07 diciembre 2015

CIRCULATION. AHA Scientific Statement. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus. A Scientific Statement From the American Heart Association

Judith G. Regensteiner, PhD, FAHA, Co-Chair; Sherita Golden, MD, MHS, FAHA, Co-Chair; Amy G. Huebschmann, MD, MSc; Elizabeth Barrett-Connor, MD, FAHA; Alice Y. Chang, MD, MSc; Deborah Chyun, PhD, RN, FAHA; Caroline S. Fox, MD, FAHA*; Catherine Kim, MD, MPH; Nehal Mehta, MD, MSCE; Jane F. Reckelhoff, PhD, FAHA; Jane E.B. Reusch, MD; Kathryn M. Rexrode, MD, MPH; Anne E. Sumner, MD, FAHA; Francine K. Welty, MD, FAHA; Nanette K. Wenger, MD, FAHA; Blair Anton, MLIS, MS, AHIP; on behalf of the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health, Council on Epidemiology and Prevention, Council on Functional Genomics and Translational Biology, and Council on Hypertension

The prevalence of diabetes mellitus (DM) is increasing at a rapid rate. In the United States in 2012, 29.1 million Americans, or 9.3% of the population, had DM.1 Currently, ≈1 in 13 people living in the United States has DM, and 90% to 95% of these individuals have type 2 DM (T2DM).2 Overall, the prevalence of T2DM is similar in women and men. In the United States, ≈12.6 million women (10.8%) and 13 million men (11.8%) ≥20 years of age are currently estimated to have T2DM.2

03 noviembre 2015

CIRCULATION. AHA/ATS Guideline. Pediatric Pulmonary Hypertension. Guidelines From the American Heart Association and American Thoracic Society

Steven H. Abman, MD, Co-Chair; Georg Hansmann, MD, PhD, FAHA, Co-Chair; Stephen L. Archer, MD, FAHA, Co-Chair; D. Dunbar Ivy, MD, FAHA; Ian Adatia, MD; Wendy K. Chung, MD, PhD; Brian D. Hanna, MD; Erika B. Rosenzweig, MD; J. Usha Raj, MD; David Cornfield, MD; Kurt R. Stenmark, MD; Robin Steinhorn, MD, FAHA; Bernard Thébaud, MD, PhD; Jeffrey R. Fineman, MD; Titus Kuehne, MD; Jeffrey A. Feinstein, MD; Mark K. Friedberg, MD; Michael Earing, MD; Robyn J. Barst, MD†; Roberta L. Keller, MD; John P. Kinsella, MD; Mary Mullen, MD, PhD; Robin Deterding, MD; Thomas Kulik, MD; George Mallory, MD; Tilman Humpl, MD; David L. Wessel, MD; on behalf of the American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; and the American Thoracic Society

Abstract: Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension.

15 septiembre 2015

CIRCULATION. AHA Scientific Statement. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications. A Scientific Statement for Healthcare Professionals From the American Heart Association

Larry M. Baddour, MD, FAHA, Chair; Walter R. Wilson, MD; Arnold S. Bayer, MD; Vance G. Fowler Jr, MD, MHS; Imad M. Tleyjeh, MD, MSc; Michael J. Rybak, PharmD, MPH; Bruno Barsic, MD, PhD; Peter B. Lockhart, DDS; Michael H. Gewitz, MD, FAHA; Matthew E. Levison, MD; Ann F. Bolger, MD, FAHA; James M. Steckelberg, MD; Robert S. Baltimore, MD; Anne M. Fink, PhD, RN; Patrick O’Gara, MD, FAHA; Kathryn A. Taubert, PhD, FAHA; on behalf of the American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council

Background: Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today’s myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances.

