Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T03:32:56.181Z Has data issue: false hasContentIssue false

Chapter 13 - Diagnosis and Management of Heart Disease

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

This chapter addresses the major cardiovascular conditions faced by clinicians caring for older adults: ischemic heart disease, heart failure, valvular disease, arrhythmias and conduction system disorders, and pericardial diseases. After a brief review of the global burden of heart disease and the effects of aging on the cardiovascular system, each subsequent section of the chapter provides a consistent approach to the description of these disease processes. Beginning with a summary of the epidemiology and clinical presentations relevant to older adults, pharmacologic and procedural recommendations are then presented based on clinical trial data and practice guidelines specific to this patient population. Each section also highlights the importance of individualized care for patients with advanced age or substantial medical comorbidities, including commentary about prognosis and palliative care, when appropriate. With clinically relevant treatment recommendations, comprehensive trial review and data tables, and several illustrative figures, this chapter provides evidence-based guidance to assist with the daily clinical care of our aging population with cardiovascular diseases.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 139 - 172
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Moran, AE, Forouzanfar, MH, Roth, GA, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980–2010: The Global Burden of Disease 2010 Study. Circulation. 2014; 129:14831492.Google Scholar
Virani, SS, Alonso, A, Benjamin, EJ, et al. Heart disease and stroke statistics – 2020 update: A report from the American Heart Association. Circulation. 2020; 141:e139e596.Google Scholar
Lakatta, EG. Age-associated cardiovascular changes in health: Impact on cardiovascular disease in older persons. Heart Failure Reviews. 2002; 7:2949.CrossRefGoogle ScholarPubMed
Rich, MW. Heart disease in the elderly. In: Rosendorff, C, ed. Essential Cardiology: Principles and Practice, 3rd edition. New York: Springer, 2013, pp. 669686.Google Scholar
D’Agostino, RB, Vasan, RS, Pencina, MJ, et al. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation. 2008; 117:743753.Google Scholar
Haffner, SM, Lehto, S, Ronnemaa, T, et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. New Engl J Med. 1998; 339:229234.CrossRefGoogle ScholarPubMed
Kuller, LH, Arnold, AM, Psaty, BM, et al. Ten-year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the Cardiovascular Health Study. Arch Int Med. 2006; 166:7178.CrossRefGoogle Scholar
White, HD, Barbash, GI, Califf, RM, et al. Age and outcome with contemporary thrombolytic therapy: Results from the GUSTO-I trial. Circulation. 1996; 94:18261833.Google Scholar
Thygesen, K, Alpert, JS, Jaffe, AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018; 72:22312264.Google Scholar
Scirica, BM. Acute coronary syndrome: Emerging tools for diagnosis and risk assessment. J Am Coll Cardiol. 2010; 55:14031415.Google Scholar
Eggers, KM, Venge, P, Lindahl, B, Lind, L. Cardiac troponin I levels measured with a high-sensitivity assay increase over time and are strong predictors of mortality in an elderly population. J Am Coll Cardiol. 2013; 61:19061913.CrossRefGoogle Scholar
O’Gara, PT, Kushner, FG, Ascheim, DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol. 2013; 61:e78140.Google Scholar
Amsterdam, EA, Wenger, NK, Brindis, RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes. Circulation. 2014; 130:e344e426.Google Scholar
Levine, GN, Bates, ER, Bittl, JA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease. J Am Coll Cardiol. 2016; 68:10821115.Google Scholar
ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet. 1988; 332:349360.CrossRefGoogle Scholar
The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001; 345:494502.Google Scholar
Wiviott, SD, Braunwald, E, McCabe, CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007; 357:2001–2015.CrossRefGoogle ScholarPubMed
Wallentin, L, Becker, RC, Budaj, A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009; 361:10451057.Google Scholar
Steen, H, James, S, Becker, RC, et al. Ticagrelor versus clopidogrel in elderly patients with acute coronary syndromes: A substudy from the Prospective Randomized PLATelet Inhibition and Patient Outcomes (PLATO) trial. Circ Cardiovasc Qual Outcomes. 2012; 680688.Google Scholar
