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September 19th | September 26th, 2019
News From Medscape
The following recommended articles on Medscape.com are freely available through the partnership between ABC and Medscape, no registration or login required.
Are 30-Day Readmission Rules Deadly for Patients?
A patient who had been in the hospital for treatment for a heart attack was sent home a week later. However, 10 days later, he was back in the hospital with chest pains and apparent complications. But, it is alleged, the hospital did not want to admit the patient because he had been a patient there less than 30 days ago; and readmitting him would trigger penalties for the readmission under Medicare's Hospital Readmissions Reduction Program (HRRP).
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ESC Diabetes and CVD Guideline: 'Unprecedented' New Evidence
The European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) has released new guidelines for the management and prevention of cardiovascular disease (CVD) in patients with diabetes or prediabetes. Recommendations in the document reflect recent positive findings from large cardiovascular outcome trials (CVOTs) of new classes of diabetes drugs and other new developments.
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AI Could Slash Diagnosis Costs in Stable Chest Pain Patients
An artificial intelligence decision support system (AI DSS) to help decide which diagnostic tests to perform in individuals with stable chest pain (SCP) could lead to substantial reductions in healthcare costs versus standard human-led care, suggests research presented as two posters at the ESC Congress 2019.
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Vintage ICD Trials in Heart Failure Upheld by Contemporary Registry Data
The survival benefits of primary-prevention device therapy seen in seminal trials reported in the early 2000s still apply today, suggests a registry study from Sweden that also saw gross implantable cardioverter-defibrillator (ICD) underuse in its sample of eligible patients.
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SYNTAXES: CABG for Best 10-Year Survival in Multivessel Disease
Among patients with complex coronary artery disease (CAD) who required de novo revascularization, those with three-vessel disease had better 10-year survival after coronary artery bypass grafting (CABG) than after percutaneous coronary intervention (PCI).
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HOPE 4: Hypertension Screening in Community Reduces CV Risk
A community-based initiative, in which nonphysician healthcare workers screened individuals for hypertension in their own homes and community centers in two middle-income countries, resulted in a substantial reduction in cardiovascular disease risk, primarily through improvements in blood pressure, low-density lipoprotein (LDL) cholesterol, medication adherence, and some health behaviors in the HOPE 4 study.
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Items of Interest
How Telemedicine Intersects With AI, Social Media, and Precision Medicine
By Sherry-Ann Brown, MD
Poor dietary quality is a leading contributor to mortality in the United States and to most, Telemedicine will eventually become a more prominent part of our clinical practice, with the incorporation of artificial intelligence (AI) and social media and networks, and integration with precision medicine in electronic health records. As clinicians and scientists, we should be thinking about where and how these four innovative strategies intersect, so that we can continue to not only contribute to the conversation and direction of these strategies, but also lead them.
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President Johnson Writes Boston Globe Op-Ed: "Speaking with the Enemy 101"
In an op-ed in the Boston Globe, President Paula A. Johnson explains why students should be equipped to talk across difference, and she shares her vision of a “Curriculum of Connection” as a way to give students a robust rhetorical toolkit that will help steer them toward shared values and common ground.
