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Source: Heart
Condition: Stroke

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Total 260 results found since Jan 2013.

Loneliness and social isolation and increased risk of coronary heart disease and stroke: clinical implications
To the Editor The recent meta-analysis published in Heart by Valtorta et al1 showed that loneliness and social isolation are associated with increased incidence of coronary heart disease (CHD) and stroke in 16 large longitudinal studies conducted in high-income countries. This finding is not surprising given the extensive literature documenting such harmful consequences of social isolation, including a study my research group published in 19922 showing in a large sample of CHD patients that those who were not married and did not have a confident—and hence likely to be lonely and socially isolated—had a 5-year m...
Source: Heart - November 24, 2016 Category: Cardiology Authors: Williams, R. B. Tags: PostScript Source Type: research

Antithrombotic drug use: scientific breakthroughs, biological limits and physician behaviour
During the past 25 years, there has been a dramatic surge in the use of antithrombotic drugs as documented in the Heart paper by Adelborg et al.1 The authors derived their findings from the Danish drug utilisation database, which is unique in its comprehensiveness and ability to capture over-the-counter aspirin. The increased prescription of antithrombotic drugs is fuelled by a better understanding of disease and risk, population growth, ageing societies, improved methods of detection, and rising global rates of obesity, a recognised risk factor for atrial fibrillation (AF), venous thromboembolic (VTE) disease, and ca...
Source: Heart - November 10, 2016 Category: Cardiology Authors: Hylek, E. M. Tags: Drugs: cardiovascular system, Venous thromboembolism, Epidemiology Editorials Source Type: research

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

On the use of genetic risk scores to predict cardiovascular disease in the general population
Using genetic information to predict the risk of common diseases has been the holy grail of several groups working in genetics of common human diseases.1 Results up to now have been contradictory and subject to widely different interpretations: from sheer enthusiasm to deep pessimism. While great success has been obtained in the identification of several hundreds of genetic markers robustly and consistently associated with a wide range of human quantitative phenotypes, for the majority of these genetic variants, no clear translation into a better prediction capacity has been shown. In their Heart publication, Morris et al2...
Source: Heart - September 26, 2016 Category: Cardiology Authors: Pereira, A. C. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Editorials Source Type: research

Management of supraventricular arrhythmias in adults with congenital heart disease
Supraventricular arrhythmias are a frequent complication in adults with congenital heart disease (ACHD). The prevalence increases with time since surgery, complexity of the underlying defect, type of repair and older age at surgery. Arrhythmias are the most frequent reason for hospital admission and along with heart failure the leading cause of death. The arrhythmia-associated increase in morbidity and mortality makes their management a key task in patients with ACHD. Intra-atrial re-entry is the most frequent arrhythmia mechanism. Less common arrhythmia mechanisms are supraventricular tachycardias in the presence of an ac...
Source: Heart - September 26, 2016 Category: Cardiology Authors: Wasmer, K., Eckardt, L. Tags: Review articles Reviews Source Type: research

Direct oral anticoagulants: unique properties and practical approaches to management
Since 2009, four direct oral anticoagulants (DOACs) have been introduced for treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. While they are currently first-line therapy for a majority of patients, there are a number of clinical situations where warfarin is preferable. In both randomised trials and real-world populations, use of DOACs significantly reduces the risk of intracranial haemorrhage as compared with warfarin. While drug-specific reversal agents are currently only available for dabigatran, andexanet alpha is pending approval for reversal of factor Xa inhibitors, reduci...
Source: Heart - September 26, 2016 Category: Cardiology Authors: Barnes, G. D., Kurtz, B. Tags: Review articles Reviews Source Type: research

Perioperative outcomes of patients with hypertrophic cardiomyopathy undergoing non-cardiac surgery
Conclusions Patients with HCM undergoing high-risk and intermediate-risk non-cardiac surgeries have a low perioperative event rate, at an experienced centre. However, they have a higher risk of composite events versus matched patients without HCM.
Source: Heart - September 26, 2016 Category: Cardiology Authors: Dhillon, A., Khanna, A., Randhawa, M. S., Cywinski, J., Saager, L., Thamilarasan, M., Lever, H. M., Desai, M. Y. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Heart failure, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Heart failure and cardiomyopathies Source Type: research

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
Conclusions The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Providencia, R., Elliott, P., Patel, K., McCready, J., Babu, G., Srinivasan, N., Bronis, K., Papageorgiou, N., Chow, A., Rowland, E., Lowe, M., Segal, O. R., Lambiase, P. D. Tags: Tachyarrhythmias, Editor's choice, Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Clinical diagnostic tests Heart failure and cardiomyopathy Source Type: research

