Emilien C J Wegerif, Çağdaş Ünlü, Manon I Generaal, Rutger van den Bor, Peter M van de Ven, Michiel L Bots, Gert J de Borst
RATIONALE: Antiplatelet therapy (APT) is the standard of care after endovascular revascularization (EVR) in patients with peripheral artery disease (PAD). APT aims to prevent both major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nonetheless, the rates of MACE and MALE after EVR remain high. In coronary artery and cerebrovascular disease, dual APT (DAPT)compared to acetylsalicylic acid alone has proven to reduce MACE without increasing the risk of major bleeding when applied for a restricted number of weeks...
April 10, 2024: American Heart Journal
Melissa A Daubert, Amanda Stebbins, Rachel Peragallo-Urrutia, Karen Chiswell, Matthew S Loop, Ceshae Harding, Thomas Price, Tracy Y Wang
BACKGROUND: Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and eclampsia, are risk factors for cardiovascular (CV) disease. Guidelines recommend that women with HDP be screened for the development of hypertension (HTN) within 6-12 months postpartum. However, the extent to which this early blood pressure (BP) screening is being performed and the impact on detection of CV risk factors is unknown. METHODS: Women with HDP and without pre-existing hypertension (HTN) who had at least 6 months of clinical follow-up were categorized by postpartum BP screening status: early BP screen (6-12 months after delivery) or late BP screen (≥12 months after delivery)...
April 4, 2024: American Heart Journal
Dae Yong Park, Yasser Jamil, Golsa Babapour, Junglee Kim, Greta Campbell, Zafer Akman, Ajar Kochar, Sounok Sen, Marc D Samsky, Nikhil V Sikand, Jennifer Frampton, Abdulla Al Damluji, Michael G Nanna
BACKGROUND: Cognitive function and cardiovascular disease (CVD) have a bidirectional relationship, but studies on the impact of CVD subtypes and aging spectrum have been scarce. METHODS: We assessed older adults aged ≥60 years from the 2011-2012 and 2013-2014 cycles of the National Health and Nutrition Examination Survey who had coronary heart disease, angina, prior myocardial infarction, congestive heart failure, or prior stroke. We compared CERAD-IR, CERAD-DR, Animal Fluency test, and DSST scores to assess cognitive performance in older adults with and without CVD...
April 2, 2024: American Heart Journal
Haibo Zhang, Xiqian Huo, Lixin Ren, Jiapeng Lu, Jing Li, Xin Zheng, Jiamin Liu, Wenjun Ma, Jing Yuan, Xiaolin Diao, Chaoqun Wu, Xiaoyan Zhang, Jin Wang, Wei Zhao, Shengshou Hu
BACKGROUND: Hypertension management in China is suboptimal with high prevalence and low control rate due to various barriers, including lack of self-management awareness of patients and inadequate capacity of physicians. Digital therapeutic interventions including mobile health and computational device algorithms such as clinical decision support systems (CDSS) are scalable with the potential to improve blood pressure (BP) management and strengthen the healthcare system in resource-constrained areas, yet their effectiveness remains to be tested...
April 2, 2024: American Heart Journal
Mehmet Özkan, Ahmet Güner, Sabahattin Gündüz, Gazi Yıldız, Ayşe İnci Yıldırım, Macit Kalçık, Mahmut Yesin, Emrah Bayam, Semih Kalkan, Mustafa Ozan Gürsoy, Alev Kılıçgedik, Zübeyde Bayram, Münevver Sarı, Mehmet Aytürk, Süleyman Karakoyun, Mehmet Ali Astarcıoğlu, Elif Cansu Gündoğdu, Asuman Biçer, Emre Gürcü, Tuncer Koçak, Recep Demirbağ
BACKGROUND: Optimal first-trimester anticoagulation is still challenging in pregnant women with mechanical heart valves (MHVs) requiring high-dose warfarin.This multicenter prospective study aims to determine the optimal anticoagulation regimens for pregnant patients with MHVs. METHODS: All women were allocated to one of three treatment options during first trimester including lone low-molecular-weight heparin (LMWH), combination of LMWH+2.5 mg warfarin, and LMWH+4 mg warfarin...
