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Source: American Heart Journal

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Total 409 results found since Jan 2013.

Low-density lipoprotein cholesterol treatment and outcomes in patients with type 2 diabetes and established cardiovascular disease: Insights from TECOS
ConclusionsAlthough most high-risk patients with T2D and CV disease were on lipid-lowering therapy, only 1:3 had LDL-C < 70 mg/dL and 1:6 had LDL-C < 55 mg/dL. Each 10 mg/dL higher LDL-C value was associated with a 5% and 6% higher 5-year incidence of MACE and CV death, respectively. (TECOS, NCT00790205).
Source: American Heart Journal - November 14, 2019 Category: Cardiology Source Type: research

Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials
ConclusionsClaims- versus site-based (+CEC) follow-up identified similar overall cardiovascular event rates despite meaningful differences in the events detected. Randomized treatment effects were similar using the 2 methods, suggesting claims data could be used to support clinical research leveraging routinely collected data. This approach may lead to more effective evidence generation, synthesis, and appraisal of medical products and inform the strategic approaches toward the National Evaluation System for Health Technology.
Source: American Heart Journal - November 12, 2019 Category: Cardiology Source Type: research

Transcatheter InterAtrial shunt device for the treatment of heart failure: Rationale and Design of the Pivotal Randomized Trial to REDUCE elevated left atrial pressure in patients with heart failure II (REDUCE LAP-HF II)
ConclusionsREDUCE LAP-HF II is designed to evaluate the clinical efficacy of the IASD device in patients with symptomatic HF with elevated LA pressure and LVEF≥40%.
Source: American Heart Journal - November 12, 2019 Category: Cardiology Source Type: research

Associations between β-blocker therapy and cardiovascular outcomes in patients with diabetes and established cardiovascular disease
ConclusionsIn this observational analysis of T2D and ASCVD, baseline β-blocker use was not associated with risks for severe hypoglycemia yet also was not associated with CV risk reduction over 3 years of follow-up, supporting a randomized examination of chronic β-blocker therapy in this patient population. (TECOS ClinicalTrials.gov number, NCT00790205).
Source: American Heart Journal - November 11, 2019 Category: Cardiology Source Type: research

Guideline-directed therapies for comorbidities and clinical outcomes among individuals with atrial fibrillation
ConclusionsIn AF patients, there is underuse of GDT for non-AF comorbidities. The association between GDT use and outcomes was strongest in heart failure and obstructive sleep apnea patients where use of GDT was associated with lower mortality and less AF progression.
Source: American Heart Journal - November 10, 2019 Category: Cardiology Source Type: research

Four-year trends in oral anticoagulant use and declining rates of ischemic stroke among 194,030 atrial fibrillation patients drawn from a sample of 12 million people
ConclusionThere was a slight increase in the prevalence of AF between 2012 and 2015, while the overall use of antiplatelet agents decreased and that of OAC, particularly DOACs, increased. Over the same period, 1 year hospitalizations for ischemic stroke declined substantially, with a declining rate of hemorrhagic strokes.
Source: American Heart Journal - November 10, 2019 Category: Cardiology Source Type: research

The effect of low-dose colchicine in patients with stable coronary artery disease: The LoDoCo2 trial rationale, design, and baseline characteristics
ConclusionThe LoDoCo2 Trial will provide information on the efficacy and safety of low-dose colchicine for secondary prevention in patients with stable coronary artery disease.
Source: American Heart Journal - November 7, 2019 Category: Cardiology Source Type: research

Gastrointestinal bleeding in patients with atrial fibrillation treated with Apixaban or warfarin: Insights from the ARISTOTLE trial
ConclusionsIn patients with AF on oral anticoagulants, prior GIB was associated with an increased risk of subsequent major GIB but not stroke, intracranial bleeding, or all-cause mortality. For the key outcomes of stroke, hemorrhagic stroke, death, and major bleeding, we found no evidence that the treatment effect (apixaban vs. warfarin) was modified by a history of GIB.
Source: American Heart Journal - November 2, 2019 Category: Cardiology Source Type: research

