Temporal trends in test utilization and prevalence of ischaemia with positron emission tomography myocardial perfusion imaging.

Aims: To examine whether test utilization and prevalence of ischemia with positron emission tomography (PET) myocardial perfusion imaging (MPI) follow the previously described trends with single photon computed tomography (SPECT).

Methods And Results: MPI studies performed between January 2003 and December 2017 were identified. Number of PET and SPECT MPI studies performed per year was determined.

Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET.

Purpose Of Review: Radionuclide myocardial perfusion imaging (MPI) continues to be the most reliable modality for diagnosis of hemodynamically significant coronary artery disease (CAD). The application of radionuclide MPI using single photon emission computed tomography (SEPCT) and positron emission tomography (PET) for CAD is reviewed, with emphasis on diagnosis and risk stratification.

Recent Findings: Contemporary studies have reported the diagnostic and prognostic value of novel imaging protocols, employing stress-first or stress-only approach.

Drivers of radiation dose reduction with myocardial perfusion imaging: A large health system experience.

Background: Despite increasing emphasis on reducing radiation exposure from myocardial perfusion imaging (MPI), the use of radiation-sparing practices (RSP) at nuclear laboratories remains limited. Defining real-world impact of RSPs on effective radiation dose (E) can potentially further motivate their adoption.

Methods: MPI studies performed between 1/2010 and 12/2016 within a single health system were included.

The utility of ADMIRE-HF risk score in predicting serious arrhythmic events in heart failure patients: incremental prognostic benefit of cardiac 123I-mIBG scintigraphy.

Background: A minority of heart failure (HF) patients who undergo implantable cardioverter defibrillator (ICD) implantation for primary prevention of sudden cardiac death (SCD) receive device therapy. Whether the addition of mIBG scintigraphy to conventional markers of arrhythmic risk can provide incremental risk stratification in HF patients has not been investigated.

Methods: We identified 778 patients from the ADMIRE-HF study with LVEF < 35% and class II or III HF symptoms who did not have an ICD at the time of enrollment.

Initiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: insights from the Prospective Registry Evaluating Outcomes After Myocardial Infarctions: Events and Recovery (PREMIER) and Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) registries.

Background: Whereas statins are considered the cornerstone of prevention after acute myocardial infarction (AMI), concerns about worsening depression in association with their use have been raised.

Methods: Using data from 2 prospective AMI registries (PREMIER and TRIUMPH), we examined the change in depressive symptoms from baseline and at 1, 6 and 12 months among statin-naïve patients who were and were not discharged on a statin. Depressive symptoms were assessed with the 8-item Patient Health Questionnaire (PHQ-8).

Red yeast rice for dysipidemia.

Red yeast rice is an ancient Chinese food product that contains monacolins, chemical substances that are similar to statins in their mechanisms of action and lipid lowering properties. Several studies have found red yeast rice to be moderately effective at improving the lipid profile, particularly for lowering the low-density lipoprotein cholesterol levels. One large randomized controlled study from China found that red yeast rice significantly improved risk of major adverse cardiovascular events and overall survival in patients following myocardial infarction.

Meta-analysis of effect of dipeptidyl peptidase-4 inhibitors on cardiovascular risk in type 2 diabetes mellitus.

Patients with type 2 diabetes mellitus (DM) have a very high risk for major adverse cardiovascular (CV) events. Previous studies have shown that traditional oral diabetic medications, despite lowering blood glucose levels, generally do not improve CV outcomes. The safety of some oral hypoglycemic medications has been questioned.

Evidence-based diuretic therapy for improving cardiovascular prognosis in systemic hypertension.

Diuretics are among the most commonly prescribed cardiovascular (CV) medications. The strength of evidence supporting the effectiveness of diuretics in lowering blood pressure and for preventing major adverse CV events in patients with hypertension varies considerably among diuretic classes and even among agents within the same class. Unfortunately, common prescribing habits among American physicians, including specialists in CV diseases, are not in line with the existing evidence regarding diuretic therapy for improving CV prognosis.

Likelihood of obstructive coronary disease in metabolic syndrome patients with abnormal stress echocardiography.

Background: Metabolic syndrome (MetSx) encompasses several risk factors for macrovascular coronary artery disease. An association between MetSx and coronary syndrome X has also been reported, suggesting that patients with MetSx are more likely to have endothelial dysfunction in the setting of angiographically normal coronary arteries. It remains unknown whether MetSx patients with abnormal stress echocardiography (SE) are more likely to have obstructive coronary disease (CAD) compared to patients without MetSx.

Iodixanol versus low-osmolar contrast media for prevention of contrast induced nephropathy: meta-analysis of randomized, controlled trials.

Background: Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN.

Methods And Results: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, iodixanol, Visipaque, and low-osmolar contrast media.

Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass surgery for multivessel coronary artery disease: a meta-analysis of data from the ARTS II, CARDia, ERACI III, and SYNTAX studies and systematic review of observational data.

Aims: The aim of this study was to systematically analyse the available data from trials comparing revascularisation by drug-eluting stent (DES) placement versus coronary artery bypass grafting (CABG) in patients with multivessel coronary artery disease (CAD).

Methods And Results: We searched PubMed, Medline and several internet sources for randomised controlled trials comparing DES placement to CABG in patients with multivessel coronary artery disease. There were no restrictions on journal type or population studied.

Impact of ezetimibe on atherosclerosis: is the jury still out?

Ezetimibe is a new lipid-lowering agent that inhibits intestinal absorption of dietary cholesterol. It substantially lowers low-density lipoprotein cholesterol levels when used alone or in combination with statins. However, its effect on cardiovascular mortality remains unknown.