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Source: Canadian Journal of Cardiology
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Total 265 results found since Jan 2013.
The potential impact of new stent platforms for coronary revascularization in diabetics
Publication date: Available online 1 March 2018 Source:Canadian Journal of Cardiology Author(s): Gustavo S. Guandalini, Sripal Bangalore Coronary artery disease in patients with diabetes mellitus (DM) is characterized by extensive atherosclerosis, longer lesions and diffuse distal disease. Consequently, these patients have worse outcomes following coronary revascularization, regardless of the modality employed. Traditionally, coronary artery bypass grafting (CABG) has been regarded as more effective than percutaneous coronary intervention (PCI) in patients with DM, owing likely to more complete revascularization and prote...
Source: Canadian Journal of Cardiology - March 2, 2018 Category: Cardiology Source Type: research
Aortic Arch Reconstructive Surgery With Conventional Techniques vs Frozen Elephant Trunk: A Systematic Review and Meta-Analysis
Conclusions Current evidence suggests that FET surgery is associated with lower mortality in patients with thoracic aneurysmal disease and dissections, without a significant increase in stroke, bleeding, or operative times. However, the risk of spinal cord ischemia is increased in patients who undergo FET. A well-powered randomized trial is needed to evaluate this evolving field.
Source: Canadian Journal of Cardiology - February 21, 2018 Category: Cardiology Source Type: research
An Invasive vs a Conservative Approach in Elderly Patients with Non –ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis
Conclusion The overall benefit with invasive strategy comes from the data of observational studies that are prone to selection bias. We believe that there is a need for a large randomized study in the elderly patients regarding management of NSTEMI.
Source: Canadian Journal of Cardiology - February 21, 2018 Category: Cardiology Source Type: research
Incident Atrial Fibrillation and Stroke in Patients with Atrial Flutter
Publication date: Available online 20 February 2018 Source:Canadian Journal of Cardiology Author(s): Jorge A. Wong, Jeff S. Healey
Source: Canadian Journal of Cardiology - February 20, 2018 Category: Cardiology Source Type: research
Long term Follow-up of the Trial of Routine ANgioplasty and Stenting after Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction (TRANSFER AMI)
Conclusion Despite the short-term benefit and safety of an early invasive strategy in STEMI patients receiving fibrinolysis, no statistically-significant differences in MACE were observed over 7.8 years.
Source: Canadian Journal of Cardiology - February 10, 2018 Category: Cardiology Source Type: research
Direct factor Xa inhibitors for long-term stroke prevention in atrial fibrillation: could the lower dose fit all?
Publication date: Available online 7 February 2018 Source:Canadian Journal of Cardiology Author(s): Thomas A. Mavrakanas, Manish M. Sood
Source: Canadian Journal of Cardiology - February 7, 2018 Category: Cardiology Source Type: research
Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE)
Conclusion MANAGE is the first randomized controlled trial to evaluate a potential treatment of patients who suffered MINS.
Source: Canadian Journal of Cardiology - February 3, 2018 Category: Cardiology Source Type: research
Stroke Prevention for High-Risk Atrial Fibrillation in the Emergency Setting: The Emergency Physician Perspective
Publication date: February 2018 Source:Canadian Journal of Cardiology, Volume 34, Issue 2 Author(s): Clare L. Atzema Atrial fibrillation is a frequent reason for presentation to an emergency department (ED), and the number of these visits are increasing. This creates an opportunity to improve the suboptimal rate of oral anticoagulation (OAC) use in patients with atrial fibrillation who are at high risk of stroke. However, there are very few data on whether OAC initiation in the ED, compared with referral to the longitudinal health care provider to initiate it, results in better long-term use. Moreover, for ethical and med...
Source: Canadian Journal of Cardiology - February 3, 2018 Category: Cardiology Source Type: research
Women and Peripheral Arterial Disease: A Review of Sex Differences in Epidemiology, Clinical Manifestation and Outcomes
Publication date: Available online 31 January 2018 Source:Canadian Journal of Cardiology Author(s): Kajenny Srivaratharajah, Beth L. Abramson Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in women. Peripheral arterial disease (PAD), a manifestation of CVD and a marker for other adverse CVD outcomes such as ischemic heart disease and stroke, remains under-recognized and under-treated in women. Contrary to previous belief that PAD is mainly a disease of Caucasian men, contemporary data suggest equal, if not higher, prevalence rates in non-Caucasian women. Women often present with asymptomatic or...
