Atrial fibrillation: a mechanism or just a bystander?
This editorial refers to ‘Rate vs. rhythm control and adverse outcomes among European patients with atrial fibrillation’ by Y. Purmahet al., doi:10.1093/europace/euw421.
In this study, we assessed the impact of interacting medication and pharmacogenetic variation to better explain apixaban concentration differences among 358 Caucasian AF patients. Genotyping (ABCG2,ABCB1,CYP3A4*22,CYP3A5*3) was performed by TaqMan assays, and apixaban quantified by mass spectrometry. The typical patient was on average 77.2 years old, 85.5 kg, and had a serum creatinine of 103.1 µmol/L. Concomitant amiodarone, an antiarrhythmic agent and moderate CYP3A/ABCB1 inhibitor, the impaired-function variantABCG2 c.421C > A, and sex predicted higher apixaban concentrations whe...
In this study the use of ad-hoc designed reagents and catcher molecules was able to accurately identify DOAs activity at ROTEM.
Atrial fibrillation can be a presenting sign of primary aldosteronism in patients with hypertension, according to findings from the PAPPHY study.Reuters Health Information
CONCLUSIONS: The GGT level was significantly associated with cardioembolic stroke via AF. The results obtained in the present study may explain why GGT is associated with stroke. PMID: 31942759 [PubMed]
Purpose of review Recent data have changed the landscape of patent foramen ovale (PFO) closure for secondary stroke prevention. This review synthesizes the data and provides a framework for optimal management of stroke patients with PFO. Recent findings The cumulative evidence indicates that PFO closure reduces the risk of recurrent stroke in carefully selected young cryptogenic stroke patients, with an annualized risk reduction of ∼0.6%. The benefit of PFO closure is particularly evident in patients with embolic appearing strokes, large right-to-left shunt, or an associated atrial septal aneurysm. There may be li...
Purpose of review The association between atrial fibrillation and stroke is firmly established, and anticoagulation reduces stroke risk in patients with atrial fibrillation. However, the role of anticoagulation in very brief durations of atrial fibrillation (subclinical atrial fibrillation) is an area of controversy. Recent findings Stroke risk increases alongside burden of atrial fibrillation. Ongoing trials will clarify if 24 h or less of atrial fibrillation on extended monitoring necessitates lifelong anticoagulation. Trials examining empiric anticoagulation for individuals with ESUS did not demonstrate benefit o...
Conclusion It was safety to discontinued oral antiplatelet agents before operation, with no MACE and death in perioperative period. DOI: 10.3779/j.issn.1009-3419.2020.01.06
Authors: Saritas T, Floege J Abstract Patients with chronic kidney disease (CKD) are at increased risk for kidney failure, cardiovascular disease (CVD), and death. In fact, the likelihood of dying from CVD is markedly higher than that for reaching end-stage renal disease. Evidence-based management of comorbidities such as CVD remains challenging in patients with advanced CKD, as they were usually excluded from randomized controlled trials. This review focuses on the epidemiology, risk factors, and clinical manifestations of CVD in patients with advanced CKD. Specific topics of interest include diagnostic and therap...
ConclusionsThe long-term risk of a malignant arrhythmic event is not higher in patients with genotype positive. However, patients with genotype positive present themselves more often with AF with a female predominance. Also, other events at follow up such as syncope, atrial flutter and palpitation were not significantly higher (9% versus 0%; p = 0.079).
PMID: 31944917 [PubMed - in process]
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