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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical impact of valvular heart disease in elderly patients admitted for acute coronary syndrome: insights from the Elderly-ACS 2 study.Can J Cardiol. 2020; 36: 1104-1111
- on behalf of the Elderly ACS 2 Investigators. A comparison of reduced-dose prasugrel and standard-dose clopidogrel in elderly patients with acute coronary syndromes undergoing early percutaneous revascularization.Circulation. 2018; 137: 2435-2445
- Epidemiology of acquired valvular heart disease.Can J Cardiol. 2014; 30: 962-970
- Aortic stenosis: insights on pathogenesis and clinical implications.J Geriatr Cardiol. 2016; 13: 489-498
- Chronic kidney disease and the pathophysiology of valvular heart disease.Can J Cardiol. 2019; 35: 1195-1207
- Contemporary revascularization dilemmas in older adults.J Am Heart Assoc. 2020; 9e014477
- Epidemiology: An Introduction.Oxford University Press, Oxford, UK2002
- Confounding: essence and detection.Am J Epidemiol. 1981; 114: 593-603
- Transcatheter mitral-valve repair in patients with heart failure.N Engl J Med. 2018; 379: 2307-2318
- Percutaneous repair or medical treatment for secondary mitral regurgitation.N Engl J Med. 2018; 379: 2297-2306
- Two-year outcomes of surgical treatment of moderate ischemic mitral regurgitation.N Engl J Med. 2016; 374: 1932-1941
- 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.J Am Coll Cardiol. 2015; 63: e57-e185
Article info
Publication history
Published online: March 12, 2020
Accepted:
February 26,
2020
Received:
February 10,
2020
Footnotes
See article by Crimi et al., pages 1104–1111 of this issue.
See page 1002 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- 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.
- Full-Text
- Preview