Patterns of Amiodarone use and outcomes in clinical practice for atrial fibrillation
ConclusionsUse of amiodarone among AF patients in community practice is highly variable. More than 2 out of 3 patients treated with amiodarone appeared to be eligible for a different AAD.
Source: American Heart Journal - October 24, 2019 Category: Cardiology Source Type: research

Applying contemporary antithrombotic therapy in the secondary prevention of chronic atherosclerotic cardiovascular disease
Publication date: Available online 23 October 2019Source: American Heart JournalAuthor(s): Robert C. Welsh, Eric D. Peterson, Raffaele De Caterina, Christoph Bode, Bernard Gersh, John W. EikelboomAbstractFor four decades, anti-thrombotic therapy with aspirin has been a cornerstone of secondary prevention for patients with chronic atherosclerotic cardiovascular disease (ASCVD). Unfortunately, despite the use of evidence-based therapies, patients with ASCVD continue to have recurrent major adverse cardiovascular (CV) events including death, myocardial infarction and stroke -- at a rate of approximately 2–4% per year. To co...
Source: American Heart Journal - October 24, 2019 Category: Cardiology Source Type: research

Outcome impact of different tranexamic acid regimens in cardiac surgery with cardiopulmonary bypass (OPTIMAL): Rationale, design, and study protocol of a multi-center randomized controlled trial
ConclusionsThe study is designed to identify a TxA dose with maximal efficacy and minimal complications. We hypothesize that the high dose has superior efficacy and non-inferior safety to the low dose.
Source: American Heart Journal - October 23, 2019 Category: Cardiology Source Type: research

Incidence and predictors of atrial fibrillation episodes as detected by implantable loop recorder in patients at risk From the LOOP study
ConclusionA considerable burden of previously unknown AF was detected when long-term monitoring was applied in at-risk patients. Biomarkers were associated with AF incidence and improved prediction of long AF episodes.
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

Association of obesity with cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease: Insights from TECOS
ConclusionsThe majority of TECOS participants with ASCVD and T2D were overweight or obese, yet overweight or obese class I individuals had lower CV risk than those who were under/normal weight. These results suggest the presence of an obesity paradox, but this paradox may reflect an epidemiological artifact rather than a true negative association between normal weight and clinical outcomes.
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

Associations between beta-blocker therapy and cardiovascular outcomes in patients with diabetes and established cardiovascular disease
ConclusionsIn this observational analysis of T2D and ASCVD, baseline beta-blocker use was not associated with risks for severe hypoglycemia yet also was not associated with CV risk reduction over 3 years of follow-up, supporting a randomized examination of chronic beta-blocker therapy in this patient population. (TECOS ClinicalTrials.gov number, NCT00790205).
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

Sex-specific Cardiac Phenotype and Clinical Outcomes in Patients with Hypertrophic Cardiomyopathy
ConclusionsOur results suggest that sex-specific differences in LV geometry, hyper-contractility and diastolic function, not greater degree of LV myopathy, contribute to a higher, age-independent risk of diastolic HF in women with HCM.Graphical abstract
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

T effect of low dose colchicine in patients with stable coronary artery disease: The LoDoCo2 trial rationale, design and baseline characteristics
ConclusionThe LoDoCo2 Trial will provide information on the efficacy and safety of low dose colchicine for secondary prevention in patients with stable coronary artery disease.
Source: American Heart Journal - October 21, 2019 Category: Cardiology Source Type: research

Claims-based cardiovascular outcome identification for clinical research: Results from seven large randomized cardiovascular clinical trials
ConclusionsClaims- vs. site-based (+CEC) follow-up identified similar overall cardiovascular event rates, despite meaningful differences in the events detected. Randomized treatment effects were similar using the two methods, suggesting claims data could be used to support clinical research leveraging routinely-collected data. This approach may lead to more effective evidence generation, synthesis, and appraisal of medical products and inform the strategic approaches toward the National Evaluation System for Health Technology.
Source: American Heart Journal - September 12, 2019 Category: Cardiology Source Type: research

