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The article discusses the projected increase in costs associated with cardiovascular disease (CVD) from 2020 to 2050. It highlights the impact of an aging population, as well as increasing rates of obesity, hypertension, and diabetes among young and middle-aged adults, particularly in low-income communities. The article emphasizes the need for effective interventions to address these disparities, especially among minority populations. It also suggests potential solutions such as value-based payment reforms, telemedicine, and wearable health monitoring devices. The article concludes by emphasizing the importance of a comprehensive approach to address the challenges posed by the growing elderly population and decreasing disparities in healthcare. [Extracted from the article]

The article discusses the need for a new, independent Board of Cardiovascular Medicine to modernize the certification process for cardiologists. The current system, established in 1941, does not adequately reflect the evolving field of cardiovascular medicine, which has its own unique care pathways, knowledge base, and specialized training. The proposed Board would focus on supportive learning and continuous competency, with a collaborative approach to assessments. It would also incorporate advanced technology and address nonclinical competencies such as diversity, inclusion, and well-being. The decision on whether to establish the new Board is still pending, but physicians are encouraged to continue participating in the current certification process. [Extracted from the article]

BACKGROUND: Canadian data suggest that patients of lower socioeconomic status with acute myocardial infarction receive less beneficial therapy and have worse clinical outcomes, raising questions regarding care disparities even in universal health care systems. We assessed the contemporary association of marginalization with clinical outcomes and health services use. METHODS: Using clinical and administrative databases in Ontario, Canada, we conducted a population-based study of patients aged ≥65 years hospitalized for their first acute myocardial infarction between April 1, 2010 and March 1, 2019. Patients receiving cardiac catheterization and surviving 7 days postdischarge were included. Our primary exposure was neighborhoodlevel marginalization, a multidimensional socioeconomic status metric. Neighborhoods were categorized by quintile from Q1 (least marginalized) to Q5 (most marginalized). Our primary outcome was all-cause mortality. A proportional hazards regression model with a robust variance estimator was used to quantify the association of marginalization with outcomes, adjusting for risk factors, comorbidities, disease severity, and regional cardiologist supply. RESULTS: Among 53 841 patients (median age, 75 years; 39.1% female) from 20 640 neighborhoods, crude 1- and 3-year mortality rates were 7.7% and 17.2%, respectively. Patients in Q5 had no significant difference in 1-year mortality (hazard ratio [HR], 1.08 [95% CI, 0.95--1.22]), but greater mortality over 3 years (HR, 1.13 [95% CI, 1.03--1.22]) compared with Q1. Over 1 year, we observed differences between Q1 and Q5 in visits to primary care physicians (Q1, 96.7%; Q5, 93.7%) and cardiologists (Q1, 82.6%; Q5, 72.6%), as well as diagnostic testing. There were no differences in secondary prevention medications dispensed or medication adherence at 1 year. CONCLUSIONS: In older patients with acute myocardial infarction who survived to hospital discharge, those residing in the most marginalized neighborhoods had a greater long-term risk of mortality, less specialist care, and fewer diagnostic tests. Yet, there were no differences across socioeconomic status in prescription medication use and adherence. [ABSTRACT FROM AUTHOR]

