Niels M R van der Sangen, I Tarik Küçük, Shabiga Sivanesan, Yolande Appelman, Jurriën M Ten Berg, Ashley Verburg, Jaouad Azzahhafi, E Karin Arkenbout, Wouter J Kikkert, Ron Pisters, J Wouter Jukema, Fatih Arslan, Arnoud van 't Hof, Mustafa Ilhan, Loes P Hoebers, René J van der Schaaf, Peter Damman, Pier Woudstra, Tim P van de Hoef, Matthijs Bax, Rutger L Anthonio, Jawed Polad, Tom Adriaenssens, Willem Dewilde, Carlo Zivelonghi, Peep Laanmets, Risko Majas, Marcel G W Dijkgraaf, Bimmer E P M Claessen, José P S Henriques
BACKGROUND: Early aspirin withdrawal, also known as P2Y12 -inhibitor monotherapy, following percutaneous coronary intervention (PCI) for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) can reduce bleeding without a trade-off in efficacy. Still the average daily bleeding risk is highest during the first months and it remains unclear if aspirin can be omitted immediately following PCI. METHODS: The LEGACY study is an open-label, multicenter randomized controlled trial evaluating the safety and efficacy of immediate P2Y12 -inhibitor monotherapy versus dual antiplatelet therapy (DAPT) for 12 months in 3090 patients...
July 28, 2023: American Heart Journal
Brent A Williams, Jigar Rajpura, Yurek M Paprocki, Neela Kumar, Stephen Voyce, Jonathan P Brady, Alexander Chang
BACKGROUND: Type 2 diabetes (T2D) is a strong risk factor for cardiovascular (CV) disease. CV outcomes in T2D have generally been improving over time but recent data from the US suggest attenuation of trends in older adults with reversal of trends in younger adults. However, published data are only reported through 2015. OBJECTIVES: To quantify trends over time in CV outcomes from 2001 to 2018, and describe changes over time in health care costs in T2D. METHODS: This retrospective cohort study incorporated data from a regional health insurance plan...
July 27, 2023: American Heart Journal
Piotr Kałmucki, Janusz Lipiecki, Klaus K Witte, Steven L Goldberg, Artur Baszko, Tomasz Siminiak
BACKGROUND: It has been suggested that the disparity of outcomes between the studies of transcutaneous edge-to-edge repair (TEER) for functional mitral regurgitation (FMR) in heart failure with reduced ejection fraction (HFrEF) could be due to systematic differences in the populations studied. One proposal is that there are two broad groups: those with proportional FMR who respond less favourably, and those in whom the FMR is greater than expected (disproportionate) FMR where edge-to-edge TEER seems to be more effective...
July 27, 2023: American Heart Journal
Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Renato D Lopes, Sana M Al-Khatib, Bernard J Gersh, M Cecilia Bahit, Stefan H Hohnloser, Greg C Flaker, Marten Rosenquist, Ziad Hijazi, Lars Wallentin, Christopher B Granger
Rate control is fundamental in the treatment of patients with atrial fibrillation (AF). The independent association of heart rate with outcomes and range of heart rate associated with best outcomes remains uncertain. We assessed the relationship between heart rate and clinical outcomes in patients with persistent or permanent AF enrolled in the randomized, double-blind ARISTOTLE trial. In patients with persistent or permanent AF, a faster heart rate is associated with a modest, but statistically significant increase in death and heart failure hospitalizations...
July 26, 2023: American Heart Journal
Daniel S Matasic, Roger S Blumenthal, Gregg C Fonarow, Martha Gulati
No abstract text is available yet for this article.
July 20, 2023: American Heart Journal
Sonali R Gnanenthiran, Isabella Tan, Emily R Atkins, Alberto Avolio, Belinda Bennett, Niamh Chapman, Clara K Chow, Ruth Freed, Danijela Gnjidic, Charlotte Hespe, Baldeep Kaur, Huei Ming Liu, Anushka Patel, David Peiris, Christopher M Reid, Markus Schlaich, James E Sharman, George S Stergiou, Tim Usherwood, Christopher Gianacas, Anthony Rodgers, Aletta E Schutte
Despite high blood pressure being the leading preventable risk factor for death, only one in three patients achieve target blood pressure control. Key contributors to this problem are clinical inertia and uncertainties in relying on clinic blood pressure measurements to make treatment decisions. The NEXTGEN-BP open-label, multicenter, randomized controlled trial will investigate the efficacy, safety, acceptability and cost-effectiveness of a wearable blood pressure monitor-based care strategy for the treatment of hypertension, compared to usual care, in lowering clinic blood pressure over 12 months...
