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Source: Journal of the American College of Cardiology
Condition: Ischemic Stroke

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Total 78 results found since Jan 2013.

High-Sensitivity Troponin T and Risk Stratification in Patients With Atrial Fibrillation During Treatment With Apixaban or Warfarin
Objectives: The aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) risk score in patients with atrial fibrillation (AF).Background: The level of troponin is a powerful predictor of cardiovascular events and mortality.Methods: A total of 14,897 patients with AF were randomized to treatment with apixaban or warfarin in the ARISTOTLE (Apixaban for...
Source: Journal of the American College of Cardiology - September 23, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, John H. Alexander, Dan Atar, Bernard J. Gersh, Michael Hanna, Veli Pekka Harjola, John D. Horowitz, Steen Husted, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Granger, Tags: Heart Rhythm Disorders Source Type: research

The HAS-BLED Score Has Better Prediction Accuracy for Major Bleeding Than CHADS2 or CHA2DS2-VASc Scores in Anticoagulated Patients With Atrial Fibrillation
Objectives: The aim of this study was to test the hypothesis that a specific bleeding risk score, HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), was better at predicting major bleeding compared with CHADS2 (congestive heart failure, hypertension, 75 years of age or older, diabetes mellitus, and previous stroke or transient ischemic attack) and CHA2DS2-VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular...
Source: Journal of the American College of Cardiology - September 20, 2013 Category: Cardiology Authors: Vanessa Roldán, Francisco Marín, Sergio Manzano-Fernández, Pilar Gallego, Juan Antonio Vílchez, Mariano Valdés, Vicente Vicente, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Effect of Percutaneous Closure of Patent Foramen Ovale on Post-Procedural Arrhythmias
Atrial arrhythmias after percutaneous patent foramen ovale (PFO) closure, including atrial fibrillation (AF), has been consistently reported in different series suggesting a causal link between mechanical closure of PFO and the new onset of post-procedural arrhythmias . We have systematically assessed the effect of percutaneous PFO closure upon the development of post-procedural arrhythmias in 221 consecutive patients (144 women; mean age 48 ± 13 years) undergoing percutaneous PFO closure. At clinical evaluation, no patient had symptoms indicative or suggestive of arrhythmias. Indications for closure were the presence of ...
Source: Journal of the American College of Cardiology - September 13, 2013 Category: Cardiology Authors: Achille Gaspardone, Arianna Giardina, Maria Iamele, Gaetano Gioffrè, Mauro Polzoni, Filippo Lamberti, Romolo Remoli, Gregory A. Sgueglia, Marco Papa, Cesare Iani Tags: Research Correspondence Source Type: research

Long-Term Cardiovascular Risk in Women Prescribed Fertility Therapy
Objectives: The purpose of the study was to investigate whether fertility therapy might contribute to subsequent cardiovascular disease.Background: Fertility medications are used for 1% of births yet may also lead to endothelial injury with long-term adverse consequences for the mother.Methods: A population-based cohort analysis was performed of women who gave birth in Ontario, Canada, between July 1, 1993, and March 31, 2010, distinguishing those who did and did not receive fertility therapy in the 2 years before delivery. Cox proportional models were derived to estimate hazard ratios with and without adjustment for basel...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: Jacob A. Udell, Hong Lu, Donald A. Redelmeier Tags: Pregnancy and Heart Disease Source Type: research

Relationship of Lipoproteins to Cardiovascular Events: The AIM-HIGH Trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes)
This study sought to examine the relationship between niacin treatment, lipoproteins, and cardiovascular (CV) outcomes in this secondary analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes) trial.Background: During a 3-year follow-up in 3,414 patients with established CV disease and low high-density lipoprotein cholesterol (HDL-C) levels, combined niacin + low-density lipoprotein cholesterol (LDL-C)–lowering therapy did not reduce CV events compared with LDL-C–lowering therapy alone.Methods: Subjects taking simvastatin and/o...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: John R. Guyton, April E. Slee, Todd Anderson, Jerome L. Fleg, Ronald B. Goldberg, Moti L. Kashyap, Santica M. Marcovina, Stephen D. Nash, Kevin D. O'Brien, William S. Weintraub, Ping Xu, Xue-Qiao Zhao, William E. Boden Tags: Cardiometabolic Risk Source Type: research

Interventional Cryoablation Therapy of Paroxysmal Atrial Fibrillation in Young Patients With Low CHADS2 Score: Worth the Risk of Periprocedural and Long-Term Adverse Events?
In this study the long-term effectiveness in the cryoablation group was reported as 69.9% after 12 months, with a mean fluoroscopy exposure time of 63 min. Regarding the adverse events during follow-up, only 1 adverse event (1.2%) occurred in the drug therapy arm (transfusion because of hemorrhage) compared with 32 adverse events (14.2%) in the cryoablation group, not regarding the 24 patients who suffered temporary phrenic nerve palsy. Five strokes, 4 transient ischemic attacks, 2 cases of tamponades, 2 myocardial infarctions, 3 transfusions, 2 atriovenous fistulas, 2 pseudoaneurysms, 4 cases of persistent phrenic nerve...
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Silke D. Braun Tags: Letters to the Editor Source Type: research

