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Source: The American Journal of Cardiology
Condition: Bleeding

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Total 138 results found since Jan 2013.

Another Step Forward in Our Ability to Predict Percutaneous Coronary Intervention Outcomes
Despite advancements in devices, technique, and patient selection, adverse events including bleeding, vascular complications, myocardial infarction, stroke, and death still occur during percutaneous coronary intervention (PCI). Accurate and up-to-date risk-adjusted models that predict mortality after PCI are important to inform clinical decision making, identify patient factors that increase risk, provide a standardized format to measure programmatic quality, and drive continuous quality improvement efforts to improve operator outcomes.
Source: The American Journal of Cardiology - September 18, 2023 Category: Cardiology Authors: Araba Ofosu-Somuah, Matthew A. Cavender, George A. Stouffer Tags: Editorial Source Type: research

Direct Oral Anticoagulants: Patients Benefit When Prescribers Get the Message
Direct oral anticoagulants (DOACs) have demonstrated similar or better efficacy to warfarin in reducing stroke and systemic embolic events in large-scale prospective trials.1 –4 In addition, these trials demonstrated either noninferiority or superiority in reducing bleeding events compared with warfarin. To treat high-risk patients with atrial fibrillation (AF) and avoid bleeding in low-risk patients, current guidelines recommend oral anticoagulants in high-risk patien ts with AF with CHA2DS2VASc scores of ≥2 in men and ≥3 in women.
Source: The American Journal of Cardiology - September 5, 2023 Category: Cardiology Authors: Gerald V. Naccarelli Tags: Editorial Source Type: research

Systematic Review and Meta-Analysis of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation With Low Stroke Risk
Oral anticoagulation (OAC) in patients with atrial fibrillation (AF) has been shown to prevent thromboembolic complications, but concerns about the increased risk of major bleeding warrant judicious consideration of the risks and benefits.1 Current guidelines recommend OAC prescription for patients with AF at high risk of stroke, as measured by CHA2DS2-VASc scores of ≥2 and ≥3 in men and women respectively.2–4 Men and women with scores of 1 and 2 respectively (i.e., a single nongender-related stroke risk factor) are deemed to be at low-moderate risk of stroke and OAC prescription may be considered to reduce thromboem...
Source: The American Journal of Cardiology - August 11, 2023 Category: Cardiology Authors: Khi Yung Fong, Yiong Huak Chan, Colin Yeo, Gregory Y.H. Lip, Vern Hsen Tan Source Type: research

Antithrombotic Medication and Major Complications After Mechanical Aortic Valve Replacement
Patients with mechanical aortic valve replacement (AVR) require lifelong vitamin K antagonist (VKA) therapy for stroke and systemic embolism prevention. However, VKA treatment predisposes patients to various types of bleeding. In the present study, we sought to assess the success of antithrombotic therapy and the occurrence and timing of strokes and bleeding events after mechanical AVR. A total of 308 patients who underwent isolated mechanical AVR were included in the study, and follow-up data were completed for 306 patients (99.4%).
Source: The American Journal of Cardiology - August 5, 2023 Category: Cardiology Authors: Rikhard Bj örn, Joonas Lehto, Markus Malmberg, Vesa Anttila, K.E. Juhani Airaksinen, Jarmo Gunn, Tuomas Kiviniemi Source Type: research

Quest for the Perfect Anticoagulant
The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with...
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Bryant Fisher, Danny Chu Source Type: research

Percutaneous Left Atrial Appendage Closure Among Patients With Diabetes (Insights from a National Database)
Atrial fibrillation is a major risk factor for stroke. Left atrial appendage closure (LAAC) has emerged as an alternative to anticoagulation for patients with high risk of bleeding. Diabetes mellitus (DM) is associated with adverse events after cardiac procedures. We sought to compare procedural and hospital outcomes in patients who underwent LAAC with and without DM. The Nationwide Inpatient Database was queried for patients with atrial fibrillation who underwent LAAC between January 1, 2016, and December 31, 2019.
Source: The American Journal of Cardiology - July 11, 2023 Category: Cardiology Authors: Mohamed Hamed, Ramez Morcos, Ayman Elbadawi, Ahmed Osman, Hani Jneid, Wissam Khalife, Brijeshwar Maini, Houman Khalili Source Type: research

