American Heart Journal via MedWorm.com

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American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

(Source: American Heart Journal)

Editorial Board

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

(Source: American Heart Journal)

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

(Source: American Heart Journal)

“High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation: A randomized controlled trial evaluating the relationship to endothelial function and inflammation.” Am Heart J 2009;158:734-41

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

The paper of Munk et al adds potential reduction of in-stent restenosis to the list of the multiple benefits of high-intensity aerobic interval training (HIIT) in a broad spectrum of patients with cardiovascular disease, which have been extensively studied by several Norwegian groups. (Source: American Heart Journal)

Low vitamin D may explain the link between preeclampsia and cardiovascular disease

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

The recent review and meta-analysis of cardiovascular sequelae of preeclampsia found large increases in risk of cardiovascular diseases for those who suffered preeclampsia and an increased risk with increasing severity of preeclampsia. Preeclampsia is also associated with increased risk of cancer. I would like to suggest that the link is low serum 25-hydroxyvitamin D (25[OH]D), which has been reported as a risk factor for preeclampsia as well as for cardiovascular disease. Serum 25(OH)D levels are associated with important cardiovascular disease risk factors in US adults. Low serum 25(OH)D is also an important risk factor for many types of cancer. It has been suggested that pregnant and nursing women should be taking 4,000 to 6,000 IU/d of vitamin D. For optimal health in general, serum 25...

Author response: B-type natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Thank you for your interest in our study. We agree that the clinical application of B-type natriuretic peptide (BNP) as a prognostic marker is still evolving. We do believe that the body of evidence supports a relationship between BNP and left ventricular end-diastolic pressure in adults with left ventricular dysfunction. The lack of such a relationship in the study by Oyamada et al may instead be related to their unique study population of infants with ventricular septal defects. The issue of false positives as a limitation to BNP testing is acknowledged but may be more germane to the use of BNP as a diagnostic, rather than a prognostic, marker and reinforces that the strength of BNP as a diagnostic test is its high negative predictive value. Nonetheless, implementation of BNP into clinic...

Brain natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

I read the recent publication by Rogers et al with great interest. Rogers et al assessed the prognostic value of brain natriuretic peptide (BNP) for cardiovascular events independent of left ventricular end-diastolic pressure (LVEDP) and reached the conclusion that plasma BNP level was not a is not just a prognostic surrogate for elevated LV filling pressure. Indeed, the clinical value of plasma BNP relating to LV function is still a topic to be studied. Recently, Oyamada et al reported that plasma BNP value did not have a significant association with the LVEDP. Oyamada et al showed that tissue Doppler imaging combined with pulsed-wave Doppler echocardiography has a better clinical usefulness. Indeed, the BNP has no underlying biological process relating to LVEDP. Nevertheless, the use of...

Reply to the Letter to the Editor by Yi et al

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

We thank Yi et al for the interest in our study and for the questions raised, which help to stimulate the discussion and to conceive further studies. Regarding their doubt about potential differences in response to cardiac resynchronization therapy (CRT) between ischemic and nonischemic patients despite interventricular pacing interval (V-V) optimization, we strongly believe that the effect of CRT may be influenced by the underlying myocardial disease. The cited study of Molhoek et al was a preliminary report on 74 patients that could not demonstrate significant differences in outcome between ischemic and nonischemic patients. However, data from clinical trials suggested that at mid- and long-term follow-up after CRT, the improvement in left ventricular (LV) size and function is significa...

Effect of interval (V-V) optimization in ischemic versus nonischemic patients after cardiac resynchronization therapy

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

It is with great interest that we read the article published in the November 2009 issue of the Journal by Marsan et al. We applaud the authors for the report of acute effect of interventricular pacing interval (V-V) optimization on left ventricular (LV) systolic performance, and dyssynchrony in ischemic versus nonischemic patients received cardiac resynchronization therapy (CRT). The limitations of the work were elucidated by the authors. However, we have some questions about the paper. (Source: American Heart Journal)

Factors associated with cardiac conduction disorders and permanent pacemaker implantation after percutaneous aortic valve implantation with the CoreValve prosthesis

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Percutaneous aortic valve implantation with the CoreValve prosthesis results in a high incidence of total atrioventricular block requiring PPI and new-onset LBBB. Preexisting disturbance of cardiac conduction, a narrow left ventricular outflow tract, and the severity of mitral annular calcification predict the need for permanent pacing, whereas the only factor shown to be predictive for new-onset LBBB is the depth of prosthesis implantation. (Source: American Heart Journal)

Timing of nonemergent coronary artery bypass grafting and mortality after non-ST elevation acute coronary syndrome

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Time from admission to CABG was not associated with an increased risk of short-term mortality. However, there was a trend toward increased mortality with early CABG, and this study does not exclude the presence of a modest risk association between timing of CABG and short-term mortality. (Source: American Heart Journal)

Temporal trends in compliance with appropriateness criteria for stress single-photon emission computed tomography sestamibi studies in an academic medical center

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: In the absence of any specific intervention, there was a significant change in the overall classification of SPECT appropriateness in an academic medical center over 17 months. The only significant difference in individual categories was a decrease in inappropriate studies. Additional measurements over time will be required to determine if this trend is sustainable or generalizable. (Source: American Heart Journal)

Trends in echocardiography utilization in the Veterans Administration Healthcare System

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

We examined changes in echocardiogram use and utilization over time and potential overuse of echocardiography.Results: The number of echocardiograms increased from 92,269 in 2000 to 195,767 in 2007 (a 112.2% increase). Alternatively, echocardiogram utilization remained relatively stable, increasing from 68.8 per 1,000 VA users in 2000 to 71.5 per 1,000 VA users in 2007 because the number of VA users increased by 104.2% over the study period. The mean number of scans per year in echocardiogram recipients remained constant at 1.1/y, and the proportion of recipients receiving multiple scans remained constant at (Source: American Heart Journal)

Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Health status domains as measured with the SF-36 predicted death at 6-year follow-up in PCI patients treated with drug-eluting stenting, independent of demographic and clinical characteristics. In contrast, a decline in health status between 1 and 12 months post index procedure, as measured with the SF-36, was not associated with 6-year mortality in PCI patients treated with drug-eluting stenting. (Source: American Heart Journal)

Clopidogrel use and clinical events after drug-eluting stent implantation: Findings from the HealthCore Integrated Research Database

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Higher clopidogrel use 12 months after drug-eluting stent implantation was associated with a greater risk of subsequent bleeding events. Lower use was associated with a greater risk of death or nonfatal myocardial infarction. (Source: American Heart Journal)

Long-term outcome of percutaneous catheter intervention for de novo coronary bifurcation lesions with drug-eluting stents or bare-metal stents

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Compared with BMSs, both PESs and SESs substantially reduced the long-term need for repeated revascularization but did not increase the risk of death and myocardial infarction. (Source: American Heart Journal)

Does “late catch-up” exist in drug-eluting stents: Insights from a serial quantitative coronary angiography analysis of sirolimus versus paclitaxel-eluting stents

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Late catch-up occurs in both PES and SES with greater delayed late loss in SES. Our data suggest that the process of neointima formation after SES and PES implantation may follow a slightly different timeline. (Source: American Heart Journal)

Mechanisms of nonfatal acute myocardial infarction late after stent implantation: The relative impact of disease progression, stent restenosis, and stent thrombosis

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: In a “real world” population, late after stent implantation, a patient has an almost equal probability to have suffered a nonfatal AMI from either stent restenosis/thrombosis or disease progression at another site. Continuous research efforts are necessary to equally address both stent therapy and disease progression. (Source: American Heart Journal)

Clinical relevance of clopidogrel unresponsiveness during elective coronary stenting: Experience with the point-of-care Platelet Function Assay–100 C/ADP

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Unresponsiveness to clopidogrel as assessed by the point-of-care test PFA-100C/ADP is an independent major risk factor for thrombotic complications after coronary intervention. (Source: American Heart Journal)

Propranolol and the risk of hospitalized myopathy: Translating chemical genomics findings into population-level hypotheses

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Propranolol may be associated with a 45% increased risk of hospitalized myopathy in the elderly. Our study illustrates how results from in vitro chemical screens can be translated into hypotheses about drug toxicity at the population level. (Source: American Heart Journal)

Detection of elevated right atrial pressure using a simple bedside ultrasound measure

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Aims: Accurate assessment of right atrial pressure (RAP) often requires invasive measurement. With normal RAP, Valsalva increases right internal jugular vein (RIJV) cross sectional area (CSA) 20% to 30%. With high RAP, when venous compliance is low, we hypothesized that the increase in CSA would be blunted and could be detected non-invasively with bedside ultrasound.Methods and Results: RIJV ultrasound images were obtained in 67 patients undergoing right heart catheterization. The median RAP at end-expiration was 7 mm Hg (interquartile range [IQR] 5-9 mm Hg) in patients with normal RAP (n = 47) versus 15 mm Hg (IQR 12-22 mm Hg) in patients with elevated RAP (n = 20). With Valsalva, the median percent change in RIJV CSA was 35% (IQR 19%-79%) versus 5% (IQR 3%-14%) for normal and high RAP, r...

