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    5692 results match your criteria Canadian Journal of Cardiology[Journal]

    1 OF 114

    Challenging Occam's Razor: An Unusual Combination of Sarcoidosis and Amyloidosis. The Value of Cardiac Magnetic Resonance Imaging in Infiltrative Cardiomyopathies.
    Can J Cardiol 2017 Jul 18. Epub 2017 Jul 18.
    Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Trust, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom.
    We describe the case of a 66-year old woman with the extremely rare combination of sarcoidosis and amyloidosis (light chain) and the important role of cardiovascular magnetic resonance imaging to differentiate between these 2 infiltrative diseases. Myocardial characterization with T1 mapping can improve disease detection, especially in overlap cases, and possibly obviate the need for cardiac biopsy. Read More

    Implantable Cardioverter Defibrillator Implantation Rates After Out of Hospital Cardiac Arrest: Are the Rates Guideline-Concordant?
    Can J Cardiol 2017 Aug 23. Epub 2017 Aug 23.
    Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, St Michael's Hospital, Toronto, Ontario, Canada. Electronic address:
    Background: Clinical practice guidelines recommend implantable cardioverter defibrillators (ICDs) for the secondary prevention of sudden death after a cardiac arrest not from a reversible cause, but "real world" implantation rates are not well described.

    Methods: Adults with out of hospital cardiac arrest attended by Emergency Medical Services are captured in the Toronto Regional RescuNET database. We analyzed those who survived to hospital discharge and collected data on age, sex, initial rhythm, ST-elevation myocardial infarction (STEMI) on presenting electrocardiogram (ECG), in-hospital revascularization, neurologic status (Modified Rankin Scale [MRS]) at discharge, and admission hospital type. Read More

    Effects of Hyperthyroidism on Coronary Artery Disease: A Computed Tomography Angiography Study.
    Can J Cardiol 2017 Jul 17. Epub 2017 Jul 17.
    Innsbruck Medical University, Department of Radiology, Innsbruck, Austria.
    Background: Changes in thyroid hormone concentration can negatively affect the cardiovascular system. Subclinical hyperthyroidism has been linked to an increase of cardiovascular heart disease, however, clinical effects and significance are still uncertain. Therefore, we analyzed coronary computed tomography angiographies of patients with overt and subclinical hyperthyroidism for quantitative parameters and plaque morphology. Read More

    Persistent Hypoxemia After Acute Myocardial Infarction: An Unexpected Culprit.
    Can J Cardiol 2017 Jul 29. Epub 2017 Jul 29.
    Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal.
    Hypoxemia after myocardial infarction (MI) is usually explained by common culprits, including congestive heart failure, pre-existing lung disease, and pulmonary infection. We report a case of a 60-year-old woman who experienced severe persistent hypoxemia caused by a patent foramen ovale in the setting of anterior MI complicated by a contained left ventricular rupture. Read More

    Histologically Proven Myocardial Carcinoid Metastases: The Value of Multimodality Imaging.
    Can J Cardiol 2017 Jun 16. Epub 2017 Jun 16.
    NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK; Imperial College London, National Heart and Lung Institute, London, UK. Electronic address:
    We present a case of a patient with intramyocardial metastases from a carcinoid tumor. These findings were detected using cardiovascular magnetic resonance imaging, with functional metabolic activity analyzed using nuclear imaging and confirmed by histologic findings at surgical biopsy. This case highlights the value of cardiovascular magnetic resonance imaging and the importance of multimodality imaging. Read More

    Utility of Unfractionated Heparin in Transradial Cardiac Catheterization: A Systematic Review and Meta-analysis.
    Can J Cardiol 2017 Jun 10. Epub 2017 Jun 10.
    Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address:
    Background: Unfractionated heparin (UFH) is purported to reduce the risk of radial artery occlusion (RAO) after transradial cardiac catheterization. However, the efficacy and optimal dose remain unclear. This meta-analysis evaluates the safety and efficacy of UFH in this context. Read More

