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The Pink Tax: Sex and Gender Disparities in Peripheral Artery Disease 粉红税外周动脉疾病的性别差异
US Cardiology Review Pub Date : 2024-02-23 DOI: 10.15420/usc.2022.28
Andrea Martinez, Jingwen Huang, Arash Harzand
{"title":"The Pink Tax: Sex and Gender Disparities in Peripheral Artery Disease","authors":"Andrea Martinez, Jingwen Huang, Arash Harzand","doi":"10.15420/usc.2022.28","DOIUrl":"https://doi.org/10.15420/usc.2022.28","url":null,"abstract":"Peripheral artery disease (PAD) is an atherosclerotic disease associated with significant functional impairment, morbidity, and mortality. Among women, PAD remains poorly recognized and undermanaged. Compared with men, women with PAD tend to be underdiagnosed or misdiagnosed, have poorer quality of life, and experience higher rates of PAD-related morbidity and cardiovascular mortality. In this review, we describe the sex- and gender-related differences in the epidemiology, presentation, diagnosis, and management of PAD. We provide specific recommendations to overcome these factors, including greater awareness and an increased emphasis on tailored and more aggressive interventions for women with PAD. Such changes are warranted and necessary to achieve more equitable outcomes in women with PAD, including improved limb outcomes, enhanced lifestyle, and cardiovascular risk reduction.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"26 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140436230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypertensive Disorders of Pregnancy: A Literature Review – Pathophysiology, Current Management, Future Perspectives, and Healthcare Disparities 妊娠期高血压疾病：文献综述--病理生理学、当前管理、未来展望和医疗差距
US Cardiology Review Pub Date : 2024-02-12 DOI: 10.15420/usc.2023.01
Ariana Traub, Apoorva Sharma, M. C. Gongora
{"title":"Hypertensive Disorders of Pregnancy: A Literature Review – Pathophysiology, Current Management, Future Perspectives, and Healthcare Disparities","authors":"Ariana Traub, Apoorva Sharma, M. C. Gongora","doi":"10.15420/usc.2023.01","DOIUrl":"https://doi.org/10.15420/usc.2023.01","url":null,"abstract":"Maternal mortality continues to increase in the US, with hypertensive disorders of pregnancy (HDP) remaining one of the leading causes of morbidity and mortality. In this article, the definition, classification, and pathophysiology of the different forms of HDP, current management of these disorders, disparities in prevalence and management of these conditions, and potential strategies to improve HDP outcomes and combat disparities to reduce maternal morbidity and mortality are reviewed. Current management favors a more conservative approach to treating mild chronic hypertension (140–160/90–100 mmHg) in pregnancy. However, recent data suggests active treatment of mild chronic hypertension improves maternofetal pregnancy related outcomes.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"73 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139843966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypertensive Disorders of Pregnancy: A Literature Review – Pathophysiology, Current Management, Future Perspectives, and Healthcare Disparities 妊娠期高血压疾病：文献综述--病理生理学、当前管理、未来展望和医疗差距
US Cardiology Review Pub Date : 2024-02-12 DOI: 10.15420/usc.2023.01
Ariana Traub, Apoorva Sharma, M. C. Gongora
{"title":"Hypertensive Disorders of Pregnancy: A Literature Review – Pathophysiology, Current Management, Future Perspectives, and Healthcare Disparities","authors":"Ariana Traub, Apoorva Sharma, M. C. Gongora","doi":"10.15420/usc.2023.01","DOIUrl":"https://doi.org/10.15420/usc.2023.01","url":null,"abstract":"Maternal mortality continues to increase in the US, with hypertensive disorders of pregnancy (HDP) remaining one of the leading causes of morbidity and mortality. In this article, the definition, classification, and pathophysiology of the different forms of HDP, current management of these disorders, disparities in prevalence and management of these conditions, and potential strategies to improve HDP outcomes and combat disparities to reduce maternal morbidity and mortality are reviewed. Current management favors a more conservative approach to treating mild chronic hypertension (140–160/90–100 mmHg) in pregnancy. However, recent data suggests active treatment of mild chronic hypertension improves maternofetal pregnancy related outcomes.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"42 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139784059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tearin’ Up My Heart: Intramural Hematoma in Spontaneous Coronary Artery Dissection 撕裂我的心自发性冠状动脉夹层中的壁内血肿