Objectives: A comprehensive cardiovascular disease (CVD) prevention approach should address patients' medical, behavioral, and psychological issues. The aim of this study was to understand the clinician-reported availability of a pertinent CVD preventive workforce across various specialties using a survey study in the southeastern United States, an area with a disproportionate burden of CVD and commonly known as the Stroke Belt. Methods: We surveyed physicians, advanced practice providers (APPs), and pharmacists in internal medicine, family medicine, endocrinology, and cardiology regarding available specialists in CVD preventive practice. We examined categorical variables using the χ² test and continuous variables using the t test/analysis of variance. Results: A total of 263 clinicians from 21 health systems participated (27.6% response rate, 91.5% from North Carolina). Most were women (54.5%) and physicians (72.5%) specializing in cardiology (43.6%) and working at academic centers (51.3%). Overall, most clinicians stated having adequate specialist services to manage hypertension (86.6%), diabetes mellitus (90.1%), and dyslipidemia (84%), with >50% stating having adequate specialist services for obesity, smoking cessation, diet/nutrition, and exercise counseling. Many reported working with an APP (69%) or a pharmacist (56.5%). Specialist services for exercise therapy, psychology, behavioral counseling, and preventive cardiology were less available. When examined across the four specialties, the majority reported having adequate specialist services for hypertension, diabetes mellitus, obesity, dyslipidemia, and diet/nutrition counseling. Providers from all four specialties were less likely to work with exercise therapists, psychologists, behavioral counselors, and preventive cardiologists. Conclusions: Amajority of providers expressed having adequate specialists for hypertension, diabetes mellitus, dyslipidemia, obesity, smoking cessation, diet/nutrition, and exercise counseling. Most worked together with APPs and pharmacists but less frequently with exercise therapists, psychologists, behavioral counselors, and preventive cardiologists. Further research should explore approaches to use and expand less commonly available specialists for optimal CVD preventive care. [ABSTRACT FROM AUTHOR]

More than 16 000 Americans experience spinal cord injury (SCI), resulting in chronic disability and other secondary sequelae, each year. Improvements in acute medical management have increased life expectancy. Cardiovascular disease is a leading cause of death in this population, and seems to occur earlier in individuals with SCI compared with the general population. People with SCI experience a high burden of traditional cardiovascular disease risk factors, including dyslipidemia and diabetes, and demonstrate anatomic, metabolic, and physiologic changes alongside stark reductions in physical activity after injury. They also experience multiple, complex barriers to care relating to disability and, in many cases, compounding effects of intersecting racial and socioeconomic health inequities. Given this combination of risk factors, some investigators have proposed that people with SCI are at increased risk for cardiovascular disease, beyond that associated with traditional risk factors, and SCI could be considered a risk-enhancing factor, analogous to other risk-enhancing factors defined by the 2019 American Heart Association/American College of Cardiology Primary Prevention Guidelines. However, more research is needed in this population to clarify the role of traditional risk factors, novel risk factors, health care access, social determinants of health, and intersectionality of disability, race, and socioeconomic status. There is an urgent need for primary care physicians and cardiologists to have awareness of the importance of timely diagnosis and management of cardiac risk factors for people with SCI. [ABSTRACT FROM AUTHOR]

Background: Congenital heart defects (CHD) are the most prevalent birth anomaly and leading cause of infant morbidity and mortality worldwide. Heart defects are often attributed to chromosomal abnormality or environmental factors, but most causes remain unknown. The purpose of this analysis was to explore maternal health variables and the relationships to birth outcomes in infants with CHD. Methods: Secondary analysis of data from the Wisconsin Pediatric Cardiac Registry. Results: Maternal history of CHDs (odds ratio [OR] = 2.38; 95% confidence interval [CI], 1.42-3.98) and serious health conditions (OR = 1.537; 95%: CI, 1.08-2.17) increase infant risk and CHD severity. Maternal history of hypertension, serious health conditions, CHD, obesity, and income were predictors of birth weight (R² = 0.049, P <.05). Maternal history of hypertension, influenza, serious health conditions, and housing were predictors of gestational age (R 2 = 0.045, P <.05). Birth weight (BW) and gestational age (GA) did not correlate to the severity of CHD in this study (simple vs complex, BW = −0.014, GA = 0.011, r). Discussion: Maternal well-being influences the health of infants born with CHD. Positive maternal health contributes to near-normal birth weight and gestational age. Conclusion: Nurses must discuss optimal reproductive life planning strategies for decreasing risk of CHD and other infant disorders. [ABSTRACT FROM AUTHOR]

