Publications by authors named "Amir Aker"

Background: Systemic sclerosis (SSc) is marked by an excessive systemic accumulation of collagen. Recent literature implies that aortic stenosis is more prevalent in patients with SSc than previously thought. While there are limited feasibility studies on transcatheter aortic valve replacement (TAVR) in this population, the long-term outcomes remain uncertain.

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Background: Aortic stenosis (AS) is treated through transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), with diabetes being prevalent among these patients. Inflammation participates in the pathogenesis of AS, and emerging evidence suggests that TAVI may exert anti-inflammatory effects. Given the established link between diabetes and inflammation, we sought to evaluate the impact of aortic valve replacement (AVR) on glycemic control.

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Background: Pacemaker recipients demonstrate a higher prevalence of atrial fibrillation (AF), yet the regular ventricular activation in pacemaker-dependent patients with AF presents a substantial diagnostic challenge.

Methods: A total of 310 medical practitioners completed a brief, validated survey consisting of three electrocardiograms displaying AF with ventricular pacing. Participants were instructed to identify the underlying rhythm.

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Introduction: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, yet interpretation concerns among healthcare providers persist. Confounding factors contribute to false-positive and false-negative AF diagnoses, leading to potential omissions. Artificial intelligence advancements show promise in electrocardiogram (ECG) interpretation.

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Real-world data on the implementation and prognostic impact of glucose-lowering drugs with proven cardiovascular benefits in patients with type 2 diabetes (T2D) following acute coronary syndrome (ACS) are limited. We investigated the utilization and treatment patterns of sodium-glucose contrasporter-2 inhibitors (SGLT2Is) and glucagon-like peptide-1 recepto-agonists (GLP1RAs) in patients with T2D experiencing ACS and analyzed their association with mortality and major adverse cardiovascular events (MACEs) including recurrent ACS, acute revascularization, heart failure, or ischemic stroke. : We carried out a retrospective analysis of 9756 patients with T2D from a nationwide healthcare organization in Israel who were hospitalized with ACS between 01/2019 and 01/2022.

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Background: Inclisiran, a small-interfering RNA enabling long-term inhibition of proprotein convertase subtilisin kexin type 9 (PCSK9) synthesis, demonstrates a good safety and efficacy profile in clinical trials. Real-world data on the potential to attain lipid-goals and reduce treatment gaps are lacking.

Objectives: To investigate the implementation of inclisiran in real-world clinical setting.

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Background: Ischemic stroke is associated with increased risk of morbidity and mortality in future vascular events.

Objectives: To investigate whether CHA2DS2-VASc scores aid in risk stratification of middle-aged patients without atrial fibrillation (AF) experiencing ischemic stroke.

Methods: We analyzed data of 2628 patients, aged 40-65 years with no known AF who presented with acute ischemic stroke between January 2020 and February 2022.

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Vagal maneuvers are techniques used to increase parasympathetic tone, particularly useful in the management of hemodynamically stable supraventricular tachycardias. If ineffective, adenosine can be attempted. We present a patient with atrioventricular nodal re-entrant tachycardia (AVNRT), who could not effectively perform Valsalva maneuvers and had contraindications for carotid massage and adenosine administration, that converted into sinus rhythm by using a rectal thermometer.

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Background: Low cardiorespiratory fitness is an established risk predictor for chronic non-communicable diseases. We aimed to investigate the prognostic significance of fitness level on the risk of major adverse cardiac events (MACE, the composite of myocardial infarction, stroke, or all-cause death), in a contemporary cohort of middle-aged subjects without cardiovascular disease.

Methods: Retrospective analysis of patients aged 40-60 years without a history of cardiovascular disease.

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We report the case of a 51-year-old male with pectus excavatum (PEX) who presented with stress-related chest pain as a symptom of acute non-ST elevation myocardial infarction. Coronary angiography (CAG) revealed a suspected single coronary artery (SCA) anatomy with diffuse atherosclerotic narrowing, without evidence of other coronary ostia in the aortic root. The diagnosis was confirmed on cardiac computed tomography (CCTA) as the SCA of the R-I type by Lipton classification.