US Cardiology Review Pub Date : 2024-01-31 DOI: 10.15420/usc.2023.23
Shen, Sibi Krishnamurthy
{"title":"Tearin’ Up My Heart: Intramural Hematoma in Spontaneous Coronary Artery Dissection","authors":"Shen, Sibi Krishnamurthy","doi":"10.15420/usc.2023.23","DOIUrl":"https://doi.org/10.15420/usc.2023.23","url":null,"abstract":"","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"244 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Calcified Coronary Lesions 钙化冠状动脉病变的处理
US Cardiology Review Pub Date : 2024-01-24 DOI: 10.15420/usc.2022.29
Khaled F. Al-Shaibi, Aditya Bharadwaj, Atul Mathur, Ashish Jaikishen, Robert Riley
{"title":"Management of Calcified Coronary Lesions","authors":"Khaled F. Al-Shaibi, Aditya Bharadwaj, Atul Mathur, Ashish Jaikishen, Robert Riley","doi":"10.15420/usc.2022.29","DOIUrl":"https://doi.org/10.15420/usc.2022.29","url":null,"abstract":"With an aging population, coronary calcification is increasingly encountered in modern day interventional practice. Unfortunately, it is associated with lower procedural success and higher rates of periprocedural complications, such as failure to deliver stents, perforations, dissections, and other major adverse cardiac events. Furthermore, suboptimal stent deployment in the setting of severe calcification is associated with both short- and long-term major adverse cardiac events, including stent thrombosis, MI, in-stent restenosis, and target lesion revascularization. A variety of treatment options for these lesions exist, including specialized balloons, atherectomy, and intravascular lithotripsy. While there is currently no universally accepted algorithm for choosing between these treatment strategies, several different algorithms exist, and the optimization of these treatment regimens will continue to evolve in the coming years. This review aims to provide insights on the different therapeutic modalities and an understanding of the current body of evidence.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"57 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139600954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chest Pain in Women: Gender- and Sex-based Differences in the Presentation and Diagnosis of Heart Disease 女性胸痛：心脏病的表现和诊断中的性别差异
US Cardiology Review Pub Date : 2023-11-28 DOI: 10.15420/usc.2022.30
Mariem A Sawan, Rebecca S Steinberg, Michael N. Sayegh, Christian Devlin, Omid Behbahani-Nejad, Nanette K Wenger
{"title":"Chest Pain in Women: Gender- and Sex-based Differences in the Presentation and Diagnosis of Heart Disease","authors":"Mariem A Sawan, Rebecca S Steinberg, Michael N. Sayegh, Christian Devlin, Omid Behbahani-Nejad, Nanette K Wenger","doi":"10.15420/usc.2022.30","DOIUrl":"https://doi.org/10.15420/usc.2022.30","url":null,"abstract":"Ischemic heart disease is a major cause of morbidity and mortality in the US, affecting both men and women significantly. The presentation of chest pain is largely similar in female and male patients, but additional non-chest pain symptoms can confound timely diagnosis in women. Management, diagnostic evaluation, and clinical outcomes for patients admitted with chest pain differ significantly between men and women, and understanding of these discrepancies is limited. The objective of this review is to familiarize readers with gender- and sex-specific differences in the presentation, diagnosis, and management of chest pain.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139219283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Complex Percutaneous Cardiac Interventions in Women 女性复杂经皮心脏介入治疗的结果
US Cardiology Review Pub Date : 2023-11-23 DOI: 10.15420/usc.2022.21
M. Alasnag, V. Paradies, Nicola Ryan, Sara C Martinez
