Subjects -> MEDICAL SCIENCES (Total: 8669 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (218 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (235 journals)
    - DENTISTRY (294 journals)
    - DERMATOLOGY AND VENEREOLOGY (164 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (124 journals)
    - ENDOCRINOLOGY (151 journals)
    - FORENSIC SCIENCES (42 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (188 journals)
    - GERONTOLOGY AND GERIATRICS (138 journals)
    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (176 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (99 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2406 journals)
    - NURSES AND NURSING (367 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (385 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (141 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (170 journals)
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    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

CARDIOVASCULAR DISEASES (338 journals)                  1 2 | Last

Showing 1 - 200 of 338 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 8)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 60)
American Journal of Cardiology     Hybrid Journal   (Followers: 68)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 18)
American Journal of Hypertension     Hybrid Journal   (Followers: 29)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 6)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 4)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 33)
Artery Research     Hybrid Journal   (Followers: 5)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 4)
ASEAN Heart Journal     Open Access   (Followers: 3)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 9)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 11)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 9)
Cardiology in the Young     Hybrid Journal   (Followers: 35)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 11)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 9)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 16)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 103)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 267)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 35)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 10)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 5)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 3)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 5)
Current Cardiology Reports     Hybrid Journal   (Followers: 6)
Current Cardiology Reviews     Hybrid Journal   (Followers: 3)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 13)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 1)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 67)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 7)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 13)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 5)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 2)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 17)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 3)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)

        1 2 | Last

Similar Journals
Journal Cover
European Heart Journal - Quality of Care and Clinical Outcomes
Number of Followers: 0  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2058-5225 - ISSN (Online) 2058-1742
Published by Oxford University Press Homepage  [412 journals]
  • Depression: are patient’s receiving adequate treatment'
    • Authors: May H.
      Pages: 235 - 236
      Abstract: This editorial refers to ‘Cardiovascular hazards of insufficient treatment of depression among patients with known cardiovascular disease: a propensity score adjusted analysis’, by S. Bangalore et al., on page 258.
      PubDate: Fri, 27 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy037
      Issue No: Vol. 4, No. 4 (2018)
       
  • Mineralocorticoid receptor antagonists for heart failure: lost in
           translation'
    • Authors: Lee E; Yan A.
      Pages: 237 - 238
      Abstract: This editorial refers to ‘A real-world cohort study on the quality of potassium and creatinine monitoring during initiation of mineralocorticoid receptor antagonists in patients with heart failure’ by E. Nilsson et al., on page 267.
      PubDate: Sat, 23 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy025
      Issue No: Vol. 4, No. 4 (2018)
       
  • Privacy of patient data in quality-of-care registries in cardiology and
           cardiothoracic surgery: the impact of the new general data protection
           regulation EU-law
    • Authors: Wierda E; Eindhoven D, Schalij M, et al.
      Pages: 239 - 245
      Abstract: AbstractQuality-of-care registries have been shown to improve quality of healthcare and should be facilitated and encouraged. The data of these registries are also very valuable for medical data research. While fully acknowledging the importance of re-using already available data for research purposes, there are concerns about how the applicable privacy legislation is dealt with. These concerns are also articulated in the new European law on privacy, the ‘General Data Protection Regulation’ (GDPR) which has come into force on 25 May 2018. The aim of this review is to examine what the implications of the new European data protection rules are for quality-of-care registries in Europe while providing examples of three quality-of-care registries in the field of cardiology and cardiothoracic surgery in Europe. A general overview of the European and national legal framework (relevant data protection and privacy legislation) applying to quality-of-care registries is provided. One of the main rules is that non-anonymous patient data may, in principle, not be used for research without the patient’s informed consent. When patient data are solely and strictly used for quality control and improvement, this rule does not apply. None of the described registries (NHR, SWEDEHEART, and NICOR) currently ask specific informed consent of patients before using their data in the registry, but they do carry out medical data research. Application of the GDPR implies that personal data may only be used for medical data research after informing patients and obtaining their explicit consent.
      PubDate: Mon, 30 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy034
      Issue No: Vol. 4, No. 4 (2018)
       