Histology of debris captured by a cerebral protection system during transcatheter valve-in-valve implantation
Conclusions Transcatheter VIV procedures were associated with the release of particulate debris into the cerebral circulation in all patients. The type of debris suggests that debris originates predominantly from arterial and valvular passage of the THV.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Schmidt, T., Schlüter, M., Alessandrini, H., Akdag, O., Schewel, D., Schewel, J., Thielsen, T., Kreidel, F., Bader, R., Romero, M., Ladich, E., Virmani, R., Schäfer, U., Kuck, K.-H., Frerker, C. Tags: Aortic and vascular disease Source Type: research

Cardiovascular events and all-cause mortality with insulin versus glucagon-like peptide-1 analogue in type 2 diabetes
Conclusions In this cohort of obese people with T2DM, intensification of dual oral therapy by adding GLP-1ar analogue is associated with a lower MACE outcome in routine clinical practice, compared with adding insulin therapy as the third glucose-lowering agent.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Anyanwagu, U., Mamza, J., Mehta, R., Donnelly, R., Idris, I. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Healthcare delivery, economics and global health Source Type: research

Cardiovascular highlights from non-cardiology journals
Cholesterol Lowering in Intermediate-risk Persons without Cardiovascular Disease Implementation of statin therapy in practice for primary prevention of cardiovascular disease is controversial due to concerns over costs and side-effects with broader use and uncertainty regarding LDL goals in the primary prevention population. Previous primary prevention trials suggest a reduction in cardiovascular outcomes in largely white patients with significant risk factors for coronary disease. The HOPE-3 trial randomized a diverse population of 12,000 individuals over 55 years of age (women over 60) with 1–2 relatively modest ri...
Source: Heart - September 12, 2016 Category: Cardiology Authors: Kearney, K., McCabe, J. M. Tags: Journal scan Source Type: research

Contemporary evaluation and management of lower extremity peripheral artery disease
Peripheral artery disease (PAD) includes atherosclerosis of the aorta and lower extremities. Affecting a large segment of the population, PAD is associated with impaired functional capacity and reduced quality of life as well as an increased risk of stroke, myocardial infarction and cardiovascular death. The evaluation of PAD begins with the physical examination, incorporating non-invasive testing such as ankle-brachial indices to confirm the diagnosis. Therapeutic interventions are aimed at alleviating symptoms while preserving limb integrity and reducing overall cardiovascular risk. With this in mind, risk factor modific...
Source: Heart - August 23, 2016 Category: Cardiology Authors: Foley, T. R., Armstrong, E. J., Waldo, S. W. Tags: Review articles Reviews Source Type: research

Obesity and atrial fibrillation: can adipokines help to solve this puzzle
Obesity is a major public health problem increasing risk for hypertension, diabetes mellitus, cardiovascular diseases, heart failure, stroke, left atrial enlargement and obstructive sleep apnoea. Conventionally, body mass index (BMI) is used in many studies to diagnose and classify obesity. However, epidemiological studies have shown that waist:hip ratio is a better predictor for myocardial infarction and sudden cardiac death compared with BMI. Nevertheless, some subjects who have ‘healthy obese phenotype’ have a benign cardiometabolic profile due to greater deposition of the fat tissue in the subcutaneous area...
Source: Heart - August 10, 2016 Category: Cardiology Authors: Güngör, B. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research

Cardiovascular highlights from non-cardiology journals
Transcatheter aortic valve implantation in intermediate risk patients Transcatheter aortic valve implantation (TAVI) has had a major impact on both morbidity and mortality in high-risk and inoperable patients with severe aortic stenosis. Robust evidence has supported widespread adoption in this patient group but uncertainty exists as to whether TAVI may also achieve clinical equipoise with surgical aortic valve replacement (AVR) in lower risk groups. In the industry sponsored PARTNER 2 trial, patients deemed at intermediate surgical risk (generally with an STS score between 4 and 8) were randomized to either TAVI with the ...
Source: Heart - July 25, 2016 Category: Cardiology Authors: McCabe, J. M. Tags: Journal scan Source Type: research

Cardiovascular disease risk assessment in HIV: navigating data-sparse zones
Persons with HIV are surviving longer than ever before due to effective antiretroviral therapy (ART) and are increasingly at risk for chronic, non-communicable diseases.1–3 Data from large cohorts in North America and Europe have demonstrated that HIV-infected persons have roughly 50% greater risks for myocardial infarction (MI) than uninfected persons, as well as greater risks for other cardiovascular diseases such as heart failure and stroke.4 5 These elevated risks for MI persist even after accounting for cardiovascular risk factors and ART regimens and are thought to result from HIV-associated inflammation, immun...
Source: Heart - July 10, 2016 Category: Cardiology Authors: Feinstein, M. J. Tags: Drugs: cardiovascular system, Acute coronary syndromes Editorials Source Type: research