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281. Hypertrophic Cardiomyopathy: Guideline For the Diagnosis and Treatment of

of the heart, with chest pain and/or an increase in pulmonary venous pressure causing dyspnea. 4.3. Myocardial Ischemia Severe myocardial ischemia and even infarction may occur in HCM (85,86). The myocardial ischemia is frequently unre- lated to the atherosclerotic epicardial coronary artery disease (CAD) but is caused by supply–demand mismatch. Patients with HCM of any age have increased oxygen demand caused by the hypertrophy and adverse loading conditions. They also have compromised coronary blood ?ow (...) and Natural History, Including Absence of Complications .e218 4. Pathophysiology .e219 4.1. LVOT Obstruction e219 4.2. Diastolic Dysfunction e220 4.3. Myocardial Ischemia e220 4.4. Autonomic Dysfunction e220 4.5. Mitral Regurgitation e220 5. Diagnosis .e220 5.1. Genetic Testing Strategies/Family Screening— Recommendations e220 5.1.1. Genotype-Positive/Phenotype-Negative Patients—Recommendation e222 5.2. Electrocardiography—Recommendations e222 5.3. Imaging e223 5.3.1. Echocardiography—Recommendations e223

2011 American College of Cardiology

282. Percutaneous Coronary Intervention: Guideline For

, multiple lesions, multi- vessel, myocardial infarction (MI), non–ST-elevation myocar- dial infarction (NSTEMI), no-re?ow, optical coherence tomog- raphy, proton pump inhibitor (PPI), return to work, same-day angioplasty and/or stenting, slow ?ow, stable ischemic heart disease (SIHD), staged angioplasty, STEMI, survival, and unstable angina (UA). Additional searches cross-referenced these topics with the following subtopics: anticoagulant therapy, contrast nephropathy, PCI-related vascular complica (...) . Radiation Safety: Recommendation e63 4.4. Contrast-Induced AKI: Recommendations e63 4.5. Anaphylactoid Reactions: Recommendations e64 4.6. Statin Treatment: Recommendation e65 4.7. Bleeding Risk: Recommendation e65 4.8. PCI in Hospitals Without On-Site Surgical Backup: Recommendations e65 5. Procedural Considerations e65 5.1. Vascular Access: Recommendation e65 5.2. PCI in Speci?c Clinical Situations e66 5.2.1. UA/NSTEMI: Recommendations e66 5.2.2. ST-Elevation Myocardial Infarction e68 5.2.2.1

2011 American College of Cardiology

283. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

systolic function, advanced age, female sex, and increased CPB time are at higher risk for life-threatening arrhythmias in the early postoperative period. Given the poor short-term prognosis of those with these arrhythmias, mechanical and ischemic causes should be considered in the postoperative setting. 277–279 2.2.3. Emergency CABG After Failed PCI: Recommendations Class I 1. Emergency CABG is recommended after failed PCI in the presence of ongoing ischemia or threatened occlusion with substantial (...) of Cardiac Surgery Outcomes: Recommendation .e685 5.1.1. Use of Outcomes or Volume as CABG Quality Measures: Recommendations .e686 5.2. Adverse Events .e687 5.2.1. Adverse Cerebral Outcomes .e687 5.2.1.1. Stroke .e687 5.2.1.1.1. Use of Epiaortic Ultra- sound Imaging to Reduce Stroke Rates: Recom- mendation .e687 5.2.1.1.2. The Role of Preoperative Carotid Artery Noninva- sive Screening in CABG Patients: Recommenda- tions .e687 5.2.1.2. Delirium .e689 5.2.1.3. Postoperative Cognitive Impairment .e689

2011 American Heart Association

284. Secondary Prevention For Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Guideline Update

intervention; TIA, transient ischemic attack; INR, international normalized ratio; and ARB, angiotensin receptor blocker. *Presence of established CVD plus 1) multiple major risk factors (especially diabetes), 2) severe and poorly controlled risk factors (especially continued cigarette smoking), 3) multiple risk factors of the metabolic syndrome (especially high triglycerides200 mg/dL plus non–HDL-C130 mg/dL with low HDL-C40 mg/dL), and 4) patients with ACSs. †Non–HDL-Ctotal cholesterol minus HDL-C (...) guideline for management of patients with peripheral artery disease (175,176), the AHA effectiveness-based guidelines for cardiovascular disease prevention in women (46), and in the AHA/American Stroke Association guidelines for the prevention of stroke in patients with stroke or transient ischemic attack (123). Finally, the practitioner should exercise judgment in initi- ating the various recommendations if the patient has recently experienced an acute event. 2438 Smith Jr. et al. JACC Vol. 58, No. 23

