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Recent items - Journal of the American College of Cardiology

Reply Ejection Fraction May Improve But the Scar Still Exists! The Risk May Be Lower But Not Zero
02/09/2014 00:17
We thank Dr. Pillarisetti and colleagues for their interest in our report (1). However, we disagree with the conclusions they have drawn from additional analysis of our data. They argue that patients with primary prevention implantable card [...]
Subspecialist Scholarship in Quality Improvement
02/09/2014 00:17
To be good at medicine, you need to follow a specific trajectory: excel in high school science, major in pre-med courses in undergraduate school, attend medical school, match into an internal medicine residency, subspecialize, publish, and [...]
Translational Molecular Imaging Repurposing an Old Technique to Track Cell Migration Into Human Atheroma ∗
02/09/2014 00:17
A wealth of basic and translational science over the last 2 decades has harnessed the cellular and molecular mechanisms underlying the initiation, progression, and complications of atherosclerosis (1–4). This progress in our fundamental und [...]
Association Between Frequency of Atrial and Ventricular Ectopic Beats and Biventricular Pacing Percentage and Outcomes in Patients With Cardiac Resynchronization Therapy
02/09/2014 00:17
BackgroundA high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been wel [...]
The Relationship of Body Mass and Fat Distribution With Incident Hypertension Observations From the Dallas Heart Study
02/09/2014 00:17
BackgroundObesity has been linked to the development of hypertension, but whether total adiposity or site-specific fat accumulation underpins this relationship is unclear.ObjectivesThis study sought to determine the relationship between adi [...]
A Systematic Examination of the 2013 ACC/AHA Pooled Cohort Risk Assessment Tool for Atherosclerotic Cardiovascular Disease
02/09/2014 00:17
BackgroundThe 2013 American College of Cardiology/American Heart Association updated cholesterol guidelines recommend the use of Pooled Cohort Equations to estimate 10-year absolute risk for atherosclerotic cardiovascular disease (ASCVD) in [...]
Reply Is it Time to Launch JACC: Early Career ?
02/09/2014 00:17
We thank Drs. Shenoy and Tuliani for their kind letter and novel idea in response to our report (1). We agree that early career academic cardiologists are in need of publications. Publications are the scientific currency that enables early [...]
Ejection Fraction May Improve But the Scar Still Exists! The Risk May Be Lower But Not Zero
02/09/2014 00:17
We read with great interest the report by Kini et al. (1). The results are interesting, and the authors make a strong case against the clinical utility and cost-effectiveness of continued generator replacements in patients with implantable [...]
A First Dilemma in Cardiovascular Medicine Adherence Versus Personalized Therapy
02/09/2014 00:17
Adiposity and Risk for Hypertension Does Location Matter? ∗
02/09/2014 00:17
Obesity is a threat to global health, especially as a precursor and risk factor for fatal and nonfatal cardiovascular disease (1,2). The evidence for this conclusion can be presented in many ways, but perhaps the most dramatic expression is [...]
Primary Prevention of Atherosclerotic Cardiovascular Disease Bringing Clinicians and Patients to the Starting Line ∗
02/09/2014 00:17
The recent American College of Cardiology/American Heart Association clinical practice guidelines for the treatment of lipids have been received with a great deal of fanfare. The debate over the most effective risk tool to estimate the 10-y [...]
The Cardiorenal Connection New Insights Toward Choice of Revascularization ∗
02/09/2014 00:17
The incidence of acute kidney injury (AKI) varies widely after coronary revascularization, likely because of the incorporation of studies spanning 3 decades, different definitions used to define AKI, and variation in the use of volume expan [...]
Functional 3D Printed Patient-Specific Modeling of Severe Aortic Stenosis
02/09/2014 00:17
Computed tomography (CT) provides high-resolution images of the aortic valve with clear localization of calcium deposition. Three-dimensional (3D) stereolithographic printing can be used to convert these data into a physical model (1,2). We [...]
Is it Time to Launch JACC: Early Career ?
02/09/2014 00:17
We greatly enjoyed reading the recent report by Tong et al. (1). The authors beautifully summarized the current situation of academic cardiology for early-stage cardiologists, presenting current challenges for early career (EC) academic car [...]
