Impact of Initial Cardiology Telemedicine Evaluation on Follow-Up Visits for Common Conditions: Quasi-Experimental Study.

Background: Telemedicine use has increased significantly in cardiology clinics, but the impact of initial telemedicine evaluation on total visit usage is unknown.

Objective: This study aimed to determine the effect of initial telemedicine evaluation on the number of follow-up visits within 6 months for common cardiovascular conditions at an academic health system.

Methods: Electronic health records data were extracted for general cardiology visits.

A Case of Postural Orthostatic Tachycardia Syndrome in a 20-Year-Old Female Athlete: Review of Ivabradine Guidelines.

Background: Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by orthostatic intolerance, tachycardia, and syncope. Ivabradine, though not Food and Drug Administration approved for POTS, has shown promise in its management.

Case Summary: A 20-year-old woman with POTS, complicated by multiple comorbidities, experienced a severe functional decline.

Bisphosphonate Use and Cardiovascular Outcomes According to Kidney Function Status in Post-Menopausal Women: An Emulated Target Trial from the Multi-Ethnic Study of Atherosclerosis.

Bisphosphonates may influence vascular calcification and atheroma formation via farnesyl pyrophosphate synthase inhibition in the mevalonate pathway regulating bone and lipid metabolism. However, the clinical impact of NCB use on cardiovascular outcomes remains uncertain, largely due to methodological heterogeneity in prior studies. We aimed to evaluate the association between nitrogen-containing bisphosphonate (NCB) therapy and coronary artery calcium (CAC) progression, as well as the incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) events.

Optimal Mode of Delivery for Individuals With Low-Risk Term Breech Presentation.

Objective: To evaluate the risks of neonatal and maternal adverse outcomes in individuals with low-risk, singleton, term breech presentation associated with vaginal compared with cesarean delivery in a contemporary cohort in the United States.

Methods: We conducted a propensity score analysis to evaluate adverse neonatal and maternal outcomes associated with mode of delivery among individuals with breech presentation at term. We used U.

Visual art and representation in cardiology: Past, present, and future.

Cardiovascular diseases (CVD) have been the leading causes of morbidity and mortality for over three decades, highlighting the necessity of integrating creative methods with traditional and innovative approaches for patient care, education, and prevention. Historically, artistic representations have played a crucial role in shaping our understanding of the anatomy, physiology, and pathologies of the human heart and cardiovascular system. Creative expressions, including visual arts, are linked to improved overall well-being for individuals of all ages.

Performance of the American Heart Association's PREVENT Equations Among Disaggregated Racial and Ethnic Subgroups.

Importance: In the original validation, the Predicting Risk of Cardiovascular Disease (CVD) Events (PREVENT) equations demonstrated good discrimination and calibration among racial and ethnic groups, but the model performance among Asian and Hispanic disaggregated subgroups has not been previously described.

Objective: To assess the performance of the PREVENT equations by race and ethnicity, including disaggregated Asian and Hispanic subgroups.

Design, Setting, And Participants: This was an electronic health record-based retrospective cohort study of primary care patients aged 30 to 79 years across Sutter Health, a large integrated health system in Northern California, from January 2010 to September 2023.

Heart Disease Mortality in the United States, 1970 to 2022.

Background: Studying trends in mortality is essential to advance understanding of population health. Further evaluation of long-term heart disease mortality trends and subtypes in the United States is needed to guide public health and clinical interventions.

Methods: This study used the National Vital Statistics System Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data for adults aged 25 years and older in the United States from 1970 to 2022.

Association between Exposure to Statin Choice and Adherence to Statins: An Observational Cohort Study.

BackgroundStatin Choice is a shared decision-making encounter tool embedded in the electronic health record.ObjectiveTo describe the association between the use of Statin Choice, statin prescriptions by clinicians, prescription fills (primary adherence), and statin adherence at 12 mo (secondary adherence).DesignObservational cohort study at the Cleveland Clinic Health System.

Understanding gastrointestinal bleeding in patients with cardiac disease: an interdisciplinary approach.

Introduction: Cardiovascular disease remains the leading cause of global mortality and a significant contributor to disability. The incidence of gastrointestinal bleeding (GIB) varies across cardiac conditions, with notable risks observed in patients undergoing complex antiplatelet or anticoagulant therapy, acute coronary syndrome, hypertrophic cardiomyopathy, percutaneous coronary interventions, mechanical cardiac support, acute decompensated heart failure, and post-cardiac surgery.

Areas Covered: A comprehensive search of the PubMed/Medline database was conducted to retrieve articles related to GIB and cardiovascular disease from 2014 to 2024.

South Asians and cardiometabolic health: A framework for comprehensive care for the individual, community, and population - An American society for preventive cardiology clinical practice statement.

South Asians (SAs) represent an increasing proportion of North American populations and demonstrate excess cardiometabolic risk. Multiple factors likely contribute; however, much is not yet known about what leads to this excess risk. Diet composition, physical activity, and mental health are important lifestyle contributors.

Performance of convolutional neural network-enhanced electrocardiography in detecting acute coronary syndrome: focusing on subtypes and reduced leads.

