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Ciccarone Center Research
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- Antiplatelet Therapy
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- Meet the Authors
Cardiovascular Risk Assessment
Association of coronary artery calcium and coronary heart disease events in young and elderly participants in the Multi-Ethnic Study of Atherosclerosis: A secondary analysis of a prospective, population-based cohort.
The potent predictive value of coronary artery calcium burden applies to middle-aged as well as older adults.Published in: Mayo Clinic ProceedingsRead on Pubmed
This is a state-of-art review on the possible effects of statin therapy on organs not in the cardiovascular system.Published in: British Medical JournalRead on Pubmed
Headed in the right direction but at risk for miscalculation: a critical appraisal of the 2013 ACC/AHA risk assessment guideline.
The newly released 2013 ACC/AHA Guideline for Assessing Cardiovascular Risk was a major advance over prior guidelines, but the new risk equations do not appear to lead to significantly better discrimination than older models. Since the same risk factors are incorporated, using the new risk estimators may lead to inaccurate assessment of atherosclerotic cardiovascular risk in certain groups of patients. There also is likely an overestimation of risk when applied to modern populations. Future guidelines could provide clearer direction on which individuals would benefit from additional testing for more personalized preventive therapies.Published in: Journal of the American College of CardiologyRead on Pubmed
Nonfatal outcomes in the primary prevention of atherosclerotic cardiovascular disease: is all-cause mortality really all that matters?
This article clearly shows that major nonfatal cardiovascular outcomes are very important to take into account when designing primary prevention guidelines.Published in: CirculationRead on Pubmed
Baseline subclinical atherosclerosis burden and distribution are associated with frequency and mode of future coronary revascularization: multi-ethnic study of atherosclerosis.
There was a strong association between the baseline burden and regional distribution of CAC and the risk and type of future coronary revascularization among asymptomatic subjects.Published in: Journal of the American College of CardiologyRead on Pubmed
This study shifts the focus from prediction of events to detection of disease in the effort to improve personalized decision-making and outcomes. It also discusses innovative future strategies for risk estimation and treatment allocation in preventive cardiology.Published in: American Journal of CardiologyRead on Pubmed
Focused update on the 2013-2014 cardiovascular disease prevention guidelines.
All men with vasculogenic erectile dysfunction require a cardiovascular workup.
This study supports the use of cardiovascular risk stratification and aggressive risk-factor management in all men with vasculogenic erectile dysfunction.
Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.
Subclinical atherosclerosis testing with CAC is currently superior to any combination of risk factors and serum biomarkers.
Risk factors: new risk-assessment guidelines— more or less personalized?
The new ACC/AHA cardiovascular-risk guidelines feature updated equations for women, distinct equations for African-Americans, and include stroke prediction. However, the equations rely on the same traditional risk factors as previous versions, are driven predominantly by age, and curtail the intermediate-risk group, in which personalized risk assessment is recommended.
Critical review of high-sensitivity C-reactive protein and coronary artery calcium for the guidance of statin allocation: head-to-head comparison of the JUPITER and St. Francis Heart Trials.
This analysis looks at the strengths and limitations of two large trials of statin therapy based on persons with an elevated hsCRP, CAC score, or both.
Concepts and controversies: the 2013 American College of Cardiology/American Heart Association risk assessment and cholesterol treatment guidelines.
This editorial discusses the strengths and limitations of the new prevention guidelines.
Incremental prognostic value of coronary artery calcium score versus CT angiography among symptomatic patients without known coronary artery disease.
Among symptomatic patients with a CAC score of zero, a very low (1-2%) prevalence of potentially obstructive CAD can occur, although this finding was not associated with future coronary revascularization or adverse prognosis within two years.
Modifiable lifestyle risks, cardiovascular disease, and all-cause mortality.
Family history of coronary heart disease and the incidence and progression of coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA).
A multiethnic, population-based study showed that a family history of premature CHD is associated with enhanced development and progression of subclinical disease, independent of other risk factors.
Obstructive sleep apnea and diurnal non-dipping hemodynamic indices in patients at increased cardiovascular risk.
We hypothesized increasing obstructive sleep apnea (OSA) severity would be associated with nondipping blood pressure (BP) in increased cardiovascular disease (CVD) risk. In patients at cardiovascular risk and moderate-to-severe OSA, increasing AHI and/or ODI were associated with increased odds of nondipping SBP and nondipping MAP. More severe levels of AHI and ODI also were associated with nondipping DBP. These results support progressive BP burden associated with increased OSA severity even in patients managed by cardiology specialty care.