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Coronary Artery Disease: HELP
Articles from US Dept of Health and Human Services
Based on 250 articles published since 2008

These are the 250 published articles about Coronary Artery Disease that originated from US Dept of Health and Human Services during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Editorial Bridging the Sex Gap in Early Myocardial Infarction Mortality: Why It Matters. 2017

Cook, Nakela L. ·From the Immediate Office of the Director, National Heart, Lung, and Blood Institute, Bethesda, MD. nakela.cook@nih.gov. ·Circ Cardiovasc Qual Outcomes · Pubmed #29246885.

ABSTRACT: -- No abstract --

2 Editorial Cholesterol Lowering in 2015: Still Answering Questions About How and in Whom. 2015

Greenland, Philip / Lauer, Michael S. ·Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois2Senior Editor, JAMA. · Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland. ·JAMA · Pubmed #26172891.

ABSTRACT: -- No abstract --

3 Editorial Reducing the burden of disease and death from familial hypercholesterolemia: a call to action. 2014

Knowles, Joshua W / O'Brien, Emily C / Greendale, Karen / Wilemon, Katherine / Genest, Jacques / Sperling, Laurence S / Neal, William A / Rader, Daniel J / Khoury, Muin J. ·Stanford University School of Medicine and Cardiovascular Institute, Stanford, CA; The FH Foundation, South Pasadena, CA. · Duke Clinical Research Institute, Durham, NC. Electronic address: emily.obrien@duke.edu. · The FH Foundation, South Pasadena, CA. · McGill University, Montreal, Canada. · Emory University School of Medicine, Atlanta, GA. · West Virginia University, Morgantown, WV. · University of Pennsylvania, Philadelphia, PA. · Office of Public Health Genomics, Centers for Disease Control & Prevention, Atlanta, GA. ·Am Heart J · Pubmed #25458642.

ABSTRACT: Familial hypercholesterolemia (FH) is a genetic disease characterized by substantial elevations of low-density lipoprotein cholesterol, unrelated to diet or lifestyle. Untreated FH patients have 20 times the risk of developing coronary artery disease, compared with the general population. Estimates indicate that as many as 1 in 500 people of all ethnicities and 1 in 250 people of Northern European descent may have FH; nevertheless, the condition remains largely undiagnosed. In the United States alone, perhaps as little as 1% of FH patients have been diagnosed. Consequently, there are potentially millions of children and adults worldwide who are unaware that they have a life-threatening condition. In countries like the Netherlands, the United Kingdom, and Spain, cascade screening programs have led to dramatic improvements in FH case identification. Given that there are currently no systematic approaches in the United States to identify FH patients or affected relatives, the patient-centric nonprofit FH Foundation convened a national FH Summit in 2013, where participants issued a "call to action" to health care providers, professional organizations, public health programs, patient advocacy groups, and FH experts, in order to bring greater attention to this potentially deadly, but (with proper diagnosis) eminently treatable, condition.

4 Editorial Coronary computed tomographic angiography and incidental pulmonary nodules. 2014

Bluemke, David A. ·From the National Institutes of Health, Bethesda, MD. bluemked@nih.gov. ·Circulation · Pubmed #25015341.

ABSTRACT: -- No abstract --

5 Editorial Computed tomography perfusion to assess physiological significance of coronary stenosis in the post-FAME era (Fractional Flow Reserve versus Angiography for Multivessel Evaluation). 2013

Arai, Andrew E. ·Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. Electronic address: araia@nih.gov. ·J Am Coll Cardiol · Pubmed #23773869.