April 1, 2024: American Heart Journal
Alexander Thomas, Soumya Banna, Andi Shahu, Tariq Ali, Christopher Schenck, Bhoumesh Patel, Andrew Notarianni, Melinda Phommalinh, Ajar Kochar, Cory Heck, Sean van Diepen, P Elliott Miller
BACKGROUND: Patients with acute myocardial infarction (AMI) requiring invasive mechanical ventilation (IMV) have a high mortality. However, little is known regarding the impact of induction agents, used prior to IMV, on clinical outcomes in this population. We assessed for the association between induction agent and mortality in patients with AMI requiring IMV. METHODS: We compared clinical outcomes between those receiving propofol compared to etomidate for induction among adults with AMI between October 2015 and December 2019 using the Vizient® Clinical Data Base, a multicenter, US national database...
March 28, 2024: American Heart Journal
Sudeep D Sunthankar, Ryan P Moore, Daniel W Byrne, Henry J Domenico, Allison P Wheeler, Shannon C Walker, Prince J Kannankeril
BACKGROUND: Children with congenital heart disease (CHD) are at high risk for hospital-associated venous thromboembolism (HA-VTE). The Children's Likelihood of Thrombosis (CLOT) trial validated a real-time predictive model for HA-VTE using data extracted from the EHR for pediatric inpatients. We tested the hypothesis that addition of CHD specific data would improve model prediction in the CHD population. METHODS: Model performance in CHD patients from 2010-2022, was assessed using three iterations of the CLOT model: 1) the original CLOT model, 2) the original model refit using only data from the CHD cohort, and 3) the model updated with the addition of cardiopulmonary bypass time, STAT mortality category, height, and weight as covariates...
March 21, 2024: American Heart Journal
Yujian Wu, Lin Hu, Xiaofei Xie, Wei Li, Yanfei Wang, Li Zhang, Ping Huang, Fengxiang Li, Jianbin Li, Shuliang Xia, Jia Yuan, Ming Li, Zhouping Wang, Xu Zhang
BACKGROUND: Kawasaki disease is a pediatric acute systemic vasculitis that specifically involves the coronary arteries. Timely initiation of immunoglobulin plus aspirin is necessary for diminishing the incidence of coronary artery abnormalities (CAAs). The optimal dose of aspirin, however, remains controversial. The trial aims to evaluate if low-dose aspirin is non-inferior to moderate-dose in reducing the risk of CAAs during the initial treatment of Kawasaki disease. METHODS: This is a multi-centre, prospective, randomized, open-label, blinded endpoint, non-inferiority trial to be conducted in China...
March 18, 2024: American Heart Journal
A T Dennis, E Traer, H Ismail, B J Riedel
BACKGROUND: Cardiovascular disease, including hypertension, in pregnant women is a leading cause of morbidity and mortality globally. The development of reference intervals for cardiovascular responses using exercising testing to measure oxygen utilisation (V̇O2 ) with cardiopulmonary exercise testing (CPET), and distances walked using the incremental shuttle walk test (ISWT), may be promising methods to assess and stratify pregnant women regarding their risk of adverse pregnancy outcomes, to encourage exercise during pregnancy, and to improve exercise prescriptions during pregnancy...
March 15, 2024: American Heart Journal
Pierre-Grégoire Guinot, Olivier Desebbe, Guillaume Besch, Philippe Guerci, Philippe Gaudard, Diane Lena, Paul Michel Mertes, Osama Abou-Arab, Belaid Bouhemad
BACKGROUND: Cardiac surgery-associated acute kidney injury (CS-AKI) affects up to 30% of patients, increasing morbidity and healthcare costs. This condition results from complex factors like ischemia-reperfusion injury and renal hemodynamic changes, often exacerbated by surgical procedures. Norepinephrine, commonly used in cardiac surgeries, may heighten the risk of CS-AKI. In contrast, vasopressin, a non-catecholaminergic agent, shows potential in preserving renal function by favorably affecting renal hemodynamic...
