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2. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Thompson, Annemarie, Fleischmann, Kirsten E., Smilowitz, Nathaniel R., de las Fuentes, Lisa, Mukherjee, Debabrata, Aggarwal, Niti R., Ahmad, Faraz S., Allen, Robert B., Altin, S. Elissa, Auerbach, Andrew, Berger, Jeffrey S., Chow, Benjamin, Dakik, Habib A., Eisenstein, Eric L., Gerhard-Herman, Marie, Ghadimi, Kamrouz, Kachulis, Bessie, Leclerc, Jacinthe, Lee, Christopher S., Macaulay, Tracy E., Mates, Gail, Merli, Geno J., Parwani, Purvi, Poole, Jeanne E., Rich, Michael W., Ruetzler, Kurt, Stain, Steven C., Sweitzer, BobbieJean, Talbot, Amy W., Vallabhajosyula, Saraschandra, Whittle, John, and Williams, Kim Allan, Sr

Published
2024
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3. Factors associated with acute limb ischemia in cardiogenic shock and downstream clinical outcomes: Insights from the Cardiogenic Shock Working Group

Author

Kochar, Ajar, Vallabhajosyula, Saraschandra, John, Kevin, Sinha, Shashank S., Esposito, Michele, Pahuja, Mohit, Hirst, Colin, Li, Song, Kong, Qiuyue, Li, Borui, Natov, Peter, Kanwar, Manreet, Hernandez-Montfort, Jaime, Garan, A. Reshad, Walec, Karol, Zazzali, Peter, Sangal, Paavni, Ton, Van-Khue, Zweck, Elric, Kataria, Rachna, Guglin, Maya, Vorovich, Esther, Nathan, Sandeep, Abraham, Jacob, Harwani, Neil M., Fried, Justin A., Farr, Maryjane, Hall, Shelley A., Hickey, Gavin W., Wencker, Detlef, Schwartzman, Andrew D., Khalife, Wissam, Mahr, Claudius, Kim, Ju H., Bhimaraj, Arvind, Blumer, Vanessa, Faugno, Anthony, Burkhoff, Daniel, and Kapur, Navin K.

Published
2024
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4. Contemporary Training in American Critical Care Cardiology: Minnesota Critical Care Cardiology Education Summit: JACC Scientific Expert Panel

Author

Elliott, Andrea M., Bartos, Jason A., Barnett, Christopher F., Miller, P. Elliott, Roswell, Robert O., Alviar, Carlos, Bennett, Courtney, Berg, David D., Bohula, Erin A., Chonde, Meshe, Dahiya, Garima, Fleitman, Jessica, Gage, Ann, Hansra, Barinder S., Higgins, Andrew, Hollenberg, Steven M., Horowitz, James M., Jentzer, Jacob C., Katz, Jason N., Karpenshif, Yoav, Lee, Ran, Menon, Venu, Metkus, Thomas S., Mukundan, Srini, Rhinehart, Zachary J., Senman, Balimkiz, Senussi, Mourad, Solomon, Michael A., Vallabhajosyula, Saraschandra, and Dudzinski, David M.

Published
2024
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6. Serial Shock Severity Assessment Within 72 Hours After Diagnosis: A Cardiogenic Shock Working Group Report

Author

Ton, Van-Khue, Li, Song, John, Kevin, Li, Borui, Zweck, Elric, Kanwar, Manreet K., Sinha, Shashank S., Hernandez-Montfort, Jaime, Garan, A. Reshad, Goodman, Rachel, Faugno, Anthony, Farr, Maryjane, Hall, Shelley, Kataria, Rachna, Guglin, Maya, Vorovich, Esther, Pahuja, Mohit, Vallabhajosyula, Saraschandra, Nathan, Sandeep, Abraham, Jacob, Harwani, Neil M., Hickey, Gavin W., Schwartzman, Andrew D., Khalife, Wissam, Mahr, Claudius, Kim, Ju H., Bhimaraj, Arvind, Sangal, Paavni, Kong, Qiuyue, Walec, Karol D., Zazzali, Peter, Fried, Justin, Burkhoff, Daniel, and Kapur, Navin K.

