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Reporting Clinical End Points and Safety Events in an Acute Coronary Syndrome Trial: Results With Integrated Collection Coronary Heart Disease
ConclusionsAn integrated collection of end points and serious AEs is feasible in a multinational trial and illustrates the shared characteristics of events. Tailoring event collection to fit the phase and purpose of the trial is achievable and informative.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00831441.
Source: JAHA:Journal of the American Heart Association - April 24, 2017 Category: Cardiology Authors: Guimaraes, P. O., Lopes, R. D., Stevens, S. R., Zimerman, A., Wruck, L., James, S. K., Haque, G., Giraldez, R. R. C. V., Alexander, J. H., Alexander, K. P. Tags: Clinical Studies, Cardiovascular Disease, Myocardial Infarction, Acute Coronary Syndromes Original Research Source Type: research

Short-Term Risk of Bleeding During Heparin Bridging at Initiation of Vitamin K Antagonist Therapy in More Than 90 000 Patients With Nonvalvular Atrial Fibrillation Managed in Outpatient Care Epidemiology
BackgroundSeveral studies have recently examined the risks of bleeding and of ischemic stroke and systemic embolism associated with perioperative heparin bridging anticoagulation in patients with nonvalvular atrial fibrillation. However, few studies have investigated bridging risks during vitamin K antagonist initiation in outpatient settings.Methods and ResultsA retrospective cohort study was conducted on individuals starting oral anticoagulation between January 2010 and November 2014 for nonvalvular atrial fibrillation managed in outpatient care and identified from French healthcare insurance. Bleeding and ischemic strok...
Source: JAHA:Journal of the American Heart Association - October 30, 2016 Category: Cardiology Authors: Bouillon, K., Bertrand, M., Boudali, L., Ducimetiere, P., Dray-Spira, R., Zureik, M. Tags: Atrial Fibrillation, Epidemiology Original Research Source Type: research

Impact of Proton Pump Inhibitor Use on the Comparative Effectiveness and Safety of Prasugrel Versus Clopidogrel: Insights From the Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Health Services and Outcomes Research
ConclusionsPPIs did not significantly affect the MACE and bleeding risk associated with prasugrel use, relative to clopidogrel.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01088503.
Source: JAHA:Journal of the American Heart Association - September 27, 2016 Category: Cardiology Authors: Jackson, L. R., Peterson, E. D., McCoy, L. A., Ju, C., Zettler, M., Baker, B. A., Messenger, J. C., Faries, D. E., Effron, M. B., Cohen, D. J., Wang, T. Y. Tags: Quality and Outcomes Original Research Source Type: research

Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Ac...
Source: JAHA:Journal of the American Heart Association - September 22, 2016 Category: Cardiology Authors: Vora, A. N., Peterson, E. D., McCoy, L. A., Effron, M. B., Anstrom, K. J., Faries, D. E., Zettler, M. E., Fonarow, G. C., Baker, B. A., Stone, G. W., Wang, T. Y. Tags: Acute Coronary Syndromes, Coronary Artery Disease Original Research Source Type: research

Stability of High-Quality Warfarin Anticoagulation in a Community-Based Atrial Fibrillation Cohort: The Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study Epidemiology
Conclusions Nearly 60% of AF patients with high-quality TTR1 on warfarin maintained TTR ≥70% over the next 6 months. A minority deteriorated to very poor TTR. Patient features did not strongly predict TTR in the second 6-month period. Our analyses support watchful waiting for AF patients with initial high-quality warfarin anticoagulation before considering alternative anticoagulants.
Source: JAHA:Journal of the American Heart Association - July 21, 2016 Category: Cardiology Authors: Dallalzadeh, L. O., Go, A. S., Chang, Y., Borowsky, L. H., Fang, M. C., Singer, D. E. Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Anticoagulants Source Type: research

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Off-Hour Admission and Mortality Risk for 28 Specific Diseases: A Systematic Review and Meta-Analysis of 251 Cohorts Epidemiology
Conclusions Off-hour admission is associated with increased mortality risk, and the associations varied substantially for different diseases. Specialists, nurses, as well as hospital administrators and health policymakers can take these findings into consideration to improve the quality and continuity of medical services.
Source: JAHA:Journal of the American Heart Association - March 17, 2016 Category: Cardiology Authors: Zhou, Y., Li, W., Herath, C., Xia, J., Hu, B., Song, F., Cao, S., Lu, Z. Tags: Epidemiology, Risk Factors, Health Services, Meta Analysis, Mortality/Survival Source Type: research

