, Anjali Khakharia, Zachary O Binney, Randall R DeMartino, Luke P Brewster, Philip P Goodney, Peter W F Wilson
Background -Statin dose guidelines for Peripheral Artery Disease (PAD) patients are largely based on coronary artery disease and stroke data. The aim of this study is to determine the effect of statin intensity on PAD outcomes of amputation and mortality. Methods -Using an observational cohort study design and a validated algorithm we identified incident PAD patients (2003-2014) in the national Veterans Affairs data. Highest statin intensity exposure [high intensity vs low- moderate intensity vs antiplatelet therapy but no statin use (AP only)] was determined within one year of diagnosis of PAD...
January 12, 2018: Circulation
https://www.readbyqxmd.com/read/29329818/hybrid-imaging-in-ischemic-heart-disease
#3
Andreas A Giannopoulos, Oliver Gaemperli
Hybrid imaging for ischemic heart disease refers to the fusion of information from a single or usually from multiple cardiovascular imaging modalities enabling synergistic assessment of the presence, the extent, and the severity of coronary atherosclerotic disease along with the hemodynamic significance of lesions and/or with evaluation of the myocardial function. A combination of coronary computed tomography angiography with myocardial perfusion imaging, such as single-photon emission computed tomography and positron emission tomography, has been adopted in several centers and implemented in international coronary artery disease management guidelines...
January 9, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29317977/stemi-due-to-big-ostial-left-main-thrombus-extending-into-aorta-challenging-situation-with-no-clear-guidelines
#4
Mohammady Shahin, Oliver Gaemperli, Patrick Siegrist, Jasmina Alibegovic
Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29315259/the-evolving-treatment-of-peripheral-arterial-disease-through-guideline-directed-recommendations
#5
REVIEW
Ramez Morcos, Boshra Louka, Andrew Tseng, Sanjay Misra, Robert McBane, Heidi Esser, Fadi Shamoun
Peripheral arterial disease (PAD) refers to partial or complete occlusion of one or more non-coronary arteries that leads to compromised blood flow and ischemia. Numerous processes are involved in arterial stenosis, however, atherosclerosis remains the most common etiology. PAD constitutes a major health economic problem, and it is estimated that over 200 million people around the world suffer from PAD, with at least 20% having some degree of claudication. The purpose of this review is to compare and contrast the guidelines on PAD published in 2005, 2011 and 2016 in terms of new recommendations and level of evidence for practicing clinicians...
January 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29301713/the-coronary-artery-disease-reporting-and-data-system-cad-rads-prognostic-and-clinical-implications-associated-with-standardized-coronary-computed-tomography-angiography-reporting
#6
Joe X Xie, Ricardo C Cury, Jonathon Leipsic, Matthew T Crim, Daniel S Berman, Heidi Gransar, Matthew J Budoff, Stephan Achenbach, Bríain Ó Hartaigh, Tracy Q Callister, Hugo Marques, Ronen Rubinshtein, Mouaz H Al-Mallah, Daniele Andreini, Gianluca Pontone, Filippo Cademartiri, Erica Maffei, Kavitha Chinnaiyan, Gilbert Raff, Martin Hadamitzky, Joerg Hausleiter, Gudrun Feuchtner, Allison Dunning, Augustin DeLago, Yong-Jin Kim, Philipp A Kaufmann, Todd C Villines, Benjamin J W Chow, Niree Hindoyan, Millie Gomez, Fay Y Lin, Erica Jones, James K Min, Leslee J Shaw
OBJECTIVES: This study sought to assess clinical outcomes associated with the novel Coronary Artery Disease-Reporting and Data System (CAD-RADS) scores used to standardize coronary computed tomography angiography (CTA) reporting and their potential utility in guiding post-coronary CTA care. BACKGROUND: Clinical decision support is a major focus of health care policies aimed at improving guideline-directed care. Recently, CAD-RADS was developed to standardize coronary CTA reporting and includes clinical recommendations to facilitate patient management after coronary CTA...
