Journal of the American College of Cardiology

For secondary prevention of coronary artery disease (CAD), oral antiplatelet therapy is essential. In case of coronary intervention, temporary dual antiplatelet therapy is mandatory as well. Recently, low-dose oral anticoagulation has entered the CAD arena. Atrial fibrillation (AF) is often seen in CAD and vice versa. In most patients stroke prevention in AF consists of oral anticoagulation. In many cases of CAD in patients with AF, anticoagulation has to be combined with antiplatelet agents (so called, dual pathway antithrombotic therapy)...

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BACKGROUND: High stroke risk atrial fibrillation patients unsuitable to oral anticoagulants (OAC) require other stroke prevention strategies. A novel permanent coil filter directly placed into both common carotid arteries (CCAs) was designed to capture emboli >1.4mm diameter. OBJECTIVES: In a multicenter, non-randomized, first-in-human clinical trial (CAPTURE), to determine the feasibility and safety of bilateral CCA filter placement. METHODS: Eligible patients had atrial fibrillation, CHA2 DS2 -VASc ≥ 2, OAC unsuitability, CCA size 4...

Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation...

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BACKGROUND: Patients with isolated tricuspid regurgitation (TR) in the absence of left-sided valvular dysfunction are historically managed nonoperatively. OBJECTIVES: To assess the impact of surgery for isolated TR, we compared survival for isolated severe TR patients who underwent surgery to those who did not. METHODS: A longitudinal echocardiography database was used to perform a retrospective analysis on 3,276 adult patients with isolated severe TR from November 2001-March 2016...

BACKGROUND: Catheter ablation of atrial fibrillation using thermal energies such as radiofrequency or cryothermy is associated with indiscriminate tissue destruction. During pulsed field ablation (PFA), sub-second electric fields create microscopic pores in cell membranes - a process called electroporation. Among cell types, cardiomyocytes have among the lowest thresholds to these fields, potentially permitting preferential myocardial ablation. OBJECTIVES: To determine whether PFA allows durable pulmonary vein (PV) isolation without damage to collateral structures...

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No abstract text is available yet for this article.

After a reperfused myocardial infarction (MI), dynamic tissue changes occur (edema, inflammation, microvascular obstruction, hemorrhage, cardiomyocyte necrosis, and ultimately replacement by fibrosis). The extension and magnitude of these changes contribute to long-term prognosis after MI. Cardiac magnetic resonance (CMR) is the gold-standard technique for noninvasive myocardial tissue characterization. CMR is also the preferred methodology for the identification of potential benefits associated with new cardioprotective strategies both in experimental and clinical trials...

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BACKGROUND: The Hospital Readmissions Reduction Program (HRRP) has been associated with reduced 30-day readmissions for acute myocardial infarction (AMI) and heart failure (HF). OBJECTIVES: The purpose of this study was to test whether this 30-day readmission reduction is a manifestation of practices that defer or avoid hospitalizations beyond the 30-day period. METHODS: At all U.S. hospitals under HRRP, the authors calculated daily readmission rates for elderly Medicare fee-for-service beneficiaries through day-60 post-discharge following a hospitalization for AMI and HF-the 2 target cardiovascular conditions-as well as pneumonia in July 2008 to June 2016...

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BACKGROUND: Drug-eluting technologies improve 12-month angiographic results of femoropopliteal (FP) interventions, but few data on the comparison between drug-coated balloons (DCBs) and drug-eluting stents (DES) are available. OBJECTIVES: The aim of this study was to compare, after balloon pre-dilation, a strategy of DCB followed by provisional self-expanding nitinol bare-metal stent implantation with a strategy of systematic DES implantation in patients at high risk for FP restenosis...

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BACKGROUND: Enterococcus faecalis is the third most frequent cause of infective endocarditis (IE). Despite this, no systematic prospective echocardiography studies have examined the prevalence of IE in patients with E. faecalis bacteremia. OBJECTIVES: This study sought to determine the prevalence of IE in patients with E. faecalis bacteremia. The secondary objective was to identify predictors of IE. METHODS: From January 1, 2014, to December 31, 2016, a prospective multicenter study was conducted with echocardiography in consecutive patients with E...

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BACKGROUND: Patients with liver disease have increased risk of thrombosis and bleeding but are typically excluded from trials of direct oral anticoagulant agents. OBJECTIVES: This study evaluated the pharmacokinetics (PK), pharmacodynamics (PD), clinical efficacy and safety of edoxaban versus warfarin in patients with atrial fibrillation (AF) and history of liver disease. METHODS: ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction Study 48) was a randomized, double-blind trial comparing edoxaban with warfarin in patients with AF followed for 2...