Source: Canadian Journal of Cardiology - January 31, 2018 Category: Cardiology Source Type: research
Elevated Incidence of Atrial Fibrillation and Stroke in Patients with Atrial Flutter – A Population-Based Study
Conclusions Patients with isolated atrial flutter develop atrial fibrillation and stroke at a higher rate than the general population. Catheter ablation reduces but does not eliminate future AF incidence and stroke risk and continued anticoagulation after successful atrial flutter ablation may therefore be warranted. Teaser We examine the incidence of atrial fibrillation and stroke in a large real-world cohort of patients with atrial flutter, and the impact of atrial flutter ablation. Patients with atrial flutter developed atrial fibrillation and stroke at a higher rate than the general population. Atrial flutter ablation ...
Source: Canadian Journal of Cardiology - January 6, 2018 Category: Cardiology Source Type: research
Multiple thromboembolic events from a left atrial appendage occlusion device
We report a clinico-pathological case where thrombus adherent to an incompletely endothelialized Watchman® device resulted in multiple thromboembolic events, contributing to a fatal outcome. This case illustrates uncertainties regarding the device’s endothelialization process. Teaser Left atrial appendage occlusion devices are an alternative to oral anticoagulation in patients with nonvalvular atrial fibrillation at risk of ischemic stroke. Post-implantation thromboprophylaxis is recommended, but the optimal regimen is unknown. We report a clinico-pathological case where thrombus adherent to an incompletely endotheliali...
Source: Canadian Journal of Cardiology - December 27, 2017 Category: Cardiology Source Type: research
Telehealth for remote stroke management
This article reviews the rationale for telestroke networks and their current implementation in Canada. Telestroke networks enable stroke-specific procedures to be performed by less experiences physicians under the guidance of stroke neurology experts. The article also presents evidence that the safety and effectiveness of intravenous alteplase in community hospitals in a telestroke network seems to be comparable to that achieved in dedicated stroke centres. It is thus a viable option to guarantee an aging population access to stroke care across large geographic regions with faster treatment and access to more advanced trea...
Source: Canadian Journal of Cardiology - December 27, 2017 Category: Cardiology Source Type: research
Associations between Complex PCI and Prasugrel or Clopidogrel use in Patients with Acute Coronary Syndromes undergoing PCI: From the PROMETHEUS Study
Conclusions Despite the use of contemporary techniques, ACS patients undergoing complex PCI had significantly higher rates of 1-year MACE. Adjusted magnitude of treatment effects with prasugrel versus clopidogrel were consistent in complex and non-complex PCI without evidence of interaction. Teaser In this analysis from the PROMETHEUS ACS registry (n = 19,914), complex PCI (PCI of left main/ bifurcation/ moderate-severely calcified lesion/ stent length ≥30mm) was associated with greater risk of 1-year MACE (death, myocardial infarction, stroke or unplanned revascularization; HR 1.29 [1.20-1.39]). Treatment effects with p...
Source: Canadian Journal of Cardiology - December 27, 2017 Category: Cardiology Source Type: research
Aortic Arch Reconstructive Surgery with Conventional Techniques versus Frozen Elephant Trunk: A Systematic Review and Meta-Analysis
Conclusion Current evidence suggests that FET surgery is associated with lower mortality in patients with thoracic aneurysmal disease and dissections, without a significant increase in stroke, bleeding or operative times. However, the risk of spinal cord ischemia is increased in FET patients. A well powered randomized trial is needed to evaluate this evolving field. Teaser To our knowledge, we have performed the most detailed meta-analysis for the use of Frozen Elephant Trunk (FET) surgery, yielding a systematic review with the most number of patients studied. Our systematic review and meta-analysis uses the most up to dat...
Source: Canadian Journal of Cardiology - December 26, 2017 Category: Cardiology Source Type: research
Assessment and management of the Left Atrial Appendage Thrombus in Patients with Nonvalvular Atrial Fibrillation
Conclusion Integration of clinical, biomarker, and imaging risk factors can improve overall prediction for the presence of LAA thrombi, translating into improved patient selection for imaging. The gold standard for the diagnosis of LAA thrombi remains TEE, although ICE, CCT, and CMR are promising alternative modalities. When LAA thrombi are discovered, the treatment regimen remains variable, although DOACs may have similar efficacy to VKA. Future trials will help further elucidate DOAC use for the treatment of LAA thrombi.
Source: Canadian Journal of Cardiology - December 15, 2017 Category: Cardiology Source Type: research
