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Source: Canadian Journal of Cardiology
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Total 265 results found since Jan 2013.
Uninterrupted new oral anticoagulants compared to uninterrupted Vitamin K antagonists in ablation of atrial fibrillation. A Meta-analysis
Conclusion Use of uninterrupted NOAC in ablation appears to be as safe and efficacious as uninterrupted VKA. Teaser This meta-analysis compares uninterrupted non vitamin K antagonists (NOAC) with uninterrupted vitamin K antagonists (VKA) in ablation of atrial fibrillation. A total of 3544 patients undergoing ablation with uninterrupted anticoagulation. Overall incidence of stroke/TIA was very low 0.16%, major bleeding was 0.5% and only once case of death reported in the uninterrupted VKA arm. Uninterrupted NOAC appears as safe as uninterrupted VKA with no difference in stroke/TIA, major bleeding, minor bleeding or cardiac tamponade.
Source: Canadian Journal of Cardiology - September 26, 2015 Category: Cardiology Source Type: research
Transradial versus transfemoral percutaneous coronary intervention in ST segment elevation myocardial infarction: A systemic review & meta-analysis
Conclusion Transradial approach for PCI in STEMI patients significantly reduces all-cause mortality, major and access site bleeding, major adverse cardiovascular events and length of hospital stay. Difference in stroke incidence was not statistically significant with transradial versus transfemoral approach. Teaser This is a contemporary, comprehensive meta-analysis designed to evaluate safety and efficacy of transradial versus transfemoral approach for primary Percutaneous Coronary Intervention in ST-segment Elevation Myocardial infarction patients. Authors analyzed 16 randomized controlled trials, comprising data from 97...
Source: Canadian Journal of Cardiology - August 29, 2015 Category: Cardiology Source Type: research
Resident Physicians Choices of Anticoagulation for Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation
This study revealed that, across a wide sampling of disciplines and centers, resident physician choices of anticoagulation in nonvalvular AF differ significantly from contemporary CCS guidelines. Teaser The mainstay of atrial fibrillation (AF) management is stroke prevention using oral anticoagulants. We surveyed 1014 resident physicians from family medicine, emergency medicine, internal medicine and adult cardiology specialties. We found that resident physicians provide care to large number of AF patients and their choices of anticoagulation for stroke prevention are not congruent with the Canadian Cardiovascular Societyâ...
Source: Canadian Journal of Cardiology - August 15, 2015 Category: Cardiology Source Type: research
Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter
Conclusions Presentation to the ED with AF/AFl, either as primary reason for consultation or as secondary diagnosis, is associated with a high risk of subsequent re-presentation and hospital admission. Teaser Retrospective cohort analysis of patients presenting to the ED with AF/AFl during years 2010-2012. After the index visit, the patients (n=1361) were followed for rates of re-presentation and hospital admissions. In the subsequent 12 months, 69.7% returned to the ED, accounting for a total of 4783 visits and 1462 admissions. In conclusion, presentation to the ED with AF/AFl, either as main or secondary diagnosis, is as...
Source: Canadian Journal of Cardiology - August 14, 2015 Category: Cardiology Source Type: research
Left Atrial Appendage Closure for Atrial Fibrillation is Safe and Effective Following Intracranial or Intraocular Hemorrhage
Conclusion In our consecutive series, LAA closure was found to be safe and effective in patients with AF and prior history of ICH or IOH. Teaser Long-term anticoagulation may be avoided in patients with non-valvular AF and previous intra-cranial (ICH) or intra-ocular (IOH) hemorrhage after LAA closure. We report our consecutive series of 26 patients with previous ICH/IOH who underwent LAA closure. At 11.9 ± 13.3 months follow-up, there was one non-cardiac death at 13 months, one TIA at 20.6 months, and no major bleed. Thus, LAA closure was safe and effective in AF patients and prior history of ICH/IOH.
Source: Canadian Journal of Cardiology - August 12, 2015 Category: Cardiology Source Type: research
CHA2DS2-VASC and CHADS2 Scores Predict Adverse Clinical Events in Patients With Pacemakers and Sinus Node Dysfunction Independent of Atrial Fibrillation
Conclusions Both CHA2DS2-VASc and CHADS2 scores predict risk of death or stroke in patients with sick sinus syndrome, regardless of AF history. These scores could be risk-stratification tools for clinical events that might respond to new therapies—ie, anticoagulation or other interventions—even in the absence of AF.
Source: Canadian Journal of Cardiology - July 26, 2015 Category: Cardiology Source Type: research
The Disconnect Between Novel Oral Anticoagulant Eligibility and Provincial Drug Coverage: An Albertan Anticoagulation Clinic Audit
Publication date: August 2015 Source:Canadian Journal of Cardiology, Volume 31, Issue 8 Author(s): Sandeep K. Dhillon, M. Sean McMurtry, Tammy J. Bungard Canadian practice guidelines for nonvalvular atrial fibrillation (NVAF) recommend that most patients receive a novel oral anticoagulant (NOAC) in preference to warfarin to prevent stroke, but not all patients have insurance that covers NOACs. The gap between optimal therapy and drug coverage is unknown. We retrospectively assessed eligibility for NOACs in patients with NVAF at our single-centre anticoagulation clinic and ascertained whether provincial drug coverage w...
