Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2011
Comparative StudyDiastolic dysfunction in patients undergoing cardiac surgery: a pathophysiological mechanism underlying the initiation of new-onset post-operative atrial fibrillation.
Our goal was to investigate whether left ventricular (LV) diastolic dysfunction was an important pathophysiological mechanism underlying the initiation of new-onset post-operative atrial fibrillation (POAF). ⋯ LV diastolic dysfunction is a powerful, independent predisposing substrate for the initiation of POAF. Evaluation may be useful during risk stratification of patients undergoing cardiac surgery.
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J. Am. Coll. Cardiol. · Aug 2011
Randomized Controlled TrialThe effect of age on clinical outcomes and health status BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes).
The purpose of this study was to determine the extent to which effectiveness of cardiac and diabetes treatment strategies varies by patient age. ⋯ Among patients with stable heart disease and type 2 diabetes, the relative beneficial effects of a strategy of prompt revascularization versus initial medical therapy and insulin-sensitizing versus insulin-providing therapy on clinical endpoints, symptom relief, and perceived health status outcomes do not vary by age. Health status improved significantly after treatment for all ages, and this improvement was sustained longer among younger patients. (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes [BARI 2D]; NCT00006305).
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J. Am. Coll. Cardiol. · Aug 2011
Multicenter StudyAge- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease.
We examined mortality in relation to coronary artery disease (CAD) as assessed by ≥64-detector row coronary computed tomography angiography (CCTA). ⋯ Among individuals without known CAD, nonobstructive and obstructive CAD by CCTA are associated with higher rates of mortality, with risk profiles differing for age and sex. Importantly, absence of CAD is associated with a very favorable prognosis.
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J. Am. Coll. Cardiol. · Aug 2011
Meta Analysis Comparative StudyCulprit vessel only versus multivessel and staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction: a pairwise and network meta-analysis.
The purposes of this study were to investigate whether, in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD), percutaneous coronary intervention (PCI) should be confined to the culprit or also nonculprit vessels and, when performing PCI for nonculprit vessels, whether it should take place during primary PCI or staged procedures. ⋯ This meta-analysis supports current guidelines discouraging performance of multivessel primary PCI for STEMI. When significant nonculprit vessel lesions are suitable for PCI, they should only be treated during staged procedures.