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Source: Journal of the American College of Cardiology
Condition: Stroke
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Total 258 results found since Jan 2013.
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 6: Hypertension A Scientific Statement from the American Heart Association and the American College of Cardiology
An elevation of blood pressure (BP) in the systemic circulation (hypertension) is the most common cardiovascular condition in the general population and considered to be the most ubiquitous cardiovascular risk factor in competitive athletes. Competitive athletes include those athletes involved in organized sports that typically occur in schools, communities, and professional leagues, including but not limited to intramural and league sports in which medical supervision is typically required. Although most competitive athletes are between the ages of 20 and 40 years, many younger people now participate in competitive athle...
Source: Journal of the American College of Cardiology - November 23, 2015 Category: Cardiology Source Type: research
Matching the NOAC to the Patient Remember the Modifiable Bleeding Risk Factors ∗
Approximately 5 years ago, when deciding on oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF), we did not have a choice; only the vitamin K antagonists (VKA; e.g., warfarin) were available. In 2015, in addition to VKAs, we currently have 4 licensed non-VKA oral anticoagulants (NOACs), and therefore have the opportunity to fit the most appropriate drug to the patient’s risk profile, and vice versa.
Source: Journal of the American College of Cardiology - November 23, 2015 Category: Cardiology Source Type: research
Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Rivaroxaban or Warfarin ROCKET AF Trial
ConclusionsIn the ROCKET AF trial, rivaroxaban increased GI bleeding compared with warfarin. The absolute fatality rate from GI bleeding was low and similar in both treatment arms. Our results further illustrate the need for minimizing modifiable risk factors for GI bleeding in patients on oral anticoagulation.
Source: Journal of the American College of Cardiology - November 23, 2015 Category: Cardiology Source Type: research
Carotid Stiffness and Cerebrovascular Disease The Physiology Beyond the Anatomy ∗
Stroke is a leading cause of morbidity, mortality, and disability worldwide, and the disease burden has progressively increased over the past decades. A rising interest in identifying risk factors for cerebrovascular disease may finally shift the focus to prevention of future events (1). Several studies have investigated carotid disease, and specifically carotid stiffness, as a risk factor for the development of cerebrovascular disease and incident stroke. These studies have been limited, however, by inconsistent results. Some reported a significant association between carotid stiffness and stroke, whereas others failed to...
Source: Journal of the American College of Cardiology - November 2, 2015 Category: Cardiology Source Type: research
Carotid Stiffness Is Associated With Incident Stroke A Systematic Review and Individual Participant Data Meta-Analysis
ConclusionsCarotid stiffness is associated with incident stroke independently of CV factors and aortic stiffness. In addition, carotid stiffness improves stroke risk prediction beyond Framingham and aortic stiffness.
Source: Journal of the American College of Cardiology - November 2, 2015 Category: Cardiology Source Type: research
Treatment of Dyslipidemia in Elderly Patients With Coronary Heart Disease There Are Miles to Go Before We Sleep ∗
The treatment of dyslipidemia with statin therapy is a cornerstone in the management of patients in both the primary and secondary prevention settings. Dyslipidemia is widely prevalent in its various forms (1). The lowering of low-density lipoprotein cholesterol (LDL-C) with a statin in patients with established coronary heart disease (CHD) has shown unequivocal capacity to safely reduce risk for clinical sequelae such as nonfatal myocardial infarction, ischemic stroke, cardiovascular and all-cause mortality, as well as the need for revascularization (2,3). The American College of Cardiology/American Heart Association Guid...
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research
Comparative Performance of ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation Results From a National Primary Care Database
ConclusionsThe ATRIA score performed better in the U.K. Clinical Practice Research Datalink AF cohort. It more accurately identified low-risk patients than the CHA2DS2-VASc score, which assigned these patients to higher-risk categories. Such reclassification of stroke risk could prevent overuse of anticoagulants in very low stroke risk patients with AF.
