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Association of Reduced Apical Untwisting With Incident HF in Asymptomatic Patients With HF Risk Factors Intravascular ultrasound guidance improves clinical outcomes during implantation of both first- and second-generation drug-eluting stents: a meta-analysis Utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention for type C lesions The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation) Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial

PerspectiveVolume 76, Issue 13, September 2020

JOURNAL:J Am Coll Cardiol. Article Link

Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives

DE Forman, JA de Lemos, and for the Geriatric Cardiology Section Leadership Council. Keywords: aging; biomarkers; cardiovascular testing; imaging; shared decision making; stress testing

ABSTRACT

Whereas the burgeoning population of older adults is intrinsically vulnerable to cardiovascular disease, the utility of many management precepts that were validated in younger adults is often unclear. Whereas biomarker- and imaging-based tests are a major part of cardiovascular disease care, basic assumptions about their use and efficacy cannot be simply extrapolated to many older adults. Biology, physiology, and body composition change with aging, with important influences on cardiovascular disease testing procedures and their interpretation. Furthermore, clinical priorities of older adults are more heterogeneous, potentially undercutting the utility of testing data that are collected. The American College of Cardiology and the National Institutes on Aging, in collaboration with the American Geriatrics Society, convened, at the American College of Cardiology Heart House, a 2-day multidisciplinary workshop, “Diagnostic Testing in Older Adults with Cardiovascular Disease,” to address these issues. This review summarizes key concepts, clinical limitations, and important opportunities for research.