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Source: The American Journal of Cardiology
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Total 715 results found since Jan 2013.
Atrial Cardiopathy: Redefining Stroke Risk Beyond Atrial Fibrillation
Atrial fibrillation (AF) and ischemic stroke are dual epidemics in society, both associated with poor clinical outcomes, patient disability, and significant healthcare expenditure. The conditions are interrelated and share complex causal pathways. Risk stratification algorithms such as the CHADS2 and CHA2DS2-VASc score offer predictive value in stroke and systemic embolism risk in the AF population, however, have limitations. Recent evidence suggests that an intrinsically prothrombotic atrial substrate may precede and promote AF and lead to thromboembolic events independent of the arrhythmia, allowing for a window of inter...
Source: The American Journal of Cardiology - June 28, 2023 Category: Cardiology Authors: Jessica Chu Zhang, Aditya Bhat Source Type: research
An Explainable Artificial Intelligence Approach for Discovering Social Determinants of Health and Risk Interactions for Stroke in Patients With Atrial Fibrillation
Stroke remains the primary source of morbidity and mortality associated with atrial fibrillation (AF), despite major advances in prevention. Although effective stroke-prevention strategies are available, optimal implementation of these treatments is limited by (1) rudimentary stroke risk stratification tools (i.e., CHADS2-VA2Sc), and (2) disparities in care and outcomes of AF. Over 150,000 yearly strokes in the United States occur in patients with AF.1 Many of these occur in patients with AF who are misclassified as low-risk or fail to receive appropriate therapies because of healthcare disparities.
Source: The American Journal of Cardiology - June 28, 2023 Category: Cardiology Authors: Raquel M. Zimmerman, Edgar J. Hernandez, W. Scott Watkins, Nathan Blue, Martin Tristani-Firouzi, Mark Yandell, Benjamin A. Steinberg Source Type: research
Left Atrial Appendage Occlusion Devices: Are We Isolating the Right Population?
Atrial fibrillation (AF) affects more than 37 million persons worldwide contributing to significant morbidity and mortality.1 Stroke prevention with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants remains the mainstay of therapy in patients with AF because of the reduction of all-cause mortality in randomized clinical trials when compared with placebo. VKAs are necessary for those patients with valvular AF but carry a higher risk of stroke, intracranial hemorrhage, and mortality when compared with non-VKA oral anticoagulants.
Source: The American Journal of Cardiology - June 27, 2023 Category: Cardiology Authors: Navid Nafissi, Anita M. Kelsey Source Type: research
Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in Patients Who Underwent Transcatheter Aortic Valve Implantation
Stroke is a known complication of both transcatheter aortic valve implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS is a predictor of worse prognosis after TAVI is unclear. We performed a meta-analysis to assess the impact of CAS on the incidence of neurovascular complications and mortality after TAVI. We searched PubMed/MEDLINE and EMBASE databases from inception to January 2023. CAS was defined by ≥50% stenosis of at 1 carotid artery. Studies comparing CAS versus non-CAS TAVI populations were included.
Source: The American Journal of Cardiology - June 22, 2023 Category: Cardiology Authors: Agnese Vella, Olivier Roux, Panagiotis Antiochos, Pierre Monney, Niccolo Maurizi, Ioannis Skalidis, Stephane Fournier, Eric Eeckhout, Christan Roguelov, Simon Oestreicher, Matthias Kirsch, Olivier Muller, Henri Lu Source Type: research
An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients With Atrial Fibrillation
The availability of direct oral anticoagulants (DOACs) with known lower bleeding risk compared with warfarin have raised questions about the role of left atrial appendage closure (LAAC). We aimed to perform a meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All studies directly comparing LAAC with DOACs up to January 2023 were included. The outcomes studied included the combined major adverse cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic events, major bleeding, CV mortality, and all-cause mortality.
