John L Jefferies, Csaba P Kovesdy, Claudio Ronco
Acute cardiorenal syndrome (CRS), categorized as CRS type 1 and 3, is defined by the interplay of acute kidney injury or dysfunction and acute cardiac disease. For optimized diagnosis and management of CRS, strategies targeting multi-organ dysfunction must be adopted. Early diagnosis of acute CRS is important to enable timely initiation of appropriate treatment to prevent serious morbidity and mortality; however, traditional biomarkers are suboptimal. Over the past two decades, numerous biomarkers have been investigated for a better and more rapid diagnosis of CRS...
March 21, 2023: American Heart Journal
Jung-Joon Cha, Soon Jun Hong, Ju Hyeon Kim, Subin Lim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Pil Hyung Lee, Seung Whan Lee, Cheol Whan Lee, Jae Youn Moon, Jong-Young Lee, Jung-Sun Kim, Jae Suk Park, Kyounghoon Lee, Sang Yup Lim, Jin Oh Na, Jin-Man Cho, Seok Yeon Kim, Do-Sun Lim
BACKGROUND: Current guidelines recommend that patients with established atherosclerotic cardiovascular disease (ASCVD) use high-intensity statin therapy to lower low-density lipoprotein (LDL)-cholesterol levels by at least 50%, irrespective of age. However, in real-world practice, there is reluctance to maintain statin use in response to side-effects, particularly statin-associated muscle symptoms (SAMS). Moreover, no randomized trial has been conducted on the safety of statin therapy in elderly patients...
March 17, 2023: American Heart Journal
Richard Descamps, Julien Amour, Emmanuel Besnier, Adrien Bougle, Hélène Charbonneau, Martin Charvin, Bernard Cholley, Olivier Desebbe, Jean-Luc Fellahi, Denis Frasca, François Labaste, Diane Lena, Yazine Mahjoub, Paul-Michel Mertes, Serge Molliex, Pierre-Henry Mouri, Mouhamed Djahoum Moussa, Jean-Ferreol Oilleau, Alexandre Ouattara, Sophie Provenchere, Bertand Rozec, Jean-Jacques Parienti, Marc-Olivier Fischer
BACKGROUND: Postoperative morbidity and mortality after cardiac surgery with cardiopulmonary bypass (CPB) remain high despite recent advances in both anesthesia and perioperative management. Among modifiable risk factors for postoperative complications, optimal arterial pressure during and after surgery has been under debate for years. Recent data suggest that optimizing arterial pressure to the baseline of the patient may improve outcomes. We hypothesize that optimizing the mean arterial pressure (MAP) to the baseline MAP of the patient during cardiac surgery with CPB and during the first 24 hours postoperatively may improve outcomes...
March 17, 2023: American Heart Journal
Luigi Gnudi, Nikolaos Fountoulakis, Angeliki Panagiotou, Antonella Corcillo, Giuseppe Maltese, Maria Flaquer Rife, Ioannis Ntalas, Russell Franks, Amedeo Chiribiri, Salma Ayis, Janaka Karalliedde
BACKGROUND: Active vitamin-D deficiency is a potential modifiable risk factor for increased ventricular mass. We explored the effects of active vitamin-D (calcitriol) treatment on left ventricular mass in patients with type-2 diabetes (T2D) and chronic kidney disease (CKD). METHODS: We performed a 48-week duration single centre randomised double-blind parallel group trial examining the impact of calcitriol, 0.5 mcg once daily, as compared to placebo on a primary endpoint of change from baseline in left ventricular mass index (LVMI) measured by magnetic resonance imaging (MRI)...
March 17, 2023: American Heart Journal
Lisa Q Rong, Antonino Di Franco, Mohamed Rahouma, Arnaldo Dimagli, June Chan, Alexandra J Lopes, Jiwon Kim, Tommaso Sanna, Richard B Devereux, Victoria Delgado, Jonathan W Weinsaft, Filippo Crea, John H Alexander, Marc Gillinov, J Michael DiMaio, Kane O Pryor, Leonard Girardi, Mario Gaudino
BACKGROUND: In the Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery (PALACS) trial, posterior pericardiotomy was associated with a significant reduction in postoperative atrial fibrillation (POAF) after cardiac surgery. We aimed to investigate the mechanisms underlying this effect. METHODS: We included PALACS patients with available echocardiographic data (n=387/420, 92%). We tested the hypotheses that the reduction in POAF with the intervention was associated with 1) a reduction in postoperative pericardial effusion and/or 2) an effect on left atrial size and function...