An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients With Atrial Fibrillation
The availability of direct oral anticoagulants (DOACs) with known lower bleeding risk compared with warfarin have raised questions about the role of left atrial appendage closure (LAAC). We aimed to perform a meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All studies directly comparing LAAC with DOACs up to January 2023 were included. The outcomes studied included the combined major adverse cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic events, major bleeding, CV mortality, and all-cause mortality.
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Haowen Jiang, Tian Hai Koh, Vijay Vengkat, Gao Fei, Zee Pin Ding, See Hooi Ewe, Ignasius Jappar, Soo Teik Lim, Jonathan Yap Source Type: research

Comparison of Stroke and Bleeding Risk Profile in Patients With Atrial Fibrillation and Chronic Kidney Disease
This study explores the impact of glomerular filtration rate (GFR) in the embolic-hemorrhagic balance among a large cohort of patients with AF. The study cohort included 15,457 patients diagnosed with AF between January 2014 and April 2020. The risk of ischemic stroke and major bleeding was determined by competing risk regression.
Source: The American Journal of Cardiology - April 12, 2023 Category: Cardiology Authors: Jos é Antonio Parada Barcia, Sergio Raposeiras Roubin, Emad Abu-Assi, Pablo Domínguez Erquicia, Andrea Lizancos Castro, Lucía Rioboo Lestón, Juan Ocampo Míguez, Inmaculada González Bermúdez, Andrés Íñiguez-Romo Source Type: research

Impact of Frailty on In-Hospital Outcomes in Patients Who Underwent Percutaneous Left Atrial Appendage Occlusion
In patients with atrial fibrillation, frailty is associated with an increased risk of bleeding, especially if patients take oral anticoagulation for stroke prophylaxis.1 Left atrial appendage occlusion (LAAO) is an alternative in patients unable to tolerate anticoagulation. However, whether patients who are frail are more vulnerable to procedural complications associated with LAAO remains undefined.2 We therefore examined in-hospital outcomes in patients who undergo LAAO procedures using a nationally representative real-world cohort of patients.
Source: The American Journal of Cardiology - April 9, 2023 Category: Cardiology Authors: Siddharth Agarwal, Muhammad Bilal Munir, Agam Bansal, Christopher V. DeSimone, Usman Baber, Abhishek Deshmukh, Zain Ul Abideen Asad Source Type: research

Effect of Duration of Anticoagulation in the Incidence of Stroke in Patients With Left-Ventricular Thrombus
The optimal duration of anticoagulation in patients with left-ventricular thrombus (LVT) is unclear. In the present study, we aimed to analyze the effect of treatment duration ( ≤12 months [short-term anticoagulation, (STA)] versus>12 months [long-term anticoagulation, (LTA)]) in the incidence of stroke and other secondary outcomes (acute myocardial infarction, bleeding, and mortality). Multivariate Cox regression was used to determine the association between treatment duration and stroke, adjusted for baseline embolic risk.
Source: The American Journal of Cardiology - October 12, 2022 Category: Cardiology Authors: Álvaro Lorente-Ros, Gonzalo L. Alonso-Salinas, Juan M. Monteagudo Ruiz, María Abellás-Sequeiros, José M. Vieítez-Florez, Diego Sánchez Vega, Jesús Álvarez-Garcia, Marcelo Sanmartín-Fernández, Marta Lorente-Ros, Susana del Prado Díaz, Covadonga Source Type: research

Reply to the Comment on “Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation”
We thank Dr. Abrahim et al for their interest and valuable comment on our study.1 In the methodology section, we intended to recruit stable patients who were able to use the standard anticoagulation in the outpatient setting. Therefore, we excluded the patients with acute stroke within 2  weeks or patients with high-bleeding risk. All the patients received standard rate control therapy according to the relevant guideline.2 The proportion of medications for rate control such as β blocker (56% of overall patients), calcium channel blocker (24%), or digitalis (31%) were already prese nted, and the mean heart rate was 74.1 ± 14.2 beats/min.
Source: The American Journal of Cardiology - October 10, 2022 Category: Cardiology Authors: Min Soo Cho, Duk-Hyun Kang, Kee-Joon Choi Source Type: research