Small-for-gestational-age birth is linked to cardiovascular dysfunction in early childhood
ConclusionsThis study shows that infants born SGA present an early and subtle cardiovascular dysfunction compared to AGA controls. These alterations are strongly related to weight at birth. Finally, breastfeeding exerts an important protective and beneficial cardiovascular effect.
Source: American Heart Journal - September 12, 2019 Category: Cardiology Source Type: research

Ticagrelor-based antiplatelet regimens in patients with atherosclerotic artery disease - a meta-analysis of randomized clinical trials
ConclusionsIn patients with atherosclerotic artery disease, the benefit of ticagrelor-based therapies was confined to patients treated for CAD. The drug significantly reduced the risk for all-cause death and MI without excess risk of bleeding in these patients. In consideration of limitations of subgroup analyses, these results need further validation.
Source: American Heart Journal - September 2, 2019 Category: Cardiology Source Type: research

Long-Term (10-Year) Outcomes of Stenting or Bypass Surgery for Acute Coronary Syndromes and Stable Ischemic Heart Disease With Unprotected Left Main Coronary Artery Disease
ConclusionsIn patients with LMCA disease, we have identified no significant interaction between the acuity of clinical indication and the relative treatment effect of PCI versus CABG on 10-year clinical outcomes.
Source: American Heart Journal - August 22, 2019 Category: Cardiology Source Type: research

Association of 25-hydroxyvitamin D with incident coronary heart disease in the reasons for geographic and racial differences in stroke (REGARDS) study
ConclusionsLower plasma 25(OH)D concentrations were associated with higher risk of incident CHD. In contrast to prior studies, these associations did not differ by race.
Source: American Heart Journal - August 21, 2019 Category: Cardiology Source Type: research

C-reactive Protein and Stroke Risk in Blacks and Whites: the REasons for Geographic and Racial Differences in Stroke Cohort
ConclusionsCRP may not be equally useful in stroke risk assessment in blacks and whites. Confirmation, similar study for coronary heart disease, and identification of reasons for these racial differences require further study.
Source: American Heart Journal - August 14, 2019 Category: Cardiology Source Type: research

Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: A Medicare analysis
ConclusionThere is an incremental risk of ischemic stroke and MI from non-diabetics to non-insulin diabetics with the highest risk in insulin users. Protective effect of anticoagulation is attenuated with insulin use.
Source: American Heart Journal - May 11, 2019 Category: Cardiology Source Type: research

Predictors of NOAC versus VKA use for stroke prevention in patients with newly diagnosed atrial fibrillation: Results from GARFIELD-AF
ConclusionGARFIELD-AF data highlights marked heterogeneity in stroke prevention strategies globally. Physicians are adopting an individualized approach to stroke prevention where NOACs are favored in patients with a lower stroke risk, but also in the elderly and patients with ACS.
Source: American Heart Journal - April 11, 2019 Category: Cardiology Source Type: research

Risk of stroke subsequent to infective endocarditis: A nationwide study
ConclusionPatients with non-surgically treated IE with a stroke during IE admission were at significant higher associated risk of subsequent stroke within the first year of follow-up as compared with patients without a stroke during IE admission. This risk difference was not evident beyond one year of discharge. These findings underline the need for identification of causes and mechanisms of recurrent strokes after IE to develop preventive means.
Source: American Heart Journal - March 28, 2019 Category: Cardiology Source Type: research

Relationship of stroke and bleeding risk profiles to efficacy and safety of dabigatran dual therapy versus warfarin triple therapy in atrial fibrillation after PCI: An ancillary analysis from the RE-DUAL PCI trial
ConclusionDabigatran dual therapy reduced bleeding events irrespective of bleeding risk category and demonstrated similar efficacy regardless of stroke risk category when compared with warfarin triple therapy.
Source: American Heart Journal - March 4, 2019 Category: Cardiology Source Type: research