Background: There are limited data on the association of material deprivation with clinical care and outcomes after atrial fibrillation (AF) diagnosis in jurisdictions with universal health care.Methods: This was a population-based cohort study of individuals ≥66 years of age with first diagnosis of AF between April 1, 2007, and March 31, 2019, in the Canadian province of Ontario, which provides public funding and prohibits private payment for medically necessary physician and hospital services. Prescription medications are subsidized for residents >65 years of age. The primary exposure was neighborhood material deprivation, a metric derived from Canadian census data to estimate inability to attain basic material needs. Neighborhoods were categorized by quintile from Q1 (least deprived) to Q5 (most deprived). Cause-specific hazards regression was used to study the association of material deprivation quintile with time to AF-related adverse events (death or hospitalization for stroke, heart failure, or bleeding), clinical services (physician visits, cardiac diagnostics), and interventions (anticoagulation, cardioversion, ablation) while adjusting for individual characteristics and regional cardiologist supply.Results: Among 347 632 individuals with AF (median age 79 years, 48.9% female), individuals in the most deprived neighborhoods (Q5) had higher prevalence of cardiovascular disease, risk factors, and noncardiovascular comorbidity relative to residents of the least deprived neighborhoods (Q1). After adjustment, Q5 residents had higher hazards of death (hazard ratio [HR], 1.16 [95% CI, 1.13-1.20]) and hospitalization for stroke (HR, 1.16 [95% CI, 1.07-1.27]), heart failure (HR, 1.14 [95% CI, 1.11-1.18]), or bleeding (HR, 1.16 [95% CI, 1.07-1.25]) relative to Q1. There were small differences across quintiles in primary care physician visits (HR, Q5 versus Q1, 0.91 [95% CI, 0.89-0.92]), echocardiography (HR, Q5 versus Q1, 0.97 [95% CI, 0.96-0.99]), and dispensation of anticoagulation (HR, Q5 versus Q1, 0.97 [95% CI, 0.95-0.98]). There were more prominent disparities for Q5 versus Q1 in cardiologist visits (HR, 0.84 [95% CI, 0.82-0.86]), cardioversion (HR, 0.80 [95% CI, 0.76-0.84]), and ablation (HR, 0.45 [95% CI, 0.30-0.67]).Conclusions: Despite universal health care and prescription medication coverage, residents of more deprived neighborhoods were less likely to visit cardiologists or receive rhythm control interventions after AF diagnosis, even though they exhibited higher cardiovascular disease burden and higher risk of adverse outcomes. [ABSTRACT FROM AUTHOR]

In a multicenter, retrospective, large database cohort study of over 15,000 mechanically ventilated COVID-19 patients at 86 U.S. healthcare systems, the authors used electronic health record data to assess the predictive capacity of the SOFA score for inhospital mortality in COVID-19 patients. Keywords: COVID-19; mechanical ventilation; mortality; outcomes research; predictive algorithms; Sequential Organ Failure Assessment Score EN COVID-19 mechanical ventilation mortality outcomes research predictive algorithms Sequential Organ Failure Assessment Score 1150 1153 4 06/23/22 20220701 NES 220701 The COVID-19 pandemic has been associated with global surges in need for hospital-based and other healthcare resources, as well as shortages in vital items such as ICU beds, mechanical ventilators, and personal protective equipment (Fig. 2021; 325:, 1469-1470, 6 Cuartas PA, Tavares Santos H, Levy BM,: Modeling outcomes using Sequential Organ Failure Assessment (SOFA) score-based ventilator triage guidelines during the COVID-19 pandemic. [Extracted from the article]

Competing Interests: The authors declare no conflicts. S.A. Murphy and Dr Bellavia are members of the TIMI Study Group, which has received institutional research grant support through Brigham and Women’s Hospital from Abbott, Abiomed, Inc, Amgen, Anthos Therapeutics, ARCA Biopharma, Inc, AstraZeneca, Boehringer Ingelheim, Daiichi-Sankyo, Ionis Pharmaceuticals, Inc, Janssen Research and Development, LLC, MedImmune, Merck, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc, Roche, Saghmos Therapeutics, Inc, Siemens Healthcare Diagnostics, Inc, Softcell Medical Limited, The Medicines Company, Verve Therapeutics, Inc, and Zora Biosciences. The content is solely the responsibility of the authors.

