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    1 OF 121

    Occurrence of primarily noninducible atrioventricular nodal reentry tachycardia after radiofrequency delivery in the slow pathway region during empirical slow pathway modulation.
    Clin Cardiol 2017 Nov 22. Epub 2017 Nov 22.
    Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
    Background: The first-line therapy for atrioventricular nodal reentry tachycardia (AVNRT) is catheter-based slow pathway modulation. If AVNRT is not inducible during an electrophysiological study, an empirical slow pathway modulation (ESPM) may be considered in patients with dual atrioventricular nodal physiology and/or a typical electrocardiogram (ECG).

    Methods: We screened 149 symptomatic patients who underwent ESPM in our department between 1993 and 2013. Read More

    Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score-matched analysis.
    Clin Cardiol 2017 Nov 22. Epub 2017 Nov 22.
    Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York.
    Background: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR).

    Hypothesis: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. Read More

    Clinical investigation of left ventricular pacing using coronary sinus in patients with mechanical prosthetic tricuspid valve replacement.
    Clin Cardiol 2017 Nov 22. Epub 2017 Nov 22.
    Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
    Background: Although transvenous right ventricular (RV) endocardial lead placement is routine practice in clinical pacing, RV inaccessibility in certain clinical situations mandates the search for other sites.

    Hypothesis: This study is aimed to verify whether left ventricular lead through coronary sinus is safe and efficient.

    Methods: Based on a retrospective analysis of a single-center series of 4 patients with inaccessibility for RV pacing, we report on the feasibility and reliability of coronary sinus (CS) pacing via left ventricular (LV) lead, which usually is used in cardiac resynchronization therapy. Read More

    Comparison of mid- to long-term clinical outcomes between anatomical testing and usual care in patients with suspected coronary artery disease: A meta-analysis of randomized trials.
    Clin Cardiol 2017 Sep 15. Epub 2017 Sep 15.
    National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea.
    Background: Controversies remain regarding clinical outcomes following initial strategies of coronary computed tomography angiography (CCTA) vs usual care with functional testing in patients with suspected coronary artery disease (CAD).

    Hypothesis: CCTA as initial diagnostic strategy results in better mid- to long-term outcomes than usual care in patients with suspected CAD.

    Methods: We searched PubMed, Embase, and Cochrane Library for randomized controlled trials comparing clinical outcomes during ≥6 months' follow-up between initial anatomical testing by CCTA vs usual care with functional testing in patients with suspected CAD. Read More

    Seasonal patterns of acute and recurrent idiopathic pericarditis.
    Clin Cardiol 2017 Sep 15. Epub 2017 Sep 15.
    Department of Cardiology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
    Background: Idiopathic pericarditis is presumed to result from viral infection. The incidence rates of some viral infections have typical seasonal patterns. The data in the literature on a possible seasonal pattern of acute pericarditis are very limited. Read More

    The prognostic significance of lung function in stable heart failure outpatients.
    Clin Cardiol 2017 Sep 13. Epub 2017 Sep 13.
    Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Denmark.
    Background: This study investigated the impact on all-cause mortality of airflow limitation indicative of chronic obstructive pulmonary disease or restrictive spirometry pattern (RSP) in a stable systolic heart failure population.

    Hypothesis: Decreased lung function indicates poor survival in heart failure.

    Methods: Inclusion criteria: NYHA class II-IV and left ventricular ejection fraction (LVEF) < 45%. Read More

    Changes in parameters of right ventricular function with cardiac resynchronization therapy.
    Clin Cardiol 2017 Sep 12. Epub 2017 Sep 12.
    Division of Cardiology, University of California, Los Angeles, California.
    Background: Studies have shown that cardiac resynchronization therapy (CRT) significantly improves right ventricle (RV) size and function in patients with heart failure (HF).

    Hypothesis: CRT does not lead to improvement in RV function independent of baseline clinical variables.

    Methods: A systematic search of studies published between 1966 to August 31, 2015 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases. Read More

    Hyperglycemia on admission and hospitalization outcomes in patients with atrial fibrillation.
    Clin Cardiol 2017 Sep 12. Epub 2017 Sep 12.
    Institute of Endocrinology, Tel Aviv University, Tel Aviv, Israel.
    Background: We evaluated the association of admission blood glucose (ABG) and mortality in patients with and without diabetes mellitus (DM) hospitalized for atrial fibrillation (AF).

    Hypothesis: Hyperglycemia on admission is a bad prognostic marker in patients with AF.

