Journal of the American College of Cardiology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Clinical and Biological Insights Into Combined Post- and Pre-Capillary Pulmonary Hypertension
ConclusionsPatients with Cpc-PH develop pulmonary vascular disease similar to patients with PAH, despite younger age and similar prevalence of obesity, diabetes mellitus, and left heart disease compared with patients with Ipc-PH. An exploratory genetic analysis in Cpc-PH identified genes and biological pathways in the lung known to contribute to PAH pathophysiology, suggesting that Cpc-PH may be a distinct and highly morbid PH subphenotype. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Anticoagulant-Related Bleeding and Mortality ∗
(Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Causes of Death in Anticoagulated Patients With Atrial Fibrillation
ConclusionsIn contemporary AF trials, most deaths were cardiac-related, whereas stroke and bleeding represented  only a small subset of deaths. Interventions beyond anticoagulation are needed to further reduce mortality in AF. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Surgical Weight Loss and Atrial Fibrillation A Convenient Paradigm to Evaluate a Complex Problem ∗
(Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Bariatric Surgery and the Risk of New-Onset Atrial Fibrillation in Swedish  Obese Subjects
BackgroundObesity is a risk factor for atrial fibrillation, which in turn is associated with stroke, heart failure, and increased all-cause mortality.ObjectivesThe authors investigated whether weight loss through bariatric surgery may reduce the risk of new-onset atrial fibrillation.MethodsSOS (Swedish Obese Subjects) is a prospective matched cohort study conducted at 25 surgical departments and 480 primary healthcare centers in Sweden. The cohort was recruited between 1987 and 2001. Among 4,021 obese  individuals with sinus rhythm and no history of atrial fibrillation, 2,000 underwent bariatric surgery (surgery group), a...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Etiology of Sudden Cardiac Death in Athletes Can Autopsy Clarify All the Issues?
The report by Finocchiaro et  al.(1) provides a valuable occasion for revisiting the difficult task of assigning a potential primary cause and determining the etiology in cases of sudden cardiac death (SCD). Assigning a primary cause usually involves guesswork, and determining the etiology can be even more complex if it is assumed that the etiology is the ultimate nature (e.g., genetic defect) of the immediate cause. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Reply Should Histologic Determination of Amyloid Load Determine Management Decisions in Light-Chain Amyloidosis?
Thank you for giving us the opportunity to respond to the comments of Dr. Ruberg and colleagues regarding our paper(1). They raise some concerns and propose that cardiac magnetic resonance (CMR) with extracellular volume (ECV) determination yields a “truer average” of amyloid load of the entire heart, and that ECV has been shown to strongly correlate with N-terminal pro−brain natriuretic peptide. However, these data were not shown in the referenced paper(2). Dr. Ruberg and colleagues also failed to mention that ECV is based on only 1 short- and 1 long-axis view. Thus, ECV does not reflect the entire heart. (Source: J...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Should Histologic Determination of Amyloid  Load Determine Management Decisions in Light-Chain Amyloidosis?
We read with interest the report of Kristen et  al.(1), in which the prognostic usefulness of histologic amyloid load quantification by endomyocardial biopsy was described. Although the investigators stated that no significant variation was observed between biopsy sites, this observation was not quantified. Our collective experience is that Congo red staining of different biopsy specimens from within the same organ in the same patient can vary greatly in the so-called amyloid load, reflecting the patchy nature of amyloid deposition, which is well described(2) and introduces the likelihood of sampling error. Furthermore, q...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Reply Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed
We are appreciative of Dr. Brown and colleagues and their interest in our recent paper in theJournal(1) regarding prescription of aspirin instead of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) who are at intermediate-to-high thromboembolic risk in the American College of Cardiology National Cardiovascular Data Registry ’s PINNACLE (Practice Innovation and Clinical Excellence) Registry. They appropriately highlight some of our main findings, including that OAC prescription was selected in 61.8% of patients with a CHADS2 score  ≥2 (meaning 38.2% of patients were treated with aspirin alone) and 5...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed
A recent paper by Hsu et  al.(1) assessed antithrombotic treatment among atrial fibrillation (AF) patients. The data, from the American College of Cardiology PINNACLE (Practice Innovation and Clinical Excellence) registry between 2008 and 2012, showed that 61.8% of patients with moderate-to-high stroke risk received anticoagulant therapy with either warfarin or newer direct oral anticoagulants (DOACs). The investigators and an editorial commentary noted the alarming prevalence of aspirin-only treatment despite clear evidence that anticoagulants are superior for prevention of thromboembolism in AF (1,2). (Source: Journal o...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Effect of Remote Ischemic  Preconditioning on Coronary Procedure-Related Impairment of Vascular Dilator Function
In this study we assessed whether RIPC protects against abnormalities of vascular function during coronary procedures. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Treatment With Dalcetrapib Modifies the Relationship Between High-Density Lipoprotein Cholesterol and C-Reactive Protein
Epidemiological data associate higher concentrations of high-density lipoprotein cholesterol (HDL-C) with lower cardiovascular risk. HDL-C isolated from healthy subjects exhibits potentially protective properties, including anti-inflammatory effects(1). However, some evidence suggests that cholesterol-overloaded HDL-C particles may lose protective properties(2), and drugs that raise HDL-C and particle size have thus far not reduced cardiovascular events in patients with established heart disease. Among these agents are inhibitors of cholesteryl ester transfer protein (CETP). These findings raise the question whether HDL-C ...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Obesity Contributes to Exercise Intolerance in Heart Failure With Preserved Ejection Fraction
In this study, we measured aerobic exercise capacity in patients with HFpEF in relation to indices of obesity and adiposity. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

A Test in Context Hemoglobin A 1c and Cardiovascular Disease
Measurement of glycated hemoglobin (HbA1c), the most widely accepted indicator of long-term glycemic exposure, is central for the diagnosis and management of diabetes mellitus. Levels of HbA1c track epidemiologically with diabetic complications, and glycemic control, as reflected by HbA1c reduction, results in decreased risk of microvascular complications, including diabetic kidney disease, neuropathy, and retinopathy. The relationship between HbA1c reduction and cardiovascular disease prevention in patients with diabetes is more complex, with data from large randomized trials published over the past decade providing clear...
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

The Risk Continuum of Atherosclerosis and  its Implications for Defining CHD by Coronary Angiography
Patients undergoing coronary angiography for suspected coronary heart disease who are found to have coronary atherosclerotic disease with   (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research