Myocardial structure and function by echocardiography in relation to glucometabolic status in elderly subjects from 2 population-based cohorts: A cross-sectional study

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Contrary to our hypothesis, in 2 independent cohorts of older individuals, associations between glucometabolic status and LV diastolic function were generally weak. These contrast with previous reports, as well as with observations among middle-aged subjects in the present study. Changes in LV diastolic function may be more age-related than associated with glucose metabolism in older subjects. (Source: American Heart Journal)

Relationships between emerging measures of heart failure processes of care and clinical outcomes

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Several evidence-based processes of care are associated with improved outcomes, can discriminate hospital-level quality of care, and could be considered as clinical performance measures. (Source: American Heart Journal)

Cuff and aortic pressure differences during dobutamine infusion: A study of the effects of systolic blood pressure amplification

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Similar to exercise, dobutamine induced cuff SBPs and pulse pressures higher than those measured in the aorta—uncorrected by the cuff-calibrated Sphygmocor. This increasing pulse amplification was explained by the effects of dobutamine on the properties of the conduit arterial walls, on changes in pulse wave velocity, on increasing heart rate, and on reflected waves. (Source: American Heart Journal)

Differences in mortality in acute coronary syndrome symptom clusters

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Most ACS symptoms occur in groups or clusters. Uncharacteristic symptom patterns may delay diagnosis and treatment by clinicians even when patients seek care rapidly. Knowledge of common symptom patterns may facilitate rapid identification of ACS. (Source: American Heart Journal)

Variations in prevalent cardiovascular disease and future risk by metabolic syndrome classification in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Consistent with previous reports, ATP-III MetSyn criteria identified individuals with increased odds of CVD and elevated future coronary heart disease risk. However, the IDF definition identified a clinically important number of additional individuals at excess CVD risk. (Source: American Heart Journal)

Evidence of disparity in the application of quality improvement efforts for the treatment of acute myocardial infarction: The American College of Cardiology's Guidelines Applied in Practice Initiative in Michigan

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: The GAP program led to significant increases in rates of evidence-based care in both white and nonwhite Medicare patients. However, nonwhite patients received less quality improvement discharge tool and smoking cessation counseling. Policies designed to reduce racial disparities in health care must address disparity in the delivery of quality improvement programs. (Source: American Heart Journal)

In-hospital management of patients with atrial flutter

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: One or more methods of conversion to sinus rhythm were used in two thirds of the hospitalizations with a primary diagnosis of AFl. Greater use of conversion therapies in patients with other heart disease were expected; however, lower use among elderly persons, females, and racial minorities may indicate some disparities in use and warrant further study. (Source: American Heart Journal)

Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)—A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors. (Source: American Heart Journal)

Rationale and design of Enhanced Angiogenic Cell Therapy in Acute Myocardial Infarction (ENACT-AMI): The first randomized placebo-controlled trial of enhanced progenitor cell therapy for acute myocardial infarction

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: This will be the first clinical trial to include a strategy designed to enhance the function of autologous progenitor cells by overexpressing endothelial nitric oxide synthase, and the first to use combination gene and cell therapy for the treatment of cardiac disease. (Source: American Heart Journal)

Rationale and design of AVERROES: Apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: By evaluating the use of apixaban as a replacement for ASA in AF patients who are not treated with a VKA, the AVERROES study is addressing an important unmet clinical need. The results of AVERROES will be complementary to those of a parallel noninferiority trial comparing apixaban with VKA therapy in patients with AF who are able to receive a VKA. (Source: American Heart Journal)

Rivaroxaban—Once daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: Rationale and Design of the ROCKET AF study

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: The ROCKET AF study will determine the efficacy and safety of rivaroxaban as an alternative to warfarin for the prevention of thromboembolism in patients with AF. (Source: American Heart Journal)

Apixaban for Reduction In Stroke and Other ThromboemboLic Events in Atrial Fibrillation (ARISTOTLE) trial: Design and rationale

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Atrial fibrillation (AF) is associated with increased risk of stroke that can be attenuated with vitamin K antagonists (VKAs). Vitamin K antagonist use is limited, in part, by the high incidence of complications when patients' international normalized ratios (INRs) deviate from the target range. The primary objective of ARISTOTLE is to determine if the factor Xa inhibitor, apixaban, is noninferior to warfarin at reducing the combined endpoint of stroke (ischemic or hemorrhagic) and systemic embolism in patients with AF and at least 1 additional risk factor for stroke. We have randomized 18,206 patients from over 1,000 centers in 40 countries. Patients were randomly assigned in a 1:1 ratio to receive apixaban or warfarin using a double-blind, double-dummy design. International normalized ra...

Information for Readers

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

(Source: American Heart Journal)

Editorial Board

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

(Source: American Heart Journal)

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

(Source: American Heart Journal)

Laskey response to Solomon

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

We thank Dr Solomon for his constructive and insightful comments. We also agree that, from a clinical standpoint, the real “issue” is the clinical significance of contrast-induced nephropathy (CIN) (defined using the extent of change in creatinine level after exposure to contrast media). To date, the “associations” between the development of CIN and subsequent clinical events, either short-term or long-term, have been just that—associations. As such and given the impossibility of randomizing patients to CIN (the exposure), extant measures of association are likely to be confounded. Nothwithstanding this important methodological detail, the suggestion that the definition of CIN be “loosened” to include lesser degrees of change in serum creatinine level compared to the “class...

Letter to the Editor—Solomon about Laskey Study

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

“Nephrotoxicity of iodixanol versus iopamidol in patients with chronic kidney disease and diabetes mellitus undergoing coronary angiographic procedures,” Warren Laskey, Peter Aspelin, Charles Davidson, Michael Rudnick, Pierre Aubry, Sreenivas Kumar, Frank Gietzen, Marcus Wiemer, on behalf of the DXV405 Study Group, Am. Heart J. 2009;158:822-28.e3. (Source: American Heart Journal)

Response to letter by Drs Dilaveris and Stefanadis: Electrocardiographic predictors of atrial fibrillation: Methodological considerations

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

We would like to thank Drs Dilaveris and Stefanidis for their interest in and insightful comments regarding our recent study on the electrocardiographic (ECG) predictors of atrial fibrillation (AF). In their letter, they noted concerns regarding the automation of the ECG measurements without manual verification. We agree with the points raised and understand the limitations of computerized measurements. Although some automated measurements such as the QT interval have been shown to be reproducible, others such as degree of ST-segment deviation have been shown to be less accurate. (Source: American Heart Journal)

Electrocardiographic predictors of atrial fibrillation: Methodological considerations

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

With great interest, we have read the article of Perez et al on the electrocardiographic (ECG) predictors of atrial fibrillation (AF). By using standard computerized methodology, they found that several ECG markers are independently predictive of future onset of AF. They introduced the P index, defined as the SD of P-wave duration across the 12 leads, as one of the strongest predictors of AF. Although these results are interesting, we believe that they should be considered cautiously because of the lack of manual verification of the automatic ECG measurements in this large cohort. (Source: American Heart Journal)

Letter to the Editor

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Blankenship et al report that ST-elevation myocardial infarction patients may be enrolled in clinical trials with no significant delay in door-to-balloon time. Specifically, the authors estimate an 11-minute trial enrollment–associated delay for patients presenting directly to a primary percutaneous coronary intervention (PCI) center and a 4-minute delay among patients arriving via interhospital transfer. The authors find these differences to be statistically nonsignificant and thus infer that “enrollment can be accomplished without significantly delaying therapy” for patients undergoing primary PCI. We respectfully disagree. (Source: American Heart Journal)

Correction

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

The article “Achieving routine sub 30- minute door-to-balloon times in a high volume 24/7 primary angioplasty center with autonomous ambulance diagnosis and immediate catheter laboratory access” (Am Heart J 2009:158;829-835) was published with errors in the titles to . The legends for both figures however are correct. The figures should be corrected as follows: (Source: American Heart Journal)

Correction

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions section of the Abstract. The last sentence should be corrected as follows: “The substantial variations in the management of post-CABG AF across sites are likely because of LACK OF definitive data on the most effective therapies, highlighting the need for clinical trials on rate versus rhythm control and on anticoagulation for AF in this setting.” We apologize for any confusion or inconvenience this has caused. (Source: American Heart Journal)

Correction

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

The article “Cardiac resynchronization therapy in patients with ischemic versus non-ischemic heart failure: Differential effect of optimizing interventricular pacing interval” (Am Heart J 2009:158;769-776) was published with an error in the fourth author's name. The correct author name is C. Jan Willem Borleffs, MD. We apologize for any confusion or inconvenience this has caused. (Source: American Heart Journal)

Relationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving System—A Bern-Rotterdam Study

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Clinical judgment and the Heart Team concept should play a key role in selecting patients for TAVI, whereas currently available surgical risk score algorithms should be used to guide clinical decision making. (Source: American Heart Journal)

The right ventricular annular velocity reduction caused by coronary artery bypass graft surgery occurs at the moment of pericardial incision

