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Source: The American Journal of Cardiology
Condition: Thrombosis
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Total 75 results found since Jan 2013.
Direct Oral Anticoagulants in the Setting of Percutaneous Coronary Intervention: “There Will Be Blood”
Direct oral anticoagulants (DOACs) are being increasingly used in clinical practice for various indications ranging from treatment of venous thromboembolism1 to stroke thromboprophylaxis in atrial fibrillation.2 Clinical practice guidelines now endorse DOACs in preference to vitamin K antagonists (VKAs) for thromboprophylaxis in patients with atrial fibrillation and after venous thromboembolism, reflecting the favorable efficacy and safety profile of this anticoagulant class compared with VKA.3 Despite increasing DOAC utilization, the optimal periprocedural antithrombotic management for patients treated with DOAC who under...
Source: The American Journal of Cardiology - August 12, 2023 Category: Cardiology Authors: Maximillian T. Bourdillon, Konstantinos Charitakis Tags: Editorial Source Type: research
Meta-Analysis of the Outcomes of Peri-Device Leak After Left Atrial Appendage Closure
Left atrial appendage closure (LAAC) reduces the risk of thromboembolic stroke in atrial fibrillation. Peri-device leak (PDL) after LAAC may affect the subsequent risk of thromboembolism. We conducted a systematic review and meta-analysis to evaluate the effect of PDL after LAAC. We searched PubMed/Medline, Embase, and Google Scholar for studies reporting outcomes of PDL after LAAC from inception through October 2022. The primary outcome was the composite of stroke, transient ischemic attack (TIA), or systemic embolism (SE).
Source: The American Journal of Cardiology - August 10, 2023 Category: Cardiology Authors: Mostafa Reda Mostafa, Mohamed Magdi Eid, Mohamed Abuelazm, Ahmad Al-Abdouh, Mostafa Najim, Abdul Rhman Hassan, Amro A. El-Sakka, Sarath Lal Mannumbeth Renjithal, Muhammad Ahmed Malik, Sarah Mohamed, Mallory Balmer-Swain, Timir K. Paul, Andrew M. Goldsweig Source Type: research
Effect of Concomitant Cardiac Arrest on Outcomes in Patients With Acute Coronary Syndrome-Related Cardiogenic Shock
Patients with acute coronary syndrome (ACS)-related cardiogenic shock (CS) with or without concomitant CA may have disparate prognoses. We compared clinical characteristics and outcomes of patients with CS secondary to ACS with and without cardiac arrest (CA). Between 2014 and 2020, 1,573 patients with ACS-related CS with or without CA who underwent percutaneous coronary intervention enrolled in a multicenter Australian registry were analyzed. Primary outcome was 30-day major adverse cardiovascular and cerebrovascular events (MACCE) (composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularization and stroke).
Source: The American Journal of Cardiology - August 2, 2023 Category: Cardiology Authors: Wayne C. Zheng, Diem Dinh, Samer Noaman, Jason E. Bloom, Riley J. Batchelor, Jeffrey Lefkovits, Angela L. Brennan, Christopher M. Reid, Omar Al-Mukhtar, James A. Shaw, Dion Stub, Yang Yang, Craig French, David M. Kaye, Nicholas Cox, William Chan Source Type: research
Efficacy of Percutaneous Coronary Intervention With Synergy Stents in Patients Aged ≥75 Years: 1-Year Clinical Outcomes from the Synergy Elderly Registry
This study investigated the 12-month clinical outcomes of older patients who underwent percutaneous coronary intervention with new-generation drug-eluting stents according to ischemic risks. This prospective multicenter study targeted patients aged ≥75 years who underwent S-EES implantation. The primary and secondary end points included 12-month device-oriented composite end point (DOCE) (cardiovascular death, target vessel myocardial infarction, or target lesion revascularization) and major adverse cardiac and cerebrovascular events (MACCE s; all-cause death, myocardial infarction, target vessel revascularization, sten...
Source: The American Journal of Cardiology - August 1, 2023 Category: Cardiology Authors: Jong-Il Park, Seung-Jun Lee, Young-Joon Hong, Sang-Yong Yoo, Yong-Sung Seo, Eui Im, Jong-Kwan Park, Jin-Bae Lee, Yong-Joon Lee, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Byeong-Keuk Kim Source Type: research
Quest for the Perfect Anticoagulant
The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with...
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Bryant Fisher, Danny Chu Source Type: research
Effect of Anticoagulation Duration on Stroke Incidence in Asian Patients With Left Ventricular Thrombus
Left ventricular thrombus (LVT) occurs in acute myocardial infarction (AMI) and in ischemic and nonischemic cardiomyopathies.1,2 LVT may result in embolic stroke.3 We read with interest the study by Lorente-Ros et al4 published in the American Journal of Cardiology. That study, conducted in a Spanish cohort, found that prolonged anticoagulation>12 months for LVT was associated with lower stroke risk. We aimed to study the generalizability of these results in an Asian population because the original article was a single-center study with limited representation.
