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Recurrent Myocardial Infarction After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction
In conclusion, recurrent MI after PPCI remains a relatively common complication in contemporary practice and confers a significantly increased risk of death, stroke, and bleeding.
Source: The American Journal of Cardiology - November 4, 2013 Category: Cardiology Authors: Wouter J. Kikkert, Loes P. Hoebers, Peter Damman, Krystien V.V. Lieve, Bimmer E.P.M. Claessen, Marije M. Vis, Jan Baan, Karel T. Koch, Robbert J. de Winter, Jan J. Piek, Jan G.P. Tijssen, Jose P.S. Henriques Tags: Coronary Artery Disease Source Type: research

Unanswered Questions in Patients With Concurrent Atrial Fibrillation and Acute Coronary Syndrome
In conclusion, until the results of additional ongoing or planned randomized trials are known, clinicians must continue to rely on expert opinion and their own clinical judgment when treating these patients.
Source: The American Journal of Cardiology - December 16, 2013 Category: Cardiology Authors: Daniel S. Ice, Timothy A. Shapiro, Eric M. Gnall, Peter R. Kowey Tags: Review Source Type: research

Usefulness and Safety of Vorapaxar in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention (from the TRACER Trial)
In conclusion, among patients with PCI, the effect of vorapaxar is consistent with the overall TRACER results. Patients who received a BMS underwent shorter courses of clopidogrel therapy and displayed trends toward greater ischemic benefit from vorapaxar and lesser bleeding risk, compared with patients who received a DES.
Source: The American Journal of Cardiology - June 20, 2014 Category: Cardiology Authors: Marco Valgimigli, Pierluigi Tricoci, Zhen Huang, Philip E. Aylward, Paul W. Armstrong, Frans Van de Werf, Sergio Leonardi, Harvey D. White, Petr Widimsky, Robert A. Harrington, Angel Cequier, Edmond Chen, Yuliya Lokhnygina, Lars Wallentin, John Strony, Ke Tags: Coronary Artery Disease Source Type: research

Comparison of Characteristics and Outcomes of Dabigatran versus Warfarin in Hypertensive Patients with Atrial Fibrillation (From the RE-LY® Trial)
Hypertension is frequent among patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg bid (D 110) and 150 mg bid (D 150) non-inferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D 110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed.
Source: The American Journal of Cardiology - July 28, 2015 Category: Cardiology Authors: Rangadham Nagarakanti, Lars Wallentin, Herbert Noack, Martina Brueckmann, Paul Reilly, Andreas Clemens, Stuart J. Connolly, Salim Yusuf, Michael D. Ezekowitz Source Type: research

Comparison of Characteristics and Outcomes of Versus in Hypertensive Patients With Atrial Fibrillation (from the RE-LY Trial)
Hypertension is frequent in patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg (D110) and 150 mg twice daily (D150) noninferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed.
Source: The American Journal of Cardiology - July 28, 2015 Category: Cardiology Authors: Rangadham Nagarakanti, Lars Wallentin, Herbert Noack, Martina Brueckmann, Paul Reilly, Andreas Clemens, Stuart J. Connolly, Salim Yusuf, Michael D. Ezekowitz Tags: Arrhythmias and Conduction Disturbances Source Type: research

The Quandary of Oral Anticoagulation in Patients with Atrial Fibrillation and Chronic Kidney Disease
Compared to patients with normal renal function, the prevalence of atrial fibrillation (AF) in chronic kidney disease (CKD) is increased, as is consequently the stroke prevalence in these patients. This increased risk of stroke in CKD patients is caused not only by the increased prevalence of AF, but also by associated comorbidities, and inherent platelet and vascular dysfunction. Paradoxically, imbalance in the same factors also increases the bleeding risk, imposing a dilemma as to whether anticoagulation should be prescribed or deferred, particularly in patients with end stage renal disease (ESRD), in whom the bleeding d...
Source: The American Journal of Cardiology - November 18, 2015 Category: Cardiology Authors: Shmuel Schwartzenberg, Eli I. Lev, Alik Sagie, Asher Korzets, Ran Kornowski Source Type: research