January 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29300792/management-of-acute-coronary-syndromes-in-patients-with-diabetes
#7
Peter P Toth
Given the heightened risk for adverse cardiovascular outcomes in patients with diabetes mellitus, it is important that primary care clinicians be comfortable with the routine management of acute coronary syndromes (ACS) in this patient population. Notably, patients with diabetes are more likely to present atypically during an ACS. To improve health outcomes, patients with a history of diabetes and ACS should be evaluated for peripheral arterial disease and encouraged to pursue cardiac rehabilitation. Clinicians should also be cognizant of the high rate of polypharmacy in patients with diabetes and the potential glycemic and cardioprotective impact of medications they prescribe for these patients...
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29281086/characteristics-of-patients-with-atrial-fibrillation-prescribed-antiplatelet-monotherapy-compared-with-those-on-anticoagulants-insights-from-the-garfield-af-registry
#8
Freek W A Verheugt, Haiyan Gao, Wael Al Mahmeed, Giuseppe Ambrosio, Pantep Angchaisuksiri, Dan Atar, Jean-Pierre Bassand, A John Camm, Frank Cools, John Eikelboom, Gloria Kayani, Toon Wei Lim, Frank Misselwitz, Karen S Pieper, Martin van Eickels, Ajay K Kakkar
Aims: Current atrial fibrillation (AF) guidelines discourage antiplatelet (AP) monotherapy as alternative to anticoagulants (ACs). Why AP only is still used is largely unknown. Methods and results: Factors associated with AP monotherapy prescription were analysed in GARFIELD-AF, a registry of patients with newly diagnosed (≤6 weeks) AF and ≥1 investigator-determined stroke risk factor. We analysed 51 270 patients from 35 countries enrolled into five sequential cohorts between 2010 and 2016...
December 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29276925/-ischemia-the-largest-ever-r-andomized-study-in-stable-coronary-artery-disease-baseline-characteristics-of-enrolled-patients-in-one-russian-site
#9
S A Sayganov, L L Bershteyn, A E Andreeva, N O Katamadze, E V Zbyshevskaya, A M Kuzmina-Krutetskaya, A V Volkov, V E Gumerova, F I Bitakova
Indications for coronary revascularization in patients with stable coronary heart disease (CHD), presented in the current international guidelines are largely based on the clinical trials conducted sometimes more than 30 years ago. ISCHEMIA is the major multicenter international randomized trial intended to answer the question about the optimal treatment strategy in stable coronary artery disease at the present time. PURPOSE: To analyze the most important baseline characteristics of patients enrolled in the ISCHEMIA study in one Russian site...
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29275344/effects-of-a-12-week-cardiovascular-rehabilitation-programme-on-systemic-inflammation-and-traditional-coronary-artery-disease-risk-factors-in-patients-with-rheumatoid-arthritis-cardia-trial-a-randomised-controlled-trial
#10
Stefan Heinze-Milne, Volodko Bakowsky, Nicholas Giacomantonio, Scott A Grandy
INTRODUCTION: Patients with systemic inflammatory diseases such as rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) above the baseline risk attributable to traditional CVD risk factors seen in the general population. Exercise in cardiac rehabilitation (CR) is designed specifically for high-risk primary prevention and those with established CVD. Even though the European League Against Rheumatism guidelines state that exercise is safe for individuals with RA and exercise can reduce CVD risk, patients with RA rarely participate in CR...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29273856/treatment-patterns-and-low-density-lipoprotein-cholesterol-ldl-c-goal-attainment-among-patients-receiving-high-or-moderate-intensity-statins
#11
Kathleen M Fox, Ming-Hui Tai, Karel Kostev, Maximilian Hatz, Yi Qian, Ulrich Laufs
BACKGROUND: European clinical guidelines recommend a low-density lipoprotein cholesterol (LDL-C) goal of < 70 mg/dL. Statin use varies and past studies suggest low rates of real-world goal attainment. This study describes LDL-C goal attainment among atherosclerotic CV disease (ASCVD) patients with various utilization patterns of moderate- or high-intensity statins in routine care. METHODS: This retrospective cohort study used electronic medical records data from the QuintilesIMS® Disease Analyzer (> 2 million individuals annually) to identify ASCVD (coronary atherosclerosis, stable/unstable angina, myocardial infarction, ischemic stroke, transient ischemic attack, aneurysm, peripheral artery disease) patients on moderate-/high-intensity statin in Germany...
