Review
Cardiac & Cardiovascular Systems
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, Jose A. Joglar, David A. Morrow, Robert E. O'Connor, Michael A. Ross, Leslee J. Shaw
Summary: This clinical practice guideline offers recommendations and algorithms for the assessment and diagnosis of chest pain in adult patients based on contemporary evidence. It focuses on risk stratification and diagnostic evaluation of chest pain, incorporating cost-value considerations in diagnostic testing and recommending shared decision-making with patients.
Review
Cardiac & Cardiovascular Systems
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, Jose A. Joglar, David A. Morrow, Robert E. O'Connor, Michael A. Ross, Leslee J. Shaw
Summary: The clinical practice guideline provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients based on contemporary evidence, emphasizing risk stratification and diagnostic workup, and recommending shared decision-making with patients.
Article
Cardiac & Cardiovascular Systems
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, Jose A. Joglar, David A. Morrow, Robert E. O'Connor, Michael A. Ross, Leslee J. Shaw, Patrick T. O'Gara, Joshua A. Beckman, Glenn N. Levine, Sana M. Al-Kharib, Anastasia L. Armbruster, Ralph G. Brindis, Joaquin E. Cigarroa, Lisa de las Fuentes, Anita Deswal, Dave L. Dixon, Lee A. Fleisher, Adrian F. Hernandez
Summary: This guideline provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients, based on contemporary evidence of risk stratification and diagnostic workup. Cost-value considerations in diagnostic testing have been incorporated, and shared decision-making with patients is recommended.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renee P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, Jose A. Joglar, David A. Morrow, Robert E. O'Connor, Michael A. Ross, Leslee J. Shaw
Summary: This clinical practice guideline provides recommendations and algorithms for evaluating and diagnosing chest pain in adult patients. It includes a comprehensive literature search and considers various types of evidence. The guideline emphasizes evidence-based risk stratification, diagnostic workup, and the importance of shared decision-making with patients.
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
(2022)
Article
Anesthesiology
Kurt Ruetzler, Esra Kutlu Yalcin, Praveen Chahar, Nathaniel R. Smilowitz, Faith Factora, Xuan Pu, Elyad Ekrami, Kamal Maheshwari, Daniel I. Sessler, Alparslan Turan
Summary: The study retrospectively analyzed noncardiac surgical inpatients who experienced postoperative chest pain triggering a multidisciplinary Rapid Response System (RRS) activation. The results indicated that chest pain postoperatively may be a serious sign of myocardial infarction and should be taken seriously.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Medicine, General & Internal
Pal Maurovich-Horvat, Maria Bosserdt, Klaus F. Kofoed, Nina Rieckmann, Theodora Benedek, Patrick Donnelly, Jose Rodriguez-Palomares, Andrejs Erglis, Cyril Stechovsk, Gintare Sakalyte, Nada Cemerlic Adic, Matthias Gutberlet, Jonathan D. Dodd, Ignacio Diez, Gershan Davis, Elke Zimmermann, Cezary Kepka, Radosav Vidakovic, Marco Francone, Malgorzata Ilnicka-Suckiel, Fabian Plank, Juhani Knuuti, Rita Faria, Stephen Schroder, Colin Berry, Luca Saba, Balazs Ruzsics, Christine Kubiak, Inaki Gutierrez-Ibarluzea, Kristian Schultz Hansen, Jacqueline Muller-Nordhorn, Bela Merkely, Andreas D. Knudsen, Imre Benedek, Clare Orr, Filipa Xavier Valente, Ligita Zvaigzne, Vojtech Suchanek, Laura Zajanckauskiene, Flip Adic, Michael Woinke, Mark Hensey, Inigo Lecumberri, Erica Thwaite, Michael Laule, Mariusz Kruk, Aleksandar N. Neskovic, Massimo Mancone, Gudrun Feuchtner, Donata Kugrnierz, Mikko Pietila, Vasco Gama Ribeiro, Tanja Drosch, Christian Delles, Gildo Matta, Michael Fisher, Balint Szilveszter, Linnea Larsen, Mihaela Ratiu, Stephanie Kelly, Bruno Garcia del Blanco, Ainhoa Rubio, Zsofia D. Drobni, Birgit Jurlander, Ioana Rodean, Susan Regan, Hug Cuellar Calabria, Melinda Boussoussou, Thomas Engstrom, Roxana Hodas, Adriane E. Napp, Robert Haase, Sarah Feger, Lina M. Serna-Higuita, Konrad Neumann, Henryk Dreger, Matthias Rief, Viktoria Wieske, Melanie Estrella, Peter Martus, Marc Dewey
Summary: This study compared the effectiveness of CT and ICA in diagnosing obstructive CAD. The results showed that among patients with stable chest pain and intermediate pretest probability of CAD, the risk of major adverse cardiovascular events was similar between the CT group and the ICA group. However, the frequency of major procedure-related complications was lower in the CT group.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Aitor Hernandez-Hernandez, Carles Diez-Lopez, Olga Azevedo, Julian Palomino-Doza, Fernando Alfonso, Maria Eugenia Fuentes-Canamero, Maria Victoria Mogollon Jimenez, Carlos Casanova Rodriguez, Aurora Ruz, Coloma Tiron, Vicente Climent, Pablo Garcia-Pavia
Summary: A study of 663 chest pain patients showed that AFD is rare in patients without obstructive coronary artery disease, with an overall prevalence of only 0.15%. Screening efforts for AFD should not be conducted in this patient population.