March 17, 2023: American Heart Journal
Patricia O'Gorman, Lawrence Nair, Nadya Kisiel, Ian Hughes, Karen Huang, Charlie Chia-Tsong Hsu, Erika Fagman, Ruth Heying, María N Pizzi, Albert Roque, Kuljit Singh
IMPORTANCE: The use of 18 F-FDG PET/CT in diagnostic algorithms for PVE has increased since publication of studies and guidelines advocating its use. The assessment of test accuracy has been limited by small study sizes. We undertook a systematic review using individual patient data (IPD) meta-analysis techniques. OBJECTIVE: To estimate the summary sensitivity and specificity of 18 F-FDG PET/CT in diagnosing PVE. We also assessed the effect of patient factors on test accuracy as defined by changes in the Odds Ratios associated with each factor...
March 17, 2023: American Heart Journal
Yuya Sudo, Takeshi Morimoto, Ryu Tsushima, Masahiro Sogo, Masatomo Ozaki, Masahiko Takahashi, Keisuke Okawa
AIMS: The P-wave terminal force in electrocardiogram lead V1 (PTFV1) correlates with outcomes in patients with paroxysmal atrial fibrillation (AF). Nevertheless, the correlation between the PTFV1 and outcomes after AF ablation in patients with persistent AF remains unclear. This study aimed to determine whether the PTFV1 at 3 months after AF ablation could predict AF recurrence and cardiovascular events in patients with persistent AF. METHODS: This historical cohort study examined 453 consecutive patients with persistent AF who underwent a first-time AF ablation...
March 17, 2023: American Heart Journal
Alexandre Gautier, Marco Roffi, Peep Laanmets, Shahzad Munir, Fazila Tun-Nesa Malik, Andres Iniguez Romo, Gabriel Maluenda, Shoichi Kuramitsu, Michael Angioi, William Wijns, Shigeru Saito, Bernard Chevalier
BACKGROUND: Large-scale registries can provide valuable complementary data to randomized controlled trials (RCT) for the post-marketing evaluation of coronary stents, but their scientific relevance remains debated. METHODS: We sought to compare the evidence on the performance of a single coronary stent platform generated by the RCT for its regulatory approval and a well-conducted international registry. Patients treated with the Ultimaster coronary stent in the CENTURY II (CII-UM) trial (n=551) were compared to patients in the real-world e-ULTIMASTER (e-UM) registry (n=35,389)...
March 15, 2023: American Heart Journal
Che Ngufor, Xiaoxi Yao, Jonathan W Inselman, Joseph S Ross, Sanket S Dhruva, David J Graham, Joo-Yeon Lee, Konstantinos C Siontis, Nihar R Desai, Eric Polley, Nilay D Shah, Peter A Noseworthy
BACKGROUND: Lifelong oral anticoagulation is recommended in patients with atrial fibrillation (AF) to prevent stroke. Over the last decade, multiple new oral anticoagulants (OACs) have expanded the number of treatment options for these patients. While population-level effectiveness of OACs has been compared, it is unclear if there is variability in benefit and risk across patient subgroups. METHODS: We analyzed claims and medical data for 34,569 patients who initiated a non-vitamin K antagonist oral anticoagulant (NOAC; apixaban, dabigatran, and rivaroxaban) or warfarin for nonvalvular AF between 08/01/2010 and 11/29/2017 from the OptumLabs® Data Warehouse...
March 7, 2023: American Heart Journal
Alexander C Fanaroff, Mitesh S Patel, Neel Chokshi, Samantha Coratti, David Farraday, Laurie Norton, Charles Rareshide, Jingsan Zhu, Julia E Szymczak, Louise B Russell, Dylan S Small, Kevin G M Volpp
BACKGROUND: Higher levels of physical activity are associated with improvements in cardiovascular health, and consensus guidelines recommend that individuals with or at risk for atherosclerotic cardiovascular disease (ASCVD) participate in regular physical activity. However, most adults do not achieve recommended levels of physical activity. Concepts from behavioral economics have been used to design scalable interventions that increase physical activity over short time periods, but the longer-term efficacy of these strategies is uncertain...