Source: The American Journal of Cardiology - January 24, 2023 Category: Cardiology Authors: Fang Qin Goh, Aloysius S.T. Leow, Jamie S.Y. Ho, Benjamin Y.Q. Tan, Leonard L.L. Yeo, Ching-Hui Sia Source Type: research
Response to Readers ’ Comments “Effect of Anticoagulation Duration on Stroke Incidence in Asian Patients With Left Ventricular Thrombus”
We appreciate the interest and feedback that our recently published article, “Effect of Duration of Anticoagulation in the Incidence of Stroke in Patients With Left Ventricular Thrombus,” has generated.1 In our study, we found that long-term anticoagulation (LTA,>12 months) was associated with lower risk of stroke than was short-term anticoagulation (STA) in a cohort of 98 patients with left ventricular thrombus (LVT). In a Letter to the Editor, in a large well-conducted study, Goh et al2 investigated the generalizability of the results in an Asian population , reporting no differences in the incidence of stroke in p...
Source: The American Journal of Cardiology - January 21, 2023 Category: Cardiology Authors: Álvaro Lorente-Ros, Gonzalo L. Alonso-Salinas, Juan M. Monteagudo Ruiz, José L. Zamorano Gómez Source Type: research
Effect of Duration of Anticoagulation in the Incidence of Stroke in Patients With Left-Ventricular Thrombus
The optimal duration of anticoagulation in patients with left-ventricular thrombus (LVT) is unclear. In the present study, we aimed to analyze the effect of treatment duration ( ≤12 months [short-term anticoagulation, (STA)] versus>12 months [long-term anticoagulation, (LTA)]) in the incidence of stroke and other secondary outcomes (acute myocardial infarction, bleeding, and mortality). Multivariate Cox regression was used to determine the association between treatment duration and stroke, adjusted for baseline embolic risk.
Source: The American Journal of Cardiology - October 12, 2022 Category: Cardiology Authors: Álvaro Lorente-Ros, Gonzalo L. Alonso-Salinas, Juan M. Monteagudo Ruiz, María Abellás-Sequeiros, José M. Vieítez-Florez, Diego Sánchez Vega, Jesús Álvarez-Garcia, Marcelo Sanmartín-Fernández, Marta Lorente-Ros, Susana del Prado Díaz, Covadonga Source Type: research
Adverse Impact of Peri-Procedural Stroke in Patients Who Underwent Percutaneous Coronary Intervention
Peri-procedural stroke (PPS) is an important complication in patients who underwent percutaneous coronary intervention (PCI). The extent to which PPS impacts mortality and outcomes remains to be defined. Consecutive patients who underwent PCI enrolled in the Victorian Cardiac Outcomes Registry (2014 to 2018) were categorized into PPS and no PPS groups. The primary outcome was 30-day major adverse cardiovascular events (MACEs) (composite of mortality, myocardial infarction, stent thrombosis, and unplanned revascularization).
Source: The American Journal of Cardiology - August 20, 2022 Category: Cardiology Authors: Noah Z. Wexler, Sara Vogrin, Angela L. Brennan, Samer Noaman, Omar Al-Mukhtar, Kawa Haji, Jason E. Bloom, Diem T. Dinh, Wayne C. Zheng, James A. Shaw, Stephen J. Duffy, Jeffrey Lefkovits, Christopher M. Reid, Dion Stub, David M. Kaye, Nicholas Cox, Willia Source Type: research
Impact of Timing and Treatment Strategy on Coronary Perforation During Percutaneous Coronary Intervention for Chronic Total Occlusion
This study aimed to describe the clinical characteristics and timing of perforations during CTO-PCI. Data from the Japanese CTO-PCI expert registry included 8,760 patients who underwent CTO-PCI between January 2014 and January 2019. The major adverse cardiac and cerebrovascular events were defined as death, tamponade, myocardial infarction, stent thrombosis, stroke, and revascularization.
Source: The American Journal of Cardiology - April 14, 2022 Category: Cardiology Authors: Katsuya Miura, Hiroyuki Tanaka, Koichi Kishi, Toshiya Muramatsu, Hisayuki Okada, Yuji Oikawa, Tomohiro Kawasaki, Ryohei Yoshikawa, Atsunori Okamura, Etsuo Tsuchikane Source Type: research
Direct Oral Anticoagulants in Cardiac Amyloidosis –Associated Heart Failure and Atrial Fibrillation
Atrial fibrillation (AF) is present in approximately 40% of patients with cardiac amyloidosis.1 AF in the setting of cardiac amyloidosis is associated with a significant risk of stroke and systemic thromboembolism regardless of the patient's CHA ₂DS₂-VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score.2 Although current guidelines recommend anticoagulation therapy in all patients with cardiac amyloidosis and AF, data about the comparative effectiveness and safety of vitamin K antagonists (VKAs) ...
