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Source: The American Journal of Cardiology
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Total 715 results found since Jan 2013.
Objectively Measured Physical Activity and the Risk of Atrial Fibrillation (From the REGARDS Study)
The association between objectively measured physical activity and atrial fibrillation (AF) has not been examined. Therefore, we examined the association between moderate and vigorous physical activity (MVPA) with incident AF in 5,147 participants who completed accelerometer assessment for 4 to 7 consecutive days in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. MVPA was defined as>1065 counts/minute, and daily mean time spent in MVPA was computed. Incident AF was identified during follow-up by a study-scheduled electrocardiogram and also from self-reported medical history of a physician diagnosis.
Source: The American Journal of Cardiology - May 13, 2020 Category: Cardiology Authors: Wesley T. O'Neal, Aleena Bennett, Matthew J. Singleton, Suzanne E. Judd, George Howard, Virginia J. Howard, Steven P. Hooker, Elsayed Z. Soliman Source Type: research
Usefulness of Long-term Anticoagulation after Catheter Ablation of Atrial Fibrillation
Although atrial fibrillation (AF) is strongly associated with stroke, previous studies have shown suboptimal use of anticoagulation (AC). In particular, there is a lack of data on the long-term use of AC after AF catheter ablation. We followed up patients 1-5 years out from catheter ablation at the Johns Hopkins Hospital (JHH) to assess their long-term use of AC. We sent a survey to patients from the JHH AF database who underwent an AF catheter ablation between 01/01/2014 and 03/31/2018. Patients were asked whether they were still on AC, if they thought the ablation was successful in controlling AF symptoms and whether the...
Source: The American Journal of Cardiology - May 11, 2020 Category: Cardiology Authors: Rafael Arias, George Leef, Usama Daimee, Bhradeev Sivasambu, Tauseef Akhtar, Joseph E. Marine, Ronald Berger, Hugh Calkins, David Spragg Source Type: research
Sleep Duration and Cardiovascular Health in A Representative Community Population (from NHANES, 2005 to 2016)
We examined the relation between sleep duration and cardiovascular health among the general population in the United States from 2005 to 2016. We sought to investigate associations between sleep duration and the prevalence of coronary artery disease (CAD), heart failure (HF), stroke, hypertension, diabetes mellitus (DM), and hyperlipidemia.
Source: The American Journal of Cardiology - April 25, 2020 Category: Cardiology Authors: Chayakrit Krittanawong, Anirudh Kumar, Zhen Wang, Hani Jneid, Usman Baber, Roxana Mehran, W. H. Wilson Tang, Deepak L. Bhatt Source Type: research
Non-Vitamin K Antagonist Oral Anticoagulant for Atrial Fibrillation in Obese Patients
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It affects 1 in 4 adults aged>40 years,1 and is associated with a 5-fold increased risk of stroke.1 Hence, anticoagulants are universally recommended to prevent stroke and systemic embolism in patients with AF.1 The non-vitamin K antagonist oral anticoagulants (NOACs) are important alternatives to warfarin for prevention of arterial thromboembolism in patients with AF. Currently, the FDA has approved four NOACs for use in patients with AF: dabigatran is a thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors.
Source: The American Journal of Cardiology - April 22, 2020 Category: Cardiology Authors: Stephen Y Wang, Robert P Giugliano Tags: Review Article Source Type: research
Long-term outcomes with drug-eluting stents or coronary artery bypass surgery for unprotected left main coronary disease: A meta-analysis and trial sequential of randomized trials
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as an acceptable revascularization strategy for select patients with unprotected left main coronary disease (LMCA).1 The EXCEL trial showed no difference between DES and coronary artery bypass surgery (CABG) at 5 years for the composite of death, procedure and non-procedure related myocardial infarction (MI), or stroke,2 however; all-cause mortality was higher with DES at 5 years, which was a secondary end-point.
