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https://www.readbyqxmd.com/read/27836915/cardiac-diagnostic-work-up-of-ischaemic-stroke
#1
REVIEW
Hayang Yang, Martina Nassif, Paul Khairy, Joris R de Groot, Yvo B W E M Roos, Robbert J de Winter, Barbara J M Mulder, Berto J Bouma
Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown aetiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and embolic strokes of undetermined source...
November 10, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27802508/management-of-acute-and-recurrent-gout-a-clinical-practice-guideline-from-the-american-college-of-physicians
#2
Amir Qaseem, Russell P Harris, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27629776/antiplatelet-versus-anticoagulation-treatment-for-patients-with-heart-failure-in-sinus-rhythm
#3
Eduard Shantsila, Gregory Yh Lip
BACKGROUND: Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure. Oral anticoagulants have become a standard in the management of heart failure with atrial fibrillation...
September 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27592289/echocardiography-as-a-guide-for-fluid-management
#4
REVIEW
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27427441/worsening-renal-function-and-outcome-in-heart-failure-patients-with-reduced-and-preserved-ejection-fraction-and-the-impact-of-angiotensin-receptor-blocker-treatment-data-from-the-charm-study-programme
#5
Kevin Damman, Scott D Solomon, Marc A Pfeffer, Karl Swedberg, Salim Yusuf, James B Young, Jean L Rouleau, Christopher B Granger, John J V McMurray
AIMS: We investigated the association between worsening renal function (WRF) that occurs during renin-angiotensin-aldosterone system inhibition initation and outcome in heart failure (HF) patients with preserved ejection fraction (HFPEF) and compared this with HF patients with reduced ejection fraction (HFREF). METHODS AND RESULTS: We examined changes in estimated glomerular filtration rate (GFR) and the relationship between WRF (defined as ≥26.5 µmol/L and ≥25% increase in serum creatinine from baseline to 6 weeks) and outcome, according to randomized treatment, in patients with HFREF (EF <45%; n = 1569) and HFPEF (EF ≥45%; n = 836) in the CHARM programme...
December 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27567407/2016-esc-eas-guidelines-for-the-management-of-dyslipidaemias-the-task-force-for-the-management-of-dyslipidaemias-of-the-european-society-of-cardiology-esc-and-european-atherosclerosis-society-eas-developed-with-the-special-contribution-of-the-european-assocciation
#6
Alberico L Catapano, Ian Graham, Guy De Backer, Olov Wiklund, M John Chapman, Heinz Drexel, Arno W Hoes, Catriona S Jennings, Ulf Landmesser, Terje R Pedersen, Željko Reiner, Gabriele Riccardi, Marja-Riita Taskinen, Lale Tokgozoglu, W M Monique Verschuren, Charalambos Vlachopoulos, David A Wood, Jose Luis Zamorano
No abstract text is available yet for this article.
August 27, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27297342/clinical-update-cardiovascular-disease-in-diabetes-mellitus-atherosclerotic-cardiovascular-disease-and-heart-failure-in-type-2-diabetes-mellitus-mechanisms-management-and-clinical-considerations
#7
Cecilia C Low Wang, Connie N Hess, William R Hiatt, Allison B Goldfine
Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without...
June 14, 2016: Circulation
https://www.readbyqxmd.com/read/27558319/early-on-the-scene-in-the-field-of-cardiac-electrophysiology
#8
(no author information available yet)
No abstract text is available yet for this article.
August 2016: European Heart Journal
https://www.readbyqxmd.com/read/27496911/recent-developments-in-the-detection-and-management-of-acute-kidney-injury
#9
James McCaffrey, Ajaya Kumar Dhakal, David V Milford, Nicholas J A Webb, Rachel Lennon
Acute kidney injury (AKI) is a common condition in children admitted to hospital and existing serum and urine biomarkers are insensitive. There have been significant developments in stratifying the risk of AKI in children and also in the identification of new AKI biomarkers. Risk stratification coupled with a panel of AKI biomarkers will improve future detection of AKI, however, paediatric validation studies in mixed patient cohorts are required. The principles of effective management rely on treating the underlying cause and preventing secondary AKI by the appropriate use of fluids and medication...