ABSTRACT: -- No abstract --

6 Review Imaging the myocardial ischemic cascade. 2018

Stillman, Arthur E / Oudkerk, Matthijs / Bluemke, David A / de Boer, Menko Jan / Bremerich, Jens / Garcia, Ernest V / Gutberlet, Matthias / van der Harst, Pim / Hundley, W Gregory / Jerosch-Herold, Michael / Kuijpers, Dirkjan / Kwong, Raymond Y / Nagel, Eike / Lerakis, Stamatios / Oshinski, John / Paul, Jean-François / Slart, Riemer H J A / Thourani, Vinod / Vliegenthart, Rozemarijn / Wintersperger, Bernd J. ·Department of Radiology and Imaging Sciences, Emory University, 1365 Clifton Rd NE, Atlanta, GA, 30322, USA. aestill@emory.edu. · Center of Medical Imaging, University Medical Center Groningen, Groningen, The Netherlands. · Department of Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA. · Department of Cardiology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands. · Department of Radiology, University of Basel Hospital, Basel, Switzerland. · Department of Radiology and Imaging Sciences, Emory University, 1365 Clifton Rd NE, Atlanta, GA, 30322, USA. · Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany. · Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands. · Departments of Internal Medicine & Radiology, Wake Forest University, Winston-Salem, NC, USA. · Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA. · Department of Radiology, Haaglanden Medical Center, The Hague, The Netherlands. · Department of Cardiology, Brigham and Women's Hospital, Boston, MA, USA. · Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital, Frankfurt/Main, Germany. · Department of Medicine, Emory University, Atlanta, GA, USA. · Department of Radiology, Institut Mutualiste Montsouris, Paris, France. · Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Georgetown University, Washington, DC, USA. · Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands. · Department of Medical Imaging, University of Toronto, Toronto, Canada. ·Int J Cardiovasc Imaging · Pubmed #29556943.

ABSTRACT: Non-invasive imaging plays a growing role in the diagnosis and management of ischemic heart disease from its earliest manifestations of endothelial dysfunction to myocardial infarction along the myocardial ischemic cascade. Experts representing the North American Society for Cardiovascular Imaging and the European Society of Cardiac Radiology have worked together to organize the role of non-invasive imaging along the framework of the ischemic cascade. The current status of non-invasive imaging for ischemic heart disease is reviewed along with the role of imaging for guiding surgical planning. The issue of cost effectiveness is also considered. Preclinical disease is primarily assessed through the coronary artery calcium score and used for risk assessment. Once the patient becomes symptomatic, other imaging tests including echocardiography, CCTA, SPECT, PET and CMR may be useful. CCTA appears to be a cost-effective gatekeeper. Post infarction CMR and PET are the preferred modalities. Imaging is increasingly used for surgical planning of patients who may require coronary artery bypass.

7 Review Bayesian Analysis: A Practical Approach to Interpret Clinical Trials and Create Clinical Practice Guidelines. 2017

Bittl, John A / He, Yulei. ·From the Munroe Regional Medical Center, Ocala, FL (J.A.B.) · and Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (Y.H.). ·Circ Cardiovasc Qual Outcomes · Pubmed #28798016.

ABSTRACT: Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on

8 Review Bridging the gap for lipid lowering therapy: plaque regression, coronary computed tomographic angiography, and imaging-guided personalized medicine. 2017

Kwan, Alan C / Aronis, Konstantinos N / Sandfort, Veit / Blumenthal, Roger S / Bluemke, David A. ·a Department of Medicine , Johns Hopkins University School of Medicine , Baltimore , MA , USA. · b Radiology and Imaging Sciences, Department of the National Institutes of Health , Bethesda , MD , USA. · c Department of Cardiology , Johns Hopkins University School of Medicine , Baltimore , MA , USA. ·Expert Rev Cardiovasc Ther · Pubmed #28657444.

ABSTRACT: INTRODUCTION: Lipid-lowering therapy effectively decreases cardiovascular risk on a population level, but it remains difficult to identify an individual patient's personal risk reduction while following guideline directed medical therapy, leading to overtreatment in some patients and cardiovascular events in others. Recent improvements in cardiac CT technology provide the ability to directly assess an individual's atherosclerotic disease burden, which has the potential to personalize risk assessment for lipid-lowering therapy. Areas covered: We review the current unmet need in identifying patients at elevated residual risk despite guideline directed medical therapy, the evidence behind plaque regression as a potential marker of therapeutic response, and highlight state-of-the-art advances in coronary computed tomographic angiography (CCTA) for measurement of quantitative and qualitative changes in coronary atherosclerosis over time. Literature search was performed using PubMed and Google Scholar for literature relevant to statin therapy and residual risk, coronary plaque regression measurement, and CCTA assessment of quantitative and qualitative change in coronary atherosclerosis. Expert commentary: We discuss the potential ability of CCTA to guide lipid-lowering therapy as a bridge between population and personalized medicine in the future, as well as the potential barriers to its use.