    Score of Adherence to 2016 European Cardiovascular Prevention Guidelines Predicts Cardiovascular and All-Cause Mortality in the General Population.
    Can J Cardiol 2017 Jun 23. Epub 2017 Jun 23.
    Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM- Toulouse University, Toulouse University Hospital (CHU), Toulouse, France; Department of Cardiology B, Toulouse University Hospital, Toulouse, France. Electronic address:
    Background: Guidelines on cardiovascular (CV) disease prevention promote healthy lifestyle behaviours and CV risk factor control to reduce CV risk. The effect of adherence to these guidelines on CV and all-cause mortality is not well known.

    Methods: We assessed the effect of baseline adherence to "2016 European Guidelines on CV Disease Prevention in Clinical Practice" on long-term CV and all-cause mortality in a sample recruited from the French general population. Read More

    Between Disease-Causing and an Innocent Bystander: The Role of Titin as a Modifier in Hypertrophic Cardiomyopathy.
    Can J Cardiol 2017 Jul 21. Epub 2017 Jul 21.
    Comprehensive Heart Failure Center and Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address:

    A Case of Cardiogenic Shock Secondary to Complement-Mediated Myopericarditis from Influenza B Infection.
    Can J Cardiol 2017 Jun 15. Epub 2017 Jun 15.
    Department of Cardiology, NYU Langone Medical Center, New York, New York, USA. Electronic address:
    Influenza B is a rare cause of myocarditis that is usually caused by histiocytic and mononuclear cellular infiltrates. We describe a 22-year-old female patient presenting with fulminant myopericarditis secondary to influenza B infection that deteriorated to cardiogenic shock. Endomyocardial biopsy results yielded myocardial necrosis through complement-mediated cellular injury without evidence of interstitial infiltrates. Read More

    Computed Tomographic and Fluoroscopic Image Fusion for Pulmonary Vein Stenosis Stenting.
    Can J Cardiol 2017 Sep 20;33(9):1206.e5-1206.e6. Epub 2017 Jul 20.
    Cardiology Department, University Hospital of Salamanca, Biomedical Research Institute of Salamanca (IBSAL), CIBER-CV, Salamanca, Spain.

    Adult Congenital Heart Disease Intervention: The Canadian Landscape.
    Can J Cardiol 2017 Sep 30;33(9):1201-1205. Epub 2017 May 30.
    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto General Hospital, Toronto, Ontario, Canada. Electronic address:
    Once considered a childhood disease, the number of adults living with congenital heart disease (CHD) has now exceeded the number of pediatric patients. The landscape of percutaneous intervention for adult congenital heart disease (ACHD) has evolved over the past decade and has yet to be characterized in Canada. The aim of this study was to begin to understand the current infrastructure underlying ACHD interventions in Canada and to characterize the type and number of interventions being carried out across the country. Read More

    Safety and Feasibility of the Transcatheter Approach to Create a Reverse Potts Shunt in Children With Idiopathic Pulmonary Arterial Hypertension.
    Can J Cardiol 2017 Sep 13;33(9):1188-1196. Epub 2017 Jun 13.
    Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Universitaire Necker Enfants Malades, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris V Descartes, Sorbonne Paris Cité, Paris, France.
    Background: The reversed Potts shunt improves right ventricular (RV) function in patients with suprasystemic pulmonary arterial hypertension (PAH). The proximity of the left pulmonary artery (LPA) to the descending aorta (DAo) permits the creation of a transcatheter connection. We sought to assess the safety, feasibility, and hemodynamic efficacy of the transcatheter Potts shunt (TPS) in children. Read More

    Transcatheter vs Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Intermediate Risk Patients: A Meta-analysis.
    Can J Cardiol 2017 Sep 15;33(9):1171-1179. Epub 2017 Jun 15.
    Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    Background: Transcatheter aortic valve replacement (TAVR) has emerged as the treatment of choice for patients with severe aortic stenosis at high surgical risk; the role of TAVR compared with surgical aortic valve replacement (SAVR) in the low-intermediate surgical risk population remains uncertain. Our primary objective was to determine differences in 30-day and late mortality in patients treated with TAVR compared with SAVR at low-intermediate risk (Society of Thoracic Surgeons Predicted Risk of Mortality < 10%).

