17 diciembre 2012

CIRCULATION. ACCF/AHA Guideline. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

Patrick T. O’Gara, MD, FACC, FAHA, Chair†; Frederick G. Kushner, MD, FACC, FAHA, FSCAI, Vice Chair*†; Deborah D. Ascheim, MD, FACC†; Donald E. Casey Jr, MD, MPH, MBA, FACP, FAHA‡; Mina K. Chung, MD, FACC, FAHA*†; James A. de Lemos, MD, FACC*†; Steven M. Ettinger, MD, FACC*§; James C. Fang, MD, FACC, FAHA*†; Francis M. Fesmire, MD, FACEP*║¶; Barry A. Franklin, PhD, FAHA†; Christopher B. Granger, MD, FACC, FAHA*†; Harlan M. Krumholz, MD, SM, FACC, FAHA†; Jane A. Linderbaum, MS, CNP-BC†; David A. Morrow, MD, MPH, FACC, FAHA*†; L. Kristin Newby, MD, MHS, FACC, FAHA*†; Joseph P. Ornato, MD, FACC, FAHA, FACP, FACEP†; Narith Ou, PharmD†; Martha J. Radford, MD, FACC, FAHA†; Jacqueline E. Tamis-Holland, MD, FACC†; Jacqueline E. Tommaso, MD, FACC, FAHA, FSCAI#; Cynthia M. Tracy, MD, FACC, FAHA†; Y. Joseph Woo, MD, FACC, FAHA†; David X. Zhao, MD, FACC*†

Preamble: The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.

EUROPEAN HEART JOURNAL. Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)†

Martin Grabenwöger, Fernando Alfonso, Jean Bachet, Robert Bonser, Martin Czerny, Holger Eggebrecht, Arturo Evangelista, Rossella Fattori, Heinz Jakob, Lars Lönn, Christoph A. Nienaber, Guido Rocchi, Hervè Rousseau, Matt Thompson, Ernst Weigang and Raimund Erbel

Thoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease.1–4 Fundamentally, it is a far less invasive approach than open surgery and its availability and relative ease of application has changed and extended management options in thoracic aortic disease, including in those patients deemed unfit or unsuitable for open surgery. In the operating room, this requires considerable perceptual, cognitive and psychomotor demands on the operators.

THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY. Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document

A. Pieter Kappeteinemail address , Stuart J. Head , Philippe Généreux , Nicolo Piazza , Nicolas M. van Mieghem , Eugene H. Blackstone , Thomas G. Brott , David J. Cohen , Donald E. Cutlip , Gerrit-Anne van Es , Rebecca T. Hahn , Ajay J. Kirtane , Mitchell W. Krucoff , Susheel Kodali , Michael J. Mack , Roxana Mehran , Josep Rodés-Cabau , Pascal Vranckx , John G. Webb , Stephan Windecker , Patrick W. Serruys , Martin B. Leon

Objectives: The aim of the current Valve Academic Research Consortium (VARC)-2 initiative was to revisit the selection and definitions of transcatheter aortic valve implantation (TAVI) clinical endpoints to make them more suitable to the present and future needs of clinical trials. In addition, this document is intended to expand the understanding of patient risk stratification and case selection.

01 julio 2013

CIRCULATION. ACCF/AHA/SCAI 2013 Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures

John G. Harold, MD, MACC, FAHA, Chair*; Theodore A. Bass, MD, FACC, FSCAI, Vice Chair†; Thomas M. Bashore, MD, FACC, FAHA, FSCAI; Ralph G. Brindis, MD, MPH, MACC, FSCAI*; John E. Brush Jr, MD, FACC; James A. Burke, MD, PhD, FACC; Gregory J. Dehmer, MD, FACC, FAHA, FSCAI†; Yuri A. Deychak, MD, FACC; Hani Jneid, MD, FACC, FAHA, FSCAI‡; James G. Jollis, MD, FACC‡; Joel S. Landzberg, MD, FACC; Glenn N. Levine, MD, FACC, FAHA; James B. McClurken, MD, FACC; John C. Messenger, MD, FACC, FSCAI*; Issam D. Moussa, MD, FACC, FAHA, FSCAI†; J. Brent Muhlestein, MD, FACC; Richard M. Pomerantz, MD, FACC, FSCAI; Timothy A. Sanborn, MD, FACC, FAHA; Chittur A. Sivaram, MBBS, FACC; Christopher J. White, MD, FACC, FAHA, FSCAI†; Eric S. Williams, MD, FACC* *American College of Cardiology Foundation representative. †Society for Cardiovascular Angiography and Interventions representative. ‡American Heart Association representative. Presidents and Staff, American College of Cardiology Foundation; American Heart Association; Society of Cardiovascular Angiography and Interventions