Mauri, L, Kereiakes, DJ, Yeh, RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med. 2014; 371:21552166.Google Scholar
Bonaca, MP, Bhatt, DL, Cohen, M, et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med. 2015; 372:17911800.Google Scholar
The PURSUIT Trial Investigators. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. N Engl J Med. 1998; 339:436443.Google Scholar
Bhatt, DL, Stone, GW, Mahaffey, KW, et al. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med. 2013; 368:13031313.Google Scholar
Antman, EM, Cohen, M, Radley, D, et al. Assessment of the treatment effect of enoxaparin for unstable angina/non-Q-wave myocardial infarction: TIMI 11B-ESSENCE meta-analysis. Circulation. 1999; 100:16021608.Google Scholar
FRagmin and Fast Revascularization during InStability in Coronary artery disease (FRISC II) Investigators. Long-term low-molecular-mass heparin in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. Lancet. 1999; 354:701707.Google Scholar
Dewilde, WJ, Oirbans, T, Verheugt, FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: An open-label, randomized, controlled trial. Lancet. 2013; 381:11071115.CrossRefGoogle ScholarPubMed
Khan, SU, Osman, M, Khan, MU. Dual versus triple therapy for atrial fibrillation after percutaneous coronary intervention: A systematic review and meta-analysis. Ann Intern Med. 2020; 172:474483.CrossRefGoogle ScholarPubMed
Mehran, R, Baber, U, Sharma, SK, et al. Ticagrelor with or without aspirin in high-risk patients after PCI. N Engl J Med. 2019; 381:20322042.Google Scholar
Watanabe, H, Domei, T, Morimoto, T, et al. Effect of 1-month dual antiplatelet therapy followed by clopidogrel vs 12-month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI. JAMA. 2019; 321:24142427.Google Scholar
COMMIT collaborative group. Early intravenous then oral metoprolol in 45852 patients with acute myocardial infarction: Randomised placebo-controlled trial. Lancet. 2005; 366:16221632.Google Scholar
ACE Inhibitor Myocardial Infarction Collaborative Group. Indications for ACE inhibitors in the early treatment of acute myocardial infarction: Systematic overview of individual data from 100,000 patients in randomized trials. Circulation. 1998; 97:22022212.CrossRefGoogle Scholar
Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet. 1994; 343:11151122.Google Scholar
Ambrosioni, E, Borghi, C, Magnani, B, for the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study Investigators. The effect of the angiotensin-converting-enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. N Engl J Med. 1995; 332:8085.Google Scholar
The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet. 1993; 342:821828.Google Scholar
Dickstein, K, Kjekshus, J. Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: The OPTIMAAL randomised trial. Lancet. 2002; 360:752760.Google Scholar
Pitt, B, Remme, W, Zannad, F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003; 348:13091321.Google Scholar
Miettinen, TA, Pyorala, K, Olsson, AG, et al. Cholesterol-lowering therapy in women and elderly patients with myocardial infarction or angina pectoris: Findings from the Scandinavian Simvastatin Survival Study (4S). Circulation. 1997; 96:42114218.Google Scholar
Lewis, SJ, Moye, LA, Sacks, FM, et al. Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range: Results of the Cholesterol and Recurrent Events (CARE) trial. Ann Intern Med. 1998; 129:681689.Google Scholar
The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998; 339:13491357.CrossRefGoogle Scholar
Shepherd, J, Blauw, GJ, Murphy, MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet. 2002; 360:16231630.CrossRefGoogle Scholar
Stone, NJ, Intwala, S, Katz, D. Statins in very elderly adults. J Am Geriatr Soc. 2014; 62:943945.CrossRefGoogle ScholarPubMed
Rich, MW. Aggressive lipid management in very elderly adults: Less is more. J Am Geriatr Soc. 2014; 62:945947.Google Scholar
Sathasivam, S, Lecky, B. Statin induced myopathy. BMJ. 2008; 337:a2286.Google Scholar
Lee, DS, Markwardt, S, Goeres, L, et al. Statins and physical activity in older men: The osteoporotic fractures in men study. JAMA Intern Med. 2014; 174:12631270.CrossRefGoogle ScholarPubMed
Golomb, BA, Evans, MA, Dimsdale, JE, et al. Effects of statins on energy and fatigue with exertion: Results from a randomized controlled trial. Arch Intern Med. 2012; 172:11801182.Google Scholar
Grundy, SM, Stone, NJ, Bailey, AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. J Am Coll Cardiol. 2019; 73:e285e350.CrossRefGoogle ScholarPubMed
The Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators. A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction. N Engl J Med. 1997; 336:16211628.Google Scholar
de Boer, MJ, Ottervanger, JP, van’t Hof, AW, et al. Reperfusion therapy in elderly patients with acute myocardial infarction: A randomized comparison of primary angioplasty and thrombolytic therapy. J Am Coll Cardiol. 2002; 39:17231728.Google Scholar
Levine, GN, Bates, ER, Blankenship, JC, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction. J Am Coll Cardiol. 2016; 67:12351250.Google Scholar
Antman, EM, Cohen, M, Bernink, PJLM, et al. The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA. 2000; 284:835842.Google Scholar
Granger, CB, Goldberg, RJ, Dabbous, O, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events (GRACE). Arch Intern Med. 2003; 163:23452353.CrossRefGoogle Scholar
FRagmin and Fast Revascularization during InStability in Coronary artery disease (FRISC II) Investigators. Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. Lancet. 1999; 354:708715.Google Scholar
Hochman, JS. Cardiogenic shock complicating acute myocardial infarction: Expanding the paradigm. Circulation. 2003; 107:29983002.Google Scholar
Hochman, JS, Sleeper, LA, White, HD, et al. for the SHOCK Investigators. One-year survival following early revascularization for cardiogenic shock. JAMA. 2001; 285:190192.Google Scholar
Dzavik, V, Sleeper, LA, Cocke, TP, et al. for the SHOCK Investigators. Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A report from the SHOCK Trial Registry. Eur Heart J. 2003; 24:828837.Google Scholar
Bueno, H, Lopez-Palop, R, Perez-David, E, et al. Combined effect of age and right ventricular involvement on acute inferior myocardial infarction prognosis. Circulation. 1998; 98:17141720.Google Scholar
Robinson, AA, Trankle, CR, Eubanks, G, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol. 2020; 5:685692.Google Scholar
Hasdai, D, Topol, EJ, Califf, RM, et al. Cardiogenic shock complicating acute coronary syndromes. Lancet. 2000; 356:749756.Google Scholar
Olgin, JE, Pletcher, MJ, Vittinghoff, E, et al. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med. 2018; 379:12051215.Google Scholar
Al-Khatib, SM, Stevenson, WG, Ackerman, MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. J Am Coll Cardiol. 2018; 72:e91e220.Google Scholar
Fihn, SD, Gardin, JM, Abrams, J, et al. 2012 ACCF/AHA/ACP/ AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol. 2012; 60:e44164.Google Scholar
Whelton, PK, Carey, RM, Aronow, WS, et al. 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol. 2018; 71:e127e248.Google Scholar
Grundy, SM, Stone, NJ, Bailey, AL, et al. 2018 ACC/AHA/ACCVPR/AAPA/ ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. J Am Coll Cardiol. 2019; 73:e285e350.CrossRefGoogle ScholarPubMed
American Diabetes Association. Older adults: Standards of medical care in diabetes – 2020. Diabetes Care. 2020; 43(suppl. 1):S152S162.Google Scholar
Witt, BJ, Jacobsen, SJ, Weston, SA, et al. Cardiac rehabilitation after myocardial infarction in the community. J Am Coll Cardiol. 2004; 44:988996.Google Scholar
Garber, AJ, Handelsman, Y, Grunberger, G, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm – 2020 executive summary. Endocr Pract. 2020; 26:107139.Google Scholar
Das, SR, Everett, BM, Birtcher, KK, et al. 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes. J Am Coll Cardiol. 2020; 76:11171145.Google Scholar
Zinman, B, Wanner, C, Lachin, JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015; 373:21172128.Google Scholar
Neal, B, Perkovic, V, Mahaffey, KW, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017; 377:644657.Google Scholar
Wiviott, SD, Raz, I, Bonaca, MP, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019; 380:347357.Google Scholar
McMurray, JJV, Solomon, SD, Inzucchi, SE, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019; 381:19952008.Google Scholar
Packer, M, Anker, SD, Butler, J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure, for the EMPEROR-Reduced Trial Investigators. N Engl J Med. 2020; 383:14131424. doi: 10.1056/NEJMoa2022190.Google Scholar
Marso, SP, Daniels, GH, Brown-Frandsen, K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016; 375:311322.Google Scholar
Marso, SP, Bain, SC, Consoli, A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016; 375:18341844.Google Scholar
Husain, M, Birkenfeld, AL, Donsmark, M, et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2019; 381(9):841851.Google Scholar