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Haowen Jiang, Tian Hai Koh, Vijay Vengkat, Gao Fei, Zee Pin Ding, See Hooi Ewe, Ignasius Jappar, Soo Teik Lim, Jonathan Yap Source Type: research
Impact of a Novel Score to Predict Left Ventricular Diastolic Dysfunction After Catheter Ablation of Nonparoxysmal Atrial Fibrillation With Preserved Ejection Fraction
This study aimed to develop a novel risk score to predict LV diastolic dysfunction (LVDD) 12 months after AFCA (12-month LVDD) and to evaluate whether the risk score was associated with cardiovascular events (cardiovascular death, transient ischemic attack/stroke, myocardial infarction, or heart failure hospitalization). We studied 397 patients with nonparoxysmal AF with preserved ejectio n fraction who underwent initial AFCA (age: 69 years, women: 32%).
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Yasuyuki Egami, Hiroaki Nohara, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino, Jun Tanouchi Source Type: research
Machine Learning-Based Prediction of Atrial Fibrillation Risk Using Electronic Medical Records in Older Aged Patients
Atrial fibrillation (AF) is an independent risk factor that increases the risk of stroke 5-fold. The purpose of our study was to develop a 1-year new-onset AF predictive model by machine learning based on 3-year medical information without electrocardiograms in our database to identify AF risk in older aged patients. We developed the predictive model according to the Taipei Medical University clinical research database electronic medical records, including diagnostic codes, medications, and laboratory data.
Source: The American Journal of Cardiology - May 18, 2023 Category: Cardiology Authors: Yung-Ta Kao, Chun-Yao Huang, Yu-Ann Fang, Ju-Chi Liu, Tzu-Hao Chang Source Type: research
High-Burden Premature Atrial Contractions Predict New-Onset Atrial Fibrillation After Surgical Septal Myectomy
We examined the correlation between different preoperative PAC burdens and POAF in patients with obstructive hypertrophic cardiomyopathy (OHCM) who underwent surgical treatment. We analyzed 304 consecutively admitted patients with OHCM without previous AF who underwent isolated septal myectomy between January 2015 and December 2018.
Source: The American Journal of Cardiology - May 5, 2023 Category: Cardiology Authors: Yanhai Meng, Changrong Nie, Yanbo Zhang, Changsheng Zhu, Enci Hu, Jigao Shang, Tao Lu, Zining Wu, Shuiyun Wang Source Type: research
Prevalence of Social Determinants Among US Residents With Heart Failure by Race/Ethnicity and Household Income
Patients with heart failure (HF) are susceptible to the impacts of social determinants of health (SDOH). Previous studies consistently suggest that a greater burden of SDOH is associated with poorer health outcomes.1,2 Data from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study reported that>70% of patients hospitalized with HF had at least 1 SDOH.3 However, the national prevalence of SDOH among patients who are ambulatory and have HF has not been reported and represents an important gap in understanding of HF SDOH.
Source: The American Journal of Cardiology - April 13, 2023 Category: Cardiology Authors: Lajjaben Patel, Nidhish Lokesh, Shreya Rao, Tiffany M. Powell-Wiley, Andrew Sumarsono Source Type: research
Comparison of Stroke and Bleeding Risk Profile in Patients With Atrial Fibrillation and Chronic Kidney Disease
This study explores the impact of glomerular filtration rate (GFR) in the embolic-hemorrhagic balance among a large cohort of patients with AF. The study cohort included 15,457 patients diagnosed with AF between January 2014 and April 2020. The risk of ischemic stroke and major bleeding was determined by competing risk regression.
Source: The American Journal of Cardiology - April 12, 2023 Category: Cardiology Authors: Jos é Antonio Parada Barcia, Sergio Raposeiras Roubin, Emad Abu-Assi, Pablo Domínguez Erquicia, Andrea Lizancos Castro, Lucía Rioboo Lestón, Juan Ocampo Míguez, Inmaculada González Bermúdez, Andrés Íñiguez-Romo Source Type: research
Impact of Frailty on In-Hospital Outcomes in Patients Who Underwent Percutaneous Left Atrial Appendage Occlusion
In patients with atrial fibrillation, frailty is associated with an increased risk of bleeding, especially if patients take oral anticoagulation for stroke prophylaxis.1 Left atrial appendage occlusion (LAAO) is an alternative in patients unable to tolerate anticoagulation. However, whether patients who are frail are more vulnerable to procedural complications associated with LAAO remains undefined.2 We therefore examined in-hospital outcomes in patients who undergo LAAO procedures using a nationally representative real-world cohort of patients.