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Minute-by-minute monitoring during cardiac surgery reveals that, virtually, all the losses in RV systolic velocity occurs within the first 3 minutes after pericardial incision. Right ventricular long-axis reduction during coronary bypass surgery results not from cardiopulmonary bypass but rather from pericardial incision. (Source: American Heart Journal)

Association of statin prescription with small abdominal aortic aneurysm progression

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: We found no association between statin prescription or LDL concentration with AAA expansion. The results do not support the findings of smaller studies and suggest that statins may have no benefit in reducing AAA progression. (Source: American Heart Journal)

Perioperative outcomes in reoperative cardiac surgery guided by cardiac multidetector computed tomographic angiography

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Background: Preoperative evaluation with contrast-enhanced multidetector computed tomographic angiography (MDCTA) is considered an “appropriate” indication based on expert consensus. We aimed to evaluate how the presurgical evaluation with MDCTA impacts the outcomes after reoperative cardiac surgery (RCS).Methods: We retrospectively studied 364 patients undergoing RCS between 2004 and 2008, including 137 referred for MDCTA. High-risk CT findings were defined as the presence of right ventricle or aorta (Source: American Heart Journal)

The effect of obesity on quality of life in patients with diabetes and coronary artery disease

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Obesity is associated with significantly reduced quality of life in patients with diabetes and CAD, independent of comorbid conditions. (Source: American Heart Journal)

Triple antiplatelet therapy reduces ischemic events after drug-eluting stent implantation: Drug-Eluting stenting followed by Cilostazol treatment REduces Adverse Serious cardiac Events (DECREASE registry)

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Triple antiplatelet therapy significantly reduced 12-month risks of stent thrombosis and MI after DES implantation compared with dual antiplatelet therapy without increased risk of bleeding complications. The longer duration of triple therapy after DES implantation was associated with the lower risk of stent thrombosis and MI. (Source: American Heart Journal)

Intracoronary thrombus formation after drug-eluting stents implantation: Optical coherence tomographic study

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Background: Intracoronary thrombus formation after drug-eluting stent (DES) implantation is not sufficiently evaluated.Methods: Optical coherence tomography (OCT) was performed in 226 patients (total DES n = 244, sirolimus-eluting stent [SES] n = 95, paclitaxel-eluting stent [PES] n = 62, zotarolimus-eluting stent [ZES] n = 87) after implantation (mean 11 months, range 3-66 months). Using OCT, we investigated the incidence and determinants of intracoronary thrombus.Results: Intracoronary thrombus was detected in 35 (14%) cases (27 SES [28%], 7 PES [11%], and 1 ZES [1%], P < .001) and was associated with longer stent, smaller stent diameter, and stents at bifurcation lesions. More uncovered stent struts (26 ± 23 vs 8 ± 17, P < .001) and malapposed stent struts (6 ± 14 vs 2 ± 6, P < .001...

Analysis of the long-term effects of drug-eluting stents on coronary arterial wall morphology as assessed by virtual histology intravascular ultrasound

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Serial VH-IVUS analysis of DES-treated lesions showed a greater frequency of unstable lesion morphometry at follow-up compared with BMS. The apparent mechanism was a suppression of the protective neointimal hyperplasia layer coupled with a lack of vulnerable plaque resolution at reference segments in DES compared with BMS. (Source: American Heart Journal)

Biventricular pacing improves cardiac function and prevents further left atrial remodeling in patients with symptomatic atrial fibrillation after atrioventricular node ablation

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: In conclusion, RV pacing results in significant increase in left atrial volume, LV mass, and worsening of LV contractility compared to patients receiving BiV pacing post-AV node ablation for refractory AF. Closed Loop Stimulation® was not associated with additional structural changes but resulted in significantly wider heart rate distribution. (Source: American Heart Journal)

Myocardial infarction and incidence of type 2 diabetes mellitus. Is admission blood glucose an independent predictor for future type 2 diabetes mellitus?

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Background: Although blood glucose levels in patients with acute myocardial infarction (AMI) are frequently elevated, studies investigating the future risk of type 2 diabetes mellitus (T2DM) in patients with AMI are scarce. We sought to investigate whether increased blood glucose levels on admission in nondiabetic patients with first AMI are predictive for future T2DM.Methods: We used the KORA MI register database in Augsburg, Germany, and included 1,239 nondiabetic patients aged 25 to 74 years who were admitted to hospital between 1998 and 2003 with a diagnosis of a first AMI and who had survived at least 28 days. Incident cases of T2DM and the date of diagnosis were validated by hospital records or by contacting the patient's treating physician.Results: A total of 108 cases of incident T...

Systematic review of trials using vasodilators in pulmonary arterial hypertension: Why a new approach is needed

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: The impact of vasodilators on long-term survival in pulmonary arterial hypertension remains uncertain. Future trials need to (a) adopt new trial designs that can better address clinical benefits, (b) use new end points that incorporate our best understanding of the disease rather than the ones that are easy to administer, and (c) include longer durations of study and other strategies to clarify if survival is affected. (Source: American Heart Journal)

Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: Findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Use of dedicated HF clinics varied in cardiology outpatient practices and was associated with greater use of cardiac resynchronization therapy and HF education but not other guideline-recommended therapies. (Source: American Heart Journal)

Mechanisms of the association between depressive symptoms and long-term mortality in heart failure

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Depressive symptoms in patients hospitalized for HF are associated with higher long-term mortality; this association is largely explained by the frequent comorbidity, physical inactivity, and disability of these patients. (Source: American Heart Journal)

Does aspirin use adversely influence intermediate-term postdischarge outcomes for hospitalized patients who are treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers? Findings from Organized Program to Facilitate Life-Saving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: When combined with ACEI or ARB, ASA had no demonstrable adverse effect on intermediate-term postdischarge outcomes for patients with ischemic or nonischemic HF. (Source: American Heart Journal)

Parity and risk of later-life maternal cardiovascular disease

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: In conclusion, parity was associated with incident maternal CVD in a J-shaped fashion, even after accounting for socioeconomic factors and pregnancy-related complications. (Source: American Heart Journal)

Are quality improvements associated with the Get With the Guidelines-Coronary Artery Disease (GWTG-CAD) program sustained over time? A longitudinal comparison of GWTG-CAD hospitals versus non–GWTG-CAD hospitals

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Hospitals participating in GWTG-CAD had modestly superior acute cardiac care and secondary prevention measures performance relative to non–GWTG-CAD. These benefits of GWTG-CAD participation were sustained over time and independent of hospital characteristics. (Source: American Heart Journal)

Anger expression and risk of coronary heart disease: Evidence from the Nova Scotia Health Survey

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Decreased constructive anger in men and increased destructive anger justification in men and women are associated with increased risk of 10-year incident CHD. (Source: American Heart Journal)

Routine use of fondaparinux in acute coronary syndromes: A 2-year multicenter experience

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Between 2006 and 2007, the use of fondaparinux in patients with acute coronary syndromes increased considerably, either because it was used instead of enoxaparin or because of a switch from UFH. Adjusted mortality in patients treated with fondaparinux was lower than with UFH and similar to enoxaparin. (Source: American Heart Journal)

Primary care practices and determinants of optimal anticoagulation management in a collaborative care model

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Primary care physicians are poorly supported by technological and human resources to monitor patients on oral anticoagulant. Even in a CCM, interprofessional collaboration and better technological support may be associated with optimal INR control. (Source: American Heart Journal)

Randomized comparison between clinical evaluation plus N-terminal pro–B-type natriuretic peptide versus exercise testing for decision making in acute chest pain of uncertain origin

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: A strategy combining clinical history and NT-proBNP is simpler and reduced initial emergency hospitalizations in patients with chest pain, in comparison with the usual strategy involving exercise testing. Larger studies to assess its impact on long-term hard end points are needed. (ClinicalTrials.gov NCT00493844) (Source: American Heart Journal)

Cardiac DeatH Prevention by aUtomated DefibrillatoRs in ChurcHes: Rationale and design of the CHURCH trial

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Early defibrillation programs by the use of automated external defibrillators (AEDs) located in high-attendance public places may improve survival and neurologic outcome of patients undergoing sudden cardiac arrest (SCA).We planned a prospective cohort study to assess the effectiveness of a public-access defibrillation program based on positioning of AEDs in churches and training of lay volunteers in Basic Life Support Defibrillation during a single-day 5-hour training session.The CHURCH project aims to promote a widespread diffusion of AEDs, to train a large number of lay volunteers in Basic Life Support Defibrillation, and to increase population awareness on the opportunities for sudden death prevention. The rationale of the study rests on a survey commissioned by the Diocese of Milan th...

Effectiveness and safety of drug-eluting stents in vein grafts: A meta-analysis

American Heart Journal — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Although data from observational studies suggest that the use of DES for vein graft stenosis has favorable effects on MACE, death, TVR, and TLR, these data should be interpreted with caution due to their observational nature. Corresponding RCT data are inconclusive. There remains a need for large multicenter RCTs to address the effectiveness and safety of DES for vein graft stenosis. (Source: American Heart Journal)

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American Heart Journal — Sat, 19 Dec 2009 13:51:06 +0100

(Source: American Heart Journal)

Editorial Board

American Heart Journal — Sat, 19 Dec 2009 13:51:06 +0100

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American Heart Journal — Sat, 19 Dec 2009 13:51:06 +0100

(Source: American Heart Journal)

Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with obstructive coronary artery disease

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusions: The GLS impairment aids detection of patients without overt LV systolic dysfunction having obstructive CAD. (Source: American Heart Journal)

Percutaneous coronary intervention or coronary artery bypass surgery for cardiogenic shock and multivessel coronary artery disease?