Gerstein, HC, Colhoun, HM, Dagenais, GR, et al. Dulaglitide and cardiovascular outcomes in type 2 diabetes (REWIND): A double-blind, randomised placebo-controlled trials. Lancet. 2019; 394:121130.CrossRefGoogle Scholar
American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ACC/AHA 2002 guidelines update for exercise testing. Circulation. 2002; 106:18831892.Google Scholar
Douglas, PS, Hoffmann, U, Patel, MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015; 372:12911300.Google Scholar
Boden, WE, O’Rourke, RA, Teo, KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007; 356:15031516.Google Scholar
Maron, DJ, Hochman, JS, Reynolds, HR, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med. 2020; 382:13951407.Google Scholar
Steg, PG, Bhatt, DL, Simon, T, et al. Ticagrelor in patients with stable coronary disease and diabetes. N Engl J Med. 2019; 381:13091320.CrossRefGoogle ScholarPubMed
Eikelboom, JW, Connolly, SJ, Bosch, J, et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med. 2017; 377:13191330.Google Scholar
The TIME Investigators. Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): A randomised trial. Lancet. 2001; 358:951957.Google Scholar
Newman, MF, Kirchner, JL, Phillips-Bute, B, et al. for the Neurological Outcome Research Groups and the Cardiothoracic Anesthesiology Research Endeavors Investigators. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001; 344:395402.CrossRefGoogle ScholarPubMed
Yancy, CW, Jessup, M, Bozkurt, B, et al. 2013 ACCF/AHA guideline for the management of heart failure. Circulation. 2013; 128:e240327.Google Scholar
The ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker versus diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:29812997.Google Scholar
The SPRINT research group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015; 373:21032116.Google Scholar
Yancy, CW, Jessup, M, Bozkurt, B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. J Am Coll Cardiol. 2017; 70:776803.Google Scholar
Okin, PM, Devereux, RB, Jern, S, et al. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of major cardiovascular events. JAMA. 2004; 292:23432349.Google Scholar
Goldman, L, Hashimoto, B, Cook, EF, Loscalzo, A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: Advantages of a new specific activity scale. Circulation. 1981; 64:12271234.CrossRefGoogle ScholarPubMed
Maisel, AS, Krishnaswamy, P, Nowak, RM, et al. for the Breathing Not Properly Multinational Study Investigators. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002; 347:161167.Google Scholar
Gaggin, HK, Mohammed, AA, Bhardwaj, A, et al. Heart failure outcomes and benefits of NT-proBNP-guided management in the elderly: Results from the Prospective, Randomized ProBNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT Study). J Cardiac Fail. 2012; 18:626634.Google Scholar
Redfield, MM, Rodeheffer, RJ, Jacobsen, SJ, et al. Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol. 2002; 40:976982.Google Scholar
Wang, TJ, Larson, MG, Levy, D, et al. Impact of age and sex on plasma natriuretic peptide levels in healthy adults. Am J Cardiol. 2002; 90:254258.Google Scholar
Januzzi, JL, Chen-Tournoux, AA, Christenson, RH, et al. N-terminal pro-B-type natriuretic peptide in the emergency department: The ICON-RELOADED study. J Am Coll Cardiol. 2018; 71:11911200.CrossRefGoogle ScholarPubMed
Heiat, A, Gross, CP, Krumholz, HM. Representation of the elderly, women, and minorities in heart failure clinical trials. Arch Intern Med. 2002; 162:16821688.Google Scholar
Rich, MW, Beckham, V, Wittenberg, C, et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995; 333:11901195.Google Scholar
Whellan, DJ, Hasselblad, V, Peterson, E, et al. Meta-analysis and review of heart failure disease management randomized controlled clinical trials. Am Heart J. 2005; 149:722729.CrossRefGoogle ScholarPubMed
Ades, PA, Keteyian, SJ, Balady, GJ, et al. Cardiac rehabilitation exercise and self-care for chronic heart failure. JACC Heart Fail. 2013; 1:540547.Google Scholar
Faris, R, Flather, M, Purcell, H, et al. Current evidence supporting the role of diuretics in heart failure: A meta analysis of randomised controlled trials. Int J Cardiol. 2002; 82:149158.Google Scholar
Domanski, M, Norman, J, Pitt, B, et al. Diuretic use, progressive heart failure, and death in patients in the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol. 2003; 42:705708.Google Scholar
Neuberg, GW, Miller, AB, O’Connor, CM, et al. Diuretic resistance predicts mortality in patients with advanced heart failure. Am Heart J. 2002; 144:3138.Google Scholar