Source: The American Journal of Cardiology - April 13, 2020 Category: Cardiology Authors: Islam Y. Elgendy, Ahmed N. Mahmoud, Mohamed Gad, Akram Y. Elgendy, Deepak L. Bhatt Source Type: research
Real-World Direct Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Medicare Beneficiaries with Atrial Fibrillation
It remains unknown whether the comparative effectiveness of direct oral anticoagulants (DOACs) and warfarin differs between atrial fibrillation (AF) patients with and without a history of stroke or transient ischemic attack (TIA). Using 2012-2014 Medicare claims data, we identified patients newly diagnosed with AF in 2013-2014 who initiated apixaban, dabigatran, rivaroxaban or warfarin. We categorized patients based on a history of stroke or TIA. We constructed Cox proportional hazard models that included indicator variables for treatment groups, a history of stroke or TIA, and the interaction between them, and controlled ...
Source: The American Journal of Cardiology - April 9, 2020 Category: Cardiology Authors: Lanting Yang, Maria M. Brooks, Nancy W. Glynn, Yuting Zhang, Samir Saba, Inmaculada Hernandez Source Type: research
Trends in the Utilization of Left Atrial Appendage Exclusion in the United States
Stroke prevention remains a cornerstone in the management of patients with non-valvular atrial fibrillation (NVAF)1. Oral anticoagulation (OAC) is the main method of stroke prevention in NVAF worldwide. However,>50% of high-risk NVAF patients are not maintained on OAC due to comorbidities, frailty, bleeding complications, or non-compliance2. In 1996, Blackshear proposed Left atrial appendage exclusion (LAAE) as an alternative stroke prevention strategy in NVAF3. Because no randomized data were available to support the routine use of LAAE, its utilization remained initially limited to selected patients undergoing a concomitant cardiac surgery.
Source: The American Journal of Cardiology - April 6, 2020 Category: Cardiology Authors: Safi U. Khan, Muhammad Zia Khan, Mohamad Alkhouli Source Type: research
Reader's Comments: Trends in the Utilization of Left Atrial Appendage Exclusion in the United States
Stroke prevention remains a cornerstone in the management of patients with nonvalvular atrial fibrillation (NVAF).1 Oral anticoagulation is the main method of stroke prevention in NVAF worldwide. However,>50% of high-risk NVAF patients are not maintained on oral anticoagulation due to comorbidities, frailty, bleeding complications, or noncompliance.2 In 1996, Blackshear proposed left atrial appendage exclusion (LAAE) as an alternative stroke prevention strategy in NVAF.3 Because no randomized data were available to support the routine use of LAAE, its utilization remained initially limited to selected patients undergoing a...
Source: The American Journal of Cardiology - April 6, 2020 Category: Cardiology Authors: Safi U. Khan, Muhammad Zia Khan, Mohamad Alkhouli Source Type: research
Use of the Burden of Diabetes Mellitus Score for Cardiovascular Disease Risk Assessment
The prevalence of diabetes mellitus (DM) is rising drastically with> 400 million patients living with the disorder worldwide.1-3 DM is associated with severe complications including coronary artery disease (CAD), stroke, neuropathy, retinopathy, and nephropathy.2,4,5 Of these, cardiovascular (CV) disease is the most substantial cause of morbidity and mortality.6-9 Hemoglobin A1c (HbA1c) levels and duration of disease are 2 of the strongest predictors of poor CV outcomes including mortality.1,2,5,7,10,11 One study showed that early onset DM with> 10 years duration was equivalent to CAD itself.
Source: The American Journal of Cardiology - April 3, 2020 Category: Cardiology Authors: Peter D. Farjo, Nadia Barghouthi, Noor Chima, Anand Desai, Wei Fang, Jennifer Giordano, Christopher M. Bianco Source Type: research
Loop Recorder Implantation on a Telemetry Ward
The implantable loop recorder (ILR) is a subcutaneous, long-term monitoring device used to detect arrhythmias in patients with recurrent falls, palpitations, unexplained syncope, and cryptogenic stroke.1-5 Historically, ILR implantations required a significant incision and were considered to be a surgical procedure. Given the invasive nature of the procedure and need for sterility, ILR implantations had traditionally been performed in the electrophysiology (EP) lab. Current ILR implantation procedures are much less invasive and require smaller incisions, resulting in reduced infection rates when compared to older devices.
