Journal of the American College of Cardiology

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ISSN / EISSN : 0735-1097 / 1558-3597
Current Publisher: Elsevier BV (10.1016)
Total articles ≅ 95,906
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Andrew J. Einstein, Leslee J. Shaw, Cole Hirschfeld, Michelle C. Williams, Todd C. Villines, Nathan Better, Joao V. Vitola, Rodrigo Cerci, Sharmila Dorbala, Paolo Raggi, et al.
Journal of the American College of Cardiology, Volume 77, pp 173-185; doi:10.1016/j.jacc.2020.10.054

Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. The study sought to assess COVID-19’s impact on global cardiovascular diagnostic procedural volumes and safety practices. The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world’s economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted.
Journal of the American College of Cardiology, Volume 77; doi:10.1016/s0735-1097(20)38017-7

Mori J. Krantz , Robert B. Palmer, Mark C.P. Haigney
Journal of the American College of Cardiology, Volume 77, pp 205-223; doi:10.1016/j.jacc.2020.11.002

Abstract:
Opioids are the most potent of all analgesics. Although traditionally used solely for acute self-limited conditions and palliation of severe cancer-associated pain, a movement to promote subjective pain (scale, 0 to 10) to the status of a “fifth vital sign” bolstered widespread prescribing for chronic, noncancer pain. This, coupled with rising misuse, initiated a surge in unintentional deaths, increased drug-associated acute coronary syndrome, and endocarditis. In response, the American College of Cardiology issued a call to action for cardiovascular care teams. Opioid toxicity is primarily mediated via potent μ-receptor agonism resulting in ventilatory depression. However, both overdose and opioid withdrawal can trigger major adverse cardiovascular events resulting from hemodynamic, vascular, and proarrhythmic/electrophysiological consequences. Although natural opioid analogues are devoid of repolarization effects, synthetic agents may be proarrhythmic. This perspective explores cardiovascular consequences of opioids, the contributions of off-target electrophysiologic properties to mortality, and provides practical safety recommendations.
Darryl P. Leong , John W. Eikelboom, Salim Yusuf
Journal of the American College of Cardiology, Volume 77, pp 186-188; doi:10.1016/j.jacc.2020.11.028

Athena Poppas, Frederick A. Masoudi
Journal of the American College of Cardiology, Volume 77, pp 224-226; doi:10.1016/j.jacc.2020.12.001

Ajar Kochar , Anubodh S. Varshney, David E. Wang
Journal of the American College of Cardiology, Volume 77, pp 156-158; doi:10.1016/j.jacc.2020.11.034

Olivier Barthélémy, Stéphanie Rouanet, Delphine Brugier, Nicolas Vignolles, Benjamin Bertin, Michel Zeitouni, Paul Guedeney, Marie Hauguel-Moreau, Georges Hage, Pavel Overtchouk, et al.
Journal of the American College of Cardiology, Volume 77, pp 144-155; doi:10.1016/j.jacc.2020.11.025

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Michael N. Young , Alexander Iribarne, David Malenka
Journal of the American College of Cardiology, Volume 77, pp 170-172; doi:10.1016/j.jacc.2020.11.027

Carolyn M. Rosner, Behnam N. Tehrani, Alexander G. Truesdell, Shashank S. Sinha, Ramesh Singh, Mehul Desai, Erik Osborn, Shashank Desai, Daniel Tang, Wayne B. Batchelor
Journal of the American College of Cardiology, Volume 77, pp 227-228; doi:10.1016/j.jacc.2020.11.026

Alberto Alperi, Pierre Voisine, Dimitri Kalavrouziotis, Eric Dumont, François Dagenais, Jean Perron, Iria Silva, Fernando Bernardi, Siamak Mohammadi, Josep Rodés-Cabau
Journal of the American College of Cardiology, Volume 77, pp 111-123; doi:10.1016/j.jacc.2020.10.056

The publisher has not yet granted permission to display this abstract.
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