Source: The American Journal of Cardiology - April 9, 2023 Category: Cardiology Authors: Siddharth Agarwal, Muhammad Bilal Munir, Agam Bansal, Christopher V. DeSimone, Usman Baber, Abhishek Deshmukh, Zain Ul Abideen Asad Source Type: research
Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) has emerged as an effective therapy for patients with severe aortic stenosis, irrespective of surgical risks.1 Stroke due to cerebral embolization of debris is a devastating periprocedural complication of TAVR and is associated with poor outcomes. The risk of stroke could be decreased by capturing the debris using cerebral embolic protection (CEP) devices.2 An analysis of the TVT (Transcatheter Valve Therapy) Registry showed that CEPs were used in 28% of centers and 13% of all procedures.
Source: The American Journal of Cardiology - February 27, 2023 Category: Cardiology Authors: Ahmad Al-Abdouh, Mohammed Mhanna, Ahmad Jabri, Taha Ahmed, Ahmed M. Altibi, Fares Ghanem, Laith Alhuneafat, Ayman Albadawi, Mahmoud Barbarawi, Nakeya Dewaswala, Huzefa Bhopalwala, Amartya Kundu, Islam Y. Elgendy Source Type: research
Probability of Cardioembolic vs. Atherothrombotic Pathogenesis of Cryptogenic Strokes in Older Patients
Some clinical, laboratory, ECG, and echocardiographic parameters could provide useful indications to assess the probability of cardioembolism or atherothrombosis in cryptogenic strokes. We retrospectively examined 290 patients with ischemic stroke aged ≥60 years, divided into 3 groups: strokes originating from large artery atherothrombosis (n = 92), cardioembolic strokes caused by paroxysmal atrial fibrillation (n = 88) and cryptogenic strokes (n = 110). In addition to echocardiographic and routine clinical-laboratory variables, neutrophi l:lymphocyte ratio, red blood cell distribution width, mean platelet volume,...
Source: The American Journal of Cardiology - February 1, 2023 Category: Cardiology Authors: Antonio Muscari, Eleonora Evangelisti, Luca Faccioli, Paola Forti, Marco Ghinelli, Giovanni M. Puddu, Luca Spinardi, Giovanni Barbara Source Type: research
Association of Frailty Status on the Causes and Outcomes of Patients Admitted With Cardiovascular Disease
Data are limited about the contemporary association between frailty and the causes and outcomes of patients admitted with cardiovascular diseases (CVD). Using the US National Inpatient Sample, CVD admissions of interest (acute myocardial infarction, ischemic stroke, atrial fibrillation (AF), heart failure, pulmonary embolism, cardiac arrest, and hemorrhagic stroke) were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of in-hospital mortality among different groups with frailty.
Source: The American Journal of Cardiology - January 24, 2023 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Muhammad Rashid, Jo Protheroe, Richard Partington, Christian Mallen, Mamas A. Mamas Source Type: research
Effect of Anticoagulation Duration on Stroke Incidence in Asian Patients With Left Ventricular Thrombus
Left ventricular thrombus (LVT) occurs in acute myocardial infarction (AMI) and in ischemic and nonischemic cardiomyopathies.1,2 LVT may result in embolic stroke.3 We read with interest the study by Lorente-Ros et al4 published in the American Journal of Cardiology. That study, conducted in a Spanish cohort, found that prolonged anticoagulation>12 months for LVT was associated with lower stroke risk. We aimed to study the generalizability of these results in an Asian population because the original article was a single-center study with limited representation.
Source: The American Journal of Cardiology - January 24, 2023 Category: Cardiology Authors: Fang Qin Goh, Aloysius S.T. Leow, Jamie S.Y. Ho, Benjamin Y.Q. Tan, Leonard L.L. Yeo, Ching-Hui Sia Source Type: research
