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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Net Clinical Benefit for Oral Anticoagulation, Aspirin, or No Therapy in Nonvalvular Atrial Fibrillation Patients With 1 Additional Risk Factor of the CHA 2 DS 2 -VASc Score (Beyond Sex)
Whether to anticoagulate patients with atrial fibrillation (AF) and 1 stroke risk factor (i.e., CHA2DS2-VASc [congestive heart failure, hypertension, age>75 years, diabetes mellitus, stroke, vascular disease, age 65–75 years, and female sex] score = 1 in men, or 2 in women) is controversial, but many studies report ischemic stroke rates of>1.5% per year, even with 1 stroke risk factor (1). We estimated the net clinical benefit (NCB) of aspirin or warfarin compared with no antithrombotic therapy among such patients on the basis of a nationwide Danish cohort, with incident AF diagnosed between 1998 and 2012 (2). Men w...
Source: Journal of the American College of Cardiology - July 20, 2015 Category: Cardiology Source Type: research

Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery
ConclusionsIn patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI.
Source: Journal of the American College of Cardiology - September 7, 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

Causes of Death in Anticoagulated Patients With Atrial Fibrillation
ConclusionsIn contemporary AF trials, most deaths were cardiac-related, whereas stroke and bleeding represented  only a small subset of deaths. Interventions beyond anticoagulation are needed to further reduce mortality in AF.
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Serial Magnetic Resonance Imaging in Hypoplastic Left Heart Syndrome Gives Valuable Insight Into Ventricular and Vascular Adaptation
Conclusions: In HLHS, serial MRI shows the adaptation of the systemic RV after HF with volume reduction in the context of a preserved stroke volume and an increased ejection fraction. The staged palliation in HLHS may be a risk factor particularly for reduced left pulmonary artery growth in itself as no factors investigated in this study were found to significantly impact on this.
Source: Journal of the American College of Cardiology - January 30, 2013 Category: Cardiology Authors: Hannah R. Bellsham-Revell, Shane M. Tibby, Aaron J. Bell, Thomas Witter, John Simpson, Philipp Beerbaum, David Anderson, Conal B. Austin, Gerald F. Greil, Reza Razavi Tags: Congenital Heart Disease 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

Discontinuation of Rivaroxaban: Filling in the Gaps⁎
Late in 2011, rivaroxaban became the first factor Xa inhibitor to receive regulatory approval for the prevention of stroke in patients with atrial fibrillation (AF), based largely on the results of the phase III 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 (), which enrolled 14,264 patients in a double-blind, double-dummy design. The ROCKET AF trial clearly established the noninferiority of rivaroxaban compared with warfarin for the primary endpoint of stroke or systemic embolism. The superio...
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Matthew R. Reynolds Tags: Heart Rhythm Disorders: Editorial Comment 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

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

A Direct Comparison of Early and Late Outcomes With Three Approaches to Carotid Revascularization and Open Heart Surgery
Conclusions: Staged CAS-OHS and combined CEA-OHS are associated with a similar risk of death, stroke, or MI in the short term, with both being better than staged CEA-OHS. However, the outcomes significantly favor staged CAS-OHS after the first year.
Source: Journal of the American College of Cardiology - July 22, 2013 Category: Cardiology Authors: Mehdi H. Shishehbor, Sridhar Venkatachalam, Zhiyuan Sun, Jeevanantham Rajeswaran, Samir R. Kapadia, Christopher Bajzer, Heather L. Gornik, Bruce H. Gray, John R. Bartholomew, Daniel G. Clair, Joseph F. Sabik, Eugene H. Blackstone Tags: Coronary Artery Disease Source Type: research

Benefits of Statins in Elderly Subjects Without Established Cardiovascular Disease: A Meta-Analysis
Conclusions: In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term.
Source: Journal of the American College of Cardiology - August 16, 2013 Category: Cardiology Authors: Gianluigi Savarese, Antonio M. Gotto, Stefania Paolillo, Carmen D'Amore, Teresa Losco, Francesca Musella, Oriana Scala, Caterina Marciano, Donatella Ruggiero, Fabio Marsico, Giuseppe De Luca, Bruno Trimarco, Pasquale Perrone-Filardi Tags: Cardiometabolic Risk 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

Multicenter Evaluation of a Next-Generation Balloon-Expandable Transcatheter Aortic Valve
ConclusionsThis third-generation device addresses major deficiencies of earlier valves in terms of ease of use, accuracy of positioning, and paravalvular sealing. The rates of mortality and stroke with transfemoral access are among the lowest reported and support further evaluation as an alternative to open surgery in intermediate-risk patients. (Safety and Performance Study of the Edwards SAPIEN 3 Transcatheter Heart Valve [SAPIEN3]; NCT01808287)
Source: Journal of the American College of Cardiology - November 24, 2014 Category: Cardiology Source Type: research

Coronary Stent Thrombosis With Vorapaxar Versus Placebo Results From the TRA 2°P-TIMI 50 Trial
BackgroundVorapaxar, a novel thrombin receptor antagonist, reduces cardiovascular death and recurrent thrombotic events when added to standard antiplatelet therapy in patients with stable atherosclerotic vascular disease.ObjectivesThe goal of this study was to test the hypothesis that treatment with vorapaxar reduces the rate of coronary stent thrombosis (ST) in stable patients with a history of coronary stenting.MethodsTRA 2°P-TIMI 50 (Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis In Myocardial Infarction 50) was a multinational, randomized, d...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Device-Detected Atrial Fibrillation What to Do With Asymptomatic Patients?
Atrial fibrillation (AF) is the most common clinically significant arrhythmia and conveys an increased risk of stroke, regardless of whether it is symptomatic. Despite multiple studies supporting an association between subclinical atrial tachyarrhythmias (ATs) detected by cardiac implantable electronic devices and increased risk of thromboembolic events, clinical intervention for device-detected AT remains sluggish, with some clinicians delaying treatment and instead opting for continued surveillance for additional or longer episodes. However, the 2014 updated clinical practice guidelines on AF recommend use of the CHA2DS2...
Source: Journal of the American College of Cardiology - January 19, 2015 Category: Cardiology Source Type: research