In Vivo Imaging of Enhanced Leukocyte Accumulation in Atherosclerotic Lesions in Humans
02/09/2014 00:17
BackgroundUnderstanding how leukocytes impact atherogenesis contributes critically to our concept of atherosclerosis development and the identification of potential therapeutic targets.ObjectivesThe study evaluates an in vivo imaging approa [...]
Impaired Responsiveness to the Platelet P2Y 12 Receptor Antagonist Clopidogrel in Patients With Type 2 Diabetes and Coronary Artery Disease
02/09/2014 00:17
BackgroundSeveral studies have shown that patients with diabetes mellitus (DM) exhibit an impaired response to clopidogrel. This may contribute to their increased risk of recurrent atherothrombotic events, despite the use of dual-antiplatel [...]
Diabetes Mellitus and Clopidogrel Response Variability ∗
02/09/2014 00:17
Platelet P2Y12-receptor antagonists reduce major adverse cardiovascular events after percutaneous coronary intervention (PCI) and in acute coronary syndrome (ACS) (1–4). Together with aspirin, they are the cornerstones of adjunctive medical [...]
20 Years of Cardiac Resynchronization Therapy
02/09/2014 00:17
Cardiac resynchronization therapy (CRT) is an accepted treatment for patients with heart failure (HF), impaired left ventricular (LV) function, and a wide QRS complex. It has been revolutionary for patients with advanced HF whose only previ [...]
Ectopic Beats Before CRT and Patient Outcomes Little Things Mean a Lot ∗
02/09/2014 00:17
The benefit of cardiac resynchronization therapy (CRT) for most heart failure (HF) patients with low ejection fraction (EF) and widened QRS is undisputed. Mortality and HF hospitalization are reduced, and multiple measures of cardiac functi [...]
Coronary Artery Manifestations of Fibromuscular Dysplasia
02/09/2014 00:17
Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiog [...]
Tackling Population Health Leaving a Meaningful Mark on the World
02/09/2014 00:17
Cardiovascular diseases know no borders. Although huge strides have been made in treating cardiovascular diseases and reducing morbidity and mortality over the last several decades, they remain the number 1 cause of death around the globe ( [...]
Acute Kidney Injury After CABG Versus PCI An Observational Study Using 2 Cohorts
02/09/2014 00:17
BackgroundAcute kidney injury (AKI) is a known complication after coronary revascularization, but few studies have directly compared the incidence of AKI after coronary artery bypass surgery (CABG) or after percutaneous coronary interventio [...]
The New Cholesterol Guidelines Finally More Light Than Heat ∗
25/08/2014 23:32
I cannot remember practice guidelines more delayed, groundbreaking, and controversial than the 2013 American College of Cardiology/American Heart Association cholesterol guidelines (1). They are groundbreaking for using a new race-specific [...]
Short Versus Long Duration of DAPT After DES Implantation: A Meta-Analysis
25/08/2014 23:32
The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has not been determined. Current American College of Cardiology Foundation/American Heart Association (AC [...]
Cardiac Intensivism A View From a Fellow-in-Training
25/08/2014 23:32
In a true and perfect form, imperturbability is indissolubly associated with wide experience and an intimate knowledge of the varied aspects of disease. With such advantages he is so equipped that no eventuality can disturb the mental equil [...]
Translating Stem Cell Research to Cardiac Disease Therapies Pitfalls and Prospects for Improvement
25/08/2014 23:32
Over the past 2 decades, there have been numerous stem cell studies focused on cardiac diseases, ranging from proof-of-concept to phase 2 trials. This series of papers focuses on the legacy of these studies and the outlook for future treatm [...]
Percutaneous Mitral Valve Edge-to-Edge Repair In-Hospital Results and 1-Year Follow-Up of 628 Patients of the 2011–2012 Pilot European Sentinel Registry
25/08/2014 23:32
BackgroundThe use of transcatheter mitral valve repair (TMVR) has gained widespread acceptance in Europe, but data on immediate success, safety, and long-term echocardiographic follow-up in real-world patients are still limited.ObjectivesTh [...]
Accuracy of Statin Assignment Using the 2013 AHA/ACC Cholesterol Guideline Versus the 2001 NCEP ATP III Guideline Correlation With Atherosclerotic Plaque Imaging
25/08/2014 23:32
BackgroundAccurate assignment of statin therapy is a major public health issue.ObjectivesThe American Heart Association and the American College of Cardiology released a new guideline on the assessment of cardiovascular risk (GACR) to repla [...]