28 marzo 2014

CIRCULATION. AHA/ACC/HRS Practice Guideline. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society

Craig T. January, MD, PhD, FACC, Chair; L. Samuel Wann, MD, MACC, FAHA, Vice Chair*; Joseph S. Alpert, MD, FACC, FAHA*†; Hugh Calkins, MD, FACC, FAHA, FHRS*‡§; Joaquin E. Cigarroa, MD, FACC†; Joseph C. Cleveland Jr, MD, FACC‖; Jamie B. Conti, MD, FACC, FHRS*†; Patrick T. Ellinor, MD, PhD, FAHA‡; Michael D. Ezekowitz, MB, ChB, FACC, FAHA*†; Michael E. Field, MD, FACC, FHRS†; Katherine T. Murray, MD, FACC, FAHA, FHRS†; Ralph L. Sacco, MD, FAHA†; William G. Stevenson, MD, FACC, FAHA, FHRS*¶; Patrick J. Tchou, MD, FACC‡; Cynthia M. Tracy, MD, FACC, FAHA†; Clyde W. Yancy, MD, FACC, FAHA†

Preamble: The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist clinicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.

04 diciembre 2015

CIRCULATION. ACC/AHA Guidelines Clarification Statement. Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves. A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

ACC/AHA TASK FORCE MEMBERS; Jonathan L. Halperin, MD, FACC, FAHA, Chair; Glenn N. Levine, MD, FACC, FAHA, Chair-Elect; Jeffrey L. Anderson, MD, FACC, FAHA, Immediate Past Chair‡; Nancy M. Albert, PhD, RN, FAHA‡; Sana M. Al-Khatib, MD, MHS, FACC, FAHA; Kim K. Birtcher, PharmD, AACC; Biykem Bozkurt, MD, PhD, FACC, FAHA; Ralph G. Brindis, MD, MPH, MACC; Joaquin E. Cigarroa, MD, FACC; Lesley H. Curtis, PhD, FAHA; Lee A. Fleisher, MD, FACC, FAHA; Federico Gentile, MD, FACC; Samuel Gidding, MD, FAHA; Mark A. Hlatky, MD, FACC; John Ikonomidis, MD, PhD, FAHA; José Joglar, MD, FACC, FAHA; Richard J. Kovacs, MD, FACC, FAHA‡; E. Magnus Ohman, MD, FACC‡; Susan J. Pressler, PhD, RN, FAHA; Frank W. Sellke, MD, FACC, FAHA‡; Win-Kuang Shen, MD, FACC, FAHA‡; Duminda N. Wijeysundera, MD, PhD

Abstract: Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the “2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease” (Circulation. 2010;121:e266–e369) and the “2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease” (Circulation. 2014;129:e521–e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.

01 diciembre 2015

JACC. Primary Prevention With Statins. ACC/AHA Risk-Based Approach Versus Trial-Based Approaches to Guide Statin Therapy

Martin B. Mortensen, MD, PhD∗; Shoaib Afzal, MD, PhD†,‡; Børge G. Nordestgaard, MD, DMSc†,‡; Erling Falk, MD, DMSc∗

Background: Guidelines recommend initiating primary prevention for atherosclerotic cardiovascular disease (ASCVD) with statins based on absolute ASCVD risk assessment. Recently, alternative trial-based and hybrid approaches were suggested for statin treatment eligibility.

01 diciembre 2015

JACC. 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (A Revision of the ACC/AHA 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion)

Douglas P. Zipes, MD, FAHA, FHRS, MACC; Hugh Calkins, MD, FACC, FAHA, FHRS; James P. Daubert, MD, FACC, FHRS; Kenneth A. Ellenbogen, MD, FACC, FAHA, FHRS; Michael E. Field, MD, FACC, FHRS; John D. Fisher, MD, FACC, FHRS; Richard Ira Fogel, MD, FACC, FHRS; David S. Frankel, MD, FACC, FHRS; Anurag Gupta, MD, FACC; Julia H. Indik, MD, PhD, FACC, FAHA, FHRS; Fred M. Kusumoto, MD, FACC, FHRS; Bruce D. Lindsay, MD, FACC, FAHA, FHRS; Joseph E. Marine, MD, FACC, FHRS; Laxmi S. Mehta, MD, FACC, FAHA; Lisa A. Mendes, MD, FACC; John M. Miller, MD, FACC, FHRS; Thomas M. Munger, MD, FACC; William H. Sauer, MD, FACC, FHRS; Win-Kuang Shen, MD, FACC, FAHA, FHRS; William G. Stevenson, MD, FACC, FAHA, FHRS; Wilber W. Su, MD, FHRS; Cynthia M. Tracy, MD, FACC; Angela Tsiperfal, NP-C