Source: The American Journal of Cardiology - April 1, 2020 Category: Cardiology Authors: Alicia Chionchio, Beom Soo Kim, David Chang, James Gabriels, Arvind Devanabanda, Jonathan Willner, Stuart Beldner, Laurence M. Epstein Source Type: research
Characteristics and Outcome of Patients ≥75 Years of Age with Prior Coronary Artery Bypass Grafting Admitted for an Acute Coronary Syndrome
The prognostic role of prior coronary artery bypass (CABG) in elderly patients admitted to hospital for an acute coronary syndrome (ACS) is unclear. Therefore, the aim of this study was to compare the prognosis of patients aged ≥75 years admitted for an ACS with or without prior history of CABG. The primary outcome of the study was a composite of overall mortality, recurrent non-fatal myocardial infarction (MI), non-fatal stroke and re-hospitalization for heart failure at 1-year follow-up. We included 2253 ACS patients, aged 81 (78-85) years enrolled in three multicentre studies (the Italian Elderly ACS study, the LADIES...
Source: The American Journal of Cardiology - April 1, 2020 Category: Cardiology Authors: Nuccia Morici, Roberta De Rosa, Gabriele Crimi, Leonardo De Luca, Luca A. Ferri, Laura Lenatti, Luigi Piatti, Giovanni Tortorella, Daniele Grosseto, Nicoletta Franco, Irene Bossi, Claudio Montalto, Roberto Antonicelli, Gianfranco Alicandro, Giuseppe De Lu Source Type: research
Relation of Advanced Interatrial Block to Risk of Atrial Fibrillation and Stroke
Advanced interatrial block (A-IAB) has been associated to atrial fibrillation (AF) and ischemic stroke, raising the question as to whether such patients, even when still in sinus rhythm without documented AF, could benefit from oral anticoagulation. AF and A-IAB are both markers of stroke. The anatomical substrate in both is fibrotic atrial cardiomyopathy, resulting in atrial electromechanical dyssynchrony, dysfunction, and left atrial remodelling, that favour blood stasis and hypercoagulation. Under these conditions thrombogenic cascade may be triggered, resulting in systemic embolization.
Source: The American Journal of Cardiology - March 16, 2020 Category: Cardiology Authors: Antoni Bay és-de-Luna, Manuel Martínez-Sellés, Roberto Elosua, Antoni Bayés-Genís, Guiomar Mendieta, Adrian Baranchuk, Günter Breithardt Source Type: research
Observed versus Expected Ischemic and Bleeding Events Following Left Atrial Appendage Occlusion
Data on the efficacy of left atrial appendage occlusion (LAAO) in clinical practice are limited. We performed a systematic review and meta-analysis of observational studies that reported observed vs. expected rates of ischemic strokes and/or major bleeding following LAAO. Our primary end points were the pooled relative risk reduction (RRR) in ischemic stroke and major bleeding with corresponding 95% confidence intervals (CI) compared with what was expected by the CHA2DS2-VASc and HASBLED scores, respectively.
Source: The American Journal of Cardiology - March 13, 2020 Category: Cardiology Authors: Tatiana Busu, Safi U Khan, Muhammad Alhajji, Fahad Alqahtani, David R Holmes, Mohamad Alkhouli Source Type: research
Valve-in-Valve Transcatheter Implantation versus Redo Surgical Aortic Valve Replacement
Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) for a failing prosthesis is an appealing alternative to redo surgical AVR. We utilized data from the US National Inpatient Sample for the period 2012-2016 to identify hospitalizations for either ViV-TAVI or redo-SAVR. The primary outcomes of interest were in-hospital adverse events composite outcome (comprising of mortality, myocardial infarction, stroke, or acute kidney injury) and all-cause mortality. We used propensity score matching to adjust for the baseline differences between ViV-TAVI and redo-SAVR cohorts.
Source: The American Journal of Cardiology - February 7, 2020 Category: Cardiology Authors: Aaqib H. Malik, Srikanth Yandrapalli, Syed Zaid, Suchith S Shetty, Wilbert S. Aronow, Hasan Ahmad, Gilbert H.L. Tang Source Type: research
Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research