Gheorghiade, M, Zannad, F, Sopko, G, et al. Acute heart failure syndromes: current state and framework for future research. Circulation. 2005; 112:39583968.Google Scholar
Gupta, D, Georgiopoulou, VV, Kalogeropoulos, AP, et al. Dietary sodium intake in heart failure. Circulation. 2012; 126:479485.Google Scholar
Flather, MD, Yusuf, S, Kober, L, et al. Long-term ACEI-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. Lancet. 2000; 355:15751581.Google Scholar
Garg, R, Yusuf, S for the Collaborative Group on ACE Inhibitor Trials. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. JAMA. 1995; 273:14501456.Google Scholar
The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fraction. N Engl J Med. 1992; 327:685691.Google Scholar
Maggioni, AP, Anand, I, Gottlieb, SO, et al. Effects of valsartan on morbidity and mortality in patients with heart failure not receiving angiotensin-converting enzyme inhibitors. J Am Coll Cardiol. 2002; 40:14141421.Google Scholar
Granger, CB, McMurray, JJV, Yusuf, S, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003; 362:772776.Google Scholar
Pfeffer, MA, Swedberg, K, Granger, CB, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet. 2003; 362:759766.Google Scholar
Kuenzli, A, Bucher, HC, Anand, I, et al. Meta-analysis of combined therapy with angiotensin receptor antagonists versus ACE inhibitors alone in patients with heart failure. PloS One. 2010; 5:e9946.Google Scholar
McMurray, JJV, Packer, M, Desai, AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014; 371:9931004.Google Scholar
Cohn, JN, Archibald, DG, Ziesche, S, et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure: Results of a Veterans Administration Cooperative Study. N Engl J Med. 1986; 314:15471552.Google Scholar
Cohn, JN, Johnson, G, Ziesche, S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med. 1991; 325:303310.Google Scholar
Taylor, AL, Ziesche, S, Yancy, C, et al. for the African-American Heart Failure Trial Investigators. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004; 351:20492057.Google Scholar
MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999; 353:20012007.Google Scholar
Packer, M, Coats, AJS, Fowler, MB, et al. for the Carvedilol Prospective Randomized Cumulative Survival Study Group. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001; 344:16511658.Google Scholar
The Cardiac Insufficiency Bisoprolol Study II (CIBIS II): A randomised trial. Lancet. 1999; 353:913.Google Scholar
Deedwania, PC, Gottlieb, S, Ghali, JK, et al. Efficacy, safety and tolerability of beta-adrenergic blockade with metoprolol CR/XL in elderly patients with heart failure. Eur Heart J. 2004; 25:13001309.Google Scholar
Swedberg, K, Komajda, M, Bohm, M, et al. Ivabradine and outcomes in chronic heart failure (SHIFT): A randomised placebo-controlled study. Lancet. 2010; 376:875885.Google Scholar
Pitt, B, Zannad, F, Remme, WJ, et al. for the Randomized Aldactone Evaluation Study Investigators. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med. 1999; 341:709717.Google Scholar
Zannad, F, McMurray, JJV, Krum, H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011; 364:1121.Google Scholar
Juurlink, DN, Mamdani, MM, Lee, DS, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med. 2004; 351:543551.Google Scholar
The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997; 336:525533.Google Scholar
Rich, MW, McSherry, F, Williford, WO, Yusuf, S for the Digitalis Investigation Group. Effect of age on mortality, hospitalizations and response to digoxin in patients with heart failure: The DIG study. J Am Coll Cardiol. 2001; 38:806813.Google Scholar
Ahmed, A, Rich, MW, Love, TE, et al. Digoxin and reduction in mortality and hospitalization in heart failure: A comprehensive post hoc analysis of the DIG trial. Eur Heart J. 2006; 27:178186.Google Scholar
Massie, BN, Collins, JF, Ammon, SE, et al. Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) Trial. Circulation. 2009; 119:16161624.Google Scholar
Homma, S, Thompson, JLP, Pullicino, PM, et al. Warfarin and aspirin in patients with heart failure and sinus rhythm. N Engl J Med. 2012; 366:18591869.Google Scholar
O’Connor, CM, Gattis, WA, Uretsky, BF, et al. Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: Insights from the Flolan International Randomized Survival Trial (FIRST). Am Heart J. 1999; 138:7886.Google Scholar
Cuffe, MS, Califf, RM, Adams, KFJ, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: A randomized controlled trial. JAMA. 2002; 287:15411547.Google Scholar
