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Accumulated data suggest that low-dose aspirin after myocardial infarction (MI) may offer similar efficacy to higher dose aspirin with reduced risk of bleeding. Few data are available on contemporary aspirin dosing patterns after MI in the United States

Fitness and traditional risk factors have well-known associations with cardiovascular disease (CVD) death in both short-term (10 years) and across the remaining lifespan. However, currently available short-term and long-term risk prediction tools do not incorporate measured fitness.

A noninvasive biomarker that could accurately diagnose acute rejection (AR) in heart transplant recipients could obviate the need for surveillance endomyocardial biopsies. We assessed the performance metrics of a novel high-sensitivity cardiac troponin I (cTnI) assay for this purpose.

Cardiac troponins, when measured using highly sensitive assays, appear to be among the most powerful prognostic biomarkers yet identified for risk assessment in the general population. Very low troponin levels detectable with these highly sensitive assays are correlated with multiple clinical determinants of future heart failure risk and cardiovascular death. Corresponding imaging evidence of subclinical heart disease includes strong associations between cardiac troponins, left ventricular hypertrophy, and reduced left ventricular ejection fraction. This is in contrast to the poor correlation with coronary disease. Cardiac troponins provide complementary information to natriuretic peptides, as well as measures of renal function, and appear to outperform high-sensitivity C-reactive protein in predicting risk for a variety of cardiovascular disease endpoints. Additional research is now needed to define the role of highly sensitive troponin assays in screening of the general population and risk assessment.

Acute cardiac allograft rejection surveillance has historically been based on serial endomyocardial biopsy (EMB). Limitations with this approach have stimulated interest in identifying noninvasive surrogate markers of rejection. This review summarizes the evidence assessing the use of direct cardiac markers B-type natriuretic peptide (BNP) and cardiac troponins in detecting acute allograft rejection.

The relation of body fat distribution to left ventricular (LV) structure and function is poorly defined.

Patients with diabetes mellitus (DM) are at high risk for mortality after myocardial infarction (MI). Despite an overall trend of reduced mortality after MI, the mortality gap between MI patients with and without DM did not decrease over time in previous analyses. We assessed recent trends in hospital mortality for patients with MI according to DM status.

Circulating biomarkers can offer insight into subclinical cardiovascular stress and thus have the potential to aid in risk stratification and tailoring of therapy.

Left ventricular hypertrophy (LVH) is traditionally classified as concentric or eccentric, based on the ratio of LV wall thickness to chamber dimension. We propose a 4-tiered LVH classification based on LV concentricity0.67(mass/end-diastolic volume0.67) and indexed LV end-diastolic volume (EDV).

This review focuses on recent developments in three controversial areas of management of acute coronary syndromes.

Since their discovery 20 years ago, natriuretic peptides have rapidly moved to the forefront in cardiovascular medicine, and have contributed to an appreciation that the heart is an important endocrine organ. Of the natriuretic peptides, brain (B-type) natriuretic peptide (BNP) has proven to be the most clinically useful. Physicians now measure circulating levels of BNP and the Nterminal fragment of its prohormone (N-proBNP) for diagnostic and prognostic assessment in patients with suspected congestive heart failure (CHF), and administer recombinant human BNP as a therapeutic agent for patients with decompensated CHF. This review will highlight the mechanisms of natriuretic peptide regulation, the physiologic actions of BNP, and its utilization in patients with cardiovascular diseases.

Background:Clopidogrel non-adherence is a strong predictor of stent thrombosis, myocardial infarction, and death after drug-eluting stent (DES) placement. Previous studies on the prevalence of premature clopidogrel discontinuation are based on self-report and have short follow-up.

Objective:Implantable cardioverter-defibrillators (ICDs) are a proven life-saving therapy for patients with low ejection fraction (EF) due to ischemic cardiomyopathy. Because ICDs are not recommended within 40 days of an acute myocardial infarction (MI), ICD consideration is potentially susceptible to errors of omission during the transition of care post-MI. This study examines ICD implantation rates within 1 year post-discharge among MI patients with low EF.

Background:ACTION Registry-GWTG (ARG) is a clinical registry and Quality Improvement (QI) program co-sponsored by the American College of Cardiology and the American Heart Association, designed to measure and improve the treatment and outcomes of patients with acute myocardial infarction (AMI). However, it is unknown whether hospital participation in ARG is associated with better performance on publicly reported AMI quality metrics and 30-day outcomes.