Alain Cribier, MD, pioneered transcatheter aortic valve implantation in Rouen 20 years ago.[4] Other breakthroughs occurred in electrophysiology (atrial fibrillation ablation; Michel Haissaguerre, MD) and resynchronization therapy (Serge Cazeau, MD, and Jean-Claude Daubert, MD), both techniques receiving worldwide recognition. Hence, efforts are underway to authorize and train allied health care professionals, in particular nurses, to administer treatment previously provided only by cardiologists (eg, transthoracic echocardiograms, heart failure treatment). If needed, the physician in charge dispatches a physician-staffed ambulance. [Extracted from the article]

These inequities include high incidence of AF risk factors, poor awareness and detection of AF, low access to AF treatment, and high prevalence of AF-related complications among individuals residing in neighborhoods at greater disadvantage. The most notable difference between those residing in low versus high neighborhood deprivation areas was the rate of AF ablation within a year of AF diagnosis (adjusted hazard ratio, 0.45 [95% CI, 0.30-0.67]). Editorials, atrial fibrillation, cardiovascular diseases, heart disease risk factors, disparities, public health, residence characteristics. [Extracted from the article]

Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs. Cardiologists are 3 times more likely than endocrinologists to see patients with both type 2 diabetes and cardiovascular disease, thus they are ideally positioned to share responsibility for SGLT-2i and GLP-1RA treatment with primary care providers. In order to increase adoption, SGLT-2i and GLP-1RA must be reframed as primarily cardiovascular and kidney disease risk-reducing agents with a side effect of glucose-lowering. Coordinated and multifaceted interventions engaging clinicians, patients, payers, professional societies, and health systems must be implemented to incentivize the adoption of these medications as part of routine cardiovascular and kidney care. Greater use of SGLT-2i and GLP-1RA will improve outcomes for patients with type 2 diabetes at high risk for cardiovascular and kidney disease. [ABSTRACT FROM AUTHOR]

In the United States, race-based disparities in cardiovascular disease care have proven to be pervasive, deadly, and expensive. African American/Black, Hispanic/Latinx, and Native/Indigenous American individuals are at an increased risk of cardiovascular disease and are less likely to receive high-quality, evidence-based medical care as compared with their White American counterparts. Although the United States population is diverse, the cardiovascular workforce that provides its much-needed care lacks diversity. The available data show that care provided by physicians from racially diverse backgrounds is associated with better quality, both for minoritized patients and for majority patients. Not only is cardiovascular workforce diversity associated with improvements in health care quality, but racial diversity among academic teams and research scientists is linked with research quality. We outline documented barriers to achieving workforce diversity and suggest evidence-based strategies to overcome these barriers. Key strategies to enhance racial diversity in cardiology include improving recruitment and retention of racially diverse members of the cardiology workforce and focusing on cardiovascular health equity for patients. This review draws attention to academic institutions, but the implications should be considered relevant for nonacademic and community settings as well. [ABSTRACT FROM AUTHOR]

Background: Delays in patient access due to excessive wait times for clinic consult appointments impair timely diagnosis and treatment, resulting in worse outcomes. Local problem: Average days wait (ADW) for clinic consult appointments for the cardiology group of a regional managed care organization was too long. A quality improvement project (QIP) was undertaken to improve efficiency/efficacy of patient coverage and reduce ADW by implementing a new cardiology hospital service with expanded roles for nurse practitioners (NPs). Methods and intervention: The QIP used the Institute for Healthcare Improvement's Model for Improvement. The new cardiology hospital service deployed a group of 11 cardiologists and three cardiology NPs who rotated between hospital and clinic service. Two cardiologists and one NP covered all cardiology inpatients, alleviating the need for clinic-assigned cardiologists to also see hospitalized patients, thus improving capacity. The primary measure was ADW, whereas secondary measures included patient satisfaction with access, hospital readmissions, clinic cancellations, and provider job satisfaction. Results: All measures were assessed on pre/post 6-month averages. Average days wait reduced from 28 to 14; patient satisfaction improved from 39% to 52%; readmissions reduced from 13.2% to 9.7%, and provider job satisfaction with the intervention was 91% positive. There were no significant changes in potential confounding factors and no identified negative consequences. Conclusions: Implementation of a cardiology hospital service leveraging NPs was feasible, increased capacity to improve patient access and associated outcomes, and did not manifest any known adverse impacts. [ABSTRACT FROM AUTHOR]

