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Source: The American Journal of Cardiology
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Total 715 results found since Jan 2013.
Efficacy of Percutaneous Coronary Intervention With Synergy Stents in Patients Aged ≥75 Years: 1-Year Clinical Outcomes from the Synergy Elderly Registry
This study investigated the 12-month clinical outcomes of older patients who underwent percutaneous coronary intervention with new-generation drug-eluting stents according to ischemic risks. This prospective multicenter study targeted patients aged ≥75 years who underwent S-EES implantation. The primary and secondary end points included 12-month device-oriented composite end point (DOCE) (cardiovascular death, target vessel myocardial infarction, or target lesion revascularization) and major adverse cardiac and cerebrovascular events (MACCE s; all-cause death, myocardial infarction, target vessel revascularization, sten...
Source: The American Journal of Cardiology - August 1, 2023 Category: Cardiology Authors: Jong-Il Park, Seung-Jun Lee, Young-Joon Hong, Sang-Yong Yoo, Yong-Sung Seo, Eui Im, Jong-Kwan Park, Jin-Bae Lee, Yong-Joon Lee, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Byeong-Keuk Kim Source Type: research
Guideline-Directed Low-Density Lipoprotein Cholesterol Management After Acute Ischemic Stroke: Findings from a National Health Care Service
Patients with ischemic stroke are at high risk for future cardiovascular events and should be treated intensively with lipid-modifying agents. Combination lipid-lowering therapies are often needed to achieve updated guideline-directed treatment goals. However, real-world data on intensification of lipid-lowering therapies and attainment of low-density lipoprotein cholesterol (LDL-C) targets early after ischemic stroke are limited. We extracted data from the largest healthcare provider in Israel on patients hospitalized with acute ischemic stroke between January 2020 and February 2022.
Source: The American Journal of Cardiology - July 28, 2023 Category: Cardiology Authors: Barak Zafrir, Amir Aker, Ibrahim Naoum, Walid Saliba Source Type: research
Trends in the Longitudinal Utilization of Oral Anticoagulants Among Newly Diagnosed Atrial Fibrillation Patients With Commercial, Medicare, and Medicaid Insurance
Long-term oral anticoagulation (OAC) is recommended for stroke prevention for most patients with atrial fibrillation (AF) and elevated stroke risk.1 While trends in initiation of OAC have been described,2,3 long-term trends in utilization of OAC in patients continuously followed for AF have not been adequately explored. Some healthcare systems adapted anticoagulation services to respond to disruptions during the COVID-19 pandemic.4 We thus investigated how OACs were utilized in patients with newly diagnosed AF from 2018 to 2021 across 3 insurance types: Medicare, Medicaid, and commercial.
Source: The American Journal of Cardiology - July 28, 2023 Category: Cardiology Authors: Jun Soo Lee, Sola Han, Nicole L. Therrien, Chanhyun Park, Feijun Luo, Utibe R. Essien Tags: Brief report Source Type: research
Atrial Myopathy and Ischemic Stroke in Heart Failure With Preserved Ejection Fraction
We examined the hypothesis that atrial myopathy may be associated with ischemic stroke in patients with heart failure with preserved ejection fraction. This is an exploratory, post hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. Patients with sinus rhythm documented at baseline electrocardiogram and without known AF were included in this analysis.
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Kassem Farhat, Khaled Elkholey, Zain Ul Abideen Asad, Stavros Stavrakis Source Type: research
Quest for the Perfect Anticoagulant
The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with...
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Bryant Fisher, Danny Chu Source Type: research
One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease
The concept of the polypill was first proposed in 2003 as a strategy to reduce cardiovascular risk by combining multiple therapeutic agents into a single daily pill. Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care.
Source: The American Journal of Cardiology - July 26, 2023 Category: Cardiology Authors: Rebecca J.C. Tran Source Type: research
A Commentary on “Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke”
Cryptogenic stroke, defined as acute ischemic stroke without a clear identifiable cause, accounts for approximately 1/3 of acute ischemic stroke cases. Undiagnosed atrial fibrillation (AF) is likely the leading underlying cause of such presentations; hence, cardiac rhythm monitoring is key to the diagnostic work-up. Commonly, long-term monitoring (LTM) using implantable cardiac monitors (ICMs) is indicated after a negative period of short-term monitoring (STM). However, the low diagnostic yield of STM prompts the question: would directly proceeding to LTM represent a more cost-effective approach?
Source: The American Journal of Cardiology - July 22, 2023 Category: Cardiology Authors: Michael Griffin, Gregory Y.H. Lip Tags: Editorial Source Type: research
Gender Differences in Atrial Fibrosis and Cardiomyopathy Assessed by Left Atrial Low-Voltage Areas During Catheter Ablation of Atrial Fibrillation
This study aimed to delineate gender differences in the prevalence, predictors, and prognostic impact of left atrial low-voltage areas (LVAs). This observational study included 1,488 consecutive patients who underwent initial ablation for AF. Voltage mapping was performed after pulmonary vein isolation during sinus rhythm.
Source: The American Journal of Cardiology - July 21, 2023 Category: Cardiology Authors: Masaharu Masuda, Yasuhiro Matsuda, Hiroyuki Uematsu, Ayako Sugino, Hirotaka Ooka, Satoshi Kudo, Subaru Fujii, Mitsutoshi Asai, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yosuke Hata, Taku Toyoshima, Naoko Higashino, Sho Source Type: research
Effectiveness and Safety of Direct Oral Anticoagulants for Stroke Prevention in Atrial Fibrillation Patients With Extreme Obesity
Direct oral anticoagulants (DOACs) are a favored treatment to prevent stroke in patients with atrial fibrillation (AF). There are limited data concerning the efficacy and safety of DOACs in obese. Obesity leads to wide structural and physiological changes that may affect the pharmacokinetics and pharmacodynamics of drugs. The optimal dosing strategies for DOACs in this significant and growing sub-group remain unknown. The study aimed to evaluate on a large scale the safety and efficacy of DOAC treatment in extreme obese patients with AF.