9 Review Cardiac Applications of PET-MR. 2017

Bergquist, Peter J / Chung, Michael S / Jones, Anja / Ahlman, Mark A / White, Charles S / Jeudy, Jean. ·Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. · Department of Radiology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA. · Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. jjeudy@umm.edu. · University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. jjeudy@umm.edu. ·Curr Cardiol Rep · Pubmed #28401505.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this study was to provide an overview of the clinical applications of PET-MR in the setting of cardiac imaging with emphasis on specific scenarios where both techniques together provided added information. RECENT FINDINGS: Synergy of cardiac PET and MR fusion may hold similar promise eliminating ionizing radiation and improving tissue contrast. Future development of new hybrid scanners, use of new imaging tracers, and clinical applications are significant factors which will influence its use. Both positron emission tomography (PET) and cardiac magnetic resonance imaging (CMR) provide important anatomic and physiologic information with regard to the heart. Being able to combine the data from these two examinations in a hybrid technique allows for a more complete evaluation of cardiac pathology. While hybrid PET-CT has already established the utility of a combined imaging approach, the use of CMR in lieu of CT allows for elimination of ionizing radiation and for improved tissue contrast.

10 Review CT calcium scoring. History, current status and outlook. 2017

Sandfort, V / Bluemke, D A. ·Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA. · Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA. Electronic address: david.bluemke@nih.gov. ·Diagn Interv Imaging · Pubmed #27423708.

ABSTRACT: Cardiovascular risk assessment has assumed a prominent role in the course of preventive care of all adults. Traditionally cardiovascular risk assessment has been performed using risk factors including gender, age, smoking history, lipid status, diabetes status, and family history. Increasingly, imaging has been deployed to directly detect coronary atherosclerotic disease. Quantification of coronary calcium (e.g., Agatston method, calcium mass and volume) is readily detected using helical CT scanners. Large multicenter cohort studies have enabled a better understanding of the relevance of coronary calcium detection. The purpose of this review is to review the methods for quantification of coronary artery calcium, as well as to present current and future perspectives on calcium scoring for cardiovascular risk stratification.

11 Review Apolipoprotein E Gene Variants and Risk of Coronary Heart Disease: A Meta-Analysis. 2016

Xu, Min / Zhao, Jun / Zhang, Yu / Ma, Xu / Dai, Qiaoyun / Zhi, Hong / Wang, Bei / Wang, Lina. ·Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China. · Graduate School of Peking Union Medical College, Beijing, China; National Research Institute for Family Planning, Beijing, China. · Centers for Disease Control and Prevention, Zhejiang, China. · National Research Institute for Family Planning, Beijing, China. · Department of Cardiology, ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, China. ·Biomed Res Int · Pubmed #27868062.


12 Review Coronary Computed Tomography Angiography in the Evaluation of Chest Pain of Suspected Cardiac Origin. 2016

Bittencourt, Marcio Sommer / Hulten, Edward A / Veeranna, Vikas / Blankstein, Ron. ·From Center for Clinical and Epidemiological Research, University Hospital & São Paulo State Cancer Institute, University of São Paulo School of Medicine, Brazil (M.S.B.);Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.);Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.A.H.) · andCardiovascular Imaging Program, Departments of Medicine and Radiology · Brigham and Women's Hospital · Harvard Medical School, Boston, MA (V.V., R.B.). ·Circulation · Pubmed #27185023.

ABSTRACT: -- No abstract --

13 Review Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). 2016

Ramsden, Christopher E / Zamora, Daisy / Majchrzak-Hong, Sharon / Faurot, Keturah R / Broste, Steven K / Frantz, Robert P / Davis, John M / Ringel, Amit / Suchindran, Chirayath M / Hibbeln, Joseph R. ·Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA Chris.Ramsden@nih.gov. · Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. · Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA. · Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA. · Medtronic, Minneapolis, MN, USA. · Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. · Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA. · Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA. ·BMJ · Pubmed #27071971.

