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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation
This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy. Background: Approximately 10% of patients who receive dual antiplatelet therapy after percutaneous coronary intervention have an indication for oral anticoagulation and are thus treated with triple therapy. The standard adenosine diphosphate receptor blocker in this setting is clopidogrel. Data regarding prasugrel as part of triple therapy are not available. Methods: We analyzed a consecutive series of 377 patients who underwent drug-eluting stent implantation and had an indication for oral antico...
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Nikolaus Sarafoff, Amadea Martischnig, Jill Wealer, Katharina Mayer, Julinda Mehilli, Dirk Sibbing, Adnan Kastrati Tags: Interventional Cardiology Source Type: research

Triple Antithrombotic Therapy With Prasugrel in the Stented Patient: Concern for More Bleeding⁎
There is a large body of evidence, including results of prospective trials, that supports oral anticoagulation therapy (OAT) as the optimal strategy to prevent fibrin-centric thrombotic events (FCTEs). Examples of FCTEs include thromboembolism in patients with mechanical heart valves, deep vein thrombosis, and atrial fibrillation (AF) (). In a large prospective trial, warfarin was found to be superior to dual antiplatelet therapy (DAPT) with aspirin + clopidogrel in the prevention of vascular events in patients with AF plus 1 or more risk factors for stroke (). European and American guidelines include a Class I recommendat...
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Paul A. Gurbel, Udaya S. Tantry Tags: Interventional Cardiology: Editorial Comment Source Type: research

Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation: The Loire Valley Atrial Fibrillation Project
Conclusions: Renal impairment was not an independent predictor of IS/TE in patients with AF and did not significantly improve the predictive ability of the CHADS2 or CHA2DS2-VASc scores.
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Amitava Banerjee, Laurent Fauchier, Patrick Vourc'h, Christian R. Andres, Sophie Taillandier, Jean Michel Halimi, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Cost-Effectiveness of Statins for Primary Cardiovascular Prevention in Chronic Kidney Disease
Conclusions: Although statins reduce absolute CVD risk in patients with CKD, the increased risk of rhabdomyolysis, and competing risks associated with progressive CKD, partly offset these gains. Low-cost generic statins appear cost-effective for primary prevention of CVD in patients with mild-to-moderate CKD and hypertension.
Source: Journal of the American College of Cardiology - March 20, 2013 Category: Cardiology Authors: Kevin F. Erickson, Sohan Japa, Douglas K. Owens, Glenn M. Chertow, Alan M. Garber, Jeremy D. Goldhaber-Fiebert Tags: Cardiovascular Risk Source Type: research

Strategies of Clopidogrel Load and Atorvastatin Reload to Prevent Ischemic Cerebral Events in Patients Undergoing Protected Carotid Stenting: Results of the Randomized ARMYDA-9 CAROTID (Clopidogrel and Atorvastatin Treatment During Carotid Artery Stenting) Study
Conclusions: In patients undergoing carotid stenting, a strategy using both a 600-mg clopidogrel load and a short-term reload with high-dose atorvastatin protects against early ischemic cerebral events. These results, obtained along with routine mechanical neuroprotection, provide new evidence of the optimization of drug therapy before percutaneous carotid intervention. (Clopidogrel and Atorvastatin Treatment During Carotid Artery Stenting [ARMYDA-9 CAROTID]; NCT01572623)
Source: Journal of the American College of Cardiology - March 14, 2013 Category: Cardiology Authors: Giuseppe Patti, Fabrizio Tomai, Rosetta Melfi, Elisabetta Ricottini, Michele Macrì, Pietro Sedati, Arianna Giardina, Cristina Aurigemma, Mario Leporace, Andrea D'Ambrosio, Germano Di Sciascio Tags: Interventional Cardiology Source Type: research

Outcomes After Cardioversion and Atrial Fibrillation Ablation in Patients Treated With Rivaroxaban and Warfarin in the ROCKET AF Trial
Conclusions: Despite an increase in hospitalization, there were no differences in long-term stroke rates or survival following cardioversion or AF ablation. Outcomes were similar in patients treated with rivaroxaban or warfarin. (An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation [ROCKET AF]; NCT00403767)
Source: Journal of the American College of Cardiology - March 13, 2013 Category: Cardiology Authors: Jonathan P. Piccini, Susanna R. Stevens, Yuliya Lokhnygina, Manesh R. Patel, Jonathan L. Halperin, Daniel E. Singer, Graeme J. Hankey, Werner Hacke, Richard C. Becker, Christopher C. Nessel, Kenneth W. Mahaffey, Keith A.A. Fox, Robert M. Califf, Günter B Tags: Heart Rhythm Disorders Source Type: research

Functional Improvement After Ventricular Assist Device Implantation: Is Ventricular Recovery More Common Than We Thought?⁎
He who's down one day can be up the next, unless he really wants to stay in bed, that is … —Miguel de Cervantes Saavedra, Don Quixote () Of the roughly 5.8 million Americans with heart failure, approximately 10% will have Stage D heart failure, defined as symptoms at rest despite optimal medical therapy. American College of Cardiology/American Heart Association and European Society of Cardiology guidelines recommend 3 options for these patients: 1) a ventricular assist device (VAD); 2) a heart transplant; or 3) hospice care (). Unfortunately, advanced therapies such as transplant and VAD are associated with significan...
Source: Journal of the American College of Cardiology - March 11, 2013 Category: Cardiology Authors: Eric Adler, Jorge Silva Enciso Tags: Heart Failure: Editorial Comment Source Type: research

