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American Heart Journal

Jacob P Kelly, Brian J Andonian, Mahesh J Patel, Zhen Huang, Linda K Shaw, Robert W McGarrah, Salvador Borges-Neto, Eric J Velazquez, William E Kraus
OBJECTIVE: To identify temporal trends in the use of exercise treadmill testing (ETT) and cardiorespiratory fitness (CRF) estimated by ETT in metabolic equivalents (METs). PATIENTS AND METHODS: We compiled an ETT database of all available treadmill tests-including those with concomitant stress echocardiography and nuclear perfusion imaging studies-performed at Duke University Hospital from January 1, 1970- December 31, 2012. Six different ramp protocols were used in these combined modalities...
January 16, 2019: American Heart Journal
Sarah R Blake, Adeel Shahzad, Suneil K Aggarwal, Abhishek Kumar, Adnan Khan, Rod H Stables
BACKGROUND: Recent randomized controlled trials comparing femoral and radial access in primary percutaneous coronary intervention (PPCI) have shown conflicting results regarding the incidence of major adverse cardiovascular events (MACE) and major bleeding. METHODS: Using data from the HEAT-PPCI trial, we compared the primary efficacy (all-cause mortality, stroke, new myocardial infarction or unplanned repeat revascularization) and safety (major bleeding BARC 3-5) outcomes at 28 days, by final access site used (radial or femoral) and by default operator type...
January 16, 2019: American Heart Journal
Roberto Ferrari, Ian Ford, Kim Fox, Mario Marzilli, Michal Tendera, Petr Widimský, Jean-Pascal Challeton, Nicolas Danchin
BACKGROUND: About 30% of angina patients have persisting symptoms despite successful revascularization and antianginal therapy. Moreover, in stable patients, percutaneous coronary intervention (PCI) does not improve survival as compared with medical therapy alone. Trimetazidine, an antianginal agent devoid of hemodynamic effect, may help reducing symptoms and improving outcomes after PCI. The ATPCI study is investigating the efficacy and safety of adding trimetazidine to standard-of-care in angina patients who had a recent PCI...
January 15, 2019: American Heart Journal
Julian T Hertz, Deng B Madut, Revogatus A Tesha, Gwamaka William, Ryan A Simmons, Sophie W Galson, Francis M Sakita, Venance P Maro, Gerald S Bloomfield, John A Crump, Matthew P Rubach
BACKGROUND: Little is known about community knowledge of myocardial infarction symptoms and perceptions of self-risk in sub-Saharan Africa. METHODS: A community survey was conducted in northern Tanzania, where the prevalence of cardiovascular risk factors is high. Households were selected randomly in a population-weighted fashion and surveys were administered to self-identified household healthcare decision-makers. Respondents were asked to list all symptoms of a heart attack and asked whether they thought they had a chance of suffering a heart attack...
January 15, 2019: American Heart Journal
Zeev Israeli, Shahar Lavi, Samir B Pancholy, Luis Nombela-Franco, Ian C Gilchrist, Ian C Gilchrist, Andrés Aldazabal, Adi Sharabi-Nov, Yaniv Levi, Samual Hayman, Nikolaos Tzemos, Diana Ayán, Mamas A Mamas, Rodrigo Bagur
BACKGROUND: Coronary angiography and intervention to saphenous venous grafts (SVGs) remain challenging. This study aimed to investigate the feasibility and safety of the radial approach compared to femoral access in a large cohort of patients undergoing SVG angiography and intervention. METHODS: Data from 1,481 patients from Canada, United States, and Spain who underwent procedures between 2010 and 2016 were collected. Patients must have undergone SVG coronary angiography and/or intervention...