December 22, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29260404/new-treatment-options-for-lipid-lowering-therapy-in-subjects-with-type-2-diabetes
#12
Roberto Scicali, Antonino Di Pino, Viviana Ferrara, Francesca Urbano, Salvatore Piro, Agata Maria Rabuazzo, Francesco Purrello
Dyslipidemias represent a variety of quantitative and/or qualitative lipoprotein abnormalities. According to etiology, we distinguish primary dyslipidemias with strictly genetic background and secondary ones with their origin in other disease or pathological states. Diabetic dyslipidemia is a type of secondary dyslipidemia and plays an important role in determining the cardiovascular risk of subjects with type 2 diabetes. In these patients, insulin resistance is responsible for overproduction and secretion of atherogenic very low density lipoprotein...
December 19, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29251761/single-pill-combinations-spcs-and-treatment-of-arterial-hypertension-in-poland-expert-consensus-statement-of-the-polish-society-of-hypertension-and-polish-cardiac-society-working-group-on-cardiovascular-pharmacotherapy
#13
Andrzej Tykarski, Krystyna Widecka, Krzysztof Narkiewicz, Beata Wożakowska-Kapłon, Zbigniew Gaciong, Stefan Grajek, Tomasz Grodzicki, Andrzej Januszewicz, Jacek Wolf, Aleksander Prejbisz, Katarzyna Kostka-Jeziorny, Krzysztof J Filipiak
The reasons for the publication of current expert consensus statement after 4 years from the previous one are: the growing number of evidence on the benefits of the use of single-pill combinations (SPCs) in hypertension (also with concomitant dyslipidaemia), the extension of indications for their use in the hypertension management algorithm and the emergence in recent years after the publication of Polish Society of Hypertension experts' position statement in 2013 of new types of SPCs available to doctors in Poland, including triple-drug combinations of antihypertensives and the so-called "hybrids" SPCs containing not only antihypertensive drugs but also statins...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29249436/identification-of-patients-with-stable-chest-pain-deriving-minimal-value-from-coronary-computed-tomography-angiography-an-external-validation-of-the-promise-minimal-risk-tool
#14
Philip D Adamson, Christopher B Fordyce, David A McAllister, James E Udelson, Pamela S Douglas, David E Newby
BACKGROUND: The PROspective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) minimal-risk tool was recently developed to identify patients with suspected stable angina at very low risk of coronary artery disease (CAD) and clinical events. We assessed the external validity of this tool within the context of the Scottish Computed Tomography of the HEART (SCOT-HEART) multicenter randomised controlled trial of patients with suspected stable angina due to coronary disease. METHODS: The minimal-risk tool was applied to 1764 patients with complete imaging and follow-up data...
