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Source: The American Journal of Cardiology
Condition: Stroke
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Total 712 results found since Jan 2013.
Impact of Heart Failure Type on Thromboembolic and Bleeding Risk in Patients with Atrial Fibrillation on Oral Anticoagulation
Heart failure (HF) increases stroke risk in atrial fibrillation (AF) patients. Differential impact of HF category on thromboembolic and bleeding risk in AF patients on oral anticoagulation (OAC) is unknown. We used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The primary endpoint of admission for ischemic stroke was evaluated using Cox proportional hazards regression models that controlled for patient demographics, comorbidities (including CHA2DS2-VASc and HASBLED score...
Source: The American Journal of Cardiology - February 28, 2019 Category: Cardiology Authors: Amgad Mentias, Alexandros Briasoulis, Ghanshyam Shantha, Paulino Alvarez, Mary Vaughan-Sarrazin Source Type: research
PFO-mediated Stroke: Exposing the Misnomer of ‘Cryptogenic’ Stroke
We read with interest the recent article by Wintzer-Wehekind et al1. In an observational study of 453 consecutive patients who underwent PFO closure due to an ischemic event of no other apparent cause, the authors evaluated the safety of discontinuing antithrombotic therapy following PFO closure. At a median follow-up of 8 years, antithrombotic therapy was associated with a 6% incidence of bleeding, and the subset of patients who discontinued their blood thinners did not have more recurrent ischemic events on long-term follow-up.
Source: The American Journal of Cardiology - March 15, 2019 Category: Cardiology Authors: Muhammad O. Zaman, Sanaullah Mojaddedi, Fabian Nietlispach, Bernhard Meier, Mohammad K. Mojadidi Source Type: research
Discriminative Ability of CHA2DS2-VASc and HAS-BLED Score in Whites and Non-Whites
The CHA2DS2-VASc and HAS-BLED scoring systems are used in patients with atrial fibrillation (AF) to estimate risk of stroke and bleeding, respectively. Both were developed in minimally diverse European populations and these scores have not yet been extensively studied in US whites and non-whites. In a retrospective cohort study, we included patients with AF who received inpatient or outpatient care in a large integrated academic health system from 2011 to 2017. Cox proportional hazards were used to analyze associations between stroke and CHA2DS2-VASc score in AF patients not prescribed anticoagulation and between incident ...
Source: The American Journal of Cardiology - March 18, 2019 Category: Cardiology Authors: Sarah M Schwartz, Yacob G Tedla, Philip Greenland, Ajay Yadlapati, Rod Passman Source Type: research
Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang and colleagues1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al.2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al.1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type ...
Source: The American Journal of Cardiology - April 8, 2019 Category: Cardiology Authors: James A. Reiffel Tags: Reader's Comments Source Type: research
Discriminative Ability of CHA2DS2-VASc and HAS-BLED Score in Whites and Nonwhites
The CHA2DS2-VASc and HAS-BLED scoring systems are used in patients with atrial fibrillation (AF) to estimate risk of stroke and bleeding, respectively. Both were developed in minimally diverse European populations and these scores have not yet been extensively studied in US whites and nonwhites. In a retrospective cohort study, we included patients with AF who received inpatient or outpatient care in a large integrated academic health system from 2011 to 2017. Cox proportional hazards were used to analyze associations between stroke and CHA2DS2-VASc score in AF patients not prescribed anticoagulation and between incident b...
Source: The American Journal of Cardiology - March 18, 2019 Category: Cardiology Authors: Sarah M. Schwartz, Yacob G. Tedla, Philip Greenland, Ajay Yadlapati, Rod S. Passman Source Type: research
PFO-Mediated Stroke: Exposing the Misnomer of “Cryptogenic” Stroke
To the Editor,
Source: The American Journal of Cardiology - March 15, 2019 Category: Cardiology Authors: Muhammad O. Zaman, Sanaullah Mojaddedi, Fabian Nietlispach, Bernhard Meier, Mohammad K. Mojadidi Source Type: research
Reader's Comments: Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang et al1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type is truly im...