Comparison of Approaches to Revascularization in Patients With Multivessel Coronary Artery Disease Presenting With ST-Segment Elevation Myocardial Infarction: Meta-analyses of Randomized Control Trials Interventional Cardiology
Conclusion Results suggest that CR and SR compared with CL reduce major adverse cardiovascular event and revascularization rates primarily by lowering repeated percutaneous coronary intervention rates. We did not observe any increase in the rate of adverse events while using a CR or SR strategy compared with a CL approach. Current guidelines discouraging CR need to be reevaluated, and clinical judgment should prevail in treating multivessel coronary artery disease patients with ST-segment elevation myocardial infarction as data from larger RCTs accumulate.
Source: JAHA:Journal of the American Heart Association - December 14, 2015 Category: Cardiology Authors: Bajaj, N. S., Kalra, R., Aggarwal, H., Ather, S., Gaba, S., Arora, G., McGiffin, D. C., Ahmed, M., Aslibekyan, S., Arora, P. Tags: Interventional Cardiology Source Type: research

Incremental Value of the CRUSADE, ACUITY, and HAS-BLED Risk Scores for the Prediction of Hemorrhagic Events After Coronary Stent Implantation in Patients Undergoing Long or Short Duration of Dual Antiplatelet Therapy Coronary Heart Disease
Conclusions Our analysis suggests that the CRUSADE score predicts major bleeding similarly to ACUITY and better than HAS BLED in an all-comer population with percutaneous coronary intervention and potentially identifies patients at higher risk of hemorrhagic complications when treated with a long-term dual antiplatelet therapy regimen. Clinical Trial Registration URL: http://clinicaltrials.gov. Unique identifier: NCT00611286.
Source: JAHA:Journal of the American Heart Association - December 7, 2015 Category: Cardiology Authors: Costa, F., Tijssen, J. G., Ariotti, S., Giatti, S., Moscarella, E., Guastaroba, P., De Palma, R., Ando, G., Oreto, G., Zijlstra, F., Valgimigli, M. Tags: Coronary Heart Disease Source Type: research

Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial Stroke
Conclusions High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. Clinical Trial Registration URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - December 1, 2015 Category: Cardiology Authors: Rao, M. P., Halvorsen, S., Wojdyla, D., Thomas, L., Alexander, J. H., Hylek, E. M., Hanna, M., Bahit, M. C., Lopes, R. D., De Caterina, R., Erol, C., Goto, S., Lanas, F., Lewis, B. S., Husted, S., Gersh, B. J., Wallentin, L., Granger, C. B., the Apixaban Tags: Stroke Source Type: research

Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research

Stroke and Bleeding Risk Associated With Antithrombotic Therapy for Patients With Nonvalvular Atrial Fibrillation in Clinical Practice Health Services and Outcomes Research
Conclusions Continuation of antithrombotic therapy as well as maintaining an adequate level of TTR is beneficial to prevent strokes while minimizing bleeding events.
Source: JAHA:Journal of the American Heart Association - July 17, 2015 Category: Cardiology Authors: An, J., Niu, F., Lang, D. T., Jazdzewski, K. P., Le, P. T., Rashid, N., Meissner, B., Mendes, R., Dills, D. G., Aranda, G., Bruno, A. Tags: Health Services and Outcomes Research Source Type: research

CYP2C19 Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Genetics
Conclusions There were significant differences in recurrent stroke by CYP2C19 genotype-inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on CYP2C19 and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the SPS3 trial does not appear to be explained by CYP2C19 genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique id...
Source: JAHA:Journal of the American Heart Association - May 27, 2015 Category: Cardiology Authors: McDonough, C. W., McClure, L. A., Mitchell, B. D., Gong, Y., Horenstein, R. B., Lewis, J. P., Field, T. S., Talbert, R. L., Benavente, O. R., Johnson, J. A., Shuldiner, A. R. Tags: Genetics Source Type: research

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