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Recent items - Journal of the American College of Cardiology

Medical Malpractice Litigation A Fellow’s Perspective
22/07/2014 00:32
The historical origin of medical malpractice litigation (MML) in the United States dates back to the first half of the 19th century (1). At that time, most cases were related to poorly repaired fractures or were obstetrics cases. In recent [...]
Intravascular Photoacoustic Tomography of Coronary Atherosclerosis Riding the Waves of Light and Sound ∗
22/07/2014 00:32
The emergence of coronary angiography in the late 1950s enabled an imaging-based understanding of coronary artery disease and led to surgical and intravascular treatment approaches of coronary luminal stenosis. Based on the increasing famil [...]
2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations
22/07/2014 00:32
A report from panel members appointed to the Eighth Joint National Committee titled “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults” has garnered much attention due to its major change in recommendations f [...]
Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
22/07/2014 00:32
BackgroundVarious national campaigns launched in recent years have focused on young women with acute myocardial infarctions (AMIs). Contemporary longitudinal data about sex differences in clinical characteristics, hospitalization rates, len [...]
At the Heart of Global Development
22/07/2014 00:32
The year 2014 is pivotally positioned between 2 years of great significance for global health. In the preceding year, 2013, the World Health Assembly adopted the Global Action Plan for Prevention and Control of Non-Communicable Diseases (NC [...]
Myocardial Damage After TAVR Assessed With CMR A New Piece in a Puzzle? ∗
22/07/2014 00:32
Myocardial damage after transcatheter aortic valve replacement (TAVR) may be common and herald a worse prognosis (1,2). In this issue of the Journal, Kim et al. (3) report on the incidence of new, ischemic-type, myocardial late enhancement [...]
Characterization of Lipid-Rich Aortic Plaques by Intravascular Photoacoustic Tomography Ex Vivo and In Vivo Validation in a Rabbit Atherosclerosis Model With Histologic Correlation
22/07/2014 00:32
BackgroundHistologic studies have demonstrated that lipid content and its spatial distribution is related to plaque vulnerability. However, in vivo imaging is still limited. Photoacoustic imaging may provide novel in vivo insights into thes [...]
Reply In Regard to the TERISA Trial
22/07/2014 00:32
Dr. Golwala raises several questions in regard to the TERISA trial (1). First is whether the patients enrolled in TERISA were truly refractory to maximally titrated baseline antianginal treatment at randomization. The protocol did not requi [...]
Management Practices and Major Infections After Cardiac Surgery
22/07/2014 00:32
BackgroundInfections are the most common noncardiac complication after cardiac surgery, but their incidence across a broad range of operations, as well as the management factors that shape infection risk, remain unknown.ObjectivesThis study [...]
Targeting Priority Populations to Reduce Disparities in Cardiovascular Care Health Equity for All ∗
22/07/2014 00:32
The evolving care paradigm and ensuing implementation of high-quality evidence that defines optimal benefits and risks into daily clinical practice has resulted in dramatic declines in case fatality rates for cardiovascular disease over the [...]
In Regard to the TERISA Trial
22/07/2014 00:32
I read with great interest the paper by Kosiborod et al. (1) showing beneficial effects of ranolazine in patients with type 2 diabetes mellitus, coronary artery disease, and chronic refractory angina taking 2 antianginal agents. The authors [...]
Variability of Individual Platelet Reactivity Over Time in Patients Treated With Clopidogrel Insights From the ELEVATE–TIMI 56 Trial
22/07/2014 00:32
BackgroundThe degree of antiplatelet response to clopidogrel has been associated with clinical outcomes. Studies have investigated whether adjustment of antiplatelet therapies based on a single platelet function test is beneficial.Objective [...]
The Chronovariability of Platelet Reactivity A Hurdle in the Road to Personalized Antiplatelet Therapy? ∗
22/07/2014 00:32
The recognition that platelets play a central role in stent thrombosis and the development of the adenosine diphosphate receptor (e.g., the P2Y12 receptor) antagonists have been instrumental in making coronary stenting a cornerstone in the [...]
Paradoxical Embolism
22/07/2014 00:32
Paradoxical embolism is an important clinical entity among patients with venous thromboembolism in the presence of intracardiac or pulmonary shunts. The clinical presentation is diverse and potentially life-threatening. Although the serious [...]
