24,492 results match your criteria Am. Heart J.[Journal]


Transcatheter InterAtrial Shunt Device for the treatment of heart failure: Rationale and design of the pivotal randomized trial to REDUCE Elevated Left Atrial Pressure in Patients with Heart Failure II (REDUCE LAP-HF II).

Am Heart J 2019 Nov 11;226:222-231. Epub 2019 Nov 11.

Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address:

Background: A randomized, sham-controlled trial in patients with heart failure (HF) and left ventricular ejection fraction (LVEF) ≥40% demonstrated reductions in pulmonary capillary wedge pressure (PCWP) with a novel transcatheter InterAtrial Shunt Device (IASD). Whether this hemodynamic effect will translate to an improvement in cardiovascular outcomes and symptoms requires additional study.

Study Design And Objectives: REDUCE Elevated Left Atrial Pressure in Patients with Heart Failure II (REDUCE LAP HF-II) is a multicenter, prospective, randomized, sham-controlled, blinded trial designed to evaluate the clinical efficacy of the IASD in symptomatic HF and elevated left atrial pressures. Read More

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http://dx.doi.org/10.1016/j.ahj.2019.10.015DOI Listing
November 2019

Acute myocardial infarction under-diagnosis and mortality in a Tanzanian emergency department: A prospective observational study.

Am Heart J 2020 Jun 5;226:214-221. Epub 2020 Jun 5.

Duke Global Health Institute, 310 Trent Drive, Durham, NC; Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC; Duke Clinical Research Institute, 300 W Morgan St, Durham, NC.

Background: Growing evidence suggests that under-diagnosis of acute myocardial infarction (AMI) may be common in sub-Saharan Africa. Prospective studies of routine AMI screening among patients presenting to emergency departments in sub-Saharan Africa are lacking. Our objective was to determine the prevalence of AMI among patients in a Tanzanian emergency department. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.017DOI Listing

High-intensity endurance training is associated with left atrial fibrosis.

Am Heart J 2020 May 30;226:206-213. Epub 2020 May 30.

Comprehensive Arrhythmia Research & Management Center (CARMA) University of Utah, Salt Lake City, UT; Tulane University Heart and Vascular Institute, New Orleans, LA.

Introduction: Endurance athletes are at higher risk for developing atrial fibrillation as compared to the general population. The exact mechanism to explain this observation is incompletely understood. Our study aimed to determine whether degree of left atrial fibrosis detected by late gadolinium-enhancement magnetic resonance imaging (LGE-MRI) differed between Masters athletes and non-athlete controls. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.015DOI Listing

Impact of salt substitute and stepwise reduction of salt supply on blood pressure in residents in senior residential facilities: Design and rationale of the DECIDE-Salt trial.

Am Heart J 2020 May 30;226:198-205. Epub 2020 May 30.

Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China. Electronic address:

Background: High sodium intake has been considered as the leading dietary risk factor for deaths and disability-adjusted life-years among older adults. High-quality randomized trials to evaluate the effects of practical sodium reduction strategies are needed.

Methods: The study is a cluster randomized trial with a 2 × 2 factorial design conducted in 48 senior residential facilities in northern China. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.013DOI Listing

Overcoming underpowering: Trial simulations and a global rank end point to optimize clinical trials in children with heart disease.

Am Heart J 2020 May 20;226:188-197. Epub 2020 May 20.

Duke Clinical Research Institute, Durham, North Carolina.

Background: Randomized controlled trials (RCTs) in children with heart disease are challenging and therefore infrequently performed. We sought to improve feasibility of perioperative RCTs for this patient cohort using data from a large, multicenter clinical registry. We evaluated potential enrollment and end point frequencies for various inclusion cohorts and developed a novel global rank trial end point. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.011DOI Listing

COVID-19 and the cardiovascular system: A review of current data, summary of best practices, outline of controversies, and illustrative case reports.

Am Heart J 2020 Jun 15;226:174-187. Epub 2020 Jun 15.

The Department of Medicine and Division of Cardiology, UT Health San Antonio, San Antonio, TX.