Publication Committee for the VMAC Investigators (Vasodilation in the Management of Acute CHF). Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA. 2002; 287:15311540.Google Scholar
O’Connor, CM, Starling, RC, Hernandez, AF, et al. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med. 2011; 365:3243.Google Scholar
Daneshvar, DA, Czer, LS, Phan, A, et al. Heart transplantation in the elderly: why cardiac transplantation does not need to be limited to younger patients but can be safely performed in patients above 65 years of age. Ann Transplant. 2010; 15:110119.Google Scholar
Atluri, P, Goldstone, AB, Kobrin, DM, et al. Ventricular assist device implant in the elderly is associated with increased, but respectable risk: A multi-institutional study. Ann Thorac Surg.2013; 96:141147.Google Scholar
DeFilippis, EM, Nakagawa, S, Maurer, MS, Topkara, VK. Left ventricular assist device therapy in older adults: Addressing common clinical questions. J Am Geriatr Soc. 2019; 67:24102419.Google Scholar
Upadhya, B, Kitzman, DW. Heart failure with preserved ejection fraction: new approaches to diagnosis and management. Clin Cardiol. 2020; 43:145155.Google Scholar
Kitzman, DW, Gardin, JM, Gottdiener, JS, et al. for the Cardiovascular Health Study Research Group. Importance of heart failure with preserved systolic function in patients > or = 65 years of age. Am J Cardiol. 2001; 87:413419.Google Scholar
Owan, TE, Hodge, DO, Herges, RM, Jacobsen, SJ, Roger, VL, Redfield, MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006; 355:251259.Google Scholar
Bhatia, RS, Tu, JV, Lee, DS, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. New Engl J Med. 2006; 355:260269.Google Scholar
Owan, TE, Hodge, DO, Herges, RM, et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. New Engl J Med. 2006; 355:251259.Google Scholar
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: An individual patient data meta-analysis. Eur Heart J. 2012; 33:17501757.CrossRefGoogle Scholar
Yusuf, S, Pfeffer, MA, Swedberg, K, et al. for the CHARM investigators and Committees. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: The CHARM-Preserved Trial. Lancet. 2003; 362:777781.Google Scholar
Ahmed, A, Rich, MW, Fleg, JL, et al. Effects of digoxin on morbidity and mortality in diastolic heart failure: the Ancillary Digitalis Investigation Group Trial. Circulation. 2006; 114:397403.Google Scholar
Cleland, JGF, Tendera, M, Adamus, J, et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J. 2006; 27:23382345.Google Scholar
Massie, BM, Carson, PE, McMurray, JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008; 359:24562467.Google Scholar
Van Veldhuisen, DJ, Cohen-Solal, A, Bohm, M, et al. Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction. J Am Coll Cardiol. 2009; 53:21502158.Google Scholar
Pitt, B, Pfeffer, MA, Assmann, SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014; 370:13831392.Google Scholar
Edelmann, F, Wachter, R, Schmidt, AG, et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: The Aldo-DHF randomized controlled trial. JAMA. 2013; 309:781791.CrossRefGoogle ScholarPubMed
Redfield, MM, Chen, HH, Borlaug, BA, et al. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. JAMA. 2013; 309:12681277.Google Scholar
Zile, MR, Bourge, RC, Redfield, MM, Zhou, D, Baicu, CF, Little, WC. Randomized, double-blind, placebo-controlled study of sitaxsentan to improve impaired exercise tolerance in patients with heart failure and a preserved ejection fraction. J Am Coll Cardiol HF. 2014; 2:123130.Google Scholar
Conraads, VM, Metra, M, Kamp, O, et al. Effects of long-term administration of nebivolol on the clinical symptoms, exercise capacity, and left ventricular function of patients with diastolic dysfunction: Results of the ELANDD study. Eur J Heart Fail. 2012; 14:219225.Google Scholar
Solomon, SD, McMurray, JJV, Anand, IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019; 381:16091620.Google Scholar
Ruberg, FL, Grogan, M, Hanna, M, et al. Transthyretin amyloid cardiomyopathy. J Am Coll Cardiol. 2019; 73:28722891.Google Scholar
Maurer, MS, Schwartz, JH, Gundapaneni, B, et al. Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. N Engl J Med. 2018; 379:10071016.Google Scholar
Bristow, MR, Saxon, LA, Boehmer, J, et al. for the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004; 350:21402150.Google Scholar
Cleland, JGF, Daubert, JC, Erdmann, E, et al. for the Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators. The effect of cardiac resynchronization on morbidity and mortality in heart failure. New Engl J Med. 2005; 352:15391549.Google Scholar
