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Contrast-free, echocardiography-guided left atrial appendage occlusion (LAAo): a propensity-matched comparison with conventional LAAo using the AMPLATZER ™ Amulet™ device
ConclusionsEchocardiographically guided LAAo without the use of contrast dye appears safe and feasible. This approach appears to be associated with reduced radiation exposure and may represent an alternative to traditional LAAo, especially in patients in whom the avoidance of contrast dye is warranted.
Source: Clinical Research in Cardiology - December 10, 2018 Category: Cardiology Source Type: research

Acute and long-term outcomes of epicardial left atrial appendage ligation with the second-generation LARIAT device: a high-volume electrophysiology center experience
ConclusionsEpicardial LAA ligation with the second-generation LARIAT device was associated with a high acute success rate comparable to endocardial LAA closure devices. LAA ligation was accompanied by a relevant incidence of periprocedural complications with mild pericarditis being the most common adverse event. Follow-up demonstrated a moderate incidence of leakages after LAA exclusion, no intracardiac thrombus formation and only a single thromboembolic event. The effectiveness in preventing thromboembolic events needs further investigation in larger patient cohorts.
Source: Clinical Research in Cardiology - June 7, 2018 Category: Cardiology Source Type: research

Antithrombotic therapy in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention: should we change our practice after the PIONEER AF-PCI and RE-DUAL PCI trials?
AbstractThe number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2DS2-VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known. In the rather small randomized WOEST trial, the combination of a vi...
Source: Clinical Research in Cardiology - April 20, 2018 Category: Cardiology Source Type: research

Risk factors and outcome of postoperative delirium after transcatheter aortic valve replacement
ConclusionsPatients with POD after TAVR are at increased risk for in-hospital mortality. However, after adjusting for postoperative events and comorbidities, stroke and bleeding, but not POD, are independent mortality predictors.
Source: Clinical Research in Cardiology - April 13, 2018 Category: Cardiology Source Type: research

Efficacy and safety of bivalirudin for percutaneous coronary intervention in acute coronary syndromes: a meta-analysis of randomized-controlled trials
ConclusionsCompared with heparin, bivalirudin was associated with a similar incidence of ischemic events following PCI for ACS. An association of bivalirudin with decreased bleeding was not seen with balanced use of GPI.
Source: Clinical Research in Cardiology - April 13, 2018 Category: Cardiology Source Type: research

NOAC monotherapy in patients with concomitant indications for oral anticoagulation undergoing transcatheter aortic valve implantation
ConclusionsThe results of this study suggest that NOAC therapy without additional antiplatelet treatment is effective and safe in patients with concomitant indications for OAC undergoing TAVI.
Source: Clinical Research in Cardiology - April 11, 2018 Category: Cardiology Source Type: research

Patent foramen ovale closure versus medical therapy for prevention of recurrent cryptogenic embolism: updated meta-analysis of randomized clinical trials
ConclusionsAmong patients with cryptogenic stroke and PFO, percutaneous closure of PFO is superior to medical therapy in preventing recurrent ischemic/embolic events and stroke but is associated with an increased risk of AF.
Source: Clinical Research in Cardiology - April 11, 2018 Category: Cardiology Source Type: research

Patent foramen ovale closure or medical therapy for cryptogenic ischemic stroke: an updated meta-analysis of randomized controlled trials
ConclusionsPFO-C after cryptogenic ischemic stroke is safe and effective to reduce the risk of recurrent stroke and recurrent stroke  + TIA, albeit with an increased risk for NOAF.
Source: Clinical Research in Cardiology - March 2, 2018 Category: Cardiology Source Type: research

Insights on mid-term TAVR performance: 3-year clinical and echocardiographic results from the CoreValve ADVANCE study
ConclusionsOur 3-year data demonstrate significant hemodynamic benefits and durable symptom relief after CoreValve prosthesis implantation. Postprocedural patient management should be carefully considered, since postprocedural valve-related events were identified as independent predictors of mid-term mortality.Trial registration ClinicalTrials.gov, NCT01074658.
Source: Clinical Research in Cardiology - May 8, 2017 Category: Cardiology Source Type: research

Comparative risk of major bleeding with new oral anticoagulants (NOACs) and phenprocoumon in patients with atrial fibrillation: a post-marketing surveillance study
ConclusionsApixaban therapy is associated with a significantly reduced risk of bleeding compared to phenprocoumon. Bleeding risk with dabigatran was similar to that of phenprocoumon but bleeding risk with rivaroxaban was higher.
Source: Clinical Research in Cardiology - March 13, 2017 Category: Cardiology Source Type: research

Safety and efficacy in ablation of premature ventricular contraction: data from the German ablation registry
ConclusionBased on the data from this registry, ablation of PVCs is a safe and efficient procedure with an excellent outcome and improved symptoms after 12  months.
Source: Clinical Research in Cardiology - August 1, 2016 Category: Cardiology Source Type: research

Deep sedation versus general anesthesia in percutaneous edge-to-edge mitral valve reconstruction using the MitraClip system
Conclusions In comparison to GA, DS reduces the ICU length of stay in PMVR without negative effects on safety and efficacy. Prospective randomized trials are needed to confirm these findings.
Source: Clinical Research in Cardiology - December 18, 2015 Category: Cardiology Source Type: research

Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome
Conclusions The primary and secondary end points were not enhanced in patients undergoing PCI. Therefore PCI is safe in patients with stroke/TIA and concomitant ACS.
Source: Clinical Research in Cardiology - October 29, 2015 Category: Cardiology Source Type: research

Efficacy and safety of novel oral anticoagulants in patients with bioprosthetic valves
Conclusion The use of NOAC therapy for AF in patients with bioprosthetic valves appears safe and effective in the occurrence of thromboembolic events, however, at the expense of increased bleeding. Larger studies are necessary to confirm these findings.
Source: Clinical Research in Cardiology - September 18, 2015 Category: Cardiology Source Type: research

Efficacy and safety of percutaneous left atrial appendage closure to prevent thromboembolic events in atrial fibrillation patients with high stroke and bleeding risk
Conclusion Left atrial appendage closure in patients with non-valvular atrial fibrillation and high risk for stroke and bleeding events effectively prevented stroke and reduced cerebral ischemic events compared to expected stroke rate according to CHA2DS2-VASc Score. Dual antiplatelet therapy for 3 months reduced the rate of bleeding events compared to 6 months therapy with no increase of thrombotic events.
Source: Clinical Research in Cardiology - August 29, 2015 Category: Cardiology Source Type: research

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