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BACKGROUND: Surveys of patients with cardiovascular disease have suggested that “home-time”—being alive and out of any healthcare institution—is a prioritized outcome. This novel measure has not been studied among patients with heart failure (HF). OBJECTIVES: This study sought to characterize home-time following hospitalization for HF and to assess its relationship with patient characteristics and traditionally reported clinical outcomes. METHODS: Using Get With The Guidelines-Heart Failure registry data, patients with a HF hospitalization and discharged alive between 2011 to 2014 and age ≥65 years were identified. Using Medicare claims, post-discharge home-time over 30-day and 1-year follow-up was calculated for each patient as the number of days alive and spent outside of a hospital, skilled nursing facility (SNF), or rehabilitation facility. RESULTS: Among 59,736 patients, 57,992 (97.1%) and 42,153 (70.6%) had complete follow-up for home-time calculation through 30 days and 1 year, respectively. Mean (standard deviation) home-time was 21.6 (11.7) days at 30 days and 243.9 (137.6) days at 1 year. Contributions to reduced home-time varied by follow-up period, with days spent in SNF being the largest contributor though 30 days and death being the largest contributor through 1 year. Over 1 year, 2,044 (4.8%) patients had no home-time following index hospitalization discharge, while 8,194 (19.4%) had 365 days of home-time. In regression models, several conditions were associated with substantially reduced home-time, including pulmonary disease, renal insufficiency, and dementia. Through 1-year, home-time was highly correlated with time-to-event endpoints of death (r=0.94) and the composite of death or HF readmission (r=0.73). CONCLUSIONS: Home-time, which can be readily calculated from administrative claims data, is substantially reduced for many patients following hospitalization for HF and is highly correlated with traditional time-to-event mortality and hospitalization outcomes. Home-time represents a novel, easily measured, patient-centered endpoint that may reflect effectiveness of interventions in future HF studies.

Left atrial appendage (LAA) occlusion is a second line therapy for prevention of stroke in patients with atrial fibrillation (AF). Patients with limited femoral venous access may require alternative access approaches. A 64 YO female with paroxysmal AF (CHADS2-VASc score 5 and HAS-BLED score 5)

Transradial access (TRA) is often avoided in favor of the Transfemoral access (TFA) during percutaneous coronary interventions (PCI) of the left main (LM) coronary artery, due to technical and safety concerns. However, there is limited evidence supporting the use of one technique over other. The aim

Treating calcified coronary artery disease (CAD) via percutaneous coronary intervention (PCI) is a challenging task often requiring atheroablative techniques such as Orbital Atherectomy (OA) and Rotational Atherectomy (RA). Treatment of these lesions is associated with high periprocedural

Randomized controlled trials (RCTs) comparing drug eluting stents (DES) with bare metal stents (BMS) for saphenous vein graft (SVG) interventions have shown conflicting results. We conducted this meta-analysis to evaluate the cumulative evidence for efficacy of DES vs BMS in SVG lesions. A

The optimum duration of dual antiplatelet therapy (DAPT) after drug eluting stent (DES) implantation in patients with or without acute coronary syndromes (ACS) is unknown. We aim to evaluate the efficacy and safety of long duration DAPT (L-DAPT) compared to short duration DAPT (S-DAPT) after drug

Coronary artery bypass grafting (CABG) has long been the preferred revascularization approach in patients with left main (LM) disease. However, evolving percutaneous coronary intervention (PCI) techniques with DES implantation have shown comparable short-term efficacy and safety during the last

To evaluate the relationship of CRT on various echocardiographic parameters of right ventricular (RV) function. A systematic search of studies reporting tricuspid annular plane systolic excursion (TAPSE) or RV basal strain or RV long or short axis diameter or RV fractional area change (FAC), before

Low HDL-C has been associated with increased risk of CV events in both observational and prospective studies. The current ACC/AHA guidelines for cholesterol management recommend a possible role for non-statin therapy in patients with intolerance or under-expected response to statins. Niacin, a

Several randomized clinical trials have evaluated the efficacy of prophylactic magnesium (Mg) supplementation in prevention of post-operative atrial fibrillation (POAF) in patients undergoing cardiac artery bypass grafting (CABG). We aim to determine the role of prophylactic Mg in 3 settings (