As the severe acute respiratory syndrome coronavirus 2 virus pandemic continues to grow globally, an association is apparent between patients with underlying cardiovascular disease comorbidities and the risk of developing severe COVID-19. Furthermore, there are potential cardiac manifestations of severe acute respiratory syndrome coronavirus 2 including myocyte injury, ventricular dysfunction, coagulopathy, and electrophysiologic abnormalities. Balancing management of the infection and treatment of underlying cardiovascular disease requires further study. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.06.009DOI Listing

A multicenter trial of a shared DECision Support Intervention for Patients offered implantable Cardioverter-DEfibrillators: DECIDE-ICD rationale, design, Medicare changes, and pilot data.

Am Heart J 2020 Apr 20;226:161-173. Epub 2020 Apr 20.

Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO.

Shared decision making (SDM) facilitates delivery of medical therapies that are in alignment with patients' goals and values. Medicare national coverage decision for several interventions now includes SDM mandates, but few have been evaluated in nationwide studies. Based upon a detailed needs assessment with diverse stakeholders, we developed pamphlet and video patient decision aids (PtDAs) for implantable cardioverter/defibrillator (ICD) implantation, ICD replacement, and cardiac resynchronization therapy with defibrillation to help patients contemplate, forecast, and deliberate their options. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.010DOI Listing

Impact of electrical cardioversion on quality of life for patients with symptomatic persistent atrial fibrillation: Is there a treatment expectation effect?

Am Heart J 2020 May 11;226:152-160. Epub 2020 May 11.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.

It is assumed that electrical cardioversion (ECV) improves the quality of life (QoL) of patients with atrial fibrillation (AF) by restoring sinus rhythm (SR).

Objective: We examined the effect of ECV and rhythm status on QoL of patients with symptomatic persistent AF in a randomized controlled trial.

Method: The elective cardioversion for prevention of symptomatic atrial fibrillation trial examined the efficacy of dronedarone around the time of ECV in maintaining SR. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.004DOI Listing

Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York.

Am Heart J 2020 May 23;226:147-151. Epub 2020 May 23.

United Health Services Hospitals, Heart and Vascular Institute, Wilson Regional Medical Center, Department of Cardiology, NY, USA.

The COVID-19 virus is a devastating pandemic that has impacted the US healthcare system significantly. More than one study reported a significant decrease in acute coronary syndrome admissions during that pandemic which is still due to unknown reasons.

Methods: This is a retrospective non-controlled multi-centered study of 180 patients (117 males and 63 females) with acute coronary syndrome (STEMI and NSTEMI) admitted during March/April of 2019 and March/April 2020 in Upstate New York. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244433PMC

The Second Strategic Reperfusion Early After Myocardial Infarction (STREAM-2) study optimizing pharmacoinvasive reperfusion strategy in older ST-elevation myocardial infarction patients.

Am Heart J 2020 May 15;226:140-146. Epub 2020 May 15.

Dept. of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. Electronic address:

Background: The STREAM study demonstrated that a pharmaco-invasive strategy was at least as effective as primary PCI (pPCI) in patients presenting early with ST-elevation myocardial infarction (STEMI). The current trial is a response to the finding that reduced intracranial hemorrhage (ICH) in patients ≥75 years occurred after halving the dose of tenecteplase. Additionally, a subsequent analysis of full dose tenecteplase or alteplase in the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT) trials demonstrated a steep increase in bleeding events beginning around the age of 60 years. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.029DOI Listing

Childhood cancer survivors: The integral role of the cardiologist and cardiovascular imaging.

Am Heart J 2020 May 14;226:127-139. Epub 2020 May 14.

Department of Pediatrics, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN.

Importance: With 80% of childhood cancer survivors (CCS) alive 30 years after diagnosis, preventable causes of death, such as cardiovascular disease resulting from initial cancer therapy, becomes an important metric. This leads to a more pronounced role for cardiologists in the care of CCS.

Observations: While routine cardiovascular screening has been traditionally performed by the hematologist/oncologist or primary care provider, our understanding of cardiovascular disease in CCS has advanced. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.008DOI Listing

Predictors of Fabry disease in patients with hypertrophic cardiomyopathy: How to guide the diagnostic strategy?

Am Heart J 2020 Apr 18;226:114-126. Epub 2020 Apr 18.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3Bs PT Government Associate Laboratory, Braga/Guimarães, Portugal.

