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https://www.readbyqxmd.com/read/28275938/role-of-coronary-calcium-for-risk-stratification-and-prognostication
#1
REVIEW
Negin Nezarat, Michael Kim, Matthew Budoff
A multitude of studies now support the understanding that an increased coronary artery calcium (CAC) score represents advanced atherosclerosis and high risk for cardiovascular disease (CVD) and, as such, should be treated with conventional therapies for those considered high risk. Data is now available to guide treatment with aspirin, statins, and lifestyle management. The new ACC/AHA 2013 guidelines support intensifying statin therapy when the CAC is ≥75th percentile for age, sex, and ethnicity/race or when the calcium score is ≥300 Agatston units...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28275165/predicting-cardiovascular-events-in-familial-hypercholesterolemia-the-safeheart-registry
#2
Leopoldo Pérez de Isla, Rodrigo Alonso, Nelva Mata, Cristina Fernández-Pérez, Ovidio Muñiz, José Luis Díaz-Díaz, Adriana Saltijeral, Francisco J Fuentes-Jiménez, Raimundo de Andrés, Daniel Zambón, Mar Piedecausa, José María Cepeda, Marta Mauri, Jesús Galiana, Ángel Brea, Juan F Sanchez Muñoz-Torrero, Teresa Padró, Rosa Argueso, José Pablo Miramontes-González, Lina Badimón, Raúl D Santos, Gerald F Watts, Pedro Mata
Background -Although risk factors for atherosclerotic cardiovascular disease (ASCVD) in familial hypercholesterolaemia (FH) have been described, models for predicting incident ASCVD have not been reported. Our aim was to utilise the SAFEHEART registry to define key risk factors for predicting incident ASCVD in patients with FH. Methods -SAFEHEART is a multicentre, nationwide, long-term prospective cohort study of a molecularly-defined population with FH, with or without previous ASCVD. Analysis to define risk factors and to build a risk prediction equation were developed and tested for its ability to discriminate patients who experience incident ASCVD from those who did not over time...
March 8, 2017: Circulation
https://www.readbyqxmd.com/read/28112798/multidisciplinary-perioperative-protocol-in-patients-undergoing-acute-high-risk-abdominal-surgery
#3
L T Tengberg, M Bay-Nielsen, T Bisgaard, M Cihoric, M L Lauritsen, N B Foss
BACKGROUND: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery. METHODS: The AHA study was a prospective single-centre controlled study in consecutive patients undergoing AHA surgery, defined as major abdominal pathology requiring emergency laparotomy or laparoscopy including reoperations after elective gastrointestinal surgery...
March 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#4
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28002833/quality-of-evidence-underlying-the-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guidelines-on-the-management-of-atrial-fibrillation
#5
Adam S Barnett, William R Lewis, Michael E Field, Gregg C Fonarow, Bernard J Gersh, Richard L Page, Hugh Calkins, Benjamin A Steinberg, Eric D Peterson, Jonathan P Piccini
Importance: The joint American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) guidelines on the management of atrial fibrillation (AF) are used extensively to guide patient care. Objective: To describe the evidence base and changes over time in the AHA/ACC/HRS guidelines on AF with respect to the distribution of recommendations across classes of recommendations and levels of evidence. Data Sources: Data from the AHA/ACC/HRS guidelines on AF from 2001, 2006, 2011, and 2014 were abstracted...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/27881560/coronary-artery-calcium-to-guide-a-personalized-risk-based-approach-to-initiation-and-intensification-of-antihypertensive-therapy
#6
John W McEvoy, Seth S Martin, Zeina A Dardari, Michael D Miedema, Veit Sandfort, Joseph Yeboah, Matthew J Budoff, David C Goff, Bruce M Psaty, Wendy S Post, Khurram Nasir, Roger S Blumenthal, Michael J Blaha
BACKGROUND: The use of atherosclerotic cardiovascular disease (ASCVD) risk to personalize systolic blood pressure (SBP) treatment goals is a topic of increasing interest. Therefore, we studied whether coronary artery calcium (CAC) can further guide the allocation of anti-hypertensive treatment intensity. METHODS: We included 3733 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with SBP between 120 and 179 mm Hg. Within subgroups categorized by both SBP (120-139 mm Hg, 140-159 mm Hg, and 160-179 mm Hg) and estimated 10-year ASCVD risk (using the American College of Cardiology/American Heart Assocation pooled-cohort equations), we compared multivariable-adjusted hazard ratios for the composite outcome of incident ASCVD or heart failure after further stratifying by CAC (0, 1-100, or >100)...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/27865187/final-shape-of-biovascular-scaffolds-and-clinical-outcome-results-from-a-multicenter-all-comers-study-with-intravascular-imaging
#7
Bernardo Cortese, Davide Piraino, Roberto A Latini, Dennis Zavalloni, Alfonso Ielasi, Piefrancesco Agostoni, Pietro Mazzarotto, Maurizio Tespili, Romano Seregni
AIMS: Radial strength of bioresorbable vascular scaffolds (BVS) implanted in coronary arteries is still under debate. Moreover, their final shape patterns, when implanted in an all-comer, unselected population, have not yet been completely correlated with clinical outcome and should be better investigated. METHODS AND RESULTS: A multicenter collaborative analysis was performed on all consecutive patients with native coronary artery disease undergoing PCI with intravascular imaging-guided BVS implantation...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27784010/clinical-application-of-biomarkers-in-heart-failure-with-a-preserved-ejection-fraction-a-review
#8
Aakash Garg, Deepti Virmani, Sahil Agrawal, Chirag Agarwal, Abhishek Sharma, Giulio Stefanini, John B Kostis
Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF)...
