17 junio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Incidence, Predictors, and Implications of Reinfarction After Primary Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction

Samantha G. Stone, Gregory W. Serrao, MD, Roxana Mehran, MD, Matthew I. Tomey, MD, Bernhard Witzenbichler, MD, Giulio Guagliumi, MD, Jan Z. Peruga, MD, Bruce R. Brodie, MD, Dariusz Dudek, MD, Martin Möckel, MD, Sorin J. Brener, MD, George Dangas, MD, PhD and Gregg W. Stone, MD

Background: Reinfarction after primary percutaneous coronary intervention in patients with ST-segment–elevation myocardial infarction has negative consequences. Little is known about reinfarction after drug-eluting stents and bivalirudin anticoagulation. We, therefore, sought to determine the incidence, predictors, and implications of reinfarction after primary percutaneous coronary intervention in the contemporary era.

01 enero 2014

CIRCULATION. Images in Cardiovascular Medicine. Streaming in Transposition of the Great Arteries by Using Cardiac Magnetic Resonance Imaging

James Wong, MA, MB, BChir; Kuberan Pushparajah, BMBS; Tarique Hussain, PhD; Daniel Giese, PhD; Nathalie Dedieu, MBBS, MSc; Sujeev Mathur, MBBS; Gerald F. Greil, MD; Reza Razavi, MD; Aaron Bell, MBChB

Introduction: A 6-month-old child with progressive cyanosis was referred to our service for assessment. Transthoracic echocardiography confirmed the diagnosis of transposition of the great arteries, a very large ventricular septal defect (VSD), and subpulmonary stenosis. The atrial septum was intact. The transcutaneous oxygen saturation levels measured 40% to 50% in room air with a hemoglobin value of 19 g/dL. Conventional treatment with an arterial switch and VSD closure was not possible, because it would result in neoaortic obstruction because of the significant subpulmonary stenosis. Additionally, the size of the VSD was such that achieving adequate septation of the ventricles remained questionable. To aid surgical planning, a cardiac magnetic resonance scan was performed to determine whether the low transcutaneous oxygen saturation levels were due to poor mixing of blood or limited pulmonary blood flow.

01 enero 2014

CIRCULATION. Images in Cardiovascular Medicine. Percutaneous Pulmonary Valve Replacement During Pregnancy

Oliver Ormerod, DM, FRCP; James D. Newton, MD, MRCP; Stephen Westaby, MS, FRCS; Neil Wilson, MD, FRCP

Introduction: The number of women of childbearing age who have congenital heart disease is increasing.1 A similar proportion of these women can be expected to attempt pregnancy as women in general.2 Although most of these women can be expected to tolerate pregnancy well, particularly if the pregnancy is carefully planned following appropriate clinical evaluation, not all pregnancies are planned, and some will occur in women with unsuitable hemodynamics.

09 diciembre 2013

CIRCULATION. Arrhythmia/Electrophysiology. Efficacy and Safety of Dabigatran Compared With Warfarin in Relation to Baseline Renal Function in Patients With Atrial Fibrillation

Ziad Hijazi, MD, PhD; Stefan H. Hohnloser, MD; Jonas Oldgren, MD, PhD; Ulrika Andersson, MSc; Stuart J. Connolly, MD; John W. Eikelboom, MD; Michael D. Ezekowitz, MB, ChB, PhD; Paul A. Reilly, PhD; Agneta Siegbahn, MD, PhD; Salim Yusuf, MD, PhD; Lars Wallentin, MD, PhD

Background: Renal impairment increases the risk of stroke and bleeding in patients with atrial fibrillation. In the Randomized Evaluation of Long-Term Anticoagulant Therapy (RELY) trial, dabigatran, with ≈80% renal elimination, displayed superiority over warfarin for prevention of stroke and systemic embolism in the 150-mg dose and significantly less major bleeding in the 110-mg dose in 18 113 patients with nonvalvular atrial fibrillation. This prespecified study investigated these outcomes in relation to renal function.

13 enero 2015

CIRCULATION. Coronary Heart Disease. Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries

Sivabaskari Pasupathy, BSc(Hons); Tracy Air, BA (Hons), M.Biostatistics; Rachel P. Dreyer, BSc(Hons), PhD; Rosanna Tavella, BSc(Hons), PhD; John F. Beltrame, BSc, BMBS, PhD

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiological mechanisms underlying this disorder.