An international cluster-randomized quality improvement trial to increase the adherence to evidence-based therapies for acute ischemic stroke and transient ischemic attack patients: Rationale and design of the BRIDGE STROKE Trial
Publication date: January 2019Source: American Heart Journal, Volume 207Author(s): Maria Julia Machline-Carrion, Eliana Vieira Santucci, Lucas Petri Damiani, Cecilia Bahit, Germán Málaga, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins, Viviane Flumignan Zétola, Karina Normilio-Silva, Gabriel Rodrigues de Freitas, Alessandra Gorgulho, Antônio De Salles, Beatriz Gonzales Pacheco da Silva, Juliana Yamashita Santos, Isabella de Andrade Jesuíno, Priscila Regina Torres Bueno, Alexandre Biasi Cavalcanti, Hélio Penna Guimarães, Ying Xian, Janet Prvu BettgerBackgroundTranslating evidence into clinical practic...
Source: American Heart Journal - November 9, 2018 Category: Cardiology Source Type: research

Blood Pressure Differences Between Home Monitoring and Daytime Ambulatory Values and their Reproducibility in Treated Hypertensive Stroke and TIA Patients
ConclusionsDaytime ambulatory systolic and diastolic blood pressure values were significantly lower than home monitored values at both time points. Differences between the two methods were not reproducible for individuals. Using the same threshold value for both out-of-office measurement methods may not be appropriate in patients with cerebrovascular disease.
Source: American Heart Journal - October 21, 2018 Category: Cardiology Source Type: research

An international cluster randomized quality-improvement trial to increase the adherence to evidence-based therapies for acute ischemic stroke and transient ischemic attack patients: Rationale and design of the BRIDGE STROKE trial
Publication date: Available online 30 September 2018Source: American Heart JournalAuthor(s): Maria Julia Machline-Carrion, Eliana Vieira Santucci, Lucas Petri Damiani, Cecilia Bahit, Germán Málaga, Octávio Marques Ponte-Neto, Sheila Cristina Ouriques Martins, Viviane Flumignan Zétola, Karina Normilio-Silva, Gabriel Rodrigues de Freitas, Alessandra Gorgulho, Antônio De Salles, Beatriz Gonzales Pacheco da Silva, Juliana Yamashita Santos, Isabella de Andrade Jesuíno, Priscila Regina Torres Bueno, Alexandre Biasi Cavalcanti, Hélio Penna Guimarães, Ying Xian, Janet Prvu BettgerAbstractBackgroundTranslating evidence into...
Source: American Heart Journal - October 5, 2018 Category: Cardiology Source Type: research

System-integrated technology-enabled model of care to improve the health of stroke patients in rural China: protocol for SINEMA--a cluster-randomized controlled trial
This study aims to develop a system-integrated technology-enabled intervention model of care (SINEMA) for the secondary prevention of stroke in rural China and to evaluate the effectiveness of the model compared with usual care.MethodsThe SINEMA model is being implemented and evaluated through a one-year cluster-randomized controlled trial in Nanhe County, Hebei Province in China. Fifty villages from five townships are randomized in a 1:1 ratio to either the intervention or the control arm (usual care) with a target to enroll 25 stroke survivors per village. Village doctors in the intervention arm 1) receive systematic cas...
Source: American Heart Journal - September 5, 2018 Category: Cardiology Source Type: research

Does self-monitoring and self-management of blood pressure after stroke or transient ischemic attack improve control? TEST-BP, a randomized controlled trial
Publication date: Available online 27 July 2018Source: American Heart JournalAuthor(s): William J. Davison, Phyo K. Myint, Allan B. Clark, Lois G. Kim, Edward C. Wilson, Maggie Langley, John F. PotterThe therapeutic benefit of self-monitoring blood pressure in stroke patients is uncertain. We investigated the effect of self-monitoring with or without guided antihypertensive management compared with usual care in patients with a recent cerebrovascular event. No between-group differences in blood pressure at outcome were found, but blood pressure self-monitoring and management was well tolerated.
Source: American Heart Journal - July 28, 2018 Category: Cardiology Source Type: research