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusions: Limited data from observational studies in patients with CS and multivessel disease suggest that CABG should be considered a complementary reperfusion strategy to PCI and may be preferred, especially when complete revascularization with PCI is not possible. Our data highlight the need for large randomized trials to further evaluate the relative benefit of PCI versus CABG in patients with multivessel coronary disease and CS using contemporary surgical and percutaneous techniques. (Source: American Heart Journal)

Plasma N-terminal fragment of the prohormone B-type natriuretic peptide concentrations in relation to time to treatment and Thrombolysis in Myocardial Infarction (TIMI) flow: A substudy of the Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention (ASSENT IV-PCI) trial

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusion: Elevated plasma concentrations of Nt-proBNP in the early phase of STEMI determine in-hospital and 90-day outcome after infarction irrespective of time to treatment and pre- or postinterventional TIMI flow. (Source: American Heart Journal)

Quantitative impact of cardiovascular risk factors and vascular closure devices on the femoral artery after repeat cardiac catheterization

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusion: Vascular closure devices are not associated with a change in the artery size or progression of PVD. Overall, there is no change in vessel size over time after repeat catheterizations, with a decrease in vessel size associated with current and former smoking and an increase with previous statin therapy. (Source: American Heart Journal)

The incidence and clinical predictors of early stent thrombosis in patients with acute coronary syndrome

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusions: Patients presenting with STEMI who are hemodynamically unstable and have multivessel coronary disease undergoing coronary stenting during ACS, are at increased risk of EST. (Source: American Heart Journal)

Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction—A prospective and randomized trial in low-risk primary percutaneous coronary intervention patients (the Safe-Depart Trial)

American Heart Journal — Sat, 19 Dec 2009 13:51:05 +0100

Conclusion: In low-risk STEMI patients treated with primary or rescue PCI, a strategy of early hospital discharge facilitated by close nursing follow-up is feasible. Although our study did not identify differences in compliance or quality of life between the 2 groups, it did provide a functional study design for a larger trial powered to detect these important clinical end points. (Source: American Heart Journal)

Hematomas of at least 5 cm and outcomes in patients undergoing elective percutaneous coronary intervention: Insights from the SafeTy and Efficacy of Enoxaparin in PCI patients, an internationaL randomized Evaluation (STEEPLE) trial

American Heart Journal — Sat, 19 Dec 2009 13:51:04 +0100

Conclusions: After PCI, hematomas ≥5 cm had no effect on 30-day ischemic events or 1-year mortality. Although there is no agreed classification for large hematomas, the lack of a relationship between hematomas ≥5 cm and clinical outcome after PCI justifies the classification of these hematomas as minor bleeds in STEEPLE. (Source: American Heart Journal)

EuroSCORE refines the predictive ability of SYNTAX score in patients undergoing left main percutaneous coronary intervention

American Heart Journal — Sat, 19 Dec 2009 13:51:04 +0100

Conclusions: We found a significant improvement in the prediction of cardiac mortality with the inclusion of EuroSCORE in a SYNTAX score-based model. The degree of reclassification between treatment threshold categories indicates that clinical and angiographic information are both important for assessing individual risk of patients undergoing left main PCI. (Source: American Heart Journal)

Intraoperative defibrillation threshold testing during implantable cardioverter-defibrillator insertion: Do we really need it?

American Heart Journal — Sat, 19 Dec 2009 13:51:04 +0100

Conclusions: At 1-year follow-up, the performance of DFT testing does not seem to add any significant efficacy advantage in patients undergoing ICD implantation. Prospective randomized trials and long-term follow-up are warranted to clarify whether routine DFT testing may be safely abandoned leading to a revision of current guidelines. (Source: American Heart Journal)

Glycemia and prognosis of patients with chronic heart failure—Subanalysis of the Long-term Prospective Randomized Controlled Study Using Repetitive Education at Six-Month Intervals and Monitoring for Adherence in Heart Failure Outpatients (REMADHE) trial

American Heart Journal — Sat, 19 Dec 2009 13:51:04 +0100

Conclusion: We report on an inverse association between glycemia and mortality in outpatients with chronic heart failure. These results point to a new pathophysiologic understanding of the interactions between diabetes mellitus, hyperglycemia, and heart disease. (Source: American Heart Journal)

Association of longitudinal measures of hemoglobin and outcomes after hospitalization for heart failure

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Conclusions: Variability in Hb over time is common in patients with HF, and declining Hb is associated with a poor prognosis. Longitudinal characterization of Hb levels has greater prognostic significance than a single measurement. Systematic surveillance of Hb levels may help identify high-risk patients with heart failure. (Source: American Heart Journal)

Obesity and survival in patients with heart failure and preserved systolic function: A U-shaped relationship

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Conclusions: Low BMI is associated with increased mortality in patients with heart failure and preserved systolic function. However, with a BMI of >45, mortality increased, raising the possibility of a U-shaped relationship between BMI and survival. (Source: American Heart Journal)

Predictive value of B-type natriuretic peptides in detecting latent left ventricular diastolic dysfunction in β-thalassemia major

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Background: β-Thalassemia major is a unique disease characterized by early diastolic dysfunction, related exclusively to iron myocardial deposition. N-terminal-proBNP(amino-terminal) (NT-proBNP) and B-type natriuretic peptide (BNP) are sensitive biomarkers for the detection of asymptomatic left ventricular (LV) dysfunction, and they have important diagnostic and prognostic implications. Using β-thalassemia as a model disease with isolated diastolic dysfunction, we sought to investigate the predictive value of NT-proBNP and BNP levels in comparison with the conventional and new Doppler echocardiography indexes in detecting this disorder.Methods: Seventy β-thalassemia major patients (mean age 27.2 ± 12.5 years) with normal LV systolic function (mean LV ejection fraction = 59% ± 6.8%), a...

Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Background: Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are useful biomarkers in patients with chronic heart failure (CHF). However, the clinical use has limitations due to the low sensitivity of a conventional commercial assay system. Recently, a high sensitive-cTnI (hs-cTnI) commercial assay has become available.Methods: To compare the prognostic value of cTnT and hs-cTnI, we measured hemodynamic parameters and serum levels of cTnT, hs-cTnI and N-terminal pro–brain natriuretic peptide (NT-proBNP)in 258 consecutive CHF patients and then followed these patients for a mean period of 2.6 years. In both assays of cTnT and hs-cTnI, the lowest concentration at which the coeffi cient of variation was ≤10% were 0.03 ng/mL, respectively. Therefore, in the present study, an elevated...

Extent of ST-segment resolution after fibrinolysis adds improved risk stratification to clinical risk score for ST-segment elevation myocardial infarction

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Conclusions: The extent of STRes based on routinely obtained ECGs is an independent predictor of death and heart failure when used together with the TIMI risk score and significantly improves the ability to risk stratify patients after fibrinolysis. (Source: American Heart Journal)

Noninvasive assessment of left ventricular filling pressure after acute myocardial infarction: A prospective study of the relative prognostic utility of clinical assessment, echocardiography, and B-type natriuretic peptide

American Heart Journal — Sat, 19 Dec 2009 13:51:03 +0100

Conclusions: The E/e' ratio and BNP levels play important and complementary roles in the risk stratification of patients after AMI. (Source: American Heart Journal)

Management patterns of non-ST segment elevation acute coronary syndromes in relation to prior coronary revascularization

American Heart Journal — Sat, 19 Dec 2009 13:51:02 +0100

Conclusions: The NSTE-ACS patients with previous PCI were more likely to be treated invasively. Conversely, patients with prior CABG less frequently received invasive therapy. Future studies should determine the appropriateness of this treatment discrepancy. (Source: American Heart Journal)

Etiology of sudden death in the community: Results of anatomical, metabolic, and genetic evaluation

American Heart Journal — Sat, 19 Dec 2009 13:51:02 +0100

Conclusions: Most of the persons who had SCD in the community had severe subclinical CHD, including undetected previous MI. Traditional coronary risk factors were prevalent and undertreated. Mutations in the long QT syndrome genes were detected in a few subjects. These findings imply that improvements in the detection and treatment of subclinical CHD in the community are needed to prevent SCD. (Source: American Heart Journal)

Altitude and the heart: Is going high safe for your cardiac patient?

American Heart Journal — Sat, 19 Dec 2009 13:51:02 +0100

Our aging population combined with the ease of travel and the interest in high altitude recreation pursuits exposes more patients to the acute physiologic effects of high altitude and lower oxygen availability. Acute exposure to high altitude is associated with significant alterations to the cardiovascular system. These may be important in patients with underlying cardiovascular disease who are not able to compensate to such physiologic changes. Exacerbating factors pertinent to patients with cardiovascular disease include acute hypoxia, increased myocardial work, increased epinephrine release, and increased pulmonary artery pressures. This review summarizes the physiology and clinical evidence regarding acute altitude exposure on the cardiopulmonary system with practical recommendations t...

