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Total 262 results found since Jan 2013.

Early detection of occult atrial fibrillation and stroke prevention
Atrial fibrillation (AF) is a very common arrhythmia and significantly increases stroke risk. This risk can be mitigated with oral anticoagulation, but AF is often asymptomatic, or occult, preventing timely detection and treatment. Accordingly, occult AF may cause stroke before it is clinically diagnosed. Currently, guidelines for the early detection and treatment of occult AF are limited. This review addresses recent advancements in occult AF detection methods, identification of populations at high risk for occult AF, the treatment of occult AF with oral anticoagulation, as well as ongoing trials that may answer criticall...
Source: Heart - June 25, 2015 Category: Cardiology Authors: Keach, J. W., Bradley, S. M., Turakhia, M. P., Maddox, T. M. Tags: Review articles Reviews Source Type: research

Antiplatelet therapy following transcatheter aortic valve implantation
Conclusions No difference in 30-day NACE rate was observed between ASA-only or DAPT following TAVI. Moreover, a trend towards less life-threatening and major bleeding was observed in favour of ASA. Consequently the additive value of clopidogrel warrants further investigation.
Source: Heart - June 25, 2015 Category: Cardiology Authors: Hassell, M. E. C. J., Hildick-Smith, D., Durand, E., Kikkert, W. J., Wiegerinck, E. M. A., Stabile, E., Ussia, G. P., Sharma, S., Baan, J., Eltchaninoff, H., Rubino, P., Barbanti, M., Tamburino, C., Poliacikova, P., Blanchard, D., Piek, J. J., Delewi, R. Tags: Drugs: cardiovascular system, Epidemiology Valvular heart disease Source Type: research

Paradoxical low-flow, low-gradient severe aortic stenosis: a distinct disease entity
Low-flow, low-gradient (LFLG) severe aortic stenosis (AS), despite preserved LVEF, that is, paradoxical LFLG, is one of the most challenging entities in valvular heart disease.1 Hachicha et al were the first to report that patients with small aortic valve area (AVA) and preserved LVEF may concomitantly have an LF and thus often low gradient.1 This new entity is defined as an AVA ≤1.0 cm2 or indexed AVA ≤0.6 cm2/m2, a mean pressure gradient (MPG) <40 mm Hg, an LVEF ≥50% and a stroke volume index (SVi) <35 mL/m2. The most recent European2 and American3 guidelines have recognised parado...
Source: Heart - June 10, 2015 Category: Cardiology Authors: Magne, J., Mohty, D. Tags: Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Right sided valvular heart disease, Clinical diagnostic tests Editorials Source Type: research

Development of paradoxical low-flow, low-gradient severe aortic stenosis
Conclusions LFLG-sAS is a distinct presentation of sAS preceded by a unique remodelling pathway and is uncommonly preceded by an HG stage.
Source: Heart - June 10, 2015 Category: Cardiology Authors: Dahl, J. S., Eleid, M. F., Pislaru, S. V., Scott, C. G., Connolly, H. M., Pellikka, P. A. Tags: Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests Valvular heart disease Source Type: research

Cardiovascular highlights from non-cardiology journals
Antiplatelet therapy in long-term risk reduction after myocardial infarction The activated platelet is central to development of ischemic cardiovascular events. Guidelines recommend treatment with a P2Y12 receptor antagonist for 1-year after myocardial infarction (MI) to reduce the risk of recurrent events. The PEGASUS trial sought to determine the impact of using the P2Y12 antagonist ticagrelor as part of long-term therapy after MI. In this trial, a total of 21,162 clinically stable patients with a MI in the prior 1 to 3 years (median 18 months) were randomized in a 1:1:1 fashion to either placebo, ticagrelor 90mg twice d...
Source: Heart - June 10, 2015 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Heartbeat: Focus on atrial fibrillation
Atrial fibrillation is very common; the estimated prevalence increases with age from about 0.1% in adults under age 55 years to 9% of those 80 years of age or older. AF is associated with a reduced quality of life due to the irregular heart rate and reduction in cardiac output. More importantly, AF is associated with an increased risk of thromboembolic events, with an annual stroke risk ranging from as low as <1% in patients with isolated AF to as high as 12% depending on additive risk factors including age over 75 years, female sex, diabetes, hypertension, heart failure, vascular disease or a prior stroke. Stroke risk ...
Source: Heart - May 12, 2015 Category: Cardiology Authors: Otto, C. M. Tags: Congenital heart disease, Drugs: cardiovascular system, Echocardiography, Hypertension, Clinical diagnostic tests, Epidemiology Heartbeat Source Type: research

