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Geriatric Cardiology

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50 papers 0 to 25 followers Seminal articles in the field of geriatric cardiology
https://www.readbyqxmd.com/read/27438112/gait-speed-and-operative-mortality-in-older-adults-following-cardiac-surgery
#1
Jonathan Afilalo, Sunghee Kim, Sean O'Brien, J Matthew Brennan, Fred H Edwards, Michael J Mack, James B McClurken, Joseph C Cleveland, Peter K Smith, David M Shahian, Karen P Alexander
IMPORTANCE: Prediction of operative risk is a critical step in decision making for cardiac surgery. Existing risk models may be improved by integrating a measure of frailty, such as 5-m gait speed, to better capture the heterogeneity of the older adult population. OBJECTIVE: To determine the association of 5-m gait speed with operative mortality and morbidity in older adults undergoing cardiac surgery. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted from July 1, 2011, to March 31, 2014, at 109 centers participating in the Society of Thoracic Surgeons Adult Cardiac Surgery Database...
June 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27568870/conceptual-models-of-frailty-the-sarcopenia-phenotype
#2
Jonathan Afilalo
Population aging has redefined cardiovascular medicine toward multifaceted patient-oriented care, with frailty emerging as a fundamental concept. The definition of frailty is ardently debated between opposing constructs: phenotypic criteria and accumulated deficits. Phenotypic criteria revolve around age-related loss of muscle mass and strength, known as sarcopenia. Skeletal muscle is crucial for functioning, mobility, energetics, and is the body's primary reservoir for amino acids. Sarcopenia can be assessed objectively, serving as an incremental predictor of adverse health outcomes and a therapeutic target for muscle-building interventions...
September 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27894734/training-geriatric-cardiologists-for-an-aging-population-time-to-get-going
#3
EDITORIAL
Scott L Hummel, Craig M Alpert, Christos Galatas, Jonathan Afilalo
No abstract text is available yet for this article.
November 25, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27765189/prediction-of-poor-outcome-after-transcatheter-aortic-valve-replacement
#4
Suzanne V Arnold, Jonathan Afilalo, John A Spertus, Yuanyuan Tang, Suzanne J Baron, Philip G Jones, Michael J Reardon, Steven J Yakubov, David H Adams, David J Cohen
BACKGROUND: A series of models have been developed to identify patients at high risk for poor outcomes after transcatheter aortic valve replacement (TAVR) to help guide treatment choices, offer patients realistic expectations of long-term outcomes, and support decision making. OBJECTIVES: This study examined the performance of the previously developed TAVR Poor Outcome risk models in an external dataset and explored the incremental contribution of geriatric domains to model performance...
October 25, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27443429/predicting-early-and-late-mortality-after-transcatheter-aortic-valve-replacement
#5
James B Hermiller, Steven J Yakubov, Michael J Reardon, G Michael Deeb, David H Adams, Jonathan Afilalo, Jian Huang, Jeffrey J Popma
BACKGROUND: Few studies have examined the impact of novel indices of comorbidity, frailty, and disability on outcomes after transcatheter aortic valve replacement (TAVR). OBJECTIVES: This study analyzed patients from the Medtronic CoreValve U.S. Pivotal Trial program to develop a simple scoring system that incorporates standard and novel predictor variables. METHODS: A multidisciplinary heart team used objective criteria, such as The Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM), and subjective criteria to assess patients' eligibility for TAVR...
July 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27706136/evidence-for-a-limit-to-human-lifespan
#6
Xiao Dong, Brandon Milholland, Jan Vijg
Driven by technological progress, human life expectancy has increased greatly since the nineteenth century. Demographic evidence has revealed an ongoing reduction in old-age mortality and a rise of the maximum age at death, which may gradually extend human longevity. Together with observations that lifespan in various animal species is flexible and can be increased by genetic or pharmaceutical intervention, these results have led to suggestions that longevity may not be subject to strict, species-specific genetic constraints...
October 5, 2016: Nature
https://www.readbyqxmd.com/read/24126387/guide-to-the-assessment-of-physical-activity-clinical-and-research-applications-a-scientific-statement-from-the-american-heart-association
#7
Scott J Strath, Leonard A Kaminsky, Barbara E Ainsworth, Ulf Ekelund, Patty S Freedson, Rebecca A Gary, Caroline R Richardson, Derek T Smith, Ann M Swartz
The deleterious health consequences of physical inactivity are vast, and they are of paramount clinical and research importance. Risk identification, benchmarks, efficacy, and evaluation of physical activity behavior change initiatives for clinicians and researchers all require a clear understanding of how to assess physical activity. In the present report, we have provided a clear rationale for the importance of assessing physical activity levels, and we have documented key concepts in understanding the different dimensions, domains, and terminology associated with physical activity measurement...