Detection of Myocardial Injury by CMR After Transcatheter Aortic Valve Replacement
22/07/2014 00:32
BackgroundMyocardial injury after transcatheter aortic valve replacement (TAVR) is common, but its cause and relationship to the extent of myocardial tissue loss remain unclear.ObjectivesThis study sought to examine the incidence and degree [...]
Resting Heart Rate An Independent Predictor of Congestive Heart Failure
22/07/2014 00:32
Opdahl et al. (1) recently reported some interesting findings from the MESA (Multi-Ethnic Study of Atherosclerosis) trial showing that elevated resting heart rate (HR) was associated with increased risk for incident heart failure (HF) durin [...]
Reply Resting Heart Rate: An Independent Predictor of Congestive Heart Failure
22/07/2014 00:32
We thank Drs. Palatini and Julius for their interest in our recent work (1). Indeed, in the MESA (Multi-Ethnic Study of Atherosclerosis) study, with participants without cardiovascular disease (CV) at enrollment, we found an increased risk [...]
Infections Post-Cardiac Surgery New Information During Challenging Times ∗
22/07/2014 00:32
Surgical site infections (SSIs) are one of the most challenging complications of surgery, for patients and surgeons alike. For that reason, it is interesting to note that in this recent experience, reported by Gelijns et al. (1) in this iss [...]
Long-Term Follow-Up of Elective Chronic Total Coronary Occlusion Angioplasty Analysis From the U.K. Central Cardiac Audit Database
14/07/2014 23:51
BackgroundChronic total occlusion (CTO) is common, being reported in 18% to 30% of patients undergoing coronary angiography. Percutaneous coronary intervention (PCI) is usually performed to relieve anginal symptoms, but data are emerging to [...]
Beta-Blocker Therapy and Cardiac Events Among Patients With Newly Diagnosed Coronary Heart Disease
14/07/2014 23:51
BackgroundThe effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI).ObjectivesThe purpose of this study was to assess t [...]
Alcohol Consumption and Risk of Atrial Fibrillation A Prospective Study and Dose-Response Meta-Analysis
14/07/2014 23:51
BackgroundAlthough high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear.ObjectivesThe study sought to investigate the association between alcoho [...]
Correction
14/07/2014 23:51
Dehmer GJ, Blankenship JC, Cilingiroglu M, Dwyer JG, Feldman DN, Gardner TJ, Grines CL, Singh M
Chronic Total Occlusion Revascularization Achilles’ Heel or Golden Opportunity for PCI? ∗
14/07/2014 23:51
Chronic total occlusions (CTOs) are frequently identified during diagnostic coronary angiography (approximately 20% of studies) (1), and successful recanalization reduces angina, lowers ischemic burden, and improves left ventricular functio [...]
The Critical Need to Share Our Successes
14/07/2014 23:51
Correction
14/07/2014 23:51
Kraigher-Krainer E, Shah AM, Gupta DK, Santos A, Claggett B, Pieske B, Zile MR, Voors AA, Lefkowitz MP, Packer M, McMurray JJ, Solomon SD, on behalf of the PARAMOUNT Investigators
A Functional Variant in APOA5/A4/C3/A1 Gene Cluster Contributes to Elevated Triglycerides and Severity of CAD by Interfering With MicroRNA 3201 Binding Efficiency
14/07/2014 23:51
BackgroundRecent genome-wide association studies identified the APOA5/A4/C3/A1 gene cluster polymorphisms influencing triglyceride level and risk of coronary artery disease (CAD).ObjectivesThe purposes of this study were to fine-map triglyc [...]
Assessing Risk of Inadequate Defibrillation Safety Margin The Strengths and Limitations of the NCDR ICD Registry ∗
14/07/2014 23:51
From the time of the initial clinical report in 1980 (1), implantable cardioverter-defibrillators (ICDs) have undergone testing to confirm that the devices can detect and terminate ventricular fibrillation (VF). The initial devices were imp [...]