Published
2024
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7. Clinical outcomes among cardiogenic shock patients supported with high-capacity Impella axial flow pumps: A report from the Cardiogenic Shock Working Group

Author

Fried, Justin, Farr, Maryjane, Kanwar, Manreet, Uriel, Nir, Hernandez-Montfort, Jaime, Blumer, Vanessa, Li, Song, Sinha, Shashank S., Garan, A. Reshad, Li, Borui, Hall, Shelley, Hickey, Gavin W., Mahr, Claudius, Nathan, Sandeep, Schwartzman, Andrew, Kim, Ju, Ton, Van-Khue, Vishnevsky, Oleg A., Vorovich, Esther, Abraham, Jacob, Zweck, Elric, Guglin, Maya, Vallabhajosyula, Saraschandra, Kataria, Rachna, Walec, Karol D., Zazzali, Peter, Kong, Qiuyue, Sangal, Paavani, Burkhoff, Daniel, and Kapur, Navin K.

Published
2024
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12. Impact of Female Sex on Cardiogenic Shock Outcomes: A Cardiogenic Shock Working Group Report

Author

Ton, Van-Khue, Kanwar, Manreet K., Li, Borui, Blumer, Vanessa, Li, Song, Zweck, Elric, Sinha, Shashank S., Farr, Maryjane, Hall, Shelley, Kataria, Rachna, Guglin, Maya, Vorovich, Esther, Hernandez-Montfort, Jaime, Garan, A. Reshad, Pahuja, Mohit, Vallabhajosyula, Saraschandra, Nathan, Sandeep, Abraham, Jacob, Harwani, Neil M., Hickey, Gavin W., Wencker, Detlef, Schwartzman, Andrew D., Khalife, Wissam, Mahr, Claudius, Kim, Ju H., Bhimaraj, Arvind, Sangal, Paavni, Zhang, Yijing, Walec, Karol D., Zazzali, Peter, Burkhoff, Daniel, and Kapur, Navin K.

Published
2023
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14. National rates and trends of tobacco and substance use disorders among atrial fibrillation hospitalizations

Author

Doshi, Rajkumar, Dave, Mihir, Majmundar, Monil, Kumar, Ashish, Adalja, Devina, Shariff, Mariam, Desai, Rupak, Ziaeian, Boback, and Vallabhajosyula, Saraschandra

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Prevention, Substance Misuse, Brain Disorders, Alcoholism, Alcohol Use and Health, Cardiovascular, Good Health and Well Being, Adolescent, Adult, Aged, Atrial Fibrillation, Female, Hospitalization, Humans, Male, Medicare, Substance-Related Disorders, Tobacco, United States, Young Adult, Atrial fibrillation, Tobacco abuse, Substance abuse, Trends, Drug abuse, Cardiorespiratory Medicine and Haematology, Nursing, Cardiovascular medicine and haematology
Abstract

BackgroundAtrial Fibrillation (AF) has been associated with various behavioral risk factors such as tobacco, alcohol, and/or substances abuse.ObjectiveThe main objective is to describe the national trends and burden of tobacco and substance abuse in AF hospitalizations. Also, this study identifies potential population who are more vulnerable to these substance abuse among AF hospitalizations.MethodsThe National Inpatient Sample database from 2007 to 2015 was utilized and the hospitalizations with AF were identified using the international classification of disease, Ninth Revision, Clinical Modification code. They were stratified into without abuse, tobacco use disorder (TUD), substance use disorder (SUD), alcohol use disorder (AUD) and drug use disorder (DUD).ResultsOf 3,631,507 AF hospitalizations, 852,110 (23.46%) had TUD, 1,851,170 (5.1%) had SUD, 155,681 (4.29%) had AUD and 42,667 (1.17%) had DUD. The prevalence of TUD, SUD, AUD, and DUD was substantially increased across all age groups, races, and gender during the study period. Female sex was associated with lower odds TUD, SUD, AUD, and DUD. Among AF hospitalizations, the black race was associated with higher odds of SUD, and DUD. The younger age group (18-35 years), male, Medicare/Medicaid as primary insurance, and lower socioeconomic status were associated with increased risk of both TUD and SUDs.ConclusionTUD and SUD among AF hospitalizations in the United States mainly affects males, younger individuals, white more than black, and those of lower socioeconomic status which demands for the development of preventive strategies to address multilevel influences.

Published
2021

15. Medical Management and Device-Based Therapies in Chronic Heart Failure

Author

Nguyen, Andrew H., Hurwitz, Madelyn, Abraham, Jacob, Blumer, Vanessa, Flanagan, M. Casey, Garan, A. Reshad, Kanwar, Manreet, Kataria, Rachna, Kennedy, Jamie L.W., Kochar, Ajar, Hernandez-Montfort, Jaime, Pahuja, Mohit, Shah, Palak, Sherwood, Matthew W., Tehrani, Behnam N., Vallabhajosyula, Saraschandra, Kapur, Navin K., and Sinha, Shashank S.