Preamble: Since the 1995 publication of its Core Cardiovascular Training Statement (COCATS), the American College of Cardiology (ACC) has played a central role in defining the knowledge, experiences, skills, and behaviors expected of all clinical cardiologists upon completion of training. Subsequent updates have incorporated major advances and revisions—both in content and structure—including, most recently, a further move toward competency (outcomes)-based training, and the use of the 6-domain competency structure promulgated by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties, and endorsed by the American Board of Internal Medicine (ABIM). A similar structure has been used by ACC to describe the aligned general cardiovascular lifelong learning competencies that all practicing cardiologists are expected to maintain. Many hospital systems also now use the 6-domain structure as part of medical staff privileging and peer-review professional competence assessments.

01 febrero 2016

JACC. 2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures. A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures

Joseph P. Drozda, Jr., MD, FACC; T. Bruce Ferguson, Jr., MD, FACC, FAHA; Hani Jneid, MD, FACC, FAHA, FSCAI; Harlan M. Krumholz, MD, SM, FACC; Brahmajee K. Nallamothu, MD, FACC; Jeffrey W. Olin, DO, FACC, FAHA, MSVM; Henry H. Ting, MD, MBA, FACC, FAHA

American College of Cardiology (ACC)/American Heart Association (AHA) performance measures can serve as vehicles to accelerate appropriate translation of scientific evidence into clinical practice. Performance measures cover a subset of the most important recommended care practices and are considered appropriate for public reporting or use in pay for performance programs. Other measures of care that are not considered appropriate for public reporting or payment modification may be used as quality or test metrics for internal quality improvement. As defined by the ACC/AHA, quality metrics are those measures that have been developed to support self-assessment and quality improvement at the provider, hospital, and/or healthcare system level. These metrics may not meet all specifications of formal performance measures (1). In certain cases, an ACC/AHA performance measure writing committee may identify particular measures as quality metrics for the purposes of pilot testing with the potential of later promotion to performance measurement. Specific criteria for performance measures have been published (2,3) by the ACC/AHA and include an important gap in care and a clear path to improve care. Recently, value was added as an exclusion criterion (4), where a care practice deemed to be of poor value by an ACC/AHA guideline would not be considered as a performance measure. The ACC/AHA Task Force on Performance Measures has historically focused on process of care measures under the control of individual providers. However, writing committees may also create structural or outcome measures when they meet the ACC/AHA performance measurement criteria.

01 noviembre 2014

JACC. ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/SCMR/SOPE 2014 Appropriate Use Criteria for Initial Transthoracic Echocardiography in Outpatient Pediatric Cardiology. A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography

Robert M. Campbell, MD, FACC, FAHA, FAAP, FHRS; Pamela S. Douglas, MD, MACC, FAHA, FASE; Benjamin W. Eidem, MD, FACC, FASE; Wyman W. Lai, MD, MPH, FACC, FASE; Leo Lopez, MD, FACC, FAAP, FASE; Ritu Sachdeva, MD, FACC, FAAP, FASE

Abstract: The American College of Cardiology (ACC) participated in a joint project with the American Society of Echocardiography, the Society of Pediatric Echocardiography, and several other subspecialty societies and organizations to establish and evaluate Appropriate Use Criteria (AUC) for the initial use of outpatient pediatric echocardiography. Assumptions for the AUC were identified, including the fact that all indications assumed a first-time transthoracic echocardiographic study in an outpatient setting for patients without previously known heart disease. The definitions for frequently used terminology in outpatient pediatric cardiology were established using published guidelines and standards and expert opinion. These AUC serve as a guide to help clinicians in the care of children with possible heart disease, specifically in terms of when a transthoracic echocardiogram is warranted as an initial diagnostic modality in the outpatient setting. They are also a useful tool for education and provide the infrastructure for future quality improvement initiatives as well as research in healthcare delivery, outcomes, and resource utilization.