Higher N-Terminal Pro–B-Type Natriuretic Peptide May Be Related to Very Different Conditions
We read the paper by Hijazi et al. with interest. The authors investigated the incremental value of measuring N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels in addition to established risk factors (including the CHA2DS2VASc [heart failure, hypertension, age 75 years and older, diabetes, and previous stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category (female sex, respectively)] score) for the prediction of cardiovascular and bleeding events. They concluded that NT-proBNP levels are often elevated in atrial fibrillation (AF) and independently associated with an increased ...
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Sevket Balta, Sait Demirkol, Mehmet Aydogan, Turgay Celik Tags: Letters to the Editor Source Type: research

Balancing the Benefits and Risks of 2 Doses of Dabigatran Compared With Warfarin in Atrial Fibrillation
Conclusions: On a group level both doses of dabigatran as compared with warfarin have similar benefits when considering a weighted estimate including both efficacy and safety. The similar overall benefits of the 2 doses of dabigatran versus warfarin support individualizing the dose based on patient characteristics and physician and patient preferences. (Randomized Evaluation of Long Term Anticoagulant Therapy [RE-LY] With Dabigatran Etexilate; NCT00262600)
Source: Journal of the American College of Cardiology - June 14, 2013 Category: Cardiology Authors: John W. Eikelboom, Stuart J. Connolly, Robert G. Hart, Lars Wallentin, Paul Reilly, Jonas Oldgren, Sean Yang, Salim Yusuf Tags: Heart Rhythm Disorders 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

Subtle Post-Procedural Cognitive Dysfunction After Atrial Fibrillation Ablation
Conclusions: Ablation for AF is associated with a 13% to 20% prevalence of POCD in patients with AF at long-term follow-up. These results were seen in a patient population with predominant CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/transient ischemic attack) scores of 0 to 1, representing the majority of patients undergoing ablation for AF. The long-term implications of these subtle changes require further study.
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Caroline Medi, Lisbeth Evered, Brendan Silbert, Andrew Teh, Karen Halloran, Joseph Morton, Peter Kistler, Jonathan Kalman Tags: Heart Rhythm Disorders Source Type: research

Preserve the Brain: Primary Goal in the Therapy of Atrial Fibrillation∗
Treatment of atrial fibrillation (AF) involves 3 major strategies: prevention of stroke, maintenance of sinus rhythm, and rate control . Stroke is the most dreaded complication of AF, and its prevention is key. Anticoagulation with warfarin and the newer agents dabigatran, rivaroxaban, and apixaban is highly effective in preventing strokes in patients with AF . However, defining the appropriate patient for anticoagulant therapy is not an exact science, and the stroke risk schema CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/transient ischemic attack) and CHA2DS2-VASc (...
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Eric N. Prystowsky, Benzy J. Padanilam Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research

Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort
Conclusions: In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease.
Source: Journal of the American College of Cardiology - May 3, 2013 Category: Cardiology Authors: Marco R. Di Tullio, Zhezhen Jin, Cesare Russo, Mitchell S.V. Elkind, Tatjana Rundek, Mitsuhiro Yoshita, Charles DeCarli, Clinton B. Wright, Shunichi Homma, Ralph L. Sacco Tags: Patent Foramen Ovale and Stroke Source Type: research

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation
Conclusions: Patients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545)
Source: Journal of the American College of Cardiology - April 24, 2013 Category: Cardiology Authors: Oluseun Alli, Shepal Doshi, Saibal Kar, Vivek Reddy, Horst Sievert, Chris Mullin, Vijay Swarup, Brian Whisenant, David Holmes Tags: Heart Rhythm Disorders Source Type: research

Left Atrial Appendage Closure With the Watchman Device in Patients With a Contraindication for Oral Anticoagulation: The ASAP Study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology)
Conclusions: LAA closure with the Watchman device can be safely performed without a warfarin transition, and is a reasonable alternative to consider for patients at high risk for stroke but with contraindications to systemic oral anticoagulation. (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology [ASAP]; NCT00851578)
Source: Journal of the American College of Cardiology - April 12, 2013 Category: Cardiology Authors: Vivek Y. Reddy, Sven Möbius-Winkler, Marc A. Miller, Petr Neuzil, Gerhard Schuler, Jens Wiebe, Peter Sick, Horst Sievert Tags: Atrial Fibrillation Source Type: research

Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation
This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy. Background: Approximately 10% of patients who receive dual antiplatelet therapy after percutaneous coronary intervention have an indication for oral anticoagulation and are thus treated with triple therapy. The standard adenosine diphosphate receptor blocker in this setting is clopidogrel. Data regarding prasugrel as part of triple therapy are not available. Methods: We analyzed a consecutive series of 377 patients who underwent drug-eluting stent implantation and had an indication for oral antico...
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Nikolaus Sarafoff, Amadea Martischnig, Jill Wealer, Katharina Mayer, Julinda Mehilli, Dirk Sibbing, Adnan Kastrati Tags: Interventional Cardiology Source Type: research