Close the appendage, open the future
Left atrial appendage closure is a proven method for prevention against stroke in patients with non-valvular atrial fibrillation. This method is proven for having clinical utility as well as safety. The need for coverage in this area is immense. Atrial fibrillation affects 1%–2% of the entire adult population.1 Of all ischaemic strokes, 15% are associated with atrial fibrillation. Both the CHADS2 and the CHA2DS2-VASc risk scores have been used for determining the level of anticoagulation in these patients. Multiple anticoagulants have been used for prevention of ischaemic stroke, including warfarin, dabigatran, rivar...
Source: Heart - May 12, 2015 Category: Cardiology Authors: Gafoor, S., Sievert, H., Matic, P. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Not all thromboembolism comes from the left atrial appendage in atrial fibrillation
Atrial fibrillation (AF) confers a substantial risk of stroke and thromboembolism, which is effectively reduced by oral anticoagulation (OAC), whether as a vitamin K antagonist (VKA, eg, warfarin) or one of non-VKA oral anticoagulants (NOACs). With the use of OACs, the risk of bleeding remains a problem associated with these agents. Thus, a clinical dilemma remains in the optimal management of patients with AF who are at high risk of stroke but have a history of bleeding. Among patients with non-valvular AF, over 90% of the thrombus is formed in the left atrial appendage (LAA).1 Thus, the exclusion of LAA could greatly dec...
Source: Heart - May 12, 2015 Category: Cardiology Authors: Senoo, K., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology Editorials Source Type: research

Left atrial appendage occlusion
Left atrial appendage (LAA) occlusion for stroke and thromboembolism prevention in patients with atrial fibrillation (AF) represents a significant advancement in the field of cardiovascular disease. Prevention and avoidance of the devastating consequences of thromboembolic complications from AF continues to be central in the management of these patients. The role of LAA as a nidus for thrombus formation is well documented. Multiple approaches to exclude the LAA from the circulation either percutaneously or surgically have been described and are undergoing testing. Although pharmacological therapy for stroke prevention rema...
Source: Heart - May 12, 2015 Category: Cardiology Authors: Alli, O., Holmes, D. Tags: Review articles Reviews Source Type: research

What can rhythm control therapy contribute to prognosis in atrial fibrillation?
This article addresses important aspects of rhythm control strategies, which may have the potential of a beneficial contribution to the prognosis of AF patients.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Rolf, S., Kornej, J., Dagres, N., Hindricks, G. Tags: Review articles Reviews Source Type: research

Safety profile of prasugrel and clopidogrel in patients with acute coronary syndromes in Switzerland
Conclusions In this large prospective ACS cohort, patients treated with prasugrel according to current guidelines (ie, in patients without cerebrovascular disease, old age or underweight) had a similar safety profile compared with patients treated with clopidogrel. Clinical trial registration number SPUM-ACS: NCT01000701; COMFORTABLE AMI: NCT00962416.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Klingenberg, R., Heg, D., Raber, L., Carballo, D., Nanchen, D., Gencer, B., Auer, R., Jaguszewski, M., Stahli, B. E., Jakob, P., Templin, C., Stefanini, G. G., Meier, B., Vogt, P., Roffi, M., Maier, W., Landmesser, U., Rodondi, N., Mach, F., Windecker, S. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Coronary artery disease Source Type: research

Prognosis of silent atrial fibrillation after acute myocardial infarction at 1-year follow-up
Conclusions Our large prospective study showed for the first time that silent AF is associated with worse 1-year prognosis after AMI. Systematic screening and specific management should be investigated in order to improve outcomes of patients after AMI.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Stamboul, K., Zeller, M., Fauchier, L., Gudjoncik, A., Buffet, P., Garnier, F., Guenancia, C., Lorgis, L., Beer, J. C., Touzery, C., Cottin, Y. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Tobacco use Coronary artery disease Source Type: research

Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure
Conclusions LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Minguez, J. R. L., Asensio, J. M. N., Gragera, J. E., Costa, M., Gonzalez, I. C., de Carlos, F. G., Diaz, J. A. F., Yuste, V. M., Gonzalez, R. M., Dominguez-Franco, A., Buendia, A. B., Garibi, J. H., Hernandez, F. H., Ribeiro, V. G. Tags: Congenital heart disease in adult patients, Editor's choice, Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology Arrhythmias and sudden death Source Type: research

Prevalence and antithrombotic management of atrial fibrillation in hospitalised patients
Conclusions This hospital-based study revealed high AF prevalence rates (16.8%). Patients with AF were present in all hospital zones and almost all patients were at high risk for stroke. Anticoagulation management was likely inappropriate in 48.7%, indicating the need for better guideline implementation initiatives to guarantee hospital-wide optimised care for patients with AF.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Berti, D., Moors, E., Moons, P., Heidbuchel, H. Tags: Drugs: cardiovascular system, Hypertension Arrhythmias and sudden death Source Type: research