Stroke type and severity in patients with subclinical atrial fibrillation: An analysis from the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial (ASSERT)
Conclusions In patients with SCAF and stroke, SCAF seems probably causal in many cases; however, in more than 40%, it seems to be acting only as a risk marker.
Source: American Heart Journal - June 15, 2018 Category: Cardiology Source Type: research

Predictors of Oral Anticoagulant Non-prescription in Patients with Atrial Fibrillation and Elevated Stroke Risk
Conclusions In this registry of AF patients, older patients at elevated stroke and low bleeding risk were commonly treated with OAC. However, a variety of factors were associated with OAC non-prescription. Specifically, antiplatelet use was prevalent and associated with the highest likelihood of OAC non-prescription. Future studies are warranted to understand provider and patient rationale that may underlie observed associations with OAC non-prescription.
Source: American Heart Journal - March 11, 2018 Category: Cardiology Source Type: research

Transcatheter closure of patent foramen ovale following cryptogenic stroke: An updated meta-analysis of randomized controlled trials
Conclusions Transcatheter closure is associated with a significant reduction in the risk of stroke compared to medical management at the expense of an increased risk of atrial arrhythmias.
Source: American Heart Journal - February 1, 2018 Category: Cardiology Source Type: research

Apixaban following acute coronary syndromes in patients with prior stroke: Insights from the APPRAISE-2 trial
Conclusions Patients with prior stroke are at higher risk for recurrent cardiovascular events post-ACS and had a differential risk/benefit profile with oral anticoagulation.
Source: American Heart Journal - October 25, 2017 Category: Cardiology Source Type: research

Two-year follow-up of patients treated with dabigatran for stroke prevention in atrial fibrillation: GLORIA-AF Registry
Conclusions These global data confirm the sustained safety and effectiveness of dabigatran over 2years of follow-up, consistent with the results from clinical trials as well as contemporary real-world studies. WHAT IS KNOWN • Non- vitamin K antagonist (VKA) anticoagulants (NOACs) are the preferred therapy for prevention of ischemic stroke based on phase 3 trials, but there is insufficient information on their efficacy and safety in daily practice, based on prospectively collected data WHAT IS NEW • This study shows that in non-valvular AF patient population, with up to 2years of follow-up, the use of dabigatran led to ...
Source: American Heart Journal - September 1, 2017 Category: Cardiology Source Type: research

Availability of patient decision aids for stroke prevention in atrial fibrillation: A systematic review
The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation. Methods Six databases were searched from inception to March 2016 with a research librarian. Two authors independently reviewed potential articles, selected trials meeting inclusion criteria, and assessed outcome measures. Outcomes included: patient knowledge, involvement, choice, and decisional conflict. Results The search resulted in 666 articles; most were excluded for not examining stroke prevention in...
Source: American Heart Journal - June 3, 2017 Category: Cardiology Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE-AF) Randomized Trial: Design and Rationale
Conclusion This trial will provide information on the value of ICMs to detect subclinical AF in patients with stroke presumed due to large vessel atherosclerosis or small vessel disease, which will have implications for guiding treatment with oral anticoagulation for secondary stroke prevention.
Source: American Heart Journal - April 19, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Rationale, design, and baseline characteristics of the Salt Substitute and Stroke Study (SSaSS) —A large-scale cluster randomized controlled trial
Publication date: June 2017 Source:American Heart Journal, Volume 188 Author(s): Bruce Neal, Maoyi Tian, Nicole Li, Paul Elliott, Lijing L. Yan, Darwin R. Labarthe, Liping Huang, Xuejun Yin, Zhixin Hao, Sandrine Stepien, Jingpu Shi, Xiangxian Feng, Jianxin Zhang, Yuhong Zhang, Ruijuan Zhang, Yangfeng Wu Lowering sodium intake with a reduced-sodium, added potassium salt substitute has been proved to lower blood pressure levels. Whether the same strategy will also reduce the risks of vascular outcomes is uncertain and controversial. The SSaSS has been designed to test whether sodium reduction achieved with a salt substitute...
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial
Conclusion The LOOP study will evaluate health benefits and cost-effectiveness of ILR as a screening tool for AF to prevent stroke in patients at risk. Secondary objectives include identification of risk factors for the development of AF and characterization of arrhythmias in the population. The trial holds the potential to influence the future of stroke prevention.
Source: American Heart Journal - March 15, 2017 Category: Cardiology Source Type: research