  • Variation in preoperative antithrombotic strategy, severe bleeding, and
           use of blood products in coronary artery bypass grafting: results from the
           multicentre E-CABG registry
    • Authors: Biancari F; Mariscalco G, Gherli R, et al.
      Pages: 246 - 257
      Abstract: AbstractAimsNo data exists on inter-institutional differences in terms of adherence to international guidelines regarding the discontinuation of antithrombotics and rates of severe bleeding in coronary artery bypass grafting (CABG).Methods and resultsThis is an analysis of 7118 patients from the prospective multicentre European CABG (E-CABG) registry who underwent isolated CABG in 15 European centres. Preoperative pause of P2Y12 receptor antagonists shorter than that suggested by the 2017 ESC guidelines (overall 11.6%) ranged from 0.7% to 24.8% between centres (adjusted P < 0.0001) and increased the rate of severe-massive bleeding [E-CABG bleeding grades 2–3, OR 1.66, 95% confidence interval (CI) 1.27–2.17; Universal Definition of Perioperative Bleeding (UDPB) bleeding grades 3–4, OR 1.50, 95% CI 1.16–1.93]. The incidence of resternotomy for bleeding (overall 2.6%) ranged from 0% to 6.9% (adjusted P < 0.0001), and surgical site bleeding (overall 59.6%) ranged from 0% to 84.6% (adjusted P = 0.003). The rate of the UDPB bleeding grades 3–4 (overall 8.4%) ranged from 3.7% to 22.3% (P < 0.0001), and of the E-CABG bleeding grades 2–3 (overall 6.5%) ranged from 0.4% to 16.4% between centres (P < 0.0001). Resternotomy for bleeding (adjusted OR 5.04, 95% CI 2.85–8.92), UDPB bleeding grades 3–4 (adjusted OR 6.61, 95% CI 4.42–9.88), and E-CABG bleeding grades 2–3 (adjusted OR 8.71, 95% CI 5.76–13.15) were associated with an increased risk of hospital/30-day mortality.ConclusionsAdherence to the current guidelines on the early discontinuation of P2Y12 receptor antagonists is of utmost importance to reduce excessive bleeding and early mortality after CABG. Inter-institutional variation should be considered for a correct interpretation of the results in multicentre studies evaluating perioperative bleeding and use of blood products.
      PubDate: Sat, 23 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy027
      Issue No: Vol. 4, No. 4 (2018)
       
  • Cardiovascular hazards of insufficient treatment of depression among
           patients with known cardiovascular disease: a propensity score adjusted
           analysis
    • Authors: Bangalore S; Shah R, Pappadopulos E, et al.
      Pages: 258 - 266
      Abstract: AbstractAimsThe association between depression care adequacy and the risk of subsequent adverse cardiovascular disease (CVD) outcomes among patients with a previous diagnosis of myocardial infarction (MI) or stroke is not well defined.Methods and resultsThis retrospective cohort study used commercial claims data (2010–2015) and included adults with newly diagnosed and treated major depressive disorder (MDD) following an initial MI or stroke diagnosis. Depression care adequacy was assessed during the 3-month period following the MDD diagnosis index date using two measures: antidepressant dosage adequacy and duration adequacy. Cox models adjusted for the propensity of receiving adequate depression care were used to compare the risk of a composite CVD outcome (MI, stroke, congestive heart failure, and angina) as well as each individual CVD event between patients receiving adequate vs. inadequate depression care. A total of 1568 patients were included in the final cohort. Of these, 937 (59.8%) were categorized as receiving inadequate depression care based on at least one of the two treatment adequacy criteria. Propensity score adjusted Cox models showed that depression care inadequacy was associated with a significantly higher risk of the composite CVD endpoint [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.04–1.39], stroke (HR 1.20, 95% CI 1.02–1.42), and angina (HR 1.95, 95% CI 1.21–3.16) with no significant interaction based on cohort included (MI vs. stroke) or the definition of inadequate depression (dose vs. duration inadequacy) (Pinteraction > 0.05).ConclusionInadequate MDD care was associated with a higher risk of adverse CVD events. These findings reveal a significant unmet clinical need in patients with post-MI or post-stroke MDD that may impact CVD outcomes.
      PubDate: Tue, 17 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy023
      Issue No: Vol. 4, No. 4 (2018)
       