During the NHLCC kickoff events at the 2022 AHA Scientific Sessions in Chicago, Rodriguez Mendoza, her fellow NHLCC students, and participating mentors found that they had shared many experiences despite coming from varied Hispanic and Latino backgrounds, Velarde said. Last fall, her confidence got a much-needed boost from the American Heart Association (AHA) National Hispanic Latino Cardiovascular Collaborative (NHLCC). [Extracted from the article]

A 2010 Italian Society of Interventional Cardiology registry showed that efficient ST-segment-elevation myocardial infarction networks cover [almost equal to]50% of Italy. Italy is assigned a total of [Euro sign]20.23 billion dedicated to health care for the strengthening of territorial assistance through the creation of new structures (such as community hospitals and homes). It is hoped that the Recovery Fund (Next Generation Eu) will enable Italy to reorganize a universal health system that previously guaranteed all citizens equal health treatment regardless of income. [Extracted from the article]

Myeloproliferative neoplasms, including polycythemia vera, essential thrombocythemia, and myelofibrosis, are characterized by somatic gene mutations in bone marrow stem cells, which trigger an inflammatory response influencing the development of associated cardiovascular complications. In recent years, the same mutations were found in individuals with cardiovascular diseases even in the absence of hematological alterations. These genetic events allow the identification of a new entity called 'clonal hematopoiesis of indeterminate potential' (CHIP), as it was uncertain whether it could evolve toward hematological malignancies. CHIP is age-related and, remarkably, myocardial infarction, stroke, and heart failure were frequently reported in these individuals and attributed to systemic chronic inflammation driven by the genetic mutation. We reviewed the connection between clonal hematopoiesis, inflammation, and cardiovascular diseases, with a practical approach to improve clinical practice and highlight the current unmet needs in this area of knowledge., (Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.)

BACKGROUND There is limited data on the risk of perioperative myocardial infarctions (MIs) in patients with a recent MI who undergo dermatologic surgeries. OBJECTIVE Present the recommendations of dermatologic surgeons and cardiologists to determine the safety of dermatologic surgeries after a recent MI. METHODS An electronic survey was distributed to Mohs surgeons and cardiologists to infer the risk of major adverse cardiac events (MACE) inherent to dermatologic surgery and determine timing of dermatologic surgery in patients with a recent MI. RESULTS One hundred twenty Mohs surgeons and 30 cardiologists were surveyed. Ninety-seven percent of cardiologists and 87% of Mohs surgeons deemed cutaneous excisions and Mohs micrographic surgery as lowrisk procedures with less than one-percent chance of MACE. Seventy-seven percent of cardiologists and 46% of Mohs surgeons stated dermatologic surgery should either not be delayed or be delayed up to 1 month after an MI. Responses between cardiologists and Mohs surgeons did not significantly differ. CONCLUSION A preponderance of surveyed experts believe that most dermatologic surgeries may be safely performed in patients with a history of an MI within 1 month. The decision to implement urgent dermatologic surgery in patients with a recent MI should account for all clinically significant factors. [ABSTRACT FROM AUTHOR]

The number of reproductive age women with valvular heart disease is rising and accounts for one third of all heart disease among pregnant women. Severe, symptomatic left-sided cardiac lesions, particularly mitral and aortic stenosis, and mechanical heart valves, are associated with adverse maternal and fetal outcomes. Decreasing maternal and fetal risk requires shared decision-making among patients and the heart team, consisting of obstetricians, maternal-fetal medicine subspecialists, and cardiologists. [ABSTRACT FROM AUTHOR]