Background: Fabry disease (FD) is a treatable cause of hypertrophic cardiomyopathy (HCM). We aimed to determine the independent predictors of FD and to define a clinically useful strategy to discriminate FD among HCM.

Methods: Multicenter study including 780 patients with the ESC definition of HCM. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.006DOI Listing

The RICH LIFE Project: A cluster randomized pragmatic trial comparing the effectiveness of health system only vs. health system Plus a collaborative/stepped care intervention to reduce hypertension disparities.

Am Heart J 2020 May 8;226:94-113. Epub 2020 May 8.

Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins Center for Health Equity, Johns Hopkins University, Baltimore, MD, USA; The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Disparities in the control of hypertension and other cardiovascular disease risk factors are well-documented in the United States, even among patients seen regularly in the healthcare system. Few existing approaches explicitly address disparities in hypertension care and control. This paper describes the RICH LIFE Project (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) design. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.001DOI Listing

Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: Results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).

Am Heart J 2020 Apr 28;226:85-93. Epub 2020 Apr 28.

Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.

While oral anticoagulation is a cornerstone of stroke prevention therapy in atrial fibrillation (AF), few studies have evaluated comparative discontinuation rates in clinical practice. The objective of this study is to evaluate discontinuation rates among patients on warfarin and direct oral anticoagulants (DOACs) in clinical practice.

Methods: The ORBIT-AF II Registry enrolled 10,005 total AF patients with a CHADSVASc score of ≥2 on warfarin or DOACs from 235 clinical practices across the US from February 13, 2013 and July 12, 2017. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.016DOI Listing
April 2020
4.463 Impact Factor

Population-level surveillance of congenital heart defects among adolescents and adults in Colorado: Implications of record linkage.

Am Heart J 2020 Apr 19;226:75-84. Epub 2020 Apr 19.

Denver Health and Hospital Authority, Denver Public Health, Denver, CO.

Background: The objective was to describe the design of a population-level electronic health record (EHR) and insurance claims-based surveillance system of adolescents and adults with congenital heart defects (CHDs) in Colorado and to evaluate the bias introduced by duplicate cases across data sources.

Methods: The Colorado CHD Surveillance System ascertained individuals aged 11-64 years with a CHD based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic coding between 2011 and 2013 from a diverse network of health care systems and an All Payer Claims Database (APCD). A probability-based identity reconciliation algorithm identified duplicate cases. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.008DOI Listing

Cardiovascular implications of idiopathic pulmonary fibrosis: A way forward together?

Am Heart J 2020 May 6;226:69-74. Epub 2020 May 6.

Duke Clinical Research Institute and the Department of Medicine, Durham, NC; Division of Cardiology, Duke University Medical Center, Durham, NC.

Cardiovascular disease has an increased prevalence among patients with idiopathic pulmonary fibrosis (IPF). Cardiovascular disease and IPF share similar symptoms with overlapping demographics and risk factors for disease development. Common cellular mediators leading to disease development and progression have been identified in both the cardiovascular and pulmonary organ systems. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.027DOI Listing

Discrepancy in recognition of symptom burden among patients with atrial fibrillation.

Am Heart J 2020 May 6. Epub 2020 May 6.

Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

Our aim was to investigate the variability in physician recognition of atrial fibrillation (AF)-related symptoms, which greatly contributes to the management of AF patients. METHODS AND RESULTS: A total of 1493 newly-referredAF patients (67 ± 11 y/o, 1057 men) consecutively registered in an outpatient-based Japanese multicenter database (KiCS-AF) from September 2012 to December 2016 were analyzed. Self-reportedAF symptom burden was assessed via symptom and daily activities domains within the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.024DOI Listing

Rationale and design of the PRAETORIAN-COVID trial: A double-blind, placebo-controlled randomized clinical trial with valsartan for PRevention of Acute rEspiraTORy dIstress syndrome in hospitAlized patieNts with SARS-COV-2 Infection Disease.

Am Heart J 2020 May 21;226:60-68. Epub 2020 May 21.

Department of Cardiology, Radboudumc, Nijmegen, the Netherlands.

