Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2014
Combining functional and tubular damage biomarkers improves diagnostic precision for acute kidney injury after cardiac surgery.
Increases in serum creatinine (ΔSCr) from baseline signify acute kidney injury (AKI) but offer little granular information regarding its characteristics. The 10th Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) suggested that combining AKI biomarkers would provide better precision for AKI course prognostication. ⋯ Composites of functional and tubular damage biomarkers are superior to ΔSCr for predicting discrete characteristics of AKI.
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J. Am. Coll. Cardiol. · Dec 2014
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
Recent coronary stent placement and noncardiac surgery contribute to the risk of adverse cardiac events, but the relative contributions of these two factors have not been quantified. ⋯ The incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months. Elective, high-risk, inpatient surgery, and patients with DES may benefit most from delay from a 6-month delay after stent placement.
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J. Am. Coll. Cardiol. · Dec 2014
Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure.
Significant tricuspid regurgitation (TR) late after left heart valve procedure is frequent and associated with increased morbidity. Surgical correction carries a significant mortality risk, whereas the impact of TR on survival in these patients is unclear. ⋯ RV dysfunction, but not significant TR, is independently associated with survival late after left heart valve procedure.
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J. Am. Coll. Cardiol. · Dec 2014
Randomized Controlled Trial Multicenter StudyIncidence, predictors, and prognostic impact of late bleeding complications after transcatheter aortic valve replacement.
The incidence and prognostic impact of late bleeding complications after transcatheter aortic valve replacement (TAVR) are unknown. ⋯ MLBCs after TAVR were frequent and associated with increased mortality. Better individualized and risk-adjusted antithrombotic therapy after TAVR is urgently needed in this high-risk population. (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial; NCT00530894).