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Warfarin may reduce risk of ischemic stroke by preventing atrial fibrillation for patients with heart failure and sinus rhythm
As compared with the general population, patients with reduced ejection fraction who are in sinus rhythm are observed with a higher risk for ischemic stroke. This relationship is caused by left ventricular stasis, a systemic hypercoagulable state, and endocardial dysfunction in a situation of impaired left ventricular systolic function . Therefore, the issue whether antithrombotic agents especially aspirin or warfarin could successfully prevent stroke for patients with heart failure and sinus rhythm has been tested in a series of clinical trials. The former two trials (the Warfarin/Aspirin Study in Heart Failure (WASH) tri...
Source: International Journal of Cardiology - July 16, 2012 Category: Cardiology Authors: Gen-Min Lin, Yi-Hwei Li, Lamin .E.S. Jaiteh, Chih-Lu Han Tags: Letters to the Editor Source Type: research

Beyond age, the need for useful parameters to identify heart failure patients in sinus rhythm that can benefit from oral anticoagulation
It is still unclear whether oral anticoagulant or aspirin therapy is superior for patients with heart failure (HF) who are in sinus rhythm. The subanalyses of the warfarin vs. aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial, that have been recently published , were aimed to identify subgroups of patients with reduced left ventricular ejection fraction (LVEF≤35%) in sinus rhythm that may benefit from warfarin or aspirin. They showed that patients under 60years have an improved outcome with warfarin over aspirin concerning the composite outcome of ischemic stroke, intracerebral hemorrhage and overall death, wha...
Source: International Journal of Cardiology - January 23, 2014 Category: Cardiology Authors: Enrico Ammirati, Dacia Dalla Libera, Maria Frigerio Tags: Online Letters to the Editor Source Type: research

Peripheral artery disease and outcomes after myocardial infarction: An individual-patient meta-analysis of 28,771 patients in CAPRICORN, EPEHESUS, OPTIMAAL and VALIANT
Abstract: Objectives: To examine the prevalence of peripheral artery disease (PAD) and the relationship between PAD and cardiovascular (CV) outcomes in subjects with left ventricular systolic dysfunction, heart failure or both after acute myocardial infarction (MI).Background: PAD is associated with poorer prognosis in patients with stable and unstable coronary heart disease but whether PAD is associated with worse outcomes following substantial acute MI is unknown.Methods: Univariate and multivariate Cox proportional hazards modelling was used to compare clinical outcomes in an individual-patient meta-analysis of 4 trials...
Source: International Journal of Cardiology - November 29, 2012 Category: Cardiology Authors: Sally C. Inglis, Judith Bebchuk, Sultan A. Al-Suhaim, Jessica Case, Marc A. Pfeffer, Scott D. Solomon, Yingxin (Rachel) Hou, Bertram Pitt, Henry J. Dargie, Ian Ford, John Kjekshus, Faiez Zannad, Kenneth Dickstein, John J.V. McMurray Tags: Original Articles Source Type: research

Long-term cardiovascular outcomes in patients with atrial fibrillation and atherothrombosis in the REACH Registry
Abstract: Background: Patients with atrial fibrillation (AF) are at increased risk of thromboembolic events. The long-term prognostic implications of AF in patients with atherothrombosis are unknown.Methods: We compared 4-year CV outcomes in patients with and without a history of AF recorded at their baseline visit in the REACH Registry, an international, prospective cohort of patients with established atherosclerotic arterial disease (CAD, CVD, PAD) or at least 3 risk factors (RFO).Results: AF status and 4year follow-up data were available on 44,518 patients. The prevalence of AF at baseline was 10.3% (n=4582). Overall, p...
Source: International Journal of Cardiology - December 9, 2013 Category: Cardiology Authors: Christian T. Ruff, Deepak L. Bhatt, Ph. Gabriel Steg, Bernard J. Gersh, Mark J. Alberts, Elaine B. Hoffman, E. Magnus Ohman, Kim A. Eagle, Gregory Y.H. Lip, Shinya Goto, On Behalf of the REACH Registry Investigators Tags: Original Articles Source Type: research