    Methods: Medline and Embase were searched from 2010 to March 2017 for studies that compared TAVR with SAVR in the low-intermediate surgical risk population, restricted to randomized clinical trials and matched observational studies. Read More

    Role of Computational Modelling in Planning and Executing Interventional Procedures for Congenital Heart Disease.
    Can J Cardiol 2017 Sep 3;33(9):1159-1170. Epub 2017 Jun 3.
    Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia. Electronic address:
    Increasingly, computational modelling and numerical simulations are used to help plan complex surgical and interventional cardiovascular procedures in children and young adults with congenital heart disease. From its origins more than 30 years ago, surgical planning with analysis of flow hemodynamics and energy loss/efficiency has helped design and implement many modifications to existing techniques. On the basis of patient-specific medical imaging, surgical planning allows accurate model production that can then be manipulated in a virtual surgical environment, with the proposed solutions finally tested with advanced computational fluid dynamics to evaluate the results. Read More

    Valve Interventions in Utero: Understanding the Timing, Indications, and Approaches.
    Can J Cardiol 2017 Sep 23;33(9):1150-1158. Epub 2017 Jun 23.
    Cardiologie pédiatrique, Centre de Référence Malformations Cardiaques Congénitales Complexes, Hôpital Universitaire Necker Enfants Malades, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris V Descartes, Paris, France. Electronic address:
    Efficient use of fetal echocardiography has enabled early detection of congenital heart disease and of its often irreversible complications, such as ventricular hypoplasia in case of severe stenosis of the semilunar valves. Experience of the past 25 years has proved that balloon dilatation of the severely stenotic or atretic valve in fetuses as early as the 23rd week of gestation is technically feasible with a learning curve. Reported results regarding the ultimate biventricular circulation outcome after fetal valve intervention are at best controversial, with the desired improvements in the quality of life and cost-benefits of the postnatal treatment being as yet unconfirmed. Read More

    Pulmonary Valve Procedures Late After Repair of Tetralogy of Fallot: Current Perspectives and Contemporary Approaches to Management.
    Can J Cardiol 2017 Sep 27;33(9):1138-1149. Epub 2017 Jun 27.
    Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada; Division of Cardiovascular Surgery, Department of Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:
    Few topics in adult congenital heart disease have approached the level of scrutiny bestowed on pulmonary valve replacement (PVR) strategies late after tetralogy of Fallot (TOF) repair. Despite the successes of primary surgery for TOF, there is a growing group of adults with residual right ventricular outflow tract and pulmonary valve dysfunction. Patients with residual chronic pulmonic regurgitation as a consequence of earlier surgery can later develop symptoms of exercise intolerance and complications including heart failure, tachyarrhythmias, and sudden cardiac death. Read More

    Minimally Invasive Heart Valve Surgery.
    Can J Cardiol 2017 Sep 25;33(9):1129-1137. Epub 2017 May 25.
    Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada. Electronic address:
    Minimally invasive valve surgery represents a recent and significant advance in modern heart surgery. Indeed, many less invasive approaches for both the aortic and mitral valves have been developed in the past 2 decades. These procedures were hypothesized to result in less operative trauma, which might translate into better patient outcomes. Read More

