Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Mar 2013
Comparative StudyTransluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve.
The purpose of this study was to assess the diagnostic accuracy of TAG320 in predicting functional stenosis severity evaluated by fractional flow reserve (FFR). ⋯ Assessment of TAG320 with a 320-detector row CT provides acceptable prediction of invasive FFR and may provide a noninvasive modality for detecting functionally significant coronary stenoses. Combined TAG320 and CCTA assessment may have incremental predictive value over CCTA alone for detecting functionally significant coronary arterial stenoses; however, larger studies are required to determine the benefit of combined TAG320 and CCTA assessment.
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J. Am. Coll. Cardiol. · Mar 2013
Randomized Controlled Trial Multicenter StudyPrognostic value of cardiac troponin I measured with a highly sensitive assay in patients with stable coronary artery disease.
The aims of this study were to assess the prognostic value of cardiac troponin I levels, measured with a new high-sensitivity assay, in low-risk patients with stable coronary artery disease (CAD) and to contrast its determinants and prognostic merit with that of high-sensitivity cardiac troponin T (hs-TnT). ⋯ In patients with stable CAD, hs-TnI concentrations are associated with cardiovascular risk independently of conventional risk markers and hs-TnT. (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy [PEACE]; NCT00000558).
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This study sought to characterize temporal trends in hospitalizations with heart failure as a primary or secondary diagnosis. ⋯ Although primary heart failure hospitalizations declined, rates of hospitalizations with a secondary diagnosis of heart failure were stable in the past decade. Strategies to reduce the high burden of hospitalizations of heart failure patients should include consideration of both cardiac disease and noncardiac conditions.
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J. Am. Coll. Cardiol. · Mar 2013
Meta AnalysisCost-effectiveness of statins for primary cardiovascular prevention in chronic kidney disease.
The authors sought to evaluate the cost-effectiveness of statins for primary prevention of myocardial infarction (MI) and stroke in patients with chronic kidney disease (CKD). ⋯ Although statins reduce absolute CVD risk in patients with CKD, the increased risk of rhabdomyolysis, and competing risks associated with progressive CKD, partly offset these gains. Low-cost generic statins appear cost-effective for primary prevention of CVD in patients with mild-to-moderate CKD and hypertension.
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J. Am. Coll. Cardiol. · Mar 2013
Contrasting effects of lower body positive pressure on upper airways resistance and partial pressure of carbon dioxide in men with heart failure and obstructive or central sleep apnea.
This study sought to test the effects of rostral fluid displacement from the legs on transpharyngeal resistance (Rph), minute volume of ventilation (Vmin), and partial pressure of carbon dioxide (PCO2) in men with heart failure (HF) and either obstructive (OSA) or central sleep apnea (CSA). ⋯ These findings suggest mechanisms by which rostral fluid shift contributes to the pathogenesis of OSA and CSA in men with HF. Rostral fluid shift could facilitate OSA if it induces pharyngeal obstruction, but could also facilitate CSA if it augments ventilation and lowers PCO2.