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The dilemma of thromboembolism prophylaxis in patient with acute heart failure
Despite advances in treatment, heart failure (HF) continues to be associated with high morbidity and mortality [1]. One of the reasons for this fact is the thrombogenicity seen in these patients through different mechanisms (Fig. 1) via Virchow's triad: blood stasis, endothelial dysfunction, and hypercoagulability; resulting in reported rates of up to 30% of venous thromboembolism (VTE), stroke, and sudden death among HF patients [2]. On the other hand, atrial fibrillation (AF) frequently coexists increasing the risk of thromboembolic events, and while the efficacy of anticoagulants in this last population has been proven ...
Source: International Journal of Cardiology - December 16, 2022 Category: Cardiology Authors: H. Amparo Taveras Tags: Editorial Source Type: research

Predicting LV thrombosis after acute myocardial infarction: From Virchow's triad to state-of-the-art cardiovascular magnetic resonance imaging
Despite the decline in incidence - in the era of primary percutaneous interventions (PCI), left ventricular (LV) thrombus remains a feared complication after acute myocardial infarction (AMI) due to the associated high risk of systemic embolism and stroke [1,2]. Depending on infarct/reperfusion-related characteristics as well as type and timing of diagnostic imaging modality, reported rates of LV thrombus following AMI are widely variable: from 2.7% for all and 9.1% for anterior ST-elevation myocardial infarction (STEMI), within 3  months on echocardiography, to 6.3% for all /19.2% for anterior STEMI with LV ejection fraction (LVEF) 
Source: International Journal of Cardiology - May 18, 2022 Category: Cardiology Authors: Anca Florian Tags: Editorial Source Type: research

Association between acute myocardial infarction and death in 386 patients with a thrombus straddling a patent foramen ovale
Right atrial thrombi are rarely found straddling a patent foramen ovale (PFO). A thrombus straddling a PFO (TSPFO), also known as impending paradoxical embolism, is a medical emergency associated with up to 11.5% risk of death within 24  h of being diagnosed. We hypothesized that acute myocardial infarction (MI) and ischemic stroke (IS) diagnosed upon the admission of patients with TSPFO are associated with increased risk of death. We also investigated if specific acute therapies are associated with reduced in-hospital mortality.
Source: International Journal of Cardiology - July 7, 2021 Category: Cardiology Authors: Palak Shah, Amado Jimenez-Ruiz, Andrew Gibson, Juan C. Vargas-Gonz ález, Maria Bres-Bullrich, Rodrigo Bagur, Luciano A. Sposato Source Type: research

E-wave propagation index (EPI) – A promising echocardiographic marker to improve left ventricular thrombus detection after STEMI?
Left ventricular (LV) thrombus formation remains a challenging complication following primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI). During the early phase following STEMI, LV thrombi are reported to occur in about 6% of all patients [1] and pose an increased risk of stroke and systemic thromboembolisms [2,3]. Given the great burden of these complications, effective strategies to detect and treat LV thrombi remain desirable for clinical care of STEMI patients [2,3].
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: Martin Reindl, Sebastian J. Reinstadler Tags: Editorial Source Type: research

E-wave propagation index (EPI) - A promising echocardiographic marker to improve left ventricular thrombus detection after STEMI?
Left ventricular (LV) thrombus formation remains a challenging complication following primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI). During the early phase following STEMI, LV thrombi are reported to occur in about 6% of all patients [1] and pose an increased risk of stroke and systemic thromboembolisms [2,3]. Given the great burden of these complications, effective strategies to detect and treat LV thrombi remain desirable for clinical care of STEMI patients [2,3].
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: Martin Reindl, Sebastian J. Reinstadler Tags: Editorial Source Type: research

Antithrombotic therapy after acute coronary syndromes in patients with atrial fibrillation: Shouldn't we pay more attention to the risk of ischemic and thromboembolic events?
The management of antithrombotic therapy in patients with atrial fibrillation (AF) presenting an acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) is particularly complex. Oral anticoagulation (OAC) is superior to single or dual antiplatelet therapy (DAPT) for the prevention of thromboembolic complications (stroke and systemic embolism) due to AF, whereas DAPT with low-dose aspirin and a P2Y12 inhibitor is the recommended antithrombotic treatment to prevent ischemic events (myocardial infarction and stent thrombosis) in patients with ACS or undergoing PCI.
Source: International Journal of Cardiology - November 29, 2018 Category: Cardiology Authors: Jos é Luis Ferreiro, Joan Antoni Gómez-Hospital Tags: Editorial Source Type: research

Finding the right balance
Patients with an indication for oral anticoagulation (OAC) that receive antiplatelet therapy after percutaneous coronary intervention (PCI) are challenging for the treating physician. It is of importance to balance their antithrombotic treatment to protect them from ischemic events, such as stent thrombosis as well as ischemic stroke without exposing them to an excess in bleeding. The current guidelines recommend a so-called triple therapy consisting of aspirin, clopidogrel and OAC for 1 –6 months after PCI depending on the patient's ischemic risk [1].
Source: International Journal of Cardiology - September 27, 2018 Category: Cardiology Authors: Alexander Goedel, Nikolaus Sarafoff Tags: Editorial Source Type: research