There is much debate on the use of angiotensin receptor blockers (ARBs) in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-infected patients. Although it has been suggested that ARBs might lead to a higher susceptibility and severity of SARS-CoV-2 infection, experimental data suggest that ARBs may reduce acute lung injury via blocking angiotensin-II-mediated pulmonary permeability, inflammation, and fibrosis. However, despite these hypotheses, specific studies on ARBs in SARS-CoV-2 patients are lacking. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239793PMC

Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--The BRACE CORONA Trial.

Am Heart J 2020 May 13;226:49-59. Epub 2020 May 13.

D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Rede D'Or São Luiz (RDSL), São Paulo, Brazil.

Angiotensin-converting enzyme-2 (ACE2) expression may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs). Because renin-angiotensin system blockers increase levels of ACE2, a protein that facilitates coronavirus entry into cells, there is concern that these drugs could increase the risk of developing a severe and fatal form of COVID-19. The impact of discontinuing ACEI and ARBs in patients with COVID-19 remains uncertain. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219415PMC

Levels of evidence supporting drug, device, and other recommendations in the American Heart Association/American College of Cardiology guidelines.

Am Heart J 2020 May 8;226:4-12. Epub 2020 May 8.

Division of Cardiology and Duke Clinical Research Institute, Duke University, Durham, NC, USA.

Clinical guideline documents reflect the evidence supporting clinical practice, but few recommendations in cardiovascular guidelines are supported by evidence from randomized controlled trials (RCTs), the highest level of evidence. Incentives for generating evidence from RCTs differ by topic of guideline recommendation, and it is uncertain whether evidence supporting guideline recommendations differs based on the topic of the recommendation.

Methods: We abstracted recommendation statements from current ACC/AHA guideline documents (2008-2019). Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.003DOI Listing

Outcomes and cost among Medicare beneficiaries hospitalized for heart failure assigned to accountable care organizations.

Am Heart J 2020 May 8;226:13-23. Epub 2020 May 8.

Duke Clinical Research Institute, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.

Little is known about the impact of accountable care organizations (ACO) on hospitalized heart failure (HF) patients, a high-cost and high-risk population.

Objective: We linked Medicare fee-for-service claims from 2013 to 2015 with data from American Heart Association Get With The Guidelines-HF registry to compare HF care, post-discharge outcomes, and total annual Medicare spending by ACO status at discharge.

Methods: Using adjusted Cox models and accounting for competing risks of death, we compared all-cause mortality and readmission at 1 year by ACO status with reporting of hazard ratios (HR) and 99% confidence intervals (CI). Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.028DOI Listing
May 2020
4.463 Impact Factor

TAVR for low-flow, low-gradient aortic stenosis: Prognostic impact of aortic valve calcification.

Am Heart J 2020 07 8;225:138-148. Epub 2020 Apr 8.

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. Electronic address:

Background: Compared to high gradient aortic stenosis (AS), patients with low-flow, low-gradient AS have higher mortality after transcatheter aortic valve replacement (TAVR), but distinct outcome predictors in this patient subset are yet to be determined. The present study investigated the prognostic impact of aortic valve calcification (AVC) in patients with low-flow, low-gradient AS undergoing TAVR.

Methods: This retrospective single-center analysis includes all patients undergoing TAVR for severe low-flow, low-gradient AS (n = 526), ie, low EF low gradient AS (LEF-LG AS; n = 290) and paradoxical low-flow, low-gradient AS (PLF-LG AS; n = 236), in whom AVC was quantified from contrast-enhanced multislice computed tomography images. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.013DOI Listing

Impact of COVID-19 pandemic on patients with ST-segment elevation myocardial infarction: Insights from a British cardiac center.

Am Heart J 2020 May 11;226:45-48. Epub 2020 May 11.

Division of Cardiology, Ain Shams University, Cairo, Egypt; Cardiovascular Institute, The Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute, Providence, RI, USA. Electronic address:

The current study aimed to examine the impact of COVID-19 pandemic on patient-related delay with ST-segment elevation myocardial infarction (STEMI) at a tertiary center in the United Kingdom. The study demonstrated a significant delay in symptom-to-first medical contact and a higher cardiac troponin-I level on admission in patients with STEMI during the COVID-19 pandemic versus the pre-COVID era. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211651PMC
May 2020
4.463 Impact Factor

A current review of COVID-19 for the cardiovascular specialist.