Source: Canadian Journal of Cardiology - July 26, 2015 Category: Cardiology Source Type: research
Novel Approaches in Primary Cardiovascular Disease Prevention: The HOPE-3 Trial Rationale, Design and Participants’ Baseline Characteristics
Conclusions The HOPE-3 trial will provide new information on cholesterol and BP lowering in intermediate risk populations with average cholesterol and BP levels and is expected to inform approaches to primary prevention worldwide (HOPE-3 ClinicalTrials.gov number, NCT00468923). Teaser The HOPE-3 trial is a large international randomized trial evaluating whether cholesterol lowering with a statin, BP lowering with low doses of two antihypertensives and their combination safely reduce major CV events in people at intermediate risk, with no previous vascular events and with average cholesterol and BP levels. The trial enrolle...
Source: Canadian Journal of Cardiology - July 9, 2015 Category: Cardiology Source Type: research
Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation
Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.
Source: Canadian Journal of Cardiology - June 23, 2015 Category: Cardiology Source Type: research
When to Suspect Sleep Apnea and What to Do About It
The objectives of treatment are to improve symptoms, quality of life, and cardiovascular outcomes. The mainstay of treatment for moderate-to-severe OSA is positive airway pressure (PAP). Automated PAP devices may be used in uncomplicated OSA, whereas continuous fixed PAP is the treatment of choice for other patients with OSA, and may also treat a proportion of patients with CSA-CSR. A form of bi-level PAP known as adaptive servoventilation is effective in treating a majority of patients with CSA-CSR.
Source: Canadian Journal of Cardiology - June 23, 2015 Category: Cardiology Source Type: research
Cardiovascular Disease in South Asian Migrants
In conclusions, South-Asians have distinct CVD risk predispositions, with a complex relationship to cultural, innate and acquired factors. Although CVD risk factor management and treatment among South-Asians is improving, opportunities exist for further advances. Teaser Within this narrative review we describe current literature regarding the prevalence, incidence, etiology and prognosis of cardiovascular disease (CVD) in South Asian (SA) Migrants, with a particular focus on coronary artery disease (CAD), stroke and heart failure. We also summarize the role of prominent risk factors contributing to CVD in SA including diab...
Source: Canadian Journal of Cardiology - June 22, 2015 Category: Cardiology Source Type: research
Standing on the Shoulders of Giants: JAP Paré and the Birth of Cardiovascular Genetics
Publication date: Available online 17 June 2015 Source:Canadian Journal of Cardiology Author(s): Srijita Sen-Chowdhry , William J. McKenna Sudden death and stroke afflicted a family from rural Quebec with such frequency as to be called the Coaticook curse by the local community. In Montreal in the late 1950s, a team of physicians led by JAP Paré investigated this family for inherited cardiovascular disease. Their efforts resulted in an extensive and now classic description of familial hypertrophic cardiomyopathy. A quarter of a century later, the same family was the subject of linkage analysis and direct sequencing, cul...
Source: Canadian Journal of Cardiology - June 22, 2015 Category: Cardiology Source Type: research
Comparison of Dual-antiplatelet Therapy to Mono-antiplatelet Therapy After Transcatheter Aortic Valve Implantation: Systematic Review and Meta-analysis
Conclusions DAPT in patients who have undergone TAVI demonstrated no benefit over MAPT in reduction of ischemic events, with a trend toward increased harm because of bleeding. Future considerations should be given to MAPT with clopidogrel alone, as well as the omission of clopidogrel loading before the procedure.
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
Is Aortic Valve Repair Reproducible? Analysis of the Learning Curve for Aortic Valve Repair
Conclusions Procedural safety and efficiency improves with experience whereas efficacy is consistent over time. AV repair is reproducible and appears to have a learning curve of approximately 40-60 cases. Teaser Aortic valve repair, while effective, is performed in a limited number of centres. We examined the learning curve in two centres with programs in AV repair for safety, efficiency, and efficacy endpoints. Early mortality was ≤1% in both cohorts. Frequency of safety endpoints was reduced in both cohorts. Procedural safety and efficiency improved with experience whereas efficacy was consistent over time. AV repair i...
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
The Effect of Bleeding Risk and Frailty Status on Anticoagulation Patterns in Octogenarians with Atrial Fibrillation: the FRAIL-AF study
Conclusion Our study suggests a higher prevalence of appropriate anticoagulation among octogenarians with atrial fibrillation than reported in previous studies. Further work is needed to develop and disseminate tools to optimize the use of anticoagulants in this high-risk population. Teaser Despite evidence-based recommendations, anticoagulation is not ubiquitous among octogenarians with atrial fibrillation. The objective of this study was to investigate the effect of thromboembolic risk, bleeding risk and frailty on the prevalence of anticoagulation for atrial fibrillation among hospitalized older adults in Montreal, Queb...
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
