collection
https://read.qxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#21
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://read.qxmd.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
#22
JOURNAL ARTICLE
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://read.qxmd.com/read/27371720/avoiding-non-responders-to-cardiac-resynchronization-therapy-a-practical-guide
#23
REVIEW
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...
May 14, 2017: European Heart Journal
https://read.qxmd.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
#24
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
https://read.qxmd.com/read/27214299/metformin-non-glycemic-effects-and-potential-novel-indications
#25
Abeer Anabtawi, John M Miles
Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin and a reduction in stroke, atrial fibrillation and all-cause mortality. The mechanism(s) explaining these putative benefits are not clear but may involve decreased energy intake (with attendant weight loss), improvement in lipids, and lowering of blood pressure; a review of selected literature suggests that metformin lowers blood pressure when it is elevated, but not when it is normal...
May 23, 2016: Endocrine Practice
https://read.qxmd.com/read/27252452/antithrombotic-therapy-in-heart-failure-patients-with-and-without-atrial-fibrillation-update-and-future-challenges
#26
REVIEW
João Pedro Ferreira, Nicolas Girerd, Saleh Alshalash, Marvin A Konstam, Faiez Zannad
Atrial fibrillation (AF) and heart failure (HF) often coexist, and patients with AF and HF have a higher risk of thromboembolic events and overall mortality compared with those with AF without HF. Additionally, the prevalence of AF increases with the severity of HF. The use of vitamin K antagonists is more unstable in patients with concomitant AF and HF, which is an independent risk factor for reduced time under therapeutic range. More recently, non-vitamin K antagonists oral anticoagulants (NOACs) have emerged as therapeutic alternatives for stroke prevention in patients with non-valvular AF, as they have been shown to be at least as efficacious and safe, with less intracranial bleeding events, compared with vitamin K antagonists...
August 2016: European Heart Journal
https://read.qxmd.com/read/27207980/the-neprilysin-pathway-in-heart-failure-a-review-and-guide-on-the-use-of-sacubitril-valsartan
#27
REVIEW
Pardeep S Jhund, John J V McMurray
Inhibition of neurohumoural pathways such as the renin angiotensin aldosterone and sympathetic nervous systems is central to the understanding and treatment of heart failure (HF). Conversely, until recently, potentially beneficial augmentation of neurohumoural systems such as the natriuretic peptides has had limited therapeutic success. Administration of synthetic natriuretic peptides has not improved outcomes in acute HF but modulation of the natriuretic system through inhibition of the enzyme that degrades natriuretic (and other vasoactive) peptides, neprilysin, has proven to be successful...
September 1, 2016: Heart
https://read.qxmd.com/read/27226327/cardiovascular-safety-of-metformin-and-sulfonylureas-in-patients-with-different-cardiac-risk-profiles
#28
MULTICENTER STUDY
Raphael Wurm, Michael Resl, Stephanie Neuhold, Rudolf Prager, Helmut Brath, Claudia Francesconi, Greisa Vila, Guido Strunk, Martin Clodi, Anton Luger, Richard Pacher, Martin Hülsmann
OBJECTIVES/BACKGROUND: Based on previous experiences, the Food and Drug Administration and the European Medicines Agency recommend that clinical trials for novel antidiabetic drugs are powered to detect increased cardiovascular risk. In this context, data concerning licensed drugs such as metformin and sulfonylureas are conflicting. The influence of baseline cardiovascular risk on any treatment effect appears obvious but has not been formally proven. We therefore evaluated association of metformin and sulfonylureas with cardiovascular events in patients with different cardiovascular risk profiles indicated by N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) levels...
October 1, 2016: Heart
https://read.qxmd.com/read/27216111/2016-acc-aha-hfsa-focused-update-on-new-pharmacological-therapy-for-heart-failure-an-update-of-the-2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task%C3%A2-force%C3%A2-on%C3%A2-clinical
#29
JOURNAL ARTICLE
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
September 27, 2016: Journal of the American College of Cardiology
https://read.qxmd.com/read/26408108/how-we-diagnose-and-treat-iron-deficiency-anemia
#30
REVIEW
Michael Auerbach, John W Adamson
It is estimated that one-third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity...
January 2016: American Journal of Hematology
https://read.qxmd.com/read/26937187/exacerbations-of-copd
#31
REVIEW
Ian D Pavord, Paul W Jones, Pierre-Régis Burgel, Klaus F Rabe
Exacerbations of chronic obstructive pulmonary disease (COPD) are defined as sustained worsening of a patient's condition beyond normal day-to-day variations that is acute in onset, and that may also require a change in medication and/or hospitalization. Exacerbations have a significant and prolonged impact on health status and outcomes, and negative effects on pulmonary function. A significant proportion of exacerbations are unreported and therefore left untreated, leading to a poorer prognosis than those treated...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://read.qxmd.com/read/27124268/managing-multivessel-coronary-artery-disease-in-patients-with-st-elevation-myocardial-infarction-a-comprehensive-review
#32
REVIEW
Andrés M Pineda, Nikita Carvalho, Saqib A Gowani, Kavit A Desouza, Orlando Santana, Christos G Mihos, Gregg W Stone, Nirat Beohar
Multivessel coronary artery disease (CAD) is found in up to 60% of the patients presenting with an ST-elevation myocardial infarction (STEMI) and worsens the prognosis proportional to the extent of CAD severity. However, the 2013 American College of Cardiology/American Heart Association STEMI guidelines, based on mostly observational data, had recommended against a routine noninfarct-related artery percutaneous coronary intervention (PCI). After these guidelines were published, a handful of randomized trials became available, and they suggested that PCI of significant lesions in a noninfarct-related artery at the time of primary PCI might result in improved patient outcomes...
