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Supracardiac atherosclerosis in embolic stroke of undetermined source: the underestimated source
AbstractThe term ‘embolic stroke of undetermined source’ (ESUS) is used to describe patients with a non-lacunar ischaemic stroke without any identified embolic source from the heart or the arteries supplying the ischaemic territory, or any other apparent cause. When the ESUS concept was introduced, covert atrial fibrillation was conceived to be the main underlying cause in the majority of ESUS patients. Another important embolic source in ESUS is the atherosclerotic plaque in the carotid, vertebrobasilar, and intracranial arteries, or the aortic arch—collectively described as supracardiac atherosclerosis . There is e...
Source: European Heart Journal - April 16, 2020 Category: Cardiology Source Type: research

Endomyocardial fibrosis and apical thrombus in patient with hypereosinophilia
A 76-year-old woman with a history of left semiovale ischaemic lacunar stroke was admitted to hospital for suspected acute coronary syndrome and transient ischaemic attack. The previous year, echocardiography had shown normal results. Neither coronarography nor encephalic computed tomography showed significant lesions. Brain magnetic resonance imaging revealed multiple strokes in different arterial regions, with probable cardioembolic origin (Panel A).
Source: European Heart Journal - July 30, 2019 Category: Cardiology Source Type: research

Uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation: the ELIMINATE-AF trial
ConclusionUninterrupted edoxaban therapy represents an alternative to uninterrupted VKA treatment in patients undergoing AF ablation.
Source: European Heart Journal - April 11, 2019 Category: Cardiology Source Type: research

Cardiac diagnostic work-up of ischaemic stroke
AbstractCardioembolic sources account for 20 –30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown a etiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and emboli...
Source: European Heart Journal - May 21, 2018 Category: Cardiology Source Type: research

Ten-year association of coronary artery calcium with atherosclerotic cardiovascular disease (ASCVD) events: the multi-ethnic study of atherosclerosis (MESA)
ConclusionsCoronary artery calcium is associated strongly and in a graded fashion with 10-year risk of incident ASCVD as it is for CHD, independent of standard risk factors, and similarly by age, gender, and ethnicity. While 10-year event rates in those with CAC  = 0 were almost exclusively below 5%, those with CAC ≥ 100 were consistently above 7.5%, making these potentially valuable cutpoints for the consideration of preventive therapies. Coronary artery calcium strongly predicts risk with the same magnitude of effect in all races, age groups, an d both sexes, which makes it among the most useful markers for predicting ASCVD risk.
Source: European Heart Journal - April 23, 2018 Category: Cardiology Source Type: research

Clinical impact of direct stenting and interaction with thrombus aspiration in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: Thrombectomy Trialists Collaboration
ConclusionDirect stenting rates were higher in patients randomized to thrombus aspiration. Clinical outcomes and myocardial reperfusion measures did not differ significantly between DS and conventional stenting and there was no interaction with thrombus aspiration.
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score
ConclusionThe ORBI risk score provides a readily useable and efficient tool to identify patients at high-risk of developing CS during hospitalization following STEMI, which may aid in further risk-stratification and thus potentially facilitate pre-emptive clinical decision making.
Source: European Heart Journal - March 15, 2018 Category: Cardiology Source Type: research

Diabetes and ischaemic stroke: a deadly association
This editorial refers to ‘Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke’††, by J.B. Echouffo-Tcheuguiet al., on page2376.
Source: European Heart Journal - February 9, 2018 Category: Cardiology Source Type: research

Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke
ConclusionAmong older IS patients diabetes was associated with increased risks of death, cardiovascular and non-cardiovascular hospitalizations, HF, and IS/TIA recurrence.
Source: European Heart Journal - February 9, 2018 Category: Cardiology Source Type: research

Prediction of ischaemic stroke in non-valvular atrial fibrillation if advanced echocardiography plays the game
Abstract
Source: European Heart Journal - February 9, 2018 Category: Cardiology Source Type: research

Blood pressure and cardiovascular outcomes in patients with diabetes and high cardiovascular risk
ConclusionsIn patients with diabetes and elevated CV risk, even after extensive adjustment for underlying disease burden, there was a persistent association for low DBP with subclinical myocardial injury and risk of MI.
Source: European Heart Journal - January 31, 2018 Category: Cardiology Source Type: research

Left atrial function to identify patients with atrial fibrillation at high risk of stroke: new insights from a large registry
ConclusionThe assessment of LA reservoir strain and PA-TDI on echocardiography after initial CHA2DS2-VASc scoring provides additional risk stratification for stroke and may be useful to guide decisions regarding anticoagulation for patients upon first diagnosis of AF.
Source: European Heart Journal - December 28, 2017 Category: Cardiology Source Type: research

External applicability of the COMPASS trial: an analysis of the reduction of atherothrombosis for continued health (REACH) registry
ConclusionCOMPASS-Eligible patients represent a substantial fraction of stable CAD/PAD patients encountered in routine clinical practice in the large international REACH registry suggesting good external applicability. COMPASS-Eligible patients experienced a higher rate of the primary outcome compared with COMPASS participants in the aspirin alone treatment arm.
Source: European Heart Journal - November 23, 2017 Category: Cardiology Source Type: research

Resumption of oral anticoagulation following traumatic injury and risk of stroke and bleeding in patients with atrial fibrillation: a nationwide cohort study
ConclusionAF patients resuming VKA and NOAC treatment following traumatic injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent traumatic injury. Withholding OAC following a traumatic injury in AF patients may not be warranted.
Source: European Heart Journal - November 18, 2017 Category: Cardiology Source Type: research

Improved outcomes in patients with ST-elevation myocardial infarction during the last 20  years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995–2014
ConclusionGradual implementation of new and established evidence-based treatments in STEMI patients during the last 20  years has been associated with prolonged survival and lower risk of recurrent ischaemic events, although a plateauing is seen since around 2008.
Source: European Heart Journal - August 29, 2017 Category: Cardiology Source Type: research

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