Preamble: Granting clinical staff privileges to physicians is the primary mechanism institutions use to uphold quality care. The Joint Commission requires that medical staff privileges be based on professional criteria specified in medical staff bylaws. Physicians themselves are charged with defining the criteria that constitute professional competence and with evaluating their peers accordingly. The process of evaluating physicians knowledge and competence has become more complex as various subspecialties have evolved over time.

01 junio 2013

THE AMERICAN JOURNAL OF CARDIOLOGY. The association between patient race, treatment, and outcomes of patients undergoing contemporary percutaneous coronary intervention: Insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)

Sherezade Khambatta, DO, MHA , Milan Seth, MS , Howard S. Rosman, MD , David Share, MD, MPH , Herbert D. Aronow, MD, MPH, FACC , Mauro Moscucci, MD, MBA , Thomas LaLonde, MD , Simon R. Dixon, MBChB, FACC , Hitinder S. Gurm, MD, FACC

Background: The aim of this study was to examine if racial disparities exist in the treatment and outcomes of patients undergoing contemporary percutaneous coronary intervention (PCI).

01 marzo 2012

JACC. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies. A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

Guillermo J. Tearney, MD, PhD; Evelyn Regar, MD, PhD; Takashi Akasaka, MD; Tom Adriaenssens, MD; Peter Barlis, MD; Hiram G. Bezerra, MD; Brett Bouma, PhD; Nico Bruining, PhD; Jin-man Cho, MD, PhD; Saqib Chowdhary, PhD; Marco A. Costa, MD, PhD; Ranil de Silva, MD, PhD; Jouke Dijkstra, PhD; Carlo Di Mario, MD, PhD; Darius Dudeck, MD, PhD; Erlin Falk, MD, PhD; Marc D. Feldman, MD; Peter Fitzgerald, MD; Hector Garcia, MD; Nieves Gonzalo, MD; Juan F. Granada, MD; Giulio Guagliumi, MD; Niels R. Holm, MD; Yasuhiro Honda, MD; Fumiaki Ikeno, MD; Masanori Kawasaki, MD; Janusz Kochman, MD, PhD; Lukasz Koltowski, MD; Takashi Kubo, MD, PhD; Teruyoshi Kume, MD; Hiroyuki Kyono, MD; Cheung Chi Simon Lam, MD; Guy Lamouche, PhD; David P. Lee, MD; Martin B. Leon, MD; Akiko Maehara, MD; Olivia Manfrini, MD; Gary S. Mintz, MD; Kyiouchi Mizuno, MD; Marie-angéle Morel, MD; Seemantini Nadkarni, PhD; Hiroyuki Okura, MD; Hiromasa Otake, MD; Arkadiusz Pietrasik, MD; Francesco Prati, MD; Lorenz Räber, MD; Maria D. Radu, MD; Johannes Rieber, MD; Maria Riga, MD; Andrew Rollins, PhD; Mireille Rosenberg, PhD; Vasile Sirbu, MD; Patrick W.J.C. Serruys, MD, PhD; Kenei Shimada, MD; Toshiro Shinke, MD; Junya Shite, MD; Eliot Siegel, MD; Shinjo Sonada, MD; Melissa Suter, PhD; Shigeho Takarada, MD, PhD; Atsushi Tanaka, MD, PhD; Mitsuyasu Terashima, MD; Thim Troels, MD, PhD; Shiro Uemura, MD, PhD; Giovanni J. Ughi, PhD; Heleen M.M. van Beusekom, PhD; Antonius F.W. van der Steen, PhD; Gerrit-Ann van Es, PhD; Gijs van Soest, PhD; Renu Virmani, MD; Sergio Waxman, MD; Neil J. Weissman, MD; Giora Weisz, MD

Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.

