Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations

Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of cardiology 2014-08, Vol.114 (4), p.624-628
Main Authors: Eijsvogels, Thijs M.H., PhD, Januzzi, James L., MD, Taylor, Beth A., PhD, Isaacs, Stephanie K., BS, D'Hemecourt, Pierre, MD, Zaleski, Amanda, MS, Dyer, Sophia, MD, Troyanos, Chris, ATC, Weiner, Rory B., MD, Thompson, Paul D., MD, Baggish, Aaron L., MD
Format: Article
Language:English
Subjects:
Adult
Cardiovascular
Cholesterol
Female
Follow-Up Studies
Healthy Volunteers
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Male
Marathons
Metabolic disorders
Middle Aged
Myocardial Ischemia - blood
Myocardial Ischemia - prevention & control
Prognosis
Retrospective Studies
Running - physiology
Statins
Troponin I - blood
Troponin T - blood
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423
cites cdi_FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423
container_end_page 628
container_issue 4
container_start_page 624
container_title The American journal of cardiology
container_volume 114
creator Eijsvogels, Thijs M.H., PhD
Januzzi, James L., MD
Taylor, Beth A., PhD
Isaacs, Stephanie K., BS
D'Hemecourt, Pierre, MD
Zaleski, Amanda, MS
Dyer, Sophia, MD
Troyanos, Chris, ATC
Weiner, Rory B., MD
Thompson, Paul D., MD
Baggish, Aaron L., MD
description Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore measured cTnI concentrations in statin-using (n = 30) and nonstatin-using (n = 41) runners who participated in the 2011 Boston Marathon. All runners provided venous blood samples the day before, within an hour of finishing, and 24 hours after the marathon. cTnI was assessed at each time point via both a contemporary cTnI and high-sensitivity cTnI (hsTnI) assay. Before the marathon, cTnI was detectable in 99% of runners with the use of the hsTnI assay. All participants completed the marathon (finish time: 4:04:09 ± 0:41:10), and none had symptoms of an acute coronary syndrome. cTnI increased in all runners (p
doi_str_mv 10.1016/j.amjcard.2014.05.047
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1622614805</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002914914012405</els_id><sourcerecordid>1622614805</sourcerecordid><originalsourceid>FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423</originalsourceid><addsrcrecordid>eNqFkt-L1DAQx4Mo3nr6JygFX3xpzeRH27wox7rqwoEPd_cc0nQKqW2yJu3h_fdm2VXhXg4CSYbPfIeZ7xDyFmgFFOqPY2Xm0ZrYV4yCqKisqGiekQ20jSpBAX9ONpRSVioQ6oK8SmnMXwBZvyQXTNL8UHxDvuzng7FLEYbiZjGL88VdwiL4Yvcbo3UJy73vV4t9sc21nLHFbQyH4DO4m_A-ZwSfXpMXg5kSvjnfl-Tu6-52-728_vFtv726Lq1oYSkHiQZwMFwpW7eNUdhZ2nQtdop2XQ53HFhjBOO87gbbwmC6Gvp8jJU8hy_Jh5PuIYZfK6ZFzy5ZnCbjMaxJQ81YDaKl8mlUSuCc8Zpn9P0jdAxr9LmRTAmlJGdMZEqeKBtDShEHfYhuNvFBA9VHR_Soz47ooyOaSp0dyXnvzuprN2P_L-uvBRn4fAIwT-7eYdTJOvR55C6iXXQf3JMlPj1SsJPzzprpJz5g-t-NTkxTfXNci-NWgKDARB7WHwrVsfM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1549953224</pqid></control><display><type>article</type><title>Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations</title><source>ScienceDirect Freedom Collection</source><creator>Eijsvogels, Thijs M.H., PhD ; Januzzi, James L., MD ; Taylor, Beth A., PhD ; Isaacs, Stephanie K., BS ; D'Hemecourt, Pierre, MD ; Zaleski, Amanda, MS ; Dyer, Sophia, MD ; Troyanos, Chris, ATC ; Weiner, Rory B., MD ; Thompson, Paul D., MD ; Baggish, Aaron L., MD</creator><creatorcontrib>Eijsvogels, Thijs M.H., PhD ; Januzzi, James L., MD ; Taylor, Beth A., PhD ; Isaacs, Stephanie K., BS ; D'Hemecourt, Pierre, MD ; Zaleski, Amanda, MS ; Dyer, Sophia, MD ; Troyanos, Chris, ATC ; Weiner, Rory B., MD ; Thompson, Paul D., MD ; Baggish, Aaron L., MD</creatorcontrib><description>Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore measured cTnI concentrations in statin-using (n = 30) and nonstatin-using (n = 41) runners who participated in the 2011 Boston Marathon. All runners provided venous blood samples the day before, within an hour of finishing, and 24 hours after the marathon. cTnI was assessed at each time point via both a contemporary cTnI and high-sensitivity cTnI (hsTnI) assay. Before the marathon, cTnI was detectable in 99% of runners with the use of the hsTnI assay. All participants completed the marathon (finish time: 4:04:09 ± 0:41:10), and none had symptoms of an acute coronary syndrome. cTnI increased in all runners (p &lt;0.001) immediately after the marathon, and half (hsTnI = 54% vs contemporary cTnI = 47%) exceeded the diagnostic cut-point for an acute myocardial infarction. Statin use did not affect the magnitude of cTnI release (group*time p = 0.47) or the incidence of runners with cTnI elevation greater than the diagnostic cut-point for myocardial infarction (57% vs 51%, p = 0.65). In addition, there was no significant association between statin potency and cTnI release (r = 0.09, p = 0.65). In conclusion, marathon-induced cTnI increases are not altered by statin use.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2014.05.047</identifier><identifier>PMID: 25015693</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Cardiovascular ; Cholesterol ; Female ; Follow-Up Studies ; Healthy Volunteers ; Heart attacks ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology ; Male ; Marathons ; Metabolic disorders ; Middle Aged ; Myocardial Ischemia - blood ; Myocardial Ischemia - prevention &amp; control ; Prognosis ; Retrospective Studies ; Running - physiology ; Statins ; Troponin I - blood ; Troponin T - blood</subject><ispartof>The American journal of cardiology, 2014-08, Vol.114 (4), p.624-628</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 15, 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423</citedby><cites>FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27915,27916</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25015693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eijsvogels, Thijs M.H., PhD</creatorcontrib><creatorcontrib>Januzzi, James L., MD</creatorcontrib><creatorcontrib>Taylor, Beth A., PhD</creatorcontrib><creatorcontrib>Isaacs, Stephanie K., BS</creatorcontrib><creatorcontrib>D'Hemecourt, Pierre, MD</creatorcontrib><creatorcontrib>Zaleski, Amanda, MS</creatorcontrib><creatorcontrib>Dyer, Sophia, MD</creatorcontrib><creatorcontrib>Troyanos, Chris, ATC</creatorcontrib><creatorcontrib>Weiner, Rory B., MD</creatorcontrib><creatorcontrib>Thompson, Paul D., MD</creatorcontrib><creatorcontrib>Baggish, Aaron L., MD</creatorcontrib><title>Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore measured cTnI concentrations in statin-using (n = 30) and nonstatin-using (n = 41) runners who participated in the 2011 Boston Marathon. All runners provided venous blood samples the day before, within an hour of finishing, and 24 hours after the marathon. cTnI was assessed at each time point via both a contemporary cTnI and high-sensitivity cTnI (hsTnI) assay. Before the marathon, cTnI was detectable in 99% of runners with the use of the hsTnI assay. All participants completed the marathon (finish time: 4:04:09 ± 0:41:10), and none had symptoms of an acute coronary syndrome. cTnI increased in all runners (p &lt;0.001) immediately after the marathon, and half (hsTnI = 54% vs contemporary cTnI = 47%) exceeded the diagnostic cut-point for an acute myocardial infarction. Statin use did not affect the magnitude of cTnI release (group*time p = 0.47) or the incidence of runners with cTnI elevation greater than the diagnostic cut-point for myocardial infarction (57% vs 51%, p = 0.65). In addition, there was no significant association between statin potency and cTnI release (r = 0.09, p = 0.65). In conclusion, marathon-induced cTnI increases are not altered by statin use.