06 octubre 2015

CIRCULATION. AHA Scientific Statement. Cardiac Arrest in Pregnancy. A Scientific Statement From the American Heart Association

Farida M. Jeejeebhoy, MD, Chair; Carolyn M. Zelop, MD; Steve Lipman, MD; Brendan Carvalho, MD; Jose Joglar, MD; Jill M. Mhyre, MD; Vern L. Katz, MD; Stephen E. Lapinsky, MB BCh, MSc; Sharon Einav, MD; Carole A. Warnes, MD; Richard L. Page, MD; Russell E. Griffin, LP, FP-C; Amish Jain, MD; Katie N. Dainty, PhD; Julie Arafeh, RN, MS; Rory Windrim, MD; Gideon Koren, MD; Clifton W. Callaway, MD, PhD; on behalf of the American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Diseases in the Young, and Council on Clinical Cardiology

Abstract: This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation.

01 noviembre 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. 2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview: A professional societal overview from the American College of Cardiology, Heart Rhythm Society, and Society for Cardiovascular Angiography and Interventions

Frederick A. Masoudi MD, MSPH, FACC, Chair1, Hugh Calkins MD, FACC, FHRS, Vice-Chair2, Clifford J. Kavinsky MD, PhD, FACC, FSCAI, Vice-Chair3, David J. Slotwiner MD, FHRS, FACC2, Zoltan G. Turi MD, FACC, MSCAI3, Joseph P. Drozda Jr MD, FACC1 andPhillip Gainsley4

PREAMBLE: Left atrial appendage (LAA) occlusion devices have the potential to influence the clinical approach to stroke prevention in patients with atrial fibrillation (AF). A number of percutaneous techniques have been proposed, including intracardiac plugs and external ligation. Several devices have been adopted to various degrees in the United States and internationally. Only 1 (WATCHMAN, Boston Scientific, Marlborough, Massachusetts) has been evaluated in randomized controlled trials compared with the current standard of care. This device was recently approved for use in the United States by the Food and Drug Administration (FDA) as an alternative to warfarin for stroke prevention. Others are less well studied: the Amplatzer Cardiac Plug (St. Jude Medical, St. Paul, Minnesota), like the WATCHMAN, has been used widely outside of the United States under the Conformité Européenne (CE) mark, despite little published data to support its use; and the LARIAT (Sentreheart, Redwood City, California) is also CE marked, has received FDA 510(k) approval as a method of soft tissue approximation but not stroke prevention, and is being used off-label in clinical practice for LAA occlusion in the United States and internationally, although the evidence of its efficacy or safety is also lacking.

03 agosto 2015

CIRCULATION. AHA Scientific Statement. Social Determinants of Risk and Outcomes for Cardiovascular Disease. A Scientific Statement From the American Heart Association

Edward P. Havranek, MD, FAHA, Chair; Mahasin S. Mujahid, PhD, MS, Co-Chair; Donald A. Barr, MD, PhD; Irene V. Blair, PhD; Meryl S. Cohen, MD, FAHA; Salvador Cruz-Flores, MD, FAHA; George Davey-Smith, MA(Oxon), MD, BChir(Cantab), MSc(Lond); Cheryl R. Dennison-Himmelfarb, RN, PhD, FAHA; Michael S. Lauer, MD, FAHA; Debra W. Lockwood; Milagros Rosal, PhD; Clyde W. Yancy, MD, FAHA; on behalf of the American Heart Association Council on Quality of Care and Outcomes Research, Council on Epidemiology and Prevention, Council on Cardiovascular and Stroke Nursing, Council on Lifestyle and Cardiometabolic Health, and Stroke Council

Introduction: An Institute of Medicine report titled U.S. Health in International Perspective: Shorter Lives, Poorer Health documents the decline in the health status of Americans relative to people in other high-income countries, concluding that “Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.”1 The report blames many factors, “adverse economic and social conditions” among them. In an editorial in Science discussing the findings of the Institute of Medicine report, Bayer et al2 call for a national commission on health “to address the social causes that have put the USA last among comparable nations.”