01 enero 2013

JACC. 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease

Christopher P. Cannon, MD, FACC; Ralph G. Brindis, MD, MPH, FACC; Bernard R. Chaitman, MD, FACC; David J. Cohen, MD, MSc; J. Thomas Cross, MD, MPH; Joseph P. Drozda, MD, FACC; Francis M. Fesmire, MD, FACEP; Dan J. Fintel, MD, FACC; Gregg C. Fonarow, MD, FACC, FAHA; Keith A. Fox, MB, ChB; Darryl T. Gray, MD, ScD, FAHA; Robert A. Harrington, MD, FACC, FAHA; Karen A. Hicks, MD, FACC; Judd E. Hollander, MD, FACEP; Harlan Krumholz, MD, SM, FACC; Darwin R. Labarthe, MD, MPH, PhD; Janet B. Long, MSN, ACNP, FAHA; Alice M. Mascette, MD, FACC, FAHA, FACP; Connie Meyer, MICT, AAS; Eric D. Peterson, MD, FACC, FAHA; Martha J. Radford, MD, FACC, FAHA; Matthew T. Roe, MD, MHS, FACC; James B. Richmann, RN, BS, MHA, CEN; Harry P. Selker, MD, MSPH, FAHA; David M. Shahian, MD, FACC, FAHA; Richard E. Shaw, MA, PhD, FACC, FAHA; Sharon Sprenger, RHIA, CPHQ, MPA; Robert Swor, DO, FACEP; James A. Underberg, MD; Frans Van de Werf, MD, FACC; Bonnie H. Weiner, MD, MSEC, MBA; William S. Weintraub, MD, FACC, FAHA

The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) support their members goal to improve the prevention and care of cardiovascular diseases through professional education, research, and development of guidelines and standards and by fostering policy that supports optimal patient outcomes. The ACCF and AHA recognize the importance of the use of clinical data standards for patient management, assessment of outcomes, and conduct of research, and the importance of defining the processes and outcomes of clinical care, whether in randomized trials, observational studies, registries, or quality-improvement initiatives.

01 febrero 2012

JACC. Appropriate Use Criteria for Coronary Revascularization. Focused Update

Manesh R. Patel, MD, FACC; Gregory J. Dehmer, MD, FACC, FACP, FSCAI, FAHA; John W. Hirshfeld, MD; Peter K. Smith, MD, FACC; John A. Spertus, MD, MPH, FACC

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain.

01 febrero 2013

NICE. Stroke and systemic embolism (prevention, non-valvular atrial fibrillation) - apixaban: guidance

NICE Guidance

Apixaban is recommended as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with 1 or more risk factors

01 enero 2013

CIRCULATION. Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary

ACCF/AHA Guideline

Preamble: The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.

01 febrero 2012

CIRCULATION. Sexual Activity and Cardiovascular Disease. A Scientific Statement From the American Heart Association

Glenn N. Levine, MD, FAHA, Chair; Elaine E. Steinke, RN, PhD, FAHA; Faisal G. Bakaeen, MD; Biykem Bozkurt, MD, PhD, FAHA; Melvin D. Cheitlin, MD, FAHA; Jamie Beth Conti, MD; Elyse Foster, MD, FAHA; Tiny Jaarsma, RN, PhD, FAHA; Robert A. Kloner, MD, PhD; Richard A. Lange, MD, MBA, FAHA; Stacy Tessler Lindau, MD; Barry J. Maron, MD; Debra K. Moser, DNSc, RN, FAHA; E. Magnus Ohman, MD; Allen D. Seftel, MD; William J. Stewart, MD on behalf of the American Heart Association Council on Clinical Cardiology Council on Cardiovascular Nursing Council on Cardiovascular Surgery and Anesthesia, and Council on Quality of Care and Outcomes Research