Rationale, design and baseline characteristics of the Salt Substitute and Stroke Study (SSaSS) – a large-scale cluster randomized controlled trial
Publication date: Available online 14 March 2017 Source:American Heart Journal Author(s): Bruce Neal, Maoyi Tian, Nicole Li, Paul Elliott, Lijing L. Yan, Darwin R. Labarthe, Liping Huang, Xuejun Yin, Zhixin Hao, Sandrine Stepien, Jingpu Shi, Xiangxian Feng, Jianxin Zhang, Yuhong Zhang, Ruijuan Zhang, Yangfeng Wu Lowering sodium intake with a reduced-sodium, added potassium salt substitute has been proved to lower blood pressure levels. Whether the same strategy will also reduce the risks of vascular outcomes is uncertain and controversial. The Salt Substitute and Stroke Study (SSaSS) has been designed to test whether sodi...
Source: American Heart Journal - March 15, 2017 Category: Cardiology Source Type: research

Atrial fibrillation detected by continuous ECG monitoring using implantable loop recorder to prevent stroke in individuals at risk (The LOOP study): Rationale and design of a large randomized controlled trial
Conclusion The LOOP study will evaluate health benefits and cost-effectiveness of ILR as a screening tool for AF to prevent stroke in patients at risk. Secondary objectives include identification of risk factors for the development of AF and characterization of arrhythmias in the population. The trial holds the potential to influence the future of stroke prevention.
Source: American Heart Journal - February 21, 2017 Category: Cardiology Source Type: research

Clinical decision support for stroke prevention in atrial fibrillation (CDS-AF): Rationale and design of a cluster randomized trial in the primary care setting
Conclusion The present study will investigate whether a clinical decision support system integrated in an EHR can increase adherence to guidelines regarding anticoagulant therapy in patients with AF. Trial registration www.clinicaltrials.gov registration number NCT02635685
Source: American Heart Journal - February 16, 2017 Category: Cardiology Source Type: research

Anemia Is Associated With Bleeding and Mortality, but Not Stroke, in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial
Conclusions Chronic anemia is associated with a higher incidence of bleeding complications and mortality, but not of stroke, in anticoagulated patients with AF. Apixaban is an attractive anticoagulant for stroke prevention in patients with AF with or without anemia.
Source: American Heart Journal - December 22, 2016 Category: Cardiology Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 5, 2016 Category: Cardiology Source Type: research

Acute management of stroke patients taking non –vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - September 24, 2016 Category: Cardiology Source Type: research

Diabetes, diabetes severity, and coronary heart disease risk equivalence: REasons for Geographic and Racial Differences in Stroke (REGARDS)
Conclusions Participants with diabetes had lower risk of CHD events than did those with prevalent CHD. However, participants with severe diabetes had similar risk to those with prevalent CHD. Diabetes severity may need consideration when deciding whether diabetes is a CHD risk equivalent.
Source: American Heart Journal - September 6, 2016 Category: Cardiology Source Type: research

How Well Does Physician Risk Assessment Predict Stroke and Bleeding in Atrial Fibrillation? Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF)
Conclusion Physician-assigned risk showed a graded relationship with outcomes and both physician-based and empirical scores yielded only moderate discrimination. While empirical scores provided valuable risk stratification information (with or without physician judgement), physician-assessment added little to existing scores. These data support the use of empirical scores for stroke and bleeding risk stratification, and the need for novel approaches to risk stratification in this population.
Source: American Heart Journal - August 27, 2016 Category: Cardiology Source Type: research