July 2017: Cardiology in Review
https://read.qxmd.com/read/27029595/zika-virus
#33
REVIEW
Didier Musso, Duane J Gubler
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the family Flaviviridae. ZIKV was first isolated from a nonhuman primate in 1947 and from mosquitoes in 1948 in Africa, and ZIKV infections in humans were sporadic for half a century before emerging in the Pacific and the Americas. ZIKV is usually transmitted by the bite of infected mosquitoes. The clinical presentation of Zika fever is nonspecific and can be misdiagnosed as other infectious diseases, especially those due to arboviruses such as dengue and chikungunya...
July 2016: Clinical Microbiology Reviews
https://read.qxmd.com/read/27043774/aliskiren-enalapril-or-aliskiren-and-enalapril-in-heart-failure
#34
RANDOMIZED CONTROLLED TRIAL
John J V McMurray, Henry Krum, William T Abraham, Kenneth Dickstein, Lars V Køber, Akshay S Desai, Scott D Solomon, Nicola Greenlaw, M Atif Ali, Yanntong Chiang, Qing Shao, Georgia Tarnesby, Barry M Massie
BACKGROUND: Among patients with chronic heart failure, angiotensin-converting-enzyme (ACE) inhibitors reduce mortality and hospitalization, but the role of a renin inhibitor in such patients is unknown. We compared the ACE inhibitor enalapril with the renin inhibitor aliskiren (to test superiority or at least noninferiority) and with the combination of the two treatments (to test superiority) in patients with heart failure and a reduced ejection fraction. METHODS: After a single-blind run-in period, we assigned patients, in a double-blind fashion, to one of three groups: 2336 patients were assigned to receive enalapril at a dose of 5 or 10 mg twice daily, 2340 to receive aliskiren at a dose of 300 mg once daily, and 2340 to receive both treatments (combination therapy)...
April 21, 2016: New England Journal of Medicine
https://read.qxmd.com/read/27046161/2016-acc-expert-consensus-decision-pathway-on-the-role-of-non-statin-therapies-for-ldl-cholesterol-lowering-in-the-management-of-atherosclerotic-cardiovascular-disease-risk-a-report-of-the-american-college-of-cardiology-task-force-on-clinical-expert-consensus
#35
REVIEW
Donald M Lloyd-Jones, Pamela B Morris, Christie M Ballantyne, Kim K Birtcher, David D Daly, Sondra M DePalma, Margo B Minissian, Carl E Orringer, Sidney C Smith
No abstract text is available yet for this article.
July 5, 2016: Journal of the American College of Cardiology
https://read.qxmd.com/read/27007094/clinical-practice-guideline-management-of-acute-pancreatitis
#36
REVIEW
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://read.qxmd.com/read/26857214/contrast-induced-nephropathy-following-angiography-and-cardiac-interventions
#37
JOURNAL ARTICLE
Roger Rear, Robert M Bell, Derek J Hausenloy
No abstract text is available yet for this article.
April 2016: Heart
https://read.qxmd.com/read/26843275/highly-sensitive-troponin-and-coronary-computed-tomography-angiography-in-the-evaluation-of-suspected-acute-coronary-syndrome-in-the-emergency-department
#38
REVIEW
Maros Ferencik, Udo Hoffmann, Fabian Bamberg, James L Januzzi
The evaluation of patients presenting to the emergency department with suspected acute coronary syndrome (ACS) remains a clinical challenge. The traditional assessment includes clinical risk assessment based on cardiovascular risk factors with serial electrocardiograms and cardiac troponin measurements, often followed by advanced cardiac testing as inpatient or outpatient (i.e. stress testing, imaging). Despite this costly and lengthy work-up, there is a non-negligible rate of missed ACS with an increased risk of death...
August 7, 2016: European Heart Journal
https://read.qxmd.com/read/26763514/multiple-myeloma-diagnosis-and-treatment
#39
REVIEW
S Vincent Rajkumar, Shaji Kumar
The diagnosis and treatment of multiple myeloma has changed dramatically in the past decade. The disease definition has been updated to include highly specific biomarkers in addition to established markers of end-organ damage. The staging system has been revised to combine both measures of tumor burden and disease biology. Advances in therapy have resulted in a marked improvement in overall survival. New drugs introduced in the past few years include carfilzomib, pomalidomide, panobinostat, ixazomib, elotuzumab, and daratumumab...
January 2016: Mayo Clinic Proceedings
https://read.qxmd.com/read/26848150/choosing-a-particular-oral-anticoagulant-and-dose-for-stroke-prevention-in-individual-patients-with-non-valvular-atrial-fibrillation-part-2
#40
REVIEW
Hans-Christoph Diener, James Aisenberg, Jack Ansell, Dan Atar, Günter Breithardt, John Eikelboom, Michael D Ezekowitz, Christopher B Granger, Jonathan L Halperin, Stefan H Hohnloser, Elaine M Hylek, Paulus Kirchhof, Deirdre A Lane, Freek W A Verheugt, Roland Veltkamp, Gregory Y H Lip
The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In addition, we discuss the timing of initiation of anticoagulation. In the second of a two-part review, we discuss the use of NOAC for stroke prevention in the following subgroups of patients with AF: (vii) secondary stroke prevention in patients after stroke or transient ischaemic attack (TIA), (viii) patients with acute stroke requiring thrombolysis or thrombectomy, (ix) those initiating or restarting OAC treatment after stroke or TIA, (x) those with renal impairment on dialysis, (xi) the elderly, (xii) those at high risk of gastrointestinal bleeding, and (xiii) those with hypertension...
March 21, 2017: European Heart Journal
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