March 2, 2023: American Heart Journal
Andrew Paul DeFilippis, Karita Claudia Freitas Lidani, Yunbi Nam, Patrick J Trainor, W Craig Johnson, Susan R Heckbert, Robyn L McClelland, Michael J Blaha, Khurram Nasir
BACKGROUND: Despite different prevalence, pathobiology, and prognosis between etiologically distinct myocardial infarction (MI) subtypes, prospective study of risk factor for MI in large NHLBI-sponsored cardiovascular cohorts is limited to acute MI as a singular entity. Therefore, we sought to utilize the Multi-Ethnic Study of Atherosclerosis (MESA), a large prospective primary prevention cardiovascular study, to define the incidence and risk factor profile of individual myocardial injury subtypes...
March 1, 2023: American Heart Journal
Jenica N Upshaw, Susan Parker, Douglas Gregory, Benjamin Koethe, Amanda R Vest, Ayan R Patel, Michael S Kiernan, David DeNofrio, Eric Davidson, Sharanya Mohanty, Patrick Arpin, Nicole Strauss, Crystal Sommer, Linda Brandon, Rita Butler, Henry Dwaah, Hilary Nadeau, Michael Cantor, Marvin A Konstam
BACKGROUND: Mobile health applications are becoming increasingly common. Prior work has demonstrated reduced HF hospitalizations with HF disease management programs; however, few of these programs have used tablet computer-based technology. METHODS: Participants with a diagnosis of HF and at least one high risk feature for hospitalization were randomized to either an established telephone-based disease management program or the same disease management program with the addition of remote monitoring of weight, blood pressure, heart rate and symptoms via a tablet computer for 90 days...
February 24, 2023: American Heart Journal
Maria C Castelijns, Steven H J Hageman, Martin Teraa, Manon G van der Meer, Jan Westerink, Francesco Costa, Jurriën M Ten Berg, Frank L J Visseren
OBJECTIVE: The long-term predictive performance of existing bleeding risk models in patients with various manifestations of cardiovascular disease (CVD) is not well known . This study aims to assess and compare the performance of relevant existing bleeding risk models in estimating the long-term risk of major bleeding in a cohort of patients with established CVD. METHODS: Seven existing bleeding risk models (PRECISE-DAPT, DAPT, Ducrocq et al, de Vries et al, S2 TOP-BLEED, Intracranial B2 LEED3 S and HAS-BLED) were identified and externally validated in 7249 patients with established CVD included in the Utrecht Cardiovascular Cohort - Second Manifestations of Arterial Disease study...
February 23, 2023: American Heart Journal
Hidenori Yaku, Takao Kato, Takeshi Morimoto, Kazuhisa Kaneda, Ryusuke Nishikawa, Takeshi Kitai, Yasutaka Inuzuka, Yodo Tamaki, Taketoshi Yamazaki, Jun Kitamura, Hirotaka Ezaki, Kazuya Nagao, Hiromi Yamamoto, Akihiro Isotani, Arita Takeshi, Chisato Izumi, Yukihito Sato, Yoshihisa Nakagawa, Satoaki Matoba, Yasushi Sakata, Koichiro Kuwahara, Takeshi Kimura
BACKGROUND: The decongestion strategy using loop diuretics is essential for improving signs and symptoms of heart failure (HF). However, chronic use of loop diuretics in HF has been linked to worsening renal function and adverse clinical outcomes in a dose-dependent manner. Goreisan, a traditional Japanese herbal medicine, has a long history of use in Japan for regulating body fluid homeostasis and has been recognized as causing less adverse outcomes such as dehydration in contrast to loop diuretics in clinical practice...
February 23, 2023: American Heart Journal
Michael G Nanna, Eric Yow, Sreekanth Vemulapalli, Daniel B Mark, Michelle Kelsey, Manesh R Patel, Hussein R Al-Khalidi, Campbell Rogers, James E Udelson, Pamela S Douglas
Current guidelines recommend a deferred testing approach in low-risk patients presenting with stable chest pain. After simulating a deferred testing approach using the PROMISE Minimal Risk Score to identify 915 minimal risk participants with cost data from the PROMISE trial, a deferred testing strategy was associated with an adjusted cost savings of -$748.74 (95% CI: -1646.97, 158.06) per participant and 74.6% of samples had better clinical outcomes and lower mean cost. This supports the current guideline recommended deferred testing approach in low-risk patients with stable chest pain...