ABSTRACT: OBJECTIVE: To examine the traditional diet-heart hypothesis through recovery and analysis of previously unpublished data from the Minnesota Coronary Experiment (MCE) and to put findings in the context of existing diet-heart randomized controlled trials through a systematic review and meta-analysis. DESIGN: The MCE (1968-73) is a double blind randomized controlled trial designed to test whether replacement of saturated fat with vegetable oil rich in linoleic acid reduces coronary heart disease and death by lowering serum cholesterol. Recovered MCE unpublished documents and raw data were analyzed according to hypotheses prespecified by original investigators. Further, a systematic review and meta-analyses of randomized controlled trials that lowered serum cholesterol by providing vegetable oil rich in linoleic acid in place of saturated fat without confounding by concomitant interventions was conducted. SETTING: One nursing home and six state mental hospitals in Minnesota, United States. PARTICIPANTS: Unpublished documents with completed analyses for the randomized cohort of 9423 women and men aged 20-97; longitudinal data on serum cholesterol for the 2355 participants exposed to the study diets for a year or more; 149 completed autopsy files. INTERVENTIONS: Serum cholesterol lowering diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). Control diet was high in saturated fat from animal fats, common margarines, and shortenings. MAIN OUTCOME MEASURES: Death from all causes; association between changes in serum cholesterol and death; and coronary atherosclerosis and myocardial infarcts detected at autopsy. RESULTS: The intervention group had significant reduction in serum cholesterol compared with controls (mean change from baseline -13.8%v-1.0%; P<0.001). Kaplan Meier graphs showed no mortality benefit for the intervention group in the full randomized cohort or for any prespecified subgroup. There was a 22% higher risk of death for each 30 mg/dL (0.78 mmol/L) reduction in serum cholesterol in covariate adjusted Cox regression models (hazard ratio 1.22, 95% confidence interval 1.14 to 1.32; P<0.001). There was no evidence of benefit in the intervention group for coronary atherosclerosis or myocardial infarcts. Systematic review identified five randomized controlled trials for inclusion (n=10,808). In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27). CONCLUSIONS: Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

14 Review The Link Between Inflammatory Disorders and Coronary Heart Disease: a Look at Recent Studies and Novel Drugs in Development. 2016

Teague, H / Mehta, Nehal N. ·National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. · National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. nehal.mehta@nih.gov. · Cardiovascular and Pulmonary Branch, NHLBI, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD, 20892, USA. nehal.mehta@nih.gov. ·Curr Atheroscler Rep · Pubmed #26739273.

ABSTRACT: Inflammation is a critical component in the development of coronary heart disease (CHD), specifically in the process of atherogenesis. Human translational and preclinical studies have demonstrated that inflammation contributes to the development, sustainment, and progression of atherosclerosis, and epidemiological studies demonstrate that human diseases associated with increased systemic inflammation increase the risk of CHD-related events. Therefore, over the last decade, multiple clinical studies were designed to target the inflammatory cascade in order to reduce the risk of CHD and to identify which populations may benefit from these preventative treatment strategies. This review briefly summarizes inflammation as a risk factor in atherosclerosis, human disease states associated with accelerated atherosclerosis, and current treatment strategies for CHD targeting the inflammatory cascade.