Planning the Safety of Atrial Fibrillation Ablation Registry Initiative (SAFARI) as a Collaborative Pan-Stakeholder Critical Path Registry Model: A Cardiac Safety Research Consortium “Incubator” Think Tank

American Heart Journal — Sat, 19 Dec 2009 13:51:02 +0100

This article summarizes the issues and directions presented and discussed at the meeting. (Source: American Heart Journal)

Prevention of sudden cardiac death: Need for a plaque stabilizer

American Heart Journal — Sat, 19 Dec 2009 13:51:02 +0100

Prevention of sudden cardiac death due to cardiac arrhythmias, asystole, or electromechanical dissociation remains a major medical and epidemiologic problem. There are many potential causes of sudden cardiac death, including acute coronary occlusion, chronic coronary heart disease with myocardial scar from one or more prior myocardial infarctions, cardiomyopathy, a host of cardiac genetic disorders such as hypertrophic cardiomyopathy and long QT syndrome to name a few, and a spectrum of other cardiac conditions. It is well recognized that acute coronary-related events account for most of the sudden cardiac deaths in the adult population. Despite the current widespread use of effective cardiac therapy, including β-blockers, angiotensin-converting enzyme inhibitors, lipid-lowering statins, ...

Race, ethnicity, and heart disease: A challenge for cardiology for the 21st century

American Heart Journal — Sat, 19 Dec 2009 13:51:01 +0100

Of all the forms of inequality, injustice in health care is the most shocking and inhumane. Martin Luther King, Jr, 1966. (Source: American Heart Journal)

Information for Readers

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

(Source: American Heart Journal)

Editorial Board

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

(Source: American Heart Journal)

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

(Source: American Heart Journal)

Correction

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

The article “Rationale and design for TIME: A phase II, randomized, double-blind, placebo-controlled pilot trial evaluating the safety and effect of timing of administration of bone marrow mononuclear cells after acute myocardial infarction” (Am Heart J 2009:158; 356-363) was published with an incorrect spelling of the third author's name. The correct author name is Douglas E. Vaughan, MD. We apologize for any confusion or inconvenience this has caused. (Source: American Heart Journal)

Ethnic differences in the prevalence and treatment of cardiovascular risk factors in US outpatients with peripheral arterial disease: Insights from the Reduction of Atherothrombosis for Continued Health (REACH) Registry

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Ethnic-related differences have been documented in the prevalence and treatment of several atherosclerotic risk factors known to be associated with PAD, including a variation in the use of surgical revascularization procedures. (Source: American Heart Journal)

Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: A randomized study of cardiovascular effects and quality of life

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Four weeks of intense training increased Vo2peak significantly after both AIT and MCT. Six months later, the AIT group had a significantly higher Vo2peak than MCT. The results indicate that AIT and MCT increase Vo2peak similarly in the short term, but with better long-term effect of AIT after CABG. (Source: American Heart Journal)

The clinical significance of hematocrit values before and after percutaneous coronary intervention

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusion: Hematocrit at baseline and the drop after PCI should be recognized as important risk factors for adverse outcomes after PCI. The inclusion of hematocrit or hemoglobin values as continuous variables in a risk-stratification scheme should be strongly considered. (Source: American Heart Journal)

Impact of computerized dosing on eptifibatide-associated bleeding and mortality

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Objective: The study aimed to determine the impact on eptifibatide-associated bleeding by implementing a computerized dosing algorithm in the cardiac catheterization suite.Background: Excessive dosing of eptifibatide is associated with increased bleeding rates and hospital mortality. Although dosing adjustments based on renal function has been recommended, its implementation and clinical impact have not been assessed in daily practice.Methods: A computerized algorithm was implemented in January 2006 to calculate appropriate eptifibatide infusion dose (1 μg kg−1 min−1 for creatinine clearance (Source: American Heart Journal)

High incidence of TIMI flow 0 to I in patients with ST-elevation myocardial infarction without electrocardiographic lytic criteria

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: ST-elevation myocardial infarction patients with minSTE present a high prevalence of TIMI flow 0 to I similar to those meeting lyticSTE suggesting an identical underlying mechanism and the potential to benefit from primary angioplasty. (Source: American Heart Journal)

Clinical and angiographic comparison of everolimus-eluting and paclitaxel-eluting stents in small coronary arteries: A post hoc analysis of the SPIRIT III randomized trial

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: In this post hoc analysis from the SPIRIT III trial, the XIENCE V 2.5-mm stent significantly reduced clinical and angiographic restenosis compared to the TAXUS 2.5-mm stent, further supporting the hypothesis that lower late loss is beneficial in small vessel disease. (Source: American Heart Journal)

Safety and feasibility of adjunctive antiplatelet therapy with intravenous elinogrel, a direct-acting and reversible P2Y12 ADP-receptor antagonist, before primary percutaneous intervention in patients with ST-elevation myocardial infarction: The Early Rapid ReversAl of Platelet ThromboSis with Intravenous Elinogrel before PCI to Optimize REperfusion in Acute Myocardial Infarction (ERASE MI) pilot trial

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: With the limitations of a small study sample size, this pilot study provided preliminary data on the feasibility and tolerability of escalating doses of a direct-acting, reversible, intravenous P2Y12 ADP-receptor antagonist, elinogrel, as an adjunctive therapy for primary PCI for STEMI. (Source: American Heart Journal)

Admission and fasting plasma glucose for estimating risk of death of diabetic and nondiabetic patients with acute coronary syndrome: nonlinearity of hazard ratios and time-dependent comparison

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Both admission and fasting glucose may be used for triage of nondiabetic ACS patients; fasting glucose may additionally be useful for long-term management, for which the relationship with the all-time mortality hazard ratio is J-shaped. (Source: American Heart Journal)

Prognostic importance of a restrictive transmitral filling pattern in patients with symptomatic congestive heart failure and atrial fibrillation

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: In a heterogeneous population hospitalized for symptomatic heart failure, a restrictive transmitral filling pattern during hospitalization is an ominous prognostic sign also in patients presenting with atrial fibrillation. (Source: American Heart Journal)

The impact of kidney transplantation on heart failure risk varies with candidate body mass index

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Heart failure risk improves in obese patients in the long term after kidney transplant, but not as much as for nonobese patients. There is need for close monitoring and for new strategies to reduce HF risk in obese patients before and after transplant. (Source: American Heart Journal)

Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Background: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied.Methods: We used data from the prospective, observational Study of Anemia in a Heart Failure Population Registry, which randomly selected outpatients with heart failure from specialty or community cardiology clinics. Hemoglobin was determined by finger stick at baseline and during medically indicated follow-up visits. Health-related quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire and the Minnesota Living with Heart Failure Questionnaire at 3-month intervals for 12 months.Results: Adjusted regression analysis demonstrated a significant, direct...

Cardiac resynchronization therapy utilization for heart failure: Findings from IMPROVE HF

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Despite being evidence based and guideline recommended, CRT is underutilized in eligible patients with significant variations associated with age, insurance, QRS duration, and geographic location of practices. Practice-specific performance improvement initiatives may be needed to reduce variations in use of CRT for eligible patients. (Source: American Heart Journal)

Coronary heart disease in moderately hypercholesterolemic, hypertensive black and non-black patients randomized to pravastatin versus usual care: The Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial (ALLHAT-LLT)

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Our results suggest that pravastatin is effective in preventing CHD in blacks. (Source: American Heart Journal)

Effects of recombinant human erythropoietin on platelet activation in acute myocardial infarction: Results of a double-blind, placebo-controlled, randomized trial

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: In acute MI patients treated with aspirin and clopidogrel, short-term administration of rHuEpo did not alter markers of platelet and endothelial cell activation associated with thrombosis, yet did increase expression of angiogenesis signaling proteins in PBMCs when compared with placebo. These data provide preliminary evidence of safety and biologic activity of rHuEpo at this dosing and support continued enrollment in ongoing efficacy trials. (Source: American Heart Journal)

Long-term morbidity and mortality among medically managed patients with angina and multivessel coronary artery disease

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Medical management after catheterization is a common in patients with severe CAD and angina. Of patients treated with medical management, one third will have a recurrent cardiac event within the first year highlighting the poor outcomes and high utilization of resources by this patient population. (Source: American Heart Journal)

Association of platelet responsiveness with clopidogrel metabolism: Role of compliance in the assessment of “resistance”

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Therapy with clopidogrel is associated with double-digit underestimated risks for noncompliance, especially in stroke survivors, supporting the hypothesis that lack of IPA, and clopidogrel “resistance” are attributed to hidden noncompliance. Plasma ICM, but not UC, or ATM is a useful marker to monitor compliance to clopidogrel in registries and clinical trials. (Source: American Heart Journal)

Underutilization of clopidogrel and glycoprotein IIb/IIIa inhibitors in non–ST-elevation acute coronary syndrome patients: The Canadian Global Registry of Acute Coronary Events (GRACE) experience

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: In this contemporary NSTE-ACS population, both clopidogrel and GpIIb/IIIa inhibitors were targeted toward patients treated with an invasive strategy but paradoxically toward the lower-risk group. In particular, clopidogrel appeared to be underused among conservatively managed patients despite its proven efficacy, whereas GpIIb/IIIa inhibitors were administered to only a minority of the high-risk patients with elevated cardiac biomarkers. Our findings emphasize the ongoing need to promote the optimal use of evidence-based antiplatelet therapies among high-risk patients with NSTE-ACS. (Source: American Heart Journal)

The Balloon pump-assisted Coronary Intervention Study (BCIS-1): Rationale and design

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Several observational studies have suggested that mortality and major complications after high-risk percutaneous coronary intervention (PCI) can be reduced by elective insertion of an intra-aortic balloon pump (IABP). However, to date, this assertion has never been tested in a randomized trial, and as such, international guidelines do not provide formal recommendations for IABP use in this setting.The BCIS-1 is a randomized trial that addresses the hypothesis that elective IABP insertion before high-risk PCI will reduce major adverse cardiac and cerebrovascular events (MACCEs) at hospital discharge or 28 days after index PCI, whichever occurs sooner. High risk is defined by the presence of severe left ventricular dysfunction as well as a large amount of myocardium at risk. Patients who are...

