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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

Ethnicity and stroke risk in patients with atrial fibrillation
Conclusions Despite a reduced prevalence of AF among South Asian patients, their risk of stroke is higher than for white patients or black African/Caribbean patients in association with diabetes, cardiovascular disease, and hypertension. Under-prescription of anticoagulation persists in all ethnic groups, a deficit most pronounced in the elderly. Use of the CHA2DS2VASc score would enhance optimal management in primary care.
Source: Heart - July 5, 2013 Category: Cardiology Authors: Mathur, R., Pollara, E., Hull, S., Schofield, P., Ashworth, M., Robson, J. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Heart rhythm disorders Source Type: research

Cognitive outcomes after acute coronary syndrome: a population based comparison with transient ischaemic attack and minor stroke
Conclusions Risk of cognitive impairment after ACS is similar to minor stroke and higher than TIA with implications for clinical practice including consent and adherence with medication. Differences in cognitive domain performance suggest a greater role for degenerative brain pathology in ACS which may be linked to vascular risk profile and cardiac factors.
Source: Heart - September 20, 2013 Category: Cardiology Authors: Volonghi, I., Pendlebury, S. T., Welch, S. J. V., Mehta, Z., Rothwell, P. M. Tags: Acute coronary syndromes, Drugs: cardiovascular system, Hypertension, Epidemiology, Tobacco use Source Type: research

Atrial appendage occlusion for stroke prevention in patients with atrial fibrillation
In the developed countries, stroke is an important cause of mortality and disability. Cardioembolism is the most frequent cause of ischaemic stroke, in the presence of atrial fibrillation (AF).1 AF is the most common cardiac arrhythmia in the general population and its prevalence increases with age; the lifetime risk of AF development is 25% in people over 40 years old.2 Anticoagulation has been established as an effective treatment strategy for stroke prevention in patients with AF and risk factors for stroke.3 The new oral anticoagulants (NOACs) seem to be similarly efficacious compared with vitamin K antagonists (V...
Source: Heart - November 24, 2016 Category: Cardiology Authors: Swaans, M. J., Boersma, L. V. A. Tags: Drugs: cardiovascular system, Echocardiography, Hypertension, Interventional cardiology, Clinical diagnostic tests, Epidemiology Editorials Source Type: research

Allopurinol reduces brachial and central blood pressure, and carotid intima-media thickness progression after ischaemic stroke and transient ischaemic attack: a randomised controlled trial
Conclusions Allopurinol lowered CBP and reduced CIMT progression at 1 year compared with placebo in patients with recent ischaemic stroke and TIA. This extends the evidence of sustained beneficial effects of allopurinol to these prognostically significant outcomes and to the stroke population, highlighting the potential for reduction in cardiovascular events with this treatment strategy. Trial registration number ISRCTN11970568.
Source: Heart - June 21, 2014 Category: Cardiology Authors: Higgins, P., Walters, M. R., Murray, H. M., McArthur, K., McConnachie, A., Lees, K. R., Dawson, J. Tags: Hypertension, Epidemiology Cardiac risk factors and prevention Source Type: research

RV stroke work in children with pulmonary arterial hypertension: estimation based on invasive haemodynamic assessment and correlation with outcomes
Conclusions RVSW can be estimated in children with PAH, and is significantly associated with abnormal WHO class, the need for septostomy, as well as mortality. Indices accounting for RV performance as well as ventricular-vascular coupling may be useful in the prognosis and, hence, management of children with PAH.
Source: Heart - August 6, 2014 Category: Cardiology Authors: Di Maria, M. V., Younoszai, A. K., Mertens, L., Landeck, B. F., Ivy, D. D., Hunter, K. S., Friedberg, M. K. Tags: Congenital heart disease, Drugs: cardiovascular system, Echocardiography, Hypertension, Clinical diagnostic tests, Epidemiology Pulmonary vascular disease Source Type: research

Dual potential embolic source detected in left atrium during hyperacute stroke
Clinical introduction A woman in her late 60s with a medical history of hypertension presented to the emergency department with symptoms of a stroke which began 40 min prior. Brain MRI was performed (figure 1A). Hyperacute CT angiography of the head and neck did not find any atherosclerosis. ECG is shown (figure 1B), and subsequent transthoracic echocardiography showed left atrium enlargement and left-to-right flow at the region of the fossa ovalis (figure 1C). Figure 1Brain MRI of diffusion-weighted image sequence (A), ECG (B), and transthoracic echocardiogram (C). Question Which of the following is the most likely mechan...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Fu, Z., Xu, C., Gao, L. Tags: Image challenges Source Type: research

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa
The early part of the new millennium witnessed reports of a growing burden of cardiovascular disease in Sub-Saharan Africa (SSA). However the contribution of ischemic heart disease and stroke to this increasing burden relative to that caused by hypertensive heart disease, cardiomyopathy and rheumatic heart disease was not clear. Over the last decade, data from the continent has begun to clarify this issue and suggests three main points. The burden of ischemic heart disease relative to other causes of heart disease remains low particularly in the black Africans majority. Stroke caused predominantly by hypertension is now a ...
Source: Heart - August 2, 2013 Category: Cardiology Authors: Ntsekhe, M., Damasceno, A. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Global burden of cardiovascular disease Source Type: research

Right ventricular stroke work in children with pulmonary arterial hypertension: a promising approach
To the Editor, We read with great interest the article by Di Maria et al,1 describing the importance of RV performance, especially RV stroke work (RVSW), in children with pulmonary arterial hypertension (PAH). The authors investigated the relation between echocardiographic measurements of RV function and the ‘gold standard’ of right heart catheterisation in children and found that RVSW strongly correlates with non-invasive data of RV function.1 The authors concluded that RVSW correlates with outcome parameters, for example, abnormal WHO class, and mortality, in children with PAH. We completely agree with the fi...
Source: Heart - August 6, 2014 Category: Cardiology Authors: Pansy, J., Koestenberger, M. Tags: PostScript 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

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