Transcatheter Aortic Valve Implantation for Pure Severe Native Aortic Valve Regurgitation
Conclusions: This registry analysis demonstrates the feasibility and potential procedure difficulties when using TAVI for severe NAVR. Acceptable results may be achieved in carefully selected patients who are deemed too high risk for conventional surgery, but the possibility of requiring 2 valves and leaving residual aortic regurgitation remain important considerations.
Source: Journal of the American College of Cardiology - February 25, 2013 Category: Cardiology Authors: David A. Roy, Ulrich Schaefer, Victor Guetta, David Hildick-Smith, Helge Möllmann, Nicholas Dumonteil, Thomas Modine, Johan Bosmans, Anna Sonia Petronio, Neil Moat, Axel Linke, Cesar Moris, Didier Champagnac, Radoslaw Parma, Andrzej Ochala, Diego Medvedo Tags: Interventional Cardiology Source Type: research

Percutaneous Coronary Intervention Versus Coronary Bypass Surgery in United States Veterans With Diabetes
Conclusions: This study was severely underpowered for its primary endpoint, and therefore no firm conclusions about the comparative effectiveness of CABG and PCI are possible. There were interesting differences in the components of the primary endpoint. However, the confidence intervals are very large, and the findings must be viewed as hypothesis generating only. (Coronary Artery Revascularization in Diabetes; NCT00326196)
Source: Journal of the American College of Cardiology - February 20, 2013 Category: Cardiology Authors: Masoor Kamalesh, Thomas G. Sharp, X. Charlene Tang, Kendrick Shunk, Herbert B. Ward, James Walsh, Spencer King, Cindy Colling, Thomas Moritz, Kevin Stroupe, Domenic Reda, VA CARDS Investigators Tags: Interventional Cardiology Source Type: research

Prognostic Impact of the Presence and Absence of Angina on Mortality and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Stable Coronary Artery Disease: Results from the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) Trial
Conclusions: Whatever their symptom status, patients with type 2 diabetes and stable CAD were at similar risk of cardiovascular events and death. These findings suggest that these patients may be similarly managed in terms of risk stratification and preventive therapies. (Bypass Angioplasty Revascularization Investigation 2 Diabetes [BARI 2D]; NCT00006305)
Source: Journal of the American College of Cardiology - February 14, 2013 Category: Cardiology Authors: Gilles R. Dagenais, Jiang Lu, David P. Faxon, Peter Bogaty, Dale Adler, Francisco Fuentes, Jorge Escobedo, Ashok Krishnaswami, James Slater, Robert L. Frye, BARI 2D Study Group Tags: Coronary Artery Disease Source Type: research

What Is the Natural Relationship Between Left Atrial Appendage Morphology and History of Stroke?
In a recent issue of the Journal, Di Biase et al. () reported that left atrial appendage (LAA) morphology imaged with computed tomography (CT) or magnetic resonance imaging correlated with a history of stroke in patients that were undergoing catheter ablation for atrial fibrillation. We disagree with their impractical and complicated classification of LAA morphology and their conclusion that patients with non-Chicken Wing LAA morphology are significantly more likely to have an embolic event.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Jian-Fang Ren, David J. Callans, Francis E. Marchlinski Tags: Letters to the Editor Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Discontinuation of Rivaroxaban: Filling in the Gaps⁎
Late in 2011, rivaroxaban became the first factor Xa inhibitor to receive regulatory approval for the prevention of stroke in patients with atrial fibrillation (AF), based largely on the results of the phase III ROCKET AF (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) trial (), which enrolled 14,264 patients in a double-blind, double-dummy design. The ROCKET AF trial clearly established the noninferiority of rivaroxaban compared with warfarin for the primary endpoint of stroke or systemic embolism. The superio...
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Matthew R. Reynolds Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research

Lack of Stroke Subtype Information May Hinder Indirect Comparison Between the ROCKET-AF and Other Trials of New Oral Anticoagulants
Although we agree with Lip et al. () on the limitation of their study, we argue that lack of stroke subtype information may hinder scientific conclusion by including the ROCKET-AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) in any indirect comparison of new oral anticoagulants (NOA).
Source: Journal of the American College of Cardiology - January 30, 2013 Category: Cardiology Authors: Hai-feng Li, Ren-liang Zhao Tags: Letters to the Editor Source Type: research

Reply
We thank Drs. Li and Zhao for their interest in our paper (). They are correct that indirect comparisons cannot address all the heterogeneity between trials, as well as the underlying pathogenic mechanisms that they allude to. However, it is not very likely that there would be major differences in stroke subtypes among the 3 studies. Also, the inclusion and exclusion criteria are broadly the same in the 3 trials, except for the ROCKET-AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) trial, wherein more patients...
Source: Journal of the American College of Cardiology - January 30, 2013 Category: Cardiology Authors: Gregory Y.H. Lip, Torben Bjerregaard Larsen, Flemming Skjøth, Lars Hvilsted Rasmussen Tags: Letters to the Editor Source Type: research