August 5, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27521067/2016-american-thyroid-association-guidelines-for-diagnosis-and-management-of-hyperthyroidism-and-other-causes-of-thyrotoxicosis
#10
Douglas S Ross, Henry B Burch, David S Cooper, M Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A Rivkees, Mary Samuels, Julie Ann Sosa, Marius N Stan, Martin A Walter
BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. METHODS: The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011...
October 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27473219/the-power-of-stress-echocardiography-and-myocardial-perfusion-scintigraphy-in-predicting-long-term-outcome-nothing-lasts-forever
#11
Abdou Elhendy
No abstract text is available yet for this article.
July 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27504002/international-patterns-of-dual-antiplatelet-therapy-duration-after-acute-coronary-syndromes
#12
Héctor Bueno, Stuart Pocock, Nicolas Danchin, Lieven Annemans, John Gregson, Jesús Medina, Frans Van de Werf
OBJECTIVE: To describe international patterns of dual antiplatelet therapy (DAPT) duration after acute coronary syndrome (ACS), and explore its determinants and correlation with clinical events. METHODS: EPICOR (long-tErm follow-uP of anti-thrombotic management patterns In acute CORonary syndrome patients) is a prospective, international, observational study of 10 568 ACS hospital survivors enrolled in 555 centres from 20 countries across Europe and Latin America between 2010 and 2011, with telephone follow-up at quarterly intervals up to 24 months to assess treatment continuation and clinical events...
August 8, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27470878/sodium-glucose-cotransporter-2-inhibitors-in-the-treatment-of-diabetes-mellitus-cardiovascular-and-kidney-effects-potential-mechanisms-and-clinical-applications
#13
Hiddo J L Heerspink, Bruce A Perkins, David H Fitchett, Mansoor Husain, David Z I Cherney
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction, and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg, respectively, which may underlie cardiovascular and kidney benefits...
September 6, 2016: Circulation
https://www.readbyqxmd.com/read/27394021/urinary-tract-infections-in-the-older-adult
#14
REVIEW
Lindsay E Nicolle
Urinary infection is the most common bacterial infection in elderly populations. The high prevalence of asymptomatic bacteriuria in both men and women is benign and should not be treated. A diagnosis of symptomatic infection for elderly residents of long-term care facilities without catheters requires localizing genitourinary findings. Symptomatic urinary infection is overdiagnosed in elderly bacteriuric persons with nonlocalizing clinical presentations, with substantial inappropriate antimicrobial use. Residents with chronic indwelling catheters experience increased morbidity from urinary tract infection...
August 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27436865/risk-score-overestimation-the-impact-of-individual-cardiovascular-risk-factors-and-preventive-therapies-on-the-performance-of-the-american-heart-association-american-college-of-cardiology-atherosclerotic-cardiovascular-disease-risk-score-in-a-modern-multi-ethnic
#15
Andrew Paul DeFilippis, Rebekah Young, John W McEvoy, Erin D Michos, Veit Sandfort, Richard A Kronmal, Robyn L McClelland, Michael J Blaha
AIMS: To evaluate the 2013 American Heart Association (AHA)-American College of Cardiology (ACC)-Atherosclerotic Cardiovascular Disease (ASCVD) risk score among four different race/ethnic groups and to ascertain which factors are most associated with risk overestimation by the AHA-ACC-ASCVD score. METHODS AND RESULTS: The Multi-Ethnic Study of Atherosclerosis (MESA), a prospective community-based cohort, was used to examine calibration and discrimination of the AHA-ACC-ASCVD risk score in 6441 White, Black, Chinese, and Hispanic Americans (aged 45-79 years and free of known ASCVD at baseline)...