Am Heart J 2020 May 3;226:29-44. Epub 2020 May 3.

Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Critical Care Cardiology Section, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address:

Although coronavirus disease 2019 (COVID-19) predominantly disrupts the respiratory system, there is accumulating experience that the disease, particularly in its more severe manifestations, also affects the cardiovascular system. Cardiovascular risk factors and chronic cardiovascular conditions are prevalent among patients affected by COVID-19 and associated with adverse outcomes. However, whether pre-existing cardiovascular disease is an independent determinant of higher mortality risk with COVID-19 remains uncertain. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252118PMC

Anticipating and curtailing the cardiometabolic toxicity of social isolation and emotional stress in the time of COVID-19.

Am Heart J 2020 May 3;226:1-3. Epub 2020 May 3.

The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD.

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http://dx.doi.org/10.1016/j.ahj.2020.04.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252181PMC
May 2020
4.463 Impact Factor

Radial versus femoral artery access for percutaneous coronary artery intervention in patients with acute myocardial infarction and multivessel disease complicated by cardiogenic shock: Subanalysis from the CULPRIT-SHOCK trial.

Am Heart J 2020 07 30;225:60-68. Epub 2020 Apr 30.

First Department of Medicine-Cardiology, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.

Background: The use and impact of transradial artery access (TRA) compared to transfemoral artery access (TFA) in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) complicated by cardiogenic shock (CS) remain unclear.

Methods: This is a post hoc analysis of the CULPRIT-SHOCK trial where patients presenting with MI and multivessel disease complicated by CS were randomized to a strategy of culprit-lesion-only or immediate multivessel PCI. Arterial access was left at operator's discretion. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.014DOI Listing
July 2020
4.463 Impact Factor

Outcomes in Kawasaki disease patients with coronary artery abnormalities at admission.

Am Heart J 2020 07 3;225:120-128. Epub 2020 May 3.

Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

Background: Previous studies demonstrated that coronary artery lesions (CALs) resulting from Kawasaki disease (KD) can improve over time. However, limited information is available on sub-acute outcomes of CALs detected at admission during KD illness.

Methods: The nationwide Japanese KD survey contained substantial information on KD patients with CALs detected at admission and who received standard IVIG treatment within 10 days of disease onset. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.019DOI Listing
July 2020
4.463 Impact Factor

Beliefs, risk perceptions, and lipid management among patients with and without diabetes: Results from the PALM registry.

Am Heart J 2020 07 30;225:88-96. Epub 2020 Apr 30.

Duke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.

Intensive lipid management is critical to reduce cardiovascular (CV) risk for patients with diabetes mellitus (DM).

Methods: We performed an observational study of 7628 patients with (n = 2943) and without DM (n = 4685), enrolled in the Provider Assessment of Lipid Management (PALM) registry and treated at 140 outpatient clinics across the United States in 2015. Patient self-estimated CV risk, patient-perceived statin benefit and risk, observed statin therapy use and dosing were assessed. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.018DOI Listing
July 2020
4.463 Impact Factor

Randomized trial of argatroban plus recombinant tissue-type plasminogen activator for acute ischemic stroke (ARAIS): Rationale and design.

Am Heart J 2020 07 8;225:38-43. Epub 2020 Apr 8.

Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. Electronic address:

Background: Previous studies have implied the efficacy and safety of argatroban plus recombinant tissue-type plasminogen activator (r-tPA) in patients with acute ischemic stroke. Further trials are needed to establish convincing conclusions in a large sample size.

Research Design And Methods: Argatroban plus r-tPA for Acute Ischemic Stroke (ARAIS) trial is a multicenter, prospective, randomized, open-label, and blind-end point trial. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.003DOI Listing
July 2020
4.463 Impact Factor

Targeted temperature management in cardiac arrest patients with a non-shockable rhythm: A national perspective.

Am Heart J 2020 07 3;225:129-137. Epub 2020 May 3.