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
(2021)
Article
Multidisciplinary Sciences
Min-Kyung Kang, Dong Geum Shin, Donghoon Han, Seonghoon Choi, Jung Rae Cho, Namho Lee
Summary: In patients with elevated cardiac troponin I (cTnI), 60% were diagnosed with coronary artery disease (CAD), 17% were suspected to have microvascular angina (MVA), and the remaining 23% had non-angina (NA). Patients with CAD had elevated blood pressure and slightly decreased heart rate, while those with NA had higher levels of high-density lipoprotein (HDL). Reduced HDL level was independently associated with the presence of CAD.
Article
Cardiac & Cardiovascular Systems
Gaetano Antonio Lanza, Doralisa Morrone, Carmine Pizzi, Isabella Tritto, Luca Bergamaschi, Antonio De Vita, Angelo Villano, Filippo Crea
Summary: Numerous studies have shown that abnormalities in coronary microcirculation may be the cause of acute and chronic cardiac ischemic syndromes. The microvascular origin of myocardial ischemia and angina is considered in clinical practice when patients have normal or near-normal coronary arteries during angiography. This article reviews the diagnostic approach for patients suspected of having coronary microvascular dysfunction as the cause of ischemic syndromes and proposes a classification for chronic and acute microvascular coronary ischemic syndrome, including myocardial infarction with normal coronary arteries.
TRENDS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medical Laboratory Technology
Aldo Clerico, Andrea Padoan, Martina Zaninotto, Claudio Passino, Mario Plebani
Summary: High-sensitivity immunoassays for cardiac troponin I and cardiac troponin T have been recommended as the gold standard laboratory methods for detecting myocardial injury and diagnosing acute myocardial infarction. These methods show favorable biological characteristics and analytical performance, significantly improving the accuracy of the diagnostic process for patients with acute coronary syndromes.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Steven E. S. Miner, Mary C. McCarthy, Chris I. Ardern, Chris G. R. Perry, Olga Toleva, Lynne E. Nield, Cedric Manlhiot, Warren J. Cantor
Summary: Acetylcholine-induced chest pain is associated with symptom burden and objective measures of vascular function, including increased coronary blood flow and decreased microvascular resistance, as well as endothelial dysfunction.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Yader Sandoval, Fred S. Apple, Simon A. Mahler, Richard Body, Paul O. Collinson, Allan S. Jaffe
Summary: The guidelines for the evaluation and diagnosis of acute chest pain released by multiple associations in 2021 provide important recommendations, including the use of high-sensitivity cardiac troponin (hs-cTn) as the preferred biomarker, defining myocardial injury with 99th percentile upper reference limits, and utilizing clinical decision pathways. However, the guidelines do not extensively address the details of integrating hs-cTn into clinical practice, and clinicians need to be aware of analytical aspects related to hs-cTn assays and how to best use it with clinical decision pathways.
Article
Medicine, General & Internal
S. R. Harrison, J. R. L. Klassen, C. Bridgewood, A. Scarsbrook, H. Marzo-Ortega, D. McGonagle
Summary: In 2020, 32.8% of ambulatory patients with suspected pulmonary embolism presenting with chest pain exhibited parenchymal changes, with 7.5% diagnosed as COVID-19 infection based on imaging criteria, despite the absence of other COVID-19 symptoms.
JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Prakriti Gaba, Evald H. Christiansen, Per H. Nielsen, Sabina A. Murphy, Patrick T. O'Gara, Peter K. Smith, Patrick W. Serruys, A. Pieter Kappetein, Seung-Jung Park, Duk-Woo Park, Gregg W. Stone, Joseph F. Sabik, Marc S. Sabatine, Niels R. Holm, Brian A. Bergmark
Summary: Patients with left main coronary artery disease presenting with ACS have higher rates of early death, but the long-term all-cause mortality rates were similar between PCI and CABG in this high-risk subgroup. The advantages and disadvantages of PCI and CABG in terms of early stroke and long-term spontaneous MI and repeat revascularization were consistent regardless of ACS status.
Article
Cardiac & Cardiovascular Systems
Kristian Taekker Madsen, Karsten Tange Veien, Pia Larsen, Majed Husain, Lone Deibjerg, Anders Junker, Martin Weber Kusk, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen, Niels Peter Ronnow Sand
Summary: This study aimed to evaluate the association between CCTA-derived FFRCT and recurrent chest pain in patients with SAP. The results showed that an abnormal FFRCT test result was associated with an increased risk of recurrent chest pain, independent of coronary calcification and stenosis. Additionally, a negative association between per-patient minimal d-FFRCT and recurrent chest pain was demonstrated, highlighting the importance of FFRCT testing in predicting long-term outcomes for patients with SAP.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Carl J. Lavie, Deepak L. Bhatt, Ian J. Neeland, Steven B. Heymsfield
TRENDS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Infectious Diseases
Daniel Pan, Caroline M. Williams, Jonathan Decker, Eve Fletcher, Shirley Sze, Sara Assadi, Richard Haigh, Baber Saleem, Joshua Nazareth, Natalie J. Garton, Manish Pareek, Michael R. Barer
Summary: This study examines the longitudinal patterns of naturally exhaled SARS-CoV-2 RNA viral load during acute infection and the relationship between emitted RNA viral load and household transmission using facemask sampling (FMS). The results show that RNA viral load peaks within the first 5 days following sampling. The study also suggests that FMS can detect high levels of exhaled RNA viral load in early infection and is strongly associated with household transmission.
CLINICAL MICROBIOLOGY AND INFECTION
(2023)
Review
Peripheral Vascular Disease
Samuel C. R. Sherratt, Peter Libby, Matthew J. Budoff, Deepak L. Bhatt, R. Preston Mason
Summary: This review examines the effects of omega-3 fatty acids (n3-FAs) on cardiovascular risk reduction. It has been found that high-purity EPA ethyl ester has significant benefits in reducing cardiovascular events and atherosclerosis progression compared to mixed EPA/DHA treatments. Mechanistic differences between n3-FAs, including membrane interactions, metabolic products, cholesterol efflux, antioxidant properties, and tissue distribution, have been explored.
CURRENT ATHEROSCLEROSIS REPORTS
(2023)
Article
Cardiac & Cardiovascular Systems
Kelley R. H. Branch, Jeffrey L. Probstfield, Jackie Bosch, Deepak L. Bhatt, Aldo P. Maggioni, Eva Muehlhofer, Alvaro Avezum, Petr Widimsky, Stuart J. Connolly, Quilong Yi, Olga Shestakovska, Salim Yusuf, John W. Eikelboom
Summary: Low dose rivaroxaban with aspirin significantly reduces cardiovascular events compared with aspirin alone in patients with cardiovascular disease.
AMERICAN HEART JOURNAL
(2023)
Article
Peripheral Vascular Disease
Shafika Abrahams-Gessel, F. Xavier Gomez-Olive, Stephen Tollman, Alisha N. Wade, Jacques D. Du Toit, Enrico G. Ferro, Chodziwadziwa W. Kabudula, Thomas A. Gaziano
Summary: Over half of the South African adults aged 45 years and older have hypertension, but effective management along the treatment cascade remains poorly understood. However, there were significant improvements in awareness, treatment, and control of hypertension from baseline to follow-up, with women having higher levels of all stages at both time points. Age and healthcare service utilization were predictors of awareness and control of hypertension.