January 12, 2019: American Heart Journal
Ioanna Kosmidou, Björn Redfors, Shmuel Chen, Aaron Crowley, Nicholas J Lembo, Dimitri Karmpaliotis, W Morris Brown, Eric Maupas, Nicolas Durrleman, Alpesh Shah, Michael J Reardon, Ovidiu Dressler, Ori Ben-Yehuda, Arie Pieter Kappetein, Joseph F Sabik, Patrick W Serruys, Gregg W Stone
BACKGROUND: The prognostic impact of high-sensitivity C-reactive protein (CRP) levels in patients with left main coronary artery disease (LMCAD) treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) is unknown. We sought to determine the effect of elevated baseline CRP levels on the 3-year outcomes after LMCAD revascularization and to examine whether CRP influenced the relative outcomes of PCI versus CABG. METHODS: In the EXCEL trial, patients with LMCAD and Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) scores ≤32 were randomized to PCI versus CABG...
January 11, 2019: American Heart Journal
Raza M Alvi, Maryam Afshar, Anne M Neilan, Noor Tariq, Malek Hassan, Jaime Gerber, Magid Awadalla, Connor P Mulligan, Adam Rokicki, Virginia A Triant, Markella V Zanni, Tomas G Neilan
BACKGROUND: Persons living with HIV (PLHIV) have an increased risk of heart failure (HF). However, little is known about outcomes among PLHIV with HF. The study aim was to compare HF outcomes among PLHIV with HF versus individuals without HIV with HF. METHODS: Our cohort included 2,308 individuals admitted with decompensated HF. We compared baseline characteristics, 30-day HF readmission, and cardiovascular (CV) and all-cause mortality. Within PLHIV, we assessed outcomes stratified between CD4 count and viral load (VL), and tested the association between traditional and HIV-specific parameters with 30-day HF readmission...
January 11, 2019: American Heart Journal
Henock G Yebyo, Hélène E Aschmann, Marco Kaufmann, Milo A Puhan
The current guidelines of statins for primary cardiovascular disease (CVD) prevention were based on results from systematic reviews and meta-analyses that suffer from limitations. METHODS: We searched in PubMed for existing systematic reviews and individual open-label or double-blinded randomized controlled trials that compared a statin with a placebo or another, which were published in English until January 01, 2018. We performed a random-effect pairwise meta-analysis of all statins as a class and network meta-analysis for the specific statins on different benefit and harm outcomes...
January 10, 2019: American Heart Journal
Gloria Santos-Beneit, Patricia Bodega, Mercedes de Miguel, Carla Rodríguez, Vanesa Carral, Xavier Orrit, Domènech Haro, Isabel Carvajal, Amaya de Cos-Gandoy, José Luis Peñalvo, Emilia Gómez-Pardo, Belén Oliva, Borja Ibañez, Juan Miguel Fernández-Alvira, Rodrigo Fernández-Jiménez, Valentin Fuster
Unhealthy habits in children are increasing at an alarming rate. The school provides a promising setting for effective preventive strategies to improve children's lifestyle behaviors. The SI! Program is a multilevel multicomponent school-based educational intervention aimed at all stages of compulsory education in Spain. Here, we present the design of the SI! Program for Elementary School cluster-randomized controlled trial, targeting children aged 6 to 11 years. This trial aims to study the impact of different timings and intensities of exposure to SI! Program activities on elementary school children and their immediate environment (parents/caregivers, teachers, and school)...
January 8, 2019: American Heart Journal
Bryant Priromprintr, Michael J Silka, Jonathan Rhodes, Anjan S Batra
BACKGROUND: The long-term benefits of Melody valve implant for right ventricular outflow tract conduit obstruction or insufficiency on exercise capacity are undefined. METHODS: As part of the Melody valve clinical trial, 136 patients with congenital heart disease underwent serial cardiopulmonary exercise testing prior to, 6 months after, and annually for up to 5 years postimplant. RESULTS: Mean age at Melody valve implantation was 22.4 ± 0...
