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Stroke and death in elderly patients with atrial fibrillation in Japan compared with the United Kingdom
Conclusions Elderly (age ≥75 years) patients with AF in both Japan and the UK are at similarly high risk of stroke and death, with OAC still underused in both populations. Ethnicity was not independently associated with the risk of stroke, regardless of OAC use or non-use.
Source: Heart - November 10, 2016 Category: Cardiology Authors: Senoo, K., An, Y., Ogawa, H., Lane, D. A., Wolff, A., Shantsila, E., Akao, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Health care delivery, economics and global health care Source Type: research

Prediction of stroke in patients without atrial fibrillation using the CHADS2 and CHA2DS2-VASc scores: a justification for more widespread thromboprophylaxis?
The CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischaemic attack (TIA) (double)) and more recently, the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years (double score), diabetes mellitus, previous stroke/TIA (double score), vascular disease, age 65–74 years, sex category (female)) scores are validated clinical prediction tools commonly used to estimate the stroke risk in atrial fibrillation (AF) patients. More recently, the focus has been on initially identifying those patients at ‘low risk’ (ie, CHA2DS...
Source: Heart - September 9, 2014 Category: Cardiology Authors: Senoo, K., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research

Risk of left atrial appendage thrombus and stroke in patients with atrial fibrillation and mitral regurgitation
Conclusions Among patients with NVAF, the presence or severity of MR was not associated with a decreased risk of LAAT or stroke.
Source: Heart - December 10, 2021 Category: Cardiology Authors: Melduni, R., Nkomo, V. T., Wysokinski, W., Gersh, B. J., Deshmukh, A., Padang, R., Greene, E. L., Oh, J. K., Lee, H.-C. Tags: Arrhythmias and sudden death Source Type: research

Rivaroxaban and other novel anticoagulants for stroke prevention in atrial fibrillation: time to embrace the future
Atrial fibrillation (AF) is now said to be at epidemic proportions.1 Although symptoms and heart failure are two of the main reasons that patients with AF suffer from reduced quality of life, thromboembolic complications, particularly stroke, remain the major determinant of significant morbidity and mortality.2 Importantly, the risk of thromboembolism (TE) is completely irrespective of symptoms, and hence the sad fact that people continue to present with catastrophic stroke in AF with no prior history of its detection.3 Appropriate anticoagulation is imperative to reduce the TE/stroke risk. Numerous large scale studies hav...
Source: Heart - February 18, 2013 Category: Cardiology Authors: Rajappan, K. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Survival by stroke volume index in low-gradient normal EF severe aortic stenosis: insights into myocardial systolic dysfunction
To the Editor, We read with interest the recent article on survival by stroke volume index (SVI) in patients with low-gradient normal EF severe aortic stenosis, which demonstrated lower SVI is incrementally associated with mortality.1 The authors discuss a putative mechanism of low stroke volume (SV) secondary to concentric remodelling which results in reduced LV cavity size. This impedes LV diastolic filling culminating in diminished systolic function despite normal EF. The authors quote evidence of systolic impairment, for example reduced longitudinal strain, in similar cohorts with preserved EF.2 In the current study, t...
Source: Heart - December 12, 2014 Category: Cardiology Authors: Rodrigues, J. C. L., Dastidar, A. G., Rohan, S., MacIver, D. H. Tags: PostScript Source Type: research

Heartbeat: sex disparities in stroke, heart failure and all-cause mortality in adults with coronary heart disease
Research on sex disparities in patients with coronary heart disease (CHD) largely has focused on events directly related to the coronary arteries themselves—recurrent myocardial infarction, revascularisation and cardiovascular death—rather than the wider consequences of atherosclerotic vascular disease. In contrast, Akyea and colleagues1 evaluated sex disparities across a broader range of major adverse cardiovascular events (MACE) including not only recurrent CHD, but also stroke, peripheral vascular disease, heart failure and all-cause mortality in a population-based cohort of 143 702 adults (median age 73 yea...
Source: Heart - December 10, 2021 Category: Cardiology Authors: Otto, C. M. Tags: Heartbeat Source Type: research

Why should we screen for atrial fibrillation?
Atrial fibrillation (AF) constitutes an increasing challenge to the medical community and healthcare providers. With a prevalence of almost 3% in the adult Swedish population1 and a forecasted twofold or threefold increase by 2050 in the USA, we are facing a diagnosis with epidemic proportions. Apart from increased mortality, AF also increases the risk of heart failure, hospitalisations and ischaemic stroke.2 Of these complications, ischaemic stroke gives a particularly heavy burden on patients, their family and society. Ischaemic stroke is the most common reason for permanent neurological disability in the adult Western p...
Source: Heart - December 8, 2016 Category: Cardiology Authors: Svennberg, E., Engdahl, J. Tags: Press releases, Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Dipeptidyl peptidase-4 inhibitors and cardiovascular risks in patients with pre-existing heart failure
Conclusions In this nationwide T2DM cohort, the risks of mortality and the combination of MI and ischaemic stroke were lower for patients receiving DPP-4 inhibitors than for those who did not receive such treatment. DPP-4 inhibitor use was not associated with a higher risk of hospitalisation for HF even in patients with pre-existing HF.
Source: Heart - February 26, 2017 Category: Cardiology Authors: Ou, S.-M., Chen, H.-T., Kuo, S.-C., Chen, T.-J., Shih, C.-J., Chen, Y.-T. Tags: Health policy, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Heart failure and cardiomyopathies Source Type: research