Division of Cardiovascular Medicine, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA; Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA. Electronic address:

Introduction: Retrospective studies have shown conflicting benefit of utilizing targeted temperature management (TTM) in cardiac arrest (CA) patients with a non-shockable rhythm and presently there is only one randomized trial in this realm. We sought to determine trends and outcomes of TTM utilization in these patients from a large nationally representative United States population database.

Methods And Results: Data were derived from National Inpatient Sample (NIS) from January 2006 to December 2013. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.023DOI Listing
July 2020
4.463 Impact Factor

In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events.

Am Heart J 2020 07 18;225:97-107. Epub 2020 Apr 18.

Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.

Background: In patients with stable coronary heart disease, it is not known whether achievement of standard of care (SOC) targets in addition to evidence-based medicine (EBM) is associated with lower major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, and stroke.

Methods: EBM use was recommended in the STabilisation of Atherosclerotic plaque By Initiation of darapLadIb TherapY trial. SOC targets were blood pressure (BP) <140/90 mm Hg and low-density lipoprotein-cholesterol (LDL-C) <100 mg/dL and <70 mg/dL. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.004DOI Listing

Expanding the clinical and genetic spectrum of ALPK3 variants: Phenotypes identified in pediatric cardiomyopathy patients and adults with heterozygous variants.

Am Heart J 2020 07 21;225:108-119. Epub 2020 Apr 21.

Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Introduction: Biallelic damaging variants in ALPK3, encoding alpha-protein kinase 3, cause pediatric-onset cardiomyopathy with manifestations that are incompletely defined.

Methods And Results: We analyzed clinical manifestations of damaging biallelic ALPK3 variants in 19 pediatric patients, including nine previously published cases. Among these, 11 loss-of-function (LoF) variants, seven compound LoF and deleterious missense variants, and one homozygous deleterious missense variant were identified. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.023DOI Listing

Epinephrine stress testing during cardiac catheterization in patients with aortic coarctation.

Am Heart J 2020 07 13;225:78-87. Epub 2020 May 13.

Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.

Background: The severity of aortic coarctation (CoA) may be underestimated during cardiac catheterization. We aimed to investigate whether epinephrine stress testing improves clinical decision making and outcome in CoA.

Methods: We retrospectively evaluated CoA patients >50 kg with a peak systolic gradient (PSG) ≤20 mm Hg during cardiac catheterization who underwent epinephrine stress testing. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.007DOI Listing

The INVICTUS rheumatic heart disease research program: Rationale, design and baseline characteristics of a randomized trial of rivaroxaban compared to vitamin K antagonists in rheumatic valvular disease and atrial fibrillation.

Am Heart J 2020 07 25;225:69-77. Epub 2020 Mar 25.

Population Health Research Institute, McMaster University, Hamilton, ON, Canada.

Background: Rheumatic heart disease (RHD) is a neglected disease affecting 33 million people, mainly in low and middle income countries. Yet very few large trials or registries have been conducted in this population. The INVICTUS program of research in RHD consists of a randomized-controlled trial (RCT) of 4500 patients comparing rivaroxaban with vitamin K antagonists (VKA) in patients with RHD and atrial fibrillation (AF), a registry of 17,000 patients to document the contemporary clinical course of patients with RHD, including a focused sub-study on pregnant women with RHD within the registry. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.018DOI Listing
July 2020
4.463 Impact Factor

Coronary revascularization and circulatory support strategies in patients with myocardial infarction, multi-vessel coronary artery disease, and cardiogenic shock: Insights from an international survey.

Am Heart J 2020 07 3;225:55-59. Epub 2020 May 3.

Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY.

Cardiogenic shock (CS) complicating acute myocardial infarction (MI) is associated with high mortality. In the absence of data to support coronary revascularization beyond the infarct artery and selection of circulatory support devices or medications, clinical practice may vary substantially.

Methods: We distributed a survey to interventional cardiologists and cardiothoracic surgeons through relevant professional societies to determine contemporary coronary revascularization and circulatory support strategies for MI with CS and multi-vessel coronary artery disease (CAD). Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.011DOI Listing

Effect on thromboprophylaxis among hospitalized patients using a system-wide multifaceted quality improvement intervention: Rationale and design for a multicenter cluster randomized clinical trial in China.

Am Heart J 2020 07 7;225:44-54. Epub 2020 May 7.

