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WITHDRAWN: Pharmacological cardioversion for atrial fibrillation and flutter.
CONCLUSIONS: There is no evidence that pharmacological cardioversion of atrial fibrillation to sinus rhythm is superior to rate control. Rhythm control is associated with more adverse effects and increased hospitalisation. It does not reduce the risk of stroke. The conclusions cannot be generalised to all people with atrial fibrillation. Most of the patients included in these studies were relatively older (>60 years) with significant cardiovascular risk factors. PMID: 29140557 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Cordina J, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Comparison of the Ecarin Chromogenic Assay and Diluted Thrombin Time for Quantification of Dabigatran Concentrations
ConclusionsFor detection of levels below 50 ng/mL both tests have specificities of at least 96%, suggesting that they accurately detect even low levels of drug. Therefore, regardless of whether a chromogenic or clot‐based platform is preferred, the STA‐ECA‐II and dTT are useful tests for measuring dabigatran concentrations. Unfortunately, neither test is licensed by the United States Food and Drug Administration. Although approved in other jurisdictions, the dTT and STA‐ECA‐II are not widely or rapidly available in most hospitals. Therefore, cooperation between regulators and hospitals is urgently needed to rende...
Source: Journal of Thrombosis and Haemostasis - October 4, 2017 Category: Hematology Authors: Iqbal H. Jaffer, Noel Chan, Robin Roberts, James C. Fredenburgh, John W. Eikelboom, Jeffrey I. Weitz Tags: Original Article ‐ Coagulation Source Type: research

Comparison of the Ecarin Chromogenic Assay and Diluted Thrombin Time for Quantification of Dabigatran Concentrations.
CONCLUSIONS: For detection of levels below 50 ng/mL both tests have specificities of at least 96%, suggesting that they accurately detect even low levels of drug. Therefore, regardless of whether a chromogenic or clot-based platform is preferred, the STA-ECA-II and dTT are useful tests for measuring dabigatran concentrations. Unfortunately, neither test is licensed by the United States Food and Drug Administration. Although approved in other jurisdictions, the dTT and STA-ECA-II are not widely or rapidly available in most hospitals. Therefore, cooperation between regulators and hospitals is urgently needed to render these ...
Source: Thrombosis and Haemostasis - October 4, 2017 Category: Hematology Authors: Jaffer IH, Chan N, Roberts R, Fredenburgh JC, Eikelboom JW, Weitz JI Tags: J Thromb Haemost Source Type: research

Recurrent Ischemic Stroke: Strategies for Prevention.
Abstract Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, ...
Source: American Family Physician - October 1, 2017 Category: Primary Care Authors: Oza R, Rundell K, Garcellano M Tags: Am Fam Physician Source Type: research

Outcomes of Berlin Heart EXCOR ® pediatric ventricular assist device support in patients with restrictive and hypertrophic cardiomyopathy
This study reviews the North American experience with Berlin Heart EXCOR® ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR® were identified. Of these, nine (45%) were successfully bridged to transplant, one (5%) weaned from support, and 10 (50%) died after support was withdrawn. Of...
Source: Pediatric Transplantation - September 1, 2017 Category: Transplant Surgery Authors: Jennifer A. Su, Jondavid Menteer Tags: ORIGINAL ARTICLE Source Type: research

Atrial Fibrillation Decision Support Tool: Population Perspective
Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Source: American Heart Journal - August 23, 2017 Category: Cardiology Source Type: research

Heartburn drugs linked to premature death
Conclusion This larger set of observational data finds that PPI drugs are associated with an increase in the risk of early death compared with either H2 blockers or no acid suppression drugs. This was the case for participants both with and without gastrointestinal problems. It also appears as though the longer the PPIs drugs are taken, the greater the risk of death. Considering that these drugs are widely used in the UK, these findings may cause concern. But the research has a number of important limitations: The study was conducted in a population of mostly white, older US male veterans, which might limit the ability...
Source: NHS News Feed - July 4, 2017 Category: Consumer Health News Tags: Medication Source Type: news

Antithrombotic Therapy in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A North American Perspective--2016 Update Special Report
The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation is an emerging clinical problem. Currently, there is limited evidenced-based data on the optimal antithrombotic treatment regimen, including antiplatelet and anticoagulant therapies, for these high-risk patients with practice guidelines, thus, providing limited recommendations. Over the past years, expert consensus documents have provided guidance to clinicians on how to manage patients with atrial fibrillation undergoing percutaneous coronary intervention. Given the recen...
Source: Circulation: Cardiovascular Interventions - October 31, 2016 Category: Cardiology Authors: Angiolillo, D. J., Goodman, S. G., Bhatt, D. L., Eikelboom, J. W., Price, M. J., Moliterno, D. J., Cannon, C. P., Tanguay, J.-F., Granger, C. B., Mauri, L., Holmes, D. R., Gibson, C. M., Faxon, D. P. Tags: Atrial Fibrillation, Anticoagulants, Pharmacology, Stent Special Report Source Type: research

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