    Methods: Observational data were collected from electronic records of patients age ≥ 18 years hospitalized for AF in 2011-2013. Read More

    Dynamic changes of QTc interval and prognostic significance in takotsubo (stress) cardiomyopathy.
    Clin Cardiol 2017 Sep 11. Epub 2017 Sep 11.
    Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
    Background: Prolonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high-risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role.

    Hypothesis: Dynamic changes of QTc interval during hospitalization for TTC could be associated with outcome at follow-up. Read More

    Seasonal variation in hospitalization outcomes in patients admitted for heart failure in the United States.
    Clin Cardiol 2017 Sep 5. Epub 2017 Sep 5.
    Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan.
    Background: There is lack of evidence of the impact of varying season on heart failure (HF) hospitalization outcomes in the U.S.

    Hypothesis: HF hospitalization outcomes exhibit significant seasonal variation in the U. Read More

    Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end-stage renal disease: Insights and pathophysiology.
    Clin Cardiol 2017 Oct 5;40(10):839-846. Epub 2017 Sep 5.
    Department of Cardiovascular Medicine, Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
    A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis. Read More

    Hemodynamic parameters predict the risk of atrial fibrillation after cardiac surgery in adults.
    Clin Cardiol 2017 Aug 29. Epub 2017 Aug 29.
    Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
    Background: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery and is associated with poorer prognosis. This study attempted to evaluate whether hemodynamic parameters determined by a right heart catheter predict the occurrence of POAF.

    Hypothesis: We hypothesized that atrial fibrillation after cardiac surgery can be predicted by hemodynamic parameters determined by a right heart catheter. Read More

    Relation of premature atrial complexes with stroke and death: Systematic review and meta-analysis.
    Clin Cardiol 2017 Aug 28. Epub 2017 Aug 28.
    Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
    Frequent premature atrial complexes (PACs) are universal in the general population; however, their clinical significance is unclear. We hypothesize that frequent PACs are associated with increased risk of stroke and death. The PubMed (from 1966 to April 2017) and Embase (from 1974 to April 2017) databases were searched for longitudinal studies that reported the relation of PACs with incidence of stroke and death with various etiologies. Read More

    DNA methylation dysregulations in valvular atrial fibrillation.
    Clin Cardiol 2017 Sep 28;40(9):686-691. Epub 2017 Aug 28.
    Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
    Background: The epigenetic changes underlying the development of atrial fibrillation (AF) remain incompletely understood. Limited evidence suggests that abnormal DNA methylation might be involved in the pathogenesis of AF. In the present study, we evaluated the methylation status of genomic DNA from myocardial tissue in AF patients and sinus rhythm (SR) patients systematically. Read More

    Apixaban, rivaroxaban, and dabigatran use in patients undergoing catheter ablation for atrial fibrillation using the second-generation cryoballoon.
    Clin Cardiol 2017 Aug 28. Epub 2017 Aug 28.
    Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
    Background: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation.

    Hypothesis: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs.

    Methods: In 200 consecutive patients (mean age, 64. Read More

    An exploration of the association between ischemic etiology and the likelihood of heart failure hospitalization following cardiac resynchronization therapy.
    Clin Cardiol 2017 Aug 28. Epub 2017 Aug 28.
    Humana Inc., Louisville, Kentucky.
    Background: Myocardial scarring resulting from cardiomyopathy with ischemic etiology may interfere with effective lead placement during implantation of multi-lead cardioverter-defibrillators for cardiac resynchronization therapy (CRT-D). Extensive scarring is known to be associated with poorer physiological and survival outcomes in patients who undergo CRT-D.

    Hypothesis: Ischemic CRT-D recipients respond as well as nonischemic recipients, using hospital admission for heart failure (HF) as a measure of response. Read More

    Comprehensive primary prevention of cardiovascular disease in women.
    Clin Cardiol 2017 Oct 28;40(10):832-838. Epub 2017 Aug 28.
    Division of Cardiology, Department of Medicine, Emory University School of Medicine, Georgia.
    Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in women. Historically, medical research has focused on male patients, and subsequently, there has been decreased awareness of the burden of ASCVD in females until recent years. The biological differences between sexes and differences in societal expectations defined by gender roles contribute to gender differences in ASCVD risk factors. Read More