Published
2023
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18. Comparative Outcomes of Catheter-Directed Thrombolysis Plus Systemic Anticoagulation Versus Systemic Anticoagulation Alone in the Management of Intermediate-Risk Pulmonary Embolism in a Systematic Review and Meta-Analysis

Author

Balakrishna, Akshay Machanahalli, Kalathil, Ruth Ann Mathew, Pusapati, Suma, Atreya, Auras, Mehta, Aryan, Bansal, Mridul, Aggarwal, Vikas, Basir, Mir B., Kochar, Ajar, Truesdell, Alexander G., and Vallabhajosyula, Saraschandra

Published
2023
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21. Conduction system pacing vs. biventricular pacing for cardiac resynchronization therapy in heart failure with reduced ejection fraction: An updated systematic review and meta-analysis

Author

Shrestha, Dhan Bahadur, Baniya, Abinash, Lamichhane, Sandesh, Shahi, Manoj, Shtembari, Jurgen, Deshmukh, Abhishek J., Voruganti, Dinesh, Patel, Nimesh Kirit, Sangal, Kunal, Vallabhajosyula, Saraschandra, Patel, Neel J., Bhave, Prashant D., Whalen, S. Patrick, and Shantha, Ghanshyam

Published
2023
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24. Treatment Intensity for the Management of Cardiogenic Shock: Comparison Between STEMI and Non-STEMI

Author

Sinha, Shashank S., Pahuja, Mohit, Kataria, Rachna, Blumer, Vanessa, Hernandez-Montfort, Jaime, Kanwar, Manreet, Garan, A. Reshad, Zhang, Yijing, Marbach, Jeffrey A., Khalif, Adnan, Vallabhajosyula, Saraschandra, Nathan, Sandeep, Abraham, Jacob, Li, Borui, Thayer, Katherine L., Baca, Paulina, Dieng, Fatou, Harwani, Neil M., Yin, Michael Y., Faugno, Anthony J., Faraz, Haroon A., Guglin, Maya, Hickey, Gavin W., Wencker, Detlef, Hall, Shelley, Schwartzman, Andrew D., Khalife, Wissam, Li, Song, Mahr, Claudius, Kim, Ju H., Bhimaraj, Arvind, Ton, Van-Khue, Vorovich, Esther, Burkhoff, Daniel, and Kapur, Navin K.

Published
2023
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27. Abstract 12481: Comparative Outcomes of Catheter Directed Thrombolysis Plus Systemic Anticoagulation versus Systemic Anticoagulation Alone in the Management of Intermediate-Risk Pulmonary Embolism: A Systematic Review and Meta-Analysis

Author

Machanahalli Balakrishna, Akshay, Mathew Kalathil, Ruth Ann, PUSAPATI, SUMA, Atreya, Auras R, Mehta, Aryan, Bansal, Mridul, Aggarwal, Vikas, Basir, Mir B, Kochar, Ajar, Truesdell, Alexander G, and Vallabhajosyula, Saraschandra

Published
2023
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28. Abstract 12328: Impact of Female Sex on Cardiogenic Shock Outcomes - A Cardiogenic Shock Working Group Report

Author

Ton, Van-Khue, Kanwar, Manreet, LI, BORUI, Blumer, Vanessa, Li, Song, Zweck, Elric, Sinha, Shashank, Farr, Maryjane, Hall, Shelley, Kataria, Rachna, guglin, maya, Vorovich, Esther, Hernandez-Montfort, Jaime, Garan, Arthur Reshad, Pahuja, Mohit, Vallabhajosyula, Saraschandra, Nathan, Sandeep, Abraham, Jacob, Harwani, Neil, Hickey, Gavin W, Wencker, Detlef, Schwartzman, Andrew, Khalife, Wissam, Mahr, Claudius, Kim, Ju H, Bhimaraj, Arvind, Sangal, Paavni, Zhang, Yijing, Burkhoff, Daniel, and Kapur, Navin K

Published
2023
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36. Dual Training in Interventional Cardiology: The Next Frontier.