Background: Hospital--physician vertical integration involving employment of physicians has increased considerably over the last decade. Cardiologists are one group of specialists being increasingly employed by hospitals. Although hospital--physician integration has the potential to produce economic and societal benefits, there is concern that this consolidation may reduce competition and concentrate bargaining power among providers. In addition, hospitals may be motivated to offer cardiologists higher compensation and reduced workloads as an incentive to integrate. Purpose: The aim of the study was to determine if there are differences in compensation and clinical productivity, measured by work relative value units (RVUs), for cardiologists as they transition from being independent practitioners to being employed by hospitals. Methodology/Approach: This study was a quantitative, retrospective, longitudinal analysis, comparing the compensation and work RVUs of integrated cardiologists to their compensation and work RVUs as independent cardiologists. Data from the MedAxiom Annual Survey from 2010 to 2014 were used. Participants included 4,830 unique cardiologists that provided 13,642 pooled physician-year observations, with ownership status, compensation, work (RVUs), and other characteristics as variables for analysis. Results: Results from the multivariate regressions indicate that average compensation for cardiologists increases by $129,263.1 (p < .001) when they move from independent to integrated practice. At the same time, physician work RVUs decline by 398.04 (p = .01). [ABSTRACT FROM AUTHOR]

Keywords: percutaneous coronary intervention; STEMI EN percutaneous coronary intervention STEMI 199 202 4 07/23/20 20200721 NES 200721 The American Heart Association (AHA) Get With The Guidelines Coronary Artery Disease Advisory Work Group, and the Acute Care and Interventional Science Subcommittees of the AHA Council on Clinical Cardiology, are responding to the call of concern on ideal ST-segment-elevation myocardial infarction (STEMI) Systems of Care during the coronavirus disease 2019 (COVID-19) pandemic. This statement addresses STEMI Systems of Care issues throughout the pandemic, to ensure that patients with STEMI continue to receive life-saving treatments while maintaining patient and healthcare worker safety. Because 25% to 50% of patients infected with SARS-CoV-2 are asymptomatic,[5] catheterization laboratory personnel should assume that all patients are COVID-19 positive, particularly in high prevalence areas, and don appropriate PPE. [Extracted from the article]

The article discusses guidelines for the appropriate use of cardiac telemetry in the acute care setting in the U.S. Topics discussed include publication of guidelines for continuous cardiac monitoring by the American Heart Association due to the widespread misuse of telemetry in the hospital setting, the objective of its use which is to observe continuous electronic cardiac waveforms in patients at risk for cardiac deterioration, and the impact of its overuse on patient safety.

A personal narrative is presented which explores the author's experiences of taking simple steps in caring for her patient with heart failure, type 2 diabetes mellitus, hypertension, and osteoarthritis.

In high-risk populations, the second stage includes diagnostic investigations and follow-up by cardiologists for certain cardiovascular diseases (15 750 certified specialists in Russia or 10.8 per 100 000 population), 90% of them being female. Despite unprecedented achievements in the prevention and treatment of cardiovascular disease, Russia is still facing profound challenges. Keywords: cardiovascular diseases; Russia EN cardiovascular diseases Russia 586 588 3 11/03/21 20210824 NES 210824 The Russian Federation has 146.6 million inhabitants and the largest territory in the world. [Extracted from the article]

Competing Interests: Disclosures None.