Electrocardiographic Changes Improve Risk Prediction in Asymptomatic Persons Age 65 Years or Above Without Cardiovascular Disease
25/08/2014 23:32
BackgroundRisk prediction in elderly patients is increasingly relevant due to longer life expectancy.ObjectivesThis study sought to examine whether electrocardiographic (ECG) changes provide prognostic information incremental to current ris [...]
Reply Immortal Time Bias and the Use of IVC Filters
25/08/2014 23:32
We thank Drs. Fernandes and White for their thoughtful comments about our registry-based retrospective cohort study of patients with acute venous thromboembolism (1). We agree that the start time of follow-up and treatment status in the des [...]
Aspirin Treatment and Outcomes in Patients Undergoing Percutaneous Coronary Intervention Is There a Role for Pharmacodynamic Testing? ∗
25/08/2014 23:32
Aspirin is an irreversible inhibitor of the platelet cyclooxygenase (COX)-1 enzyme, which in adjunct to a P2Y12 receptor antagonist, represents the cornerstone of treatment for patients undergoing percutaneous coronary interventions (PCI) ( [...]
The Murky World of Effective Dose for Cardiovascular CT
25/08/2014 23:32
We read with interest the excellent report by Einstein et al. (1) and the accompanying pragmatic editorial (2). We support the laudable aim of involving patients in the discussion of radiation exposure as part of the clinical decision proce [...]
Reply The Murky World of Effective Dose for Cardiovascular CT
25/08/2014 23:32
We thank Drs. Castellano and Nicol for their interest in our paper (1) and their many insightful comments, which focus specifically on the radiation dose for patients undergoing cardiovascular computed tomography (CT). The central themes of [...]
Sex-Specific Mortality Risk by QRS Morphology and Duration in Patients Receiving CRT Results From the NCDR
25/08/2014 23:32
BackgroundPrior studies have suggested that women have better outcomes than men after cardiac resynchronization therapy-defibrillator (CRT-D) implantation.ObjectivesThe purpose of this study was to compare mortality after CRT-D implantation [...]
Leaning Toward a Better Understanding of CRT in Women ∗
25/08/2014 23:32
Cardiac resynchronization-defibrillation therapy (CRT-D) is now a well-established treatment for patients with symptomatic heart failure unresponsive to optimized pharmacological therapy, including an angiotensin-converting enzyme inhibitor [...]
Is Lp(a) Ready for Prime Time? ∗
25/08/2014 23:32
Despite the established benefits of randomized controlled trials in the primary and secondary prevention settings, atherosclerotic cardiovascular disease continues to present a major public health challenge throughout the world. Beyond the [...]
Aspirin Treatment and Outcomes After Percutaneous Coronary Intervention Results of the ISAR-ASPI Registry
25/08/2014 23:32
BackgroundAspirin administration, as part of a dual antiplatelet treatment regimen, is essential for patients undergoing percutaneous coronary intervention (PCI). Although the correlation between high on-clopidogrel treatment platelet react [...]
Time to Bring the “Electrocardio-ome” Into Modern Cardiovascular Epidemiology? ∗
25/08/2014 23:32
More than 50 years have passed since the Framingham Heart Study investigators published their first major report on “risk factors” for coronary heart disease (1). Kannel et al. (1) discovered 3 risk factors, namely elevated blood pressure, [...
Using Basic and Clinical Research in Cardiology to Achieve Personalized Medicine Is it a Maze or Math?
25/08/2014 23:32
Personalized medicine will be integral in further driving down the global impact of cardiovascular disease. Basic and clinical research in cardiovascular medicine has rapidly progressed over the last several decades, causing decreases in mo [...]
Snake Eyes ∗
25/08/2014 23:32
Analogous to transcatheter aortic valve replacement, the assessment and treatment of mitral insufficiency have assumed more central importance, primarily driven by 4 major factors: 1) The recognition that the disease is complex, consisting [...]
Discrimination and Net Reclassification of Cardiovascular Risk With Lipoprotein(a) Prospective 15-Year Outcomes in the Bruneck Study
25/08/2014 23:32
BackgroundRecent studies showed that lipoprotein(a) [Lp(a)] is a causal risk factor for cardiovascular disease (CVD). However, whether Lp(a) modifies clinical risk assessment was not established.ObjectivesThis study was conducted to determi [...]