    Should TAVR Replace Surgery for Aortic Stenosis in Low- to Intermediate-Risk Patients?
    Can J Cardiol 2017 Sep 27;33(9):1124-1128. Epub 2017 Jun 27.
    Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.
    Transcatheter aortic valve replacement (TAVR) was initially envisioned as a less invasive option for patients with severe symptomatic aortic stenosis who either were not candidates or were very high-risk candidates for surgical aortic valve replacement (SAVR). Based on data from the original Placement of Aortic Transcatheter Valve (PARTNER) trials as well as the CoreValve Pivotal trials, TAVR is now approved and accepted in the treatment of severe symptomatic aortic stenosis in extreme-risk and high-risk patient populations. Thus far, the randomized controlled trial data for TAVR have been noninferior or even superior to both medical therapy and SAVR. Read More

    Latest-Generation Transcatheter Aortic Valve Replacement Devices and Procedures.
    Can J Cardiol 2017 Sep 25;33(9):1082-1090. Epub 2017 Mar 25.
    Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address:
    Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks. Read More

    Titin-Truncating Variants Increase the Risk of Cardiovascular Death in Patients With Hypertrophic Cardiomyopathy.
    Can J Cardiol 2017 Jun 8. Epub 2017 Jun 8.
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:
    Background: Titin-truncating variants (TTNtv) have been detected in a variety of cardiomyopathies and represent the most common cause of dilated cardiomyopathy. However, their significance in hypertrophic cardiomyopathy (HCM) is still unclear.

    Methods: The titin gene (TTN) was sequenced for truncating variants in a cohort of 529 Chinese patients with HCM and 307 healthy controls. Read More

    Progressive and Reversible Conduction Disease With Checkpoint Inhibitors.
    Can J Cardiol 2017 Jun 8. Epub 2017 Jun 8.
    Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address:
    Novel antineoplastic therapies are focused on harnessing our own immune system to fight cancer. To that end, cytotoxic T-lymphocyte-associated antigen 4 and programmed death ligand 1 are 2 coinhibitory signals that play central roles in decreasing T-cell response and represent a class of medications termed "checkpoint inhibitors." We present an unusual case of progressive conduction abnormalities induced by checkpoint inhibitors. Read More

    A Complex Heart Team's Approach to a Patient With Giant Cell Myocarditis.
    Can J Cardiol 2017 Jun 10. Epub 2017 Jun 10.
    Cardiac Centre, IKEM, Prague, Czech Republic.
    Giant cell myocarditis is known as a rare and frequently fatal type of myocarditis that is usually characterized by progressive congestive heart failure and frequent ventricular arrhythmias. We report a rare case of giant cell myocarditis in a 64-year-old previously healthy woman. The case was complicated by the rapid development of progressive acute heart failure, which required the comprehensive care of our heart team. Read More

    Multidisciplinary Heart Failure Clinics Are Associated With Lower Heart Failure Hospitalization and Mortality: Systematic Review and Meta-analysis.
    Can J Cardiol 2017 May 24. Epub 2017 May 24.
    McMaster University, Hamilton Health Sciences, Population Health Research Institute, Hamilton, Ontario, Canada.
    Background: Heart failure (HF) clinics (HFCs) are an integral aspect of the strategy for community HF care.

    Methods: A systematic search was conducted to retrieve studies. We searched for candidate articles in the PubMed, EMBASE, and Cochrane databases from 1990 to January 2017. Read More

    Orthostatic Hypotension: A Practical Approach to Investigation and Management.
    Can J Cardiol 2017 May 17. Epub 2017 May 17.
    Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address:
    The maintenance of blood pressure upon the assumption of upright posture depends on rapid cardiovascular adaptations driven primarily by the autonomic nervous system. Failure of these compensatory mechanisms can result in orthostatic hypotension (OH), defined as sustained reduction in systolic blood pressure > 20 mm Hg or diastolic blood pressure > 10 mm Hg within 3 minutes of standing or > 60° head-up tilt. OH is a common finding, particularly in elderly populations, associated with cardiovascular and cerebrovascular morbidity and mortality. Read More