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A variety of noncardiac conditions mimic the electrocardiographic changes of ST-elevation myocardial infarction (STEMI). Therefore, a physician must maintain a high index of suspicion when evaluating ST-segment elevation (STE). We present a case of epigastric pain secondary to ileus and gastric dilatation masquerading as anterolateral STEMI on an electrocardiogram (ECG).

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Patients with ischemic stroke are at high risk for future cardiovascular events and should be treated intensively with lipid-modifying agents. Combination lipid-lowering therapies are often needed to achieve updated guideline-directed treatment goals. However, real-world data on intensification of lipid-lowering therapies and attainment of low-density lipoprotein cholesterol (LDL-C) targets early after ischemic stroke are limited.

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Introduction: Measurement of lipoprotein(a) [Lp(a)] is recommended once in a lifetime to identify individuals at high risk of atherosclerotic cardiovascular disease (ASCVD). We aimed to analyze the clinical features of patients with extreme Lp(a).

Methods: Cross-sectional, case-control study of a single healthcare organization between 2015 and 2021.

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Background: Hypertension, obesity, and low cardiorespiratory fitness (CRF) are known risk predictors for the development of atrial fibrillation (AF) that often interrelate with each other. We examined the interplay of these 3 risk indicators with the occurrence of AF in patients without known cardiovascular disease.

Methods: A retrospective analysis of 13,042 patients underwent exercise stress testing (EST).

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Smoking is associated with increased risk for acute ST-elevation myocardial infarction (STEMI) at a young age. Although smoking is a modifiable risk factor, smoking cessation rates after STEMI are suboptimal. We investigated the association between smoking status 1 year after STEMI and adverse events in patients (n = 765) aged ≤60 years.

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Hypertension is a well-established risk factor for the onset and progression of atrial fibrillation (AF). Blood pressure (BP) measurements during routine exercise stress testing (EST) may identify subjects at increased risk for developing AF. We performed a retrospective analysis of treadmill EST carried out using the Bruce protocol in patients aged ≥40 years without a history of AF (n = 17,617; 42% women).

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Purpose: Heart rate response during exercise testing (ET) provides valuable prognostic information. Limited data are available regarding the prognostic interplay of heart rate (HR) measured at rest, exercise and recovery phases of ET, and its ability to predict risk beyond exercise capacity.

Methods: Retrospective analysis of treadmill ETs was performed by the Bruce protocol in patients aged 35-75 yr without known cardiovascular disease (CVD; n = 13 887; 47% women).

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Objective: The physiologic response to exercise may provide valuable prognostic information. We investigated the association of blood pressure (BP) measurements during exercise stress testing (EST) with long-term risk of myocardial infarction, stroke or death (major adverse cardiovascular event, MACE), as well as the development of new-onset hypertension.

Methods: A retrospective analysis of treadmill ESTs (years 2005-2019) performed by the Bruce protocol in patients aged 35-75 years without a history of cardiovascular disease (n = 14 792; 48% women).

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Introduction: Calcium score (CS) in cardiac CT scans represents an effective tool in the early diagnosis of cardiovascular disease. Few studies evaluated the value of incidental arterial calcification (AC) in non-cardiac CT scans, especially in young adults with no prior cardiovascular disease.

Aims: To examine the relationship between arterial calcifications and the incidence of cardiovascular events.

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Background: Estimation of kidney function by glomerular filtration rate (eGFR) is affected by age and is important for decision making regarding treatment and prognosis of patients with cardiovascular disease. We investigated the impact of eGFR on long-term cardiovascular outcomes in an elderly population undergoing coronary angiography for evaluation or treatment of coronary artery disease.

Methods: GFR was estimated according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in 3690 elderly patients (aged 70-100 years) undergoing coronary angiography.

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