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Off Script: Implicit Bias Can Be a Matter of Life and Death—Let's Do Something About It
In an op-ed for TCTMD’s The Heart Beat section, Dr. Quinn Capers IV illustrates how even well-meaning clinicians with egalitarian beliefs are vulnerable to the insidious effects of implicit bias and offers research-proven strategies that people can take to neutralize or mitigate them.
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Almost 2/3 of Medical Students Have Higher-Than-Normal Blood Pressure
Nearly two-thirds of American medical students have higher-than-average blood pressure, according to research presented at the American Heart Association’s Hypertension 2019 Scientific Sessions, with male students in particular struggling to control their BP.
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Docs Lack Info on Chronic Illness Prevention, Patient Engagement
Doctors might not have the tools to help drive patient engagement in preventing and detecting chronic illness, according to researchers from Johns Hopkins Medicine. In a survey of about 1,000 primary care providers, the researchers found that clinicians struggled to correctly identify key diabetes risk factors, diagnostic criteria, and care management and preventive care strategies. These findings are likely the result of a culture of reactive, not proactive, healthcare that pervades medical education and the healthcare industry.
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Cardiac Amyloidosis Increasingly Common in U.S.
New research suggests the incidence of cardiac amyloidosis in the U.S. is trending up, bringing with it high rates of morbidity and mortality. Scientists have long assumed the instance of cardiac amyloidosis—the deposition and buildup of immunoglobulin light chains (AL) or transthyretin (ATTR) in heart tissue—is on the rise, Brett W. Sperry, MD, and colleagues wrote in the American Journal of Cardiology. Recent years have seen a rise in awareness of the disease, more novel treatment options and improved noninvasive diagnostic imaging modalities, but the hospitalization trends for amyloidosis remain unclear, especially for AL type.
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Caution: Sleeping Too Little — or Too Much — Boosts Heart Attack Risk
Even if you are a non-smoker who exercises and has no genetic predisposition to cardiovascular disease, skimping on sleep—or getting too much of it—can boost your risk of heart attack, according to a new CU Boulder study of nearly a half-million people. The research, published in the Journal of the American College of Cardiology, also found that for those at high genetic risk for heart attack, sleeping between 6 and 9 hours nightly can offset that risk.
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FDA Grants Fast Track Designation for FARXIGA in Heart Failure
Astrazeneca today announced that the US Food and Drug Administration (FDA) has granted Fast Track designation for the development of FARXIGA (dapagliflozin) to reduce the risk of cardiovascular (CV) death or worsening of heart failure in adults with heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). The FDA’s Fast Track program is designed to accelerate the development and review of new medicines for the treatment of serious conditions where there is unmet treatment need.
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Is Your Physician Colleague At Risk For Suicide? Signs to Look For
Two-thirds of people who attempt suicide do so after having seen a physician within the previous month. It’s a strong statement about the importance of being alert for telltale signals. That extends to high-risk individuals who aren’t patients, but who many physicians see every day—their colleagues. Recently released CME covering suicide screening and prevention for patients also addresses what physicians should look for among their colleagues—and themselves—to reduce the chances of suicide. The CME video, “Identifying and Responding to Suicide Risk,” is designated by the AMA for one AMA PRA Category 1 Credit™.

