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B-Type Natriuretic Peptides and Cardiac Troponins for Diagnosis and Risk-Stratification of Syncope.
CONCLUSIONS: BNP, NT-proBNP, hs-cTnT, and hs-cTnI concentrations provide useful diagnostic and prognostic information in ED patients with syncope. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov Unique Identifier: NCT01548352. PMID: 30798615 [PubMed - as supplied by publisher]
Source: Circulation - February 25, 2019 Category: Cardiology Authors: du Fay de Lavallaz J, Badertscher P, Nestelberger T, Zimmermann T, Miró Ò, Salgado E, Christ M, Geigy N, Cullen L, Than M, Martin-Sanchez FJ, Di Somma S, Peacock WF, Morawiec B, Walter J, Twerenbold R, Puelacher C, Wussler D, Boeddinghaus J, Koechlin L, Tags: Circulation Source Type: research

Stroke Prevention, Evaluation of Bleeding Risk and Anticoagulant Treatment Management in Atrial Fibrillation Contemporary International Guidelines
Publication date: Available online 21 February 2019Source: Canadian Journal of CardiologyAuthor(s): Marco Proietti, Deirdre A. Lane, Giuseppe Boriani, Gregory Y.H. LipAbstractIn recent years the management of AF patients has progressively and substantially changed due to the introduction of new treatments and the availability of new data regarding the epidemiology and clinical management of these patients. In the last two years alone, there have been seven new guidelines or guideline updates that have been published, introducing new recommendations and significantly revising previously published ones. Two updates for Canad...
Source: Canadian Journal of Cardiology - February 22, 2019 Category: Cardiology Source Type: research

Aortic root enlargement is safe and reduces the incidence of patient-prosthesis mismatch: A Meta-analysis of early and late outcomes
ConclusionsSurgical ARE is a safe adjunct to AVR in selected patients that does not increase early adverse events and results in less patient-prosthesis mismatch. This strategy allows for a larger valve size at the time of implantation – an important consideration for potential future valve-in-valve procedures in the era of TAVR.
Source: Canadian Journal of Cardiology - February 13, 2019 Category: Cardiology Source Type: research

Optimal duration of dual antiplatelet therapy following percutaneous coronary intervention: An umbrella review
ConclusionsExtended DAPT may reduce the risk of MI and stent thrombosis but increase major bleeding and death. Whether the effects of extended DAPT are consistent across patient subgroups is unclear, and future SRs should address this knowledge gap. PROSPERO: CRD42016047735.
Source: Canadian Journal of Cardiology - February 6, 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

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

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

XANTUS-EL: A real-world, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation in Eastern Europe, Middle East, Africa and Latin America
ConclusionsXANTUS-EL confirmed low stroke and major bleeding rates in patients with NVAF from EEMEA and Latin America. The population was younger but with more heart failure and hypertension than XANTUS; stroke/SE rate was similar but major bleeding lower.
Source: The Egyptian Heart Journal - October 5, 2018 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

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

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

Clinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome Original Articles
Conclusions: Generic clopidogrel was noninferior to Plavix with respect to the composite end point of death and recurrent hospitalization for ACS at 1 year among adults >65 years after an ACS hospitalization. Our findings support generic clopidogrel in ACS, which could lead to substantial healthcare cost savings.
Source: Circulation: Cardiovascular Quality and Outcomes - March 13, 2018 Category: Cardiology Authors: Ko, D. T., Krumholz, H. M., Tu, J. V., Austin, P. C., Stukel, T. A., Koh, M., Chong, A., de Melo, J. F., Jackevicius, C. A. Tags: Health Services, Mortality/Survival Original Articles 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

An Invasive vs a Conservative Approach in Elderly Patients with Non –ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis
Conclusion The overall benefit with invasive strategy comes from the data of observational studies that are prone to selection bias. We believe that there is a need for a large randomized study in the elderly patients regarding management of NSTEMI.
Source: Canadian Journal of Cardiology - February 21, 2018 Category: Cardiology Source Type: research

Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE)
Conclusion MANAGE is the first randomized controlled trial to evaluate a potential treatment of patients who suffered MINS.
Source: Canadian Journal of Cardiology - February 3, 2018 Category: Cardiology Source Type: research

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