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Status, Indications and Use of Cardiac Replacement Therapy in the Era of Multimodal Mechanical Approaches to Circulatory Support: A Scoping Review
In conclusion, the SynCardia temporary TAH is a reasonable bridge-to-transplant option for selected patients with either biventricular failure or special anatomical conditions.
Source: Canadian Journal of Cardiology - November 30, 2019 Category: Cardiology Source Type: research

Dual antithrombotic therapy with DOACs after ACS or PCI in Atrial Fibrillation: A meta-analysis of Randomized Controlled Trials
ConclusionsIn patients with AF and recent ACS or PCI, the use of dual antithrombotic therapy with DOACs was associated with less major bleeding, and major bleeding or clinically relevant non-major bleeding, compared to triple therapy. The use of dual therapy also shows non-significantly higher composite of death/ischemic events but no difference in mortality.
Source: Canadian Journal of Cardiology - November 14, 2019 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

Outcomes Among Clopidogrel, Prasugrel, and Ticagrelor in ST-Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention From the TOTAL Trial
ConclusionsIn this observational analysis of STEMI patients who underwent primary percutaneous coronary intervention, ticagrelor was associated with improved outcomes compared with clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.RésuméContexteIl n’existe pas d’analyse robuste comparant les inhibiteurs P2Y12 à prise orale (clopidogrel, prasugrel et ticagrélor) chez les patients ayant subi un infarctus du myocarde avec élévation du segment ST (STEMI) traités par une intervention coronaire percutanée (ICP) primaire. Nous avons entrepris d’évaluer les rés...
Source: Canadian Journal of Cardiology - October 9, 2019 Category: Cardiology Source Type: research

Medical Management of LVAD Patients: A Practical Guide for the Non-Expert Clinician
This article provides a concise overview of the medical management of LVAD patients aimed for non-expert clinicians. Our presentation includes the basics of LVAD physiology, design and operation, patient selection, patient assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances such as non-cardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood-pressure and heart-rate assessment, LVAD ‘hum’ auscultation, driveline/insertion-site inspection, and device-parameter record...
Source: Canadian Journal of Cardiology - October 5, 2019 Category: Cardiology Source Type: research

Bleeding tolerance among patients with atrial fibrillation on oral anticoagulation
ConclusionsThe key determinants of the Bleeding Ratio among anticoagulated AF patients are age, prior thromboembolic and bleeding episodes. The study could support identification of AF patients who need additional effort to increase their acceptance of a life-long OAC therapy.
Source: Canadian Journal of Cardiology - September 18, 2019 Category: Cardiology Source Type: research

Antithrombotic Management Following Transcatheter Aortic Valve Replacement: A Survey of Canadian Physicians
Publication date: Available online 22 August 2019Source: Canadian Journal of CardiologyAuthor(s): Seleman Reza Bsc, Natalia Pinilla, Emilie P. Belley-Côté, Kevin J. Um, Serena Sibilio, Madhu K. Natarajan, Richard P. WhitlockAbstractOptimal post-procedural 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 antip...
Source: Canadian Journal of Cardiology - August 22, 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

Anticoagulation in Patients with Advanced Chronic Kidney Disease: Walking the Fine Line between Benefit and Harm
Publication date: Available online 11 July 2019Source: Canadian Journal of CardiologyAuthor(s): Januvi Jegatheswaran, Gregory L. Hundemer, David Massicotte-Azarniouch, Manish M. SoodAbstractChronic kidney disease affects over 3 million Canadians and is highly associated with cardiovascular diseases that require anticoagulation, such as atrial fibrillation and venous thromboembolism. Patients with chronic kidney disease are at a problematic crossroads; they are at high risk of both thrombotic conditions requiring anticoagulation and bleeding complications due to anticoagulation. The limited high-quality clinical evidence to...
Source: Canadian Journal of Cardiology - July 12, 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

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

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

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

Stroke Prevention, Evaluation of Bleeding Risk, and Anticoagulant Treatment Management in Atrial Fibrillation Contemporary International Guidelines
Publication date: May 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 5Author(s): Marco Proietti, Deirdre A. Lane, Giuseppe Boriani, Gregory Y.H. LipAbstractIn recent years the management of atrial fibrillation patients has progressively and substantially changed because of the introduction of new treatments and the availability of new data regarding the epidemiology and clinical management of these patients. In the past 2 years alone, there have been 7 new guidelines or guideline updates that have been published, which have introduced new recommendations and significantly revised previously published ones. Tw...
Source: Canadian Journal of Cardiology - April 27, 2019 Category: Cardiology Source Type: research

Early complete revascularization in hemodynamically stable patients with ST-segment elevation myocardial infarction and multivessel disease
ConclusionsEarly complete revascularization should be considered in hemodynamically stable patients with STEMI and multivessel disease deemed suitable for percutaneous interventions. FFR-guided complete revascularization may be superior to angiography-guided procedure in reducing need for further interventions.
Source: Canadian Journal of Cardiology - March 19, 2019 Category: Cardiology Source Type: research

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