15 Review Cardiovascular magnetic resonance phase contrast imaging. 2015

Nayak, Krishna S / Nielsen, Jon-Fredrik / Bernstein, Matt A / Markl, Michael / D Gatehouse, Peter / M Botnar, Rene / Saloner, David / Lorenz, Christine / Wen, Han / S Hu, Bob / Epstein, Frederick H / N Oshinski, John / Raman, Subha V. ·Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, California, 90089-2564, USA. knayak@usc.edu. · Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA. jfnielse@umich.edu. · Mayo Clinic, Rochester, MN, USA. mbernstein@mayo.edu. · Department of Radiology, Northwestern University, Chicago, IL, USA. mmarkl@northwestern.edu. · Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK. p.gatehouse@rbht.nhs.uk. · Cardiovascular Imaging, Imaging Sciences Division, Kings's College London, London, UK. rene.botnar@kcl.ac.uk. · Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA. david.saloner@ucsf.edu. · Center for Applied Medical Imaging, Siemens Corporation, Baltimore, MD, USA. christine.lorenz@siemens.com. · Imaging Physics Laboratory, National Heart Lung and Blood Institute, Bethesda, MD, USA. han.wen@nih.gov. · Palo Alto Medical Foundation, Palo Alto, CA, USA. hub@pamf.org. · Departments of Radiology and Biomedical Engineering, University of Virginia, Charlottesville, VA, USA. fredepstein@virginia.edu. · Departments of Radiology and Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, USA. jnoshin@emory.edu. · Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA. raman.1@osu.edu. ·J Cardiovasc Magn Reson · Pubmed #26254979.

ABSTRACT: Cardiovascular magnetic resonance (CMR) phase contrast imaging has undergone a wide range of changes with the development and availability of improved calibration procedures, visualization tools, and analysis methods. This article provides a comprehensive review of the current state-of-the-art in CMR phase contrast imaging methodology, clinical applications including summaries of past clinical performance, and emerging research and clinical applications that utilize today's latest technology.

16 Review Noninvasive Imaging of Atherosclerotic Plaque Progression: Status of Coronary Computed Tomography Angiography. 2015

Sandfort, Veit / Lima, Joao A C / Bluemke, David A. ·From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.) · and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD. ·Circ Cardiovasc Imaging · Pubmed #26156016.

ABSTRACT: The process of coronary artery disease progression is infrequently visualized. Intravascular ultrasound has been used to gain important insights but is invasive and therefore limited to high-risk patients. For low-to-moderate risk patients, noninvasive methods may be useful to quantitatively monitor plaque progression or regression and to understand and personalize atherosclerosis therapy. This review discusses the potential for coronary computed tomography angiography to evaluate the extent and subtypes of coronary plaque. Computed tomographic technology is evolving and image quality of the method approaches the level required for plaque progression monitoring. Methods to quantify plaque on computed tomography angiography are reviewed as well as a discussion of their use in clinical trials. Limitations of coronary computed tomography angiography compared with competing modalities include limited evaluation of plaque subcomponents and incomplete knowledge of the value of the method especially in patients with low-to-moderate cardiovascular risk.

17 Review Percutaneous Coronary Intervention at Centers With and Without On-Site Surgical Backup: An Updated Meta-Analysis of 23 Studies. 2015

Lee, Joo Myung / Hwang, Doyeon / Park, Jonghanne / Kim, Kyung-Jin / Ahn, Chul / Koo, Bon-Kwon. ·From Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Korea (J.M.L., D.H., J.P., K.-J.K., B.-K.K.) · Division of Biostatistics, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.A.) · and Institute of Aging, Seoul National University, Korea (B.-K.K.). ·Circulation · Pubmed #26152708.

ABSTRACT: BACKGROUND: Emergency coronary artery bypass grafting for unsuccessful percutaneous coronary intervention (PCI) is now rare. We aimed to evaluate the current safety and outcomes of primary PCI and nonprimary PCI at centers with and without on-site surgical backup. METHODS AND RESULTS: We performed an updated systematic review and meta-analysis by using mixed-effects models. We included 23 high-quality studies that compared clinical outcomes and complication rates of 1 101 123 patients after PCI at centers with or without on-site surgery. For primary PCI for ST-segment-elevation myocardial infarction (133 574 patients), all-cause mortality (without on-site surgery versus with on-site surgery: observed rates, 4.8% versus 7.2%; pooled odds ratio [OR], 0.99; 95% confidence interval, 0.91-1.07; P=0.729; I(2)=3.4%) or emergency coronary artery bypass grafting rates (observed rates, 1.5% versus 2.4%; pooled OR, 0.76; 95% confidence interval, 0.56-1.01; P=0.062; I(2)=42.5%) did not differ by presence of on-site surgery. For nonprimary PCI (967 549 patients), all-cause mortality (observed rates, 1.6% versus 2.1%; pooled OR, 1.15; 95% confidence interval, 0.94-1.41; P=0.172; I(2)=67.5%) and emergency coronary artery bypass grafting rates (observed rates, 0.5% versus 0.8%; pooled OR, 1.14; 95% confidence interval, 0.62-2.13; P=0.669; I(2)=81.7%) were not significantly different. PCI complication rates (cardiogenic shock, stroke, aortic dissection, tamponade, recurrent infarction) also did not differ by on-site surgical capability. Cumulative meta-analysis of nonprimary PCI showed a temporal decrease of the effect size (OR) for all-cause mortality after 2007. CONCLUSIONS: Clinical outcomes and complication rates of PCI at centers without on-site surgery did not differ from those with on-site surgery, for both primary and nonprimary PCI. Temporal trends indicated improving clinical outcomes in nonprimary PCI at centers without on-site surgery.