    Sudden Death Due to Coronary Artery Lesions Long-term After the Arterial Switch Operation: A Systematic Review.
    Can J Cardiol 2017 Sep 8;33(9):1180-1187. Epub 2017 Apr 8.
    Pediatric Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
    Background: The arterial switch operation (ASO) is the preferred procedure for children with dextrotransposition of the great arteries or Taussig-Bing anomaly. Short- as well as long-term outcome of ASO are excellent, but coronary artery stenoses are reported as a common long-term complication. It has been hypothesized that these might result in sudden cardiac death late after ASO. Read More

    Diagnostic Value of Neurological Studies in Diagnosing Syncope: A Systematic Review.
    Can J Cardiol 2017 Apr 13. Epub 2017 Apr 13.
    Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address:
    Background: Syncope is common and approaches to establishing etiology remain a matter of clinical and financial importance. Patients often undergo comprehensive neurologic investigations despite a lack of compelling indications. The aim was to determine the prevalence of use and diagnostic yield of electroencephalography (EEG), head computed tomography (CT), head magnetic resonance imaging (MRI), and carotid Doppler ultrasound (CUS) examinations. Read More

    Relation Between Superficial Calcifications and Plaque Rupture: An Optical Coherence Tomography Study.
    Can J Cardiol 2017 Aug 10;33(8):991-997. Epub 2017 May 10.
    Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. Electronic address:
    Background: There are several forms of calcium deposition, which play different roles in the stability of the coronary artery. It remains unknown whether certain calcification morphological characteristics determine rupture of lipid-rich lesions in the same plaque in acute coronary syndrome (ACS).

    Methods: We retrospectively analyzed 550 patients with ACS between May 2008 and October 2014, who had undergone preintervention optical coherence tomography (OCT) imaging examination. Read More

    Management of Implantable Cardioverter Defibrillator Recipients: Care Beyond Guidelines.
    Can J Cardiol 2017 Aug 26;33(8):977-990. Epub 2017 May 26.
    University of British Columbia, Vancouver, British Columbia, Canada.
    This companion article is intended to address common clinical scenarios in patients with implantable defibrillators that were not addressed in the 2016 Canadian Cardiovascular Society/Canadian Heart Rhythm Society implantable cardioverter defibrillator guidelines including recommendations for device programming to improve detection, to minimize shocks (appropriate and inappropriate), and to minimize ventricular pacing. Important issues at the time of replacement such as device prescription, technical aspects (vascular access, extraction), and management of components on advisories are also discussed. Finally, common clinical scenarios such as management of patients with terminal illnesses, recurrent ventricular tachycardia, electrical storms, catheter ablation for ventricular tachycardia, and system infection management are considered. Read More

    Contemporary Atrial Fibrillation Management: A Comparison of the Current AHA/ACC/HRS, CCS, and ESC Guidelines.
    Can J Cardiol 2017 Aug 9;33(8):965-976. Epub 2017 Jun 9.
    University of British Columbia, Vancouver, British Columbia, Canada.
    In this article we compare and contrast the current recommendations, and highlight the important differences, in the American College of Cardiology/American Heart Association/Heart Rhythm Society, European Society of Cardiology, and Canadian Cardiovascular Society atrial fibrillation (AF) guidelines. Although many of the recommendations of the various societies are similar, there are important differences in the methodologies underlying their development and the specific content. Specifically, key differences can be observed in: (1) the definition of nonvalvular AF, which subsequently affects anticoagulation choices and candidacy for non-vitamin K antagonist oral anticoagulants; (2) the symptom score used to guide management decisions and longitudinal patient profiling; (3) the stroke risk stratification algorithm used to determine indications for oral anticoagulant therapy; (4) the role of acetylsalicylic acid in stroke prevention in AF; (5) the antithrombotic regimens used in the context of coronary artery disease, acute coronary syndromes, and percutaneous coronary intervention; (6) the rate control target and medications recommended to achieve the target; and (7) the role of "first-line" catheter ablation, open surgical ablation, and left atrial appendage exclusion. Read More