Beta-Blockers in Asymptomatic Coronary Artery Disease No Benefit or No Evidence? ∗
14/07/2014 23:51
The benefit of beta-blockers in the management of patients with heart failure and left ventricular dysfunction has been incontrovertibly established in multiple contemporary randomized clinical trials (1–5). The recommendation for use of be [...]
Predictors of an Inadequate Defibrillation Safety Margin at ICD Implantation Insights From the National Cardiovascular Data Registry
14/07/2014 23:51
BackgroundDefibrillation testing is often performed to establish effective arrhythmia termination, but predictors and consequences of an inadequate defibrillation safety margin (DSM) remain largely unknown.ObjectivesThe aims of this study w [...]
Single Nucleotide Variances Can Account for Loss of microRNA Function The Emerging Cross Talk Between Genetics and Epigenetics ∗
14/07/2014 23:51
Cardiovascular disease is the leading cause of death worldwide, and accumulating evidence has demonstrated that mutations in the gene cluster APOA5/A4/C3/A1 are associated with hypertriglyceridemia, which may predispose to atherosclerosis a [...]
Notice
14/07/2014 23:51
In the JACC ACC.13, Abstract Supplement (61/10 Suppl A), for abstract E112, one of the authors names was printed incorrectly.
Alcohol Consumption and Risk of Atrial Fibrillation How Much Is Too Much? ∗
14/07/2014 23:51
Atrial fibrillation (AF) is the most common arrhythmia and a strong predictor of major cardiovascular complications and death (1,2). Unfortunately, few interventions have been shown to improve hard clinical outcomes in the growing populatio [...]
Yield of Serial Evaluation in At-Risk Family Members of Patients With ARVD/C
14/07/2014 23:51
BackgroundIncomplete penetrance and variable expressivity of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) complicate family screening.ObjectivesThe objective of the present study was to determine the optimal approach t [...]
Family Members of Patients With ARVC Who Is at Risk? At What Age? When and How Often Should We Evaluate to Determine Risk? ∗
14/07/2014 23:51
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is being recognized with increasing frequency as physicians have become more aware of this entity. Some estimate that ARVC may be present in 1 in 5,000 people. The disease is primarily [...]
The MOGE(S) Classification of Cardiomyopathy for Clinicians
14/07/2014 23:51
Most cardiomyopathies are familial diseases. Cascade family screening identifies asymptomatic patients and family members with early traits of disease. The inheritance is autosomal dominant in a majority of cases, and recessive, X-linked, o [...]
Aspirin Therapy in Primary Cardiovascular Disease Prevention A Position Paper of the European Society of Cardiology Working Group on Thrombosis
14/07/2014 23:51
Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a sourc [...]
7 Lessons From Fellowship
14/07/2014 23:51
In my office at the University of Michigan Cardiovascular Center is a plaque—one accorded to me at the end of my cardiology fellowship. At the very bottom is inscribed “June 20, 2012.” As on numerous occasions since then, I now close my eye [..
Intravenous Hydration (With or Without Rosuvastatin) Should Remain the Cornerstone of the Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease
14/07/2014 23:51
In a recent randomized, controlled, multicenter trial, Han et al. (1) showed that rosuvastatin, compared with “standard of care,” significantly reduced the risk of contrast-induced acute kidney injury (AKI) in diabetic patients with chronic [...
Reply Intravenous Hydration (With or Without Rosuvastatin) Should Remain the Cornerstone of the Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease
14/07/2014 23:51
We thank Dr. Cecere and colleagues for their interest in and comments on our study (1). They raise a very important question of whether rosuvastatin was consistently effective among various subgroups, especially the subgroup of patients wit [...]
The Importance of Genotype Variation Beyond Different Antiplatelet Therapy in Nonresponder Patients
14/07/2014 23:51
We read with great interest the recently published paper on prasugrel or high-dose clopidogrel for high platelet reactivity (HPR) in the Journal(1). Using the Multiplate analyzer (Roche Diagnostics, Mannheim, Germany), the authors described [...]
Reply The Importance of Genotype Variation Beyond Different Antiplatelet Therapy in Nonresponder Patients
14/07/2014 23:51
We thank Drs. Sardella and Calcagno for their interest in our paper (1). Following their prior publication (2), they emphasize the importance of genotyping for the CYP2C19*2 allele to define the pharmacodynamic benefit from prasugrel or dou [...]