July 19, 2023: American Heart Journal
Adam N Berman, Curtis Ginder, Xianghong S Wang, Linnea Borden, Michael K Hidrue, Jennifer M Searl Como, Danielle Daly, Yee-Ping Sun, William T Curry, Marcela Del Carmen, David A Morrow, Benjamin Scirica, Niteesh K Choudhry, James L Januzzi, Jason H Wasfy
BACKGROUND: Electronic health records contain vast amounts of cardiovascular data, including potential clues suggesting unrecognized conditions. One important example is the identification of left ventricular hypertrophy (LVH) on echocardiography. If the underlying causes are untreated, individuals are at increased risk of developing clinically significant pathology. As the most common cause of LVH, hypertension accounts for more cardiovascular deaths than any other modifiable risk factor...
July 14, 2023: American Heart Journal
Ann Banke, Charlotte Andersson, Maria D'Souza, Emil Fosbøl, Dorte Nielsen, Christian Torp Pedersen, Gunnar H Gislason, Jacob Eifer Møller, Lars Køber, Christian Madelaire Rasmussen, Morten Schou
BACKGROUND: Anthracycline-based chemotherapy has improved the prognosis of various malignancies, but increases the long-term risk of heart failure (HF). Identification of patients at risk prior to treatment initiation is warranted. Therefore, the aim of this study was to evaluate if a familial predisposition to HF increases the risk of anthracycline related HF. METHODS: Using nationwide Danish registries, all patients treated with anthracycline from 2004-16 were identified...
July 13, 2023: American Heart Journal
Andrew S Oseran, Huaying Dong, Rishi K Wadhera
BACKGROUND: Federal programs measuring hospital quality of care for acute cardiovascular conditions are based solely on Medicare fee-for-service (FFS) beneficiaries, and exclude Medicare Advantage (MA) beneficiaries. Little is known about the proportion of Medicare beneficiaries enrolled in MA at the time of an acute cardiovascular hospitalization. Therefore, in this study we characterize the proportion of Medicare beneficiaries enrolled in MA at the time of acute myocardial infarction (AMI), heart failure (HF), and ischemic stroke hospitalization...
July 12, 2023: American Heart Journal
Daniel C Pipilas, Shaan Khurshid, Steven J Atlas, Jeffrey M Ashburner, Ana T Lipsanopoulos, Leila H Borowsky, Wyliena Guan, Patrick T Ellinor, David D McManus, Daniel E Singer, Yuchiao Chang, Steven A Lubitz
BACKGROUND: Screening for atrial fibrillation (AF) using consumer-based devices capable of producing a single lead electrocardiogram (1L ECG) is increasing. There are limited data on the accuracy of physician interpretation of these tracings. The goal of this study is to assess the sensitivity, specificity, confidence, and variability of cardiologist interpretation of point-of-care 1L ECGs. METHODS: Fifteen cardiologists reviewed point-of-care handheld 1L ECGs collected from patients aged 65 years or older enrolled in the VITAL-AF clinical trial [NCT035115057] who underwent cardiac rhythm assessments with a 1L ECG using an AliveCor KardiaMobile device...
July 12, 2023: American Heart Journal
Tobias Uhe, Katrin Wasser, Mark Weber-Krüger, Wolf-Rüdiger Schäbitz, Martin Köhrmann, Johannes Brachmann, Ulrich Laufs, Martin Dichgans, Götz Gelbrich, David Petroff, Christiane Prettin, Dominik Michalski, Andrea Kraft, Thorleif Etgen, Peter D Schellinger, Hassan Soda, Florian Bethke, Michael Ertl, Bernd Kallmünzer, Martin Grond, Katharina Althaus, Gerhard F Hamann, Meinhard Mende, Marcus Wagner, Sonja Gröschel, Timo Uphaus, Klaus Gröschel, Rolf Wachter
BACKGROUND: Atrial fibrillation (AF) is one of the most frequent causes of stroke. Several randomized trials have shown that prolonged monitoring increases the detection of AF, but the effect on reducing recurrent cardioembolism, ie, ischemic stroke and systemic embolism, remains unknown. We aim to evaluate whether a risk-adapted, intensified heart rhythm monitoring with consequent guideline conform treatment, which implies initiation of oral anticoagulation (OAC), leads to a reduction of recurrent cardioembolism...
July 7, 2023: American Heart Journal
Soohyung Park, Seung-Woon Rha, Byoung Geol Choi, Woohyeun Kim, Woong Gil Choi, Seung Jin Lee, Jae Beom Lee, Ji Young Park, Sang Min Park, Myung Ho Jeong, Yong Hoon Kim, Ae-Young Her, Min Woong Kim, Kang-Yin Chen, Bae Keun Kim, Eun-Seok Shin, Jae-Bin Seo, Jihun Ahn, Se Yeon Choi, Jae Kyeong Byun, Jin Ah Cha, Su Jin Hyun, Cheol Ung Choi, Chang Gyu Park
BACKGROUND: Previous studies reported that compared to conventional dual antiplatelet therapy (DAT; aspirin + clopidogrel), triple antiplatelet therapy (TAT), involving the addition of cilostazol to DAT, had better clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). However, the optimal duration of TAT is yet to be determined. METHODS: In total, 985 patients with STEMI who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) were prospectively enrolled in 15 PCI centers in South Korea and China...