    A Potentially Lethal Dysfunction of a Subcutaneous Implantable Cardiac Defibrillator: "The Phantom Menace"?
    Can J Cardiol 2017 Aug 13;33(8):1066.e9-1066.e11. Epub 2017 May 13.
    Cardiac Intensive Care Unit, "Emille Muller" Hospital, Mulhouse, France.
    In this article we describe, to our knowledge, the first case of a potentially lethal dysfunction of a subcutaneous implantable cardioverter-defibrillator (S-ICD). A 70-year-old patient underwent primary S-ICD implantation. Nine months after, communication could not be established with the device. Read More

    Totally Leadless Dual-Device Implantation for Combined Spontaneous Ventricular Tachycardia Defibrillation and Pacemaker Function: A First Report.
    Can J Cardiol 2017 Aug 30;33(8):1066.e5-1066.e7. Epub 2017 May 30.
    Manchester Heart Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
    Subcutaneous implantable cardioverter defibrillators (S-ICDs) provide effective defibrillation, while also reducing the risk of long-term lead problems. However, S-ICDs do not offer bradycardia or antitachycardia pacing and therefore use has been limited. Combined implantation of an S-ICD with a leadless pacemaker (LP) has been proposed to overcome this limitation. Read More

    Bridged Bilateral Superior Venae Cavae With Direct Left Atrial Appendage Connection and No Other Congenital Cardiac Anomaly.
    Can J Cardiol 2017 Aug 8;33(8):1066.e13-1066.e15. Epub 2017 Jun 8.
    Department of Medical Imaging, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    A persistent left superior vena cava (SVC) results from failed obliteration of the left common cardinal vein during embryogenesis, with a spectrum of anatomic variants. We report a rare case of bilateral SVCs connected by a bridging vein and with a direct left SVC connection to the left atrial appendage in an asymptomatic patient without hypoxemia or associated congenital heart disease on transthoracic echocardiography, computed tomography, and magnetic resonance imaging. A multimodality imaging approach is valuable to search for associated anomalies and to confirm this anatomic variant, which has important implications on vascular procedures and avoidance of systemic embolism. Read More

    Validity of Health Administrative Database Definitions for Hypertension: A Systematic Review.
    Can J Cardiol 2017 Aug 7;33(8):1052-1059. Epub 2017 Jun 7.
    Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada. Electronic address:
    Background: Health administrative data are frequently used for hypertension surveillance. The aim of this systematic review was to determine the sensitivity and specificity of the commonly used hypertension case definition of 2 physician outpatient claims within a 2-year period or 1 hospital discharge abstract record.

    Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE (from 1946) and EMBASE (from 1947) for relevant studies through September 2016 (keywords: "hypertension," "administrative databases," "validation studies"). Read More

    Bariatric Surgery-Induced Lower Angiopoietin-Like 2 Protein Is Associated With Improved Cardiometabolic Profile.
    Can J Cardiol 2017 Aug 2;33(8):1044-1051. Epub 2017 Jun 2.
    Quebec Heart and Lung Institute, Quebec City, Quebec, Canada; Faculty of Pharmacy, Laval University, Quebec City, Quebec, Canada. Electronic address:
    Background: Plasma angiopoietin-like 2 (Angptl2), a proinflammatory protein, has been associated with obesity and diabetes. Whether weight loss induced by bariatric surgery and associated improvement of the cardiometabolic risk profile influence circulating Angptl2 levels is unknown. We tested whether biliopancreatic diversion with duodenal switch (BPD-DS) surgery alters plasma Angptl2 concentrations. Read More

    Interpatient Variation in Rivaroxaban and Apixaban Plasma Concentrations in Routine Care.
    Can J Cardiol 2017 Aug 24;33(8):1036-1043. Epub 2017 Apr 24.
    Division of Clinical Pharmacology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada; Department of Physiology and Pharmacology, Western University, London, Ontario, Canada. Electronic address:
    Background: Direct-acting oral anticoagulants (DOACs) are widely prescribed for stroke prevention in patients with atrial fibrillation (AF). An important advantage of DOACs is that routine monitoring of an anticoagulation response is not necessary. Nevertheless, because of their mechanism of action, a DOAC anticoagulation effect can be inferred based on the observed plasma concentration. Read More