Source: The American Journal of Cardiology - November 27, 2021 Category: Cardiology Authors: Amgad Mentias, Paulino Alvarez, Pulkit Chaudhury, Michael Nakhla, Rohit Moudgil, Mohamad Kanj, Mazen Hanna, Milind Y. Desai Source Type: research
The CHA2DS2-VASc Score for Risk Stratification of Stroke in Heart Failure With-vs-Without Atrial Fibrillation
A recent study suggested that the CHA2DS2-VASc score can risk stratify heart failure (HF) patients without atrial fibrillation (AF) for stroke. We performed a retrospective analysis using the national Veteran Affairs database to externally validate the findings. Crude incidence rates of end points were calculated. A Cox proportional model was used to study the association between the CHA2DS2-VASc score and outcomes. In HF patients with AF (n = 17,481) and without AF (n = 36,935), the 1 year incidence rate for ischemic stroke, thromboembolism, thromboembolism (without MI), and death were 2.7 and 2.0%; 10.3 and 7.9%; 4....
Source: The American Journal of Cardiology - July 14, 2021 Category: Cardiology Authors: George R. Marzouka, Harold Rivner, Vijay Mehta, Juan Lopez, Igor Vaz, Fei Tang, Hemant Ishwaran, Jeffrey J. Goldberger Source Type: research
Blood Coagulation Changes With or Without Direct Oral Anticoagulant Therapy Following Transcatheter Aortic Valve Implantation
Thromboembolic events remain clinically unresolved after transcatheter aortic valve implantation (TAVI).1, 2 The mechanism of thromboembolic events after TAVI is multifactorial. The activation of the coagulation pathway induced by valve implantation may stimulate thrombus formation. 1, 3 However, blood coagulation change following TAVI was not fully investigated. The incidence of preexisting atrial fibrillation in patients with severe aortic valve stenosis is as high as 20% –30%.4 Although the use of direct oral anticoagulant (DOAC) for stroke prevention has increased, DOAC use to reduce thrombosis associated with TAVI r...
Source: The American Journal of Cardiology - February 19, 2021 Category: Cardiology Authors: Taiga Katayama, Naoyuki Yokoyama, Yusuke Watanabe, Shinji Takahashi, Hirofumi Hioki, Kazuo Kawasugi, Ken Kozuma Source Type: research
Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients with Coronavirus Disease 2019 (From the Yale COVID-19 Cardiovascular Registry)
Individuals with established cardiovascular disease or a high burden of cardiovascular risk factors may be particularly vulnerable to develop complications from coronavirus disease 2019 (COVID-19). We conducted a prospective cohort study at a tertiary care center to identify risk factors for in-hospital mortality and major adverse cardiovascular events (MACE; a composite of myocardial infarction, stroke, new acute decompensated heart failure, venous thromboembolism, ventricular or atrial arrhythmia, pericardial effusion, or aborted cardiac arrest) among consecutively hospitalized adults with COVID-19, using multivariable b...
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Manan Pareek, Avinainder Singh, Lina Vadlamani, Maxwell Eder, Justin Pacor, Jakob Park, Zaniar Ghazizadeh, Alex Heard, Ana Sofia Cruz-Solbes, Roozbeh Nikooie, Chad Gier, Zain V. Ahmed, James V. Freeman, Judith Meadows, Kim G.E. Smolderen, Rachel Lampert, Source Type: research
Effect of Mitral Regurgitation on Thrombotic Risk in Patients with Nonrheumatic Atrial Fibrillation: a New CHA2DS2-VASc Score Risk Modifier?
Atrial fibrillation (AF) significantly increases the risk of ischemic stroke (IS), but the risk varies strongly depending on the individual patient's stroke risk factors.1 Many scores, such as the CHA2DS2-VASc score, have been developed to guide physicians in their decision to start anticoagulation.2 However, the risk prediction with these models is modest at best (C-statistic = 0.6).3,4 Severe mitral regurgitation (MR) has been shown to decrease left atrial (LA) thrombus formation and systemic thromboembolic (TE) events in AF patients with rheumatic valve disease with an observed risk reduction of more than 50%.
Source: The American Journal of Cardiology - January 14, 2021 Category: Cardiology Authors: Sven L. Van Laer, Seppe Verreyen, Koen M. Winkler, Hielko Miljoen, Andrea Sarkozy, Hilde Heuten, Johan Saenen, Paul Van Herck, Caroline M. Van de Heyning, Hein Heidbuchel, Marc J. Claeys Source Type: research