September is National Suicide Prevention Awareness Month
Featured Articles by Members
ABC Members: We welcome your published research submissions and articles for inclusion in future issues of Clinical Updates and Insights. Email Rachel Williams at rwilliams@abcardio.org and please attach file or include links to the original published work and/or abstract.
Surgical Treatment For Heart Failure: Cell-Based Therapy With Engineered Tissue
Co-authored by Ikeotunye Royal Chinyere (with Jordan J. Lancaster, Jen Watson Koevary, Sherry L. Daugherty, Kenneth A. Fox, and Steven Goldman)
This review will outline cell-based therapy for heart failure focusing on tissue engineering to deliver cells to the damaged heart. We will present an overview of the central approaches focusing on pluripotent stem cell-derived cells, mechanisms of action, autologous vs. allogeneic cell approaches, immunologic modulation, and safety considerations. We will outline the progress that has been made to-date and define the areas that still need to be investigated in order to advance the field.
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World Heart Federation Roadmap for Heart Failure
Co-authored by Gurusher Panjrath, Ileana L. Piña and Clyde Yancy (with Joáo Pedro Ferreira, Sarah Kraus, Sharon Mitchell, Pablo Perel, Daniel Piñeiro, Ovidiu Chioncel, Roberto Colque, Rudolf A. de Boer, Juan Esteban Gomez-Mesa,
This consensus document offers an ideal pathway of care for heart failure patients from which to assess barriers that are context-specific. The roadblocks and potential solutions to patient care are offered based on key stages of the patient care pathway. They have been accumulated from previous WHF Roadmaps, built on the experience of the core writing group, and based on consensus and feedback from a wider survey process.
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Sleep Debt: The Impact of Weekday Sleep Deprivation On Cardiovascular Health in Older Women
Co-authored by Michelle A. Albert (with Tomás Cabeza de Baca, Koharu Loulou Chayama, Susan Redline, Natalie Slopen, Fumika Matsushita, Aric A Prather, David R Williams, Julie E Buring, and Alan M Zaslavsky)
Short sleep duration is associated with increased cardiovascular disease (CVD) risk. However, it is uncertain whether sleep debt, a measure of sleep deficiency during the week compared to the weekend, confers increased cardiovascular risk. Because sleep disturbances increases with age, particularly in women, we examined the relationship between sleep debt and ideal cardiovascular health (ICH) in older women.
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HFSA & ASNC 2019 CONFERENCE HIGHLIGHTS
Heart Failure Burden Increasing for Black Adults in the U.S.
A new analysis suggests that the total burden of heart failure is increasing, and that disparities between black and white adults persist. The study researchers, presented at the Heart Failure Society of America and published in the meeting supplement of the Journal of Cardiac Failure, included over 20,000 participants who identified as non-Hispanic black or white from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016.
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Q&A: Shaq Gets Real About HF Awareness in Black Population
Shaquille O’Neal, EdD, FHFSA, retired basketball star and winner of four NBA championships, discussed the recently launched campaign Shaq Gets Real, which focuses on raising awareness about HF in the black population and providing support for improved access to medication and treatment, at the Heart Failure Society of America Scientific Meeting. Joining O’Neal, Elizabeth Ofili, MD, MPH, FACC, past president, chair-elect and board member of the Association of Black Cardiologists, highlighted many of the existing disparities that put African Americans at a higher risk of HF. Healio spoke with O’Neal and Ofili regarding their joint efforts to inform black individuals about HF and to minimize racial disparities in prevalence and treatment of HF.
READ MORE
Elizabeth Ofili, MD: Heart Failure Outreach
A special session at this year’s Heart Failure Society of America (HFSA) 2019 Scientific Sessions featured a presentation and discussion with Elizabeth Ofili, MD and Shaquille O’Neal, EdD, who spoke about disparities in heart failure rates among African Americans and how to better serve that population. After the presentation, Ofili, who is the first female president of the Association of Black Cardiologists, sat down with MD Magazine® to discuss the importance of annual conferences such as HFSA 2019 for outreach and engagement.
WATCH NOW
DEFINE-HF: Dapagliflozin Improves Function and QoL, but Not Biomarkers, in HFrEF
Like DAPA-HF, this much smaller trial confirms the ability of an SGLT2 inhibitor to confer symptom improvement over time. Dapagliflozin added to optimal medical therapy results in meaningful improvements in symptoms and health-related quality of life in heart failure patients with reduced ejection fraction (HFrEF), the results of the DEFINE-HF trial show. However, the sodium glucose co-transporter-2 (SGLT2) inhibitor did not reduce levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) compared with placebo.
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Debate: Is LVEF Really That Important in Heart Failure?
Left ventricular ejection fraction (LVEF or EF) was in the hot seat during a debate at the Heart Failure Society of America (HFSA) annual meeting, in which Gregg Fonarow, MD, argued in favor of LVEF as essential for the diagnosis of HF and its treatment by guideline-directed medical and device therapy.
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Highlights of ASNC 2019
Learn about key moments at the recent Annual Scientific Session of American Society of Nuclear Cardiology (ASNC), including a session with Clyde W. Yancy, MD, who outlined practical approaches to tackling disparities in cardiovascular disease during an opening keynote address.
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ASNC Releases Multisocietal Cardiac Amyloidosis Imaging Guidelines
The American Society of Nuclear Cardiology (ASNC) has published a new expert consensus document along with eight other nuclear medicine and cardiology societies - consisting of 26 experts - on best practices for multimodality imaging and diagnosing cardiac amyloidosis in the Journal of Nuclear Cardiology. Newer imaging methods have facilitated earlier diagnosis of the disease and improved treatments, but those advancements haven’t been reflected in the medical literature. Watch a video of the guidelines.
READ MORE

