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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Kristian A., Øvrehus , Jesper K., Jensen , Hans F., Mickley , Henrik, Munkholm , Morten, Bøttcher , …

In patients suspected of having coronary artery disease (CAD), we compared the diagnostic sensitivity and specificity of exercise testing using ST-segment changes alone and ST-segment changes, angina pectoris, and hemodynamic variables compared to coronary computed tomographic angiography (CTA). Quantitative invasive coronary angiography was the reference method (>50% coronary lumen reduction). A positive exercise test was defined as the development of significant ST-segment changes (≥1 mV measured 80 ms from the J-point), and the occurrence of one or more of the following criteria: ST-segment changes ≥1 mV measured 80 ms from the J-point, angina pectoris, ventricular arrhythmia (the occurrence of ≥3…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Fleur R., de Graaf , Joanne D., Schuijf , Joëlla E., van Velzen , Lucia J., Kroft , Albert de, Roos , …

Multidetector computed tomographic coronary angiography (CTA) image quality is inversely related to the heart rate (HR). As a result beta-blocking medication is routinely administered before investigation. In the present study, the use, contraindications, and efficacy of prescan beta blockade with regard to HR reduction and CTA image quality were assessed. In 537 patients referred for CTA, the baseline HR and blood pressure were measured on arrival, and contraindications for beta blockade were noted. Unless contraindicated, a single dose of metoprolol was administered orally 1 hour before data acquisition in patients with a HR of ≥65 beats/min according to a predefined…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Charles J., Glueck , Jitender, Munjal , Ayub, Khan , Muhammad, Umar , Ping, Wang

Because the endothelial nitric oxide synthase (eNOS) T-786C polymorphism is associated with reduced nitric oxide production and coronary artery spasm in Japanese patients, we speculated that it might be reversibly associated with Prinzmetal’s variant angina in white Americans. Polymerase chain reaction analyses of eNOS T-786C and stromelysin 5A6A polymorphisms were done in 31 women and 12 men (42 white and 1 black American, median age 50 years), with well-documented Prinzmetal’s variant angina. We matched each case with 1 healthy control by race and gender. Of the 43 cases, 21 (49%) were homozygous for wild-type normal eNOS, 19 (44%) were T-786C…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Victor Y., Cheng , Arik, Wolak , Ariel, Gutstein , Heidi, Gransar , Nathan D., Wong , …

We sought to determine significant relations between atherogenic lipoproteins and the contribution of calcified plaque (CP), mixed plaque (MP), and noncalcified plaque (NCP) to the total plaque (TP) burden in patients without previous coronary artery disease. From 823 adult patients without previously established coronary artery disease (52% receiving statin therapy, 34% asymptomatic) but with visible coronary plaque on coronary computed tomographic angiography, we obtained segmental CP, MP, NCP, and TP counts from contrast-enhanced, electrocardiographic-gated computed tomography. Multivariate linear regression analysis was used to determine the associations of clinical factors and lipoprotein levels to CP, MP, and NCP counts and CP/TP,…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Gregory A., Nichols , Fang, Wang , Kathryn L., Pedula

Landmark studies have proved that several therapies reduce cardiovascular disease (CVD) risk; however, the rates of secondary CVD in the context of therapies delivered according to current guidelines are largely unknown. Therefore, we sought to estimate the incidence of secondary CVD hospitalizations and all-cause mortality among patients who did and did not receive guideline-level pharmacotherapy. For the 12,278 patients added to the Kaiser Permanente, Northwest CVD registry in 2000 to 2005, we used the pharmacy records to define guideline-level care (GLC) as at least one dispense of aspirin/antiplatelets, statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and β blockers within…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Jochen, Wöhrle , Nico, Merkle , Volker, Mailänder , Thorsten, Nusser , Peter, Schauwecker , …

To assess the effect of autologous bone-marrow cell (BMC) therapy in patients with acute myocardial infarction in a rigorous double-blind, randomized, placebo-controlled trial. Patients with reperfusion >6 hours after symptom onset were randomly assigned in a 2:1 ratio to receive intracoronary BMC or placebo therapy 5 to 7 days after symptom onset. The patients were stratified according to age, acute myocardial infarction localization, and left ventricular (LV) function. Rigorous double-blinding was ensured using autologous erythrocytes for the placebo preparation that was visually indistinguishable from the active treatment. Serial cardiac magnetic resonance imaging studies were performed before study therapy and after…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Asmir I., Syed , Itsik, Ben-Dor , Yanlin, Li , Sara D., Collins , Manuel A., Gonzalez , …

Patients with diabetes mellitus (DM) are at a greater risk of mortality and cardiovascular events after percutaneous coronary intervention than those without DM. We aimed to determine whether differences exist in the long-term mortality of patients with versus without DM who present with acute myocardial infarction and receive drug-eluting stents. Data were collected on 161 patients with and 395 without DM referred for primary percutaneous coronary intervention for acute myocardial infarction and treated with drug-eluting stents. The patients with cardiac arrest or cardiogenic shock were excluded. The 1-year major cardiac event (MACE) rates, defined as death, Q-wave myocardial infarction, or…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Michael A., Gaglia Jr. , Rebecca, Torguson , Nicholas, Hanna , Manuel A., Gonzalez , Sara D., Collins , …

Recent evidence has shown that clopidogrel and proton pump inhibitors (PPIs) are metabolized by the same pathway and that patients taking both drugs have greater levels of platelet reactivity and more adverse outcomes than patients taking only clopidogrel. We sought to examine the effect of a PPI at discharge from the hospital after percutaneous coronary intervention with drug-eluting stents on the incidence of major adverse cardiac events (MACE) at 1 year. We compared 502 patients who were not prescribed a PPI at discharge and 318 patients who were prescribed a PPI. All patients were taking clopidogrel. We followed patients for…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Kemal, Akat , Jens Johannes, Kaden , Fabian, Schmitz , Silke, Ewering , Anja, Anton , …

Data suggest a link of aortic stenosis (AS) with calcium and bone metabolism. To further investigate this, the following parameters were analyzed in 38 patients with severe AS and in 38 age- and gender-matched controls, without obstructive coronary artery disease and with preserved renal function: calcium, phosphate, 1,25(OH2)-vitamin D3, intact parathyroid hormone (iPTH), and osteoprotegerin. Patients with AS had significantly higher serum levels of calcium (2.63 ± 0.28 vs 2.48 ± 0.23 mmol/L, p <0.01) and phosphate (1.56 ± 0.33 vs 1.38 ± 0.26 mmol/L, p <0.01) and increased calcium-phosphorus products (4.16 ± 1.13 vs 3.44 ± 0.89 mmol/L2, p…

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Publication year: 2010
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 5 February 2010

Adam, Parr , Petra, Buttner , Anwar, Shahzad , Jonathan, Golledge

In patients with peripheral artery disease, aortic calcific deposits are a common finding. The aim of this study was to assess the association of infrarenal abdominal aortic calcific deposits with prospective cardiovascular events in patients with peripheral artery disease. A consecutive series of 213 patients who presented for investigation of abdominal aortic aneurysm or intermittent claudication were assessed using computed tomographic angiography. Infrarenal abdominal aortic calcific deposits were estimated using a previously defined highly reproducible semiautomated program. Patients were followed prospectively for a median of 2.8 years (interquartile range 1.7 to 3.6), and cardiovascular events were recorded. Kaplan-Meier and Cox…

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