Foros de Conocimiento
medtronic PRODUCTOS
boston_scientific PRODUCTOS
TERUMO PRODUCTOS
Biotronik PRODUCTOS
Sirtex PRODUCTOS
Striker Neurovascular PRODUCTOS
BIOSENSORS PRODUCTOS

GUÍAS CLÍNICAS


09 mayo 2017

CIRCULATION. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association

Miriam B. Vos , Jill L. Kaar , Jean A. Welsh , Linda V. Van Horn , Daniel I. Feig , Cheryl A.M. Anderson , Mahesh J. Patel , Jessica Cruz Munos , Nancy F. Krebs , Stavra A. Xanthakos and Rachel K. Johnson

Background: Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries.

25 abril 2017

CIRCULATION. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Brian W. McCrindle , Anne H. Rowley , Jane W. Newburger , Jane C. Burns , Anne F. Bolger , Michael Gewitz , Annette L. Baker , Mary Anne Jackson , Masato Takahashi , Pinak B. Shah , Tohru Kobayashi , Mei-Hwan Wu , Tsutomu T. Saji and Elfriede Pahl

Background: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in =25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries.

18 abril 2017

CIRCULATION. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease

Bertil Lindahl , Tomasz Baron , David Erlinge , Nermin Hadziosmanovic , Anna Nordenskjöld , Anton Gard and Tomas Jernberg

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) occurs in 5% to 10% of all patients with myocardial infarction. Clinical trials of secondary prevention treatment in MINOCA patients are lacking. Therefore, the aim of this study was to examine the associations between treatment with statins, renin-angiotensin system blockers, ß-blockers, dual antiplatelet therapy, and long-term cardiovascular events.

18 abril 2017

CIRCULATION. Range of Risk Factor Levels: Control, Mortality, and Cardiovascular Outcomes in Type 1 Diabetes Mellitus

Aidin Rawshani , Araz Rawshani , Stefan Franzén , Björn Eliasson , Ann-Marie Svensson , Mervete Miftaraj , Darren K. McGuire , Naveed Sattar , Annika Rosengren and Soffia Gudbjörnsdottir

Background: Individuals with type 1 diabetes mellitus (T1DM) have a high risk of cardiovascular complications, but it is unknown to what extent fulfilling all cardiovascular treatment goals is associated with residual risk of mortality and cardiovascular outcomes in those with T1DM compared with the general population.

18 abril 2017

CIRCULATION. Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Daniel E. Forman , Ross Arena , Rebecca Boxer , Mary A. Dolansky , Janice J. Eng , Jerome L. Fleg , Mark Haykowsky , Arshad Jahangir , Leonard A. Kaminsky , Dalane W. Kitzman , Eldrin F. Lewis , Jonathan Myers , Gordon R. Reeves and Win-Kuang Shen

Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.

11 abril 2017

CIRCULATION. Risk of Heart Failure With Preserved Ejection Fraction in Older Women After Contemporary Radiotherapy for Breast Cancer

Hirofumi Saiki , Ivy A. Petersen , Christopher G. Scott , Kent R. Bailey , Shannon M. Dunlay , Randi R. Finley , Kathryn J. Ruddy , Elizabeth Yan and Margaret M. Redfield

Background: Cardiomyocytes are resistant to radiation. However, cardiac radiation exposure causes coronary microvascular endothelial inflammation, a perturbation implicated in the pathogenesis of heart failure (HF) and particularly HF with preserved ejection fraction (HFpEF). Radiotherapy for breast cancer results in variable cardiac radiation exposure and may increase the risk of HF.

11 abril 2017

CIRCULATION. Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease

David S. Siscovick , Thomas A. Barringer , Amanda M. Fretts , Jason H.Y. Wu , Alice H. Lichtenstein , Rebecca B. Costello , Penny M. Kris-Etherton , Terry A. Jacobson , Mary B. Engler , Heather M. Alger , Lawrence J. Appel and Dariush Mozaffarian

Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease. In this scientific advisory, we take a clinical approach and focus on common indications for omega-3 polyunsaturated fatty acid supplements related to the prevention of clinical cardiovascular events. We limited the scope of our review to large RCTs of supplementation with major clinical cardiovascular disease end points; meta-analyses were considered secondarily. We discuss the features of available RCTs and provide the rationale for our recommendations. We then use existing American Heart Association criteria to assess the strength of the recommendation and the level of evidence. On the basis of our review of the cumulative evidence from RCTs designed to assess the effect of omega-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events, we update prior recommendations for patients with prevalent coronary heart disease, and we offer recommendations, when data are available, for patients with other clinical indications, including patients with diabetes mellitus and prediabetes and those with high risk of cardiovascular disease, stroke, heart failure, and atrial fibrillation.

04 abril 2017

CIRCULATION. The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association

Thomas M. Maddox , Nancy M. Albert , William B. Borden , Lesley H. Curtis , T. Bruce FergusonJr , David P. Kao , Gregory M. Marcus , Eric D. Peterson , Rita Redberg , John S. Rumsfeld , Nilay D. Shah and James E. Tcheng

The learning healthcare system uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery. To achieve these goals, the learning healthcare system requires systematic redesign of the current healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture. This scientific statement provides an overview of how these learning healthcare system domains can be realized in cardiovascular disease care. Current cardiovascular disease care innovations in informatics, data uses, patient engagement, continuous learning culture, and incentives are profiled. In addition, recommendations for next steps for the development of a learning healthcare system in cardiovascular care are presented.