18 Review Outcomes after multivessel or culprit-Vessel intervention for ST-elevation myocardial infarction in patients with multivessel coronary disease: a Bayesian cross-design meta-analysis. 2015

Bittl, John A / Tamis-Holland, Jacqueline E / Lang, Christopher D / He, Yulei. ·Munroe Regional Medical Center, Ocala, Florida. · Mount Sinai Saint Luke's Hospital and the Icahn School of Medicine, New York, New York. · Alpert School of Medicine, Brown University, Providence, Rhode Island. · Office of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland. ·Catheter Cardiovasc Interv · Pubmed #26011638.

ABSTRACT: INTRODUCTION: During primary percutaneous coronary intervention (PCI), patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary disease can undergo either multivessel intervention (MVI) or culprit-vessel intervention (CVI) only. BACKGROUND: Randomized controlled trials (RCTs) support the use of MVI, but cohort studies support the use of CVI. METHODS: We developed Bayesian models that incorporated parameters for study type and study outcome after MVI or CVI. RESULTS: A total of 18 studies (4 RCTs, 3 matched cohort studies, and 11 unmatched observational studies) enrolled 48,398 patients with STEMI and multivessel CAD and reported outcomes after MVI or CVI-only at the time of primary PCI. Using a Bayesian hierarchical model, we found that the point estimates replicated previously reported trends, but the wide Bayesian credible intervals (BCI) excluded any plausible mortality difference between MVI versus CVI in all three study types: RCTs (odds ratio [OR] 0.60, 95% BCI 0.31-1.20), matched cohort studies (OR 1.37, 95% BCI 0.86-2.24), or unmatched cohort studies (OR 1.16, 95% BCI 0.70-1.89). Both the global summary (OR 1.10, 95% BCI 0.74-1.51) and a sensitivity analysis that weighted the RCTs 1-5 times as much as observational studies revealed no credible advantage of one PCI strategy over the other (OR 1.05, 95% BCI 0.64-1.48). CONCLUSIONS: Bayesian approaches contextualize the comparison of different strategies by study type and suggest that neither MVI nor CVI emerges as a preferred strategy in an analysis that accounts mortality differences.

19 Review New Insights from Major Prospective Cohort Studies with Cardiovascular Magnetic Resonance (CMR). 2015

Arai, Andrew E. ·National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services, Bldg 10, Rm B1D416, MSC 1061, 10 Center Drive, Bethesda, MD, 20892-1061, USA, araia@nih.gov. ·Curr Cardiol Rep · Pubmed #25939757.

ABSTRACT: Since 1948, epidemiology studies played an important role in understanding cardiovascular disease and afforded an opportunity to learn about newer diagnostic tests. In 2000, the MESA Study incorporated several advanced cardiovascular imaging modalities including cardiac magnetic resonance imaging (MRI) and coronary artery calcium scans. The decade of follow-up enabled prognosis studies, an important step beyond association studies. In brief, left ventricular hypertrophy by cardiac MRI predicted incident heart failure and stroke. In the MESA Study, coronary artery calcium was a better predictor of coronary artery disease end points than the non-contrast-enhanced MRI scan. In the ICELAND MI substudy of the AGES-Reykjavik Study, a contrast-enhanced MRI scan detected many more unrecognized myocardial infarctions (MIs) (UMIs) than detected by electrocardiography and documented these UMI had adverse prognostic significance. Thus, cardiac MRI has been successfully incorporated into large population studies and shown added value over conventional measurements of cardiovascular disease.