Background: Global collaboration in cardio-oncology is needed to understand the prevalence of cancer therapy-related cardiovascular toxicity in different risk groups, practice settings, and geographic locations. There are limited data on the socioeconomic and racial/ethnic disparities that may impact access to care and outcomes. To address these gaps, we established the Global Cardio-Oncology Registry, a multinational, multicenter prospective registry., Methods: We assembled cardiologists and oncologists from academic and community settings to collaborate in the first Global Cardio-Oncology Registry. Subsequently, a survey for site resources, demographics, and intention to participate was conducted. We designed an online data platform to facilitate this global initiative., Results: A total of 119 sites responded to an online questionnaire on their practices and main goals of the registry: 49 US sites from 23 states and 70 international sites from 5 continents indicated a willingness to participate in the Global Cardio-Oncology Registry. Sites were more commonly led by cardiologists (85/119; 72%) and were more often university/teaching (81/119; 68%) than community based (38/119; 32%). The average number of cardio-oncology patients treated per month was 80 per site. The top 3 Global Cardio-Oncology Registry priorities in cardio-oncology care were breast cancer, hematologic malignancies, and patients treated with immune checkpoint inhibitors. Executive and scientific committees and specific committees were established. A pilot phase for breast cancer using Research Electronic Data Capture Cloud platform recently started patient enrollment., Conclusions: We present the structure for a global collaboration. Information derived from the Global Cardio-Oncology Registry will help understand the risk factors impacting cancer therapy-related cardiovascular toxicity in different geographic locations and therefore contribute to reduce access gaps in cardio-oncology care. Risk calculators will be prospectively derived and validated., Competing Interests: Disclosures Dr Teske has received speaker fees from Philips and Abbott; consulting from Nordic Pharma. Dr Neilan reports consulting from BMS, Abbvie, Sanofi, Genentech, Roche, and C4-Therapeutics; grant funding from BMS and AZ. Dr López-Fernández has received speaker fees from Philips, Janssen, and Incyte. Dr Szmit has received speaker fees from Amgen, Angelini, Astra Zeneca, Bayer, Bristol-Myers Squibb, Gilead, and Pfizer. Dr Guha is supported by American Heart Association-Strategically Focused Research Network Grant in Disparities in Cardio-Oncology (847740 and 863620). Dr Iakobishvili has received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Novo-Nordisk, and Bayer. Dr Sverdlov is supported by the National Heart Foundation of Australia Future Leader Fellowship (Award ID 106025) and reports research grants from the Medical Research Future Fund (Australia), NSW Health (Australia), Cancer Institute NSW (Australia), Hunter Medical Research Institute (Australia), Biotronik, RACE Oncology, Bristol Myer Squibb, Roche Diagnostics, and Vifor; and personal speaker fees from Novartis, Bayer, Bristol Myer Squibb, AstraZeneca, and Boehringer Ingelheim. The other authors report no conflicts.

Patients with heart failure who received palliative care from a multidisciplinary team of clinicians were twice as likely to fulfill their wish of dying at home as patients who received usual care, found a study[1] in Canada. Cardiologists helped guide the dosing of diuretics for patients with advanced heart failure by home palliative care physicians and developed a home diuretic protocol for titrating doses based on the patient's weight and symptoms, he said. Patients may mistakenly believe that palliative care is only for patients who are dying or have cancer, Quinn explained. [Extracted from the article]

This review provides an updated summary of the state of our knowledge of the genetic contributions to the pathogenesis of congenital heart disease. Since 2007, when the initial American Heart Association scientific statement on the genetic basis of congenital heart disease was published, new genomic techniques have become widely available that have dramatically changed our understanding of the causes of congenital heart disease and, clinically, have allowed more accurate definition of the pathogeneses of congenital heart disease in patients of all ages and even prenatally. Information is presented on new molecular testing techniques and their application to congenital heart disease, both isolated and associated with other congenital anomalies or syndromes. Recent advances in the understanding of copy number variants, syndromes, RASopathies, and heterotaxy/ciliopathies are provided. Insights into new research with congenital heart disease models, including genetically manipulated animals such as mice, chicks, and zebrafish, as well as human induced pluripotent stem cell-based approaches are provided to allow an understanding of how future research breakthroughs for congenital heart disease are likely to happen. It is anticipated that this review will provide a large range of health care-related personnel, including pediatric cardiologists, pediatricians, adult cardiologists, thoracic surgeons, obstetricians, geneticists, genetic counselors, and other related clinicians, timely information on the genetic aspects of congenital heart disease. The objective is to provide a comprehensive basis for interdisciplinary care for those with congenital heart disease. [ABSTRACT FROM AUTHOR]

The article presents the case study of two male patients, one 56-year-old and one 79-year-old, who are admitted to the hospital due to elevation of myocardial infarction in Stockholm, Sweden. The topics discussed include the results of both patients' angiography and electrocardiography and the challenges encountered by the cardiologist in interpreting the results of the ECG, and the

More than 105 million referrals of Medicare beneficiaries to specialists occur annually. Different settings and electronic health records have made care coordination complex. PCPI (formerly American Medical Association-convened Physicians Consortium for Performance Improvement) and The Wright Center for Graduate Medical Education sponsored the Closing the Referral Loop pilot project. Twelve dyads of primary care and specialist physicians sought to improve ambulatory referrals by mapping the referral process, and using care compacts, metrics, and electronic health records. Referrals closed on time increased from 40% to 70%. Clinical questions answered increased from 50% to 75%. Adoption of the change package and lessons from this project may significantly improve ambulatory referral management. [ABSTRACT FROM AUTHOR]

