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Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives

Perspective | By W Batchelor, S Anwaruddin, L Ross et al.

Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing...

Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis

Review Article | By Suchard MA, Schuemie MJ, Krumholz HM et al.

BACKGROUND - Uncertainty remains about the optimal monotherapy for hypertension, with current guidelines recommending any primary agent among the first-line drug classes thiazide or thiazide-like diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, dihydropyridine calcium channel blockers, and non-dihydropyridine calcium channel blockers, in the absence of comorbid indications. Ra...

2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure: A Report of the American College of Cardiology Solution Set Oversight Committee

Consensus | By Hollenberg SM, Warner Stevenson L, Ahmad T

A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus

Consensus | By Farmakis D, Agostoni P, Baholli L et al.

How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Consensus | By Pieske B Tschöpe C, de Boer RA et al.

Making a firm diagnosis of chronic heartfailure with preservedejectionfraction (HFpEF) remains a challenge. We recommend a new stepwise diagnostic process, the 'HFA-PEFFdiagnosticalgorithm'. Step 1 (P=Pre-test assessment) is typically performed in the ambulatory setting and includes assessment for HF symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes mellitus, elderly, atrial fibrilla...

Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

Original Research | By Serruys PW, Morice MC, SYNTAX Investigators.

BACKGROUND - Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating patients with previously untreated three-vessel or left main coronary artery disease (or both). METHODS - We randoml...

Expansion or contraction of stenting in coronary artery disease?

Editorial | By Taggart DP, Pagano D.

In the past four decades, more than 20 trials of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) have tested whether iterative technical advances in PCI have made it as effective as CABG in patients with stable coronary artery disease. The clinical relevance of most of these trials to real-world practice has, however, been plagued by three issues. F...

A Novel Algorithm for Treating Chronic Total Coronary Artery Occlusion

Original Research | By H Tanaka, E Tsuchikane, T Muramatsu et al.

BACKGROUND - Guidewire manipulation time is rarely used in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) strategies.   OBJECTIVES - This study sought to develop an algorithm based on angiographic characteristics and guidewire manipulation time.   METHODS - This study assessed 5,843 patients undergoing CTO PCI between January 2014 and December 2017 and enr...

Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association

| By Noseworthy PA, American Heart Association Council on Clinical Cardiology Electrocardiography and Arrhythmias Committee; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and Stroke Council.

An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction

Original Research | By Attia ZI, Noseworthy PA, Lopez-Jimenez F et al.

BACKGROUND - Atrial fibrillation is frequently asymptomatic and thus underdetected but is associated with stroke, heart failure, and death. Existing screening methods require prolonged monitoring and are limited by cost and low yield. We aimed to develop a rapid, inexpensive, point-of-care means of identifying patients with atrial fibrillation using machine learning. METHODS - We developed an artificial i...

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