• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Trends in the Utilization of Left Atrial Appendage Exclusion in the United States
Stroke prevention remains a cornerstone in the management of patients with non-valvular atrial fibrillation (NVAF)1. Oral anticoagulation (OAC) is the main method of stroke prevention in NVAF worldwide. However,>50% of high-risk NVAF patients are not maintained on OAC due to comorbidities, frailty, bleeding complications, or non-compliance2. In 1996, Blackshear proposed Left atrial appendage exclusion (LAAE) as an alternative stroke prevention strategy in NVAF3. Because no randomized data were available to support the routine use of LAAE, its utilization remained initially limited to selected patients undergoing a concomitant cardiac surgery.
Source: The American Journal of Cardiology - April 6, 2020 Category: Cardiology Authors: Safi U. Khan, Muhammad Zia Khan, Mohamad Alkhouli Source Type: research

Reader's Comments: Trends in the Utilization of Left Atrial Appendage Exclusion in the United States
Stroke prevention remains a cornerstone in the management of patients with nonvalvular atrial fibrillation (NVAF).1 Oral anticoagulation is the main method of stroke prevention in NVAF worldwide. However,>50% of high-risk NVAF patients are not maintained on oral anticoagulation due to comorbidities, frailty, bleeding complications, or noncompliance.2 In 1996, Blackshear proposed left atrial appendage exclusion (LAAE) as an alternative stroke prevention strategy in NVAF.3 Because no randomized data were available to support the routine use of LAAE, its utilization remained initially limited to selected patients undergoing a...
Source: The American Journal of Cardiology - April 6, 2020 Category: Cardiology Authors: Safi U. Khan, Muhammad Zia Khan, Mohamad Alkhouli Source Type: research

Observed versus Expected Ischemic and Bleeding Events Following Left Atrial Appendage Occlusion
Data on the efficacy of left atrial appendage occlusion (LAAO) in clinical practice are limited. We performed a systematic review and meta-analysis of observational studies that reported observed vs. expected rates of ischemic strokes and/or major bleeding following LAAO. Our primary end points were the pooled relative risk reduction (RRR) in ischemic stroke and major bleeding with corresponding 95% confidence intervals (CI) compared with what was expected by the CHA2DS2-VASc and HASBLED scores, respectively.
Source: The American Journal of Cardiology - March 13, 2020 Category: Cardiology Authors: Tatiana Busu, Safi U Khan, Muhammad Alhajji, Fahad Alqahtani, David R Holmes, Mohamad Alkhouli Source Type: research

Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research

Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices
New-generation devices such as Evolut and Portico have provided favorable results in patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing on long-term outcomes, including major adverse events (i.e., the composite of death, stroke, myocardial infarction, major vascular complication, or major bleeding).
Source: The American Journal of Cardiology - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Long-term Follow-up of Transcatheter Aortic Valve Implantation with Portico vs. Evolut devices
New-generation devices such as Evolut and Portico have provided favorable results in patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing long-term outcomes, including the major adverse events (i.e. the composite of death, stroke, myocardial infarction, major vascular complication or major bleeding).
Source: The American Journal of Cardiology - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Safety and Efficacy of Direct Oral Anticoagulants Versus Warfarin in Patients with Chronic Kidney Disease and Atrial Fibrillation
This study evaluated and compared the safety outcomes of DOACs versus warfarin in patients with non-valvular AF and concomitant CKD. Patients in our health system with AF prescribed oral anticoagulants during 2010 to 2017 were identified. All-cause mortality, bleeding, and hemorrhagic and ischemic stroke were evaluated based on degree of renal impairment and method of anticoagulation.
Source: The American Journal of Cardiology - October 30, 2019 Category: Cardiology Authors: Amber Makani, Samir Saba, Sandeep K. Jain, Aditya Bhonsale, Michael S. Sharbaugh, Floyd Thoma, Yisi Wang, Oscar C. Marroquin, Joon S. Lee, N.A. Mark Estes, Suresh R. Mulukutla 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

Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy After Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment
The patient's profile drawing the greatest benefit from dual antiplatelet therapy (DAPT) after a non-cardioembolic, ischemic cerebrovascular event is not well characterized. Aim of this meta-regression analysis was to compare DAPT versus single antiplatelet therapy (SAPT) in patients with stroke or transient ischemic attack (TIA). We searched randomized trials evaluating clinical outcome with aspirin plus a P2Y12 inhibitor versus SAPT in patients with non-cardioembolic stroke or TIA. Primary endpoint was the incidence of recurrent stroke; safety outcome measure was major bleeding.
Source: The American Journal of Cardiology - May 24, 2019 Category: Cardiology Authors: Giuseppe Patti, Alessandro Sticchi, Antonio Bisignani, Francesco Pelliccia, Vincenzo Pasceri, Giulio Speciale, Maria Penco 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

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

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

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

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

Pages: 1  2  3  4  5  6  7  8  9  10