2017: Cardiology
https://www.readbyqxmd.com/read/27754284/me-04-2-aortic-pwv-for-risk-stratification-in-hypertension
#9
Jeong Bae Park
High pressure of the blood in artery is a common condition and it is closely related to cardiovascular (CV) diseases in future. Blood pressure itself is the most important criteria for hypertension prognosis but attempts are being made to detect hypertensive vascular changes early. Healthy arteries are flexible, strong and elastic but if the condition of high blood pressure persists, arteries turn narrow, thick and stiff, become a condition of arteriosclerosis. And so now, pulse wave velocity (PWV) which measures arteriosclerosis became one of the clinically significant method that evaluates CV risks among patients in hypertension (yes, it is also very important for general population), detects biological changes in blood vessels caused by hypertension, and it is known as a guide for hypertension management...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27746074/-changes-in-the-international-recommendations-on-neonatal-stabilisation-and-resuscitation-2015
#10
Gonzalo Zeballos Sarrato, Enrique Salguero García, Josefa Aguayo Maldonado, Celia Gómez Robles, Marta Thió Lluch, Martín Iriondo Sanz
The International Liaison Committee on Resuscitation (ILCOR) recommendations provide a universal guide of measures to support the transition and resuscitation of newborn after their birth. This guide is expected to be adapted by local groups or committees on resuscitation, according to their own circumstances. The objective of this review is to analyse the main changes, to discuss several of the controversies that have appeared since 2010, and contrasting with other national and international organisations, such as European Resuscitation Council (ERC), American Heart Association (AHA), or the Australian-New Zealand Committee on Resuscitation (ANZCOR)...
January 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27682885/predicting-the-10-year-risks-of-atherosclerotic-cardiovascular-disease-in-chinese-population-the-china-par-project-prediction-for-ascvd-risk-in-china
#11
Xueli Yang, Jianxin Li, Dongsheng Hu, Jichun Chen, Ying Li, Jianfeng Huang, Xiaoqing Liu, Fangchao Liu, Jie Cao, Chong Shen, Ling Yu, Fanghong Lu, Xianping Wu, Liancheng Zhao, Xigui Wu, Dongfeng Gu
BACKGROUND: The accurate assessment of individual risk can be of great value to guiding and facilitating the prevention of atherosclerotic cardiovascular disease (ASCVD). However, prediction models in common use were formulated primarily in white populations. The China-PAR project (Prediction for ASCVD Risk in China) is aimed at developing and validating 10-year risk prediction equations for ASCVD from 4 contemporary Chinese cohorts. METHODS: Two prospective studies followed up together with a unified protocol were used as the derivation cohort to develop 10-year ASCVD risk equations in 21 320 Chinese participants...
November 8, 2016: Circulation
https://www.readbyqxmd.com/read/27681577/update-on-hypertrophic-cardiomyopathy-and-a-guide-to-the-guidelines
#12
REVIEW
Srijita Sen-Chowdhry, Daniel Jacoby, James C Moon, William J McKenna
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment...
November 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27673575/knowledge-gaps-in-cardiovascular-care-of-older-adults-a-scientific-statement-from-the-american-heart-association-american-college-of-cardiology-and-american-geriatrics-society-executive-summary
#13
Michael W Rich, Deborah A Chyun, Adam H Skolnick, Karen P Alexander, Daniel E Forman, Dalane W Kitzman, Mathew S Maurer, James B McClurken, Barbara M Resnick, Win K Shen, David L Tirschwell
The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease (CVD) is the leading cause of death and major disability in adults aged 75 and older. Despite the effect of CVD on quality of life, morbidity, and mortality in older adults, individuals aged 75 and older have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older adults with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in nursing homes and assisted living facilities...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27661783/hypertension-management-in-the-oldest-old-findings-from-a-large-long-term-care-facility
#14
Susan Schwinn, Robin McKay, Shirley Dinkel, Bobbe Mansfield, Brooke Faria Da Cunha, Savanna Cummins, Krystal Brunin
PURPOSE: The purpose of this quality improvement project was to evaluate hypertension (HTN) management in patients 80 years of age and older who reside in a large, long-term care (LTC) facility. DATA SOURCE: A retrospective chart audit was conducted on 75 charts of patients 80 years of age and older and who had a diagnosis of HTN. Using the 2011 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Expert Consensus Document on Management of Hypertension in the Elderly as a guide, blood pressure readings, significant comorbidities, and antihypertensive medication utilization were analyzed...