    Deceleration capacity of heart rate predicts 1-year mortality of patients undergoing transcatheter aortic valve implantation.
    Clin Cardiol 2017 Oct 28;40(10):919-924. Epub 2017 Aug 28.
    Department of Internal Medicine III, Department of Cardiology, Eberhard Karls University of Tübingen, Germany.
    Background: Risk prediction in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is challenging. Development of novel markers for patient risk assessment is of great clinical value. Deceleration capacity (DC) of heart rate is a strong risk predictor in post-infarction patients. Read More

    Facility-level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database.
    Clin Cardiol 2017 Aug 25. Epub 2017 Aug 25.
    Health Policy, Quality and Informatics Program, Michael E. DeBakey VA Medical Center, Health Services Research and Development Center for Innovations, Houston, Texas; and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas.
    Background: Intensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes.

    Hypothesis: We hypothesized that there is suboptimal glycemic and BP control with significant facility-level variation in patients with diabetes.

    Methods: We identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. Read More

    Patients without comorbidities at the time of diagnosis of atrial fibrillation: causes of death during long-term follow-up compared to matched controls.
    Clin Cardiol 2017 Aug 25. Epub 2017 Aug 25.
    Department of Cardiology, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Background: Little is known about the long-term, cause-specific mortality risk in patients without comorbidities at the time of diagnosis of atrial fibrillation (AF).

    Methods: From a nation-wide registry of patients hospitalized with incident AF between 1995 and 2008 we identified 9 519 patients with a first diagnosed AF and no comorbidities at the time of AF diagnosis. They were matched with 12 468 controls. Read More

    Rationale and design of the Drug-Eluting Stents vs Bare-Metal Stents in Saphenous Vein Graft Angioplasty (DIVA) Trial.
    Clin Cardiol 2017 Aug 25. Epub 2017 Aug 25.
    VA Cooperative Studies Program Coordinating Center, Mountain View, California.
    VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site. Read More

    The shifting paradigm in the treatment of type 2 diabetes mellitus-A cardiologist's perspective.
    Clin Cardiol 2017 Aug 25. Epub 2017 Aug 25.
    Interventional Cardiology and Catheterization Laboratories, Bassett Medical Center, New York.
    In patients with diabetes mellitus, cardiovascular (CV) disease is the leading cause of morbidity and mortality. A multitude of contemporary antidiabetic agents presents different CV safety profiles. Metformin forms the cornerstone agent to reduce CV events. Read More

    Association between modifiable lifestyle and the prevalence of atrial fibrillation in a Chinese population: Based on the cardiovascular health score.
    Clin Cardiol 2017 Aug 21. Epub 2017 Aug 21.
    Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
    Background: The Cardiovascular Health (CVH) Score was comprised of a series of modifiable lifestyle and health factors, which was published by American Heart Association in 2010. Its relationship with atrial fibrillation (AF) remains unclear.

    Hypothesis: Individuals with a higher CVH Score had a lower risk of AF. Read More

    Home monitoring after ambulatory implanted primary cardiac implantable electronic devices: The home ambulance pilot study.
    Clin Cardiol 2017 Aug 21. Epub 2017 Aug 21.
    Internist Practice Center, Balserische Stiftung Hospital, Giessen, Germany.
    Background: The Home Monitoring (HM) system of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias or device system failures. The aim of this pilot study was to examine how the safety and efficacy of the HM system in patients after ambulatory implanted primary CIEDs compare to patients with a standard procedure and hospitalization.

    Hypothesis: We hypothesized that HM and their modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs. Read More

    Prediction and prognosis of ventricular tachycardia recurrence after catheter ablation with remote magnetic navigation for electrical storm in patients with ischemic cardiomyopathy.
    Clin Cardiol 2017 Aug 17. Epub 2017 Aug 17.
    Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark.
    Background: Ventricular tachycardia (VT) recurrence after catheter ablation for electrical storm is commonly seen in patients with ischemic cardiomyopathy (ICM).

    Hypothesis: We hypothesized that VT recurrence can be predicted and be related to the all-cause death after VT storm ablation guided by remote magnetic navigation (RMN) in patients with ICM.