    Rationale, Design and Baseline Characteristics of Participants in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) Trial.
    Can J Cardiol 2017 Aug 8;33(8):1027-1035. Epub 2017 Jun 8.
    Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
    Background: Long-term aspirin prevents vascular events but is only modestly effective. Rivaroxaban alone or in combination with aspirin might be more effective than aspirin alone for vascular prevention in patients with stable coronary artery disease (CAD) or peripheral artery disease (PAD). Rivaroxaban as well as aspirin increase upper gastrointestinal (GI) bleeding and this might be prevented by proton pump inhibitor therapy. Read More

    Cost of Cardiac Surgery in Frail Compared With Nonfrail Older Adults.
    Can J Cardiol 2017 Aug 30;33(8):1020-1026. Epub 2017 Mar 30.
    Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute, McGill University, Montreal, Quebec, Canada; Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address:
    Background: Frailty is a risk factor for mortality, morbidity, and prolonged length of stay after cardiac surgery, all of which are major drivers of hospitalization costs. The incremental hospitalization costs incurred in frail patients have yet to be elucidated.

    Methods: Patients aged ≥ 60 years were evaluated for frailty before coronary artery bypass grafting or heart valve surgery at 2 academic centres between 2013 and 2015 as part of the McGill Frailty Registry. Read More

    Sex-Specific Differences in the Association Between Childhood Adversity and Cardiovascular Disease in Adulthood: Evidence From a National Cohort Study.
    Can J Cardiol 2017 Aug 19;33(8):1013-1019. Epub 2017 May 19.
    School of Public Health, University of Alberta, Edmonton, Alberta, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address:
    Background: Childhood adversity increases the risk for cardiovascular disease (CVD) in adulthood. Previously proposed mechanisms suggest that the association is mediated by stress reactivity-known to be higher in women-and is aggravated by adult stress, but this has not yet been confirmed. Therefore, we investigated sex differences to better understand possible pathways from childhood adversity to CVD. Read More

    Primary Percutaneous Coronary Intervention As Treatment for ST-Elevation Myocardial Infarction in a Centenarian: Choosing Carefully.
    Can J Cardiol 2017 Aug 8;33(8):1066.e1-1066.e3. Epub 2017 May 8.
    Section of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada.
    We report on a 105-year-old woman presenting with inferior ST-elevation myocardial infarction (STEMI). She was managed with primary percutaneous intervention (PCI) to the right coronary artery with a single bare-metal stent. There were no acute complications, although she experienced delirium and functional decline requiring prolonged hospital admission. Read More

    Incidence and Prognostic Implications of Late Bleeding After Myocardial Infarction or Unstable Angina According to Treatment Strategy.
    Can J Cardiol 2017 Aug 5;33(8):998-1005. Epub 2017 May 5.
    Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address:
    Background: Bleeding complications accompanying coronary revascularization are associated with increased mortality; however, few data are available on subsequent bleeding risk. We used administrative data to assess the incidence of late bleeding events in patients with acute coronary syndrome (ACS) according to treatment allocation.

    Methods: The cohort and bleeding events were identified through the Canadian Institute for Health Information discharge abstract database. Read More

    Comparative Evaluation of 2-Hour Rapid Diagnostic Algorithms for Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin T.
    Can J Cardiol 2017 Aug 3;33(8):1006-1012. Epub 2017 May 3.
    Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
    Background: Symptoms of acute coronary syndrome account for a large proportion of emergency department (ED) visits and hospitalizations. High-sensitivity troponin can rapidly rule out or rule in acute myocardial infarction (AMI) within a short time of ED arrival. We sought to validate test characteristics and classification performance of 2-hour high-sensitivity troponin T (hsTnT) algorithms for the rapid diagnosis of AMI. Read More

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