16 febrero 2015

CIRCULATION. Health Services and Outcomes Research. Doing the Right Things and Doing Them the Right Way. Association Between Hospital Guideline Adherence, Dosing Safety, and Outcomes Among Patients With Acute Coronary Syndrome

Rajendra H. Mehta, MD, MS; Anita Y. Chen, MS; Karen P. Alexander, MD; E. Magnus Ohman, MD; Matthew T. Roe, MD, MHS; Eric D. Peterson, MD, MPH

Background: Performance metrics currently focus on the measurement of the application of guideline-indicated medications without considering the appropriate dosing of these drugs.

17 febrero 2015

CIRCULATION. Valvular Heart Disease. Temporal Trends in the Incidence and Prognosis of Aortic Stenosis. A Nationwide Study of the Swedish Population

Andreas Martinsson, MD; Xinjun Li, MD, PhD; Charlotte Andersson, MD, PhD; Johan Nilsson, MD, PhD; J. Gustav Smith, MD, PhD; Kristina Sundquist, MD, PhD

Background: The aging of Western populations is expected to result in increasing occurrence of aortic stenosis (AS), but data are limited. Recent studies have reported declining incidence and mortality for other major heart diseases. We aimed to study temporal trends in the incidence and prognosis for AS in Sweden.

13 febrero 2015

CIRCULATION. Coronary Heart Disease. Vorapaxar in Patients With Diabetes Mellitus and Previous Myocardial Infarction

Matthew A. Cavender, MD, MPH; Benjamin M. Scirica, MD, MPH; Marc P. Bonaca, MD, MPH; Dominick J. Angiolillo, MD, PhD; Anthony J. Dalby, MD; Mikael Dellborg, MD; Joao Morais, MD; Sabina A. Murphy, MPH; Ton Oude Ophuis, MD; Michal Tendera, MD; Eugene Braunwald, MD; David A. Morrow, MD, MPH

Background: Vorapaxar reduces cardiovascular death, myocardial infarction (MI), or stroke in patients with previous MI while increasing bleeding. Patients with diabetes mellitus (DM) are at high risk of recurrent thrombotic events despite standard therapy and may derive particular benefit from antithrombotic therapies. The Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-TIMI 50 trial was a randomized, double-blind, placebo-controlled trial of vorapaxar in patients with stable atherosclerosis.

06 abril 2015

CIRCULATION. Epidemiology and Prevention. Sudden Cardiac Arrest During Sports Activity in Middle Age

Eloi Marijon, MD, PhD; Audrey Uy-Evanado, MD; Kyndaron Reinier, MPH, PhD; Carmen Teodorescu, MD, PhD; Kumar Narayanan, MD; Xavier Jouven, MD, PhD; Karen Gunson, MD; Jonathan Jui, MD, MPH; Sumeet S. Chugh, MD

Background: Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine the burden, characteristics, and outcomes of SCA during sports among middle-aged residents of a large US community.

23 marzo 2015

CIRCULATION. Epidemiology and Prevention. Exposure to Parental Smoking in Childhood Is Associated With Increased Risk of Carotid Atherosclerotic Plaque in Adulthood

Henry W. West, BM; Markus Juonala, MD, PhD; Seana L. Gall, PhD; Mika Kähönen, MD, PhD; Tomi Laitinen, MD, PhD; Leena Taittonen, MD, PhD; Jorma S.A. Viikari, MD, PhD; Olli T. Raitakari, MD, PhD*; Costan G. Magnussen, PhD*

Background: The association between passive smoking exposure in childhood and adverse cardiovascular health in adulthood is not well understood. Using a 26-year follow-up study, we examined whether childhood exposure to passive smoking was associated with carotid atherosclerotic plaque in young adults.

14 marzo 2014

CIRCULATION. Arrhythmia/Electrophysiology. Temporal Relationship Between Subclinical Atrial Fibrillation and Embolic Events

Michela Brambatti, MD; Stuart J. Connolly, MD; Michael R. Gold, MD; Carlos A. Morillo, MD; Alessandro Capucci, MD; Carmine Muto, MD; Chu P. Lau, MD; Isabelle C. Van Gelder, MD; Stefan H. Hohnloser, MD; Mark Carlson, MD; Eric Fain, MD; Juliet Nakamya, PhD; Georges H. Mairesse, MD; Marta Halytska, BSc; Wei Q. Deng, MSc; Carsten W Israel, MD; Jeff S. Healey, MD; on behalf of the ASSERT Investigators

Background: Among patients with implantable pacemakers and defibrillators, subclinical atrial fibrillation (SCAF) is associated with an increased risk of stroke; however, there is limited understanding of their temporal relationship.

