Filtered By:
Source: Journal of the American College of Cardiology
Condition: Thrombosis

This page shows you your search results in order of relevance.

Order by Relevance | Date

Total 41 results found since Jan 2013.

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

Standards and Barriers in Acute Stroke Therapy A Leap Forward in the Evolution of Endovascular Interventions for Stroke ∗
Whether interventional approaches to stroke neurology have lagged behind those aimed at heart attack—for reasons biological or practical—are topics for another day. However, the balance has changed. Tissue plasminogen activator (tPA) was first approved in the United States for intravenous administration to patients with acute stroke in 1996 (1), and a study for catheter-directed intra-arterial infusion of a thrombolytic agent for this indication was first published in 1998 (2). The first positive randomized controlled study using mechanical thrombectomy devices for stroke came from the Netherlands just last year (3), ...
Source: Journal of the American College of Cardiology - November 30, 2015 Category: Cardiology Source Type: research

Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation: The Loire Valley Atrial Fibrillation Project
Conclusions: Renal impairment was not an independent predictor of IS/TE in patients with AF and did not significantly improve the predictive ability of the CHADS2 or CHA2DS2-VASc scores.
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Amitava Banerjee, Laurent Fauchier, Patrick Vourc'h, Christian R. Andres, Sophie Taillandier, Jean Michel Halimi, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Predicting Stroke in Patients With Atrial Fibrillation An Incomplete Picture Without Considering Quality of Anticoagulation
Van den Ham et al. (1) nicely compare the new stroke risk stratification tool anticoagulation and risk factors in atrial fibrillation (ATRIA) with CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism, Vascular disease, Age 65–74 years, Sex category [female]) in patients with atrial fibrillation.
Source: Journal of the American College of Cardiology - May 3, 2016 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

Stroke, Superior Vena Cava Syndrome, and the Snowman in the Chest Roentgenogram
A 55-year-old man had left hemiparesis 1 month earlier, followed by progressive swelling and dilated nonpulsatile veins over the chest, neck, and upper arm (A, arrows) along with a pulsatile swelling over the right infraclavicular and parasternal area. A chest x-ray (B) showed a widened superior mediastinum with a “figure of 8” appearance. Transthoracic echocardiogram showed a dilated left ventricle (LV) with severe aortic regurgitation (G, Online Video 1). The ascending aorta (AA) was aneurysmally dilated, with a mobile thrombus (asterisk) attached to its wall (E, Online Video 2). Bicaval view (F, Online Video 3) sho...
Source: Journal of the American College of Cardiology - May 28, 2013 Category: Cardiology Authors: Bhupinder Singh, Ravindran Rajendran, Yadvinder Singh, Vivek Singla, Ravindranath K. Shankarappa, Manjunath C. Nanjappa Tags: IMAGES IN CARDIOLOGY Source Type: research

Left Atrial Appendage Closure for Stroke Prevention in AF The Quest for the Holy Grail ∗
Strokes resulting from embolization of left atrial appendage (LAA) thrombi in patients with atrial fibrillation (AF) account for up to 25% of the 700,000 cerebrovascular accidents occurring annually in the United States. LAA, a complex structure with considerable anatomic variability, has been appropriately described as the “most lethal human attachment” (1). Stasis, hypercoagulability, and endothelial dysfunction (Virchow triad) contribute to LAA thrombus formation in AF patients. This pathophysiological process results in a 5-fold increased risk for cerebral embolization (2). Stroke is currently the major cause of di...
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed
A recent paper by Hsu et  al.(1) assessed antithrombotic treatment among atrial fibrillation (AF) patients. The data, from the American College of Cardiology PINNACLE (Practice Innovation and Clinical Excellence) registry between 2008 and 2012, showed that 61.8% of patients with moderate-to-high stroke risk received anticoagulant therapy with either warfarin or newer direct oral anticoagulants (DOACs). The investigators and an editorial commentary noted the alarming prevalence of aspirin-only treatment despite clear evidence that anticoagulants are superior for prevention of thromboembolism in AF (1,2).
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Net Clinical Benefit of Antithrombotic Therapy in Patients With Atrial Fibrillation and Chronic Kidney Disease A Nationwide Observational Cohort Study
ConclusionsCKD is associated with a higher risk of stroke/thromboembolism across stroke risk strata in AF patients. High-risk CKD patients (CHA2DS2-VASc ≥2) with AF benefit from warfarin treatment for stroke prevention.
Source: Journal of the American College of Cardiology - December 8, 2014 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

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

Fibrotic Atrial Cardiomyopathy, Atrial Fibrillation, and Thromboembolism Mechanistic Links and Clinical Inferences
The association of atrial fibrillation (AF) with ischemic stroke has long been recognized; yet, the pathogenic mechanisms underlying this relationship are incompletely understood. Clinical schemas, such as the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score, incompletely account for thromboembolic risk, and emerging evidence suggests that stroke can occur in patients with AF even after sinus rhythm is restored. Atrial fibrosis correlates with both the persistence and burden of AF, and gadol...
Source: Journal of the American College of Cardiology - May 18, 2015 Category: Cardiology Source Type: research

Reply
We thank Drs. Li and Zhao for their interest in our paper (). They are correct that indirect comparisons cannot address all the heterogeneity between trials, as well as the underlying pathogenic mechanisms that they allude to. However, it is not very likely that there would be major differences in stroke subtypes among the 3 studies. Also, the inclusion and exclusion criteria are broadly the same in the 3 trials, except for the ROCKET-AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) trial, wherein more patients...
Source: Journal of the American College of Cardiology - January 30, 2013 Category: Cardiology Authors: Gregory Y.H. Lip, Torben Bjerregaard Larsen, Flemming Skjøth, Lars Hvilsted Rasmussen Tags: Letters to the Editor 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

Left Atrial Appendage Occlusion: Opportunities and Challenges
Stroke prevention in patients with atrial fibrillation is a growing clinical dilemma as the incidence of the arrhythmia increases and risk profiles worsen. Strategies in patients with nonvalvular atrial fibrillation have included anticoagulation with a variety of drugs. Knowledge that stroke in this setting typically results from thrombus in the left atrial appendage has led to the development of mechanical approaches, both catheter-based and surgical, to occlude that structure. Such a device, if it were safe and effective, might avoid the need for anticoagulation and prevent stroke in the large number of patients who are ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: David R. Holmes, Dhanunjaya R. Lakkireddy, Richard P. Whitlock, Ron Waksman, Michael J. Mack Tags: STATE-OF-THE-ART PAPER Source Type: research