</description><subject>Adult</subject><subject>Cardiovascular</subject><subject>Cholesterol</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Healthy Volunteers</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology</subject><subject>Male</subject><subject>Marathons</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - blood</subject><subject>Myocardial Ischemia - prevention &amp; control</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Running - physiology</subject><subject>Statins</subject><subject>Troponin I - blood</subject><subject>Troponin T - blood</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNqFkt-L1DAQx4Mo3nr6JygFX3xpzeRH27wox7rqwoEPd_cc0nQKqW2yJu3h_fdm2VXhXg4CSYbPfIeZ7xDyFmgFFOqPY2Xm0ZrYV4yCqKisqGiekQ20jSpBAX9ONpRSVioQ6oK8SmnMXwBZvyQXTNL8UHxDvuzng7FLEYbiZjGL88VdwiL4Yvcbo3UJy73vV4t9sc21nLHFbQyH4DO4m_A-ZwSfXpMXg5kSvjnfl-Tu6-52-728_vFtv726Lq1oYSkHiQZwMFwpW7eNUdhZ2nQtdop2XQ53HFhjBOO87gbbwmC6Gvp8jJU8hy_Jh5PuIYZfK6ZFzy5ZnCbjMaxJQ81YDaKl8mlUSuCc8Zpn9P0jdAxr9LmRTAmlJGdMZEqeKBtDShEHfYhuNvFBA9VHR_Soz47ooyOaSp0dyXnvzuprN2P_L-uvBRn4fAIwT-7eYdTJOvR55C6iXXQf3JMlPj1SsJPzzprpJz5g-t-NTkxTfXNci-NWgKDARB7WHwrVsfM</recordid><startdate>20140815</startdate><enddate>20140815</enddate><creator>Eijsvogels, Thijs M.H., PhD</creator><creator>Januzzi, James L., MD</creator><creator>Taylor, Beth A., PhD</creator><creator>Isaacs, Stephanie K., BS</creator><creator>D'Hemecourt, Pierre, MD</creator><creator>Zaleski, Amanda, MS</creator><creator>Dyer, Sophia, MD</creator><creator>Troyanos, Chris, ATC</creator><creator>Weiner, Rory B., MD</creator><creator>Thompson, Paul D., MD</creator><creator>Baggish, Aaron L., MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140815</creationdate><title>Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations</title><author>Eijsvogels, Thijs M.H., PhD ; Januzzi, James L., MD ; Taylor, Beth A., PhD ; Isaacs, Stephanie K., BS ; D'Hemecourt, Pierre, MD ; Zaleski, Amanda, MS ; Dyer, Sophia, MD ; Troyanos, Chris, ATC ; Weiner, Rory B., MD ; Thompson, Paul D., MD ; Baggish, Aaron L., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Cardiovascular</topic><topic>Cholesterol</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Healthy Volunteers</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology</topic><topic>Male</topic><topic>Marathons</topic><topic>Metabolic disorders</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - blood</topic><topic>Myocardial Ischemia - prevention &amp; control</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Running - physiology</topic><topic>Statins</topic><topic>Troponin I - blood</topic><topic>Troponin T - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eijsvogels, Thijs M.H., PhD</creatorcontrib><creatorcontrib>Januzzi, James L., MD</creatorcontrib><creatorcontrib>Taylor, Beth A., PhD</creatorcontrib><creatorcontrib>Isaacs, Stephanie K., BS</creatorcontrib><creatorcontrib>D'Hemecourt, Pierre, MD</creatorcontrib><creatorcontrib>Zaleski, Amanda, MS</creatorcontrib><creatorcontrib>Dyer, Sophia, MD</creatorcontrib><creatorcontrib>Troyanos, Chris, ATC</creatorcontrib><creatorcontrib>Weiner, Rory