March 14, 2024: American Heart Journal
Lihua Zhang, Wei Wang, Xiqian Huo, Guangda He, Yanchen Liu, Yan Li, Lubi Lei, Jingkuo Li, Boxuan Pu, Yue Peng, Jing Li
OBJECTIVES: We aimed to develop and validate a model to predict 1-year mortality risk among patients hospitalized for acute heart failure (AHF), build a risk score and interpret its application in clinical decision making. METHODS: By using data from China Patient-Centred Evaluative Assessment of Cardiac Events Prospective Heart Failure Study, which prospectively enrolled patients hospitalized for AHF in 52 hospitals across 20 provinces, we used multivariate Cox proportional hazard model to develop and validate a model to predict 1-year mortality...
March 13, 2024: American Heart Journal
Hayley E Miller, Seda Tierney, Marcia L Stefanick, Jonathan A Mayo, Oshra Sedan, Lisa G Rosas, Mads Melbye, Heather A Boyd, David K Stevenson, Gary M Shaw, Virginia D Winn, Mark A Hlatky
BACKGROUND: Preeclampsia is associated with a two-fold increase in a woman's lifetime risk of developing atherosclerotic cardiovascular disease (ASCVD), but the reasons for this association are uncertain. The objective of this study was to examine the associations between vascular health and a hypertensive disorder of pregnancy among women ≥ 2 years postpartum. METHODS: Pre-menopausal women with a history of either a hypertensive disorder of pregnancy (cases: preeclampsia or gestational hypertension) or a normotensive pregnancy (controls) were enrolled...
March 12, 2024: American Heart Journal
Niklas Dyrby Johansen, Muthiah Vaduganathan, Ankeet S Bhatt, Daniel Modin, Safia Chatur, Brian L Claggett, Kira Hyldekær Janstrup, Carsten Schade Larsen, Lykke Larsen, Lothar Wiese, Michael Dalager-Pedersen, Lars Køber, Scott D Solomon, Pradeesh Sivapalan, Jens Ulrik Stæhr Jensen, Cyril Jean-Marie Martel, Tyra Grove Krause, Tor Biering-Sørensen
BACKGROUND: Yearly influenza vaccination is strongly recommended for older adults and patients with chronic diseases including cardiovascular disease (CVD); however, vaccination rates remain suboptimal, particularly among younger patients. Electronic letters incorporating behavioral nudges are highly scalable public health interventions which can potentially increase vaccination, but further research is needed to determine the most effective strategies and to assess effectiveness across different populations...
March 7, 2024: American Heart Journal
Jianhua Wu, Ramesh Nadarajah, Yoko M Nakao, Kazuhiro Nakao, Ronen Arbel, Moti Haim, Doron Zahger, Gregory Y H Lip, Campbell Cowan, Chris P Gale
BACKGROUND: The increasing burden of atrial fibrillation (AF) emphasizes the need to identify high-risk individuals for enrolment in clinical trials of AF screening and primary prevention. We aimed to develop prediction models to identify individuals at high-risk of AF across prediction horizons from 6-months to 10-years. METHODS: We used secondary-care linked primary care electronic health record data from individuals aged ≥30 years without known AF in the UK Clinical Practice Research Datalink-GOLD dataset between Jan 2, 1998 and Nov 30, 2018; randomly divided into derivation (80%) and validation (20%) datasets...
March 6, 2024: American Heart Journal
Mitchell Krucoff, Alessandro Spirito, Usman Baber, Samantha Sartori, Dominick J Angiolillo, Carlo Briguori, David J Cohen, Timothy Collier, George Dangas, Dariusz Dudek, Javier Escaned, C Michael Gibson, Ya-Ling Han, Kurt Huber, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Vijay Kunadian, Birgit Vogel, Shamir R Mehta, David Moliterno, Gennaro Sardella, Richard A Shlofmitz, Samin Sharma, Philippe Gabriel Steg, Stuart Pocock, Roxana Mehran
BACKGROUND: The optimal antiplatelet regimen after percutaneous coronary intervention (PCI) in patients with peripheral artery disease (PAD) is still debated. This analysis aimed to compare the effect of ticagrelor monotherapy versus ticagrelor plus aspirin in patients with PAD undergoing PCI. METHODS: In the TWILIGHT trial, patients at high ischemic or bleeding risk that underwent PCI were randomized after 3 months of dual antiplatelet therapy (DAPT) to aspirin or matching placebo in addition to open-label ticagrelor for 12 additional months...
