The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events: A Multicenter Study.

Background: Observational data have suggested that patients with moderate to severe ischemia benefit from revascularization. However, this was not confirmed in a large, randomized trial.

Objectives: Using a contemporary, multicenter registry, the authors evaluated differences in the association between quantitative ischemia, revascularization, and outcomes across important subgroups.

10-year experience of utilizing a stress-first SPECT myocardial perfusion imaging.

Background: Despite its potential benefits, the utilization of stress-only protocol in clinical practice has been limited. We report utilizing stress-first single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).

Methods: We assessed 12,472 patients who were referred for SPECT-MPI between 2013 and 2020.

Simplified Approach to Predicting Obstructive Coronary Disease With Integration of Coronary Calcium: Development and External Validation.

Background: The Diamond-Forrester model was used extensively to predict obstructive coronary artery disease (CAD) but overestimates probability in current populations. Coronary artery calcium (CAC) is a useful marker of CAD, which is not routinely integrated with other features. We derived simple likelihood tables, integrating CAC with age, sex, and cardiac chest pain to predict obstructive CAD.

Increasing frequency of dyspnea among patients referred for cardiac stress testing.

Objective: To assess the frequency, change in prevalence, and prognostic significance of dyspnea among contemporary patients referred for cardiac stress testing.

Patients And Methods: We evaluated the prevalence of dyspnea and its relationship to all-cause mortality among 33,564 patients undergoing stress/rest SPECT-MPI between January 1, 2002 and December 31, 2017. Dyspnea was assessed as a single-item question.

Real-World Utilization of an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device.

Objective: To assess the real-world effectiveness and safety of a U.S. Food and Drug Administration (FDA)-cleared intrauterine vacuum-induced-hemorrhage control device for postpartum hemorrhage (PPH) management.

Decline in typical angina among patients referred for cardiac stress testing.

Objective: To evaluate temporal trends in the prevalence of typical angina and its clinical correlates among patients referred for stress/rest SPECT myocardial perfusion imaging (MPI).

Patients And Methods: We evaluated the prevalence of chest pain symptoms and their relationship to inducible myocardial ischemia among 61,717 patients undergoing stress/rest SPECT-MPI between January 2, 1991 and December 31, 2017. We also assessed the relationship between chest pain symptom and angiographic findings among 6,579 patients undergoing coronary CT angiography between 2011 and 2017.

Cardiology and lifestyle medicine.

Poor lifestyle habits, such as physical inactivity and poor diets, are highly prevalent within society and even more so among patients with chronic disease. The need to stem poor lifestyle habits has led to the development of a new field of Lifestyle Medicine, whose mission is to prevent, treat, and even reverse chronic diseases through lifestyle interventions. Three fields within Cardiology relate to this mission: Cardiac Rehabilitation, Preventive Cardiology, and Behavioral Cardiology.

The pursuit of health: A vitality based perspective.

The large number of adults who enter their senior years with a high burden of chronic diseases has led to new metrics designed to promote health pro-activity, such as the calculation of one's "healthspan". These efforts call for re-evaluation as to what is meant by "health". A large body of epidemiologic and clinical investigation identifies that good health is shaped by specific health behaviors (aerobic exercise, resistance training, sleep, and good diet quality) and four psychological determinants (positive emotions, positive mindsets, purposeful living, and social connectivity).

New principles, the benefits, and practices for fostering a physically active lifestyle.

The modern environment has led to an increased risk and incidence of sedentary lifestyles. When physical activity (PA) becomes insufficient, pathophysiological pathways are invoked and the future risk for chronic diseases and premature mortality increases. As a consequence, since the 1970s governmental agencies and medical societies have published guidelines to promote PA.

Assessment of lifestyle "vital signs" in healthcare settings.

Unhealthy lifestyles, such as maintenance of poor diets and physical inactivity, are a powerful driver of disease-producing risk factors and chronic illnesses. This has led to an increasing call to assess adverse lifestyle factors in healthcare settings. This approach could be aided by designating health-related lifestyle factors as "vital signs" that can be recorded during patient visits.

Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors.

Lifestyle medicine practice can be enhanced with interpersonal communication skills to help patients adopt and maintain positive health behaviors, such as improving diet or initiating exercise. We review two approaches that incorporate evidenced-based skills for this purpose: motivational interviewing and brief action planning (BAP). Motivational interviewing involves four processes conducted in a climate of compassion, acceptance, partnership, and empowerment.

Predictors of chronic COVID-19 symptoms in a community-based cohort of adults.

Background: COVID-19 can cause some individuals to experience chronic symptoms. Rates and predictors of chronic COVID-19 symptoms are not fully elucidated.

Objective: To examine occurrence and patterns of post-acute sequelae of SARS-CoV2 infection (PASC) symptomatology and their relationship with demographics, acute COVID-19 symptoms and anti-SARS-CoV-2 IgG antibody responses.

2021 ACC/AHA/SCAI Coronary Artery Revascularization Guidelines for Managing the Nonculprit Artery in STEMI.

The 2021 Coronary Artery Disease revascularization guidelines of the American College of Cardiology (ACC), the American Heart Association (AHA), and the Society for Cardiovascular Angiography and Interventions (SCAI) provide recommendations for managing nonculprit arteries in ST-segment elevation myocardial infarction (STEMI). Although staged revascularization is preferred, at times same-setting intervention, coronary artery bypass surgery, or medical therapy may be preferable. These cases exemplify clinical scenarios for treating nonculprit arteries in STEMI.

Relationship between ischaemia, coronary artery calcium scores, and major adverse cardiovascular events.

Aims: Positron emission tomography (PET) myocardial perfusion imaging (MPI) is often combined with coronary artery calcium (CAC) scanning, allowing for a combined anatomic and functional assessment. We evaluated the independent prognostic value of quantitative assessment of myocardial perfusion and CAC scores in patients undergoing PET.

Methods And Results: Consecutive patients who underwent Rb-82 PET with CAC scoring between 2010 and 2018, with follow-up for major adverse cardiovascular events (MACE), were identified.

Development and validation of ischemia risk scores.

Background: The likelihood of ischemia on myocardial perfusion imaging is central to physician decisions regarding test selection, but dedicated risk scores are lacking. We derived and validated two novel ischemia risk scores to support physician decision making.

Methods: Risk scores were derived using 15,186 patients and validated with 2,995 patients from a different center.

Comparison of Endobronchial Intubation Versus Bronchial Blockade for Elective Pulmonary Lobectomy of Congenital Lung Anomalies in Small Children.

Resection of many congenital lung lesions is commonly performed under single-lung ventilation, which helps collapse the lung being manipulated and enables a thoracoscopic approach in most cases. We set out to determine whether lung isolation achieved by either main stem intubation or usage of a bronchial blocker was associated with superior clinical outcomes. A retrospective review of all patients aged <2 years undergoing elective pulmonary lobectomy for congenital lung malformations at a tertiary-care pediatric hospital from 2011 through 2020 was performed.

Trial of Spesolimab for Generalized Pustular Psoriasis.

Background: Generalized pustular psoriasis (GPP) is a rare, life-threatening, inflammatory skin disease characterized by widespread eruption of sterile pustules. Interleukin-36 signaling is involved in the pathogenesis of this disorder. Spesolimab, a humanized anti-interleukin-36 receptor monoclonal antibody, is being studied for the treatment of GPP flares.

The prevalence and predictors of inducible myocardial ischemia among patients referred for radionuclide stress testing.

Background: The frequency of inducible myocardial ischemia has declined in contemporary stress test cohorts, suggesting a need to re-evaluate its optimal use. To-date, however, a comprehensive analysis of the most potent predictors of myocardial ischemia among cardiac stress test patients has not been conducted.

Methods: We assessed 27,615 patients referred for stress-rest SPECT myocardial perfusion imaging between January 1, 2004 and December 31, 2017.