20 Review Noncoding RNA in age-related cardiovascular diseases. 2015

Greco, Simona / Gorospe, Myriam / Martelli, Fabio. ·Laboratory of Molecular Cardiology, Policlinico San Donato-IRCCS, Milan, 20097, Italy. · Laboratory of Genetics, National Institute on Aging-Intramural Research Program, NIH, Baltimore, MD 21224, USA. Electronic address: myriam-gorospe@nih.gov. · Laboratory of Molecular Cardiology, Policlinico San Donato-IRCCS, Milan, 20097, Italy. Electronic address: fabio.martelli@grupposandonato.it. ·J Mol Cell Cardiol · Pubmed #25640162.

ABSTRACT: Eukaryotic gene expression is tightly regulated transcriptionally and post-transcriptionally by a host of noncoding (nc)RNAs. The best-studied class of short ncRNAs, microRNAs, mainly repress gene expression post-transcriptionally. Long noncoding (lnc)RNAs, which comprise RNAs differing widely in length and function, can regulate gene transcription as well as post-transcriptional mRNA fate. Collectively, ncRNAs affect a broad range of age-related physiologic deteriorations and pathologies, including reduced cardiovascular vigor and age-associated cardiovascular disease. This review presents an update of our understanding of regulatory ncRNAs contributing to cardiovascular health and disease as a function of advancing age. We will discuss (1) regulatory ncRNAs that control aging-associated cardiovascular homeostasis and disease, (2) the concepts, approaches, and methodologies needed to study regulatory ncRNAs in cardiovascular aging and (3) the challenges and opportunities that age-associated regulatory ncRNAs present in cardiovascular physiology and pathology. This article is part of a Special Issue entitled "CV Aging".

21 Review Cardiovascular imaging in 2013: New era of evidence-based medicine with noninvasive imaging. 2014

Pattanayak, Puskar / Bluemke, David A. ·National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Engineering, 10 Center Drive, Bethesda, MD 20892, USA. ·Nat Rev Cardiol · Pubmed #24419259.

ABSTRACT: In 2013, advances in noninvasive imaging methods pushed traditional boundaries in the detection, diagnosis, and functional assessment of coronary artery disease, atherosclerotic plaque, and myocardial function. We highlight five important studies that demonstrate how these developments are allowing medicine to become increasingly evidence-based and personalized.

22 Review Using advanced noninvasive imaging techniques to probe the links between regional coronary artery endothelial dysfunction and atherosclerosis. 2014

Iantorno, Micaela / Weiss, Robert G. ·Critical Care Medicine Department, National Institutes of Health, 10 Center Drive, Room 2C145, Bethesda, MD, USA; Department of Medicine, Cardiology Division, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21205 USA. · Department of Medicine, Cardiology Division, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21205 USA. Electronic address: rweiss@jhmi.edu. ·Trends Cardiovasc Med · Pubmed #24296299.

ABSTRACT: Cardiovascular disease remains the number one cause of death in the US annually. The development in recent years of imaging strategies that can identify coronary endothelial dysfunction noninvasively provides new information about the early presence and local spatial heterogeneity of endothelial function in patients with, and those at risk for, coronary artery disease. In this article, we will briefly review the mechanisms relating endothelial function and atherosclerosis, contemporary imaging strategies now able to quantify coronary endothelial function noninvasively, and recent insights on human coronary endothelial function.

23 Review Detection of high-risk atherosclerotic plaque: report of the NHLBI Working Group on current status and future directions. 2012

Fleg, Jerome L / Stone, Gregg W / Fayad, Zahi A / Granada, Juan F / Hatsukami, Thomas S / Kolodgie, Frank D / Ohayon, Jacques / Pettigrew, Roderic / Sabatine, Marc S / Tearney, Guillermo J / Waxman, Sergio / Domanski, Michael J / Srinivas, Pothur R / Narula, Jagat. ·Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892, USA. flegj@nhlbi.nih.gov ·JACC Cardiovasc Imaging · Pubmed #22974808.

