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https://www.readbyqxmd.com/read/27881560/coronary-artery-calcium-to-guide-a-personalized-risk-based-approach-to-initiation-and-intensification-of-antihypertensive-therapy
#1
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: -There is interest in using atherosclerotic cardiovascular disease (ASCVD) risk to personalize systolic blood pressure (SBP) treatment goals. Therefore, we studied whether Coronary Artery Calcium (CAC) can further guide the allocation of anti-hypertensive treatment intensity. METHODS: -We included 3,733 participants from the Multi-Ethnic Study of Atherosclerosis with SBP between 120-179mmHg. Within subgroups categorized by both SBP (120-139, 140-159, 160-179mmHg) and estimated 10-year ASCVD risk (using the ACC/AHA pooled-cohort equations), we compared multivariable-adjusted hazard ratios (HRs) for the composite outcome of incident ASCVD or heart failure, after further stratifying by CAC (0, 1-100, or >100)...
November 23, 2016: 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
#2
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...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27784010/clinical-application-of-biomarkers-in-heart-failure-with-a-preserved-ejection-fraction-a-review
#3
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)...
October 27, 2016: Cardiology
https://www.readbyqxmd.com/read/27754284/me-04-2-aortic-pwv-for-risk-stratification-in-hypertension
#4
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
#5
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)...
October 13, 2016: 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27389543/a-radiologist-s-guide-to-the-clinical-scales-used-in-the-2015-endovascular-stroke-trials-and-the-revised-american-heart-association-american-stroke-association-guidelines-for-endovascular-stroke-treatment
#16
REVIEW
Meir H Scheinfeld, Amichai J Erdfarb, Daniel A Krieger, Deepa Bhupali, Richard L Zampolin
In 2015, five trials demonstrated the efficacy of endovascular treatment for acute stroke, culminating in the revised American Heart Association/American Stroke Association (AHA/ASA) recommendations for stroke management. The different clinical scales used in these trials may be unfamiliar to emergency and on-call radiologists. The modified Rankin Scale was used to describe patient disability for prestroke assessment in three of the trials and for the 90-day follow up in all five trials. The Barthel index was used in one trial to score prestroke ability to perform activities of daily living...
October 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27173039/operationalizing-the-2014-acc-aha-guidelines-for-valvular-heart-disease-a-guide-for-clinicians
#17
REVIEW
Rick A Nishimura, Blase Carabello
The 2014 American College of Cardiology/American Heart Association guidelines for valvular heart disease were released to help guide the clinician in caring for patients with this ever more prevalent and complex group of diseases and have been instrumental in providing a foundation of knowledge for the management of patients with valvular heart disease. However, there are many caveats in applying the guidelines to individual patients. As clinicians, we wish to outline important aspects to be considered by other clinicians, including the integration of the echocardiogram with the history and physical examination, recognition of discordant data within an echocardiographic examination, and proper interpretation of the cutoff measurements applied to timing of intervention...
May 17, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27107688/a-quantitative-comparison-of-physiologic-indicators-of-cardiopulmonary-resuscitation-quality-diastolic-blood-pressure-versus-end-tidal-carbon-dioxide
#18
Ryan W Morgan, Benjamin French, Todd J Kilbaugh, Maryam Y Naim, Heather Wolfe, George Bratinov, Wesley Shoap, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP vs. ETCO2 during CPR as predictors of cardiac arrest survival. METHODS: In two models of cardiac arrest (primary ventricular fibrillation [VF] and asphyxia-associated VF), 3-month old swine received either standard AHA guideline-based CPR or patient-centric, BP-guided CPR...
July 2016: Resuscitation
https://www.readbyqxmd.com/read/26848560/predictors-of-medical-management-in-patients-undergoing-elective-cardiac-catheterization-for-chronic-ischemic-heart-disease
#19
Auras R Atreya, Senthil K Sivalingam, Sonali Arora, Mohammad Amin Kashef, Janice Fitzgerald, Paul Visintainer, Amir Lotfi, Michael B Rothberg
BACKGROUND: Compared with medical therapy, percutaneous coronary intervention (PCI) does not reduce mortality or myocardial infarction in patients with stable angina. Therefore, PCI should be guided by refractory anginal symptoms and not just lesion characteristics. HYPOTHESIS: We hypothesized that angiographic lesion characteristics and stress test results would have a greater role in the decision to proceed with PCI than would symptom severity. METHODS: We performed a retrospective cohort study of patients undergoing elective cardiac catheterization and possible PCI at an academic medical center...
April 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/26700832/primary-prevention-with-statins-acc-aha-risk-based-approach-versus-trial-based-approaches-to-guide-statin-therapy
#20
RANDOMIZED CONTROLLED TRIAL
Martin B Mortensen, Shoaib Afzal, Børge G Nordestgaard, Erling Falk
BACKGROUND: Guidelines recommend initiating primary prevention for atherosclerotic cardiovascular disease (ASCVD) with statins based on absolute ASCVD risk assessment. Recently, alternative trial-based and hybrid approaches were suggested for statin treatment eligibility. OBJECTIVES: This study compared these approaches in a direct head-to-head fashion in a contemporary population. METHODS: The study used the CGPS (Copenhagen General Population Study) with 37,892 subjects aged 40 to 75 years recruited in 2003 to 2008, all free of ASCVD, diabetes, and statin use at baseline...
December 22, 2015: Journal of the American College of Cardiology
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