July 3, 2023: American Heart Journal
Anthony E Peters, Nicole Solomon, Karen Chiswell, Gregg C Fonarow, Michel G Khouri, Lori Baylor, Jose Alvir, Marianna Bruno, Ahsan Huda, Larry A Allen, Kavita Sharma, Adam D DeVore, Stephen J Greene
BACKGROUND: An 11-factor random forest model has been developed among ambulatory heart failure (HF) patients for identifying potential wild-type amyloidogenic TTR cardiomyopathy (wtATTR-CM). The model has not been evaluated in a large sample of patients hospitalized for HF. METHODS: This study included Medicare beneficiaries aged ≥65 years hospitalized for HF in the Get With The Guidelines-HF® Registry from 2008-2019. Patients with and without a diagnosis of ATTR-CM were compared, as defined by inpatient and outpatient claims data within 6 months pre- or post-index hospitalization...
July 1, 2023: American Heart Journal
Avishag Laish-Farkash, Emanuel Harari, Michael Rahkovich, Yonatan Kogan, Gergana Marincheva, Guy Scheinman, Eyal Ben-Assa, Eli I Lev
BACKGROUND: A robotic Radiaction Shielding System (RSS) was developed to provide a full-body protection to all medical personnel during fluoroscopy-guided procedures, by encapsulating the imaging beam and blocking scattered radiation. OBJECTIVES: We aimed to evaluate its efficacy in real-world electrophysiologic (EP) laboratory- both during ablations and cardiovascular implantable electronic devices (CIED) procedures. METHODS: A prospective controlled study comparing consecutive real-life EP procedures with and without RSS using highly sensitive sensors in different locations...
July 2023: American Heart Journal
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 2 decades, numerous biomarkers have been investigated for a better and more rapid diagnosis of CRS...
July 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...
July 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 center randomized 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 ...
July 2023: American Heart Journal
Marwah E Alnewais, Lauren Adams, Abdulaziz S Alfehaid, Shayma Alzaidi, Erin R Weeda
BACKGROUND: This study aimed to evaluate the geographic distribution of United States (US) clinical trial sites utilizedfor guideline changing studies of cholesterol management. METHODS: Randomized trials evaluating pharmacologic interventions for cholesterol treatment and reporting location data (ie, zip code of trial sites) were identified. Location data was abstracted from RESULTS: Half of US counties were over 30 miles from a study site and, social determinants of health were more favorable in counties with versus without clinical trial sites...
June 26, 2023: American Heart Journal
Chen Li, John W Eikelboom, Zihang Zhong, Xiwen Zhang, Kun Liu, Li Zhu, Naiquan Yang, Xin Chen, Xiaoyan Wang, Xin Zhao, Jun Jiang, Jun Pu, Bo Zhao, Fumin Zhang, Jun Zhu, Jun Huang, Xiangqing Kong, Hao Yu, Chunyue Tan, Wenhao Zhang, Qin Wang, Xiaoxuan Gong, Jianling Bai, Chunjian Li
BACKGROUND: Time to reperfusion is the key to the treatment of patients with ST-elevation myocardial infarction (STEMI). It is uncertain whether adjunctive thrombolytic therapy combined with contemporary antiplatelet agent ticagrelor improves outcomes as administered prior to primary percutaneous coronary intervention (PCI) expected to be performed within 120 minutes. METHODS: OPTIMA-6 is a multicenter, randomized, double-blind, placebo-controlled, and superiority trial to evaluate the efficacy of a bolus of half-dose recombinant staphylokinase (r-SAK) vs placebo prior to timely primary PCI in patients with STEMI...
June 25, 2023: American Heart Journal
Michael P Gray, Yemima Berman, Giordano Bottà, Stuart M Grieve, Amy Ho, Jessica Hu, Karice Hyun, Jodie Ingles, Garry Jennings, Gary Kilov, Jean-Frederic Levesque, Peter Meikle, Julie Redfern, Tim Usherwood, Stephen T Vernon, Stephen J Nicholls, Gemma A Figtree
BACKGROUND: Identifying and targeting established modifiable risk factors has been a successful strategy for reducing the burden of coronary artery disease (CAD) at the population-level. However, up to 1-in-4 patients who present with ST elevation myocardial infarction do so in the absence of such risk factors. Polygenic risk scores (PRS) have demonstrated an ability to improve risk prediction models independent of traditional risk factors and self-reported family history, but a pathway for implementation has yet to be clearly identified...
June 25, 2023: American Heart Journal
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