December 29, 2018: American Heart Journal
Sammy Elmariah, Gary M Ansel, Marianne Brodmann, Gheorghe Doros, Shawn Fuller, William A Gray, Duane S Pinto, Kenneth A Rosenfield, Laura Mauri
BACKGROUND: Drug-coated balloons (DCBs), developed to reduce restenosis after percutaneous intervention in peripheral arterial disease (PAD), have been shown to be safe and efficacious, particularly in treating PAD affecting the femoropopliteal segment. The SurVeil DCB uses an excipient intended to optimize both the uniformity and transfer of paclitaxel to the vessel wall, allowing for efficient drug loading and lower systemic exposure than currently available DCBs, Heretofore, clinical outcomes have not previously been compared to other DCBs...
December 28, 2018: American Heart Journal
Robert A Riestenberg, Andrew Furman, Avery Cowen, Anna Pawlowksi, Daniel Schneider, Alana A Lewis, Sean Kelly, Babafemi Taiwo, Chad Achenbach, Frank Palella, Neil J Stone, Donald M Lloyd-Jones, Matthew J Feinstein
BACKGROUND: Risks for cardiovascular diseases, including myocardial infarction and stroke, are elevated in people with HIV infection (PWH). However, no trials of statin utilization with clinical cardiovascular disease (CVD) end points have been completed in PWH, and there are sparse real-world data regarding statin use and lipid-lowering effectiveness. We therefore used a unique cohort of PWH and uninfected controls to evaluate (1) differences in statin types used for PWH versus uninfected persons; (2) lipid lowering achieved by statin use for PWH versus uninfected persons; and (3) racial and ethnic disparities in appropriate statin use among PWH and uninfected persons...
December 20, 2018: American Heart Journal
Nikki J Earle, Jackie Crawford, Ian Hayes, Mark I Rees, John French, Martin K Stiles, Kathryn E Waddell-Smith, Tom Donoghue, Rachael Monkley, Katherine Neas, Andrew Aitken, Rexson Tse, Donald R Love, Jonathan R Skinner
In 2002, the Cardiac Inherited Diseases Registry New Zealand was established with an associated clinical service, in order to identify pre-symptomatic people with inherited heart conditions, enable tracking of families, and collate data. We describe the establishment of this registry and discuss the key features, including dedicated coordinators, links to a multidisciplinary and collaborative clinical service, a translational research program, a secure web-based database, and governance encompassing ethical and cultural approval...
December 19, 2018: American Heart Journal
Xiaoxi Yao, Bernard J Gersh, Francisco Lopez-Jimenez, Nilay D Shah, Peter A Noseworthy
BACKGROUND: In the FOURIER trial, evolocumab, a proprotein convertase subtilisin-kexin type 9 inhibitor, reduced cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD). We aimed to examine how closely patients in routine practice resemble the FOURIER trial participants and to assess the observed cardiovascular risks based on trial eligibility and underrepresentativeness. METHODS: Using a large US administrative database with linked laboratory data, we identified adult patients with ASCVD between January 1, 2012, and December 31, 2016...
December 16, 2018: American Heart Journal
Martine E Bol, Martje M Suverein, Roberto Lorusso, Thijs S R Delnoij, George J Brandon Bravo Bruinsma, Luuk Otterspoor, Marijn Kuijpers, Ka Yan Lam, Alexander P J Vlaar, Carlos V Elzo Kraemer, Joris J van der Heijden, Erik Scholten, Antoine H G Driessen, José M Montero Cabezas, Saskia Z H Rittersma, Bram G Heijnen, Fabio S Taccone, Brigitte Essers, Tammo Delhaas, Patrick W Weerwind, Paul M H J Roekaerts, Jos G Maessen, Marcel C G van de Poll
Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR...