Author

APPLEFELD, WILLARD N., GAGE, ANN, VALLABHAJOSYULA, SARASCHANDRA, and ASLAM, M. IMRAN

Abstract

Dual training in Interventional Cardiology (IC) with other cardiac subspecialties such as Advanced Heart Failure and Transplant Cardiology (AHFTC) and Critical Care Cardiology (CCC) is becoming a pathway for trainees to acquire a needed skill set to deliver comprehensive care for increasingly complex patients in the intensive care unit and catheterization laboratory settings. The makeup of these training pathways varies depending on several factors, with the resultant role of the specialist reflecting this reality. Herein, we review the merits to combined fellowship training for the Interventional Cardiologist, the ideal structure of programs to facilitate this, and how the faculty position for such a unique specialist can enhance a program. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Multidisciplinary Care Teams in Acute Cardiovascular Care: A Review of Composition, Logistics, Outcomes, Training, and Future Directions.

Author

VALLABHAJOSYULA, SARASCHANDRA, OGUNSAKIN, ADEBOLA, JENTZER, JACOB C., SINHA, SHASHANK S., KOCHAR, AJAR, GERBERI, DANA J., MULLIN, CHRISTOPHER J., AHN, SUN HO, SODHA, NEEL R., VENTETUOLO, COREY E., LEVINE, DANIEL J., ABBOTT, BRIAN G., ALIOTTA, JASON M., POPPAS, ATHENA, and ABBOTT, J. DAWN

Abstract

• Patients in the cardiac intensive care unit have become increasingly complex and require multidisciplinary care. • There are limited and heterogeneous data on the role of multidisciplinary teams in acute cardiovascular care. • Further data on optimal leadership structure, training paradigms, staffing ratios, system-based logistics, and outcomes are needed. As cardiovascular care continues to advance and with an aging population with higher comorbidities, the epidemiology of the cardiac intensive care unit has undergone a paradigm shift. There has been increasing emphasis on the development of multidisciplinary teams (MDTs) for providing holistic care to complex critically ill patients, analogous to heart teams for chronic cardiovascular care. Outside of cardiovascular medicine, MDTs in critical care medicine focus on implementation of guideline-directed care, prevention of iatrogenic harm, communication with patients and families, point-of-care decision-making, and the development of care plans. MDTs in acute cardiovascular care include physicians from cardiovascular medicine, critical care medicine, interventional cardiology, cardiac surgery, and advanced heart failure, in addition to nonphysician team members. In this document, we seek to describe the changes in patients in the cardiac intensive care unit, health care delivery, composition, logistics, outcomes, training, and future directions for MDTs involved in acute cardiovascular care. As a part of the comprehensive review, we performed a scoping of concepts of MDTs, acute hospital care, and cardiovascular conditions and procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Anticoagulation Medications, Monitoring, and Outcomes in Patients with Cardiogenic Shock Requiring Temporary Mechanical Circulatory Support.

Author

Mehta, Chirag, Osorio, Brian, Sodha, Neel R., Gibson, Halley C., Clancy, Annaliese, Poppas, Athena, Hyder, Omar N, Saad, Marwan, Kataria, Rachna, Abbott, J. Dawn, and Vallabhajosyula, Saraschandra

Abstract

• In patients receiving temporary MCS, anticoagulation is recommended to prevent device-related thromboembolism. • There are limited data on optimal anticoagulation strategies that balance the risk of bleeding and thrombosis. • The ideal anticoagulant should have short duration of action, reliability in monitoring and titration, and easy reversibility. Cardiogenic shock (CS) is a syndrome of low cardiac output resulting in critical end-organ hypoperfusion and hypoxia. The mainstay of management involves optimizing preload, afterload and contractility. In medically refractory cases, temporary percutaneous mechanical support (MCS) is used as a bridge to recovery, surgical ventricular assist device, or transplant. Anticoagulation is recommended to prevent device-related thromboembolism. However, MCS can be fraught with hemorrhagic complications, compounded by incident multisystem organ failure often complicating CS. Currently, there are limited data on optimal anticoagulation strategies that balance the risk of bleeding and thrombosis, with most centers adopting local antithrombotic stewardship practices. In this review, we detail anticoagulation protocols, including anticoagulation agents, therapeutic monitoring, and complication mitigation in CS requiring MCS. This review is intended to provide an evidence-based framework in this population at high risk for in-hospital bleeding and mortality. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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39. Association of Hemometabolic Trajectory and Mortality: Insights From the Cardiogenic Shock Working Group Registry.

