Urine albumin excretion and the risk of incident atrial fibrillation: predictive or aetiological relevance?
I read with great interest the article by Marcoset al. investigating observational associations of urine albumin measures either by a simple urine albumin test or a more complex 24-h urine collection test with incident atrial fibrillation (AF) in an apparently healthy general population cohort enriched with individuals having an urine albumin concentration >10 mg/L at baseline.1 In line with previously published epidemiological studies, the authors report a positive association between elevated urine albumin and an increased risk of incident AF. While the associations were independent of common and novel risk factors in prospective observations, but a possibility of unmeasured confounding or reverse causality cannot be ruled out. As the authors and others noted a complementary strand of evidence from a randomized clinical trial or its analog, called Mendelian randomization, needs to investigate whether the association between urine albumin and AF is causal or not. In this context, genetic evidence from available genome-wide association studies (GWAS) for urine albumin and AF or a meta-analysis of genome-wide genotype data from large cohorts can enhance the likelihood of causal or non-causal associations.2,3
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).
Owing to a type error during final correction and proof data submission to the journal, there were mistakes introduced into the legends of Fig. 3 and Fig. 4 as well as into the Y-axis title of the plot of Fig. 4.
ConclusionsWhile TEE is the gold standard for perioperative imaging with LAAO, ICE is a feasible and safe alternative that reduces exposure to general anesthesia and associated potential risks.
A smartwatch band with integrated electrodes to produce an electrocardiogram (ECG) might be able to help detect atrial fibrillation, but not as well as a traditional ECG machine used in a hospital, a recent study suggests.