AMERICAN JOURNAL OF HYPERTENSION
(2023)
Article
Cardiac & Cardiovascular Systems
Cesar R. R. Zoni, Debabrata Mukherjee, Martha Gulati
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
(2023)
Letter
Endocrinology & Metabolism
Subodh Verma, Jens-Peter David, Lawrence A. Leiter, Marie Mide Michelsen, Soren Rasmussen, Deepak L. Bhatt
DIABETES OBESITY & METABOLISM
(2023)
Review
Cardiac & Cardiovascular Systems
Davide Cao, Nicolas Amabile, Mauro Chiarito, Victoria T. Lee, Dominick J. Angiolillo, Davide Capodanno, Deepak L. Bhatt, Michael J. Mack, Robert F. Storey, Michael Schmoeckel, C. Michael Gibson, Efthymios N. Deliargyris, Roxana Mehran
Summary: Significant progress has been made in the pharmacological management of cardiovascular disease, but bleeding complications remain common. Therapeutic interventions for antithrombotic drug reversal or removal have shown promising results but require careful consideration of the potential prothrombotic effects and risks associated with withdrawal of antithrombotic protection. There is a need for dedicated clinical investigations to understand the risk tradeoff in urgent high-risk settings, but challenges in trial design exist with practical, financial, and ethical implications.
EUROPEAN HEART JOURNAL
(2023)
Review
Cardiac & Cardiovascular Systems
Gianluigi Bisleri, Arjun K. Pandey, Subodh Verma, Syed M. Ali Hassan, Bobby Yanagawa, Masud Khandaker, Mario Gaudino, Andrea M. Russo, Atul Verma, Deepak L. Bhatt, Andrew C. T. Ha
Summary: Hybrid ablation is a novel therapy that combines minimally invasive surgical and percutaneous catheter-based techniques for the management of atrial fibrillation (AF). Observational studies have shown approximately 70% success rates but higher risks compared to catheter-based ablation. Hybrid ablation is typically offered to patients with persistent or longstanding persistent AF, requiring two procedures. While a randomized trial demonstrated its superiority over catheter-based ablation, it also showed higher complication rates. Contemporary studies have shown a decrease in the incidence of serious complications. Additional randomized trials are needed to determine the risks, benefits, and cost effectiveness of hybrid ablation in clinical practice.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Mark G. Rabbat, Suvasini Lakshmanan, Mina M. Benjamin, Gheorghe Doros, April Kinninger, Matthew J. Budoff, Deepak L. Bhatt
Summary: The EVAPORATE trial demonstrated that IPE significantly reduced plaque burden. This study assessed the impact of IPE on coronary physiology using FFRCT. The results showed that IPE improved coronary distal segment FFRCT, providing mechanistic insight into the clinical benefit observed in the REDUCE-IT trial.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2023)
Article
Cardiac & Cardiovascular Systems
Zainali S. Chunawala, Melissa C. Caughey, Deepak L. Bhatt, Michael Hendrickson, Sameer Arora, Sripal Bangalore, John P. Erwin, Justin P. Levisay, Jonathan R. Rosenberg, Mark J. Ricciardi, Ron Blankstein, Kunihiro Matsushita, Sidney Smith, Arman Qamar
Summary: AMI is not rare among individuals without SMuRFs. The clinical characteristics and prognosis of SMuRFless individuals are not well described. Therefore, personalized prevention and treatment strategies need to be developed for this population.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Samuel C. R. R. Sherratt, Peter Libby, Deepak L. Bhatt, R. Preston Mason
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Subodh Verma, Deepak L. Bhatt, Michael Szarek, Philippe Gabriel Steg, Bertram Pitt
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Vera Bittner, Gregory G. Schwartz, Deepak L. Bhatt, Rafael Diaz, Genevieve Garon, Shaun G. Goodman, Robert A. Harrington, Johan Wouter Jukema, Robert Pordy, Michael Szarek, Harvey D. White, Andreas M. Zeiher, Philippe Gabriel Steg
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Gregory G. Schwartz, Michael Szarek, Deepak L. Bhatt, Vera Bittner, Maja Bujas-Bobanovic, Rafael Diaz, Sergio Fazio, Shaun G. Goodman, Robert A. Harrington, Johan Wouter Jukema, Robert Pordy, Michel Scemama, Harvey D. White, Andreas M. Zeiher, Philippe Gabriel Steg
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