Author

KHALIFE, WISSAM, KANWAR, MANREET K., ABRAHAM, JACOB, LI, SONG, JOHN, KEVIN, SINHA, SHASHANK S., ZWECK, ELRIC, LI, BORUI, GARAN, ARTHUR R., HERNANDEZ-MONTFORT, JAIME, ZHANG, YIJING, TON, VAN-KHUE, GUGLIN, MAYA, KATARIA, RACHNA, HICKEY, GAVIN W., VALLABHAJOSYULA, SARASCHANDRA, KONG, CHLOE, FARR, MARYJANE, FRIED, JUSTIN, and HALL, SHELLEY

Abstract

Cardiogenic shock (CS) is a hemodynamic syndrome that can progress to systemic metabolic derangements and end-organ dysfunction. Prior studies have reported hemodynamic parameters at the time of admission to be associated with mortality but hemodynamic trajectories in CS have not been well described. We studied the association between hemodynamic profiles and their trajectories and in-hospital mortality in patients with CS due to heart failure (HF-CS) and acute myocardial infarction (MI-CS). Using data from the large multicenter Cardiogenic Shock Working Group (CSWG) registry, we analyzed hemodynamic data obtained at the time of pulmonary artery catheter (PAC) insertion (dataset at baseline) and at PAC removal or death (dataset at final time point). Univariable regression analyses for prediction of in-hospital mortality were conducted for baseline and final hemodynamic values, as well as the interval change (delta-P). Data was further analyzed based on CS etiology and survival status. A total of 2260 patients with PAC data were included (70% male, age 61 ± 14 years, 61% HF-CS, 27% MI-CS). In-hospital mortality was higher in the MI-CS group (40.1%) compared with HF-CS (22.4%, P <.01). In the HF-CS cohort, survivors exhibited lower right atrial pressure (RAP), pulmonary artery pressure (PAP), cardiac output/index (CO/CI), lactate, and higher blood pressure (BP) than nonsurvivors at baseline. In this cohort, during hospitalization, improvement in metabolic (aspartate transaminase, lactate), BP, hemodynamic (RAP, pulmonary artery pulsatility index [PAPi], pulmonary artery compliance for right-sided profile and CO/CI for left-sided profile), had association with survival. In the MI-CS cohort, a lower systolic BP and higher PAP at baseline were associated with odds of death. Improvement in metabolic (lactate), BP, hemodynamic (RAP, PAPi for right-sided profile and CO/CI for left-sided profile) were associated with survival. In a large contemporary CS registry, hemodynamic trajectories had a strong association with short-term outcomes in both cohorts. These findings suggest the clinical importance of timing and monitoring hemodynamic trajectories to tailor management in patients with CS. • Baseline hemodynamics impact mortality in HF-CS more so than MI-CS. • Hemodynamics indicative of end-organ perfusion and congestion have distinct trajectories between survivors and non-survivors in CS. • Hemodynamic trajectories have strong association with hospital outcomes in both HF- and MI-CS • Changes in hemodynamics should be closely monitored to tailor management practices in CS [ABSTRACT FROM AUTHOR]

Published
2024
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40. Short-term and long-term outcomes of cardiac arrhythmias in patients with cardiogenic shock.

Author

Asaker, Jean-Claude, Bansal, Mridul, Mehta, Aryan, Joice, Melvin G., Kataria, Rachna, Saad, Marwan, Abbott, J. Dawn, and Vallabhajosyula, Saraschandra

Abstract

Introduction: Cardiogenic shock is severe circulatory failure that results in significant in-hospital mortality, related morbidity, and economic burden. Patients with cardiogenic shock are at high risk for atrial and ventricular arrhythmias, particularly within the subset of patients with an overlap of cardiogenic shock and cardiac arrest. Areas covered: This review article will explore the prevalence, definition, management, and outcomes of common arrhythmias in patients with cardiogenic shock. This review will describe the pathophysiology of arrhythmia in cardiogenic shock and the impact of inotropic agents on increased arrhythmogenicity. In addition to medical management, focused assessment of mechanical circulatory support, radiofrequency ablation, deep sedation, and stellate ganglion block will be provided. Expert opinion: We will navigate the limited data and describe the prognostic impacts of arrhythmia. Finally, we will conclude the review with a discussion of prevention strategies, research limitations, and future research directions. [ABSTRACT FROM AUTHOR]

Published
2024
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