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Source: The American Journal of Medicine

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Total 259 results found since Jan 2013.

Non-Vitamin K Antagonists versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Valves: a Systematic Review and Meta-Analysis
Patients with bioprosthetic heart valves and valve repair with concomitant atrial fibrillation are at an increased risk of thromboembolic events.1-5 Until recently, there was a paucity of randomized data to guide the optimal anticoagulation strategy in this patient population. In a prior meta-analysis of 4 randomized studies in patients with atrial fibrillation and valvular heart disease, excluding significant mitral stenosis and mechanical valves, there was a significant reduction in the risk of stroke or systemic embolism with non-vitamin K antagonist oral anticoagulants (NOACs) vs.
Source: The American Journal of Medicine - October 7, 2021 Category: General Medicine Authors: Rhanderson Cardoso, Caique M.P. Ternes, Gustavo B. Justino, Amanda Fernandes, Ana Vitoria Rocha, Leonardo Knijnik, Andre d'Avila, Renato D. Lopes Tags: Clinical Research Study Source Type: research

Effects of Anticoagulation on Low-Density Lipoprotein-Cholesterol and Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation
The study by Omelchenko et al1 concluded that, unlike the general population, low-density lipoprotein-cholesterol (LDL-C) levels were not associated with ischemic stroke risk among patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). To arrive at this conclusion, they retrospectively analyzed data of 21,229 patients with a first-time diagnosis of nonvalvular atrial fibrillation treated with DOACs categorized according to the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category, ...
Source: The American Journal of Medicine - September 28, 2021 Category: General Medicine Authors: Zeeshan H. Ismail, Zekarias T. Asnake, Joshua K. Salabei Tags: Letter Source Type: research

An updated review of the efficacy and safety of direct oral anticoagulants in treatment of left ventricular thrombus
Left ventricular (LV) thrombus is a potentially serious complication affecting males and females with ischemic and non-ischemic cardiomyopathy - specifically after acute myocardial infarctions of the anterior left ventricular wall, and long-standing tachyarrhythmias, respectively1. LV thrombi pose significant risks for systemic embolization and devastating stroke events, while also demanding a treatment carrying inherit risks of its own. It is therefore imperative to have accurate detection of these ventricular thrombi and an appropriate understanding of the risks and benefits regarding management.
Source: The American Journal of Medicine - August 29, 2021 Category: General Medicine Authors: Kevin A. Honan, Arjun Jogimahanti, Tarif Khair Tags: Review, meta-analysis Source Type: research

Ischemic Stroke
This concise review of the epidemiology, pathophysiology, evaluation, acute management, and prevention of ischemic stroke targets internists, family practicioners, and emergency physicians who manage patient with stroke.
Source: The American Journal of Medicine - August 26, 2021 Category: General Medicine Authors: Steven K. Feske Tags: Review Source Type: research

The Reply
Dr. Jolobe, in his comments on our case study,1 is quite right in highlighting 2 pertinent examples of the potentially severe iatrogenic patient harm that may result from erroneous treatment of pauci-symptomatic acute type A aortic dissection masquerading and possibly misdiagnosed as an acute vascular event, be it ischemic stroke, acute myocardial infarction, or pulmonary thromboembolism.
Source: The American Journal of Medicine - August 1, 2021 Category: General Medicine Authors: Ami Schattner Tags: Letter Source Type: research

Impact of Atrial Fibrillation on In-Hospital Mortality and Stroke in Acute Aortic Syndromes
Acute aortic syndromes may present with a number of cardiovascular complications, including atrial fibrillation. We assessed the prevalence of atrial fibrillation in patients presenting with acute aortic syndromes and evaluated atrial fibrillation's association with in-hospital mortality and stroke.
Source: The American Journal of Medicine - July 6, 2021 Category: General Medicine Authors: Umberto Campia, Samantha M. Rizzo, Julia E. Snyder, Mariana A. Pfefferman, Ruth B. Morrison, Gregory Piazza, Samuel Z. Goldhaber Source Type: research

Optimizing Blood Pressure Control without adding Anti-hypertensive Medications
Hypertension is a major risk factor for cardiovascular diseases and chronic kidney disease, the leading causes of death globally.1 The recent decrease in blood pressure to 130/80 mmHg substantially increases hypertension prevalence.2 A positive outcome of this change is early hypertension diagnosis that allows proactive use of lifestyle interventions. Lowering blood pressure by any anti-hypertensive drug class results in a significant reduction in major cardiovascular events, stroke, and chronic kidney disease progression.
Source: The American Journal of Medicine - June 28, 2021 Category: General Medicine Authors: Vishnu Priya Pulipati, Jon W. Mares, George L. Bakris Tags: Commentary Source Type: research

The impact of strong inducers on direct oral anticoagulant levels
Direct oral anticoagulants (DOAC) are widely used in clinical practice. They are now recommended over warfarin in eligible patients, for stroke prevention in atrial fibrillation (SPAF) or the treatment of venous thromboembolism1,2. Given their predictable dose response, DOAC have a fixed-dose regimen and do not require routine laboratory monitoring. However, inter-individual variability in DOAC plasma concentrations has been described. In phase 3 trials and registries, low and high DOAC levels were shown to correlate with thromboembolic and bleeding events respectively3,4.
Source: The American Journal of Medicine - June 24, 2021 Category: General Medicine Authors: Anne-Laure Sennesael, Anne-Sophie Larock, Philippe Hainaut, Sarah Lessire, Michael Hardy, Jonathan Douxfils, Anne Spinewine, Fran çois Mullier Tags: Brief Observation Source Type: research

