Best of JACC 2014 Session Explores Practice-Changing Research

A special session today will look at the practice-changing research published over the past year in the Journal of the American College of Cardiology (JACC), as well as JACC: Cardiovascular Interventions, JACC: Cardiovascular Imaging and JACC: Heart Failure. In addition, Salim Yusuf, MD, DPhil, will present the Eugene Braunwald Lecture on “The Global Epidemic of Cardiovascular Disease.” Yusuf is professor of medicine for cardiology and clinical epidemiology and biostatistics at McMaster University, the director of the Population Health Research Institute at McMaster University and Hamilton Health Sciences, and vice president of research and chief scientific officer at Hamilton Health Sciences.

JACC Editor-in-Chief Valentin Fuster, MD, PhD, who took the helm of JACC in July 2014, along with Spencer B. King, MD, Jagat Narula, MD, DM, PhD, and Christopher M. O’Connor, MD, personally selected the top papers from their respective journals. According to Fuster, he is “incredibly excited about … the rich and diverse content.”

Earlier this year, Fuster singled out 150 manuscripts, both original investigations and review articles, representing the top 3 percent of the hundreds of articles submitted to JACC. Among the research he highlighted:

  • Results from the “Undetectable High-Sensitivity Cardiac Troponin T Level in the Emergency Department and Risk of Myocardial Infarction,” by Nadia Bandstein, MD, et al., which found that patients presenting to the emergency department with an undetectable level of high-sensitivity cardiac troponin T, and whose ECGs show no sign of restricted blood flow, have a minimal risk of heart attack within 30 days. The probability that patients with an undetectable level of the blood biomarker are not at risk was 99.8 percent for heart attack and 100 percent for death.
  • Results from the METOCARD-CNIC trial by Gonzalo Pizarro, MD, et al., which found that in patients with anterior Killip class ≤II STEMI undergoing percutaneous coronary intervention, early IV metoprolol before reperfusion resulted in higher long-term left ventricular ejection fraction, reduced incidence of severe left ventricular systolic dysfunction and implantable cardioverter defibrillator indications, and fewer heart failure admissions.
  • Results from the MENDEL-2 trial by Michael J. Koren, MD, et al., which found that in the largest monotherapy trial using a PCSK9 inhibitor to date, evolocumab yielded significant LDL-C reductions compared with placebo or ezetimibe and was well tolerated in patients with hypercholesterolemia.
  • Results of the “Short-Term Rosuvastatin Therapy for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease,” by Yaling Han, MD, PhD, et al., which found that rosuvastatin significantly reduced the risk of contrast-induced acute kidney injury in patients with diabetes mellitus and chronic kidney disease undergoing arterial contrast medium injection.

Fuster also highlighted the paper “2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations,” by Lawrence R. Krakoff, MD, et al., which garnered attention due to major changes in recommendations for hypertension treatment for patients older than 60 years and for its treatment goals. Some groups opposed the decision to initiate pharmacologic treatment to lower blood pressure at systolic ≥150 mm Hg and treat to a goal systolic blood pressure of <150 mm Hg for these patients. This paper contained three sections outlining objections to or support of maintaining this proposed strategy in certain at-risk populations, namely African Americans, women and the elderly.

A separate paper, “Hypertrophic Cardiomyopathy: Present and Future, With Translation Into Contemporary Cardiovascular Medicine,” by Barry J. Maron, MD, et al., explained that substantial advances in the diagnosis of and treatment options for hypertrophic cardiomyopathy have emerged since it was identified 55 years ago, along with increased recognition of the disease in clinical practice. Hypertrophic cardiomyopathy has moved from an era of misunderstanding and pessimism to acquire an effective and diverse management armamentarium – transforming it into a contemporary treatable disease.

He also noted that indications for aspirin use in primary cardiovascular prevention continue to be a source of major debate, with major international guidelines providing conflicting recommendations. A position paper from the European Society of Cardiology Working Group on Thrombosis by Sigrun Halvorsen, MD, et al., looked at aspirin therapy in primary cardiovascular disease prevention, and reviewed the evidence accumulated to date, including recent data linking aspirin with cancer protection.

Read more about Fuster’s top picks in JACC. The newest journal, JACC: Clinical Electrophysiology, will debut next month.

Clinical Topics: Arrhythmias and Clinical EP, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Homozygous Familial Hypercholesterolemia, Statins, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Interventions and Structural Heart Disease, Hypertension

Keywords: Acute Kidney Injury, Aspirin, Biological Markers, Biostatistics, Blood Pressure, Cardiomyopathy, Hypertrophic, Cardiovascular Diseases, Defibrillators, Implantable, Diabetes Mellitus, Electrophysiology, Female, Fluorobenzenes, Heart Failure, Hypercholesterolemia, Hypertension, Metoprolol, Myocardial Infarction, Neoplasms, Percutaneous Coronary Intervention, Renal Insufficiency, Chronic

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