In medicine, an epiphenomenon is a secondary clinical finding that manifests alongside a primary phenomenon but has little to no causal influence itself. The epiphenomenon may be a useful indicator to establish the diagnosis or prognosis of a related condition; yet, paradoxically, it may not be a worthwhile target to treat the condition or prevent its undesirable outcomes. Therefore, ascertaining causal influence is critical to foreshadow whether an association suggested by observational research will likely translate into positive clinical trials and new treatment paradigms. The echocardiographic finding of moderate heart valve dysfunction in older adults has been associated with adverse health outcomes, seemingly out of proportion to the degree of pressure or volume overload and impervious to the restoration of valvular competency.
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Published online: March 12, 2020
Accepted: February 26, 2020
Received: February 10, 2020
See article by Crimi et al., pages 1104–1111 of this issue.
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© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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- Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 StudyCanadian Journal of CardiologyVol. 36Issue 7
- PreviewElderly patients are under-represented in clinical trials and registries, and a gap of evidence exists for clinical decision making in the setting of acute coronary syndromes (ACS). We aimed to assess the prevalence and independent prognostic impact of valvular heart disease (VHD) diagnosed during the index hospitalization on clinical outcomes among elderly patients with ACS. Included VHDs were moderate-to-severe mitral regurgitation (MR), moderate-to-severe aortic stenosis (AS), or both combined.