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Source: JAMA
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Total 276 results found since Jan 2013.
Benefits of Pulmonary Vein Isolation Beyond Rhythm Control
The prevalence of atrial fibrillation (AF) is continually increasing, with major implications for patients and health care systems given the increased morbidity and mortality. Approximately one-third of patients with AF additionally are affected by mental health conditions (notably depression, anxiety, and perceived stress). Psychological distress conditions are independent risk factors for adverse cardiovascular outcomes (including stroke and major bleeding) in patients with AF and promote AF recurrence. Without doubt, these associations add more complexity to comprehensive treatment decisions for patients with AF.
Source: JAMA - September 12, 2023 Category: General Medicine Source Type: research
Blood Pressure Management After Successful Thrombectomy
Despite the success of endovascular therapy (EVT) in acute ischemic stroke due to large vessel occlusion, opportunities to further optimize clinical outcomes remain. One such avenue is to reduce hemorrhagic transformation in the infarcted tissue bed after successful reperfusion, which has been shown to be associated with worsened clinical outcomes. Because higher cerebral perfusion pressures may foster hemorrhagic transformation, it has been hypothesized that lowering systemic blood pressure (BP) after successful reperfusion could decrease cerebral hemorrhagic complications. Reducing systemic BP may also lead to a decrease...
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research
Blood Pressure Management After Endovascular Therapy for Stroke
This randomized clinical trial evaluates whether moderately lowering systolic blood pressure, compared with a higher target, in the first 24 hours after successful endovascular treatment for acute ischemic stroke is futile.
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research
Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke
This randomized trial assesses the effect of intensive blood pressure management vs conventional management on functional independence at 3 months among patients with large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy.
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research
Extracranial-Intracranial Bypass Surgery for Stroke Prevention
The concept of performing an extracranial-intracranial (EC-IC) arterial bypass operation for a patient with an internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion is intuitively appealing. In these patients, it is believed that areas of hypoperfusion exist and anastomosis of the superficial temporal artery to the MCA is designed to augment brain perfusion. In vascular territories outside of the brain, bypass procedures performed to augment arterial flow typically improve clinical outcomes. For reasons unknown, however, the brain appears to respond differently to bypass surgery.
Source: JAMA - August 22, 2023 Category: General Medicine Source Type: research
Extracranial-Intracranial Bypass and Risk of Stroke and Death in Patients With Symptomatic Artery Occlusion
This clinical trial compares the efficacy of extracranial-intracranial bypass surgery plus medical therapy vs medical therapy alone in symptomatic patients with internal carotid artery or middle cerebral artery occlusion and hemodynamic insufficiency on a composite of stroke or death within 30 days or ipsilateral ischemic stroke beyond 30 days through 2 years after randomization.
Source: JAMA - August 22, 2023 Category: General Medicine Source Type: research
Door-in-Door-out Times for Transfer of Patients With Stroke
This retrospective study involving patients with acute stroke requiring transfers from hospitals in the Get With the Guidelines –Stroke registry assesses patient and hospital factors associated with door-in-door-out times.
Source: JAMA - August 15, 2023 Category: General Medicine Source Type: research
Treating Coronary Artery Disease With Treat-to-Target or High-Intensity Statin —Reply
In Reply We appreciate Dr Kawada ’s comments about our study, which demonstrated that a treat-to-target LDL-C strategy of 50 to 70 mg/dL as the goal was noninferior to a high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.
Source: JAMA - August 1, 2023 Category: General Medicine Source Type: research
Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke
This randomized trial examines whether dual antiplatelet therapy is noninferior to intravenous thrombolysis among patients with minor nondisabling acute ischemic stroke.
Source: JAMA - June 27, 2023 Category: General Medicine Source Type: research
Rate-Adaptive Atrial Pacing for Heart Failure With Preserved Ejection Fraction
To the Editor The recent RAPID-HF study explored the important concept of supporting heart rate in patients with heart failure and chronotropic insufficiency. Although the study reached a null conclusion, I believe it is important not to overextrapolate the findings. Cardiac output, by definition, is heart rate × stroke volume. Because these are not independent variables, the authors saw that when exercise heart rate was increased with atrial pacing, they could not measure an increase in cardiac output.
Source: JAMA - June 20, 2023 Category: General Medicine Source Type: research
Rate-Adaptive Atrial Pacing for Heart Failure With Preserved Ejection Fraction —Reply
In Reply The RAPID-HF study, which was the first randomized trial testing atrial pacing to increase exercise heart rate in patients with HFpEF, demonstrated no benefit in exercise performance, with a decrease in exercise stroke volume preventing gains in cardiac output. Dr Yamamoto speculates that atrial pacing might have been more effective for older patients because diastolic dysfunction worsens with aging. However, shortening of diastole with higher heart rate would be expected to be even more poorly tolerated in these patients. The devices were programmed based on hall walk and each participant ’s prior peak heart ra...
Source: JAMA - June 20, 2023 Category: General Medicine Source Type: research
Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy
This retrospective cohort study assesses the association between recent use of oral vitamin K antagonists and symptomatic intracranial hemorrhage among patients with acute ischemic stroke undergoing endovascular thrombectomy.
Source: JAMA - June 20, 2023 Category: General Medicine Source Type: research
Errors in Secondary Outcomes
This article was corrected online.
Source: JAMA - April 11, 2023 Category: General Medicine Source Type: research
Author Affiliations Omitted
This article has been corrected online.
Source: JAMA - April 4, 2023 Category: General Medicine Source Type: research