March 6, 2024: American Heart Journal
Dou Dou, Su Yuan, Yuan Jia, Yang Wang, Yinan Li, Hongbai Wang, Jie Ding, Xie Wu, Dongyun Bie, Qiao Liu, Ran An, Haoqi Yan, Fuxia Yan
BACKGROUND: The Enhanced Recovery After Cardiac Surgery is a bundle of measurements from preoperative to postoperative phases to improve patients' recovery. METHODS: This study is a multicenter, stepwise design, cluster randomized controlled trial. 3600 patients presenting during control and intervention periods are eligible if they are aged from 18 to 80 years old awaiting elective cardiac surgery with cardiopulmonary bypass (CPB). 5 centers are randomly assigned to staggered start dates for one-way crossover from the control phase to the intervention phase...
March 2, 2024: American Heart Journal
Ghazaleh Mehdipoor, Björn Redfors, Shmuel Chen, Fotios Gkargkoulas, Zixuan Zhang, Manesh R Patel, Christopher B Granger, E Magnus Ohman, Akiko Maehara, Ingo Eitel, Ori Ben-Yehuda, Suzanne de Waha-Thiele, Holger Thiele, Gregg W Stone
INTRODUCTION: Mortality after ST-segment elevation myocardial infarction (STEMI) is increased in patients with hypertension. The mechanisms underlying this association are uncertain. We sought to investigate whether patients with STEMI and prior hypertension have greater microvascular obstruction (MVO) and infarct size (IS) compared with those without hypertension. METHODS: We pooled individual patient data from 7 randomized trials of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) in whom cardiac magnetic resonance imaging was performed within 1 month after reperfusion...
February 29, 2024: American Heart Journal
Emelie Dillenbeck, Jacob Hollenberg, Michael Holzer, Hans-Jörg Busch, Graham Nichol, Peter Radsel, Jan Belohlavec, Ervigio Corral Torres, Esteban López-de-Sa, Fernando Rosell, Giuseppe Ristagno, Sune Forsberg, Filippo Annoni, Leif Svensson, Martin Jonsson, Denise Bäckström, Mikael Gellerfors, Akil Awad, Fabio S Taccone, Per Nordberg
BACKGROUND: Delayed hypothermia, initiated after hospital arrival, several hours after cardiac arrest with 8-10 hours to reach the target temperature, is likely to have limited impact on overall survival. However, the effect of ultrafast hypothermia, i.e., delivered intra-arrest or immediately after return of spontaneous circulation (ROSC), on functional neurologic outcome after out-of-hospital cardiac arrest (OHCA) is unclear. In two prior trials, prehospital trans-nasal evaporative intra-arrest cooling was safe, feasible and reduced time to target temperature compared to delayed cooling...
February 28, 2024: American Heart Journal
Barna Szabo, Lina Benson, Gianluigi Savarese, Camilla Hage, Marat Fudim, Adam Devore, Bertram Pitt, Lars H Lund
BACKGROUND: Hospitalization for heart failure (HHF) is associated with poor post-discharge outcomes but the role of time since most recent HHF and potential treatment interactions are unknown. We aimed to assess history of and time since previous HHF, associations with composite of cardiovascular (CV) death and total HHF, first HHF and interactions with randomization to spironolactone, in heart failure with preserved ejection fraction. METHODS AND RESULTS: We assessed these objectives using uni- and multivariable regressions and spline analyses in TOPCAT-Americas...
February 25, 2024: American Heart Journal
Bethan A Lemley, Oluwatimilehin Okunowo, Steve B Ampah, Lezhou Wu, Russel T Shinohara, David J Goldberg, Jack Rychik, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne
BACKGROUND: There are no consensus guidelines defining optimal timing for the Fontan operation, the last planned surgery in staged palliation for single-ventricle heart disease. OBJECTIVES: Identify patient-level characteristics, center-level variation, and secular trends driving Fontan timing. METHODS: A retrospective observational study of subjects who underwent Fontan from 2007-2021 at centers in the Pediatric Health Information Systems database was performed using linear mixed-effects modeling in which age at Fontan was regressed on patient characteristics and date of operation with center as random effect...
February 25, 2024: American Heart Journal
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