Background: Early and accurate diagnosis of acute coronary syndrome (ACS), particularly non-ST-elevation ACS (NSTE-ACS), remains a critical challenge in emergency settings. Despite advancements in diagnostic modalities, conventional electrographic (ECG) interpretation often fails to detect subtle ischemic changes, particularly in NSTE-ACS, highlighting the need for artificial intelligence (AI)-driven approaches.

Methods: This study retrospectively analyzed data from a single-center cohort (Shinken Database 2010-2022, n = 32,167) to develop AI-driven ECG models for ACS detection.

Percutaneous Coronary Intervention Outcomes for Chronic Total Occlusion in Patients on Dialysis: Analysis of the Japanese CTO-PCI Expert Registry.

Background: Patients undergoing dialysis are at a high risk of cardiovascular death, and the prevalence of coronary complex lesions is high.

Aims: This study aimed to analyze the characteristics, outcomes, and adverse events of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI) in patients undergoing dialysis.

Methods: We examined 11,664 patients enrolled in the Japanese CTO-PCI Expert Registry between January 2014 and December 2022.

Utility of convolutional neural network-enhanced electrocardiogram to diagnose and predict mitral regurgitation in patients with chronic atrial fibrillation.

A convolutional neural network (CNN)-enhanced electrocardiogram (ECG) has been reported for detecting mitral regurgitation (MR). This tool may be particularly useful for identifying candidates for echocardiography in patients with chronic atrial fibrillation (AF) to detect atrial functional MR early. The data from a single-center, prospective cohort study (Shinken Database 2010-2017, n = 19,170) were combined with an ECG database.

Stroke Prevention With Oral Anticoagulants in High-Risk Atrial Fibrillation in an Aging Population.

Aging societies will pose unique health challenges in the near future. Elderly and very elderly patients often have complex medical needs, including comorbidities and polypharmacy. Contributing to this, atrial fibrillation (AF) is common among elderly patients.

Win ratio analysis of the LANDMARK trial.

The LANDMARK trial reported the non-inferiority of the Myval transcatheter heart valve (THV) series compared with the contemporary standard THV series (Sapien and Evolut) for a 30-day composite endpoint in patients with severe aortic stenosis. This exploratory study compared the performance of the Myval THV series with the contemporary THV series using the win ratio analysis.

Calcium modification techniques in complex percutaneous coronary intervention: State-of-the-art review.

As patients increase in age and medical complexity, coronary artery calcification is frequently encountered and its presence portends worse outcomes following percutaneous coronary intervention (PCI) - negatively impacting procedural success and long-term outcomes. This review paper explores available imaging techniques and calcium modification technique that can identify, characterize and modify these lesions to facilitate stent implantation. The data supporting these techniques are explored and an algorithm for decision-making during lesion modification is presented.

Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in Patients with Non-ST-Segment Elevation Myocardial Infarction in the United States: Results from Big Data Analysis.

Non-ST-segment elevation myocardial infarction (NSTEMI) can be managed by ischemia guide strategies or early invasive strategies. Here, we present the findings of an updated contemporary analysis regarding the use of intracoronary imaging (ICI)-guided PCI versus angiography-guided PCI and in-hospital mortality in patients with NSTEMI in the United States using the NIS database from 2016 to 2021. ICI use increased by nearly threefold between 2016 and 2021, without a significant difference in in-hospital mortality, though interestingly, mortality rates compared with angiography guidance were similar and relatively low.

Efficacy of Mavacamten in Reducing Cardiac Obstruction in an Elderly Patient with Hypertrophic Cardiomyopathy: A Case Study.

BACKGROUND Mavacamten, a first-in-class cardiac myosin inhibitor, targets myosin adenosine triphosphatase to treat adults with moderate to severe symptomatic obstructive hypertrophic cardiomyopathy. Previous studies have demonstrated an approximate 50% reduction in left ventricular outflow tract pressure gradient in selected patients after 4 weeks of treatment. CASE REPORT We report the case of a 91-year-old man with hypertrophic cardiomyopathy, who presented with a longstanding history of progressive shortness of breath, unresponsive to treatment.

Outcomes of Percutaneous Coronary Intervention in Nonagenarians in the United States.

Background: Although Percutaneous Coronary Intervention (PCI) is the cornerstone treatment acute myocardial infarction (AMI), its use in the elderly, specifically nonagenarians patients, is not well studied. This study sought to compare the outcomes and complications of nonagenarian patients who experienced AMI between those who underwent PCI and those who underwent medical treatment only.

Methods: We evaluated 301,440 nonagenarian (ages 90-99) patients who presented to the hospital with AMI who were listed in the National Inpatient Sample from 2016 to 2021.

Triphasic Changes in Ischemic Stroke Incidence With Age in Non-Valvular Atrial Fibrillation Patients - Pooled Analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry.

Background: The basis for the specific age threshold for increasing of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients has not been fully evaluated.

Methods And Results: We conducted a pooled analysis of 3,588 Japanese NVAF patients without anticoagulation therapy from the Shinken Database (n=1,099), the J-RHYTHM Registry (n=1,002), and the Fushimi AF Registry (n=1,487) to determine the incidence of ischemic stroke by age group; patients aged between 31 and 90 years (n=3,455) were analyzed. During a follow-up period of 1.