28 febrero 2017

CIRCULATION. Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association

Marie-Pierre St-Onge , Jamy Ard , Monica L. Baskin , Stephanie E. Chiuve , Heather M. Johnson , Penny Kris-Etherton and Krista Varady

Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.

21 febrero 2017

CIRCULATION. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Mary M. Canobbio , Carole A. Warnes , Jamil Aboulhosn , Heidi M. Connolly , Amber Khanna , Brian J. Koos , Seema Mital , Carl Rose , Candice Silversides and Karen Stout

Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management.

14 febrero 2017

CIRCULATION. Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association

Lee H. Schwamm , Neale Chumbler , Ed Brown , Gregg C. Fonarow , David Berube , Karin Nystrom , Robert Suter , Mirian Zavala , Daniel Polsky , Kavita Radhakrishnan , Nathaniel Lacktman , Katherine Horton , Mary-Beth Malcarney , John Halamka and A. Colby Tiner

The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating the use of telemedicine in cardiovascular and stroke care and to provide consensus policy suggestions. We evaluate the effectiveness of telehealth in advancing healthcare quality, identify legal and regulatory barriers that impede telehealth adoption or delivery, propose steps to overcome these barriers, and identify areas for future research to ensure that telehealth continues to enhance the quality of cardiovascular and stroke care. The result of these efforts is designed to promote telehealth models that ensure better patient access to high-quality cardiovascular and stroke care while striving for optimal protection of patient safety and privacy.

07 marzo 2017

CIRCULATION. Management of Patients on Non–Vitamin K Antagonist Oral Anticoagulants in the Acute Care and Periprocedural Setting: A Scientific Statement From the American Heart Association

Amish N. Raval , Joaquin E. Cigarroa , Mina K. Chung , Larry J. Diaz-Sandoval , Deborah Diercks , Jonathan P. Piccini , Hee Soo Jung , Jeffrey B. Washam , Babu G. Welch , Allyson R. Zazulia and Sean P. Collins

Non–vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States. Idarucizumab is available as an antidote to rapidly reverse the effects of dabigatran. At present, there is no specific antidote available in the United States for the oral factor Xa inhibitors. Prothrombin concentrate may be considered in life-threatening bleeding. Healthcare institutions should adopt a NOAC reversal and perioperative management protocol developed with multidisciplinary input.

14 marzo 2017

CIRCULATION. Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Gary M. Satou , Karen Rheuban , Dale Alverson , Mark Lewin , Christopher Mahnke , James Marcin , Gerard R. Martin , Lisa Schmitz Mazur , David J. Sahn , Sanket Shah , Reed Tuckson , Catherine L. Webb and Craig A. Sable

Advancements in technology and broadband have revolutionized the current practice of medicine. The field of pediatric cardiology is no exception given the need for prompt diagnosis and reliance on cardiac imaging to identify infants and children with potentially life-threatening cardiovascular disease. As the relationship between telemedicine and pediatric cardiology has advanced, it has created a need to develop a broad, comprehensive document reviewing all the various aspects of telemedicine in pediatric cardiology. For more than a decade, a significant body of literature has been published describing individual experiences and practices, yet there remains no comprehensive statement or document summarizing this rapidly advancing field. In an effort to describe the collective experience and to provide structure and guidance for pediatric cardiology practitioners and healthcare providers, we have developed a scientific statement on the use of telemedicine in pediatric cardiology.

28 marzo 2017

CIRCULATION. Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

Donald M. Lloyd-Jones , Mark D. Huffman , Kunal N. Karmali , Darshak M. Sanghavi , Janet S. Wright , Colleen Pelser , Martha Gulati , Frederick A. Masoudi and David C. Goff Jr

The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes—the leading causes of mortality—through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to assess a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the “ABCS” (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation). The purpose of this special report is to describe the development and intended use of the Million Hearts Longitudinal ASCVD Risk Assessment Tool. The Million Hearts Tool reinforces and builds on the “2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk” by allowing clinicians to estimate baseline and updated 10-year ASCVD risk estimates for primary prevention patients adhering to the appropriate ABCS over time, alone or in combination. The tool provides updated risk estimates based on evidence from high-quality systematic reviews and meta-analyses of the ABCS therapies. This novel approach to personalized estimation of benefits from risk-reducing therapies in primary prevention may help target therapies to those in whom they will provide the greatest benefit, and serves as the basis for a Center for Medicare & Medicaid Services program designed to evaluate the Million Hearts Cardiovascular Risk Reduction Model.

01 marzo 2016

CIRCULATION. Acute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association

Laxmi S. Mehta , Theresa M. Beckie , Holli A. DeVon , Cindy L. Grines , Harlan M. Krumholz , Michelle N. Johnson , Kathryn J. Lindley , Viola Vaccarino , Tracy Y. Wang , Karol E. Watson and Nanette K. Wenger

Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

Utilizamos cookies propias para el correcto funcionamiento del sitio web y mejorar nuestros servicios. Pulse el botón Aceptar todas para aceptar su uso. Puede cambiar la configuración u obtener más información en nuestra Política de cookies o pulsando Modificar configuración.