    Methods: A total of 54 ICM patients (87% male; mean age, 65 ± 7. Read More

    Study of young patients with myocardial infarction: Design and rationale of the YOUNG-MI Registry.
    Clin Cardiol 2017 Aug 14. Epub 2017 Aug 14.
    Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.
    The YOUNG-MI registry is a retrospective study examining a cohort of young adults age ≤ 50 years with a first-time myocardial infarction. The study will use the robust electronic health records of 2 large academic medical centers, as well as detailed chart review of all patients, to generate high-quality longitudinal data regarding the clinical characteristics, management, and outcomes of patients who experience a myocardial infarction at a young age. Our findings will provide important insights regarding prevention, risk stratification, treatment, and outcomes of cardiovascular disease in this understudied population, as well as identify disparities which, if addressed, can lead to further improvement in patient outcomes. Read More

    Prognostic value of exercise capacity among men undergoing pharmacologic treatment for erectile dysfunction: The FIT Project.
    Clin Cardiol 2017 Aug 14. Epub 2017 Aug 14.
    Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medicine, Baltimore, Maryland.
    Background: Vascular erectile dysfunction (ED) has been identified as a potentially useful risk factor for predicting future cardiovascular events, particularly in younger men. Because these men typically score more favorably on traditional cardiovascular disease risk assessment tools, there exists a gap in knowledge for how to most appropriately identify those men who would benefit from more aggressive treatments. To date, no studies have examined the impact of fitness on cardiovascular outcomes in men with ED. Read More

    Stroke or left atrial thrombus prediction using antithrombin III and mean platelet volume in patients with nonvalvular atrial fibrillation.
    Clin Cardiol 2017 Aug 14. Epub 2017 Aug 14.
    Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea.
    Background: CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF).

    Hypothesis: To determine the association of antithrombin III (AT-III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF.

    Methods: AT-III and MPV were analyzed in 352 patients with AF. Read More

    Atrial fibrillation variability on long-term monitoring of implantable cardiac rhythm management devices.
    Clin Cardiol 2017 Aug 11. Epub 2017 Aug 11.
    Department of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
    Background: Atrial fibrillation (AF) burden and duration are predictors of thromboembolic events. The random nature of these measures may affect clinical decision making. The objective of this study was to determine temporal changes in AF burden as detected by continuous monitoring. Read More

    Psychiatric conditions as predictors of rehospitalization among African American patients hospitalized with heart failure.
    Clin Cardiol 2017 Jul 27. Epub 2017 Jul 27.
    Einstein Institute for Heart and Vascular Health, Einstein Medical Center, Philadelphia, Pennsylvania.
    Introduction: African Americans (AAs) have the highest risk of developing heart failure (HF) among all ethnicities in the United States and are associated with higher rates of readmissions and mortality. This study aims to determine the prevalence and relationship of common psychiatric conditions to outcomes of patients hospitalized with HF.

    Hypothesis: Psychiatric conditions lead to worse outcomes in HF patients. Read More

    Left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation.
    Clin Cardiol 2017 Oct 27;40(10):825-831. Epub 2017 Jul 27.
    Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
    Atrial fibrillation (AF) is a commonly sustained atrial arrhythmia with associated morbidity and mortality. AF is associated with increased risk of thromboembolism and stroke, requiring use of anticoagulation. Anticoagulation decreases the risk of stroke but is associated with a higher risk of bleeding, necessitating discontinuation in some patients. Read More

    Early segmental relaxation abnormalities in hypertrophic cardiomyopathy for differential diagnostic of patients with left ventricular hypertrophy.
    Clin Cardiol 2017 Jul 24. Epub 2017 Jul 24.
    Department of General and Interventional Cardiology, University Heart Center Hamburg, Germany.
    Background: Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric left ventricular hypertrophy (LVH). However, clinical signs can be subtle and differentiation from other causes of LVH is challenging.

    Hypothesis: As diastolic dysfunction (DD) is an early sign in HCM, we aimed to find regional changes in relaxation pattern for differentiation from other entities of LVH. Read More

    Handheld echocardiography during hospitalization for acute myocardial infarction.
    Clin Cardiol 2017 Jul 19. Epub 2017 Jul 19.
    Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
    Background: Handheld echocardiography (HHE) is concordant with standard transthoracic echocardiography (TTE) in a variety of settings but has not been thoroughly compared to traditional TTE in patients with acute myocardial infarction (AMI).

    Hypothesis: Completed by experienced operators, HHE provides accurate diagnostic capabilities compared with standard TTE in AMI patients.

