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Association Between Patient and Physician Sex and Physician-Estimated Stroke and Bleeding Risks in Atrial Fibrillation
ConclusionsOur study is the first to examine the association between patient and physician sex influences and stroke and bleeding risk estimation in AF. While there were differences in agreement between physician estimated stroke risk and calculated CHADS2 scores, these differences were small and unlikely to impact clinical practice; further, despite any perceived differences in the accuracy of risk assessment by sex, most patients received anticoagulation.
Source: Canadian Journal of Cardiology - December 4, 2018 Category: Cardiology Source Type: research

Blinded Randomized trial of Anticoagulation to prevent Ischemic stroke and Neurocognitive impairment in AF (BRAIN-AF): Methods and design
ConclusionBRAIN-AF will determine whether oral anticoagulation therapy with rivaroxaban compared with standard of care reduces the risk of stroke, TIA or cognitive decline in patients with non-valvular AF and a low risk of stroke.
Source: Canadian Journal of Cardiology - May 8, 2019 Category: Cardiology Source Type: research

Clot lysis time predicts stroke during anticoagulant therapy in patients with atrial fibrillation
ConclusionsImpaired fibrinolysis may predict thromboembolic events in AF patients receiving VKA.
Source: Canadian Journal of Cardiology - August 8, 2019 Category: Cardiology Source Type: research

Importance of risk reassessment in patients with atrial fibrillation in guidelines: Assessing risk as a dynamic process
Publication date: Available online 2 February 2019Source: Canadian Journal of CardiologyAuthor(s): Ting-Yung Chang, Gregory Y.H. Lip, Shih-Ann Chen, Tze-Fan ChaoAbstractThe appropriate use of oral anticoagulants (OACs) for stroke prevention in atrial fibrillation (AF) relies on the convenient and accurate stroke risk prediction scheme, namely the CHA2DS2-VASc score. Since AF patients would become older and accumulate more comorbidities, their risk (for example, as reflected by the CHA2DS2-VASc scores) are not static and could increase over time. The available data demonstrated that follow-up and delta CHA2DS2-VASc scores p...
Source: Canadian Journal of Cardiology - February 2, 2019 Category: Cardiology Source Type: research

Antithrombotic Therapy for Atrial Fibrillation and Coronary Disease de-Mystified
Publication date: Available online 20 August 2018Source: Canadian Journal of CardiologyAuthor(s): Jason G. Andrade, Marc W. Deyell, Graham C. Wong, Laurent MacleABSTRACTAtrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20-30% of those with AF also have coronary artery disease (CAD), and 5-15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on ischemic out...
Source: Canadian Journal of Cardiology - August 21, 2018 Category: Cardiology Source Type: research

Antithrombotic Therapy for Atrial Fibrillation and Coronary Disease Demystified
Publication date: November 2018Source: Canadian Journal of Cardiology, Volume 34, Issue 11Author(s): Jason G. Andrade, Marc W. Deyell, Graham C. Wong, Laurent MacleAbstractAtrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20% to 30% of those with AF also have coronary artery disease (CAD), and 5% to 15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on i...
Source: Canadian Journal of Cardiology - November 6, 2018 Category: Cardiology Source Type: research

Aortic Arch Reconstructive Surgery with Conventional Techniques versus Frozen Elephant Trunk: A Systematic Review and Meta-Analysis
Conclusion Current evidence suggests that FET surgery is associated with lower mortality in patients with thoracic aneurysmal disease and dissections, without a significant increase in stroke, bleeding or operative times. However, the risk of spinal cord ischemia is increased in FET patients. A well powered randomized trial is needed to evaluate this evolving field. Teaser To our knowledge, we have performed the most detailed meta-analysis for the use of Frozen Elephant Trunk (FET) surgery, yielding a systematic review with the most number of patients studied. Our systematic review and meta-analysis uses the most up to dat...
Source: Canadian Journal of Cardiology - December 26, 2017 Category: Cardiology Source Type: research

Aortic Arch Reconstructive Surgery With Conventional Techniques vs Frozen Elephant Trunk: A Systematic Review and Meta-Analysis
Conclusions Current evidence suggests that FET surgery is associated with lower mortality in patients with thoracic aneurysmal disease and dissections, without a significant increase in stroke, bleeding, or operative times. However, the risk of spinal cord ischemia is increased in patients who undergo FET. A well-powered randomized trial is needed to evaluate this evolving field.
Source: Canadian Journal of Cardiology - February 21, 2018 Category: Cardiology Source Type: research

