Cardiology Commons^™

Development Of A Cardio-Oncology Program In A Community Hospital, Deborah W. Sundlof Do, Brijesh D. Patel Md, Kelly C. Schadler Msn, Crnp, Ross G. Biggs Do, Cheri A. Silverstein Fadlon Md, Mscr, Paul S. Corotto Md, Sameer Tolay Md, Ahmed J. Nadeem Do, Ranju Gupta Md, Nadeem V. Ahmad Md

Department of Medicine

No abstract provided.

Chemo-Coronaries: A Rare Form Of Coronary Vasospasm Following 5-Fu Infusion, George Prousi Md, Joseph Moran Do, Ross Biggs Do, John Mannisi Md

Department of Medicine

No abstract provided.

Platelet Reactivity And Risk Of Ischemic Stroke After Coronary Drug-Eluting Stent Implantation: From The Adapt-Des Study., Gennaro Giustino, Björn Redfors, Ajay J Kirtane, Roxana Mehran, George D Dangas, Bernhard Witzenbichler, Franz-Josef Neumann, Giora Weisz, Philippe Généreux, Akiko Maehara, Thomas Mcandrew, Serdar Farhan, Michael J Rinaldi, D Christopher Metzger, David A. Cox Md, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Paul Gurbel, Ori Ben-Yehuda, Gregg W Stone

Department of Medicine

OBJECTIVES: The authors sought to investigate the association between P2Y

BACKGROUND: The association between platelet reactivity on clopidogrel and the risk for ischemic cerebrovascular events remains unclear.

METHODS: Incidence, predictors, and prognostic impact of IS were evaluated among patients enrolled in the multicenter, prospective ADAPT-DES (Assessment of Dual AntiPlatelet Therapy With Drug Eluting Stents) study. By protocol, patients were maintained on aspirin for 2 years and clopidogrel for at least 1 year. Baseline platelet reactivity on clopidogrel and aspirin were assessed by means of VerifyNow point-of-care assay after successful DES implantation.

RESULTS: Among 8,582 patients enrolled, 68 (0.8%) had an …

The Disappearing Murmur: Systolic Anterior Motion Of The Mitral Valve Leaflet In A Non-Hypertrophic Cardiomyopathy Patient, Syed Rafay Ali Sabzwari, James R. Kimber, Hiwot Ayele, Nimra Khan, Tarick Sheikh, Ghulam Akbar Md, Bruce Feldman Do

Department of Medicine

Systolic anterior motion (SAM) of the mitral valve is a well-known phenomenon associated with left ventricular outflow tract obstruction and hemodynamic compromise. This finding may occur in patients with or without hypertrophic cardiomyopathy. In this report, a patient with no prior medical history presented to the hospital with left-sided chest pain and high-risk echocardiogram (ECG) findings. Left heart catheterization with coronary angiography was negative for coronary artery disease. His initial examination was significant for a systolic murmur due to the underlying SAM, as demonstrated by transthoracic echocardiogram. During his hospitalization, he developed acute heart failure syndrome as a result of …

A Case Of Flash Pulmonary Edema Caused By Iliac Artery Stenosis, Grace Chong Do, Joseph Moran Do, Fnu Vikram Md, Benjamin Sanchez Md

Department of Medicine

No abstract provided.

Ten Lifestyle Modification Approaches To Treat Atrial Fibrillation, Syed Rafay Ali Sabzwari, Lohit Garg Md, Dhanunjaya Lakkireddy, John Day

Department of Medicine

Atrial fibrillation (AF) is the most common arrhythmia affecting three million people in the United States (US). Across different races in the US, the incidence of other races was comparable to that of Caucasian population. This points towards the importance of certain lifestyle modifications that can help prevent and treat this disorder. This article discusses 10 such factors. Smoking has been linked to AF, with almost 36% risk reduction if quit. Hypertension has 56% increased risk of atrial fibrillation in which the role of lifestyle changes is well known. Similarly, alcohol-induced atrial fibrillation has 10% increased risk of atrial fibrillation. …

Outcomes Of Catheter Ablation For Supraventricular Tachycardia In Adult Patients With Congenital Heart Disease, Lohit Garg Md, Sahil Agrawal Md, Manyoo Agarwal Md, Brijesh Patel Md, Mahek Shah Md, Aakash Garg Md, Sudip Nanda Md, Facp, Talha Nazir Md, Raman Dusaj Md

Department of Medicine

Background: Supraventricular tachyarrhythmias (SVT) are common in adult patients with congenital heart disease (CHD). There is paucity of data regarding the safety and outcomes associated with catheter ablation in these patients.