A comprehensive cardiovascular-renal-metabolic risk reduction approach to patients with Type 2 Diabetes Mellitus
Cardiovascular disease remains the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus, despite decades of research into risk reduction strategies (1,2). While myocardial infarction and ischemic stroke are the most recognized drivers of mortality in this population, less well-appreciated forms of cardiovascular disease, including heart failure and peripheral arterial disease, also contribute significantly to this risk (3-5). Further, the development of renal disease among patients with type 2 diabetes mellitus is common (6), and it drastically increases the risk of cardiovascular disease a...
Source: The American Journal of Medicine - May 21, 2021 Category: General Medicine Authors: Neha J. Pagidipati, Dr. Prakash Deedwania Tags: Review Source Type: research

Intravascular Large B Cell Lymphoma as a Cause of Multifocal Cryptogenic Stroke
All authors verify they had access to all data and participated in writing the manuscript
Source: The American Journal of Medicine - May 10, 2021 Category: General Medicine Authors: Sriram Anbil, Kathleen Fenerty, Zekun Feng, Reece Doughty, Neveen S El-Farra Source Type: research

Assessment of Cardiovascular Risk in Transgender Patients Presenting for Gender-Affirming Care
The transgender population is rapidly growing in the United States and abroad. Transgender men and women are marginalized as a result of their transgender status with resultant health repercussions. This and other factors such as increased substance use, mental health disorders, violence, and chronic stress may place transgender individuals at higher risk for cardiovascular disease. Additionally, many transgender patients pursue gender affirming hormone therapy which has been linked to increased rates of some cardiovascular events such as metabolic syndrome, venous thromboembolism, and stroke.
Source: The American Journal of Medicine - April 22, 2021 Category: General Medicine Authors: Kara J. Denby, Leslie Cho, Karlo Toljan, Meghana Patil, Cecile A. Ferrando Source Type: research

Should Senior Citizens Take Aspirin Daily to Prevent Heart Attacks or Strokes?
More than one-half of Americans age 45 to 75 years take aspirin daily to prevent a stroke or a heart attack.1 Nearly half of US adults 75 years and older take daily aspirin even though they do not have a history of stroke or heart attack; they take it for the primary prevention of cardiovascular disease.2 Half of these individuals had discussed this with a physician.1 IS this a good or a bad idea? And how did the controversy surrounding the use of aspirin to prevent cardiovascular disease get started?
Source: The American Journal of Medicine - April 13, 2021 Category: General Medicine Authors: James E. Dalen, Robert J. Goldberg, Anna Waterbrook, Laura Wylie, Joseph S. Alpert Tags: Commentary Source Type: research

Should Senior Citizens Take Aspirin Daily to Prevent Heart Attacks or Strokes??
More than one-half of Americans aged 45 to 75 years take aspirin daily to prevent a stroke or a heart attack.1 Nearly half of American adults 75 years and older take daily aspirin even though they do not have a history of stroke or heart attack; they take it for the primary prevention of cardiovascular disease.2 Half of these individuals had discussed this with a physician.1 Was this a good or a bad idea? And how did the controversy surrounding the use of aspirin to prevent cardiovascular disease get started?
Source: The American Journal of Medicine - April 13, 2021 Category: General Medicine Authors: James E. Dalen, Robert Goldberg, Anna Waterbrook, Laura Wylie, Joseph S. Alpert Tags: COMMENTARY Source Type: research

Long-term Clinical Outcomes of Underdosed Direct Oral Anticoagulants in patients with Atrial Fibrillation and Atrial Flutter
Although direct oral anticoagulants (DOACs) have been shown to be effective at reducing the risk of stroke in patients with atrial fibrillation/flutter (AF), they are sometimes underdosed off-label to mitigate their associated higher bleeding risk. We sought to evaluate frequency and clinical outcomes of inappropriate underdosing of DOACS in patients with AF.
Source: The American Journal of Medicine - January 11, 2021 Category: General Medicine Authors: Hasan Ashraf, Pradyumna Agasthi, Anusha Shanbhag, Ramila A. Mehta, Pattara Rattanawong, Mohamed Allam, Sai Harika Pujari, Farouk Mookadam, William K. Freeman, Komandoor Srivathsan, Dan Sorajja, Win-Kuang Shen, Peter A. Noseworthy, Eric H. Yang, Hicham Z. Tags: Clinical Research Study Source Type: research

Oral Anticoagulation Use in High-Risk Patients Is Improved by Elimination of False-Positive and Inactive Atrial Fibrillation Cases
Multiple registries have reported that>40% of high-risk atrial fibrillation patients are not taking oral anticoagulants. The purpose of our study was to determine the presence or absence of active atrial fibrillation and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 y, Diabetes mellitus, prior Stroke [or transient ischemic attack or thromboembolism], Vascular disease, Age 65-74 y, Sex category) risk factors to accurately identify high-risk atrial fibrillation (CHA2DS2-VASc ≥2) patients requiring oral anticoagulants and the magnitude of the anticoagulant treatment gap.
Source: The American Journal of Medicine - December 23, 2020 Category: General Medicine Authors: Gerald V. Naccarelli, Mohammed Ruzieh, Deborah L. Wolbrette, Mauricio Sendra-Ferrer, John van Harskamp, Barbara Bentz, Gregory Caputo, Nathan McConkey, Kevin Mills, Stephen Wasemiller, Jovan Plamenac, Douglas Leslie, Frendy D. Glasser, Thomas W. Abendroth Tags: Clinical Research Study Source Type: research