B., MD</creatorcontrib><creatorcontrib>Thompson, Paul D., MD</creatorcontrib><creatorcontrib>Baggish, Aaron L., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing &amp; Allied Health Database</collection><collection>Physical Education Index</collection><collection>ProQuest Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eijsvogels, Thijs M.H., PhD</au><au>Januzzi, James L., MD</au><au>Taylor, Beth A., PhD</au><au>Isaacs, Stephanie K., BS</au><au>D'Hemecourt, Pierre, MD</au><au>Zaleski, Amanda, MS</au><au>Dyer, Sophia, MD</au><au>Troyanos, Chris, ATC</au><au>Weiner, Rory B., MD</au><au>Thompson, Paul D., MD</au><au>Baggish, Aaron L., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2014-08-15</date><risdate>2014</risdate><volume>114</volume><issue>4</issue><spage>624</spage><epage>628</epage><pages>624-628</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore measured cTnI concentrations in statin-using (n = 30) and nonstatin-using (n = 41) runners who participated in the 2011 Boston Marathon. All runners provided venous blood samples the day before, within an hour of finishing, and 24 hours after the marathon. cTnI was assessed at each time point via both a contemporary cTnI and high-sensitivity cTnI (hsTnI) assay. Before the marathon, cTnI was detectable in 99% of runners with the use of the hsTnI assay. All participants completed the marathon (finish time: 4:04:09 ± 0:41:10), and none had symptoms of an acute coronary syndrome. cTnI increased in all runners (p &lt;0.001) immediately after the marathon, and half (hsTnI = 54% vs contemporary cTnI = 47%) exceeded the diagnostic cut-point for an acute myocardial infarction. Statin use did not affect the magnitude of cTnI release (group*time p = 0.47) or the incidence of runners with cTnI elevation greater than the diagnostic cut-point for myocardial infarction (57% vs 51%, p = 0.65). In addition, there was no significant association between statin potency and cTnI release (r = 0.09, p = 0.65). In conclusion, marathon-induced cTnI increases are not altered by statin use.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25015693</pmid><doi>10.1016/j.amjcard.2014.05.047</doi><tpages>5</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0002-9149
ispartof The American journal of cardiology, 2014-08, Vol.114 (4), p.624-628
issn 0002-9149
1879-1913
language eng
recordid cdi_proquest_miscellaneous_1622614805
source ScienceDirect Freedom Collection
subjects Adult
Cardiovascular
Cholesterol
Female
Follow-Up Studies
Healthy Volunteers
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Male
Marathons
Metabolic disorders
Middle Aged
Myocardial Ischemia - blood
Myocardial Ischemia - prevention & control
Prognosis
Retrospective Studies
Running - physiology
Statins
Troponin I - blood
Troponin T - blood
title Impact of Statin Use on Exercise-Induced Cardiac Troponin Elevations
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T23%3A05%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20Statin%20Use%20on%20Exercise-Induced%20Cardiac%20Troponin%20Elevations&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Eijsvogels,%20Thijs%20M.H.,%20PhD&rft.date=2014-08-15&rft.volume=114&rft.issue=4&rft.spage=624&rft.epage=628&rft.pages=624-628&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/j.amjcard.2014.05.047&rft_dat=%3Cproquest_cross%3E1622614805%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c481t-f5ea1efa399c687a9ebc07b8eb90bba39b3127a42336bfc81fab61d61dac53423%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1549953224&rft_id=info:pmid/25015693&rfr_iscdi=true