Cho et al. ([1][1]) should be commended for their recent attempt to answer an important question in an ongoing debate on the prognostic value of coronary computed tomography angiography (CCTA). In their retrospective cohort study from a single center, they concluded that CCTA provided improved

Arnold et al. ([1][1]) should be commended for their recent study in which they evaluated the clinical usefulness of blood oxygen level-dependent (BOLD) magnetic resonance imaging. They used 3-Tesla cardiac magnetic resonance and steady-state free precession sequence to overcome technical

Sarrazin et al. ([1][1]) highlighted the usefulness of positron emission tomography (PET)/computed tomography (CT) in patients with suspected cardiovascular implantable electronic device infection (CIED). The following points should be considered before reaching a final conclusion. Considering high

Watabe et al. ([1][1]) should be commended for their recent study, which evaluated the impact of coronary plaque composition on cardiac troponin elevation after percutaneous coronary intervention in patients with stable angina pectoris. It is a novel approach and could have important clinical

In the ACIC (Advanced Cardiovascular Imaging Consortium) registry, Chinnaiyan et al. ([1][1]) evaluated the correlation between stress test results and extent of coronary artery disease (CAD) on coronary computed tomography angiography (CCTA) and compared the diagnostic performance of both

Objective To investigate the relationship of body mass index (BMI) with total mortality, cardiovascular (CV) mortality, and myocardial infarction (MI) after coronary revascularization procedures (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]). Patients and Methods Systematic search of studies was conducted using PubMed, CINAHL, Cochran CENTRAL, Scopus, and the Web of Science databases. We identified studies reporting the rate of MI, CV mortality, and total mortality among coronary artery disease patients' postcoronary revascularization procedures in various BMI categories: less than 20 (underweight), 20-24.9 (normal reference), 25-29.9 (overweight), 30-34.9 (obese), and 35 or more (severely obese). Event rates were compared using a random effects model assuming interstudy heterogeneity. Results A total of 36 studies (12 CABG; 26 PCI) were selected for final analyses. The risk of total mortality (relative risk [RR], 2.59; 95% CI, 2.09-3.21), CV mortality (RR, 2.67; 95% CI, 1.63-4.39), and MI (RR, 1.79; 95% CI, 1.28-2.50) was highest among patients with low BMI at the end of a mean follow-up period of 1.7 years. The risk of CV mortality was lowest among overweight patients (RR, 0.81; 95% CI, 0.68-0.95). Increasing degree of adiposity as assessed by BMI had a neutral effect on the risk of MI for overweight (RR, 0.92; 95% CI, 0.84-1.01), obese (RR, 0.99; 95% CI, 0.85-1.15), and severely obese (RR, 0.93; 95% CI, 0.78-1.11) patients. Conclusion After coronary artery disease revascularization procedures (PCI and CABG), the risk of total mortality, CV mortality, and MI was highest among underweight patients as defined by low BMI and CV mortality was lowest among overweight patients.

Saby et al. [(1)][1] should be commended for their recent attempt to address limitations of modified Duke Criteria to diagnose infective endocarditis in patients with prosthetic valve (PVE). These investigators suggested that abnormal fluorodeoxyglucose (FDG) uptake on 18F-FDG positron emission

Clinical studies have suggested an association between bisphosphonate use and the onset of atrial fibrillation. However, data on the risk of developing atrial fibrillation, stroke and cardiovascular mortality with use of bisphosphonate is conflicting. To evaluate the risk of serious atrial

We read with great interest the article by Sato et al. ([1][1]) that evaluated the prognostic value of myocardial contrast delayed enhancement with 64-slice multidetector computed tomography (MDCT) after acute myocardial infarction. They should be commended for conducting the study elegantly.

Dr. Bettencourt and colleagues compare the diagnostic performance of multidetector computed tomography (MDCT) stress-rest perfusion imaging (using significantly lower dose radiation) with cardiac magnetic resonance myocardial perfusion imaging (CMR-Perf) for detection of functionally significant

Marfan’s syndrome is a multi-systemic connective tissue disorder caused by a fibrillin-1 mutation. The objective of our study was to determine the effect of beta-blockers on aortic dilatation progression in patients with Marfan’s syndrome. We performed a systematic review of all prospective