    Methods: This study prospectively enrolled patients admitted to the coronary care unit with AMI. Read More

    Frailty is an independent prognostic marker in elderly patients with myocardial infarction.
    Clin Cardiol 2017 Oct 16;40(10):925-931. Epub 2017 Jul 16.
    Cardiology Department, Hospital Ramón y Cajal, University of Alcalá, Madrid, Spain.
    Background: Acute coronary syndrome (ACS) patients are increasingly older. Conventional prognostic scales include chronological age but do not consider vulnerability. In elderly patients, a frail phenotype represents a better reflection of biological age. Read More

    Rationale and design of a randomized trial of apixaban vs warfarin to evaluate atherosclerotic calcification and vulnerable plaque progression.
    Clin Cardiol 2017 Oct 13;40(10):807-813. Epub 2017 Jul 13.
    Los Angeles Biomedical Research Institute at Harbor University of California-Los Angeles.
    Vitamin K antagonists (VKAs) are known to increase vascular calcification, suggesting increased cardiovascular disease events. Apixaban is an oral direct factor Xa inhibitor superior to warfarin at preventing stroke or systemic embolism and may stabilize coronary atherosclerosis. The potential benefits of avoiding VKA therapy and the favorable effects of factor Xa inhibitors could contribute to cardiovascular disease event reduction. Read More

    Does education modify the effect of ethnicity in the expression of ideal cardiovascular health? The Baptist Health South Florida Employee Study.
    Clin Cardiol 2017 Jul 11. Epub 2017 Jul 11.
    Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida.
    Background: Despite the progress made to decrease risk factors for cardiovascular diseases, disparities still exist. We examined how education and ethnicity interact to determine disparities in cardiovascular health (CVH) as defined by the American Heart Association.

    Hypothesis: Education modifies the effect of ethnicity on CVH. Read More

    Prognostic implications of Q waves at presentation in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: An analysis of the HORIZONS-AMI study.
    Clin Cardiol 2017 Jul 11. Epub 2017 Jul 11.
    Clinical Trials Center, Cardiovascular Research Foundation, New York City, New York.
    Background: Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown.

    Hypothesis: We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion.

    Methods: The Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial enrolled 3602 patients with STEMI undergoing primary percutaneous coronary intervention. Read More

    Current trends in admissions and outcomes of cardiac diseases in Ghana.
    Clin Cardiol 2017 Oct 10;40(10):783-788. Epub 2017 Jul 10.
    Department of Cardiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
    Cardiovascular diseases (CVDs) pose a major burden in Africa, but data on temporal trends in disease burden are lacking. We assessed trends in CVD admissions and outcomes in central Ghana using a retrospective analysis of data from January 2004 to December 2015 among patients admitted to the medical wards of a tertiary medical center in Kumasi, Ghana. Rates of admissions and mortality were expressed as CVD admissions and deaths divided by the total number of medical admissions and deaths, respectively. Read More

    Decreased pulmonary arterial proportional pulse pressure is associated with increased mortality in group 1 pulmonary hypertension.
    Clin Cardiol 2017 Jul 10. Epub 2017 Jul 10.
    Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, Virginia.
    Background: This study evaluated the utility of a novel index, pulmonary arterial (PA) proportional pulse pressure (PAPP; range 0-1, defined as [PA systolic pressure - PA diastolic pressure] / PA systolic pressure), in predicting mortality in patients with World Health Organization group 1 pulmonary hypertension (PH).

    Hypothesis: Low PAPP is associated with increased 5-year mortality independent of a validated contemporary risk-prediction equation (Pulmonary Hypertension Connection [PHC] equation).

    Methods: In a group of 262 patients in the National Institutes of Health Primary Pulmonary Hypertension (NIH-PPH) Registry, PAPP and the PHC risk equation were used to predict mortality during 5 years of follow-up using Cox proportional hazards models. Read More

    Vitamin K antagonists with or without long-term antiplatelet therapy in outpatients with stable coronary artery disease and atrial fibrillation: Association with ischemic and bleeding events.
    Clin Cardiol 2017 Oct 10;40(10):932-939. Epub 2017 Jul 10.
    Universitary and Hospital Department of FIRE (Fibrosis, Inflammation, Remodeling), University of Paris-Diderot, Sorbonne Paris Cité, Paris France; FACT (French Alliance for Cardiovascular Trials); Hospital of Bichat, Public Assistance of Hospital of Paris, Paris, France; INSERM U-1148, Paris, France; National Heart and Lung Institute, Royal Brompton Hospital, Imperial College, London, United Kingdom.
    Background: It remains uncertain whether patients with atrial fibrillation (AF) requiring long-term oral anticoagulation (OAC) and with stable coronary artery disease (CAD) should receive antiplatelet therapy (APT) in addition to OAC.