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Venous thromboembolism (VTE) is a life-threatening disease that can affect each hospitalized patient. But the current in-hospital thromboprophylaxis remains suboptimal and there exists a large gap between clinical practice and guideline-recommended care in China.

Methods: To facilitate implementation of guideline recommendations, we conduct a multicenter, adjudicator-blinded, cluster-randomized clinical trial, aiming to assess the effectiveness of a system-wide multifaceted quality improvement (QI) strategy on VTE prophylaxis improvement and thromboembolism reduction in clinical setting. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204686PMC
July 2020
4.463 Impact Factor

Blunting periprocedural myocardial necrosis: Rationale and design of the randomized ALPHEUS study.

Am Heart J 2020 07 29;225:27-37. Epub 2020 Apr 29.

Sorbonne Université, ACTION Study Group, INSERM UMRS1166, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France. Electronic address:

Background: Clopidogrel associated with aspirin is the recommended treatment for patients undergoing elective percutaneous coronary intervention (PCI). Although severe PCI-related events are rare, evidence suggests that PCI-related myocardial infarction and myocardial injury are frequent complications that can impact the clinical prognosis of the patients. Antiplatelet therapy with a potent P2Y receptor inhibitor such as ticagrelor may reduce periprocedural ischemic complications while maintaining a similar safety profile as compared with conventional dual antiplatelet therapy by aspirin and clopidogrel in this setting. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.017DOI Listing

TicagRelor Or Clopidogrel in severe or terminal chronic kidney patients Undergoing PERcutaneous coronary intervention for acute coronary syndrome: The TROUPER trial.

Am Heart J 2020 07 30;225:19-26. Epub 2020 Apr 30.

Aix-Marseille Univ, Intensive cardiac care unit, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.

Chronic kidney disease (CKD) is associated with an increased risk of acute coronary syndrome (ACS) and cardiovascular death. CKD patients suffering from ACS are exposed to an increased risk of thrombotic recurrences and a higher bleeding rate than patients with normal renal function. However, CKD patients are excluded or underrepresented in clinical trials. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.013DOI Listing

Evaluation of safety and efficacy of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: Design and rationale for the Disrupt CAD III trial.

Am Heart J 2020 07 18;225:10-18. Epub 2020 Apr 18.

Clinical Trials Center, Cardiovascular Research Foundation, New York, NY; New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY.

Coronary calcification limits optimal stent expansion and apposition and worsens safety and effectiveness outcomes of percutaneous coronary intervention (PCI). Current ablative technologies that modify calcium to optimize stent deployment are limited by guidewire bias and periprocedural complications related to atheroembolization, coronary dissection, and perforation. Intravascular lithotripsy (IVL) delivers pulsatile ultrasonic pressure waves through a fluid-filled balloon into the vessel wall to modify calcium and enhance vessel compliance, reduce fibroelastic recoil, and decrease the need for high-pressure balloon (barotrauma) inflations. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.005DOI Listing

COVID-19 pandemic-Some cardiovascular considerations from the trench.

Authors:
Bernardo Cortese

Am Heart J 2020 07 8;225:1-2. Epub 2020 May 8.

Cardiovascular Research Team, San Carlo Clinic, Milano, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.ahj.2020.04.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205669PMC

Extending physicians' reach in grasping AF symptoms.

Am Heart J 2020 May 4. Epub 2020 May 4.

Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA. Electronic address:

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http://dx.doi.org/10.1016/j.ahj.2020.04.012DOI Listing

Longitudinal study of anthropometry in Fontan survivors: Pediatric Heart Network Fontan study.

Am Heart J 2020 06 4;224:192-200. Epub 2020 Apr 4.

University of Utah/Primary Children's Hospital, Salt Lake City, UT.

Background: Growth abnormalities in single-ventricle survivors may reduce quality of life (QoL) and exercise capacity.

Methods: This multicenter, longitudinal analysis evaluated changes in height and body mass index (BMI) compared to population norms and their relationship to mortality, ventricular morphology, QoL, and exercise capacity in the Pediatric Heart Network Fontan studies.

Results: Fontan 1 (F1) included 546 participants (12 ± 3. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293556PMC

orth merican OVID-19 ST-segment elevation yocardial nfarction ( registry: Rationale, design, and implications.

