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A journey through clinic and research
I started to study Medicine at the University of Genoa, Italy more than 20 years ago and I now realize that I was quite far from understanding what ‘Medicine’ really means. After weeks and weeks spent on books during the first year, I understood that becoming a MD not only requires the willingness to help people with health problems, but also strong motivation and dedication to learn a huge amount of notions. In Italy, as it is the case for several other countries, the University courses last 6 years, during which the MD student is fully engaged by individual study, lessons and seminars, exercises, and internships. Wit...
Source: European Heart Journal - March 29, 2021 Category: Cardiology Source Type: research

Validation of risk scores for ischaemic stroke in atrial fibrillation across the spectrum of kidney function
Conclusion  In the most clinically relevant stages of CKD, predictive performance of the majority of risk scores was poor, increasing the risk of misclassification and thus of over- or undertreatment. The Modified CHADS2 score performed good and consistently across all kidney function strata, and should therefore be preferred for risk estimation in AF patients.
Source: European Heart Journal - March 26, 2021 Category: Cardiology Source Type: research

Serial assessment of biomarkers and the risk of stroke or systemic embolism and bleeding in patients with atrial fibrillation in the ENGAGE AF-TIMI 48 trial
ConclusionSerial assessment of hsTnT, NT-proBNP, and GDF-15 revealed that a substantial proportion of patients with AF had dynamic values. Greater increases in these biomarkers measured over 1 year are associated with important clinical outcomes in anticoagulated patients with AF.
Source: European Heart Journal - March 24, 2021 Category: Cardiology Source Type: research

All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study
ConclusionsAmong patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.
Source: European Heart Journal - February 24, 2021 Category: Cardiology Source Type: research

Low-density lipoprotein cholesterol reduction and statin intensity in myocardial infarction patients and major adverse outcomes: a Swedish nationwide cohort study
Conclusions  Larger early LDL-C reduction and more intensive statin therapy after MI were associated with a reduced hazard of all CV outcomes and all-cause mortality. This supports clinical trial data suggesting that earlier lowering of LDL-C after an MI confers the greatest benefit.
Source: European Heart Journal - December 24, 2020 Category: Cardiology Source Type: research

Vegetarians, fish, poultry, and meat-eaters: who has higher risk of cardiovascular disease incidence and mortality? A prospective study from UK Biobank
Conclusion  Eating fish rather than meat or poultry was associated with a lower risk of a range of adverse cardiovascular outcomes. Vegetarianism was only associated with a lower risk of CVD incidence.
Source: European Heart Journal - December 14, 2020 Category: Cardiology Source Type: research

Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS
Conclusion  Among patients with or without NSTE-ACS who have completed an initial 3-month course of DAPT following PCI with DES, ticagrelor monotherapy reduced clinically meaningful bleeding events without increasing ischaemic risk as compared with ticagrelor plus aspirin. The benefits of ticagrelor monotherapy with respect to bleeding events were more pronounced in patients with NSTE-ACS.Trial registrationClinicaltrials.gov identifier: NCT02270242.
Source: European Heart Journal - October 20, 2020 Category: Cardiology Source Type: research

Prevalence, incidence, and outcomes across cardiovascular diseases in homeless individuals using national linked electronic health records
Conclusion  CVD in homeless individuals has high prevalence, incidence, and 1-year mortality risk post-diagnosis with earlier onset, and high burden of risk factors. Inclusion health and social care strategies should reflect this high preventable and treatable burden, which is increasingly important in the current COVID-19 context.
Source: European Heart Journal - September 10, 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

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

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

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

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