{"title":"Outcomes of Complex Percutaneous Cardiac Interventions in Women","authors":"M. Alasnag, V. Paradies, Nicola Ryan, Sara C Martinez","doi":"10.15420/usc.2022.21","DOIUrl":"https://doi.org/10.15420/usc.2022.21","url":null,"abstract":"Complex percutaneous cardiac intervention (PCI) is a growing procedure in modern day cath labs. The treated population is often older, with multiple comorbidities, complex coronary anatomy, left ventricular dysfunction, and possibly concomitant valvular heart disease and/or cardiogenic shock. As such, PCI of bifurcations, chronic total occlusions, and atherectomy coronary interventions are becoming more common. The outcomes in terms of acute procedural success, procedure-related complications, and long-term mortality or heart failure hospitalizations are important to consider. Unfortunately, to date there is a paucity of data identifying sex and gender disparities following such interventions. With respect to bifurcation lesions, women usually have more comorbidities with less complex coronary anatomy. However, despite less complex anatomy, women have a significantly increased risk of MI. These differences are also noted with left main stem and multivessel disease, during which women appear to have a trend towards worse outcomes following PCI compared with coronary artery bypass grafting. Randomized trials have revealed that women present with increased cardiovascular risk factors, which may contribute to adverse longer-term outcomes. Revascularization of women with concomitant valvular heart disease is particularly challenging because the existing data are conflicted on not only the indication, but also the timing of revascularization. Similarly, women undergoing PCI of calcified lesions with drug-eluting stents have a worse clinical profile and remain at increased ischemic risk. The lower incidence of coronary calcification in women, combined with the under-representation of women in randomized trials, poses a real challenge when attempting to address safety and survival benefit in women undergoing complex interventions. This warrants dedicated trials exploring the safety and efficacy of complex interventions in women.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcatheter Tricuspid Valve Replacement: Case Selection, Technical Considerations, and Procedural Planning. 经导管三尖瓣置换术：病例选择、技术考虑和手术计划
US Cardiology Review Pub Date : 2023-08-17 eCollection Date: 2023-01-01 DOI: 10.15420/usc.2023.07
Muhammad Asim Shabbir, Pradeep Yadav, Nidhish Tiwari, Poonam Velagapudi
{"title":"Transcatheter Tricuspid Valve Replacement: Case Selection, Technical Considerations, and Procedural Planning.","authors":"Muhammad Asim Shabbir, Pradeep Yadav, Nidhish Tiwari, Poonam Velagapudi","doi":"10.15420/usc.2023.07","DOIUrl":"10.15420/usc.2023.07","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a highly prevalent valve disorder in the US, with prevalence increasing with age. Without treatment, severe TR carries a poor prognosis. Tricuspid valve (TV) surgery is recommended for patients with severe TR undergoing left-sided valve surgery. Transcatheter TV repair or transcatheter TV replacement are potential options for patients who are not surgical candidates. A few small studies have demonstrated the feasibility and efficacy of transcatheter TV repair in patients with severe symptomatic TR. Careful patient selection by assessing tricuspid valve anatomy, right ventricular and pulmonary hemodynamics, candidacy for anticoagulation, comorbid conditions, and frailty is key to procedural success. Transcatheter TV repair can be performed via the transjugular or transfemoral access, and requires a large-caliber sheath (up to 45 Fr) and delivery system, particularly with dilated tricuspid annulus due to right ventricular enlargement. Multimodality imaging is essential for diagnosing TR severity, defining valve anatomy, and comprehensive functional assessment of the tricuspid valve, right atrium, and right ventricle. Several prosthetic valves, including the EVOQUE system, NaviGate system, Intrepid valve, and Cardiovalve, are currently being investigated in clinical trials.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e11"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45544421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review. 非左主分叉病变的一种方法:当代回顾