November 12, 2013: Circulation
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/26794722/invasive-versus-conservative-strategy-in-patients-aged-80-years-or-older-with-non-st-elevation-myocardial-infarction-or-unstable-angina-pectoris-after-eighty-study-an-open-label-randomised-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Nicolai Tegn, Michael Abdelnoor, Lars Aaberge, Knut Endresen, Pål Smith, Svend Aakhus, Erik Gjertsen, Ola Dahl-Hofseth, Anette Hylen Ranhoff, Lars Gullestad, Bjørn Bendz
BACKGROUND: Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris are frequent causes of hospital admission in the elderly. However, clinical trials targeting this population are scarce, and these patients are less likely to receive treatment according to guidelines. We aimed to investigate whether this population would benefit from an early invasive strategy versus a conservative strategy. METHODS: In this open-label randomised controlled multicentre trial, patients aged 80 years or older with NSTEMI or unstable angina admitted to 16 hospitals in the South-East Health Region of Norway were randomly assigned to an invasive strategy (including early coronary angiography with immediate assessment for percutaneous coronary intervention, coronary artery bypass graft, and optimum medical treatment) or to a conservative strategy (optimum medical treatment alone)...
March 12, 2016: Lancet
https://www.readbyqxmd.com/read/26821840/psoas-muscle-area-and-all-cause-mortality-after-transcatheter-aortic-valve-replacement-the-montreal-munich-study
#10
MULTICENTER STUDY
Samuel Mamane, Louis Mullie, Nicolo Piazza, Giuseppe Martucci, José Morais, Antonio Vigano, Mark Levental, Kristoff Nelson, Ruediger Lange, Jonathan Afilalo
BACKGROUND: Psoas muscle area (PMA) is a novel measure of frailty that can be efficiently measured from computed tomography images to help predict risk in older adults referred for transcatheter aortic valve replacement (TAVR). The objective of this study was to determine if PMA would be incrementally predictive of mortality and morbidity after TAVR. METHODS: The pre-TAVR computed tomography scans of 208 consecutive patients at 2 hospitals in Montreal and Munich were analyzed to measure the cross-sectional area of the left and right psoas muscles on a single axial slice at the level of L4...
February 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27407052/derivation-and-validation-of-prognosis-based-age-cutoffs-to-define-elderly-in-cardiac-surgery
#11
Jonathan Afilalo, Russell Steele, Warren J Manning, Kamal R Khabbaz, Lawrence G Rudski, Yves Langlois, Jean-Francois Morin, Michael H Picard
BACKGROUND: The age cutoff to define elderly is controversial in cardiac surgery, empirically ranging from ≥65 to ≥80 years. Beyond semantics, this has important implications as a starting point for clinical care pathways and inclusion in trials. We sought to characterize the relationship between age and adverse outcomes in patients undergoing cardiac surgery and to derive and validate prognosis-based age cutoffs. METHODS AND RESULTS: Six thousand five hundred seventy one consecutive adult patients undergoing cardiac surgery at 3 hospitals in the United States and Canada were included in the cohort...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27166212/the-road-to-frailty-is-paved-with-good-intentions
#12
EDITORIAL
Jonathan Afilalo
No abstract text is available yet for this article.
May 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/26920495/gait-speed-predicts-30-day-mortality-after-transcatheter-aortic-valve-replacement-results-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#13
COMPARATIVE STUDY
Joakim Alfredsson, Amanda Stebbins, J Matthew Brennan, Roland Matsouaka, Jonathan Afilalo, Eric D Peterson, Sreekanth Vemulapalli, John S Rumsfeld, David Shahian, Michael J Mack, Karen P Alexander
BACKGROUND: Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. METHODS AND RESULTS: We assessed the association of 5-m gait speed with outcomes in a cohort of 8039 patients who underwent transcatheter aortic valve replacement (November 2011-June 2014) and were included in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry...