Source: The American Journal of Cardiology - April 8, 2019 Category: Cardiology Authors: James A. Reiffel Source Type: research
Meta-Analysis Evaluating the Safety and Efficacy of Transcarotid Transcatheter Aortic Valve Implantation
We performed a systemic review and meta-analysis of studies evaluating transcarotid vascular access for transcatheter aortic valve implantation (TAVI). Published studies evaluating transcarotid vascular access for TAVI were included in this analysis. Outcomes of interest included thirty-day mortality, stroke/TIA, new pacemaker implantation, acute kidney injury (AKI), major vascular complication, major bleeding, and myocardial infarction. Pooled estimate for 30-day mortality was 5.3% (95% CI: 4.0%-6.8%; I2=4%), stroke/TIA was 3.4% (95% CI: 2.4%-4.6%; I2=0%), new pacemaker implantation was 15.3% (95% CI: 10.8%-19.7%; I2=72%)...
Source: The American Journal of Cardiology - September 24, 2019 Category: Cardiology Authors: Muhammad Shariq Usman, Wasiq Faraz Rawasia, Tariq Jamal Siddiqi, Firzah Abdul Mujeeb, Shahrukh Nadeem, Mohamad Alkhouli Source Type: research
Non-Vitamin K Antagonist Oral Anticoagulant for Atrial Fibrillation in Obese Patients
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It affects 1 in 4 adults aged>40 years,1 and is associated with a 5-fold increased risk of stroke.1 Hence, anticoagulants are universally recommended to prevent stroke and systemic embolism in patients with AF.1 The non-vitamin K antagonist oral anticoagulants (NOACs) are important alternatives to warfarin for prevention of arterial thromboembolism in patients with AF. Currently, the FDA has approved four NOACs for use in patients with AF: dabigatran is a thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors.
Source: The American Journal of Cardiology - April 22, 2020 Category: Cardiology Authors: Stephen Y Wang, Robert P Giugliano Tags: Review Article Source Type: research
A Novel Model for Prediction of Thromboembolic and Cardiovascular Events in Patients without Atrial Fibrillation
Patients without atrial fibrillation (AF) constitute approximately 75% of patients with thromboembolic events (TE: ischemic stroke, transient ischemic attack (TIA), and systemic embolism)1 but evidence supporting risk stratification and prophylactic treatment in these patients is sparse. The latter may be explained by the lack of an intervention that, beyond treatment of hypertension and cholesterol, reduces TE risk in patients without AF. However, the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial, that almost exclusively included patients without AF, showed that the combination of asp...
Source: The American Journal of Cardiology - June 26, 2020 Category: Cardiology Authors: Kamilla Steensig, Kevin K W Olesen, Morten Madsen, Troels Thim, Lisette Okkels Jensen, Morten W ürtz, Steen Dalby Kristensen, Hans Erik Bøtker, Gregory Y H Lip, John William Eikelboom, Michael Maeng Source Type: research
Frequency, Trends and Outcomes of Cerebrovascular Events Associated with Atrial Fibrillation Hospitalizations
Atrial Fibrillation (AF) is the leading heart rhythm disorder with lifetime risk as high as 1 in 3 people across the world, contributing significantly to the risk of stroke, heart failure and mortality.1, 2 The incidence and prevalence of AF continue to increase for many reasons including, but not limited to the aging population in the Unites States and the newer technological modalities such as smartwatch detecting AF early among asymptomatic patients.3, 4 It is well established that AF is an independent risk factor for stroke as demonstrated by the Framingham study, and in recent times has been implicated in cryptogenic strokes.