Does renal function have incremental predictive value of stroke in atrial fibrillation?
It is well known that both atrial fibrillation (AF) and chronic kidney disease (CKD) are respectively independent predictors of stroke and systemic thromboembolism. A number of epidemiological and observational studies have shown that there are close relationships between AF and CKD [1 –3]. Indeed, the prevalence of AF increases from non-CKD to CKD stages of 1 to 2, 3 and 4 to 5 by 1.0%, 2.8%, 2.7%, and 4.2%, respectively [1], and the prevalence is 7% to 27% in patients with end-stage renal disease who are undergoing hemodialysis therapy [2].
Source: International Journal of Cardiology - August 28, 2018 Category: Cardiology Authors: Yukihito Higashi Tags: Editorial Source Type: research

Type 1 versus type 2 diabetes and thromboembolic risk in patients with atrial fibrillation: A Danish nationwide cohort study
Atrial fibrillation is a common cause of stroke, and diabetes increases stroke risk. Stroke risk may vary depending on the type of diabetes. We investigated whether type 1 and type 2 diabetes are associated with different risks of thromboembolism among patients with atrial fibrillation.
Source: International Journal of Cardiology - July 22, 2018 Category: Cardiology Authors: Mia V. Fangel, Peter B. Nielsen, Torben B. Larsen, Bo Christensen, Thure F. Overvad, Gregory Y.H. Lip, Samuel Z. Goldhaber, Martin B. Jensen Source Type: research

Lowering the risk of stroke prevention: Managing bleeding complications
Oral anticoagulation is increasingly used, predominantly for thromboprophylaxis of atrial fibrillation and the prevention and treatment of venous thromboembolism. With an ageing population, increasing burden, and earlier recognition of atrial fibrillation, the number of patients taking oral anticoagulation is increasing year on year.
Source: International Journal of Cardiology - July 3, 2018 Category: Cardiology Authors: Diana A. Gorog Tags: Editorial Source Type: research

The safety and efficacy of non-vitamin K antagonist oral anticoagulants in atrial fibrillation in the elderly
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence increases with age. Age also increases the risk of thromboembolism related to AF. As a result, elderly patients are at increased risk of AF-related stroke compared to younger patients. Age, however, also increases the risk of bleeding, including that of intracranial haemorrhage, an important cause of death and disability. Elderly patients with AF are, therefore, often undertreated due to the fear of bleeding complications, although recent data suggest an even greater net clinical benefit for anticoagulation in general in the elderly, even the very el...
Source: International Journal of Cardiology - June 7, 2018 Category: Cardiology Authors: Giuseppe Patti, Ilaria Cavallari, Olivier Hanon, Raffaele De Caterina Source Type: research

Oral anticoagulation alone for concomitant stable coronary artery disease and atrial fibrillation: A definitive strategy?
Thrombus formation, albeit with partially different mechanisms, is the common denominator of adverse ischemic events in both coronary artery disease (CAD) and atrial fibrillation (AF) [1]. Accordingly, long-term oral antiplatelet therapy with aspirin, and oral anticoagulation (OAC) with either warfarin or a direct oral anticoagulant (DOAC), including dabigatran, rivaroxaban, apixaban, and edoxaban, have long been established as the standard treatments for the prevention of (recurrent) cardiac ischemic events and stroke, respectively [2].
Source: International Journal of Cardiology - May 16, 2018 Category: Cardiology Authors: Andrea Rubboli Source Type: research

Impact of BMI on clinical outcomes of NOAC therapy in daily care - Results of the prospective Dresden NOAC Registry (NCT01588119)
Direct acting non-Vitamin K antagonist oral anticoagulants (NOAC) are characterized by a fixed dosing regimen. Despite the potential for relative underdosing due to large distribution volumes, dose adjustments for patients with high body mass index (BMI) are not recommended. Since efficacy and safety data in obese patients are scarce, we evaluated the impact of BMI on clinical outcomes in daily care patients treated with NOAC for stroke prevention in atrial fibrillation or venous thromboembolism.
Source: International Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: L. Tittl, S. Endig, S. Marten, A. Reitter, I. Beyer-Westendorf, J. Beyer-Westendorf Source Type: research

Stroke, thromboembolism and bleeding in patients with atrial fibrillation according to the EHRA valvular heart disease classification
We compared thromboembolic (TE) and bleeding risks in patients with atrial fibrillation (AF) according to the new ‘Evaluated Heartvalves, Rheumatic or Artificial’ (EHRA) valve classification.
Source: International Journal of Cardiology - March 7, 2018 Category: Cardiology Authors: Arnaud Bisson, Alexandre Bodin, Nicolas Clementy, Anne Bernard, Dominique Babuty, Gregory Y.H. Lip, Laurent Fauchier Source Type: research

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