  • A real-world cohort study on the quality of potassium and creatinine
           monitoring during initiation of mineralocorticoid receptor antagonists in
           patients with heart failure
    • Authors: Nilsson E; De Deco P, Trevisan M, et al.
      Pages: 267 - 273
      Abstract: AbstractAimsClinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our health care.Methods and resultsObservational study in 2007–2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (Days 1–10) and extended (Days 11–90) post-initiation periods. Exclusion criteria considered death/hospitalization within 90 days, and lack of a second MRA dispense. Of 4036 HF patients starting on MRA, 45% were initiated from a hospital, 24% from a primary care centre, and 30% from other private centres. Overall, 89% underwent pre-initiation testing, being more common among hospital (97%) than for primary care (74%) initiations. Only 24% were adequately monitored in all three recommended intervals, being again more frequent following hospital (33%) than private (21%) or primary care (17%) initiations. In multivariable analyses, adequate monitoring was more likely for hospital [odds ratio (OR) 2.85, 95% confidence interval (95% CI) 2.34–3.56] initiations, and for patients with chronic kidney disease (OR 1.79, 95% CI 1.30–2.43) and concomitant use of angiotensin-converting enzyme (OR 1.27, 95% CI 1.05–1.52), angiotensin receptor blockers (OR 1.19, 95% CI 1.01–1.40) or beta-blockers (OR 1.65, 95% CI 1.22–2.26). Age, sex, and prescribing centre explained a small portion of adequate monitoring (c-statistic 0.63). Addition of comorbidities and medications improved prediction marginally (c-statistic 0.65).ConclusionAlthough serum potassium and creatinine monitoring before MRA initiation for HF is frequent, rates of post-initiation monitoring remain suboptimal, especially among primary care centres.
      PubDate: Wed, 02 May 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy019
      Issue No: Vol. 4, No. 4 (2018)
       
  • Use of clinical risk stratification in non-ST elevation acute coronary
           syndromes: an analysis from the CONCORDANCE registry
    • Authors: Bing R; Goodman S, Yan A, et al.
      Pages: 309 - 317
      Abstract: AbstractAimsThere is little information on clinical risk stratification (CRS) compared to objective risk tools in patients with non-ST elevation acute coronary syndromes (NSTEACS). We quantified CRS use, its agreement with Global Registry of Acute Coronary Events (GRACE) risk scores (GRS), and association with outcomes.Methods and resultsData were extracted from the Australian Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events (CONCORDANCE), a multi-centre NSTEACS registry. From February 2009 to December 2015, 4512 patients from 41 sites were included. Predictors of CRS use and association with treatment were identified, CRS–GRS agreement determined and prediction of in-hospital and 6-month mortality compared. Clinical risk stratification was documented in 21% of patients. Family history of coronary disease was the only independent predictor of CRS use [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.04–1.45]; electrocardiogram changes (OR 0.8, 95% CI 0.68–0.96), elevated biomarkers (OR 0.59, 95% CI 0.48–0.73), dementia (OR 0.56, 95% CI 0.36–0.84), and an urban hospital setting (OR 0.41, 95% CI 0.19–0.89) were independent negative predictors. A treatment-risk paradox was observed: high CRS risk patients received less anticoagulation (79% vs. 88%, P = 0.001) and angiography (83% vs. 71%, P < 0.001). CRS–GRS agreement was poor (kappa coefficient = 0.034) and CRS less predictive for in-hospital (c-statistic 0.54 vs. 0.87, P < 0.001) and 6-month (c-statistic 0.55 vs. 0.74, P < 0.01) mortality.ConclusionIn Australia, CRS does not guide treatment, correlate with GRS or predict outcomes. This study suggests the need for greater awareness and integration of validated tools such as the GRACE score to optimally direct treatment and potentially improve outcomes.
      PubDate: Fri, 09 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy002
      Issue No: Vol. 4, No. 4 (2018)
       