Rationale and design of the Patient Related OuTcomes with Endeavor versus Cypher stenting Trial (PROTECT): Randomized controlled trial comparing the incidence of stent thrombosis and clinical events after sirolimus or zotarolimus drug-eluting stent implantation

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Drug-eluting stents (DES) reduce restenosis rates compared to bare-metal stents. Most trials using DES enrolled selected patient and lesion subtypes, and primary endpoint focused on angiographic metrics or relatively short-term outcomes. When DES are used in broader types of lesions and patients, important differences may emerge in long-term outcomes between stent types, particularly the incidence of late stent thrombosis. PROTECT is a randomized, open-label trial comparing the long-term safety of the zotarolimus-eluting stent and the sirolimus-eluting stent. The trial has enrolled 8,800 patients representative of those seen in routine clinical practice, undergoing elective, unplanned, or emergency procedures in native coronary arteries in 196 centers in 36 countries. Indications for the p...

Rationale and design of the dal-OUTCOMES trial: Efficacy and safety of dalcetrapib in patients with recent acute coronary syndrome

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Background: Despite contemporary therapies for acute coronary syndrome (ACS), morbidity and mortality remain high. Low levels of high-density lipoprotein (HDL) cholesterol are common among patients with ACS and may contribute to ongoing risk. Strategies that raise levels of HDL cholesterol, such as inhibition of cholesterol ester transfer protein (CETP), might reduce risk after ACS. Dal-OUTCOMES is a multicenter, randomized, double-blind, placebo-controlled trial designed to test the hypothesis that CETP inhibition with dalcetrapib reduces cardiovascular morbidity and mortality in patients with recent ACS.Design: The study will randomize approximately 15,600 patients to receive daily doses of dalcetrapib 600 mg or matching placebo, beginning 4 to 12 weeks after an index ACS event. There ar...

Contemporary insights into the functional anatomy of the mitral valve

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

The mitral valve is a highly complex structure the normal functioning of which requires the coordinated interaction of the leaflets, annulus, chordae tendineae, and papillary muscles. Perturbations of any of these components can interfere with normal valve function. The integrity of the mitral valve is also essential to maintaining normal left ventricular geometry and function through closely coupled ventricular-valvular interactions. This review summarizes recent developments in our understanding of the anatomy and physiology of the mitral valve. (Source: American Heart Journal)

Standardized reporting of bleeding complications for clinical investigations in acute coronary syndromes: A proposal from the Academic Bleeding Consensus (ABC) Multidisciplinary Working Group

American Heart Journal — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: The ABC Group recommendations for collection and reporting of bleeding complications provide a framework for consistency in the collection of information on hemorrhagic complications in trials of ACS. Widespread adoption of the statement recommendations will facilitate understanding of the mechanisms of adverse outcomes after bleeding and comparisons of the relative safety of antithrombotic agents, as well as the interpretation of safety results from future studies. (Source: American Heart Journal)

Information for Readers

American Heart Journal — Sat, 24 Oct 2009 12:49:46 +0100

(Source: American Heart Journal)

Editorial Board

American Heart Journal — Sat, 24 Oct 2009 12:49:46 +0100

(Source: American Heart Journal)

American Heart Journal — Sat, 24 Oct 2009 12:49:46 +0100

(Source: American Heart Journal)

Response to, "Atrial fibrillation and quality of life"

American Heart Journal — Sat, 24 Oct 2009 12:49:45 +0100

Thank you for your interest in our recent publication. We fully agree that atrial fibrillation is not a benign condition. However, its effect on health-related quality of life (HRQOL) can vary significantly from asymptomatic patients unaware of their arrhythmia to those whose symptoms are difficult to control despite optimal medical care. In this analysis of an older (mean age, 73 years) cohort undergoing pacemaker placement, atrial fibrillation was associated with a decrement in functional status as measured by the Specific Activity Scale but was not a major driver of overall HRQOL as measured by the SF-36. In this respect, our results are similar to those of the AFFIRM trial but are not necessarily generalizable to cohorts with different characteristics. Thus, we do not believe that the ...

Atrial fibrillation and quality of life

American Heart Journal — Sat, 24 Oct 2009 12:49:45 +0100

Fleischmann et al have analyzed serial quality of life (QOL) measures using a Short Form-36, Specific Activity Scale, time trade-off in patients who had atrial fibrillation after pacemaker implantation. They have also concluded that in elderly patients, AF was not a major determinant of QOL. Authors argue that previous studies were small in size and used of invalidated measures to determine the QOL. However, the major reason for treating patients with AF is to reduce the frequency of AF and also to decrease the disabling symptoms associated with its severity. There is documentation that QOL of patients with AF is poor compared not only to healthy individuals but also to patients with coronary artery disease. The odds ratio for total mortality in Framingham population after adjusting for ag...

Mortality associated with adult congenital heart disease: Trends in the US population from 1979 to 2005

American Heart Journal — Sat, 24 Oct 2009 12:49:45 +0100

Conclusions: Patients with congenital heart disease are living longer. Arrhythmia remains the primary contributing cause of death for those with cyanotic lesions. Myocardial infarction is now the leading contributing cause for adults with noncyanotic congenital heart disease consistent with late survival and an increasing impact of acquired heart disease. (Source: American Heart Journal)

Low- and high-density lipoprotein cholesterol goal attainment in dyslipidemic women: The Lipid Treatment Assessment Project (L-TAP) 2

American Heart Journal — Sat, 24 Oct 2009 12:49:45 +0100

Background: Differences between women and men have been documented for both diagnostic testing and treatment in cardiology. This analysis evaluates whether low-density lipoprotein cholesterol (LDL-C) success rates according to current guidelines and high-density lipoprotein cholesterol (HDL-C) levels differ by gender in the L-TAP 2 population.Methods: Patients aged ≥20 years with dyslipidemia on stable lipid-lowering therapy were assessed in 9 countries between September 2006 and April 2007. Low-density lipoprotein cholesterol goal attainment by cardiovascular risk level and region and determinants of low HDL-C were compared between genders.Results: Of 9,955 patients (45.3% women) evaluated, women had a significantly lower overall LDL-C success rate than men (71.5% vs 73.7%, P = .014), d...

Achieving routine sub 30 minute door-to-balloon times in a high volume 24/7 primary angioplasty center with autonomous ambulance diagnosis and immediate catheter laboratory access

American Heart Journal — Sat, 24 Oct 2009 12:49:44 +0100

Conclusions: Interhospital transfer remains slow even with rapid institutional door-to-balloon times. With autonomous ambulance diagnosis and open access direct to the catheter laboratory, a median door-to-balloon time of 95% of patients were reperfused within 1 hour. (Source: American Heart Journal)

Nephrotoxicity of iodixanol versus iopamidol in patients with chronic kidney disease and diabetes mellitus undergoing coronary angiographic procedures

American Heart Journal — Sat, 24 Oct 2009 12:49:44 +0100

Conclusions: In the present study, the overall rate of CIN in patients with chronic kidney disease and DM undergoing coronary angiographic procedures was 10.5%. There was no significant difference between iodixanol and iopamidol in either peak increase in SCr or risk of CIN. (Source: American Heart Journal)

Transradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction: Systematic overview and meta-analysis

American Heart Journal — Sat, 24 Oct 2009 12:49:44 +0100

Conclusions: Transradial PCI reduces the risk of periprocedural major bleeding and major adverse events in the STEMI setting. (Source: American Heart Journal)

Prognostic significance and magnetic resonance imaging findings in aborted myocardial infarction after primary angioplasty

American Heart Journal — Sat, 24 Oct 2009 12:49:43 +0100

Conclusion: The proven prognostic relevance of aborted MI makes it a meaningful end point and therapeutic target in future MI studies. MRI can further distinguish between true aborted MI with absence of myocardial scar and aborted MI with scar formations. (Source: American Heart Journal)