Methods: We queried the National Inpatient Sample (NIS) to identify all adults patients > 18 years with CHD undergoing catheter ablation for SVT.

Results: Between 2003-2013, 5,966 patients with CHD underwent catheter ablation for SVT. Of these 4,769 were performed for atrial fibrillation or atrial flutter and rest for other SVTs. The mean age of these patient was 47+/- 15 years, 59.9% were males. 18% of patients experienced procedure related …

Type Ii Brugada Syndrome Syncopal Seizure: A Diagnostic Dilemma, Syed Rafay Ali Sabzwari, Nghia Hoang

Department of Medicine

Background: Type II Brugada syndrome is a rare entity that can present as syncope, sudden cardiac death, palpitations and nocturnal agonal respiration as a manifestation of ventricular tachyarrythmia. Although patients can experience a syncopal seizure, the dilemma between epileptic seizure and syncopal seizure due to type II Brugada syndrome is rarely encountered and reported in literature.

Case: 45 years old caucasian male with history of bicuspid aortic valve and no family history of sudden cardiac death or arrhythmia presented with generalized body shaking, unresponsiveness, mouth frothing and rolling of eyes for 4 minutes during sleep followed by 30 minutes of …

Cardiac Amyloidosis Masquerading As Hypertrophic Obstructive Cardiomyopathy, Lohit Garg Md, Naveen Sablani, Amy Ahnert, Bruce Feldman Do

Department of Medicine

Background: Cardiac amyloidosis (CA) remains a diagnostic challenge and is associated with significant morbidity and mortality.

Case: A 67-year old male was referred for septal myomectomy for hypertrophic obstructive cardiomyopathy (HOCM) due to worsening symptoms despite medical therapy. His medical history included chronic diastolic heart failure, and atrial fibrillation post pulmonary vein isolation. His examination revealed mid peaking crescendo-decrescendo systolic murmur, worse on Valsalva. An electrocardiogram revealed normal sinus rhythm and normal voltage. Transthoracic and transesophageal echocardiogram revealed asymmetric septal hypertrophy, chordal systolic anterior motion (SAM), and left ventricular (LV) obstruction with a peak gradient of 40 mmHg at rest. …

Obesity Is Not Associated With A Differential Outcome Following Coronary Artery Bypass Surgery, Lohit Garg Md, Sahil Agrawal Md, Amitoj Singh, Raman Dusaj, Jamshid Shirani

Department of Medicine

Background: Conflicting data exists regarding the impact of obesity on mortality and morbidity following coronary artery bypass graft (CABG) surgery with some suggesting a paradoxical reduction in adverse outcomes. We aimed to compare the in-hospital outcomes of CABG in obese and non-obese subjects.

Methods: The Nationwide Inpatient Sample for years 2003- 2014 was used to identify adults (age ≥18 years) who underwent isolated CABG.

Results: A total of 2,297,932 patients underwent CABG of which 554,857 (28.2%) surgeries were for acute coronary syndrome (ACS) and 1,743075 (74.2%) were elective. Obese patients in either group were younger, were more likely to be …

Risk Scores-Medical Derivatives., Ronald S. Freudenberger Md

Department of Medicine

No abstract provided.

A Reversible Cause Of Complete Heart Block Causing Chest Pain And Syncope., Syed Rafay Ali Sabzwari, Zoltan Varga, Khurram Butt, Nimra Khan

Department of Medicine

Vasospastic angina (VSA), also known as variant or Prinzmetal's angina, is a relatively uncommon cause of retrosternal chest pain with transient ST segment elevation, mainly due to vasospasm in the coronary arteries. This is a case of 37-year-old female who presented with chest pain and syncope. Her initial workup, including echocardiogram, was negative. Subsequently, she was sent home with an event monitor. During the next two weeks, she continued to have recurrent episodes of similar chest pains and presented to her cardiology appointment with a heart rate of 45 bpm and blood pressure of 100/60 mmHg and was taken to …

It's Just Diastolic Heart Failure, Right? A Lesson In Humility From A Patient With Ttr-Amyloid Cardiomyopathy., Nathan Brewster Do, Michael Sumner Do, Ross Biggs Do, Ronald S. Freudenberger Md

Department of Medicine

No abstract provided.

