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Geriatric Cardiology

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43 papers 0 to 25 followers Seminal articles in the field of geriatric cardiology
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...
September 27, 2016: Journal of the American Geriatrics Society
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
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
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
Jonathan Afilalo
No abstract text is available yet for this article.
May 2016: Circulation. Cardiovascular Quality and Outcomes
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
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
Frédéric Roca, Oarda Bahri, Philippe Chassagne
No abstract text is available yet for this article.
February 2016: Canadian Journal of Cardiology
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
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
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
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
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
Olga Toleva, Quazi Ibrahim, Neil Brass, Sunil Sookram, Robert Welsh
BACKGROUND: Management of elderly patients with ST elevation myocardial infarction (STEMI) is challenging and they are under-represented in trials. Accordingly, we analysed reperfusion strategies and their effectiveness in patients with STEMI ≥75 years compared to <75 years within a comprehensive inclusive registry. METHODS: Consecutive patients with STEMI admitted to hospital and tracked within a regional registry (2006-2011) were analysed comparing reperfusion strategy (primary percutaneous coronary intervention (PPCI), fibrinolysis and no reperfusion) between patients ≥75 vs <75 years old as well as across the reperfusion strategies in those ≥75 years...
2015: Open Heart
Caroline A Kim, Dae Hyun Kim
OBJECTIVES: To examine whether the benefit of statins varied according to cardiovascular (CV) and non-CV mortality of the treated population. DESIGN: Meta-analysis and meta-regression of 16 randomized placebo-controlled trials. SETTING: Community and hospital. PARTICIPANTS: Statin- (n = 59,671) and placebo-treated (n = 59,707) individuals with and without CV disease (mean age 55 to 75). MEASUREMENTS: Meta-regression was used to model relative risks (RRs) of major CV events (myocardial infarction and stroke) and total mortality for statins versus placebo as a function of CV and non-CV mortality risks of the study population...
July 2015: Journal of the American Geriatrics Society
Robert D Boutin, Lawrence Yao, Robert J Canter, Leon Lenchik
OBJECTIVE: The purpose of this article is to review the nomenclature, clinical impact, and diagnostic techniques characterizing sarcopenia. CONCLUSION: Sarcopenia-defined as significant loss of muscle-is associated with cachexia and frailty. Specific diagnostic criteria for sarcopenia continue to evolve, but imaging can play a role in the detection and quantification of muscle depletion. Emerging evidence indicates that sarcopenia is a relevant predictor of quality and quantity of life, particularly in patients who are elderly, have cancer, or undergo surgery...
September 2015: AJR. American Journal of Roentgenology
Philip Green, Suzanne V Arnold, David J Cohen, Ajay J Kirtane, Susheel K Kodali, David L Brown, Charanjit S Rihal, Ke Xu, Yang Lei, Marian C Hawkey, Rebeca J Kim, Maria C Alu, Martin B Leon, Michael J Mack
Transcatheter aortic valve replacement (TAVR) is an effective treatment for severe symptomatic aortic stenosis (AS) in patients who are inoperable or at high risk for surgery. However, the intermediate- to long-term mortality is high, emphasizing the importance of patient selection. We, therefore, sought to evaluate the prognostic value of frailty in older recipients of TAVR, hypothesizing that frail patients would experience a higher mortality rate and a higher likelihood of poor outcome 1 year after TAVR...
July 15, 2015: American Journal of Cardiology
Renato D Lopes, S Michael Gharacholou, DaJuanicia N Holmes, Laine Thomas, Tracy Y Wang, Matthew T Roe, Eric D Peterson, Karen P Alexander
BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in this growing population of older adults with ischemic heart disease. METHODS: We linked 36,711 patients aged ≥65 years who survived an index non-ST-segment elevation myocardial infarction from the CRUSADE registry to Medicare claims data for follow-up...
June 2015: American Journal of Medicine
Marie Eve Brault, Samuel M Ohayon, Ricky Kwan, Howard Bergman, Mark J Eisenberg, Jean-François Boivin, Jean-François Morin, Yves Langlois, Chantal Autexier, Jonathan Afilalo
No abstract text is available yet for this article.
November 2014: Journal of the American Geriatrics Society
Melissa Bendayan, Lior Bibas, Michael Levi, Louie Mullie, Daniel E Forman, Jonathan Afilalo
There is increasing momentum to measure frailty in clinical practice given its proven value as a predictor of outcomes, particularly in elderly patients with cardiovascular disease. The number of randomized clinical trials targeting frail older adults has been modest to date. Therefore, we systematically searched the registry in order to review the frailty intervention trials that had been actively initiated or completed but not yet published. The interventions studied were exercise training in 2 trials, nutritional supplementation in 3 trials, combined exercise plus nutritional supplementation in 5 trials, pharmaceutical agents in 5 trials, multi-dimensional programs in 2 trials, and home-based services in 3 trials...
September 2014: Progress in Cardiovascular Diseases
2015-07-18 17:40:46
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