Source: The American Journal of Cardiology - October 12, 2020 Category: Cardiology Authors: Rajkumar Doshi, Devina Adalja, Ashish Kumar, Mihir Dave, Mariam Shariff, Jay Shah, Nageshwara Gullapalli, Rupak Desai, Chintan Rupareliya, Yasar Sattar, Saraschandra Vallabhajosyula Source Type: research
Frequency, Trends, and Outcomes of Cerebrovascular Events Associated With Atrial Fibrillation Hospitalizations
Atrial Fibrillation (AF) is the leading heart rhythm disorder with lifetime risk as high as 1 in 3 people across the world, contributing significantly to the risk of stroke, heart failure and mortality.1,2 The incidence and prevalence of AF continue to increase for many reasons including, but not limited to the aging population in the Unites States and the newer technological modalities such as smartwatch detecting AF early among asymptomatic patients.3,4 It is well established that AF is an independent risk factor for stroke as demonstrated by the Framingham study, and in recent times has been implicated in cryptogenic strokes.
Source: The American Journal of Cardiology - October 12, 2020 Category: Cardiology Authors: Rajkumar Doshi, Devina Adalja, Ashish Kumar, Mihir Dave, Mariam Shariff, Jay Shah, Nageshwara Gullapalli, Rupak Desai, Chintan Rupareliya, Yasar Sattar, Saraschandra Vallabhajosyula Source Type: research
Effect of Mitral Regurgitation on Thrombotic Risk in Patients with Nonrheumatic Atrial Fibrillation: a New CHA2DS2-VASc Score Risk Modifier?
Atrial fibrillation (AF) significantly increases the risk of ischemic stroke (IS), but the risk varies strongly depending on the individual patient's stroke risk factors.1 Many scores, such as the CHA2DS2-VASc score, have been developed to guide physicians in their decision to start anticoagulation.2 However, the risk prediction with these models is modest at best (C-statistic = 0.6).3,4 Severe mitral regurgitation (MR) has been shown to decrease left atrial (LA) thrombus formation and systemic thromboembolic (TE) events in AF patients with rheumatic valve disease with an observed risk reduction of more than 50%.
Source: The American Journal of Cardiology - January 14, 2021 Category: Cardiology Authors: Sven L. Van Laer, Seppe Verreyen, Koen M. Winkler, Hielko Miljoen, Andrea Sarkozy, Hilde Heuten, Johan Saenen, Paul Van Herck, Caroline M. Van de Heyning, Hein Heidbuchel, Marc J. Claeys Source Type: research
Direct Oral Anticoagulants in Cardiac Amyloidosis –Associated Heart Failure and Atrial Fibrillation
Atrial fibrillation (AF) is present in approximately 40% of patients with cardiac amyloidosis.1 AF in the setting of cardiac amyloidosis is associated with a significant risk of stroke and systemic thromboembolism regardless of the patient's CHA ₂DS₂-VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score.2 Although current guidelines recommend anticoagulation therapy in all patients with cardiac amyloidosis and AF, data about the comparative effectiveness and safety of vitamin K antagonists (VKAs) ...
Source: The American Journal of Cardiology - November 27, 2021 Category: Cardiology Authors: Amgad Mentias, Paulino Alvarez, Pulkit Chaudhury, Michael Nakhla, Rohit Moudgil, Mohamad Kanj, Mazen Hanna, Milind Y. Desai Source Type: research
Relation of Cannabis Use to Elevated Atherosclerotic Cardiovascular Disease Risk Score
We hypothesized that cannabis use is associated with cardiovascular disease (CVD) risk factors. This could explain the reported link between cannabis and cardiovascular events including stroke and myocardial infarction. This analysis included 7,159 participants (age 37.8 ± 12.4 years, 48.6% men, and 61.5% Caucasian) from the National Health and Nutrition Examination Survey years 2011 to 2018. Cannabis use was defined by self-report. Participants with a history of stroke or myocardial infarction were excluded.
Source: The American Journal of Cardiology - December 17, 2021 Category: Cardiology Authors: Travis M. Skipina, Nikhil Patel, Bharathi Upadhya, Elsayed Z. Soliman Source Type: research