February 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29248657/comprehensive-cardiac-ct-with-myocardial-perfusion-imaging-versus-functional-testing-in-suspected-coronary-artery-disease-the-multicenter-randomized-crescent-ii-trial
#15
Marisa Lubbers, Adriaan Coenen, Marcel Kofflard, Tobias Bruning, Bas Kietselaer, Tjebbe Galema, Marc Kock, Andre Niezen, Marco Das, Marco van Gent, Ewout-Jan van den Bos, Leon van Woerkens, Paul Musters, Suze Kooij, Fay Nous, Ricardo Budde, Miriam Hunink, Koen Nieman
OBJECTIVES: This study sought to assess the effectiveness, efficiency, and safety of a tiered, comprehensive cardiac computed tomography (CT) protocol in comparison with functional testing. BACKGROUND: Although CT angiography accurately rules out coronary artery disease (CAD), incorporation of CT myocardial perfusion imaging as part of a tiered diagnostic approach could improve the clinical value and efficiency of cardiac CT in the diagnostic work-up of patients with angina pectoris...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29246884/mortality-of-myocardial-infarction-by-sex-age-and-obstructive-coronary-artery-disease-status-in-the-action-registry-gwtg-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#16
Nathaniel R Smilowitz, Asha M Mahajan, Matthew T Roe, Anne S Hellkamp, Karen Chiswell, Martha Gulati, Harmony R Reynolds
BACKGROUND: Sex differences in early mortality after myocardial infarction (MI) vary by age. MI with nonobstructive coronary arteries (MINOCA [<50% stenosis]) is more common among younger patients and women, and MINOCA has a better prognosis than MI with obstructive coronary artery disease (MI-CAD). The relationship between age, sex, and obstructive CAD status and outcomes post-MI has not been established. METHODS AND RESULTS: Adults who underwent coronary angiography for acute ST-segment-elevation and non-ST-segment-elevation MI in the National Cardiovascular Data Registry ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines) from 2007 to 2014 were identified...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29217675/ten-year-mortality-in-the-wise-study-women-s-ischemia-syndrome-evaluation
#17
Tanya S Kenkre, Pankaj Malhotra, B Delia Johnson, Eileen M Handberg, Diane V Thompson, Oscar C Marroquin, William J Rogers, Carl J Pepine, C Noel Bairey Merz, Sheryl F Kelsey
BACKGROUND: The WISE study (Women's Ischemia Syndrome Evaluation) was a prospective cohort study of 936 clinically stable symptomatic women who underwent coronary angiography to evaluate symptoms and signs of ischemia. Long-term mortality data for such women are limited. METHODS AND RESULTS: Obstructive coronary artery disease (CAD) was defined as ≥50% stenosis on angiography by core laboratory. We conducted a National Death Index search to assess the mortality of women who were alive at their final WISE contact date...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29215404/quality-and-safety-in-health-care-part-xxxiv-coronary-artery-disease-secondary-prevention-medications
#18
Jay A Harolds
There is an important opportunity for improvement in the care of cardiology outpatients by having greater compliance with published guidelines, and the PINNACLE (Practice Innovation and Clinical Excellence) Registry seeks to do that. One of the major areas studied by this registry is the use of secondary prevention medications for patients with coronary artery disease. Appropriate use of these medications decreases later myocardial infarctions and death from a cardiac cause.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215402/quality-and-safety-in-health-care-part-xxxiv-the-pinnacle-registry
#19
Jay A Harolds
The PINNACLE (Practice INNovation And Clinical Excellence) program was started in 2008 by the American College of Cardiology and its National Cardiovascular Data Registry. This was the first and now the largest countrywide prospective registry to improve care quality for cardiac outpatients. The registry focuses on reporting about the adherence to guidelines in treating individuals with high blood pressure, atrial fibrillation, coronary artery disease, and/or cardiac failure.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29214822/meeting-sleep-guidelines-is-associated-with-better-health-related-quality-of-life-and-reduced-premature-all-cause-mortality-risk
#20
Paul D Loprinzi, Chelsea Joyner
PURPOSE: To examine whether meeting sleep guidelines (7-9 hours/night) is associated with better health-related quality of life (HRQOL) and reduced all-cause mortality risk. DESIGN: Prospective cohort study. SETTING: 2005 to 2010 National Health and Nutrition Examination Survey. PARTICIPANTS: A total of 13 423 adults. MEASURES: Sleep duration and HRQOL were assessed from self-report; covariates assessed via survey, examination, and laboratory data; and mortality assessed through 2011 via matching from the National Death Index...
January 2018: American Journal of Health Promotion: AJHP
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