Source: The American Journal of Cardiology - July 18, 2023 Category: Cardiology Authors: Boaz Elad, Nimra Maman, Snait Ayalon, Lee Hilary Goldstein Source Type: research
Percutaneous Left Atrial Appendage Closure Among Patients With Diabetes (Insights from a National Database)
Atrial fibrillation is a major risk factor for stroke. Left atrial appendage closure (LAAC) has emerged as an alternative to anticoagulation for patients with high risk of bleeding. Diabetes mellitus (DM) is associated with adverse events after cardiac procedures. We sought to compare procedural and hospital outcomes in patients who underwent LAAC with and without DM. The Nationwide Inpatient Database was queried for patients with atrial fibrillation who underwent LAAC between January 1, 2016, and December 31, 2019.
Source: The American Journal of Cardiology - July 11, 2023 Category: Cardiology Authors: Mohamed Hamed, Ramez Morcos, Ayman Elbadawi, Ahmed Osman, Hani Jneid, Wissam Khalife, Brijeshwar Maini, Houman Khalili Source Type: research
Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke
Implantable cardiac monitors are routinely placed for long-term monitoring (LTM) after a period of negative short-term monitoring (STM) to increase atrial fibrillation (AF) detection after a cryptogenic stroke or transient ischemic attack (TIA). Optimizing AF monitoring after a cryptogenic stroke is critical to improve outcomes and reduce costs. We sought to compare the diagnostic yield of STM versus LTM, assess the impact of routine STM on hospitalization length of stay, and perform a financial analysis comparing the current model to a theoretical model wherein patients can proceed directly to LTM.
Source: The American Journal of Cardiology - July 11, 2023 Category: Cardiology Authors: Samuel J. Apple, David Flomenbaum, Matthew Parker, Sanya Chhikara, Aaron Stolarov, Jack Moser, Sheetal Vasundara Mathai, Jiyoung Seo, Neal Ferrick, Jay J. Chudow, Luigi Di Biase, Andrew Krumerman, Kevin J. Ferrick Source Type: research
Should Pleiotropic Effects of Antiplatelet Agents Be Considered for Acute Coronary Syndrome?
When he coined the phrase, “A man is as old as his arteries,” Dr. Williams Osler anticipated the concept of the spectrum cardiovascular disease (CVD) by a century. The populations of many countries are becoming older, which has also led to the number of patients suffering from CVD to increase. Global rates of CVD such as ischemic heart disease (IHD) and stroke have been rising since the 1970s and the leading 2 causes of years of life lost in 2017 may continue to be the same in 2040.1 About 9 million deaths were because of IHD in 2017.
Source: The American Journal of Cardiology - July 10, 2023 Category: Cardiology Authors: Hideki Ishii Source Type: research
Propensity Matched Comparison of Clinical Outcome After Immediate Versus Staged Complete Revascularization in Patients With Acute Coronary Syndrome and Multivessel Disease
This study evaluated patients presenting with ACS and MVD admitted between January 2015 and September 2021 at the Erasmus University Medical Center. Clinical outcomes were compared between immediate and staged CR in terms of major adverse cardiac and cer ebrovascular events (MACCEs), a composite of all-cause mortality, myocardial infarction, stroke, and any unplanned revascularization.
Source: The American Journal of Cardiology - July 4, 2023 Category: Cardiology Authors: Hala Kakar, Jacob J. Elscot, Annebel De Gier, Paola Scarparo, Isabella Kardys, Rutger Jan Nuis, Jeroen Wilschut, Wijnand K. Den Dekker, Joost Daemen, Nicolas M. Van Mieghem, Roberto Diletti Source Type: research
Transcatheter Aortic Valve Implantation: Transvascular Is the Way to Go!
There is no doubt that transcatheter aortic valve implantation (TAVI) has been widely accepted by the whole medical community dedicated to the heart care of patients with aortic valve stenosis. Increasing clinical experience and constant refinement of devices and procedural techniques have resulted in improved outcomes, especially since the generalized use of the transfemoral approach for TAVI.1 So far, only transfemoral TAVI has been associated with a significant reduction of mortality or disabling stroke in patients at intermediate risk, compared with surgical aortic valve replacement (AVR).
Source: The American Journal of Cardiology - July 1, 2023 Category: Cardiology Authors: Thierry Bov é Tags: Editorial Source Type: research
Long-Term Imaging and Clinical Outcomes of Surgical Left Atrial Appendage Occlusion With AtriClip
Surgical left atrial appendage (LAA) occlusion with an AtriClip (AtriCure, West Chester, Ohio) is frequently performed for stroke prophylaxis in patients with atrial fibrillation (AF). We conducted a retrospective analysis of all patients with long-standing persistent AF who underwent hybrid convergent ablation and LAA clipping. Contrast-enhanced cardiac computed tomography was performed at 3 to 6 months after LAA clipping to assess the degree of complete closure and the residual LAA stump. A total of 78 patients (64 ± 10 years, 72% male) underwent LAA clipping as part of hybrid convergent AF ablation, from 2019 to 2020.
Source: The American Journal of Cardiology - June 28, 2023 Category: Cardiology Authors: Adnan Ahmed, Naga Venkata K. Pothineni, Vasvi Singh, Danish Bawa, Douglas Darden, Rajesh Kabra, Angad Singh, Saira Memon, Ahmed Romeya, Justin Van Meeteren, Senthil Thambidorai, Dhanunjaya Lakkireddy, Rakesh Gopinathannair Source Type: research