Influence of the Danish Co-morbidity Index Score on the Treatment and Outcomes of 2.5 Million Patients Admitted With Acute Myocardial Infarction in the United States
This study aimed to determine the association between the Danish Co-morbidity Index for Acute Myocardial Infarction (DANCAMI) and restricted DANCAMI (rDANCAMI) scores and clinical outcomes in patients hospitalized with AMI. Using the National Inpatient Sample, all AMI hospitalizations were stratified into four groups based on their DANCAMI and rDANCAMI score (0; 1 to 3; 4 to 5; ≥6). The primary outcome was all-cause mortality, whereas secondary outcomes were major adverse cardiovascular/cerebrovascular events, major bleeding, ischemic stroke, and receipt of coronary angiography or percutaneous coronary intervention.
Source: The American Journal of Cardiology - July 14, 2022 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Abhishek, Philip Freeman, Jan Walter Dhillon Shanmuganathan, Mohamed O. Mohamed, Christian Mallen, Mamas A. Mamas Source Type: research

Meta-Analysis Comparing Apixaban Versus Rivaroxaban for Management of Patients With Nonvalvular Atrial Fibrillation
To compare the efficacy and safety of apixaban and rivaroxaban for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) by way of a meta-analysis informed by real-world evidence. Systematic review and meta-analysis of observational studies including patients with NVAF on apixaban and rivaroxaban, which reported stroke/systemic embolism and/or major bleeding. Prospero registration number: CRD42021251719. Estimates of relative treatment effect (based on hazard ratios[HRs]) were pooled using the inverse variance method.
Source: The American Journal of Cardiology - December 20, 2021 Category: Cardiology Authors: Mamas A. Mamas, Sarah Batson, Kevin G. Pollock, Sarah Grundy, Andrew Matthew, Chris Chapman, Joana Assis Manuel, Usman Farooqui, Stephen A. Mitchell Source Type: research

Effectiveness and Safety of Apixaban Versus Warfarin in Obese Patients with Nonvalvular Atrial Fibrillation Enrolled in Medicare and Veteran Affairs
Real-world studies have evaluated the use of anticoagulants in obese patients with nonvalvular atrial fibrillation (NVAF), but they have been limited by sample size or the use of diagnosis codes on claims to define obesity. This retrospective study used body weight data of ≥100 kg or a body mass index of ≥30 kg/m2 to identify elderly (aged ≥65 years) NVAF patients with obesity in dually enrolled Veterans Affairs and fee-for-service Medicare patients. It evaluated the risk of stroke/systemic embolism (SE) and major bleeding (MB) in patients that initiated apixaba n versus warfarin.
Source: The American Journal of Cardiology - December 18, 2021 Category: Cardiology Authors: Steve Deitelzweig, Janvi Sah, Amiee Kang, Cristina Russ, Madison Preib, Amol D. Dhamane, Anna Ratiu, Matthew Cato, Tamuno Alfred, Edi Levi, Manuela Di Fusco Source Type: research

Outcomes of Direct Oral Anticoagulants Co-Prescribed with Common Interacting Medications
We examined the prevalence of co-prescription of DOACs with interacting medications and its impact on outcomes in patients with atrial fibrillation (AF). Patients with AF treated with a DOAC from 2010 to 2017 at the Mayo Clinic and co-prescribed medications that are inhibitors or inducers of the P-glycoprotein and/or Cytochrome P450 3A4 pathways were identified. The outcomes of stroke, transient ischemic attack, or systemic embolism, major bleeding, and minor bleeds were compared between patients with and without an enzyme inducer.
Source: The American Journal of Cardiology - October 27, 2021 Category: Cardiology Authors: David Sanborn, Alan Sugrue, Mustapha Amin, Ramila Mehta, Medhat Farwati, Abhishek J. Deshmukh, Haarini Sridhar, Azza Ahmed, Samuel J. Asirvatham, Narith N. Ou, Peter A. Noseworthy, Ammar M. Killu, Siva K. Mulpuru, Malini Madhavan Source Type: research