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An Invasive vs a Conservative Approach in Elderly Patients with Non –ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis
Conclusion The overall benefit with invasive strategy comes from the data of observational studies that are prone to selection bias. We believe that there is a need for a large randomized study in the elderly patients regarding management of NSTEMI.
Source: Canadian Journal of Cardiology - February 21, 2018 Category: Cardiology Source Type: research

Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE)
Conclusion MANAGE is the first randomized controlled trial to evaluate a potential treatment of patients who suffered MINS.
Source: Canadian Journal of Cardiology - February 3, 2018 Category: Cardiology Source Type: research

Aortic Arch Reconstructive Surgery with Conventional Techniques versus Frozen Elephant Trunk: A Systematic Review and Meta-Analysis
Conclusion Current evidence suggests that FET surgery is associated with lower mortality in patients with thoracic aneurysmal disease and dissections, without a significant increase in stroke, bleeding or operative times. However, the risk of spinal cord ischemia is increased in FET patients. A well powered randomized trial is needed to evaluate this evolving field. Teaser To our knowledge, we have performed the most detailed meta-analysis for the use of Frozen Elephant Trunk (FET) surgery, yielding a systematic review with the most number of patients studied. Our systematic review and meta-analysis uses the most up to dat...
Source: Canadian Journal of Cardiology - December 26, 2017 Category: Cardiology Source Type: research

Invasive or Conservative Approach in Elderly Patients with Non-ST-segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis
Conclusion The “overall” benefit with “invasive” strategy comes from the data of observational studies that are prone to selection bias. We believe that there is a need for a large randomised study in the elderly patients regarding management of NSTEMI. Teaser Trials comparing invasive with conservation treatment for elderly patients presenting with NSTEMI are limited resulting in considerable variation in the management of such patients. In the current systematic review, we tried to consolidate the current evidence on these 2 modes of treatment. There was a reduction in mortality with the invasive approach. Howeve...
Source: Canadian Journal of Cardiology - December 6, 2017 Category: Cardiology Source Type: research

Antiplatelet Effect of Different Loading Doses of Ticagrelor in Patients With Non –ST-Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: The APELOT Trial
Conclusions Doubling the ticagrelor LD achieved faster onset and greater platelet inhibition without an increase in adverse events in patients with NSTE-ACS undergoing PCI.
Source: Canadian Journal of Cardiology - December 3, 2017 Category: Cardiology Source Type: research

The Relationship Between Cardiologist Care and Clinical Outcomes in Patients With New-Onset Atrial Fibrillation
Conclusions Cardiologist care was associated with a reduction in death in patients with new-onset AF. Further study to obtain a greater understanding of the processes of care associated with the observed survival improvement is warranted.
Source: Canadian Journal of Cardiology - December 3, 2017 Category: Cardiology Source Type: research

Antiplatelet Effect of Different Loading Doses of Ticagrelor in Non-ST-Elevation Acute Coronary Syndrome Patients Undergoing PCI: The APELOT Trial
Conclusions Doubling the ticagrelor loading dose achieved faster onset and greater platelet inhibition without an increase in adverse events in patients with NSTE-ACS undergoing PCI.
Source: Canadian Journal of Cardiology - September 13, 2017 Category: Cardiology Source Type: research

Transcatheter vs Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Intermediate Risk Patients: A Meta-analysis
Conclusions Although there was no difference in 30-day and late mortality, the rate of complications differed between TAVR and SAVR in the low-intermediate surgical risk population.
Source: Canadian Journal of Cardiology - August 25, 2017 Category: Cardiology Source Type: research

Transcatheter Versus Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Intermediate Risk Patients: A Meta-Analysis
Conclusions While there was no difference in 30-day and late mortality, the rate of complications differed between TAVR and SAVR in the low-intermediate surgical risk population. Teaser In this meta-analysis, there was no difference in 30-day and median 1.5-year mortality outcomes between TAVR and SAVR. However, there was a higher incidence of aortic insufficiency, vascular complications and permanent pacemaker implantation after TAVR compared to SAVR and a higher incidence of atrial fibrillation, acute kidney injury, major bleeding and cardiogenic shock after SAVR compared to TAVR.
Source: Canadian Journal of Cardiology - June 16, 2017 Category: Cardiology Source Type: research

Rationale, Design and Baseline Characteristics of Participants in the Cardiovascular OutcoMes for People Using Anticoagulation StrategieS (COMPASS) Trial
Conclusion COMPASS will provide information on the efficacy and safety of rivaroxaban, alone or in combination with aspirin, in the long-term management of patients with stable CAD or PAD, and on the efficacy and safety of pantoprazole in preventing upper GI complications in patients receiving antithrombotic therapy. Teaser COMPASS is a global randomized controlled trial comparing rivaroxaban 2.5mg twice-daily plus aspirin 100mg once-daily, rivaroxaban 5mg twice-daily, and aspirin 100mg once-daily for prevention of myocardial infarction, stroke, or cardiovascular death in patients with stable coronary or peripheral artery ...
Source: Canadian Journal of Cardiology - June 8, 2017 Category: Cardiology Source Type: research

Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research

Antithrombotic Treatments for Stroke Prevention in Elderly Patients With Nonvalvular Atrial Fibrillation: Drugs and Doses
Publication date: September 2016 Source:Canadian Journal of Cardiology, Volume 32, Issue 9 Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are previous stroke and age ≥ 75 years. Canadian guidelines recommend anticoagulant therapy for patients with AF who are older than the age of 65 years, but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagu...
Source: Canadian Journal of Cardiology - August 25, 2016 Category: Cardiology Source Type: research

Antithrombotic treatments for stroke prevention in elderly patients with non-valvular atrial fibrillation: Drugs and doses
Publication date: Available online 14 June 2016 Source:Canadian Journal of Cardiology Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are prior stroke and age ≥75 years. Canadian guidelines recommend anticoagulant therapy for AF patients over the age of 65 but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagulants appear to be safer, at l...
Source: Canadian Journal of Cardiology - June 14, 2016 Category: Cardiology Source Type: research

Transradial vs Transfemoral Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: A Systemic Review and Meta-analysis
Conclusions The transradial approach for PCI in STEMI patients significantly reduced all-cause mortality, major and access site bleeding, major adverse cardiovascular events, and length of hospital stay. Difference in stroke incidence was not statistically significant with the transradial vs the transfemoral approach.
Source: Canadian Journal of Cardiology - May 24, 2016 Category: Cardiology Source Type: research

Uninterrupted New Oral Anticoagulants Compared With Uninterrupted Vitamin K Antagonists in Ablation of Atrial Fibrillation: A Meta-analysis
Conclusions Use of uninterrupted NOACs in ablation appears to be as safe and efficacious as use of uninterrupted VKAs.
Source: Canadian Journal of Cardiology - May 24, 2016 Category: Cardiology Source Type: research

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