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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

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

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

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

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

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

Fully Magnetically Levitated Left Ventricular Assist System for Treating Advanced HF A Multicenter Study
ConclusionsThe results show that the fully magnetically levitated centrifugal-flow chronic LVAS is safe, with high 30-day and 6-month survival rates, a favorable adverse event profile, and improved quality of life and functional status. (HeartMate 3™ CE Mark Clinical Investigation Plan [HM3 CE Mark]; NCT02170363)
Source: Journal of the American College of Cardiology - December 7, 2015 Category: Cardiology Source Type: research

Selecting Patients for Statin Therapy in Primary Prevention If We Could Only Predict the Future ∗
Statins are effective in the primary and secondary prevention of coronary heart disease and stroke. Although many would agree that primary prevention of atherosclerotic cardiovascular disease (ASCVD) is preferable to secondary prevention, no consensus exists on how to best identify individuals at risk for the disease, when to commence screening and risk assessment, at what age to start (or stop) treatment, how to treat, and how intensively to treat. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines concluded that net benefit was sufficient to recommend statin treatment for ...
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Annual Outcomes With Transcatheter Valve Therapy From the STS/ACC TVT Registry
ConclusionsThe TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.
Source: Journal of the American College of Cardiology - December 21, 2015 Category: Cardiology Source Type: research

Bivalirudin Versus Heparin Anticoagulation in Transcatheter Aortic Valve Replacement The Randomized BRAVO-3 Trial
BackgroundAnticoagulation is required during transcatheter aortic valve replacement (TAVR) procedures. Although an optimal regimen has not been determined, heparin is mainly used. Direct thrombin inhibition with bivalirudin may be an effective alternative to heparin as the procedural anticoagulant agent in this setting.ObjectivesThe goal of this study was to determine whether bivalirudin offers an alternative to heparin as the procedural anticoagulant agent in patients undergoing TAVR.MethodsA total of 802 patients with aortic stenosis were randomized to undergo transfemoral TAVR with bivalirudin versus unfractionated hepa...
Source: Journal of the American College of Cardiology - December 21, 2015 Category: Cardiology Source Type: research

Utility of Nontraditional Risk Markers in Atherosclerotic Cardiovascular Disease Risk Assessment
ConclusionsCAC score, ABI, and FH were independent predictors of ASCVD events. CAC score modestly improved the discriminative ability of the cPCE compared with other nontraditional risk markers.
Source: Journal of the American College of Cardiology - January 12, 2016 Category: Cardiology Source Type: research

Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves CHOICE Trial Results
We read with interest the paper by Abdel-Wahab et al. (1) on 1-year outcomes of the CHOICE (Randomized Comparison of Transcatheter Heart Valves in High Risk Patients With Severe Aortic Stenosis: Medtronic CoreValve Versus Edwards SAPIEN XT Trial) randomized clinical trial comparing transcatheter aortic valve replacement (TAVR) with the balloon-expandable (BE) Edwards SAPIEN XT valve (Edwards Lifesciences, Irvine, California) versus self-expandable (SE) Medtronic CoreValve (Medtronic, Minneapolis, Minnesota). Of interest, the authors concluded that mortality was not statistically different between the 2 groups, but there w...
Source: Journal of the American College of Cardiology - January 12, 2016 Category: Cardiology Source Type: research

A Diabetes-Atrial Fibrillation Conundrum Does Duration Trump Glycemia? ∗
The disease and cost burden of atrial fibrillation (AF) is expected to double over the next 25 years (1). With availability of newer therapies, efforts to refine the triage of who receives therapies, when, and for how long have assumed center stage. Over the last few years, a host of new scores such as CHADS-VASc (congestive heart failure [or Left ventricular systolic dysfunction], hypertension, age≥75 years, diabetes, prior Stroke, TIA, or thromboembolism, vascular disease [e.g. peripheral artery disease, myocardial infarction, aortic plaque], age 65–74 years, sex category) and ATRIA (Anticoagulation and Risk Factors...
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research

Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients The SMILE Trial
ConclusionsIn multivessel non–ST-segment elevation myocardial infarction patients, complete 1-stage coronary revascularization is superior to multistage PCI in terms of major adverse cardiovascular and cerebrovascular events. (Impact of Different Treatment in Multivessel Non ST Elevation Myocardial Infarction [NSTEMI] Patients: One Stage Versus Multistaged Percutaneous Coronary Intervention [PCI] [SMILE]: NCT01478984)
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research

CHA 2 DS 2 -VASc Score for Predicting Stroke and Thromboembolism in Patients With AF and Biological Valve Prosthesis
Patients with valvular atrial fibrillation (AF), as defined in the 2012 European Society of Cardiology guidelines (those with a valvular prosthesis or rheumatic mitral disease) should receive anticoagulation regardless of the CHA2DS2-VASc score, with vitamin K antagonist being recommended (1–3). Whether thromboembolic risk related to bioprosthetic valve implantation differs from other forms of AF is not established with certainty. We evaluated the prognostic value of the CHA2DS2-VASc score for thromboembolic in AF patients with aortic or mitral bioprosthesis.
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research

Testosterone and Cardiovascular Disease
Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in t...
Source: Journal of the American College of Cardiology - February 2, 2016 Category: Cardiology Source Type: research