Blood pressure targets in patients with coronary artery disease: observations from traditional and Bayesian random effects meta-analysis of randomised trials
Conclusions The present body of evidence suggests that in patients with CAD, intensive systolic BP control to ≤135 mm Hg and possibly to ≤130 mm Hg is associated with a modest reduction in stroke and heart failure but at the expense of hypotension. Lower was better, although not consistently so for myocardial infarction, stroke, heart failure and perhaps angina. Further trials are needed to prove these findings.
Source: Heart - April 5, 2013 Category: Cardiology Authors: Bangalore, S., Kumar, S., Volodarskiy, A., Messerli, F. H. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Stable coronary heart disease, Epidemiology Systematic review Source Type: research

Heartbeat: Focus on atrial fibrillation
Atrial fibrillation is very common; the estimated prevalence increases with age from about 0.1% in adults under age 55 years to 9% of those 80 years of age or older. AF is associated with a reduced quality of life due to the irregular heart rate and reduction in cardiac output. More importantly, AF is associated with an increased risk of thromboembolic events, with an annual stroke risk ranging from as low as <1% in patients with isolated AF to as high as 12% depending on additive risk factors including age over 75 years, female sex, diabetes, hypertension, heart failure, vascular disease or a prior stroke. Stroke risk ...
Source: Heart - May 12, 2015 Category: Cardiology Authors: Otto, C. M. Tags: Congenital heart disease, Drugs: cardiovascular system, Echocardiography, Hypertension, Clinical diagnostic tests, Epidemiology Heartbeat Source Type: research

Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure
Conclusions LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Minguez, J. R. L., Asensio, J. M. N., Gragera, J. E., Costa, M., Gonzalez, I. C., de Carlos, F. G., Diaz, J. A. F., Yuste, V. M., Gonzalez, R. M., Dominguez-Franco, A., Buendia, A. B., Garibi, J. H., Hernandez, F. H., Ribeiro, V. G. Tags: Congenital heart disease in adult patients, Editor's choice, Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology Arrhythmias and sudden death Source Type: research

Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis
Conclusions Our analysis suggests that off-label underdosing of NOACs does not reduce bleeding outcomes. Patients prescribed off-label NOAC doses are at an increased risk of all-cause mortality. These data underscore the importance of prescriber adherence to NOAC dosing guidelines to achieve optimal clinical outcomes for patients with AF. PROSPERO registration number CRD42020219844.
Source: Heart - January 11, 2023 Category: Cardiology Authors: Caso, V., de Groot, J. R., Sanmartin Fernandez, M., Segura, T., Blomström-Lundqvist, C., Hargroves, D., Antoniou, S., Williams, H., Worsley, A., Harris, J., Caleyachetty, A., Vardar, B., Field, P., Ruff, C. T. Tags: Open access Systematic review Source Type: research

Trends in cardiovascular mortality and hospitalisations, and potential contribution of inhospital case-fatality rates to changes in national mortality in the Czech Republic 1994-2009
Conclusions During the study period, the overall CVD hospitalisation rates remained high but inhospital CFR declined considerably. The improved case-fatality seems to have made a substantial contribution to the decline in the national CVD mortality, particularly for AMI and stroke.
Source: Heart - February 18, 2013 Category: Cardiology Authors: Davidkovova, H., Kysely, J., Kriz, B., Vojtisek, P., Bobak, M. Tags: Health policy, Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Stable coronary heart disease, Epidemiology Source Type: research

Biomarkers and atrial fibrillation: is it prime time yet?
Atrial fibrillation (AF) is a global epidemic with increasing burden on healthcare systems.1 AF is associated with increased risk of thromboembolic stroke, heart failure, cognitive dysfunction and mortality. In improving prognosis, the focus of management revolves around stroke prevention with clinical scores developed to identify people with increased stroke risk. The CHADS2 and CHA2DS2-VASc scores are the most commonly used scores, with the latter being better able to discriminate low-risk subjects.2 However, both the risk scores have a modest predictive value for identifying high-risk subjects for stroke with C statisti...
Source: Heart - July 3, 2014 Category: Cardiology Authors: Mahajan, R., Lau, D. H., Sanders, P. Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests, Epidemiology Editorials Source Type: research

Prediction of incident atrial fibrillation in community-based electronic health records: a systematic review with meta-analysis
Conclusions Models externally validated for prediction of incident AF in community-based EHR demonstrate moderate predictive ability and high risk of bias. Novel methods may provide stronger discriminative performance. Systematic review registration PROSPERO CRD42021245093.
Source: Heart - June 10, 2022 Category: Cardiology Authors: Nadarajah, R., Alsaeed, E., Hurdus, B., Aktaa, S., Hogg, D., Bates, M. G. D., Cowan, C., Wu, J., Gale, C. P. Tags: Open access Arrhythmias and sudden death Source Type: research

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