Am Heart J 2020 May 16. Epub 2020 May 16.

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH.

Background: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. Patients with cardiovascular risk factors or established cardiovascular disease are more likely to experience severe or critical COVID-19 illness and myocardial injury is a key extra-pulmonary manifestation. These patients frequently present with ST-elevation on an electrocardiogram (ECG) due to multiple etiologies including obstructive, non-obstructive, and/or angiographically normal coronary arteries. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229476PMC

Cardiovascular comorbidities, cardiac injury, and prognosis of COVID-19 in New York City.

Am Heart J 2020 May 15;226:24-25. Epub 2020 May 15.

Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, NY, USA.

Using Mt. Sinai (New York City) EMR health system data, we retrospectively analyzed a cohort of 8438 COVID-19 patients seen between March 1 and April 22, 2020. Risk of intubation and of death rose as a function of increasing age and as a function of greater cardiovascular comorbidity. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.05.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227573PMC

Racial disparities and democratization of health care: A focus on TAVR in the United States.

Am Heart J 2020 06 13;224:166-170. Epub 2020 Mar 13.

Duke Clinical Research Institute and Duke University School of Medicine, Durham, NC, USA.

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http://dx.doi.org/10.1016/j.ahj.2020.03.008DOI Listing

A care pathway for the cardiovascular complications of COVID-19: Insights from an institutional response.

Am Heart J 2020 07 3;225:3-9. Epub 2020 May 3.

Division of Cardiology and Duke Heart Center, Duke University Medical Center, Durham, NC.

The infection caused by severe acute respiratory syndrome coronavirus-2, or COVID-19, can result in myocardial injury, heart failure, and arrhythmias. In addition to the viral infection itself, investigational therapies for the infection can interact with the cardiovascular system. As cardiologists and cardiovascular service lines will be heavily involved in the care of patients with COVID-19, our division organized an approach to manage these complications, attempting to balance resource utilization and risk to personnel with optimal cardiovascular care. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252188PMC
July 2020
4.463 Impact Factor

Convergence of Epicardial and Endocardial RF Ablation for the Treatment of Symptomatic Persistent AF (CONVERGE Trial): Rationale and design.

Am Heart J 2020 06 29;224:182-191. Epub 2020 Feb 29.

North Mississippi Medical Center, Tupelo, MS.

Atrial fibrillation is the most common sustained arrhythmia affecting over 33 million people worldwide. Approximately 70% of AF patients have non-paroxysmal AF. As AF progresses from paroxysmal to non-paroxysmal forms, the prevalence of comorbidities increases. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.02.016DOI Listing

Sarcopenia and health-related quality of life in older adults after transcatheter aortic valve replacement.

Am Heart J 2020 06 4;224:171-181. Epub 2020 Apr 4.

Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Fairfax, VA. Electronic address:

Background: Skeletal muscle wasting, or sarcopenia, affects a significant proportion of patients undergoing transcatheter aortic valve replacement (TAVR). However, its influence on post-TAVR recovery and 1-year health-related quality of life (HR-QOL) remains unknown. We examined the relationship between skeletal muscle index (SMI), post-TAVR length of hospital stay (LOS), and 1-year QOL. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.021DOI Listing
June 2020
4.463 Impact Factor

Pragmatic trial comparing routine versus no routine functional testing in high-risk patients who underwent percutaneous coronary intervention: Rationale and design of POST-PCI trial.

Am Heart J 2020 06 25;224:156-165. Epub 2020 Mar 25.

Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Although the need to detect restenosis has diminished in the contemporary practice of percutaneous coronary intervention (PCI) with drug-eluting stents (DES), the surveillance of ischemia owing to restenosis or disease progression deserves attention in high-risk PCI settings. It is unknown whether follow-up strategy of routine noninvasive functional testing potentially reduces the risk of major cardiovascular events in high-risk PCI patients.

Methods: The POST-PCI study is an investigator-initiated, multicenter, prospective randomized trial comparing the effectiveness of two follow-up strategies in patients with high-risk anatomic or clinical characteristics who underwent PCI. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.019DOI Listing
June 2020
4.463 Impact Factor