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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

Concomitant Use of Single Antiplatelet Therapy With Edoxaban or Warfarin in Patients With Atrial Fibrillation: Analysis From the ENGAGE AF-TIMI48 Trial Arrhythmia and Electrophysiology
Conclusions Patients with AF who were selected by their physicians to receive SAPT in addition to an anticoagulant had a similar risk of stroke/SEE and higher rates of bleeding than those not receiving SAPT. Edoxaban exhibited similar relative efficacy and reduced bleeding compared to warfarin, with or without concomitant SAPT. Clinical Trial Registration URL: http://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Xu, H., Ruff, C. T., Giugliano, R. P., Murphy, S. A., Nordio, F., Patel, I., Shi, M., Mercuri, M., Antman, E. M., Braunwald, E. Tags: Platelets, Chronic Ischemic Heart Disease, Anticoagulants, Acute Coronary Syndromes Arrhythmia and Electrophysiology Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology 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

Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease: An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial Coronary Heart Disease
Conclusions In this post-hoc analysis, COPD patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in COPD patients, without increasing overall major bleeding events. The benefit-risk profile supports the use of ticagrelor in patients with ACS and concomitant COPD. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
Source: JAHA:Journal of the American Heart Association - October 9, 2015 Category: Cardiology Authors: Andell, P., James, S. K., Cannon, C. P., Cyr, D. D., Himmelmann, A., Husted, S., Keltai, M., Koul, S., Santoso, A., Steg, P. G., Storey, R. F., Wallentin, L., Erlinge, D., the PLATO Investigators Tags: Coronary Heart Disease Source Type: research

Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta-Analysis Stroke
Conclusions Long-term monotherapy was a better choice than long-term dual therapy, and cilostazol had the best risk–benefit profile for long-term secondary prevention after stroke or transient ischemic attack. More randomized controlled trials in non–East Asian patients are needed to determine whether long-term use of cilostazol is the best option for the prevention of recurrent stroke.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Xie, W., Zheng, F., Zhong, B., Song, X. 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

Outcome Reporting in Cardiac Surgery Trials: Systematic Review and Critical Appraisal Cardiovascular Surgery
Conclusions Outcome reporting in the cardiac surgery literature is heterogeneous, and efforts should be made to standardize the outcomes reported and the definitions used to ascertain them. The development of standardizing outcome reporting is an essential step toward strengthening the process of evidence-based care in cardiac surgery.
Source: JAHA:Journal of the American Heart Association - August 17, 2015 Category: Cardiology Authors: Goldfarb, M., Drudi, L., Almohammadi, M., Langlois, Y., Noiseux, N., Perrault, L., Piazza, N., Afilalo, J. Tags: Cardiovascular Surgery 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

Effectiveness and Safety of Dabigatran and Warfarin in Real-World US Patients With Non-Valvular Atrial Fibrillation: A Retrospective Cohort Study Health Services and Outcomes Research
Conclusions Dabigatran could be a safe and potentially more effective alternative to warfarin in patients with atrial fibrillation managed in routine practice settings.
Source: JAHA:Journal of the American Heart Association - April 10, 2015 Category: Cardiology Authors: Lauffenburger, J. C., Farley, J. F., Gehi, A. K., Rhoney, D. H., Brookhart, M. A., Fang, G. Tags: Health Services and Outcomes Research Source Type: research

Efficacy and Safety of Vorapaxar as Approved for Clinical Use in the United States Coronary Heart Disease
Conclusions In patients with prior MI or PAD who have not had a previous stroke or TIA, vorapaxar added to standard therapy is effective for long-term secondary prevention of thrombotic CV events, while increasing moderate or severe bleeding. Clinical Trial Registration URL: clinicaltrials.gov Unique Identifier: NCT00526474.
Source: JAHA:Journal of the American Heart Association - March 19, 2015 Category: Cardiology Authors: Magnani, G., Bonaca, M. P., Braunwald, E., Dalby, A. J., Fox, K. A. A., Murphy, S. A., Nicolau, J. C., Oude Ophuis, T., Scirica, B. M., Spinar, J., Theroux, P., Morrow, D. A. Tags: Coronary Heart Disease Source Type: research

Reduction in Overall Occurrences of Ischemic Events With Vorapaxar: Results From TRACER Coronary Heart Disease
Conclusions Vorapaxar reduced overall occurrences of ischemic events, but increased bleeding. These exploratory findings broaden our understanding of vorapaxar's potential and expand our understanding of the value of capturing recurrent events. Clinical Trial Registration URL: ClinicalTrials.gov. Unique identifier: NCT00527943.
Source: JAHA:Journal of the American Heart Association - July 10, 2014 Category: Cardiology Authors: White, H. D., Huang, Z., Tricoci, P., Van de Werf, F., Wallentin, L., Lokhnygina, Y., Moliterno, D. J., Aylward, P. E., Mahaffey, K. W., Armstrong, P. W. Tags: Coronary Heart Disease Source Type: research

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