Patterns of management of atrial fibrillation complicating coronary artery bypass grafting: Results from the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT-IV) Trial

American Heart Journal — Sat, 24 Oct 2009 12:49:43 +0100

Conclusion: Although a rhythm control strategy was used in most of the patients in this trial and the overall rate of use of warfarin was low, the significance of these findings is uncertain because of the lack of data from randomized clinical trials. The substantial variations in the management of post-CABG AF across sites are likely because of definitive data on the most effective therapies, highlighting the need for clinical trials on rate versus rhythm control and on anticoagulation for AF in this setting. (Source: American Heart Journal)

Does intensity of rate control influence outcome in persistent atrial fibrillation? Data of the RACE study

American Heart Journal — Sat, 24 Oct 2009 12:49:43 +0100

Background: Large trials have demonstrated that rate control is an acceptable alternative for rhythm control. However, optimal heart rate during atrial fibrillation (AF) remains unknown. Aim of this analysis was to compare outcome between rate control ≥80 and (Source: American Heart Journal)

The relation between platelet reactivity and glycemic control in diabetic patients with cardiovascular disease on maintenance aspirin and clopidogrel therapy

American Heart Journal — Sat, 24 Oct 2009 12:49:43 +0100

Background: High platelet reactivity (HPR) during aspirin and clopidogrel therapy in patients with diabetes has been reported and may affect outcomes. However, the relation of platelet reactivity to glycemic control is less studied in patients on dual antiplatelet therapy.Methods: Platelet aggregation (PA) in response to 5 and 20 μmol/L adenosine diphosphate (ADP) was compared in type 2 diabetic (n = 36) and nondiabetic patients (n = 35) undergoing elective stenting on aspirin and clopidogrel maintenance therapy. The relation of glycosylated hemoglobin (HbA1c) 46% for 5 μmol/L ADP-induced and >59% for 20 μmol/L ADP-induced PA.Results: Diabetic patients had higher 5 and 20 μmol/L ADP-induced PA than nondiabetic patients (45 ± 17 vs 33 ± 12, P = .009 and 52 ± 19 vs 40 ± 12, P = .004,...

Prognostic value of B-type natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

American Heart Journal — Sat, 24 Oct 2009 12:49:43 +0100

Background: B-type natriuretic peptide (BNP) correlates with left ventricular (LV) end-diastolic pressure (LVEDP) and predicts cardiovascular events. We sought to determine whether BNP has prognostic value independent of LVEDP.Methods: Eligible patients were referred for coronary angiography between March 15, 2002, and April 30, 2008, at a single institution. Inclusion criteria were having BNP, LV ejection fraction (EF), and LVEDP measured within 24 hours of the angiogram. The predictive value of BNP for events independent of LVEDP, EF, and other confounders was determined.Results: The study population (n = 1,059) was followed for a mean of 1.8 ± 1.7 years. The mean age was 63 ± 13 years. The median BNP value was 182 pg/mL; 59% of patients had LVEDP ≥16 mm Hg. B-type natriuretic peptid...

Cardiac resynchronization therapy in patients with ischemic versus non-ischemic heart failure: Differential effect of optimizing interventricular pacing interval

American Heart Journal — Sat, 24 Oct 2009 12:49:42 +0100

Conclusions: Optimized sequential biventricular pacing further increased LV systolic performance as compared to simultaneous stimulation, particularly in ischemic patients where the presence of a large scar was correlated with a larger LV preactivation. (Source: American Heart Journal)

Comparative trends in guidelines adherence among patients with non–ST-segment elevation acute coronary syndromes treated with invasive versus conservative management strategies: Results from the CRUSADE quality improvement initiative

American Heart Journal — Sat, 24 Oct 2009 12:49:42 +0100

Conclusions: Improvements in the use of guidelines-recommended therapies were seen among all patients with NSTE ACS in CRUSADE over a 4-year period regardless of management strategy, and the trajectory of improvement in acute care was greatest in patients managed conservatively. (Source: American Heart Journal)

High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation: A randomized controlled trial evaluating the relationship to endothelial function and inflammation

American Heart Journal — Sat, 24 Oct 2009 12:49:41 +0100

Conclusions: Regular high-intensity interval exercise training was associated with a significant reduction in late luminal loss in the stented coronary segment. This effect was associated with increased aerobic capacity, improved endothelium function, and attenuated inflammation. (Source: American Heart Journal)

Rationale and design of the Duke Electrophysiology Genetic and Genomic Studies (EPGEN) biorepository

American Heart Journal — Sat, 24 Oct 2009 12:49:41 +0100

Conclusions: We have established a biorepository and clinical database composed of patients with electrophysiologic diseases. EPGEN will seek to (1) improve risk stratification, (2) elucidate mechanisms of arrhythmogenesis, and (3) identify novel pharmacologic targets for the treatment of heart rhythm disorders. (Source: American Heart Journal)

Design and rationale of the WOEST trial: What is the Optimal antiplatElet and anticoagulant therapy in patients with oral anticoagulation and coronary StenTing (WOEST)

American Heart Journal — Sat, 24 Oct 2009 12:49:40 +0100

Conclusions: No prospective randomized study has yet addressed the issue of optimal antiplatelet therapy in patients with chronic oral anticoagulant therapy undergoing coronary stenting. Therefore, the WOEST trial will help to define new guidelines for patients with indication for chronic anticoagulation who need coronary stenting. (Source: American Heart Journal)

Management of ST-segment elevation myocardial infarction: Comparison of the updated guidelines from North America and Europe

American Heart Journal — Sat, 24 Oct 2009 12:49:40 +0100

The American College of Cardiology/American Heart Association and the European Society of Cardiology each recently published updated guidelines for management of patients with acute ST elevation myocardial infarction. In this article, we highlight the most important new recommendations, review their supporting data, and describe differences between the guidelines.Key aspects of these updates include detailed guidance regarding the selection of a reperfusion strategy and the incorporation of newer adjunctive antithrombotic agents. Both new guidelines suggest caution in the administration of intravenous β-blockers, avoidance of nonsteroidal anti-inflammatory agents, and support a more aggressive approach to secondary risk factor management.The 2 guidelines have some nuanced differences as w...

Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography

American Heart Journal — Sun, 04 Oct 2009 23:00:00 +0100

Conclusion: Longitudinal strain analysis had higher diagnostic accuracy than circumferential and radial strains and was comparable to WMSI for detection of significant coronary artery disease. However, combination longitudinal strain and WMSI resulted in significant incremental increase in diagnostic accuracy. (Source: American Heart Journal)

Histologic characterization of hypertrophic cardiomyopathy with and without myofilament mutations

American Heart Journal — Sun, 04 Oct 2009 23:00:00 +0100

Conclusion: Myofilament-positive HC does not appear to represent a distinct clinical phenotypic entity as evidenced by specific histologic characteristics and septal shape. (Source: American Heart Journal)

Addition of inspiratory muscle training to aerobic training improves cardiorespiratory responses to exercise in patients with heart failure and inspiratory muscle weakness

American Heart Journal — Sun, 04 Oct 2009 23:00:00 +0100

Background: This small clinical trial tested the hypothesis that the addition of inspiratory muscle training (IMT) to aerobic exercise training (AE) results in further improvement in cardiorespiratory responses to exercise than those obtained with AE in patients with chronic heart failure (CHF) and inspiratory muscle weakness (IMW).Methods: Twenty-four patients with CHF and IMW (maximal inspiratory pressure (Source: American Heart Journal)

Contribution of angiographic and electrocardiographic parameters of reperfusion to prediction of mortality and morbidity after acute ST-elevation myocardial infarction: Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction trial

American Heart Journal — Sun, 04 Oct 2009 23:00:00 +0100

Background: Reperfusion with primary percutaneous intervention (PCI) in ST-segment elevation myocardial infarction leads to improved clinical outcomes. The contribution angiographic vs electrocardiographic reperfusion parameters confer on prognosis is unclear.Methods: A prespecified subset of the APEX-AMI trial patients was analyzed by independent angiographic and electrocardiographic core laboratories (n = 1,018). Angiographic reperfusion after PCI and electrocardiogram 30 minutes post-PCI were assessed.Results: Of the 941 patients in the angiographic substudy, 796 (85%) attained post-PCI Thrombolysis In Myocardial Infarction (TIMI) flow 3 and 852 (91%) had TIMI Myocardial Perfusion Grade (TMPG) 2/3. There were 664 (71%) patients with residual ST elevation (ST-E) (Source: American Heart J...

