Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter Study Observational StudyThromboembolic Risk After Atriopulmonary, Lateral Tunnel, and Extracardiac Conduit Fontan Surgery.
Thromboembolic events contribute greatly to morbidity and mortality following Fontan surgery for univentricular hearts. ⋯ The EC Fontan was independently associated with a lower thromboembolic risk after controlling for time-varying effects of atrial arrhythmias and thromboprophylaxis.
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J. Am. Coll. Cardiol. · Aug 2019
Long-Term Results of Mitral Valve Repair for Regurgitation Due to Leaflet Prolapse.
Mitral valve (MV) repair has become the standard therapy for mitral regurgitation (MR) due to degenerative diseases, but information on late outcomes is limited. ⋯ MV reoperation was uncommon after MV repair, but there was an increasing incidence of recurrent MR, TR, and new AF over time.
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J. Am. Coll. Cardiol. · Aug 2019
Practice Guideline Comparative StudyImpact of Physiologic Pacing Versus Right Ventricular Pacing Among Patients With Left Ventricular Ejection Fraction Greater Than 35%: A Systematic Review for the 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
It is unclear whether physiologic pacing by either cardiac biventricular pacing (BiVP) or His bundle pacing (HisBP) may prevent adverse structural and functional consequences known to occur among some patients who receive right ventricular pacing (RVP). ⋯ Among patients with LVEF >35%, the LVEF remained preserved or increased with either BiVP or HisBP compared with RVP. However, patient-centered clinical outcome improvement appears to be limited primarily to patients who have chronic atrial fibrillation with rapid ventricular response rates and have undergone atrioventricular node ablation.
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter StudyPredicting Major Adverse Events in Patients With Acute Myocardial Infarction.
Early and accurate detection of short-term major adverse cardiac events (MACE) in patients with suspected acute myocardial infarction (AMI) is an unmet clinical need. ⋯ The ESC hs-cTn 0/1 h algorithm better balanced efficacy and safety in the prediction of MACE, whereas the extended algorithm is the preferred option for the rule-out of 30-day MACE + UA. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE]; NCT00470587).
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter StudyDigoxin Discontinuation and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction.
The deleterious effects of discontinuation of digoxin on outcomes in ambulatory patients with chronic heart failure (HF) with reduced ejection fraction (HFrEF) receiving angiotensin-converting enzyme inhibitors are well-documented. ⋯ Among hospitalized older patients with HFrEF on more contemporary guideline-directed medical therapies, discontinuation of pre-admission digoxin therapy was associated with poor outcomes.