  • Does the subtype of acute coronary syndrome treated by percutaneous
           coronary intervention predict long-term clinical outcomes'
    • Authors: Biswas S; Andrianopoulos N, Papapostolou S, et al.
      Pages: 318 - 327
      Abstract: AbstractAims The prognosis of patients undergoing percutaneous coronary intervention (PCI) for different subtypes of acute coronary syndromes (ACS) remains unclear. We compared short- and long-term mortality in patients undergoing PCI for unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).Methods and resultsThis was a retrospective cohort study of 13 184 patients (5966 STEMI, 5307 NSTEMI, and 1911 UA) undergoing PCI between 1 January 2005 and 30 November 2013 in a multi-centre registry. Clinical and procedural characteristics, as well as outcomes, were compared by ACS subtype. Long-term all-cause mortality data were obtained via linkage to the National Death Index (NDI). Patients with STEMI compared with NSTEMI and UA were younger (62.9 ± 12.8 vs. 64.7 ± 12.5 vs. 65.5 ± 11.8 years; P < 0.01), had fewer comorbidities including diabetes, heart failure, and previous myocardial infarction (all P < 0.01). Procedural success was similar across all groups (P = 0.54). In-hospital, 30-day and 1-year all-cause mortality increased significantly from UA to NSTEMI to STEMI patients (1-year mortality 2.5% vs. 4.5% vs. 8.7%; P < 0.01). Kaplan–Meier survival estimates showed increased early mortality in the STEMI group (log-rank P < 0.01). However, after approximately 8.2 years, survival was similar across all groups. In a proportional-odds model using flexible parametric survival modelling, ACS subtype was not an independent predictor of NDI-linked mortality [UA: odds ratio (OR) 0.85, 95% CI 0.71–1.02; STEMI: OR 1.01, 95% confidence interval (CI) 0.88–1.16; NSTEMI as reference category].ConclusionDespite disparate baseline characteristics and differences in short-term mortality, long-term mortality was similar across the spectrum of ACS treated by PCI and contemporary medical therapy.
      PubDate: Wed, 21 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcy009
      Issue No: Vol. 4, No. 4 (2018)
       