Summary: Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease (CVD), including many elderly patients.1 Decreased sexual activity and function are common in patients with CVD and are often interrelated to anxiety and depression.2,3 The intent of this American Heart Association Scientific Statement is to synthesize and summarize data relevant to sexual activity and heart disease in order to provide recommendations and foster physician and other healthcare professional communication with patients about sexual activity. Recommendations in this document are based on published studies, the Princeton Consensus Panel,4,5 the 36th Bethesda Conference,6–10 European Society of Cardiology recommendations on physical activity and sports participation for patients with CVD,11–13 practice guidelines from the American College of Cardiology/American Heart Association14–16 and other organizations,17 and the multidisciplinary expertise of the writing group. The classification of recommendations in this document are based on established ACCF/AHA criteria (Table).

01 enero 2012

CIRCULATION. Heart Disease and Stroke Statistics—2012 Update. A Report From the American Heart Association

Writing Group Members; Véronique L. Roger, MD, MPH, FAHA; Alan S. Go, MD; Donald M. Lloyd-Jones, MD, ScM, FAHA; Emelia J. Benjamin, MD, ScM, FAHA; Jarett D. Berry, MD; William B. Borden, MD; Dawn M. Bravata, MD; Shifan Dai, MD, PhD*; Earl S. Ford, MD, MPH, FAHA*; Caroline S. Fox, MD, MPH; Heather J. Fullerton, MD; Cathleen Gillespie, MS*; Susan M. Hailpern, DPH, MS; John A. Heit, MD, FAHA; Virginia J. Howard, PhD, FAHA; Brett M. Kissela, MD; Steven J. Kittner, MD, FAHA; Daniel T. Lackland, DrPH, MSPH, FAHA; Judith H. Lichtman, PhD, MPH; Lynda D. Lisabeth, PhD, FAHA; Diane M. Makuc, DrPH*; Gregory M. Marcus, MD, MAS, FAHA; Ariane Marelli, MD, MPH; David B. Matchar, MD, FAHA; Claudia S. Moy, PhD, MPH; Dariush Mozaffarian, MD, DrPH, FAHA; Michael E. Mussolino, PhD; Graham Nichol, MD, MPH, FAHA; Nina P. Paynter, PhD, MHSc; Elsayed Z. Soliman, MD, MSc, MS; Paul D. Sorlie, PhD; Nona Sotoodehnia, MD, MPH; Tanya N. Turan, MD, FAHA; Salim S. Virani, MD; Nathan D. Wong, PhD, MPH, FAHA; Daniel Woo, MD, MS, FAHA; Melanie B. Turner, MPH on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Summary: Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update.

01 noviembre 2012

EUROPEAN HEARTE JOURNAL. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation

ESC Committee for Practice Guidelines (CPG), Jeroen J. Bax, (CPG Chairperson) (The Netherlands), Helmut Baumgartner, (Germany), Claudio Ceconi, (Italy), Veronica Dean, (France), Christi Deaton, (UK), Robert Fagard, (Belgium), Christian Funck-Brentano, (France), David Hasdai, (Israel), Arno Hoes, (The Netherlands), Paulus Kirchhof, (Germany/UK), Juhani Knuuti, (Finland), Philippe Kolh, (Belgium), Theresa McDonagh, (UK), Cyril Moulin, (France), Bogdan A. Popescu, (Romania), Željko Reiner, (Croatia), Udo Sechtem, (Germany), Per Anton Sirnes, (Norway), Michal Tendera, (Poland), Adam Torbicki, (Poland), Alec Vahanian, (France) and Stephan Windecker, (Switzerland)

The current estimate of the prevalence of atrial fibrillation (AF) in the developed world is approximately 1.5–2% of the general population, with the average age of patients with this condition steadily rising, such that it now averages between 75 and 85 years. The arrhythmia is associated with a five-fold risk of stroke and a three-fold incidence of congestive heart failure, and higher mortality. Hospitalization of patients with AF is also very common. This arrhythmia is a major cardiovascular challenge in modern society and its medical, social and economic aspects are all set to worsen over the coming decades. Fortunately a number of valuable treatments have been devised in recent years that may offer some solution to this problem. Eur Heart J (2012) 33 (21): 2719-2747. doi: 10.1093/eurheartj/ehs253 First published online: August 24, 2012. Copyright © The European Society of Cardiology 2012. All rights reserved.