09 abril 2014

CIRCULATION. Interventional Cardiology. High On-Treatment Platelet Reactivity as a Risk Factor for Secondary Prevention After Coronary Stent Revascularization

Gilles Montalescot, MD, PhD; Grégoire Rangé, MD; Johanne Silvain, MD, PhD; Jean-Louis Bonnet, MD; Ziad Boueri, MD; Olivier Barthélémy, MD; Guillaume Cayla, MD, PhD; Loic Belle, MD; Eric Van Belle, MD, PhD; Thomas Cuisset, MD, PhD; Simon Elhadad, MD; Christophe Pouillot, MD; Patrick Henry, MD, PhD; Pascal Motreff, MD, PhD; Didier Carrié, MD, PhD; Hélène Rousseau, PhD; Pierre Aubry, MD; Jacques Monségu, MD; Pierre Sabouret, MD; Stephen A. O’Connor, MB BCh, MD; Jérémie Abtan, MD; Mathieu Kerneis, MD; Christophe Saint-Etienne, MD; Farzin Beygui, MD, PhD; Eric Vicaut, MD, PhD; Jean-Philippe Collet, MD, PhD; for the ARCTIC Investigators

Background: Individualizing antiplatelet therapy after platelet function testing did not improve outcome after coronary stenting in the Assessment by a Double Randomization of a Conventional Antiplatelet Strategy Versus a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation and of Treatment Interruption Versus Continuation One Year After Stenting (ARCTIC) study. Whether results are different during the phase of secondary prevention starting after hospital discharge, when periprocedural events have been excluded, is unknown.

01 enero 2014

CIRCULATION. Controversies in Cardiovascular Medicine. Fractional Flow Reserve–Guided Percutaneous Coronary Intervention Is Not a Valid Concept

Armin Arbab-Zadeh, MD, PhD

Introduction: The concept of fractional flow reserve (FFR)–guided percutaneous coronary intervention (PCI) has gained worldwide acceptance in the cardiology community.1 Hemodynamic assessment with FFR in the cardiac catheterization laboratory is now routinely being performed in intermediate-range coronary arterial stenoses to inform the decision to proceed with PCI.

26 febrero 2014

CIRCULATION. Coronary Heart Disease. Clinical Usefulness, Angiographic Characteristics, and Safety Evaluation of Intracoronary Acetylcholine Provocation Testing Among 921 Consecutive White Patients With Unobstructed Coronary Arteries

Peter Ong, MD; Anastasios Athanasiadis, MD; Gabor Borgulya, MD, MSc; Ismail Vokshi, MBBS; Rachel Bastiaenen, MBBS; Sebastian Kubik; Stephan Hill, MD; Tim Schäufele, MD; Heiko Mahrholdt, MD; Juan Carlos Kaski, MD, DSc*; Udo Sechtem, MD*

Background: Coronary spasm can cause myocardial ischemia and angina in patients with and those without obstructive coronary artery disease. However, provocation tests using intracoronary acetylcholine administration are rarely performed in clinical routine in the United States and Europe. Thus, we assessed the clinical usefulness, angiographic characteristics, and safety of intracoronary acetylcholine provocation testing in white patients with unobstructed coronary arteries.

01 enero 2014

CIRCULATION. Images in Cardiovascular Medicine. Coronary Aneurysm With Stent Dislocation Leading to the Diagnosis of Marfan Syndrome

Nadine Abanador-Kamper, MD; Lars Kamper, MD; Marc Vorpahl, MD; Klaus Tiroch, MD; Patrick Haage, MD; Melchior Seyfarth, MD

A 50-year-old male patient presented with unstable angina in our chest pain unit. He had a history of successful resuscitation after sudden cardiac arrest attributable to acute myocardial infarction 3 years ago. Coronary angiography at that time demonstrated acute proximal occlusion of the right coronary artery (Figure 1A) treated by balloon dilatation and implantation of 2 bare metal stents (Figure 1B). The second overlapping stent was necessary because of insufficient coverage of the diseased ostium after the first stent.