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Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Assessment and Quantitation of Stent Results by Intracoronary Optical Coherence Tomography Computed tomography angiography-derived extracellular volume fraction predicts early recovery of left ventricular systolic function after transcatheter aortic valve replacement Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative Comprehensive Investigation of Circulating Biomarkers and their Causal Role in Atherosclerosis-related Risk Factors and Clinical Events Impact of Pre-Existing and New-Onset Atrial Fibrillation on Outcomes After Transcatheter Aortic Valve Replacement Prognostic Value of Intravascular Ultrasound in Patients With Coronary Artery Disease Pulmonary artery denervation for treatment of a patient with pulmonary hypertension secondary to left heart disease

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.