Kusumoto, FM, Schoenfeld, MH, Barrett, CN, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. J Am Coll Cardiol. 2019; 74:e51e156.Google Scholar
Cheng, YJ, Zhang, J, Li, WJ, et al. More favorable response to cardiac resynchronization therapy in women than in men. Circ Arrhythm Electrophysiol. 2014; 7:807815.Google Scholar
Zusterzeel, R, Selzman, KA, Sanders, WE, et al. Cardiac resynchronization therapy in women: US Food and Drug Administration meta-analysis of patient-level data. JAMA Intern Med. 2014; 174:13401348.Google Scholar
Verbrugge, FH, Dupont, M, De Vusser, P, et al. Response to cardiac resynchronization therapy in elderly patients (≥70 years) and octogenarians. Eur J Heart Fail. 2013; 15:203210.Google Scholar
Sandhu, A, Levy, A, Varosy, PD, Matlock, D. Implantable cardioverter-defibrillators and cardiac resynchronization therapy in older adults with heart failure. J Am Geriatr Soc. 2019; 67:21932199.Google Scholar
Moss, AJ, Zareba, W, Hall, WJ, et al. for the Multicenter Automatic Defibrillator Implantation Trial II Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002; 346:877883.Google Scholar
Bardy, GH, Lee, KL, Mark, DB, et al. for the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005; 352:225237.Google Scholar
Santangeli, P, Di Biase, L, Dello Russo, A, et al. Meta-analysis: Age and effectiveness of prophylactic implantable cardioverter-defibrillators. Ann Intern Med. 2010; 153:592599.Google Scholar
Lampert, R, Hayes, DL, Annas, GJ, et al. HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm. 2010; 7:10081026.Google Scholar
Takeda, A, Martin, N, Taylor, RS, Taylor, SJC. Disease management interventions for heart failure. Cochrane Database Syst Rev. 2019; 1:CD002752.Google Scholar
Huynh, BC, Rovner, A, Rich, MW. Long-term survival in elderly patients hospitalized for heart failure: 14 year follow-up from a prospective randomized trial. Arch Intern Med. 2006; 166:18921898.Google Scholar
Whellan, DJ, Goodlin, SJ, Dickinson, MG, et al. End-of-life care in patients with heart failure. J Card Fail. 2014; 20:121134.Google Scholar
Otto, CM, Prendergast, B. Aortic-valve stenosis: From patients at risk to severe valve obstruction. N Engl J Med. 2014; 371:744756.Google Scholar
Nishimura, RA, Otto, CM, Ronow, RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease. J Am Coll Cardiol. 2017; 70:252289.Google Scholar
Leon, MB, Smith, CR, Mack, M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363:15971607.Google Scholar
Smith, CR, Leon, MB, Mack, MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011; 364:21872198.Google Scholar
Kodali, SK, Williams, MR, Smith, CR, et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med. 2012; 366:16861695.Google Scholar
Reynolds, MR, Magnuson, EA, Lei, Y, et al. Health-related quality of life after transcatheter aortic valve replacement in inoperable patients with severe aortic stenosis. Circulation. 2011; 124:19641972.Google Scholar
Mack, MJ, Leon, MB, Thourani, VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019; 380:16951705.Google Scholar
Popma, JJ, Deeb, GM, Yakubov, SJ, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med. 2019; 380:17061715.Google Scholar
Lindman, BR, Alexander, KP, O’Gara, PT, Afilalo, J. Futility, benefit, and transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2014; 7:707716.Google Scholar
Scognamiglio, R, Rahimtoola, SH, Fasoli, G, et al. Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function. N Engl J Med. 1994; 331:689694.Google Scholar
Evangelista, A, Tornos, P, Sambola, A, et al. Long-term vasodilator therapy in patients with severe aortic regurgitation. N Engl J Med. 2005; 353:13421349.Google Scholar
Rawasia, WF, Khan, MS, Usman, MS, et al. Safety and efficacy of transcatheter aortic valve replacement for native aortic valve regurgitation: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 2019; 93:345353.Google Scholar
Mathew, JP, Fontes, ML, Tudor, IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004; 291:17201729.Google Scholar
Crystal, E, Connolly, SJ, Sleik, K, et al. Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: A meta-analysis. Circulation. 2002; 106:7580.Google Scholar
Mitchell, LB, Exner, DV, Wyse, DG, et al. Prophylactic oral amiodarone for the prevention of arrhythmias that begin early after revascularization, valve replacement, or repair – PAPABEAR: A randomized controlled trial. JAMA. 2005; 294:30933100.Google Scholar
Enriquez-Sarano, M, Avierinos, JF, Messika-Zeitoun, D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005; 352:875883.Google Scholar