Drug-coated balloon for in-stent restenosis in high risk patients: Another brick in the wall of the challenging settings for interventionists
Recently Miglionico et al. published in this Journal an interesting prospective observational study regarding 82 high-risk patients with in-stent restenosis of bare metal stent (BMS), n=48 (59%) or drug-eluting stent (DES), n=34 (41%) .1 All patients had at least one of the following high-risk features: history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or non-cardiac surgery or recent surgery, chronic inflammatory disease or neoplasm.
Source: The American Journal of Cardiology - March 21, 2016 Category: Cardiology Authors: Dario Buccheri, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Source Type: research

Drug-Coated Balloon for Instent Restenosis in Patients at High Risk: Another Brick in the Wall of the Challenging Settings for Interventionists
Recently, Miglionico et al1 published in this journal an interesting prospective observational study regarding 82 patients at high-risk with instent restenosis of bare-metal stent, n = 48 (59%) or drug-eluting stent (DES), n = 34 (41%). All patients had at least one of the following high-risk features: a history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or noncardiac surgery or recent surgery, chronic inflammatory disease, or neoplasm.
Source: The American Journal of Cardiology - March 20, 2016 Category: Cardiology Authors: Dario Bucchei, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Tags: Readers' Comments Source Type: research

Safety and Efficacy of Uninterrupted Apixaban Therapy Versus Warfarin During Atrial Fibrillation Ablation
Thromboembolic cerebrovascular accident remains a rare but potentially devastating complication of catheter based atrial fibrillation (AF) ablation. Uninterrupted oral anticoagulant (OAC) therapy with warfarin has become the standard of care when performing catheter based AF ablation. Compared with warfarin, apixaban, a factor Xa inhibitor, has been shown to reduce the risk of stroke and major bleeding in non-valvular AF. With an increase in apixaban use for stroke prophylaxis in AF patients there is an increased interest in the safety and efficacy of uninterrupted apixaban therapy during AF ablation.
Source: The American Journal of Cardiology - May 10, 2017 Category: Cardiology Authors: Ruchit R. Shah, Ajay Pillai, Pascha Schafer, David Meggo, Tom McElderry, Vance Plumb, Takumi Yamada, Vineet Kumar, Harish Doppalapudi, Alicia Gunter, Emily Pentecost, William R. Maddox Source Type: research

Bleeding Risk Scores in Atrial Fibrillation and Venous Thromboembolism
Patients receiving oral anticoagulant (OAC) therapy for stroke prevention in atrial fibrillation (AF) and prevention of venous thromboembolism (VTE) face an increased risk of bleeding with OAC treatment. Clinicians need to weigh-up the benefits of OAC treatment against the risk of bleeding. To help formalise bleeding risk assessment, various bleeding risk scores have been developed to help predict the risk of bleeding in AF and VTE patients receiving anticoagulant therapy. This review summarises the literature involving original studies deriving bleeding risk scores and validation studies of these scores for stroke prevent...
Source: The American Journal of Cardiology - July 14, 2017 Category: Cardiology Authors: Hanis Zulkifly, Gregory Yoke Hong Lip, Deirdre Anne Lane Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and End Stage Renal Disease
Over the last decade there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) demonstrated favorable clinical outcomes compared to warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) is a particularly complex issue. CKD and ESRD increase both the risk of stroke as well as bleeding, and since all of the NOACs undergo various level of renal clearance, rena...
Source: The American Journal of Cardiology - October 13, 2017 Category: Cardiology Authors: Marin Nishimura, Jonathan C. Hsu Source Type: research

Non –Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and End-Stage Renal Disease
Over the past decade, there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the non –vitamin K antagonist oral anticoagulants (NOACs) demonstrated favorable clinical outcomes compared with warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) are a part icularly complex issue. CKD and ESRD increase both the risk of stroke and bleeding, and since all of the NOACs undergo various levels of renal clearance, re...
Source: The American Journal of Cardiology - October 13, 2017 Category: Cardiology Authors: Marin Nishimura, Jonathan C. Hsu Tags: Review Source Type: research

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients with Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients of nonvalvular atrial fibrillation with LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n  = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

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

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