Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Apr 2019
Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock.
There are limited data on acute noncardiac multiorgan failure in cardiogenic shock complicating acute myocardial infarction (AMI-CS). ⋯ There has been a steady increase in the prevalence of multiorgan failure in AMI-CS. Presence of multiorgan failure was independently associated with higher in-hospital mortality and greater resource utilization.
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J. Am. Coll. Cardiol. · Apr 2019
Characterization and Management of Arrhythmic Events in Young Patients With Brugada Syndrome.
Information on young patients with Brugada syndrome (BrS) and arrhythmic events (AEs) is limited. ⋯ Young BrS patients with AE represent a very arrhythmogenic group. Current management after first arrhythmia episode is associated with high recurrence rate. Alternative therapies, besides defibrillator implantation, should be considered.
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J. Am. Coll. Cardiol. · Mar 2019
Randomized Controlled TrialB-Type Natriuretic Peptide During Treatment With Sacubitril/Valsartan: The PARADIGM-HF Trial.
Natriuretic peptides are substrates of neprilysin; hence, B-type natriuretic peptide (BNP) concentrations rise with neprilysin inhibition. Thus, the clinical validity of measuring BNP in sacubitril/valsartan-treated patients has been questioned, and use of N-terminal pro-B-type natriuretic peptides (NT-proBNP) has been preferred and recommended. ⋯ Circulating levels of BNP may increase meaningfully early after initiation of sacubitril/valsartan. In comparison, NT-proBNP is not a substrate of neprilysin inhibition, and thus may lead to less clinical confusion when measured within 8 to 10 weeks of drug initiation. However, during treatment, either biomarker predicts the risk of major adverse outcomes in patients treated with angiotensin receptor-neprilysin inhibitors. (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF]; NCT01035255).
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J. Am. Coll. Cardiol. · Mar 2019
Detection and Prediction of Bioprosthetic Aortic Valve Degeneration.
Bioprosthetic aortic valve degeneration is increasingly common, often unheralded, and can have catastrophic consequences. ⋯ 18F-fluoride PET-CT identifies subclinical bioprosthetic valve degeneration, providing powerful prediction of subsequent valvular dysfunction and highlighting patients at risk of valve failure. This technique holds major promise in the diagnosis of valvular degeneration and the surveillance of patients with bioprosthetic valves. (18F-Fluoride Assessment of Aortic Bioprosthesis Durability and Outcome [18F-FAABULOUS]; NCT02304276).
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J. Am. Coll. Cardiol. · Mar 2019
Editorial CommentPrecision Medicine for Heart Failure: Back to the Future.