Percutaneous Mitral Valve Repair for Mitral Regurgitation in High-Risk Patients Results of the EVEREST II Study
07/07/2014 21:58
BackgroundThe EVEREST II (Endovascular Valve Edge-to-Edge REpair STudy) High-Risk registry and REALISM Continued Access Study High-Risk Arm are prospective registries of patients who received the MitraClip device (Abbott Vascular, Santa Cla [...]
Reply Baroreflex Sensitivity: A Reliable Predictor of Response to Renal Denervation?
07/07/2014 21:58
We appreciate the interest in our paper (1) and the opportunity to reply to the thoughtful comments by Dr. Hering and colleagues.
Where Is the American College of Cardiology Heading? A PINNACLE Registry Case Study
07/07/2014 21:58
Comprehensive Analysis of Mortality Among Patients Undergoing TAVR Results of the PARTNER Trial
07/07/2014 21:58
BackgroundPatients with severe aortic stenosis (AS) who were deemed too high risk or inoperable for conventional aortic valve replacement (AVR) in the PARTNER (Placement of Aortic Transcatheter Valves) trial were randomized to transcatheter [...]
Reply A Persisting Dilemma for Triple Antithrombotic Therapy: Are We Close to Finding the Correct Answer?
07/07/2014 21:58
In response to our article (1), Dr. Aytürk and colleagues emphasize that the type of stent might affect the risk of stent thrombosis and consequently the need of prolonged dual antiplatelet therapy with aspirin and clopidogrel. We agree tha [...]
Mortality in the PARTNER Trials Transfemoral Is Better ∗
07/07/2014 21:58
Severe aortic stenosis (AS) is the most frequent form of valvular heart disease in Western countries, and symptomatic AS has become an increasing health problem for their growing elderly populations. The lethality of symptomatic AS has been [...]
A Persisting Dilemma for Triple Antithrombotic Therapy Are We Close to Finding the Correct Answer?
07/07/2014 21:58
We have read with much interest the article by Lamberts et al. (1), who reported on oral anticoagulation (OAC) and antiplatelets in atrial fibrillation (AF) patients after myocardial infarction (MI) and coronary intervention, and who conclu [...]
Baroreflex Sensitivity A Reliable Predictor of Response to Renal Denervation?
07/07/2014 21:58
We read the paper by Zuern et al. (1), demonstrating that cardiac baroreflex sensitivity (BRS) may predict the blood pressure (BP) response to renal denervation (RDN) in patients with treatment-resistant hypertension, with great interest. T [...]
Improved Functional Status and Quality of Life in Prohibitive Surgical Risk Patients With Degenerative Mitral Regurgitation After Transcatheter Mitral Valve Repair
07/07/2014 21:58
BackgroundSurgical mitral valve repair (SMVR) remains the gold standard for severe degenerative mitral regurgitation (DMR). However, the results with transcatheter mitral valve repair (TMVR) in prohibitive-risk DMR patients have not been pr [...]
Handheld Ultrasound and Diagnosis of Cardiovascular Disease at the Bedside
07/07/2014 21:58
In 1903, Dr. William Osler advocated for reform of medical education to emphasize bedside teaching, recommending “no teaching without a patient for a text and the best teaching is that taught by the patient himself” (1). More than a century [...]
Treatment for Mitral Regurgitation Which One Are We Talking About? ∗
07/07/2014 21:58
As emphasized in the 2014 American College of Cardiology/American Heart Association guidelines for the treatment of valvular heart disease (1), primary (degenerative) and secondary (functional) mitral regurgitation (MR) are 2 nearly separat [...]
Clinical Utility of Intravascular Imaging and Physiology in Coronary Artery Disease
07/07/2014 21:58
Intravascular imaging and physiology techniques and technologies are moving beyond the framework of research to inform clinical decision making. Currently available technologies and techniques include fractional flow reserve; grayscale intr [...]
Review of Clinical Practice Guidelines for the Management of LDL-Related Risk
07/07/2014 21:58
Managing risk related to low-density lipoprotein (LDL) is vital in therapy for patients at risk for atherosclerotic cardiovascular disease (ASCVD) events given its important etiologic role in atherogenesis. Despite decades of research showi [...]