Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2013
Randomized Controlled TrialThe ATLAS ACS 2-TIMI 51 trial and the burden of missing data: (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects With Acute Coronary Syndrome ACS 2-Thrombolysis In Myocardial Infarction 51).
Rivaroxaban is a factor Xa inhibitor that was recently reviewed by the Food and Drug Administration as a potential therapy to reduce the risk of recurrent atherothrombotic events in patients with acute coronary syndromes. Approval of this drug would represent a paradigm shift away from dual antiplatelet therapy toward long-term triple antithrombotic therapy. ⋯ Although the primary efficacy endpoint was met, a substantial amount of missing data was observed. We discuss the impact of missing data in this trial, its implications for informative censoring of safety events (major bleeding), and implications for future cardiovascular outcomes trials.
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J. Am. Coll. Cardiol. · Aug 2013
Paradoxical response to exercise in asymptomatic hypertrophic cardiomyopathy: a new description of outflow tract obstruction dynamics.
The purpose of this study was to analyze left ventricular obstruction in patients with hypertrophic cardiomyopathy (HCM) during exercise echocardiography. ⋯ Our study reports a subgroup of HCM patients, designated PRE based on a decreased intraventricular gradient during exercise. The reduced exertional obstruction may account for the better functional class and trend toward fewer clinical events in PRE patients.
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J. Am. Coll. Cardiol. · Aug 2013
Multicenter StudyImpact of low flow on the outcome of high-risk patients undergoing transcatheter aortic valve replacement.
This study sought to assess the impact of baseline left ventricular (LV) outflow, LV ejection fraction (LVEF), and transvalvular gradient on outcomes following transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS). ⋯ Low flow but not low LVEF or low gradient is an independent predictor of early and late mortality following TAVR in high-risk patients with severe AS. SVi should be integrated in the risk stratification process of these patients.
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J. Am. Coll. Cardiol. · Aug 2013
Modeling serum level of s100β and bispectral index to predict outcome after cardiac arrest.
This study was designed to evaluate multimodal prognostication in patients after cardiac arrest (CA). ⋯ Combined determination of serum level of S100β and BIS monitoring accurately predicts outcome after CA.
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J. Am. Coll. Cardiol. · Aug 2013
Multicenter StudyCandidate gene association study of coronary artery calcification in chronic kidney disease: findings from the CRIC study (Chronic Renal Insufficiency Cohort).
This study sought to identify loci for coronary artery calcification (CAC) in patients with chronic kidney disease (CKD). ⋯ We identified several loci associated with CAC in CKD that also relate to MI in a general population sample. CKD imparts a high risk of CHD and may provide a useful setting for discovery of novel CHD genes and pathways.