December 14, 2018: American Heart Journal
Brian C Boursiquot, Joseph C Larson, Omaima A Shalash, Mara Z Vitolins, Elsayed Z Soliman, Marco V Perez
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia in adults. Although vitamin D deficiency is associated with AF risk factors, retrospective studies of association with AF have shown mixed results. We sought to determine the efficacy of calcium and vitamin D (CaD) supplementation for AF prevention in a randomized trial. METHODS: We performed a secondary analysis of the Women's Health Initiative trial on CaD supplementation versus placebo. We linked participants to their Medicare claims to ascertain incident AF...
December 13, 2018: American Heart Journal
Steffen Desch, Anne Freund, Tobias Graf, Stephan Fichtlscherer, Hendrik Haake, Michael Preusch, Fabian Hammer, Ibrahim Akin, Martin Christ, Christoph Liebetrau, Carsten Skurk, Stephan Steiner, Ingo Voigt, Roland Schmitz, Harald Mudra, Jakob Ledwoch, Niels Menck, Jan Horstkotte, Klaus Pels, Anna-Lena Lahmann, Sylvia Otto, Karsten Lenk, Marc-Alexander Ohlow, Christian Hassager, Peter Nordbeck, Uwe Zeymer, Alexander Jobs, Suzanne de Waha-Thiele, Denise Olbrich, Inke König, Kathrin Klinge, Holger Thiele
Patients experiencing out-of-hospital cardiac arrest (OHCA) without ST-segment elevation are a heterogenic group with a variety of underlying causes. Up to one-third of patients display a significant coronary lesion compatible with myocardial infarction as OHCA trigger. There are no randomized data on patient selection and timing of invasive coronary angiography after admission. METHODS AND RESULTS: The TOMAHAWK trial randomly assigns 558 patients with return of spontaneous circulation after OHCA with no obvious extracardiac origin of cardiac arrest and no ST-segment elevation/left bundle-branch block on postresuscitation electrocardiogram to either immediate coronary angiography or initial intensive care assessment with delayed/selective angiography in a 1:1 ratio...
December 11, 2018: American Heart Journal
Anirban Basu, David L Veenstra, Josh J Carlson, Wei-Jhih Wang, Kelley Branch, Jeffrey Probstfield
A research funder faces the challenge of selecting to fund a small set of studies from a larger pool of proposals, even after proposals achieve the benchmarks of scientific rigor and integrity. Clinical researchers can better quantify the value of their proposed study to facilitate this prioritization process. Value of information analysis can help in this quantification and inform the funder about the population and individual patient-level impact of a comparative research proposal. In this article, we introduce the overarching framework of the value of information to a clinical research audience, identify the steps required to calculate value of information for a proposal, and highlight some software that can be used to readily compute these estimates based on information available for a research protocol...
December 8, 2018: American Heart Journal
Christophe Leclercq, Haran Burri, Antonio Curnis, Peter Paul Delnoy, Christopher A Rinaldi, Johannes Sperzel, Kwangdeok Lee, Clay Cohorn, Bernard Thibault
BACKGROUND: Although cardiac resynchronization therapy (CRT) is beneficial in most heart failure patients, up to 40% do not respond to CRT. Data from the MultiPoint Pacing (MPP) IDE trial and MORE-CRT MPP-PHASE I study suggest improved response in subjects in the MPP arm-programmed with wide left ventricular (LV) electrode anatomical separation (≥30 mm) and shortest timing delays of 5 milliseconds (MPP-AS)-compared with quadripolar biventricular (BiV) pacing. STUDY DESIGN: The MORE-CRT MPP-PHASE II trial is a prospective, randomized, multicenter study to assess the 6-month impact of MPP programmed to mandated MPP-AS settings in subjects who do not respond to 6 months of BiV pacing (MPP OFF)...
December 8, 2018: American Heart Journal
Alexander T Sandhu, Paul A Heidenreich
BACKGROUND: The Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure. METHODS: We compared heart failure readmission and mortality rates in hospitals exposed to HRRP financial penalties with critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare. RESULTS: After HRRP introduction, CAHs experienced a 0...
December 7, 2018: American Heart Journal
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