Reply The Murky World of Effective Dose for Cardiovascular CT
25/08/2014 23:32
The letter by Drs. Castellano and Nicol in response to my editorial introduces an additional complexity regarding radiation exposure from cardiovascular computed tomography (CT), namely the difficulty in measuring the actual dose that any g [...]
Prevention of Anthracycline-Induced Cardiotoxicity Challenges and Opportunities
25/08/2014 23:32
Anthracycline compounds are major culprits in chemotherapy-induced cardiotoxicity, which is the chief limiting factor in delivering optimal chemotherapy to cancer patients. Although extensive efforts have been devoted to identifying strateg [...]
Immortal Time Bias and the Use of IVC Filters
25/08/2014 23:32
We commend the RIETE (Computerized Registry of Patients with Venous Thromboembolism) group for attempting to analyze the benefits of use of an inferior vena cava (IVC) filter after acute pulmonary embolism (PE) using their large prospective [...]
MicroRNA-29a Is a Friend or Foe for Cardiac Hypertrophy?
18/08/2014 23:24
MicroRNAs (miRNAs) play an important role in the pathogenesis of structural alterations of cardiac hypertrophy (1). However, the precise mechanisms of miRNA-29a in cardiac hypertrophy are still unclear. A recent report in the Journal by Ron [...]
Blood Transfusion in Myocardial Infarction Opening Old Wounds for Comparative-Effectiveness Research ∗
18/08/2014 23:24
The treatment of anemia in the general population of medical or surgical patients has long been an area of uncertainty, particularly with regard to the transfusion of red blood cells. A multitude of studies, conducted over >4 decades and in [...]
Atrial Fibrillation Ablation Translating Basic Mechanistic Insights to the Patient
18/08/2014 23:24
Atrial fibrillation (AF) ablation is widely performed and is progressively supplanting drug therapy. Catheter-based AF ablation modalities have evolved progressively in parallel to our understanding of underlying mechanisms. Initial attempt [...]
Inspiring Possibility
18/08/2014 23:24
In July 2014, I began work as a cardiologist. It happens routinely and without fanfare, but there is something worthy of pause during one’s transition to faculty from fellowship training. The world of health care that I now enter as a cardi [...]
A Roadmap to Investigate the Genetic Basis of Bicuspid Aortic Valve and its Complications Insights From the International BAVCon (Bicuspid Aortic Valve Consortium)
18/08/2014 23:24
Bicuspid aortic valve (BAV) is the most common adult congenital heart defect and is found in 0.5% to 2.0% of the general population. The term “BAV” refers to a heterogeneous group of disorders characterized by diverse aortic valve malformat [...
Knowing Plasma Concentrations Improves Management of the Effects of Dabigatran
18/08/2014 23:24
With interest we read the report by Reilly et al. (1) in a recent issue of the Journal regarding the effect of dabigatran plasma concentrations and patient characteristics on the frequency of ischemic stroke and major bleeding in patients w [...]
Disparities in Heart Failure Care Now Is the Time to Focus on Health Care Delivery ∗
18/08/2014 23:24
Over the past 3 decades, heart failure patients have enjoyed major improvements in survival and quality of life. Well-conducted clinical trials have proven the effectiveness of neurohormonal antagonists, cardiac resynchronization therapy (C [...]
Blood Transfusion During Acute Myocardial Infarction Association With Mortality and Variability Across Hospitals
18/08/2014 23:24
BackgroundBlood transfusion is controversial for anemic patients with acute myocardial infarction (AMI), with some previous studies reporting increased risk of transfusion-associated mortality.ObjectivesThe goal of this study was to examine [...]
Lack of Negative Interaction Between Use of Beta-Blockers and Statins on Cardiovascular Outcomes Among Patients With or At Risk for Atherothrombosis
18/08/2014 23:24
For many years, some have suggested that beta-blockers modify the metabolic profile of patients treated for high blood pressure. A pre-specified analysis of ASCOTAnglo-SCandinavian Outcomes Trial) (1) assessing the synergistic effects of li [...]
Pro-Inflammatory Interleukin Genotypes Potentiate Early and Advanced Atherosclerosis Differently
18/08/2014 23:24
We read with interest the paper by Tsimikas et al. (1) in a recent issue of the Journal, which reported that genetic differences in the interleukin (IL)-1 gene cluster, known to be associated with inflammatory responsiveness, strongly influ [...]