ABSTRACT: The leading cause of major morbidity and mortality in most countries around the world is atherosclerotic cardiovascular disease, most commonly caused by thrombotic occlusion of a high-risk coronary plaque resulting in myocardial infarction or cardiac death, or embolization from a high-risk carotid plaque resulting in stroke. The lesions prone to result in such clinical events are termed vulnerable or high-risk plaques, and their identification may lead to the development of pharmacological and mechanical intervention strategies to prevent such events. Autopsy studies from patients dying of acute myocardial infarction or sudden death have shown that such events typically arise from specific types of atherosclerotic plaques, most commonly the thin-cap fibroatheroma. However, the search in human beings for vulnerable plaques before their becoming symptomatic has been elusive. Recently, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study demonstrated that coronary plaques that are likely to cause future cardiac events, regardless of angiographic severity, are characterized by large plaque burden and small lumen area and/or are thin-cap fibroatheromas verified by radiofrequency intravascular ultrasound imaging. This study opened the door to identifying additional invasive and noninvasive imaging modalities that may improve detection of high-risk atherosclerotic lesions and patients. Beyond classic risk factors, novel biomarkers and genetic profiling may identify those patients in whom noninvasive imaging for vulnerable plaque screening, followed by invasive imaging for risk confirmation is warranted, and in whom future pharmacological and/or device-based focal or regional therapies may be applied to improve long-term prognosis.

24 Review Understanding the genetics of coronary artery disease through the lens of noninvasive imaging. 2012

Yang, Eunice / Vargas, Jose D / Bluemke, David A. ·Johns Hopkins School of Medicine, Baltimore, MD, USA. bluemked@nih.gov ·Expert Rev Cardiovasc Ther · Pubmed #22149524.

ABSTRACT: Coronary artery disease is a common condition with a known heritable component that has spurred interest in genetic research for decades, resulting in a handful of candidate genes and an appreciation for the complexity of its genetic contributions. Recent advances in sequencing technologies have resulted in large-scale association studies, possibly adding to our current understanding of the genetics of coronary artery disease. Sifting through the statistical noise, however, requires the selection of effective phenotypic markers. New imaging technologies have improved our ability to detect subclinical atherosclerosis in a safe and reproducible manner in large numbers of patients. In this article, we propose that advances in imaging technology have generated improved phenotypic markers for genetic association studies of coronary artery disease.

25 Review Serum bilirubin and genes controlling bilirubin concentrations as biomarkers for cardiovascular disease. 2010

Lin, Jing-Ping / Vitek, Libor / Schwertner, Harvey A. ·Office of Biostatistics Research, Division of Cardiovascular Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. ·Clin Chem · Pubmed #20693308.

ABSTRACT: BACKGROUND: Serum bilirubin has been consistently shown to be inversely related to cardiovascular disease (CVD). Recent studies showed serum bilirubin to be associated with CVD-related factors such as diabetes, metabolic syndrome, and body mass index. Although the association of serum bilirubin with CVD has been found in both retrospective and prospective studies, less information is available on the role of genes that control bilirubin concentrations and their association with CVD. CONTENT: In this review, we provide detailed information on the identity of the major genes that control bilirubin concentrations and their association with serum bilirubin concentrations and CVD risk. We also update the results of the major studies that have been performed on the association between serum bilirubin, CVD, and CVD-related diseases such as diabetes or metabolic syndrome. Studies consistently indicate that bilirubin concentrations are inversely associated with different types of CVD and CVD-related diseases. A conditional linkage study indicates that UGT1A1 is the major gene controlling serum bilirubin concentrations, and this finding has been confirmed in recent genomewide association studies. Studies also indicate that individuals homozygous for UGT1A1*28 have a significantly lower risk of developing CVD than carriers of the wild-type alleles. SUMMARY: Serum bilirubin has a protective effect on CVD and CVD-related diseases, and UGT1A1 is the major gene controlling serum bilirubin concentrations. Pharmacologic, nonpharmacologic, or genetic interventions that increase serum bilirubin concentrations could provide more direct evidence on the role of bilirubin in CVD prevention.