Feldman, T, Foster, E, Glower, DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med. 2011; 364:13951406.Google Scholar
Wan, B, Rahnvavardi, M, Tian, DH, et al. A meta-analysis of MitraClip system versus surgery for treatment of severe mitral regurgitation. Ann Cardiothorac Surg. 2013; 2:683692.Google Scholar
Stone, GW, Lindenfeld, J, Abraham, WT, et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018; 379:23072318.Google Scholar
Lamas, GA, Lee, KL, Silverman, R, et al. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction. N Engl J Med. 2002; 346:18541862.Google Scholar
Dewland, TA, Olgin, JE, Vittinghoff, E, Marcus, GM. Incident atrial fibrillation among Asians, Hispanics, Blacks, and Whites. Circulation. 2013; 128:24702477.Google Scholar
January, CT, Wann, LS, Calkins, H, et al. 2019 ACC/AHA/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. J Am Coll Cardiol. 2019; 74:104132.Google Scholar
Coleman, CI, Perkerson, KA, Gillespie, EL, et al. Impact of prophylactic beta blockade on post-cardiothoracic surgery length of stay and atrial fibrillation. Ann Phamacother. 2004; 38:20122016.Google Scholar
Kluger, J, White, CM. Amiodarone prevents symptomatic atrial fibrillation and reduces the risk of cerebrovascular events and ventricular tachycardia after open heart surgery: Results of the Atrial Fibrillation Suppression Trial (AFIST). Card Electrophysiol Rev. 2003; 7:165167.Google Scholar
Wyse, DG, Waldo, AL, DiMarco, JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002; 347:18251833.Google Scholar
The AFFIRM Investigators. Quality of life in atrial fibrillation: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. Am Heart J. 2005; 149:112120.Google Scholar
Packer, DL, Mark, DB, Robb, RA, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation (the CABANA randomized clinical trial). JAMA. 2019; 321:12611274.Google Scholar
Wolf, PA, Abbott, RD, Kannel, WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991; 22:983988.Google Scholar
Gage, BF, Waterman, AD, Shannon, W, et al. Validation of clinical classification schemes for predicting stroke: Results from the National Registry of Atrial Fibrillation. JAMA. 2001; 285:28642870.Google Scholar
Lip, GY, Nieuwlaat, R, Pisters, R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The Euro Heart Survey on Atrial Fibrillation. Chest. 2010; 137:263272.Google Scholar
SPORTIF III Investigators: Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation. Lancet. 2003; 362:16911698.Google Scholar
SPORTIF V Investigators. Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. JAMA. 2005; 293:690698.Google Scholar
Connolly, SJ, Ezekowitz, MD, Yusuf, S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361:11391151.Google Scholar
Patel, MR, Mahaffey, KW, Garg, J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011; 365:883891.Google Scholar
Granger, CB, Alexander, JH, McMurray, JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011; 365:981992.Google Scholar
Sardar, P, Chatterjee, S, Chaudhari, S, Lip, GYH. New oral anticoagulants in elderly adults: Evidence from a meta-analysis of randomized trials. J Am Geriatr Soc. 2014; 62:857864.Google Scholar
Pisters, R, Lane, DA, Nieuwlaat, R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: The Euro Heart Survey. Chest. 2010; 138:10931100.Google Scholar
Lane, DA, Lip, GYH. Clinician update: Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012; 126:860865.Google Scholar
Gage, BF, Birman-Deych, E, Kerzner, R, et al. Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall. Am J Med. 2005; 118:612617.Google Scholar
Donze, J, Clair, C, Hug, B, et al. Risk of falls and major bleeds in patients on oral anticoagulation therapy. Am J Med. 2012; 125:773778.Google Scholar
Reddy, VY, Sievert, H, Halperin, J, et al. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: A randomized clinical trial. JAMA. 2014; 312:19881998.Google Scholar
Boersma, LV, Ince, H, Kische, S, et al. Evaluating real-world clinical outcomes in atrial fibrillation patients receiving the Watchman left atrial appendage closure technology. Circ Arrhythm Electrophysiol. 2019; 12:e006841.Google Scholar
Freeman, JV, Varosy, P, Price, MJ, et al. The NCDR left atrial appendage occlusion registry. J Am Coll Cardiol. 2020; 75:15031518.Google Scholar
Buxton, AE, Lee, KL, Fisher, JD, et al. For the Multicenter Unsustained Tachycardia Trial Investigators. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med. 1999; 341:18821890.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×