The Prognostic Effects of Ventricular Heart Rate Among Patients With Permanent Atrial Fibrillation With and Without Coronary Artery Disease: A Multicenter Prospective Observational Study

This study aimed to assess the prognostic effects of ventricular heart rate in patients with permanent AF (permAF) and CAD. We performed a multicenter, prospective, observational study of patients with AF in China. Patients≥18 years old with permAF were included and divided into a CAD group and a non-CAD group. All patients underwent 1 year of follow-up. The primary outcome was total mortality. Cox proportional hazard models were used to evaluate the relationship between risk factors and the survival rate in the study population. A total of 852 patients (69.1±12.7 years old, 43.3% male, 44.7% with CAD) were included in the analysis. Patients with CAD were older, were more likely to be male and exhibited higher prevalences of hypertension, diabetes mellitus, LV dysfunction, chronic obstructive pulmonary disease (COPD) and stroke compared with patients without CAD. During the follow-up period, a higher total mortality rate was noted in the CAD group than in the non-CAD group (21.5% vs 15.5%, P = 0.023). In the patients without CAD, the lowest quartile (≤76 beats/min) exhibited the best 1-year survival rate; however, in the patients with CAD, the highest quartile (>110 beats/min) exhibited the worst survival rate. Multivariate adjusted Cox analysis indicated that age (HR 1.039, 95% CI 1.025–1.055, P 110 beats/min.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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Conclusions: The incidence of death without stroke was 9-fold higher than that of stroke, leading to biased estimates of stroke risk with traditional time-to-event methods. Statistical methods that appropriately account for competing risks should be used to mitigate this bias.
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Cerebrovascular Disease/Stroke Original Articles Source Type: research
Chronic obstructive pulmonary disease (COPD) is associated with a high risk of ischaemic stroke.1 CHA2DS2-VASc score is recommended and is widely used for stroke risk stratification in atrial fibrillation (AF) patients,2 but it has been shown to be an independent predictor of thrombo-embolic events in patients without AF, as well.3 In this issue ofEuropace, Huet al. performed a retrospective cohort study in a very big case sample (1492 COPD patients with AF and 50  343 COPD patients without AF), and reported that COPD patients with a higher CHA2DS2-VASc score were more likely to develop ischaemic stroke whether or n...
Source: Europace - Category: Cardiology Source Type: research
Conclusions: Long-term exposure to NO2 and road traffic noise was associated with higher risk of heart failure, mainly among men, in both single- and two-pollutant models. High exposure to both pollutants was associated with highest risk. https://doi.org/10.1289/EHP1272 Received: 25 October 2016 Revised: 09 August 2017 Accepted: 09 August 2017 Published: 26 September 2017 Address correspondence to M. Sørensen. Diet, Genes and Environment, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark. Telephone: +45 35257626. Email: mettes@cancer.dk Supplemental Material is available online (https://doi...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Aging is an accumulation of molecular damage and its consequences. The greater the level of damage, the greater the dysfunction in organs and the immune system, then the closer the individual comes to the arbitrary dividing line at which that dysfunction becomes a formal, named age-related disease. Further, the more damage, the higher the mortality rate. Given this view of aging, it should be no great surprise to find that the longest lived people have a history of comparatively little age-related disease: the only ways to become extremely old are to either (a) have accumulated damage at a slower rate that everyone else, m...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
ObjectivesTo assess the incidence of chronic illness and its effect on veteran centenarians. DesignRetrospective longitudinal cohort study. SettingUnited States Veterans Affairs Corporate Data Warehouse (CDW). ParticipantsCommunity‐dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians). MeasurementsThe Kaplan–Meier method was used to estimate cumulative incidence of chronic conditions according to age group. Incidence rates were compared using the log‐rank test. Cox proportional hazards models were used to estimate ...
Source: Journal of the American Geriatrics Society - Category: Geriatrics Authors: Tags: Ethnogeriatrics and Special Population Source Type: research
This study was attempted to address the association between early onset cataract (EOC) and ischemic stroke. Using the Longitudinal Health Insurance Database 2000, we established an EOC cohort and a comparison cohort by using 4-fold propensity score matching according to age, gender and comorbidities to detect the incidence of ischemic stroke. A Cox model was used to express the risk of ischemic stroke for the EOC patients compared with the comparison cohort. After adjusting for age, gender and comorbidities of hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, asthma, chronic obstructive pulmonary...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Authors: Cerit L, Duygu H, Gulsen K, Kemal HS, Ozcem B, Balcioglu O, Gunsel A, Tosun O, Emren V Abstract BACKGROUND AND OBJECTIVES: The relationship of synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score and development of atrial fibrillation (AF) after coronary artery bypass surgery (CABG) has not been studied. Therefore, we assessed the relationship between the SYNTAX score and development of AF after CABG (POAF). SUBJECTS AND METHODS: The medical records of consecutive patients, who underwent CABG surgery from January 2013 to September 2015, were retrospectively r...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
IntroductionCarotid stenting (CAS) has been widely used since the seminal CREST trial, demonstrating equivalent results to carotid endarterectomy (CEA). With normal surgical risk patients having symptomatic or asymptomatic carotid artery disease, CAS and CEA, in qualified hands, have comparable outcomes, but patient-specific risk factors to estimate functional outcome were poorly studied. In practice, the choice between CEA and CAS is based on lesion anatomy and preference of patient and surgeon rather than considering defined risk factors associated with unfavorable outcome. We aimed to determine medical risk factors for ...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Oral abstracts Source Type: research
ConclusionsThere were no differences in hospital outcome among races/ethnicities in endovascular thrombectomy outcomes for acute stroke patients in the Premier data. Racial/ethnic disparities play role for patients’ selection not for patients’ outcome in endovascular thrombectomy.DisclosuresS. Park: None. M. Pilot: None. M. Alexander: 1; C; Consultant for Stryker Neurovascular, Medtronic, and Penumbra, Inc. A. Rosengart: None.
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Oral poster abstracts Source Type: research
Abstract Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and...
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
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