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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
Recent Diabetes and Atrial Fibrillation Report Diverges From Pre-Existing Evidence
We read with interest the study by Ashburner et al. (1), investigating associations between duration of diabetes, glycemic control, and risk of ischemic stroke in patients with atrial fibrillation (AF) in the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) cohort.
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research
Reply Recent Diabetes and Atrial Fibrillation Report Diverges From Pre-Existing Evidence
We are delighted to recognize the thoughtful work by Overvad et al. (1) and Saliba et al. (2). The association of diabetes and ischemic stroke risk in patients with atrial fibrillation (AF) was first observed more than 20 years ago (3). Yet, there is scant published data analyzing this association by the core epidemiological components of diabetes duration and glycemic control.
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research
Validation of BARC Bleeding Criteria in Patients With Acute Coronary Syndromes The TRACER Trial
This study sought to investigate the relationship between BARC-classified bleeding and mortality and compared its prognostic value against 2 validated bleeding scales: TIMI (Thrombolysis In Myocardial Infarction) and GUSTO (Global Use of Strategies to Open Occluded Arteries).MethodsWe analyzed bleeding in 12,944 patients with acute coronary syndromes without ST-segment elevation, with or without early invasive strategy. The main outcome measure was all-cause death.ResultsDuring follow-up (median: 502 days), noncoronary artery bypass graft (CABG) bleeding occurred in 1,998 (15.4%) patients according to BARC (grades 2, 3, or...
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research
Left Atrial Appendage Closure in Patients With Contraindications to Oral Anticoagulation
The PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) and PREVAIL (Prospective Randomized Evaluation of the Watchman LAA Closure Device In Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy) trials revealed that in atrial fibrillation (AF) patients suitable for oral anticoagulation (OAC), mechanical left atrial appendage closure (LAAC) with a catheter-delivered heart implant device (Watchman; Boston Scientific, Marlborough, Massachusetts) is effective for stroke prevention (1,2). Importantly, these patients received at least 6 weeks ...
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research
Predicting Stroke in Patients With Atrial Fibrillation An Incomplete Picture Without Considering Quality of Anticoagulation
Van den Ham et al. (1) nicely compare the new stroke risk stratification tool anticoagulation and risk factors in atrial fibrillation (ATRIA) with CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism, Vascular disease, Age 65–74 years, Sex category [female]) in patients with atrial fibrillation.
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research
Considerations When Evaluating Cost-Effectiveness Analyses of Novel Stroke Prevention Therapies
The study by Reddy et al. (1) adds to the growing body of work evaluating the cost effectiveness of stroke prevention therapies from a U.S. perspective. We applaud their use of decision analytical models to inform practitioners and payers. We highlight 3 important considerations for readers of this work.
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research
Reply Considerations When Evaluating Cost-Effectiveness Analyses of Novel Stroke Prevention Therapies
We appreciate the thorough review of our paper (1) by Drs. Singh and Wijeysundera and wish to clarify our analysis based upon their feedback.
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research
Proton-Pump Inhibitors Reduce Gastrointestinal Events Regardless of Aspirin Dose in Patients Requiring Dual Antiplatelet Therapy
ConclusionsGastroprotection with PPI therapy should be utilized in appropriately selected patients with coronary artery disease requiring DAPT, even if the patients are on low-dose aspirin. (Clopidogrel and the Optimization of Gastrointestinal Events Trial [COGENT]; NCT00557921)
Source: Journal of the American College of Cardiology - April 4, 2016 Category: Cardiology Source Type: research
Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Myocardial Infarction Patients With Renal Dysfunction
ConclusionsTreatment with ACEI/ARB after AMI was associated with improved long-term survival, regardless of underlying renal function, and was accompanied by low rates of adverse renal events.
Source: Journal of the American College of Cardiology - April 4, 2016 Category: Cardiology Source Type: research
Antihypertensive Drug Usage in Prediction of Incident Atrial Fibrillation A Factor Not to Be Disregarded
The Dutch PREVEND (Prevention of Renal and Vascular End-Stage Disease) cohort study (1) reported both the risk factors for atrial fibrillation (AF) and the association of AF with cardiovascular events, heart failure, and all-cause mortality. At a mean 9.7 years of follow-up of more than 8,000 middle-aged men and women, 265 cases of AF were confirmed. A greater focus was given to associations with outcome than to determinants of AF, perhaps because no unexpected factors were perceived by the investigators to emerge. However, one of the main reported findings was related to the use of antihypertensive drugs. Age- and sex-adj...
Source: Journal of the American College of Cardiology - April 4, 2016 Category: Cardiology Source Type: research
Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke
ConclusionsIndividuals with hypercholesterolemia and hypertension who fail to take their prescribed statin and antihypertensive medication experience a substantially increased risk of fatal stroke. The risk is lower if the patient is adherent to either one of these therapies.
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research
Adherence to Medical Therapy and the Global Burden of Cardiovascular Disease ∗
Ischemic heart disease and cerebrovascular disease account for>20% of worldwide mortality and are the 2 leading causes of death on a global basis (1). Although mortality from ischemic heart disease is greater than that from stroke worldwide, the mortality from stroke is actually higher than from ischemic heart disease in 39% of countries. For example, mortality from stroke is generally higher than that for ischemic heart disease in China, Africa, and South America. In addition, stroke disability–adjusted life-year loss rates exceed ischemic heart disease-related disability in 32% of countries (2). Because of this, strate...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research
Morning Home Blood Pressure Is a Strong Predictor of Coronary Artery Disease The HONEST Study
BackgroundFew studies have evaluated out-of-office blood pressure (BP) measurements as predictors of coronary artery disease (CAD) events.ObjectivesThe aim of this study was to determine morning home blood pressure (HBP) as a predictor of CAD events.MethodsUsing data from the HONEST (Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study, we investigated the relationship between morning HBP and incidence of stroke and CAD events.ResultsIn 21,591 treated hypertensive patients (mean age 64.9 years; mean follow-up 2.02 years), 127 stroke events (2.92 per 1,000 patien...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research
Histamine H 2 Receptor Antagonists, Left Ventricular Morphology, and Heart Failure Risk The MESA Study
This study sought to determine whether H2RA use is associated with incident HF and change in LV morphology over time.MethodsWe included 6,378 men and women from MESA (Multi-Ethnic Study of Atherosclerosis), a multicenter prospective observational cohort of participants without cardiovascular disease at baseline. Cox proportional hazards were used to estimate the association between H2RA use and incident HF in adjusted models. In participants with cardiac magnetic resonance imaging, associations between H2RA use, baseline LV morphology (n = 4,691), and longitudinal change in the LV (n = 2,806) were estimated using linear ...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research
Peripheral Artery Disease Evolving Role of Exercise, Medical Therapy, and Endovascular Options
The prevalence of peripheral artery disease (PAD) continues to increase worldwide. It is important to identify patients with PAD because of the increased risk of myocardial infarction, stroke, and cardiovascular death and impaired quality of life because of a profound limitation in exercise performance and the potential to develop critical limb ischemia. Despite effective therapies to lower the cardiovascular risk and prevent progression to critical limb ischemia, patients with PAD continue to be under-recognized and undertreated. The management of PAD patients should include an exercise program, guideline-based medical th...
Source: Journal of the American College of Cardiology - March 15, 2016 Category: Cardiology Source Type: research