July 19, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27443431/hybrid-coronary-revascularization-for%C3%A2-the%C3%A2-treatment-of-multivessel-coronary%C3%A2-artery-disease-a-multicenter-observational-study
#16
John D Puskas, Michael E Halkos, Joseph J DeRose, Emilia Bagiella, Marissa A Miller, Jessica Overbey, Johannes Bonatti, V S Srinivas, Mark Vesely, Francis Sutter, Janine Lynch, Katherine Kirkwood, Timothy A Shapiro, Konstantinos D Boudoulas, Juan Crestanello, Thomas Gehrig, Peter Smith, Michael Ragosta, Steven J Hoff, David Zhao, Annetine C Gelijns, Wilson Y Szeto, Giora Weisz, Michael Argenziano, Thomas Vassiliades, Henry Liberman, William Matthai, Deborah D Ascheim
BACKGROUND: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is increasingly used to treat multivessel coronary artery disease that includes stenoses in the proximal left anterior descending artery and at least 1 other vessel, but its effectiveness has not been rigorously evaluated. OBJECTIVES: This National Institutes of Health-funded, multicenter, observational study was conducted to explore the characteristics and outcomes of patients undergoing clinically indicated HCR and multivessel PCI for hybrid-eligible coronary artery disease, to inform the design of a confirmatory comparative effectiveness trial...
July 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#17
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/27413052/european-society-of-cardiology-recommended-coronary-artery-disease-consortium-pretest-probability-scores-more-accurately-predict-obstructive-coronary-disease-and-cardiovascular-events-than-the-diamond-and-forrester-score-the-partners-registry
#18
Marcio Sommer Bittencourt, Edward Hulten, Tamar S Polonsky, Udo Hoffman, Khurram Nasir, Suhny Abbara, Marcelo Di Carli, Ron Blankstein
BACKGROUND: The most appropriate score for evaluating the pretest probability of obstructive coronary artery disease (CAD) is unknown. We sought to compare the Diamond-Forrester (DF) score with the 2 CAD consortium scores recently recommended by the European Society of Cardiology. METHODS: We included 2274 consecutive patients (age, 56±13 years; 57% male) without prior CAD referred for coronary computed tomographic angiography. Computed tomographic angiography findings were used to determine the presence or absence of obstructive CAD (≥50% stenosis)...
July 19, 2016: Circulation
https://www.readbyqxmd.com/read/27371720/avoiding-non-responders-to-cardiac-resynchronization-therapy-a-practical-guide
#19
Claude Daubert, Nathalie Behar, Raphaël P Martins, Philippe Mabo, Christophe Leclercq
Over two decades after the introduction of cardiac resynchronization therapy (CRT) into clinical practice, ∼30% of candidates continue to fail to respond to this highly effective treatment of drug-refractory heart failure (HF). Since the causes of this non-response (NR) are multifactorial, it will require multidisciplinary efforts to overcome. Progress has, thus far, been slowed by several factors, ranging from a lack of consensus regarding the definition of NR and technological limitations to the delivery of therapy...
July 1, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26678630/perindopril-and-%C3%AE-blocker-for-the-prevention-of-cardiac-events-and-mortality-in-stable-coronary-artery-disease-patients-a-european-trial-on-reduction-of-cardiac-events-with-perindopril-in-stable-coronary-artery-disease-europa-subanalysis
#20
RANDOMIZED CONTROLLED TRIAL
Michel E Bertrand, Roberto Ferrari, Willem J Remme, Maarten L Simoons, Kim M Fox
BACKGROUND: β-Blockers relieve angina/ischemia in stable coronary artery disease (CAD), and angiotensin-converting enzyme inhibitors prevent CAD outcomes. In EUROPA, the angiotensin-converting enzyme inhibitor perindopril reduced cardiovascular outcomes in low-risk stable CAD patients over 4.2 years. This post hoc analysis examined whether the addition of perindopril to β-blocker in EUROPA had additional benefits on outcomes compared with standard therapy including β-blocker. METHODS: EUROPA was a multicenter, double-blind, placebo-controlled, randomized trial in patients with documented stable CAD...
December 2015: American Heart Journal
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