Key Words: cardiologists COVID-19 gender equity physicians, women Reza et al COVID-19 and Women in Cardiology FRAME OF REFERENCE February 16, 2021 Circulation. Career preferences and perceptions of cardiology among US internal medicine trainees: factors influencing cardiology career choice. [Extracted from the article]

2 The American Heart Association has previously identified several barriers preventing the reduction of disease burden in the Black community, including mistrust of the medical system and a lack of access to racially concordant physicians, yet the majority of patients will never meet a Black cardiologist. 1 Furthermore, the 2020 American Heart Association Heart Disease and Stroke Statistical Update revealed that Black patients with peripheral vascular disease are 37% more likely to undergo amputation than other patients of similar socioeconomic status. Acknowledging the prevalence of cardiovascular disease in the Black community, the 2020 Dallas BMWC Youth Summit identified cardiology as a specialty that could offer an accessible entry point to get students excited about medicine. [Extracted from the article]

Keywords: clinical trial protocols; COVID-19; heparin; post-exposure prophylaxis; randomized controlled trial EN clinical trial protocols COVID-19 heparin post-exposure prophylaxis randomized controlled trial 2296 2298 3 12/17/20 20201215 NES 201215 In collaboration with the National Heart, Lung, and Blood Institute, Operation Warp Speed, the US Food and Drug Administration, and as part of the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) initiative, the 3 of us have been asked to lead nationwide randomized clinical trials of anticoagulant and antithrombotic therapies to improve clinical outcomes among coronavirus disease 2019 (COVID-19)-infected inpatients and outpatients and those convalescing from the disease. Known collectively as ACTIV-4 Antithrombotics, the need for these trials is clear because life-threatening deep vein thromboses, pulmonary emboli, systemic arterial thromboses, and microvascular thromboses occur commonly in patients with COVID-19, even among those who appear otherwise minimally symptomatic. [Extracted from the article]

Fitness - Rather Than BMI - Appears to Be a Better Predictor of Survival for Women With Heart Disease Physically fit women who are overweight or obese according to body mass index (BMI) with suspected ischemic heart disease are 40% less likely to die of any cause than are unfit women with a BMI in the normal range (18.5-24.9), according to the results of a new study.[1] The results are part of a growing body of evidence that suggests physical fitness may be more important than body weight in determining cardiovascular outcomes and health, particularly for women. References 1 Quesada O, Lauzon M, Buttle R, Wei J, Suppogu N, Kelsey SF, Reis SE, Shaw LJ, Sopko G, Handberg E. Body weight and physical fitness in women with ischemic heart disease: does physical fitness contribute to our understanding of the obesity paradox in women?. [Extracted from the article]

Keywords: COVID-19; decision making; heart failure; heart transplantation; medical ethics; pandemics; resource allocation EN COVID-19 decision making heart failure heart transplantation medical ethics pandemics resource allocation 194 196 3 07/23/20 20200721 NES 200721 The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the healthcare landscape. Cardiologists must tell some patients who would normally be evaluated in-person to stay home; we must also implore some fearful patients to seek care.[2] The importance of the latter is illustrated by concerning observations of underpresentation of critical cardiovascular diseases like acute coronary syndrome. [Extracted from the article]

Cardiology fellows at Mount Sinai Hospital in New York City have been helping to manage the cardiac complications of coronavirus disease 2019 (COVID-19) in the epicenter of the outbreak in the United States. "If a COVID patient needs a cardiology consult, an echocardiogram, or a cardiology procedure, our fellows are continuing to provide care for them, but [we haven't] drafted them into roles outside of their normal training", Silvestry said. [Extracted from the article]

Keywords: COVID-19; critical illness; pandemics EN COVID-19 critical illness pandemics 2039 2041 3 06/25/20 20200623 NES 200623 There is no normalcy in New York City in April 2020...especially if you work in health care. In the COVID-19 pandemic where we may soon run out of ventilators and providers, we would argue that the ideal of social justice must be considered. [Extracted from the article]