    Hypothesis: APT in addition to OAC would be more effective than OAC alone in preventing ischaemic events in such patients.

    Methods: In the international REduction of Atherothrombosis for Continued Health (REACH) Registry including 68 236 outpatients with or at risk for atherothrombosis, we identified 2347 patients with stable CAD and AF receiving vitamin K antagonists (VKA). Read More

    Determination of ideal target exercise heart rate for cardiac patients suitable for rehabilitation.
    Clin Cardiol 2017 Jul 6. Epub 2017 Jul 6.
    Department of Cardiology, National Heart Centre Singapore, Singapore.
    Background: Exercise prescription for patients with cardiovascular disease remains a challenge. The concept of exercising at an intensity equivalent to one's anaerobic threshold has been well studied and highly recommended in the fitness industry for other populations. For this concept to be applicable to patients with cardiovascular disease, the level and intensity of activity must not trigger myocardial ischemia. Read More

    Cost-effectiveness analysis of 30-month vs 12-month dual antiplatelet therapy with clopidogrel and aspirin after drug-eluting stents in patients with acute coronary syndrome.
    Clin Cardiol 2017 Oct 6;40(10):789-796. Epub 2017 Jul 6.
    School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China.
    Continuation of dual antiplatelet therapy (DAPT) beyond 1 year reduces late stent thrombosis and ischemic events after drug-eluting stents (DES) but increases risk of bleeding. We hypothesized that extending DAPT from 12 months to 30 months in patients with acute coronary syndrome (ACS) after DES is cost-effective. A lifelong decision-analytic model was designed to simulate 2 antiplatelet strategies in event-free ACS patients who had completed 12-month DAPT after DES: aspirin monotherapy (75-162 mg daily) and continuation of DAPT (clopidogrel 75 mg daily plus aspirin 75-162 mg daily) for 18 months. Read More

    Clinical, scintigraphic, and angiographic predictors of oxygen pulse abnormality in patients undergoing cardiopulmonary exercise testing.
    Clin Cardiol 2017 Oct 5;40(10):914-918. Epub 2017 Jul 5.
    Federal University of Rio de Janeiro, National Institute of Cardiology, Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, Brazil.
    Background: The oxygen (O2 ) pulse curve obtained at cardiopulmonary exercise testing provides information on cardiorespiratory fitness and the presence of cardiovascular disease. O2 pulse abnormalities have been attributed to myocardial ischemia, among other conditions, but the predictors of abnormal O2 pulse curves are not completely known.

    Hypothesis: Perfusion abnormalities detected by myocardial perfusion scintigraphy (MPS) may be associated with abnormal O2 pulse curves. Read More

    Repeated procedures at the generator pocket are a determinant of implantable cardioverter-defibrillator infection.
    Clin Cardiol 2017 Oct 21;40(10):892-898. Epub 2017 Jun 21.
    Department of Infectious Diseases, Virgen del Rocío University Hospital, Seville, Spain.
    Background: Rates of cardiac-device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter-defibrillators (ICDs) are not well known.

    Hypothesis: The increasing number of ICD infections is related to accumulated pocket manipulations over time.

    Methods: This single-center, prospective study included patients that underwent ICD implantation from 2008 to 2015. Read More

    The value of electrocardiography in prognosticating clinical deterioration and mortality in acute pulmonary embolism: A systematic review and meta-analysis.
    Clin Cardiol 2017 Oct 19;40(10):814-824. Epub 2017 Jun 19.
    Department of Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
    The role of electrocardiography (ECG) in prognosticating pulmonary embolism (PE) is increasingly recognized. ECG is quickly interpretable, noninvasive, inexpensive, and available in remote areas. We hypothesized that ECG can provide useful information about PE prognostication. Read More

    ESC sudden-death risk model in hypertrophic cardiomyopathy: Incremental value of quantitative contrast-enhanced CMR in intermediate-risk patients.
    Clin Cardiol 2017 Oct 14;40(10):853-860. Epub 2017 Jun 14.
    Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain.
    Background: Hypertrophic cardiomyopathy (HCM) remains the most common cause of sudden cardiac death (SCD) in the young; however, current strategies do not identify all HCM patients at risk. A novel validated algorithm was proposed by the last European Society of Cardiology guidelines to guide implantable cardioverter-defibrillator (ICD) therapy. Recently, extensive myocardial fibrosis was independently associated with increased risk of SCD events. Read More

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