Identifying Patients at High Risk of a Cardiovascular Event in the Near Future Current Status and Future Directions: Report of a National Heart, Lung, and Blood Institute Working Group

The National Heart, Lung, and Blood Institute convened a working group to provide basic and clinical research recommendations to the National Heart, Lung, and Blood Institute on the development of an integrated approach for identifying those individuals who are at high risk for a cardiovascular event such as acute coronary syndromes (ACS) or sudden cardiac death in the “near term.” The working group members defined near-term as occurring within 1 year of the time of assessment. The participants reviewed current clinical cardiology practices for risk assessment and state-of-the-science techniques in several areas, including biomarkers, proteomics, genetics, psychosocial factors, imaging, coagulation, and vascular and myocardial susceptibility. This report presents highlights of these reviews and a summary of suggested research directions

2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

[Extract] Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease 1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions. 3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning. 4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss. 5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist. 7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit. 8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit. 9. Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion. 10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

Online social networks and micro-blogging in political campaigning: The exploration of a new campaign tool and a new campaign style

Contains fulltext : 120235.pdf (publisher's version ) (Closed access)This study explores how candidates running for the European Parliament (EP) in 2009 used micro-blogging and online social networks – in this case Twitter (www.twitter.com) in the early stage of its adoption – to communicate and connect with citizens. Micro-blogging in general, and Twitter in particular, is one of the new and popular Web 2.0 applications, yet there has been little research focusing on the use of Twitter by politicians. After reviewing different types of campaigning strategies and introducing a new and distinct strategy, this descriptive and exploratory study focuses on political candidates' use of micro-blogging and online social networking (i.e. Twitter) from a longitudinal, social network, and ideological perspective. The results clearly show that most candidates in 2009 still used Twitter reluctantly. Those who used Twitter did so predominantly for electoral campaigning and only sparingly for continuous campaigning. Candidates from progressive parties are the most active users of Twitter as a campaigning tool, whereas conservatives are virtually absent online. Although candidates' first degree networks are still relatively small and unconnected, their second degree networks are quite extensive. Candidates from parties in opposition have more extensive first degree networks than those from ruling parties. Candidates from fringe parties show small online networks.25 p

VENTRICULAR SEPTAL DEFECT WITH SHUNT FROM LEFT VENTRICLE TO RIGHT ATRIUM: BACTERIAL ENDOCARDITIS AS A COMPLICATION

During a two-year period we have seen six patients with malformations of the ventricular septum resulting in the shunting of blood between the left ventricle and the right atrium. Surgical closure of the defect has been successful in all. A history of bacterial endocarditis was established in two patients and strongly suspected in two others before operation. The surprisingly large number of patients with a malformation previously considered rare and the unusually high incidence of endo-carditis as a complication prompted a review of the anatomical and clinical features of this anomaly. There have been 26 patients reported with left ventricular to right atrial shuntst on whom relatively complete clinical studies are available (Perry, Burchell, and Edwards, 1949; Stahlman et al.