Sex-specific differences in outcome of transcatheter or surgical aortic valve replacement
Conclusions This nation-wide analysis of sex-specific outcomes after aortic-valve replacement procedures showed that women are higher-risk for bleeding, but lower-risk for stroke, mechanical ventilation, and TF-TAVR mortality. Understanding these differences and their basis may help improve outcomes. Teaser We analyzed baseline characteristics and outcomes of all isolated TAVR or SAVR procedures performed in Germany between 2011 and 2014. In comparison to male patients, females were preferentially treated with TF-TAVR rather than SAVR due to their generally older age and higher EuroSCORE. Females suffered from more relevan...
Source: Canadian Journal of Cardiology - April 13, 2018 Category: Cardiology Source Type: research

Antithrombotic Management After Transcatheter Aortic Valve Replacement: A Survey of Canadian Physicians
Publication date: November 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 11Author(s): Seleman Reza, Natalia Pinilla, Emilie P. Belley-Côté, Kevin J. Um, Serena Sibilio, Madhu K. Natarajan, Richard P. WhitlockAbstractOptimal postprocedural antithrombotic regimen is uncertain after transcatheter aortic valve replacement (TAVR). We developed an online questionnaire on post-TAVR antithrombotic management. After research ethics board approval, we distributed the survey to TAVR implanters across Canada. A total of 24 TAVR implanters from 17 centres responded to the survey for a response rate of 75%. Dual antipla...
Source: Canadian Journal of Cardiology - November 2, 2019 Category: Cardiology Source Type: research

The Relationship Between Cardiologist Care and Clinical Outcomes in Patients With New-Onset Atrial Fibrillation
Conclusions Cardiologist care was associated with a reduction in death in patients with new-onset AF. Further study to obtain a greater understanding of the processes of care associated with the observed survival improvement is warranted.
Source: Canadian Journal of Cardiology - December 3, 2017 Category: Cardiology Source Type: research

Sex-Specific Differences in Outcome of Transcatheter or Surgical Aortic Valve Replacement
ConclusionsThis nation-wide analysis of sex-specific outcomes after aortic-valve replacement procedures showed that women are higher-risk for bleeding, but lower-risk for stroke, mechanical ventilation, and TF-TAVR mortality. Understanding these differences and their basis may help improve outcomes.RésuméContexteLes différences anatomiques et celles au niveau des caractéristiques initiales entre patients de sexe masculin et féminin présentant une sténose valvulaire aortique pourraient influencer l’issue après un remplacement valvulaire aortique par voie chirurgicale et transcathéter. Nous avons évalué l’effe...
Source: Canadian Journal of Cardiology - July 24, 2018 Category: Cardiology Source Type: research

Acute Myocardial Infarction in Severe Mental Health Illness: prevalence, clinical outcomes and process of care in United States hospitalizations.
ConclusionSchizophrenia and ‘other non-organic psychoses’ are the only SMI subtypes associated with adverse clinical outcomes after AMI. However, all patients with SMI were less likely to receive invasive management for AMI, with women and schizophrenia diagnosis being the strongest predictors of conservative management. A multidisciplinary approach between psychiatrists and cardiologists could improve outcomes of this high-risk population.
Source: Canadian Journal of Cardiology - May 3, 2019 Category: Cardiology Source Type: research

Outcomes Among Clopidogrel, Prasugrel, And Ticagrelor In Stemi Patients Undergoing Primary Percutaneous Coronary Intervention From The Total Trial
ConclusionsIn this observational analysis of STEMI patients undergoing PPCI, ticagrelor was associated with improved outcomes compared to clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.
Source: Canadian Journal of Cardiology - May 8, 2019 Category: Cardiology Source Type: research

Acute Myocardial Infarction in Severe Mental Illness: Prevalence, Clinical Outcomes, and Process of Care in U.S. Hospitalizations
ConclusionSchizophrenia and ONOP are the only SMI subtypes associated with adverse clinical outcomes after AMI. However, all patients with SMI were less likely to receive invasive management for AMI, with female gender and schizophrenia diagnosis being the strongest predictors of conservative management. A multidisciplinary approach between psychiatrists and cardiologists could improve the outcomes of this high-risk population.RésuméContexteLe trouble mental grave (TMG) est associé à une augmentation de la mortalité cardiovasculaire. Nous avons étudié la prévalence des patients atteints d’un TMG qui avaient subi ...
Source: Canadian Journal of Cardiology - July 8, 2019 Category: Cardiology Source Type: research

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