Design and rationale of the Evaluation of M118 IN pErcutaNeous Coronary intErvention (EMINENCE) trial

American Heart Journal — Wed, 30 Sep 2009 23:00:00 +0100

Conclusion: The EMINENCE trial will assess the safety and feasibility of M118 as an anticoagulant in the setting of PCI and will provide important information to determine the appropriate therapeutic range of activated clotting time for M118 and the appropriate dose or doses to be explored in a phase 3 clinical trial. (Source: American Heart Journal)

Barriers to participation in cardiac rehabilitation

American Heart Journal — Tue, 29 Sep 2009 23:00:00 +0100

Conclusions: Several clinical and psychosocial factors are associated with decreased participation in cardiac rehabilitation programs after MI in the community. As many are modifiable, addressing them may improve participation and outcomes. (Source: American Heart Journal)

Reporting and representation of race/ethnicity in published randomized trials

American Heart Journal — Tue, 29 Sep 2009 23:00:00 +0100

Conclusion: Although reporting the race/ethnic composition of study populations is increasing over time, two thirds of all RCTs supporting a recent American Heart Association () guideline failed to publish any information on race. A necessary first requirement in translating RCT evidence to patients of all races is information regarding racial demographics. Such information should be strongly encouraged in future publications. (Source: American Heart Journal)

Self-reported anxiety and the risk of clinical events and atherosclerotic progression among patients with Coronary Artery Bypass Grafts (CABG)

American Heart Journal — Thu, 24 Sep 2009 23:00:00 +0100

Conclusions: Anxiety symptoms are associated with increased risk of death or MI among patients with saphenous vein grafts, but this risk does not appear to be mediated by more extensive atherosclerotic progression. (Source: American Heart Journal)

Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention

American Heart Journal — Thu, 24 Sep 2009 23:00:00 +0100

Conclusion: Physical examination, exercise testing, and arterial ultrasonography provide incremental information on the risk of coronary event in asymptomatic adults. Exercise testing and femoral ultrasonography also improve the accuracy of the risk stratification. (Source: American Heart Journal)

Magnitude and consequences of missing the acute infarct-related circumflex artery

American Heart Journal — Thu, 24 Sep 2009 23:00:00 +0100

Emergent reperfusion strategies are integral to providing optimal patient outcomes in the setting of acute coronary artery occlusion. ST-segment elevation on the surface 12-lead electrocardiogram, although specific as a surrogate marker, is insensitive to acute posterior circulation coronary artery occlusion. Studies of non–ST-segment elevation acute coronary syndrome consistently identify patients who have epicardial vessel occlusion at the time of initial angiography, which is usually delayed for hours or days after the initial presentation. In addition, studies of ST-segment elevation myocardial infarction often divulge a disparity in identification of the infarct-related artery, with an underrepresentation of the left circumflex artery. Taken together, it is likely that many patients...

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American Heart Journal — Thu, 24 Sep 2009 16:17:19 +0100

(Source: American Heart Journal)

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American Heart Journal — Thu, 24 Sep 2009 16:17:19 +0100

(Source: American Heart Journal)

American Heart Journal via MedWorm.com

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“High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation: A randomized controlled trial evaluating the relationship to endothelial function and inflammation.” Am Heart J 2009;158:734-41

Low vitamin D may explain the link between preeclampsia and cardiovascular disease

Author response: B-type natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

Brain natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

Reply to the Letter to the Editor by Yi et al

Effect of interval (V-V) optimization in ischemic versus nonischemic patients after cardiac resynchronization therapy

Factors associated with cardiac conduction disorders and permanent pacemaker implantation after percutaneous aortic valve implantation with the CoreValve prosthesis

Timing of nonemergent coronary artery bypass grafting and mortality after non-ST elevation acute coronary syndrome

Temporal trends in compliance with appropriateness criteria for stress single-photon emission computed tomography sestamibi studies in an academic medical center

Trends in echocardiography utilization in the Veterans Administration Healthcare System

Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

Clopidogrel use and clinical events after drug-eluting stent implantation: Findings from the HealthCore Integrated Research Database

Long-term outcome of percutaneous catheter intervention for de novo coronary bifurcation lesions with drug-eluting stents or bare-metal stents

Does “late catch-up” exist in drug-eluting stents: Insights from a serial quantitative coronary angiography analysis of sirolimus versus paclitaxel-eluting stents

Mechanisms of nonfatal acute myocardial infarction late after stent implantation: The relative impact of disease progression, stent restenosis, and stent thrombosis

Clinical relevance of clopidogrel unresponsiveness during elective coronary stenting: Experience with the point-of-care Platelet Function Assay–100 C/ADP

Propranolol and the risk of hospitalized myopathy: Translating chemical genomics findings into population-level hypotheses

Detection of elevated right atrial pressure using a simple bedside ultrasound measure

Myocardial structure and function by echocardiography in relation to glucometabolic status in elderly subjects from 2 population-based cohorts: A cross-sectional study

Relationships between emerging measures of heart failure processes of care and clinical outcomes

Cuff and aortic pressure differences during dobutamine infusion: A study of the effects of systolic blood pressure amplification

Differences in mortality in acute coronary syndrome symptom clusters

Variations in prevalent cardiovascular disease and future risk by metabolic syndrome classification in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

Evidence of disparity in the application of quality improvement efforts for the treatment of acute myocardial infarction: The American College of Cardiology's Guidelines Applied in Practice Initiative in Michigan

In-hospital management of patients with atrial flutter

Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)—A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events

Rationale and design of Enhanced Angiogenic Cell Therapy in Acute Myocardial Infarction (ENACT-AMI): The first randomized placebo-controlled trial of enhanced progenitor cell therapy for acute myocardial infarction

Rationale and design of AVERROES: Apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment

Rivaroxaban—Once daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: Rationale and Design of the ROCKET AF study

Apixaban for Reduction In Stroke and Other ThromboemboLic Events in Atrial Fibrillation (ARISTOTLE) trial: Design and rationale

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Laskey response to Solomon

Letter to the Editor—Solomon about Laskey Study

Response to letter by Drs Dilaveris and Stefanadis: Electrocardiographic predictors of atrial fibrillation: Methodological considerations

Electrocardiographic predictors of atrial fibrillation: Methodological considerations

Letter to the Editor

Correction

Correction

Correction

Relationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving System—A Bern-Rotterdam Study

The right ventricular annular velocity reduction caused by coronary artery bypass graft surgery occurs at the moment of pericardial incision

Association of statin prescription with small abdominal aortic aneurysm progression

Perioperative outcomes in reoperative cardiac surgery guided by cardiac multidetector computed tomographic angiography

The effect of obesity on quality of life in patients with diabetes and coronary artery disease

Triple antiplatelet therapy reduces ischemic events after drug-eluting stent implantation: Drug-Eluting stenting followed by Cilostazol treatment REduces Adverse Serious cardiac Events (DECREASE registry)

Intracoronary thrombus formation after drug-eluting stents implantation: Optical coherence tomographic study

Analysis of the long-term effects of drug-eluting stents on coronary arterial wall morphology as assessed by virtual histology intravascular ultrasound

Biventricular pacing improves cardiac function and prevents further left atrial remodeling in patients with symptomatic atrial fibrillation after atrioventricular node ablation

Myocardial infarction and incidence of type 2 diabetes mellitus. Is admission blood glucose an independent predictor for future type 2 diabetes mellitus?

Systematic review of trials using vasodilators in pulmonary arterial hypertension: Why a new approach is needed

Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: Findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)

Mechanisms of the association between depressive symptoms and long-term mortality in heart failure

Parity and risk of later-life maternal cardiovascular disease

Are quality improvements associated with the Get With the Guidelines-Coronary Artery Disease (GWTG-CAD) program sustained over time? A longitudinal comparison of GWTG-CAD hospitals versus non–GWTG-CAD hospitals

Anger expression and risk of coronary heart disease: Evidence from the Nova Scotia Health Survey

Routine use of fondaparinux in acute coronary syndromes: A 2-year multicenter experience

Primary care practices and determinants of optimal anticoagulation management in a collaborative care model

Randomized comparison between clinical evaluation plus N-terminal pro–B-type natriuretic peptide versus exercise testing for decision making in acute chest pain of uncertain origin

Cardiac DeatH Prevention by aUtomated DefibrillatoRs in ChurcHes: Rationale and design of the CHURCH trial

Effectiveness and safety of drug-eluting stents in vein grafts: A meta-analysis

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Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with obstructive coronary artery disease

Percutaneous coronary intervention or coronary artery bypass surgery for cardiogenic shock and multivessel coronary artery disease?

Quantitative impact of cardiovascular risk factors and vascular closure devices on the femoral artery after repeat cardiac catheterization

The incidence and clinical predictors of early stent thrombosis in patients with acute coronary syndrome

Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction—A prospective and randomized trial in low-risk primary percutaneous coronary intervention patients (the Safe-Depart Trial)

Hematomas of at least 5 cm and outcomes in patients undergoing elective percutaneous coronary intervention: Insights from the SafeTy and Efficacy of Enoxaparin in PCI patients, an internationaL randomized Evaluation (STEEPLE) trial

EuroSCORE refines the predictive ability of SYNTAX score in patients undergoing left main percutaneous coronary intervention

Intraoperative defibrillation threshold testing during implantable cardioverter-defibrillator insertion: Do we really need it?

Glycemia and prognosis of patients with chronic heart failure—Subanalysis of the Long-term Prospective Randomized Controlled Study Using Repetitive Education at Six-Month Intervals and Monitoring for Adherence in Heart Failure Outpatients (REMADHE) trial

Association of longitudinal measures of hemoglobin and outcomes after hospitalization for heart failure

Obesity and survival in patients with heart failure and preserved systolic function: A U-shaped relationship