February 22, 2023: American Heart Journal
Christopher S Almond, Lynn A Sleeper, Joseph W Rossano, Matthew J Bock, Elfriede Pahl, Scott Auerbach, Ashwin Lal, Seth A Hollander, Shelley D Miyamoto, Chesney Castleberry, Joanne Lee, Lynsey M Barkoff, Selena Gonzales, Gloria Klein, Kevin P Daly
BACKGROUND: Currently there are no immunosuppression regimens FDA-approved to prevent rejection in pediatric heart transplantation (HT). In recent years, everolimus (EVL) has emerged as a potential alternative to standard tacrolimus (TAC) as the primary immunosuppressant to prevent rejection that may also reduce the risk of cardiac allograft vasculopathy (CAV), chronic kidney disease (CKD) and cytomegalovirus (CMV) infection. However, the two regimens have never been compared head-to-head in a randomized trial...
February 22, 2023: American Heart Journal
Xiao Wang, Ruifeng Guo, Yingying Guo, Qian Guo, Yan Yan, Wei Gong, Wen Zheng, Hui Wang, Lei Xu, Hui Ai, Bin Que, Xiaoyan Yan, Xinliang Ma, Shaoping Nie
BACKGROUND: The mortality following ST-segment elevation myocardial infarction (STEMI) remains substantial in the reperfusion era. Shenfu injection, as a traditional Chinese herbal formula, can alleviate ischemia-reperfusion injury through multiple pharmacologic effects. However, no robust data are available regarding the role of Shenfu injection in reducing infarct size for patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). METHODS/DESIGN: This RESTORE trial is a multicenter, randomized, double-blind, parallel-group, placebo-controlled trial (NCT04493840)...
February 21, 2023: American Heart Journal
Xiao-Xia Liu, Qiang Liu, Yi-Wei Lai, Qi Guo, Rong Bai, De-Yong Long, Rong-Hui Yu, Ri-Bo Tang, Nian Liu, Chen-Xi Jiang, Wei Wang, Xue-Yuan Guo, Song-Nan Li, Xin Zhao, Song Zuo, Chang-Yi Li, Shang-Ming Song, Shuang-Lun Xie, Wei-Li Ge, Jian-Gang Zou, Xiao-Feng Hou, Ke Chen, Jin-Lin Zhang, He-Sheng Hu, Xin-Hua Wang, Zhao-Jun Wang, Xin Du, Chen-Yang Jiang, Cai-Hua Sang, Jian-Zeng Dong, Chang-Sheng Ma
BACKGROUND: In randomized studies, the strategy of pulmonary vein antral isolation (PVI) plus linear ablation has failed to increase success rates for persistent atrial fibrillation (PeAF) ablation when compared with PVI alone. Peri-mitral reentry related atrial tachycardia due to incomplete linear block is an important cause of clinical failures of a first ablation procedure. Ethanol infusion (EI) into the vein of Marshall (EI-VOM) has been demonstrated to facilitate a durable mitral isthmus linear lesion...
February 20, 2023: American Heart Journal
Niklas Dyrby Johansen, Muthiah Vaduganathan, Ankeet S Bhatt, Simin Gharib Lee, Daniel Modin, Brian L Claggett, Erica L Dueger, Sandrine Samson, Matthew M Loiacono, Lars Køber, Scott D Solomon, Pradeesh Sivapalan, Jens Ulrik Stæhr Jensen, Palle Valentiner-Branth, Tyra Grove Krause, Tor Biering-Sørensen
BACKGROUND: Annual influenza vaccination is widely recommended in older adults and other high-risk groups including patients with cardiovascular disease. The real-world effectiveness of influenza vaccination is limited by suboptimal uptake and effective strategies for increasing vaccination rates are therefore needed. The purpose of this trial is to investigate whether behavioral nudges digitally delivered via the Danish nationwide mandatory governmental electronic letter system can increase influenza vaccination uptake among older adults...
February 16, 2023: American Heart Journal
Nathaniel R Smilowitz, Kurt Ruetzler, Jeffrey S Berger
BACKGROUND: Perioperative bleeding is a common and potentially life-threatening complication after surgery. We sought to identify the frequency, patient characteristics, causes, and outcomes of perioperative bleeding in patients undergoing noncardiac surgery. METHODS: In a retrospective cohort study of a large administrative database, adults age ≥45 years hospitalized for noncardiac surgery in 2018 were identified. Perioperative bleeding was defined using ICD-10 diagnosis and procedure codes...
February 16, 2023: American Heart Journal
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