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Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs. prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials
ConclusionAfter second-generation DES implantation, 1 –3 months of DAPT followed by P2Y12 inhibitor SAPT is associated with lower major bleeding and similar stent thrombosis, all-cause death, myocardial infarction, and stroke compared with prolonged DAPT. Whether P2Y12 inhibitor SAPT is preferable to aspirin SAPT needs further investigation.
Source: European Heart Journal - December 7, 2020 Category: Cardiology Source Type: research

Late device-related thrombus after left atrial appendage closure: never let your guard down
Left atrial appendage closure (LAAC) is an established strategy for stroke prevention in patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation. Device-related thrombus (DRT) is a feared short-term complication with an incidence of 4 –17%. Data regarding the likelihood of late DRT are scarce.
Source: European Heart Journal - November 12, 2020 Category: Cardiology Source Type: research

Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial
ConclusionBaseline lipoprotein(a) predicted the risk of total cardiovascular events and risk reduction by alirocumab. Lipoprotein(a) lowering contributed independently to cardiovascular event reduction, supporting the concept of lipoprotein(a) as a treatment target after ACS.
Source: European Heart Journal - October 14, 2020 Category: Cardiology Source Type: research

Edoxaban in atrial fibrillation patients with percutaneous coronary intervention by acute or chronic coronary syndrome presentation: a pre-specified analysis of the ENTRUST-AF PCI trial
Conclusions  In patients with AF who underwent PCI, the edoxaban-based regimen, as compared with VKA-based regimen, provides consistent safety and similar efficacy for ischaemic events in patients with AF regardless of their clinical presentation.
Source: European Heart Journal - August 29, 2020 Category: Cardiology Source Type: research

Genetic predisposition to smoking in relation to 14 cardiovascular diseases
ConclusionThis MR study supports a causal association between smoking and a broad range of CVDs, in particular, coronary artery disease, heart failure, abdominal aortic aneurysm, ischaemic stroke, transient ischaemic attack, peripheral arterial disease, and arterial hypertension.
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

Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience
ConclusionTranscatheter mitral valve implantation using balloon-expandable valves in selected patients with bioprosthesis or annuloplasty failure or severe MAC was associated with a low rate of peri-procedural complications and acceptable long-term outcomes.
Source: European Heart Journal - May 19, 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

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials
ConclusionCompared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI.
Source: European Heart Journal - April 13, 2018 Category: Cardiology Source Type: research

Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study
ConclusionAt one year, clinical outcomes with the SYNTAX-II strategy were associated with improved clinical results compared to the PCI performed in comparable patients from the original SYNTAX-I trial. Longer term follow-up is awaited and a randomized clinical trial with contemporary CABG is warranted.ClinicalTrials.gov IdentifierNCT02015832
Source: European Heart Journal - August 26, 2017 Category: Cardiology Source Type: research

Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke
ConclusionIn patients hospitalized with ischaemic stroke, J-shaped, or U-shaped relationships were observed between BP variables and short-term outcomes. However, haemorrhagic complications with thrombolytic therapy were lower with lower BP.
Source: European Heart Journal - June 30, 2017 Category: Cardiology Source Type: research

Prediction of adverse events after catheter-based procedures in adolescents and adults with congenital heart disease in the IMPACT registry
ConclusionThe factors predicting adverse events after cardiac catheterization in adolescents and adults with CHD are different than in the general population. Validation of this model in other national or multi-institutional datasets is the next step.
Source: European Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Transcatheter aortic valve thrombosis: the relation between hypo-attenuated leaflet thickening, abnormal valve haemodynamics, and stroke
Conclusion</div>On MDCT, 12.5% of patients showed HALT or reduced leaflet motion, whereas only one of these patients had abnormal valve haemodynamics on echocardiography. Neither HALT nor increased transvalvular gradient were associated with stroke/TIA.</span>
Source: European Heart Journal - March 27, 2017 Category: Cardiology Source Type: research

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