  • Kidney function modifies the selection of treatment strategies and
           long-term survival in stable ischaemic heart disease: insights from the
           Alberta Provincial Project for Outcomes Assessment in Coronary Heart
           Disease (APPROACH) registry
    • Authors: Shavadia J; Southern D, James M, et al.
      Pages: 274 - 282
      Abstract: AbstractAimsPatients with chronic kidney disease (CKD) have been under-represented in stable ischaemic heart disease (SIHD) trials despite their heightened risk of cardiovascular mortality. We examine associations between kidney disease, treatment selection, and long-term survival in patients with SIHD.Methods and resultsSIHD patients with angiographically significant stenosis (≥70%) were categorized by renal function [dialysis-dependent, severe CKD [estimated glomerular filtration rate (eGFR) < 30], mild-moderate CKD (eGFR 30–59), and no CKD (eGFR ≥ 60)] and by treatment groups [revascularization ≤3 months of angiogram (percutaneous coronary intervention or coronary artery bypass surgery) vs. medical therapy]. The association between renal function category and treatment on long-term survival was examined and adjusted for differences in age, sex, co-morbidities, and coronary anatomy. Of the 17 910 SIHD patients, 0.7% (n = 118) were dialysis-dependent, 1.2% (n = 215) severe CKD, 12.0% (n = 2157) mild-moderate CKD, and 86.1% (n = 15420) no CKD. The presence of CKD was associated with significantly lower adjusted odds of receiving revascularization [reference no CKD: dialysis-dependent: odds ratio (OR) 0.52 (0.35, 0.79), severe (non-dialysis) CKD: OR 0.54 (0.40, 0.73), and mild-moderate CKD: OR 0.80 (0.71, 0.89)]. Over a median follow-up of 8.0 (interquartile range 3.2) years, patients with progressive CKD had higher long-term mortality (dialysis-dependent, 53.4%; severe CKD, 30.2%; mild-moderate CKD, 22.2%; no CKD, 11.9%, Ptrend < 0.0001). Revascularization was associated with improved long-term survival [adjusted hazard ratio (HR): dialysis-dependent: HR 0.29 (0.15, 0.55), severe CKD: HR 0.63 (0.36, 1.08), mild-moderate CKD: HR 0.49 (0.40, 0.60), and no CKD: HR 0.47 (0.42, 0.52)] (Pinteraction < 0.001).ConclusionIn SIHD, the presence of CKD was accompanied by lower revascularization rates and a higher risk of mortality. However, revascularization in CKD was associated with improved long-term survival.
      PubDate: Thu, 02 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcx042
      Issue No: Vol. 4, No. 4 (2017)
       
  • Risk scoring to guide antiplatelet therapy post-percutaneous coronary
           intervention for acute coronary syndrome results in improved clinical
           outcomes
    • Authors: Antoniou S; Colicchia M, Guttmann O, et al.
      Pages: 283 - 289
      Abstract: AbstractAimsTo use the Global Registry of Acute Coronary Events (GRACE) and Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) scores to risk stratify antiplatelet treatment post-acute coronary syndrome (ACS).Methods and resultsThis was a prospective registry of 3374 patients undergoing percutaneous coronary intervention for ACS between 2013 and 2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified either to clopidogrel therapy or ticagrelor was used. The primary endpoint was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1.8 years (interquartile range 0.8–3.4 years). A total of 1723 (51.1%) patients were risk stratified to either clopidogrel (n = 520) or ticagrelor treatment (n = 1203), with the remaining 1651 not risk scored and treated with clopidogrel therapy. Patients in the risk score stratified group were older than the control group otherwise the groups were similar. Over the follow-up period, a significant reduction in MACE rates between the patients’ risk score stratified and control (clopidogrel therapy) (13.7% vs. 19.7%, P < 0.0001) was seen [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.31–0.86]. This persisted after adjusting for baseline variables (HR 0.65, 95% CI 0.37–0.89) and propensity matching (HR = 0.63, 95% CI 0.27–0.93; P = 0.0015) No significant differences in the rate of major bleeding were seen between the groups (5.3% vs. 5.1%, P = 0.86). In the risk-stratified group, no difference in outcome (ischaemic/bleeding) was seen between clopidogrel and ticagrelor.ConclusionOur registry data suggest that using appropriate risk scoring to guide antiplatelet therapy after ACS is safe and can result in improved clinical outcomes.
      PubDate: Wed, 08 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcx041
      Issue No: Vol. 4, No. 4 (2017)
       