2011 American College of Cardiology

285. ACC/AHA/SCAI/AMA?Convened PCPI/NCQA 2013 Performance Measures for Adults Undergoing Percutaneous Coronary Intervention

with Unstable Angina/Non-–ST-Elevation Myocardial Infarction (updating the 2007 guideline) (7) ACCF/AHA 2012 Focused Update of the Guideline for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (updating the 2007 guideline and replacing the 2011 focused update) (8) AHA/ACCF 2011 Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 Update ( 9) ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria (...) for Cardiovascular Angiography and Interventions, the American Medical Association–Convened Physician Consortium for Performance Improvement, and the National Committee for Quality Assurance Developed in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation and Mended Hearts Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and Mended Hearts Writing Committee Members Brahmajee K. Nallamothu, MD, MPH, FACC, FAHA, Co-Chair* Carl L. Tommaso, MD

2013 Society for Cardiovascular Angiography and Interventions

286. 2013 ACC/AHA Guideline for the Management of ST-Elevation Myocardial Infarction - Focused Update

THROMBOCYTOPENIA .e111 9.7.2. Bleeding Complications .e111 9.7.2.1. TREATMENT OF ICH .e112 9.7.2.2. VASCULAR ACCESS SITE BLEEDING .e112 9.8. Acute Kidney Injury .e112 9.9. Hyperglycemia .e112 10. Risk Assessment After STEMI .e113 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations . .e113 10.2. Assessment of LV Function: Recommendation .e114 10.3. Assessment of Risk for SCD: Recommendation .e114 11. Posthospitalization Plan of Care .e114 11.1. Posthospitalization Plan of Care (...) is a clinical syndrome de?ned by characteristic symptoms of myocardial ischemia in association with persis- tent electrocardiographic (ECG) ST elevation and subsequent release of biomarkers of myocardial necrosis. Diagnostic ST elevation in the absence of left ventricular (LV) hypertrophy or left bundle-branch block (LBBB) is de?ned by the Euro- pean Society of Cardiology/ACCF/AHA/World Heart Feder- ation Task Force for the Universal De?nition of Myocardial Infarction as new ST elevation at the J point

2013 Society for Cardiovascular Angiography and Interventions

287. An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain - Part 1 - Introduction and General Considerations

procedures per year in the U.S. population. From 2000 to 2011, increases for specialties including interventional pain management, anesthesiology, physical medicine and rehabilitation, and neurology were 199% per 100,000 in the Medicare population, compared to 98% for neurological and or- thopedic surgery, 166% for radiologic specialties, 48% for other physicians, and 246% for non-physician pro- viders (Fig. 4). The Office of Inspector General (OIG), Department of Health and Human Services (HHS), has

2013 American Society of Interventional Pain Physicians

288. Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee

upper GI events. In the clinical scenario where the patient with OA is taking low-dose aspirin (325 mg per day) for cardiopro- tection and the practitioner chooses to use an oral NSAID, the TEP strongly recommends using a nonselective NSAID other than ibuprofen in combination with a proton-pump inhibitor. This recommendation is based, in part, on the FDA warning that the concomitant use of ibuprofen and low-dose aspirin may render aspirin less effective when used for cardioprotection and stroke

2012 American College of Rheumatology

289. Management of Hyperglycemia in Hospitalized Patients in Non-critical Care Setting (Full text)

; 95% confidence interval, 0.21–0.77). There was a trend for increased risk of hypoglycemia (relative risk, 1.58; 95% confidence interval, 0.97–2.57) that was most common in surgical studies. There was no significant effect on death, myocardial infarction, or stroke. The definition of “intensive control” varied across studies but was generally consistent with BG targets in the ADA/American Association of Clinical Endocrinologists Practice Guideline ( , ). That guideline recommended a premeal

2012 The Endocrine Society PubMed abstract

290. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction (Full text)

STEMI e397 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations e397 10.2. Assessment of LV Function: Recommendation e398 10.3. Assessment of Risk for SCD: Recommendation e398 11. Posthospitalization Plan of Care e399 11.1. Posthospitalization Plan of Care: Recommendations e399 11.1.1. The Plan of Care for Patients With STEMI e399 11.1.2. Smoking Cessation e399 11.1.3. Cardiac Rehabilitation e399 11.1.4. Systems of Care to Promote Care Coordination e399 12. Unresolved (...) • Daiichi-Sankyo None None 4.4.14.4.25.1.4.15.1.4.26.4.16.4.27.29.6 Steven M. Ettinger Penn State Heart & Vascular Institute—Professor of Medicine and Radiology None None None • Medtronic None None 4.3.1 James C. Fang University Hospitals Case Medical Center—Director, Heart Transplantation • Accorda• Novartis• Thoratec None None None • Medtronic None 9.5.4.1 Francis M. Fesmire Heart Stroke Center—Director • Abbott None None None None • Plaintiff, Missed ACS, 2010 8.3 Barry A. Franklin William Beaumont