Sick Sinus Syndrome And Chronic Chagas Cardiomyopathy., Sagar Vadhar Do, Benjamin Sanchez Md

Department of Medicine

No abstract provided.

A Retrospective Analysis Of The Outcomes Of Extracorporeal Cardiopulmonary Resuscitation (Ecpr)., Rachel Wills, Kennedy Gallagher, James A. Burke Md, Timothy S. Misselbeck, James K. Wu Md

Department of Surgery

No abstract provided.

Trends Of Revascularization In Acute Myocardial Infarction Patients With Coronary Artery Anomalies: A Nationwide Analysis Of 8,131 Patients., Neeraj Shah Md, Vratika Agarwal Md, Nainesh C. Patel Md

Department of Medicine

No abstract provided.

A Ruptured Basilar Aneurysm Resulting In Takotsubo Cardiomyopathy., Ryan Murphy Do, Apurva Vyas Md, Megan Leary Md

Department of Medicine

No abstract provided.

Impact Of Atrial Fibrillation On Outcomes In Patients Hospitalized With St-Segment Elevation Myocardial Infarction (Poster)., Lohit Garg Md, Sahil Agrawal Md, Manyoo Agarwal Md, Aakash Garg Md, Amitoj Singh, Nirmanmoh Bhatia, Mahek Shah Md, Brijesh Patel Md, Sudip Nanda Md, Facp, David A. Cox Md

Department of Medicine

No abstract provided.

An Over-The-Counter Treatment For Diarrhea Leading To Euphoria And Fatal Arrhythmia., Angela Magdaleno, Michael Sumner Do, Travis Magdaleno Md, Justin L. Guthier Do, Apurva Vyas Md

Department of Medicine

No abstract provided.

Impact Of Atrial Fibrillation On Outcomes In Patients Hospitalized With St- Segment Elevation Myocardial Infarction., Lohit Garg Md, Sahil Agrawal Md, Manyoo Agarwal Md, Aakash Garg Md, Amitoj Singh, Nirmanmoh Bhatia, Mahek Shah Md, Brijesh Patel Md, Sudip Nanda Md, Facp, David A. Cox Md

Department of Medicine

Background: Atrial fibrillation (AF) is reported in 7-19% patients with acute ST- Segment Elevation Myocardial Infarction (STEMI). There is

a paucity of data on the impact of AF on outcomes in patients with acute STEMI.

Methods: We queried the National Inpatient Sample (NIS) database for years 2003- 2013 to identify all patients >=18 years of age

admitted with acute STEMI.

Results: Of the total 2,632,447 STEMI hospitalizations, AF was documented in 339,987 (12.9%) patients. At baseline, patients with

AF were older (mean 74 vs 63 years, p

Hypertension, renal failure, diabetes mellitus and congestive heart failure were all more prevalent …

Sports Cardiology: Core Curriculum For Providing Cardiovascular Care To Competitive Athletes And Highly Active People., Aaron L. Baggish Md, Robert W. Battle Md, James G. Beckerman Md, Alfred A. Bove Md, Phd, Rachel J. Lampert Md, Benjamin D. Levine Md, Mark S. Link Md, Matthew W. Martinez Md, Silvana M. Molossi Md, Phd, Jack Salerno Md, Meagan M. Wasfy Md, Rory B. Weiner Md, Michael S. Emery Md

Department of Medicine

The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP. However, there is increasing recognition that a care team including qualified CV specialists optimizes care delivery for CAHAP. In recognition …

Tct-732 Relationship Between Stent Diameter, Platelet Reactivity, And Adverse Events After Pci: Analysis From The Adapt-Des Study., Björn Redfors, Philippe Généreux Md, Bernhard Witzenbichler Md, Ajay J. Kirtane Md, Thomas Mcandrew, Bruce R. Brodie Md, Michael J. Rinaldi Md, Timothy D. Henry Md, David A. Cox Md, Ernest L. Mazzaferri Md, Ori B. Yehuda, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

Small vessel diameter and residual high platelet reactivity (HPR) have both been associated with adverse events after PCI. We sought to determine whether a specific interaction exists between HPR and stent diameter in regard to outcomes after PCI.

