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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

The Incidence and Predictors of Early- and Mid-Term Clinically Relevant Neurological Events After Transcatheter Aortic Valve Replacement in Real-World Patients
ConclusionsTreatment of high-risk patients with aortic stenosis using a self-expandable system was associated with a low stroke rate at short- and long-term follow-up. Multivariable predictors of clinically relevant neurological events differed on the basis of the timing after TAVR. (CoreValve Advance International Post Market Study; NCT01074658)
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research

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

Reply One More “C” for CHA 2 DS 2 -VASc Score
We thank Dr. Siu for his comments regarding our recently published paper (1) about the usefulness of the CHA2DS2-VASc score for refining stroke risk stratification among patients with atrial fibrillation (AF) having an ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) score of 0 to 5. We agree that the risk of ischemic stroke for Chinese AF patients with a CHA2DS2-VASc score of 0 is higher than that of Caucasians. However, it does not mean that non-vitamin K antagonist oral anticoagulants (NOACs) should be routinely prescribed for these patients. Our previous study demonstrated that the risk of ischemic strok...
Source: Journal of the American College of Cardiology - April 13, 2015 Category: Cardiology Source Type: research

Outcomes After Cardioversion and Atrial Fibrillation Ablation in Patients Treated With Rivaroxaban and Warfarin in the ROCKET AF Trial
Conclusions: Despite an increase in hospitalization, there were no differences in long-term stroke rates or survival following cardioversion or AF ablation. Outcomes were similar in patients treated with rivaroxaban or warfarin. (An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation [ROCKET AF]; NCT00403767)
Source: Journal of the American College of Cardiology - March 13, 2013 Category: Cardiology Authors: Jonathan P. Piccini, Susanna R. Stevens, Yuliya Lokhnygina, Manesh R. Patel, Jonathan L. Halperin, Daniel E. Singer, Graeme J. Hankey, Werner Hacke, Richard C. Becker, Christopher C. Nessel, Kenneth W. Mahaffey, Keith A.A. Fox, Robert M. Califf, Günter B Tags: Heart Rhythm Disorders Source Type: research

Adherence to Medical Therapy and the Global Burden of Cardiovascular Disease ∗
Ischemic heart disease and cerebrovascular disease account for>20% of worldwide mortality and are the 2 leading causes of death on a global basis (1). Although mortality from ischemic heart disease is greater than that from stroke worldwide, the mortality from stroke is actually higher than from ischemic heart disease in 39% of countries. For example, mortality from stroke is generally higher than that for ischemic heart disease in China, Africa, and South America. In addition, stroke disability–adjusted life-year loss rates exceed ischemic heart disease-related disability in 32% of countries (2). Because of this, strate...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research

Cerebral Embolism A Silent Iatrogenic Complication of TAVR That Needs Voiced  Consideration ∗
Transcatheter aortic valve replacement (TAVR) has rapidly and definitely changed the way patients with aortic stenosis are treated. Both the number of procedures and the indications have increased worldwide, allowing the inoperable patient to be treated, the high risk patient to be treated less invasively, and the intermediate risk patient to have the choice of an alternative to surgery (1–4). Clinical stroke or transient ischemic attack is not uncommon after aortic stenosis treatment, ranging in the randomized studies from 5% to 6% at 30 days to 8% to 10% at 1 year —one-half of them being major/disabling strokes (Tabl...
Source: Journal of the American College of Cardiology - August 2, 2016 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 Heart and the Head Neurological Implications of Transcatheter Aortic Valve Replacement ∗
In this issue of the Journal, Bosmans et al. (1) report much-awaited stroke outcomes from the ADVANCE study, a multicenter, prospective, nonrandomized cohort of patients undergoing transcatheter aortic valve replacement (TAVR) with the CoreValve prosthesis (Medtronic Inc., Minneapolis, Minnesota) at 44 mostly European sites between March 2010 and July 2011. In this real-world cohort of patients with severe aortic stenosis, the investigators observed stroke rates of 3.0% at 30 days post-TAVR and 5.6% at 2 years. They reported no significant predictors of periprocedural stroke or transient ischemic attack (TIA) occurring ...
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology 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

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

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

Cardiovascular Disease Mortality in Asian Americans
ConclusionsThe heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population.
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology 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

One More “C” for CHA 2 DS 2 -VASc Score?
Oral anticoagulation therapy for stroke prevention is the cornerstone of atrial fibrillation (AF) management. Current international guidelines focus on accurate identification of “truly low-risk” patients in order to exclude them from such therapy, reserving it for those with immediate or high stroke risk. Accordingly, the CHA2DS2-VASc score has been recommended as the standard means of stroke risk stratification. With the exception of those with a CHA2DS2-VASc score of 0, that is an annual stroke risk of 0.7%/year, oral anticoagulation therapy should be considered/recommended (Class I, Level of Evidence: A, and Class...
Source: Journal of the American College of Cardiology - April 13, 2015 Category: Cardiology 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