01 noviembre 2012

EUROPEAN HEART JOURNAL. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Authors/Task Force Members, Ph. Gabriel Steg, (Chairperson) (France), Stefan K. James, (Chairperson) (Sweden)*, Dan Atar, (Norway), Luigi P. Badano, (Italy), Carina Blomstrom Lundqvist, (Sweden), Michael A. Borger, (Germany), Carlo Di Mario, (United Kingdom), Kenneth Dickstein, (Norway), Gregory Ducrocq, (France), Francisco Fernandez-Aviles, (Spain), Anthony H. Gershlick, (United Kingdom), Pantaleo Giannuzzi, (Italy), Sigrun Halvorsen, (Norway), Kurt Huber, (Austria), Peter Juni, (Switzerland), Adnan Kastrati, (Germany), Juhani Knuuti, (Finland), Mattie J. Lenzen, (Netherlands), Kenneth W. Mahaffey, (USA), Marco Valgimigli, (Italy), Arnoud van t Hof, (Netherlands), Petr Widimsky, (Czech Republic) and Doron Zahger, (Israel)

The management of acute myocardial infarction continues to undergo major changes. Good practice should be based on sound evidence, derived from well-conducted clinical trials. Because of the great number of trials on new treatments performed in recent years, and in view of new diagnostic tests, the ESC decided that it was opportune to upgrade the previous guidelines and appointed a Task Force. It must be recognized that, even when excellent clinical trials have been undertaken, their results are open to interpretation and that treatment options may be limited by resources. Indeed, cost-effectiveness is becoming an increasingly important issue when deciding upon therapeutic strategies. Eur Heart J (2012) 33 (20): 2569-2619. doi: 10.1093/eurheartj/ehs215 First published online: August 24, 2012. Copyright © The European Society of Cardiology 2012. All rights reserved.

01 noviembre 2012

EUROPEAN HEART JOURNAL. Guidelines on the management of valvular heart disease (version 2012)

Authors/Task Force Members, Alec Vahanian, (Chairperson) (France)*, Ottavio Alfieri, (Chairperson) (Italy)*, Felicita Andreotti, (Italy), Manuel J. Antunes, (Portugal), Gonzalo Barón-Esquivias, (Spain), Helmut Baumgartner, (Germany), Michael Andrew Borger, (Germany), Thierry P. Carrel, (Switzerland), Michele De Bonis, (Italy), Arturo Evangelista, (Spain), Volkmar Falk, (Switzerland), Bernard Iung, (France), Patrizio Lancellotti, (Belgium), Luc Pierard, (Belgium), Susanna Price, (UK), Hans-Joachim Schäfers, (Germany), Gerhard Schuler, (Germany), Janina Stepinska, (Poland), Karl Swedberg, (Sweden), Johanna Takkenberg, (The Netherlands), Ulrich Otto Von Oppell, (UK), Stephan Windecker, (Switzerland), Jose Luis Zamorano, (Spain) and Marian Zembala, (Poland)

Although valvular heart disease (VHD) is less common in industrialized countries than coronary artery disease (CAD), heart failure (HF), or hypertension, guidelines are of interest in this field because VHD is frequent and often requires intervention.1,2 Decision-making for intervention is complex, since VHD is often seen at an older age and, as a consequence, there is a higher frequency of comorbidity, contributing to increased risk of intervention.1,2 Another important aspect of contemporary VHD is the growing proportion of previously-operated patients who present with further problems.1 Conversely, rheumatic valve disease still remains a major public health problem in developing countries, where it predominantly affects young adults.3 Eur Heart J (2012) 33 (19): 2451-2496. doi: 10.1093/eurheartj/ehs109 First published online: August 24, 2012. Copyright © The European Society of Cardiology 2012. All rights reserved.