Methods

We stratified pts in the prospective ADAPT-DES registry who underwent successful single-lesion PCI with DES according to whether or not they received only small diameter stents (diameter ≤2.5 mm). Pts receiving ≤2.5 mm stents were compared to pts receiving a stent with a diameter >2.5 mm using propensity score (PS) adjusted Cox proportional hazards regression. HPR was defined as P2Y12 …

Tct-733 Association Between Hypertension, Platelet Reactivity, And The Risk Of Adverse Events After Pci: Analysis From The Adapt-Des Study, Björn Redfors, Xin Huang, Bernhard Witzenbichler Md, Shmuel Chen, Yangbo Liu, Bruce R. Brodie Md, Michael J. Rinaldi Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Roxana Mehran Md, Ajay J. Kirtane Md, Ori B. Yehuda, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Tct-546 Performance Of The Dual Antiplatelet Therapy (Dapt) Score In The Adapt-Des Study., Sorin J. Brener, Ajay J. Kirtane Md, Michael J. Rinaldi Md, Bernhard Witzenbichler Md, Franz-Josef Neumann Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest Mazzaferri Md, Bruce R. Brodie Md, Roxana Mehran Md, Thomas Mcandrew, Gregg W. Stone Md

Department of Medicine

Background

The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains in dispute, particularly after 12 months. The DAPT Score was developed from the DAPT trial to identify pts who may benefit the most from extended therapy. We sought to assess the performance of the DAPT risk score in the all-comers Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry, and to test the utility of additional predictors of events on its performance.

Methods

Patients free from ischemic or hemorrhagic events after 1 year of DAPT after successful DES implantation were analyzed. The DAPT score …

Tct-353 Underweight Status, Platelet Reactivity, And 2-Year Clinical Outcomes In Patients Undergoing Pci With Des: An Adapt-Des Study Analysis., Puja B. Parikh Md, Ajay J. Kirtane Md, Giora Weisz Md, Thomas D. Stuckey Md, M Ozgu Ozan Ms, Bernhard Witzenbichler Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Bruce R. Brodie Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

The relationships between underweight status, platelet reactivity, and clinical outcomes after PCI with DES are not well understood.

Methods

ADAPT-DES was a prospective, multicenter study of 8582 pts treated with aspirin and clopidogrel in whom routine measurement of P2Y12 reaction units (PRU) by VerifyNow testing was performed following successful DES implantation. Pts were classified according to the following body mass index (BMI) groups: Underweight (BMI/m2), normal weight (20 kg/m2 ≤ BMI/m2), overweight (25 kg/m2 ≤ BMI/m2), and obese (BMI ≥30 kg/m2).

Results

Underweight pts were more often female, smokers, had higher rates of peripheral arterial disease and renal insufficiency, …

Tct-352 Proportion Of Ischemic Risk After Pci Mediated By High Platelet Reactivity On Clopidogrel: Analysis From The Adapt-Des Study., Björn Redfors, Ori Ben-Yehuda Md, Sheng-Hsuan Lin, Ariel Furer, Ajay J. Kirtane Md, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Akiko Maehara Md, Philippe Généreux Md, Gennaro Giustino Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Girma M. Ayele, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Tct-237 Outcomes After Successful Pci Of Severely Calcified Lesions Using Rotational Atherectomy, Cutting Balloon, Or Balloon Angioplasty Only Before Second-Generation Drug-Eluting Stent Implantation., Björn Redfors, Philippe Généreux Md, Akiko Maehara Md, Ajay J. Kirtane Md, Rushad Dordi, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Claire Litherland Ms, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Cardiac Consequences Of The Heroin Epidemic: Loperamide Causing Torsades De Pointes, Justin L. Guthier Do, Apurva Vyas Md

Department of Medicine

No abstract provided.

Role Of Prophylactic Magnesium Supplementation In Prevention Of Postoperative Atrial Fibrillation In Patients Undergoing Coronary Artery Bypass Grafting: A Meta-Analysis Of 23 Randomized Controlled Trials (Poster)., Jalaj Garg Md, Rahul Chaudhary Md, Parasuram Krishnamoorthy Md, Neeraj Shah Md, Babak Bozorgnia Md

Department of Medicine

No abstract provided.

Transcatheter Aortic Valve Replacement Is Associated With A Higher Rate Of Permanent Pacemaker Implantation Compared To Surgical Aortic Valve Replacement: A Propensity Matched Analysis (Poster)., Neeraj Shah Md, Achint Patel Mbbs, Nileshkumar Patel Md, Vratika Agarwal Md, Jalaj Garg Md, Nainesh C. Patel Md, Facc, David A. Cox Md, Facc, Fscai

Department of Medicine