September 23, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27643282/me-04-2-aortic-pwv-for-risk-stratification-in-hypertension
#15
Jeong Bae Park
High pressure of the blood in artery is a common condition and it is closely related to cardiovascular (CV) diseases in future. Blood pressure itself is the most important criteria for hypertension prognosis but attempts are being made to detect hypertensive vascular changes early. Healthy arteries are flexible, strong and elastic but if the condition of high blood pressure persists, arteries turn narrow, thick and stiff, become a condition of arteriosclerosis. And so now, pulse wave velocity (PWV) which measures arteriosclerosis became one of the clinically significant method that evaluates CV risks among patients in hypertension (yes, it is also very important for general population), detects biological changes in blood vessels caused by hypertension, and it is known as a guide for hypertension management...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27561760/a-simple-disease-guided-approach-to-personalize-acc-aha-recommended-statin%C3%A2-allocation-in-elderly-people-the-bioimage-study
#16
Martin Bødtker Mortensen, Valentin Fuster, Pieter Muntendam, Roxana Mehran, Usman Baber, Samantha Sartori, Erling Falk
BACKGROUND: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines recommend primary prevention with statins for individuals with ≥7.5% 10-year risk for atherosclerotic cardiovascular disease (ASCVD). Everyone living long enough will become eligible for risk-based statin therapy due to age alone. OBJECTIVES: This study sought to personalize ACC/AHA risk-based statin eligibility using noninvasive assessment of subclinical atherosclerosis...
August 30, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27543306/2013-acc-aha-cholesterol-guideline-and-implications-for-healthy-people-2020-cardiovascular-disease-prevention-goals
#17
Brent M Egan, Jiexiang Li, Kellee White, Douglas O Fleming, Kenneth Connell, German T Hernandez, Daniel W Jones, Keith C Ferdinand, Angelo Sinopoli
BACKGROUND: Healthy People 2020 aim to reduce fatal atherosclerotic cardiovascular disease (ASCVD) by 20%, which translates into 310 000 fewer events annually assuming proportional reduction in fatal and nonfatal ASCVD. We estimated preventable ASCVD events by implementing the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Cholesterol Guideline in all statin-eligible adults. Absolute risk reduction (ARR) and number needed-to-treat (NNT) were calculated. METHODS AND RESULTS: National Health and Nutrition Examination Survey data for 2007-2012 were analyzed for adults aged 21 to 79 years and extrapolated to the US population...
2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27455341/capnography-use-during-intubation-and-cardiopulmonary-resuscitation-in-the-pediatric-emergency-department
#18
Adam Bullock, James M Dodington, Aaron J Donoghue, Melissa L Langhan
OBJECTIVE: Capnography is indicated as a guide to assess and monitor both endotracheal intubation and cardiopulmonary resuscitation (CPR). Our primary objective was to determine the effect of the 2010 American Heart Association (AHA) guidelines on the frequency of capnography use during critical events in children in the emergency department (ED). Our secondary objective was to examine associations between patient characteristics and capnography use among these patients. METHODS: A retrospective chart review was performed on children aged 0 to 21 years who were intubated or received CPR in 2 academic children's hospital EDs between January 2009 and December 2012...
July 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#19
REVIEW
Fatima Rodriguez, Kenneth W Mahaffey
Non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are the leading cause of morbidity and mortality from cardiovascular disease worldwide. The American Heart Association/American College of Cardiology and the European Society of Cardiology periodically release practice guidelines to guide clinicians in the management of NSTE-ACS, most recently in in 2014 and 2015, respectively. The present review compares and contrasts the 2 guidelines, with a focus on the strength of recommendation and level of evidence in the approach to initial presentation and diagnosis of NSTE-ACS, risk assessment, treatments, and systems of care...
July 19, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27404705/optical-coherence-tomography-guidance-for-percutaneous-coronary-intervention-with-bioresorbable-scaffolds
#20
Gianluca Caiazzo, Giovanni Longo, Alessandra Giavarini, Ismail Dogu Kilic, Enrico Fabris, Roberta Serdoz, Alessio Mattesini, Nicolas Foin, Gioel Gabrio Secco, Salvatore De Rosa, Ciro Indolfi, Carlo Di Mario
BACKGROUND: The effect of optical coherence tomography (OCT) guidance on the implantation strategy during all phases of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVSs) in a real-world scenario has been poorly investigated. METHODS: Consecutive patients undergoing BVS implantation at our institution were included in this registry. Frequency-domain OCT pullbacks were performed at the operator's discretion during all phases of BVS implantation procedures to optimize preparation of lesions, confirm BVS size, and optimize expansion and apposition of scaffolds...
October 15, 2016: International Journal of Cardiology
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