2012 American Heart Association PubMed abstract

291. 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (Full text)

in destruction of sinus node cells, such as ischemia or infarction, infiltrative disease, collagen vascular disease, surgical trauma, endocrinologic abnormalities, autonomic insufficiency, and others. The clinical manifestations of SND are diverse, reflecting the range of typical sinoatrial rhythm disturbances. The most dramatic presentation is syncope. The mechanism of syncope is a sudden pause in sinus impulse formation or sinus exit block, either spontaneously or after the termination of an atrial (...) judgment and available data in deciding when a condition is persistent or when it can be expected to be transient. Section 2.1.4, “Pacing for Atrioventricular Block Associated With Acute Myocardial Infarction,” overlaps with the “ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction” and includes expanded indications and stylistic changes. The statement “incidental finding at electrophysiological study” is used several times in this document and does not mean

2012 American Heart Association PubMed abstract

292. Intravenous immunoglobulin in the treatment of neuromuscular disorders

in the treatment of LEMS (Level C). Adverse effects of IVIg. Eighteen of the 22 prospective studies reviewed recorded the number of serious and minor AEs from 632 patients receiving IVIg (total dose 2.0–2.5 g/kg). There were no IVIg-related deaths in these studies. Most studies concluded that IVIg was well-tolerated and AEs were either transient or manageable. Serious AEs related to IVIg were rare and included aseptic meningitis (n = 3), urticaria (n = 2), heart failure (n = 1), myocardial infarction (n = 1 (...) ), and renal failure (n = 1). These findings do not exclude the possibility of rare AEs such as stroke and thrombotic events, which have been previously reported with IVIg. It is important to screen for vascular risk factors before infusion and to monitor carefully during and after infusion. , , The most common IVIg-related AEs included headache (16.1%), fever (6.6%), mild hypertension (4.6%), chills (3.3%), nausea (3.2%), asthenia (1.4%), arthralgia (1.3%), anorexia (1.1%), dizziness (1.1%), malaise (1.1

2012 American Academy of Neurology

293. Clinical Practice Guideline for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

, but is not associated with an increased incidence of myocardial ischemia (B). The association between depth of sedation and psychological stress in these patients remains unclear (C). We recommend that sedative medications be titrated to maintain a light rather than a deep level of sedation in adult ICU patients, unless clinically contraindicated (+1B). Monitoring depth of sedation and brain function The Richmond Agitation - Sedation Scale (RASS) and Sedation - Agitation Scale (SAS) are the most valid and reliable

2013 Society of Critical Care Medicine

294. Evidence-Based Guideline: Diagnosis and Treatment of Limb-Girdle and Distal Dystrophies

of Neurology, Mayo Clinic, Rochester, MN (4) Department of Neurology, Massachusetts General Hospital, Boston, MA/Harvard Medical School, Boston, MA (5) St Luke's Rehabilitation Institute, Spokane, WA (6) Department of Neurology, Penn State Hershey Medical Center, Hershey, PA (7) Department of Neurology, University of Kansas Medical Center, Kansas City, KS (8) Neuromuscular Center, Boston VA Medical Center, Boston, MA (9) Department of Neurology, University of Rochester Medical Center, Rochester, NY 2 (10 (...) for Disease Control and Prevention. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The remaining funding was provided by the American Academy of Neurology. This guideline was endorsed by the American Academy of Physical Medicine and Rehabilitation on April 17, 2014; by the Child Neurology Society on July 11, 2014; by the Jain Foundation on March 14, 2013; and by the Muscular

2013 American Association of Neuromuscular & Electrodiagnostic Medicine

295. 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease (Full text)

standards—sets of standardized data elements and corresponding definitions—to collect data relevant to cardiovascular conditions. The ultimate purpose of clinical data standards is to contribute to the infrastructure necessary to accomplish the ACCF/AHA mission of fostering optimal cardiovascular care and disease prevention and building healthier lives, free of cardiovascular diseases and stroke. The specific goals of clinical data standards are To establish a consistent, interoperable, and universal (...) a wealth of data on the treatment and outcomes for hundreds of thousands of patients. Many of these efforts have focused on patients with acute coronary syndromes (ACS), which range from ST-segment elevation myocardial infarction (STEMI) to non–ST-segment elevation myocardial infarction (NSTEMI) to unstable angina (UA). These data have been used to evaluate the effectiveness of the pharmacological and interventional management of these patients, define new therapies, and guide clinical care through

