Journal of the American Heart Association
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Background Sugar-sweetened beverages are associated with hypertension. We assessed the relation of important food sources of fructose-containing sugars with incident hypertension using a systematic review and meta-analysis of prospective cohort studies. Methods and Results We searched MEDLINE, EMBASE, and Cochrane (through December week 2, 2018) for eligible studies. ⋯ Further research is needed to improve our estimates and better understand the dose-response relationship between food sources of fructose-containing sugars and hypertension. Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02702375.
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Comparative Study
Low-Dose Aspirin for Primary Prevention of Cardiovascular Disease: Use Patterns and Impact Across Race and Ethnicity in the Southern Community Cohort Study.
Background Data are limited on use patterns of low-dose aspirin and its role for primary prevention of cardiovascular disease (CVD) in different racial and ethnic groups. Methods and Results Overall, 65 231 non-Hispanic black and white people aged 40 to 79 years with no history of CVD enrolled from 2002 through 2009 in the SCCS (Southern Community Cohort Study). At cohort entry, the simplified Framingham 10-year CVD risk was calculated, and data related to low-dose aspirin use and clinical and socioeconomic covariates were collected. ⋯ Conclusions Low-dose aspirin use for primary prevention of CVD is lower among black than white patients. Its use might be associated with a disparate impact on ischemic cardiac death according to race and ethnicity. Although additional studies are required, these findings provide no evidence of a beneficial effect of aspirin among black patients for CVD primary prevention.
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Comparative Study
Retrospective Study Using Computed Tomography to Compare Sufficient Chest Compression Depth for Cardiopulmonary Resuscitation in Obese Patients.
Background This study aimed to investigate the relationship between body mass index (BMI) and sufficient chest compression depth (CCD) in obese patients by a mathematical model. Methods and Results This retrospective analysis was performed with chest computed tomography images conducted between 2006 and 2018. We classified the selected individuals into underweight (<18.5), normal weight (≥18.5, <25), overweight (≥25, <30), and obese (≥30) groups according to BMI (kg/m2). ⋯ The proportion of under-HCF with both depths increased according to BMI group, whereas the proportion of over-HCF decreased except for the 5 cm depth (P<0.001). The adjusted odds ratio of under-HCF, according to BMI group after adjustment of age and sex, was 7.325 (95% CI, 3.412-15.726; P<0.001), with 5 cm and 10.517 (95% CI, 2.353-47.001; P=0.002) with 6 cm depth, respectively. Conclusions The recommended chest compression depth of 5 to 6 cm in the current international guideline is unlikely to provide sufficient ejection fraction during cardiopulmonary resuscitation in obese patients.
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Observational Study
Feasibility of Pre-Hospital Resuscitative Endovascular Balloon Occlusion of the Aorta in Non-Traumatic Out-of-Hospital Cardiac Arrest.
Background Few patients survive after out-of-hospital cardiac arrest and any measure that improve circulation during cardiopulmonary resuscitation is beneficial. Animal studies support that resuscitative endovascular balloon occlusion of the aorta (REBOA) during cardiopulmonary resuscitation might benefit patients suffering from out-of-hospital cardiac arrest, but human data are scarce. Methods and Results We performed an observational study at the helicopter emergency medical service in Trondheim (Norway) to assess the feasibility and safety of establishing REBOA in patients with out-of-hospital cardiac arrest. ⋯ The significant increase in end-tidal CO2 after occlusion suggests improved organ circulation during cardiopulmonary resuscitation. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03534011.
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Background Takotsubo syndrome (TTS) mimics acute myocardial infarction in the absence of culprit coronary artery disease and is more common in women. Spontaneous coronary artery dissection (SCAD) shares a predilection for women, can result in left ventricular wall motion abnormalities similar to TTS, and may manifest subtle angiographic findings. The aim of this study was to determine the frequency of SCAD misdiagnosed as TTS. ⋯ Conclusions Among patients with a provisional diagnosis of TTS, definite SCAD in the left anterior descending coronary artery was present in 2.5% of cases, and coronary angiography was indeterminate for SCAD in an additional 9%. Careful review of coronary angiography may avoid missed diagnoses of SCAD in patients with myocardial infarction, nonobstructive coronary arteries, and wall motion abnormalities consistent with TTS. Intracoronary imaging maybe considered to establish a definitive diagnosis of SCAD when angiography is inconclusive.