April 5, 2016: Circulation
https://www.readbyqxmd.com/read/26490492/association-of-habitual-dietary-resveratrol-exposure-with-the-development-of-frailty-in-older-age-the-invecchiare-in-chianti-study
#14
Montserrat Rabassa, Raul Zamora-Ros, Mireia Urpi-Sarda, Stefania Bandinelli, Luigi Ferrucci, Cristina Andres-Lacueva, Antonio Cherubini
BACKGROUND: Resveratrol may play a protective role against the frailty syndrome (FS) because of its antioxidant and anti-inflammatory properties. OBJECTIVE: We prospectively evaluated the association between habitual dietary resveratrol exposure and the development of FS after 3-, 6-, and 9-y follow-up periods in a community-dwelling older population. DESIGN: We conducted a longitudinal analysis with the use of data from 769 participants aged ≥65 y from the Invecchiare in Chianti (Aging in Chianti) study...
December 2015: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/26483093/frailty-and-anticoagulation-prescription-rate-for-atrial-fibrillation-in-the-elderly
#15
LETTER
Frédéric Roca, Oarda Bahri, Philippe Chassagne
No abstract text is available yet for this article.
February 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/26442861/prevalence-of-potential-and-clinically-relevant-statin-drug-interactions-in-frail-and-robust-older-inpatients
#16
Michele Thai, Sarah Hilmer, Sallie-Anne Pearson, Emily Reeve, Danijela Gnjidic
BACKGROUND: A significant proportion of older people are prescribed statins and are also exposed to polypharmacy, placing them at increased risk of statin-drug interactions. OBJECTIVE: To describe the prevalence rates of potential and clinically relevant statin-drug interactions in older inpatients according to frailty status. METHODS: A cross-sectional study of patients aged ≥65 years who were prescribed a statin and were admitted to a teaching hospital between 30 July and 10 October 2014 in Sydney, Australia, was conducted...
October 2015: Drugs & Aging
https://www.readbyqxmd.com/read/26345308/statins-for-primary-cardiovascular-prevention-in-the-elderly
#17
REVIEW
Juan Pedro-Botet, Elisenda Climent, Juan J Chillarón, Rocio Toro, David Benaiges, Juana A Flores-Le Roux
The elderly population is increasing worldwide, with subjects > 65 years of age constituting the fastest-growing age group. Furthermore, the elderly face the greatest risk and burden of cardiovascular disease mortality and morbidity. Although elderly patients, particularly those older > 75, have not been well represented in randomized clinical trials evaluating lipid-lowering therapy, the available evidence supporting the use of statin therapy in primary prevention in older individuals is derived mainly from subgroup analyses and post-hoc data...
July 2015: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/26361161/what-to-expect-from-the-evolving-field-of-geriatric-cardiology
#18
REVIEW
Susan P Bell, Nicole M Orr, John A Dodson, Michael W Rich, Nanette K Wenger, Kay Blum, John Gordon Harold, Mary E Tinetti, Mathew S Maurer, Daniel E Forman
The population of older adults is expanding rapidly, and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with the complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. Although some assume that a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care...
September 15, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26163482/antithrombotic-therapy-in-the-elderly-expert-position-paper-of-the-european-society-of-cardiology-working-group-on-thrombosis
#19
REVIEW
Felicita Andreotti, Bianca Rocca, Steen Husted, Ramzi A Ajjan, Jurrien ten Berg, Marco Cattaneo, Jean-Philippe Collet, Raffaele De Caterina, Keith A A Fox, Sigrun Halvorsen, Kurt Huber, Elaine M Hylek, Gregory Y H Lip, Gilles Montalescot, Joao Morais, Carlo Patrono, Freek W A Verheugt, Lars Wallentin, Thomas W Weiss, Robert F Storey
No abstract text is available yet for this article.
December 7, 2015: European Heart Journal
https://www.readbyqxmd.com/read/26346250/prognostic-and-therapeutic-implications-of-frailty-in-older-adults-with-heart-failure
#20
REVIEW
Michael Goldfarb, Richard Sheppard, Jonathan Afilalo
Frailty is increasingly recognized in older adults with cardiovascular disease, particularly in those with heart failure (HF). A growing body of evidence has shown that frailty has a negative effect on survival, hospitalizations, disability, and quality of life. Beyond frailty, additional domains captured by a comprehensive geriatric assessment contribute incremental value in predicting outcomes and identifying treatment targets. Exercise training is ideally suited to this setting as it can concomitantly improve physical frailty and HF symptoms...
November 2015: Current Cardiology Reports
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