EP News: Clinical

Yasada et  al (N Engl J Med 2019;381:1103, PMID 31475793) conducted a prospective randomized multicenter trial of 2236 patients with atrial fibrillation (AF) who had undergone percutaneous coronary intervention or coronary artery bypass grafting more than 1 year earlier or who had angiographically confirmed coronary artery disease not requiring revascularization. Patients were randomized to monotherapy with rivaroxaban or combination therapy with rivaroxaban plus a single antiplatelet agent. The primary efficacy end point was a composite of stroke, systemic embolism, myocardial infarction, unstable ang ina requiring revascularization, or death from any cause.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: EP News Source Type: research

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Abstract BACKGROUND: Hypertensive urgencies (HypUrg) are define as severe elevation in blood pressure (BP) without acute target organ damage (TOD). In the office setting, treated asymptomatic patients, with severe BP elevation meeting criteria for urgency are often seen. We evaluate incident CV events (fatal and non-fatal stroke or acute myocardial infarction, TIA, coronary or carotid revascularization, atrial fibrillation (n=311)) during follow-up (FU) in patients with HypUrg at first outpatient visit. METHODS: From the Campania Salute Network (CSN) Registry. HypUrg was define by systolic BP ≥180mmHg and/...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research
In this study, we investigated the link between AF and senescence markers through the assessment of protein expression in the tissue lysates of human appendages from patients in AF, including paroxysmal (PAF) or permanent AF (PmAF), and in sinus rhythm (SR). The major findings of the study indicated that the progression of AF is strongly related to the human atrial senescence burden as determined by p53 and p16 expression. The stepwise increase of senescence (p53, p16), prothrombotic (TF), and proremodeling (MMP-9) markers observed in the right atrial appendages of patients in SR, PAF, and PmAF points toward multiple inter...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
AbstractBackgroundPatients with atrial fibrillation (AF) and dementia experience reduced quality of life and increased mortality. Technetium 99m ECD brain perfusion single-photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a beneficial modality for diagnosing dementia and identifying high-risk patients with mild cognitive impairment. The aim of this study was to evaluate the prognostic value of brain perfusion using99mTc-ECD SPECT in patients with AF and dementia.MethodsOf a total of 405 consecutive patients diagnosed with AF as cardiac outpatients with dementia using the Mini-Mental State Examination...
Source: EJNMMI Research - Category: Radiology Source Type: research
Authors: Khan AA, Thomas GN, Lip GYH, Shantsila A Abstract Atrial fibrillation is the most common heart arrhythmia and is associated with poor outcomes. The adverse effects of atrial fibrillation are mediated through multiple pathways, including endothelial dysfunction, as measured by flow-mediated dilatation. Flow-mediated dilatation has demonstrated endothelial dysfunction in several conditions and is associated with poor outcomes including mortality, yet can be improved with medical therapy. It is thus a useful tool in assessing endothelial function in patients.Endothelial dysfunction is present in patients with...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
ConclusionsEdoxaban had comparable efficacy and safety to optimized anticoagulation with enox –warf. The primary efficacy and safety endpoint outcomes were broadly similar between VKA experienced or naïve patients.
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
ConclusionAmong patients with AF, OSA is an independent risk factor for MACNE and, more specifically, stroke/SE.Graphical Abstract
Source: American Heart Journal - Category: Cardiology Source Type: research
Low-dose aspirin reduces the frequency of adverse vascular events in those at increased risk of occlusive cardiovascular disease (CVD). People who benefit include those: with a history of myocardial infarction, ischaemic stroke, unstable or stable angina, peripheral arterial disease, or atrial fibrillation (1). The pathophysiology of CVD risk contributes to cognitive decline through multiple pathways that include cerebral hypo-perfusion, hypoxia, hippocampal atrophy, emboli, or infarcts (2,3). However, the value of aspirin use in prevention of cognitive impairment remains uncertain since results relating to the influence o...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
Conclusion: Some cases with CCI treated with IV-tPA and endovascular intervention were reported, but the treatment strategy should be still discussed multidisciplinary. Especially, the administration of antithrombotic drugs for CCI should be carefully performed because fatal hemorrhage such as cardiac tamponade can occur. PMID: 31893142 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
The objective of this study was to investigate whether statins confer a beneficial effect on AF after AMI. Data available in the Taiwan National Health Insurance Research Database on 32886 AMI patients between 2008 and 2011 were retrospectively analyzed. Total 27553 (83.8%) had complete 1-yr follow-up data. Cardiovascular outcomes were analyzed based on the baseline characteristics and AF type (existing, new-onset, or non-AF). AF groups had significantly higher incidence of heart failure (HF), stroke, all-cause death, and major adverse cardiac and cerebrovascular event (MACCE) after index AMI (all P 
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Publication date: January 2020Source: Canadian Journal of Cardiology, Volume 36, Issue 1Author(s): Mohammed Shurrab, Asaf Danon, Sami Alnasser, Benedict Glover, Anna Kaoutskaia, Mark Henderson, David Newman, Eugene Crystal, Dennis KoAbstractBackgroundThe choice of antithrombotic therapy for atrial fibrillation (AF) patients who have an acute coronary syndrome (ACS) or have undergone percutaneous coronary intervention (PCI) is challenging. We aimed to assess outcomes between dual-antithrombotic therapy with the use of direct-acting oral anticoagulants (DOACs) plus an antiplatelet agent (dual therapy) compared with warfarin ...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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