06 julio 2015

CIRCULATION. AHA Scientific Statement. Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

Goutham Rao, MD, FAHA; Tiffany M. Powell-Wiley, MD, MPH, FAHA; Irma Ancheta, PhD, FAHA; Kristen Hairston, MD; Katherine Kirley, MD, MS; Scott A. Lear, PhD; Kari E. North, PhD; Latha Palaniappan, MD, MS, FAHA; Milagros C. Rosal, PhD; on behalf of the American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health

Obesity, defined as excess fat (adipose) tissue accumulation that may impair health,1 is a highly prevalent and serious public health problem. Roughly 35.7% of American adults are obese.2 High rates of obesity are not limited to the United States or even to other highly developed countries.

05 agosto 2015

CIRCULATION. AHA/ADA Scientific Statement. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Caroline S. Fox, MD, MPH, FAHA, Co-Chair; Sherita Hill Golden, MD, MHS, FAHA, Co-Chair; Cheryl Anderson, PhD, MPH, MS; George A. Bray, MD; Lora E. Burke, PhD, MPH, FAHA; Ian H. de Boer, MD, MS; Prakash Deedwania, MD, FAHA; Robert H. Eckel, MD; Abby G. Ershow, ScD, RD, FAHA; Judith Fradkin, MD; Silvio E. Inzucchi, MD; Mikhail Kosiborod, MD, FAHA; Robert G. Nelson, MD, PhD; Mahesh J. Patel, MD; Michael Pignone, MD, MPH; Laurie Quinn, PhD, RN; Philip R. Schauer, MD; Elizabeth Selvin, PhD, MPH, FAHA; Dorothea K. Vafiadis, MS, FAHA; on behalf of the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health, Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, Council on Quality of Care and Outcomes Research, and the American Diabetes Association

Abstract: Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus.

29 diciembre 2014

CIRCULATION. ACC/AHA Clinical Data Standards. 2014 ACC/AHA Key Data Elements and Definitions for Cardiovascular Endpoint Events in Clinical Trials. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Cardiovascular Endpoints Data Standards)

Karen A. Hicks, MD, FACC, Chair*; James E. Tcheng, MD, FACC, Vice-Chair; Biykem Bozkurt, MD, PhD, FACC, FAHA; Bernard R. Chaitman, MD, FACC; Donald E. Cutlip, MD, FACC; Andrew Farb, MD, FACC*; Gregg C. Fonarow, MD, FACC, FAHA; Jeffrey P. Jacobs, MD, FACC; Michael R. Jaff, DO, FACC; Judith H. Lichtman, MPH, PhD; Marian C. Limacher, MD, FACC, FAHA; Kenneth W. Mahaffey, MD, FACC; Roxana Mehran, MD, FACC, FAHA; Steven E. Nissen, MD, MACC, FAHA; Eric E. Smith, MD, MPH, FAHA; Shari L. Targum, MD, FACC*

Clinical data standards strive to define and standardize data relevant to clinical concepts, with the primary goal of facilitating uniform data collection by providing a platform of clinical terms with corresponding definitions and data elements. Broad agreement on a common vocabulary with reliable definitions used by all is vital to pool and/or compare data across clinical trials to promote interoperability with electronic health records (EHRs) and to assess the applicability of research to clinical practice. The ultimate purpose of clinical data standards is to contribute to the infrastructure necessary to accomplish the ACC’s mission of fostering optimal cardiovascular care and disease prevention and the AHA’s mission of building healthier lives, free of cardiovascular diseases and stroke.