US Cardiology Review Pub Date : 2023-08-04 eCollection Date: 2023-01-01 DOI: 10.15420/usc.2022.25
Ali Nazmi Calik, F Aaysha Cader, Erik Rafflenbeul, Sercan Okutucu, Saidur Rahman Khan, Ismail Polat Canbolat, Umit Yasar Sinan, Mirvat A Alasnag
{"title":"An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review.","authors":"Ali Nazmi Calik, F Aaysha Cader, Erik Rafflenbeul, Sercan Okutucu, Saidur Rahman Khan, Ismail Polat Canbolat, Umit Yasar Sinan, Mirvat A Alasnag","doi":"10.15420/usc.2022.25","DOIUrl":"10.15420/usc.2022.25","url":null,"abstract":"<p><p>Bifurcated anatomical locations in the arterial tree, such as coronary artery bifurcations, are prone to develop obstructive atherosclerotic lesions due to the pro-atherogenic low wall shear stress. The percutaneous treatment of bifurcation lesions is among the most challenging complex coronary interventions, including different multistep stenting strategies. Even though provisional side branch (SB) stenting is recommended as the primary approach in most cases, the debate continues between provisional SB and upfront two-stent strategies, particularly in complex bifurcations consisting of a significantly diseased SB that supplies a crucial myocardial territory. This review will highlight the importance of understanding the bifurcation philosophy and provide an individual algorithmic approach to find the optimal treatment strategy for each patient with a non-left main coronary bifurcation lesion. Considering the most recent scientific evidence, the advantages and disadvantages of each stenting technique and the role of intracoronary imaging to optimize bifurcation percutaneous coronary intervention outcomes will be discussed.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e10"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46676021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Left Main Percutaneous Coronary Revascularization. 左主干经皮冠状动脉血管重建术
US Cardiology Review Pub Date : 2023-07-20 eCollection Date: 2023-01-01 DOI: 10.15420/usc.2022.24
Abdulrahman Almoghairi, Nayef Al-Asiri, Khalid Aljohani, Ayman AlSaleh, Nasser G Alqahtani, Mohammed Alasmary, Rudaynah Alali, Khaled Tamam, Mirvat Alasnag
{"title":"Left Main Percutaneous Coronary Revascularization.","authors":"Abdulrahman Almoghairi, Nayef Al-Asiri, Khalid Aljohani, Ayman AlSaleh, Nasser G Alqahtani, Mohammed Alasmary, Rudaynah Alali, Khaled Tamam, Mirvat Alasnag","doi":"10.15420/usc.2022.24","DOIUrl":"10.15420/usc.2022.24","url":null,"abstract":"<p><p>Left main (LM) coronary artery disease accounts for approximately 4-6% of all percutaneous coronary interventions (PCIs). There has been mounting evidence indicating the non-inferiority of LM PCI as a revascularization option, particularly for those with a low SYNTAX score. The EXCEL and NOBEL trials have shaped current guidelines. The European Society of Cardiology assigned a class 2a (level of evidence B) for isolated LM disease involving the shaft and ostium and a class IIb (level of evidence B) for isolated LM disease involving the bifurcation or additional two- or three-vessel disease and a SYNTAX score <32. However, data on the use of a single stent or an upfront two-stent strategy for distal LM disease are conflicting, wherein the EBC Main trial reported similar outcomes with a stepwise provisional approach and the DKCRUSH-V trial reported better outcomes with an upfront two-stent strategy using the 'double-kissing' crush technique. Although several studies have noted better immediate results with image-guided PCI, there are few data on outcomes in LM disease specifically. In fact, the uptake of imaging in the aforementioned landmark trials was only 40%. More importantly, the role of mechanical circulatory support (MCS) has been less well studied in LM PCI. Indiscriminate use of MCS for LM PCI has been noted in clinical practice. Trials evaluating the benefit of MCS in high-risk PCI demonstrated no benefit. This review highlights contemporary trials as they apply to current practice in LM PCI.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e09"},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45816328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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