2013 American Heart Association PubMed abstract

296. Lifestyle Management to Reduce Cardiovascular Risk: Guideline on

sup- plements may not have similar effects and are not considered “lifestyle”interventions. The Work Group focused on CVD risk factors to provide a free-standing Lifestyle document and to inform the Blood Cholesterol guideline (4) and the hypertension panel. It also recognized that RCTs examining the effects on hard outcomes (myocardial infarction, stroke, heart failure, and CVD-related death) are dif?cult if not impossible to conduct for several reasons (e.g., long-term adherence to dietary (...) Lifestyle Management to Reduce Cardiovascular Risk: Guideline on 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk q A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, American Pharmacists Association, American Society for Nutrition, American Society for Preventive Cardiology, American Society of Hypertension, Association

2013 American College of Cardiology

297. Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Guidelines For the Management of Patients With

or surgical), or prior amputation for lower extremity ischemia. (Level of Evidence: B) 3. 2011 Updated Recommendation: Clopidogrel (75 mg per day) is recommended as a safe and effective alternative antiplatelet therapy to aspirin to reduce the risk of MI, ischemic stroke, or vascular death in individuals with symptomatic atherosclerotic lower extremity PAD, including those with intermittent claudica- tionorCLI,priorlowerextremityrevascularization(endovascular or surgical), or prior amputation for lower (...) extremity revascularization (endovascular or surgical), or prior amputation for lower extremity ischemia. (Level of Evi- dence: A) 2. 2011UpdatedRecommendation: Aspirin, typically in daily doses of 75 to 325 mg, is recommended as safe and effective anti- platelet therapy to reduce the risk of MI, stroke, or vascular death in individuals with symptomatic atherosclerotic lower extremity PAD, including those with intermittent claudication or CLI, prior lower extremity revascularization (endovascular

2013 American College of Cardiology

298. The Importance of Cardiorespiratory Fitness in the United States: The Need for a National Registry (Full text)

published 7 Jan 2013 Circulation. 2013;127:652–662 You are viewing the most recent version of this article. Previous versions: Introduction The recent 2012 update of the Heart Disease and Stroke Statistics from the American Heart Association (AHA) emphasizes the continuing burden of cardiovascular disease (CVD) in the United States, with a prevalence of CVD nearing 40% in those approaching 60 years of age and exceeding 70% in older ages. Direct and indirect costs of CVD in the United States exceeded (...) of clinically referred subjects, including those from the Cleveland Clinic, Mayo Clinic, , and Toronto Rehabilitation Institute, , have documented the importance of CRF as a predictor of mortality, demonstrating survival benefits in the range of 15% to 35% per MET achieved. The strength of the association between CRF and both CVD and all-cause mortality was recently underscored in an eloquent meta-analysis by Kodama et al. Data were extracted from 33 studies and nearly 103 000 participants. Compared

2013 American Heart Association PubMed abstract

299. American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 Update (Full text)

. AED indicates automatic external defibrillator; AHA, American Heart Association; CPR, cardiopulmonary resuscitation; CVD, cardiovascular disease; EPA, Environmental Protection Agency; MI, myocardial infarction; and TIA, transient ischemic attack. A major addition has been the listing of current programs ( ) that illustrate best practices at the national, regional, or local levels, including recommendations, methods, and tools to support strategic implementation to attain the goals of each (...) acute coronary syndromes and transient ischemic attack/stroke. The rationale for inclusion on this list of targeted behaviors includes a high relative risk for heart and stroke associated with them in those individuals who have not optimized these behaviors and factors, , significant room for their improvement in the general US population or specific communities, and evidence that these behaviors are modifiable. includes references to systematic reviews and previous AHA Scientific Statements, which

2013 American Heart Association PubMed abstract

300. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure (Full text)

strokes and ischemic heart disease events are attributable to high blood pressure (BP). , Given the monotonic relationship between cardiovascular events and BP even down to optimal levels (115/75 mm Hg), the global hypertension-related public health burden is enormous. An important component of the overall strategy to prevent the adverse health consequences of hypertension is the recommendation promulgated by formal guidelines for individuals to adopt lifestyle changes that reduce BP. Proven (...) , body mass index >25 kg/m 2 , BP >130/85 mm Hg, and/or a self-reported family history of hypertension). The effect of TM versus health education was also recently assessed in a randomized, controlled trial for the secondary prevention of cardiovascular disease among 201 blacks. During an average follow-up of 5.4 years, the primary end point (composite of all-cause mortality, myocardial infarctions, or stroke) was significantly reduced by 48% (hazard ratio, 0.52; 95% CI, 0.29–0.92) in the TM group

2013 American Heart Association PubMed abstract

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