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Source: Journal of the American College of Cardiology
Condition: Heart Attack

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Total 81 results found since Jan 2013.

New Ischemic Stroke and Outcomes With Vorapaxar Versus Placebo Results From the TRA 2°P-TIMI 50 Trial
BackgroundVorapaxar, a novel antiplatelet therapy, reduces thrombotic events in patients with a history of myocardial infarction (MI) or peripheral artery disease (PAD); however, because of an increased risk of intracranial hemorrhage, it is contraindicated in patients with a history of stroke.ObjectivesThe aim of this study was to investigate the incidence of new ischemic stroke and subsequent death or intracerebral hemorrhage in patients with MI or PAD and no cerebrovascular disease (CVD) treated with vorapaxar.MethodsThe TRA 2°P-TIMI 50 (Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in ...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Aspirin Instead of Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Risk for Stroke
ConclusionsIn a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC. Specific patient characteristics predicted prescription of aspirin therapy over OAC.
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Vorapaxar, Combination Antiplatelet Therapy, and Stroke ∗
Drugs that inhibit platelet activation and aggregation reduce vascular events, notably myocardial infarction (MI) and ischemic stroke, and are generally associated with low rates of bleeding (1). Available agents inhibit platelets via distinct mechanisms (Table 1) (2), and combining antiplatelet drugs with different mechanisms of action should enhance net antithrombotic activity. For over a decade, the standard of care in patients with acute coronary syndromes, particularly those undergoing coronary stent implantation, has been dual antiplatelet therapy with aspirin plus an adenosine diphosphate receptor antagonist. When ...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Age, Ethnicity, and Stroke Risk in Patients With Atrial Fibrillation Another Stitch in the Patchwork ∗
The frequency with which clinicians encounter patients with nonvalvular atrial fibrillation (AF) and its association with ischemic stroke make estimation of the risk borne by individuals a daily issue in contemporary cardiology practice across the globe. In the balance lies the decision to employ long-term anticoagulation therapy with its attendant risk of severe bleeding. A variety of clinical risk scores are available to guide this decision, most prominently the CHA2DS2-VASc score, which cumulates the widely accepted, if unequally validated, clinical risk factors: heart failure (or impaired left ventricular function), hy...
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research

Atrial Fibrillation and Thrombosis: The Missing Molecular Links⁎
Nonvalvular atrial fibrillation (AF) confers a 5-fold increased risk of stroke and systemic thromboembolism (TE), especially in the presence of stroke risk factors (). AF is common, and the TE manifestations are evident in many diverse cardiovascular conditions. For example, transient new-onset AF in acute myocardial infarction is a risk factor for stroke (). Also, patients with left ventricular systolic impairment with associated AF are at high risk of TE (). Fortunately, the use of anticoagulation therapy reduces the risk of stroke and/or TE (by 64%) as well as all-cause mortality (by 26%), whereas aspirin results in a n...
Source: Journal of the American College of Cardiology - January 21, 2013 Category: Cardiology Authors: Andrew D. Blann, Gregory Y.H. Lip Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research

Cost-Effectiveness of Statins for Primary Cardiovascular Prevention in Chronic Kidney Disease
Conclusions: Although statins reduce absolute CVD risk in patients with CKD, the increased risk of rhabdomyolysis, and competing risks associated with progressive CKD, partly offset these gains. Low-cost generic statins appear cost-effective for primary prevention of CVD in patients with mild-to-moderate CKD and hypertension.
Source: Journal of the American College of Cardiology - March 20, 2013 Category: Cardiology Authors: Kevin F. Erickson, Sohan Japa, Douglas K. Owens, Glenn M. Chertow, Alan M. Garber, Jeremy D. Goldhaber-Fiebert Tags: Cardiovascular Risk Source Type: research

Coronary Artery Bypass Graft Surgery Versus Drug-Eluting Stents for Patients With Isolated Proximal Left Anterior Descending Disease
ConclusionsDespite the higher rating in current guidelines of CABG (Class IIa vs. Class IIb) for patients with isolated PLAD disease, there were no differences in mortality or mortality, MI, and/or stroke, although CABG patients had significantly lower repeat revascularization rates.
Source: Journal of the American College of Cardiology - December 22, 2014 Category: Cardiology Source Type: research

Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery
ConclusionsIn patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research

Oral Anticoagulation and Antiplatelets in Atrial Fibrillation Patients After Myocardial Infarction and Coronary Intervention
Conclusions: In real-life AF patients with indication for multiple antithrombotic drugs after MI/PCI, OAC and clopidogrel was equal or better on both benefit and safety outcomes compared to triple therapy.
Source: Journal of the American College of Cardiology - June 10, 2013 Category: Cardiology Authors: Morten Lamberts, Gunnar H. Gislason, Jonas Bjerring Olesen, Søren Lund Kristensen, Anne-Marie Schjerning Olsen, Anders Mikkelsen, Christine Benn Christensen, Gregory Y.H. Lip, Lars Køber, Christian Torp-Pedersen, Morten Lock Hansen Tags: Coronary Artery Disease Source Type: research

A Direct Comparison of Early and Late Outcomes With Three Approaches to Carotid Revascularization and Open Heart Surgery
Conclusions: Staged CAS-OHS and combined CEA-OHS are associated with a similar risk of death, stroke, or MI in the short term, with both being better than staged CEA-OHS. However, the outcomes significantly favor staged CAS-OHS after the first year.
Source: Journal of the American College of Cardiology - July 22, 2013 Category: Cardiology Authors: Mehdi H. Shishehbor, Sridhar Venkatachalam, Zhiyuan Sun, Jeevanantham Rajeswaran, Samir R. Kapadia, Christopher Bajzer, Heather L. Gornik, Bruce H. Gray, John R. Bartholomew, Daniel G. Clair, Joseph F. Sabik, Eugene H. Blackstone Tags: Coronary Artery Disease Source Type: research

Benefits of Statins in Elderly Subjects Without Established Cardiovascular Disease: A Meta-Analysis
Conclusions: In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term.
Source: Journal of the American College of Cardiology - August 16, 2013 Category: Cardiology Authors: Gianluigi Savarese, Antonio M. Gotto, Stefania Paolillo, Carmen D'Amore, Teresa Losco, Francesca Musella, Oriana Scala, Caterina Marciano, Donatella Ruggiero, Fabio Marsico, Giuseppe De Luca, Bruno Trimarco, Pasquale Perrone-Filardi Tags: Cardiometabolic Risk Source Type: research

Coronary Stent Thrombosis With Vorapaxar Versus Placebo Results From the TRA 2°P-TIMI 50 Trial
BackgroundVorapaxar, a novel thrombin receptor antagonist, reduces cardiovascular death and recurrent thrombotic events when added to standard antiplatelet therapy in patients with stable atherosclerotic vascular disease.ObjectivesThe goal of this study was to test the hypothesis that treatment with vorapaxar reduces the rate of coronary stent thrombosis (ST) in stable patients with a history of coronary stenting.MethodsTRA 2°P-TIMI 50 (Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis In Myocardial Infarction 50) was a multinational, randomized, d...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG The SYNTAX Trial at 5-Year Follow-Up
ConclusionsSmoking is associated with poor clinical outcomes after revascularization in patients with complex CAD. This places further emphasis on efforts at smoking cessation to improve revascularization benefits. (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries; NCT00114972)
Source: Journal of the American College of Cardiology - March 16, 2015 Category: Cardiology Source Type: research

Efficacy and Safety of Dabigatran Etexilate and Warfarin in “Real-World” Patients With Atrial Fibrillation: A Prospective Nationwide Cohort Study
Conclusions: In this “everyday clinical practice” post-approval nationwide clinical cohort, there were similar stroke/systemic embolism and major bleeding rates with dabigatran (both doses) compared with warfarin. Mortality, intracranial bleeding, pulmonary embolism, and MI were lower with dabigatran, compared with warfarin. We found no evidence of an excess of bleeding events or MI among dabigatran-treated patients in this propensity-matched comparison against warfarin, even in the subgroup with ≥1-year follow-up.
Source: Journal of the American College of Cardiology - April 4, 2013 Category: Cardiology Authors: Torben Bjerregaard Larsen, Lars Hvilsted Rasmussen, Flemming Skjøth, Karen Margrete Due, Torbjörn Callréus, Mary Rosenzweig, Gregory Y.H. Lip Tags: Atrial Fibrillation Source Type: research