We LOVE to LEARN how our ABC Members are making a difference! Please Share. Giving a keynote speech? Presenting at a Grand Round? Receiving an Award? Interviewed by the Press? Published in a journal? Presenter or Panelist at a Conference? Graduating? Email Rachel Williams at rwilliams@abcardio.org or please tag or DM us on Facebook, Twitter or Instagram with links/details, so we can spotlight your excellence in our newsletter!

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Announcements
ABC Member CME Event
UCSF Division of Cardiology at Zuckerberg San Francisco
General Hospital and Trauma Center Seeks Chief

The University of California San Francisco (UCSF) Department of Medicine at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) seeks an outstanding leader for its Division of Cardiology. The Division is comprised of 15 MD faculty, 2 PhD faculty and clinical/research staff.

The position is for a Chief who has a demonstrated commitment to science, education and clinical practice, the ability to lead a diverse group and work with hospital partners using a collaborative approach, success in promoting or producing scholarship and funding, and the ability to mentor young academic clinicians. Successful candidates must demonstrate exceptional leadership, administrative and organizational skills and have national stature in academic Cardiology. Board-certification in Cardiology is required. An understanding of and commitment to the safety net population is also crucial.

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ABIM Calling for Board and Committee Nominations

Help Shape the Future of Board Certification. Please consider nominating a colleague or applying yourself to join an ABIM board or committee.

The Cardiovascular Board for the American Board of Internal Medicine (ABIM) is seeking four new member(s) for the Specialty Board next year. Priorities for candidates are an adult congenital heart disease physician, allied health professional with deep expertise in cardiology, a general cardiologist with experience in a large academic or non-academic healthcare system and an interventional cardiologist.

The submission deadline has been extended to September 30, 2019.

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NHLBI Seeking exceptional candidates. Scientific excellence. Passion for leading change & leading people.
Send CV to lhellinger@nhlbi.nih.gov.
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Call-To-Action

September is PAD Awareness Month!

Today, nearly 20 million Americans are living with peripheral artery disease (PAD) and an estimated 200,000 of them – disproportionately from minority communities – suffer avoidable amputations every year.

Fortunately, lawmakers in Congress are taking action. Representatives Donald M. Payne, Jr. (D-NJ-10) and Gus Bilirakis (R-FL-12) have worked together to establish the first Congressional PAD Caucus to educate Congress and communities about PAD while supporting legislative activities to improve PAD research, education, and treatment, with the goal of preventing non-traumatic amputations due to PAD and other related diseases.

In honor of PAD Awareness Month, ask your Member of Congress to raise #PADAwareness by becoming a member of the Congressional PAD Caucus.

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Register for ABC @ AHA Events

Saturday, November 16th | Philadelphia Marriott Downtown
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‘A New Beat’ Reception | 5:15pm – 6:00pm
ABC General Membership Dinner Meeting | 6:00pm – 7:00pm
ABC Dr. Walter M. Booker, Sr. Memorial Symposium | 7:00pm – 9:00pm
“Navigating and Translating Guideline Directed Therapies and Interventions to Real-World Management of Cardiovascular Disease:
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ABC Job Opening | Certified Clinical Research Coordinator

The Association of Black Cardiologists (ABC), is a nonprofit organization whose mission is to reduce the burden of cardiovascular disease among minority populations and abolish disparities in healthcare outcomes in all people of color with a particular emphasis on the African-American population. The ABC is actively involved in research and seeks to hire a certified clinical research coordinator who will avidly engage in the broad breadth of research activities that are underway and under consideration at the ABC. This individual will work under the supervision of ABC investigators, Research Committee Chair, and the Chief Science Officer.

The research coordinator must be familiar with the various aspects of study design, clinical trial operations, study site management, data management and informatics. Additionally, it is expected that the individual will be familiar with ethical and safety aspects involved in conducting research, examining and submitting protocols to institutional review boards, assisting in writing protocols and also will be a liaison and major advocate in enhancing the participation of underrepresented minorities in the research endeavor. Qualifications entail a bachelor’s degree (Master’s preferred) and certification as a clinical research coordinator.

To apply for this opportunity, please send resume, cover letter
and salary requirements to info@abcardio.org
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