  • Outcome of current and history of cancer on the risk of cardiovascular
           events following percutaneous coronary intervention: a Kumamoto University
           Malignancy and Atherosclerosis (KUMA) study
    • Authors: Tabata N; Sueta D, Yamamoto E, et al.
      Pages: 290 - 300
      Abstract: AbstractAimsWith the advancement in successfully treating different types of cancers, there is an immediate and increased need to focus on the risk and complexity of treating cardiovascular events in cancer survivors. This has led to the emergence of onco-cardiology/cardio-oncology field. We examined the varying incidence of cardiovascular events after percutaneous coronary intervention (PCI) in patients with or without cancer.Methods and resultsParticipants were divided into a non-malignant group and a malignant group, consisting of patients who were receiving or had ever received cancer treatment. The primary endpoint was target lesion revascularization (TLR) within 1 year of PCI. In the patient groups studied, we showed that the malignant group had a significantly higher probability of TLR than the non-malignant group (P = 0.002). Moreover, proportional hazards analyses identified malignancy as an independent predictor of TLR [hazard ratio (HR) 2.28, 95% confidential interval (CI) 1.3–4.0; P = 0.004]. Combining malignancy status with high-sensitivity C-reactive protein levels further increased the HR for TLR (HR 3.01, 95% CI 1.57–5.76; P = 0.001), and the net reclassification improvement was significant (15.2%, 95% CI 4.3–26%; P = 0.02). Time since completion of cancer treatment had an impact on the rate of TLR, with those patients with a current or recent cancer history having more TLR events within 1 year.ConclusionWe demonstrated a significant association between the recent history of cancer and the risk of recurrent coronary atherosclerosis in patients undergoing PCI and showed that malignancy status can predict the likelihood of cardiovascular events following this procedure.
      PubDate: Fri, 01 Dec 2017 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcx047
      Issue No: Vol. 4, No. 4 (2017)
       
  • Low diagnostic yield of non-invasive testing in patients with suspected
           coronary artery disease: results from a large unselected hospital-based
           sample
    • Authors: Therming C; Galatius S, Heitmann M, et al.
      Pages: 301 - 308
      Abstract: AbstractAimsStable angina is the most common presentation of heart disease and has a good prognosis. With declining coronary artery disease (CAD), rates a diagnostic approach balancing costs and benefits is a challenge, particularly in women. This study describes the real-life diagnostic workup in a large hospital to explore whether the diagnostic approach may be improved.Methods and resultsWe identified 4028 patients free of CAD, referred for and assessed with non-invasive (NIT) or invasive test for stable suspected CAD in 2012–15. In both the sexes, the majority (>85%) presented with chest pain as primary symptom. Women had more non-angina (60.2 vs. 54.5%) and less typical angina (8.2 vs. 11.8%, P < 0.001). Despite a mean pretest probability of 20.9% in women and 45.1% in men (P < 0.001), only 69 (3.1%) women and 190 men (10.4%) were diagnosed with obstructive CAD. In all, 93% underwent a NIT and 80% of these were normal. Among the 1238 men and 1595 women with non-angina or dyspnoea, only 6.1% and 2.9%, respectively, had positive NIT. After multiple adjustments, women remained less likely to have positive NIT [odds ratio (OR) 0.42 95% confidence interval (95% CI 0.32–0.56)] and given a positive test also less likely to have obstructive CAD [OR 0.30 (0.17–0.52)]. The C-statistics for predicting positive NIT was 0.77 (0.72–0.82) in women and 0.77 (0.74–0.80) in men.ConclusionThese data confirm the very low diagnostic yield of non-invasive and invasive assessment of CAD in current clinical practice, particularly in women and in patients with atypical symptoms. Data call for a more rational approach to avoid unnecessary testing.
      PubDate: Mon, 18 Dec 2017 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcx048
      Issue No: Vol. 4, No. 4 (2017)
       
  • Effectiveness and safety of rivaroxaban vs. warfarin in patients 80+ years
           of age with non-valvular atrial fibrillation
    • Authors: Coleman C; Weeda E, Nguyen E, et al.
      Pages: 328 - 329
      Abstract: Non-valuvular atrial fibrillation (NVAF) is common among the elderly; with >50% NVAF patients being ≥80 years of age.1 Despite this fact, patients ≥80 years of age are often under-represented in trials, with only ∼one-third of patients enrolled in the four landmark NVAF trials of the non-vitamin K oral anticoagulants (OAC) being ≥75 years of age.2
      PubDate: Tue, 07 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ehjqcco/qcx044
      Issue No: Vol. 4, No. 4 (2017)
       
 
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