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research
Stroke Risk Stratification in Patients With Atrial Fibrillation Comme Ci, Comme Ça, Plus Ça Change… ∗
There has been a huge increase in academic interest in atrial fibrillation (AF) and particularly its major complication: thromboembolism. This sustained flurry of activity is fueled by the development of better thromboprophylaxis with well-controlled vitamin K antagonist (VKA) anticoagulation rather than antiplatelet therapy or poorly controlled management with VKAs. The emergence of new therapies, such as non-VKA oral anticoagulant agents and left atrial appendage occlusion devices with better net clinical benefit (less strokes, fewer intracranial or life-threatening bleeds, and reduced mortality) than with warfarin or as...
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research
Next Steps in Primary Prevention of Coronary Heart Disease Rationale for and Design of the ECAD Trial
Atherosclerotic cardiovascular disease (ASCVD) events, including coronary heart disease and stroke, are the most frequent cause of death and major disability in the world. Current American College of Cardiology/American Heart Association primary prevention guidelines are mainly on the basis of randomized controlled trials of statin-based low-density lipoprotein cholesterol (LDL-C)–lowering therapy for primary prevention of ASCVD events. Despite the clear demonstration of statin-based LDL-C lowering, substantial 10-year and lifetime risks of incident ASCVD continue. Although the 10-year risk is low in young and middle-age...
Source: Journal of the American College of Cardiology - October 12, 2015 Category: Cardiology Source Type: research
Sodium Nitrite Improves Exercise Hemodynamics and Ventricular Performance in Heart Failure With Preserved Ejection Fraction
This study sought to determine whether acute nitrite administration improves exercise hemodynamics and cardiac reserve in HFpEF.MethodsIn a double-blind, randomized, placebo-controlled, parallel-group trial, subjects with HFpEF (N = 28) underwent invasive cardiac catheterization with simultaneous expired gas analysis at rest and during exercise, before and 15 min after treatment with either sodium nitrite or matching placebo.ResultsBefore the study drug infusion, HFpEF subjects displayed an increase in PCWP with exercise from 16 ± 5 mm Hg to 30 ± 7 mm Hg (p
Source: Journal of the American College of Cardiology - October 5, 2015 Category: Cardiology Source Type: research
Coronary Calcium Score and the New Guidelines Back to Square One? ∗
Previous guidelines for cardiovascular risk assessment recommended the use of a modified Framingham score to estimate the 10-year risk of hard coronary heart disease (CHD) events, defined as myocardial infarction and CHD death (1). Coronary artery calcium (CAC) scoring for refined stratification received Class IIa or IIb recommendations for those at intermediate (10% to 20%) or low to intermediate (6% to 10%) risk, respectively (2). In 2013, the American College of Cardiology (ACC) and American Heart Association (AHA) released guidelines (3,4) endorsing new sex- and race-specific predictive equations derived from 5 large p...
Source: Journal of the American College of Cardiology - October 5, 2015 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
Age Threshold for Increased Stroke Risk Among Patients With Atrial Fibrillation A Nationwide Cohort Study From Taiwan
This study hypothesized that the age threshold (65 years) used in the CHA2DS2-VASc system for initiating oral anticoagulants (OACs) might be lower in Taiwanese AF patients than in non-Asians.MethodsWe used the National Health Insurance Research Database in Taiwan to study 186,570 nonanticoagulated AF patients. There were 9,416 males with a CHA2DS2-VASc score of 0 and 6,390 females with a CHA2DS2-VASc score of 1. Their risk of ischemic stroke was analyzed with stratification on the basis of age.ResultsThe annual risks of ischemic stroke for males (score 0) and females (score 1) were 1.15% and 1.12%, respectively, and contin...
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research
2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery
ConclusionsPatients with severe AS at extreme surgical risk treated with self-expanding TAVR continued to show good clinical outcomes and hemodynamic valve performance at 2 years. The presence of comorbid conditions rather than valve performance affected 2-year outcomes in these patients. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902)
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research
Clinical Benefit of Warfarin in Dialysis Patients With Atrial Fibrillation
Patients with atrial fibrillation (AF) and end-stage chronic kidney disease (CKD) receiving dialysis are at higher risk of stroke (1). Warfarin has been shown to reduce the frequency of strokes by 64.0% in patients with AF; however, its use in dialysis patients has not received consensus owing to the lack of randomized controlled trial data and associated increased bleeding risk.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research
