Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2014
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
Recent coronary stent placement and noncardiac surgery contribute to the risk of adverse cardiac events, but the relative contributions of these two factors have not been quantified. ⋯ The incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months. Elective, high-risk, inpatient surgery, and patients with DES may benefit most from delay from a 6-month delay after stent placement.
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J. Am. Coll. Cardiol. · Dec 2014
Combining functional and tubular damage biomarkers improves diagnostic precision for acute kidney injury after cardiac surgery.
Increases in serum creatinine (ΔSCr) from baseline signify acute kidney injury (AKI) but offer little granular information regarding its characteristics. The 10th Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) suggested that combining AKI biomarkers would provide better precision for AKI course prognostication. ⋯ Composites of functional and tubular damage biomarkers are superior to ΔSCr for predicting discrete characteristics of AKI.
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J. Am. Coll. Cardiol. · Dec 2014
Comparative StudyClinical phenotype and outcome of hypertrophic cardiomyopathy associated with thin-filament gene mutations.
Mild hypertrophy but increased arrhythmic risk characterizes the stereotypic phenotype proposed for hypertrophic cardiomyopathy (HCM) caused by thin-filament mutations. However, whether such clinical profile is different from more prevalent thick-filament-associated disease is unresolved. ⋯ In adult HCM patients, thin-filament mutations are associated with increased likelihood of advanced LV dysfunction and heart failure compared with thick-filament disease, whereas arrhythmic risk in both subsets is comparable. Triphasic LV filling is particularly common in thin-filament HCM, reflecting profound diastolic dysfunction.
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J. Am. Coll. Cardiol. · Dec 2014
Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure.
Significant tricuspid regurgitation (TR) late after left heart valve procedure is frequent and associated with increased morbidity. Surgical correction carries a significant mortality risk, whereas the impact of TR on survival in these patients is unclear. ⋯ RV dysfunction, but not significant TR, is independently associated with survival late after left heart valve procedure.