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Source: JAMA
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Total 276 results found since Jan 2013.
Atrial Myopathy and Dementia
Dementia is a leading cause of disability and death with an estimate of more than 50 million people living with the disease worldwide, a number that is projected to triple by 2050. Unlike Alzheimer disease, a degenerative condition without proven cure or treatment, vascular dementia is the second most common etiology and opens up opportunities for dementia prevention through treatment of known risk factors such as hypertension and atrial fibrillation (AF). The latter is a known risk factor for dementia through cerebral embolism and ischemic stroke primarily but also through nonstroke mechanisms. Thus, prevention, detection...
Source: JAMA - March 22, 2022 Category: General Medicine Source Type: research
Rivaroxaban vs Apixaban and Ischemic or Hemorrhagic Events in Patients With Atrial Fibrillation —Reply
In Reply Dr Gu questions whether the differences in outcomes reported in our study of rivaroxaban vs apixaban are clinically significant. A widely accepted measure of clinical impact is the number needed to harm, estimated as the reciprocal of the rate difference. We found 1 additional major ischemic or hemorrhagic event for every 370 patients treated with rivaroxaban compared with apixaban. Given the severity of the study events —stroke, other intracranial hemorrhage, and fatal bleeding—we disagree with the contention that the difference is not clinically important. Furthermore, the number needed to harm for nonfatal ...
Source: JAMA - April 5, 2022 Category: General Medicine Source Type: research
Progress Against Cardiovascular Disease Putting the Pieces Together
The JAMA theme issue on cardiovascular disease (CVD) recognizes the progress made in CVD but also acknowledges the challenges that remain. On the positive side, from 2000 to 2010 age-adjusted death rates attributable to overall CVD in the United States declined by more than 30%. Yet CVD continued to account for a third (787 650) of the 2.5 million deaths in the United States per year, an average of 1 death every 40 seconds. Worldwide, the picture is more concerning. The incidence of CVD is increasing rapidly in low- or-moderate income countries, and according to current World Health Organization statistics, ischemic hear...
Source: JAMA - November 17, 2014 Category: Journals (General) Source Type: research
Role of Glycemic Index in the Context of an Overall Heart-Healthy Diet
Randomized trials designed to assess possible effects of a dietary intervention on hard outcomes such as cardiovascular disease (CVD) events, cancer incidence, or all-cause mortality are nearly nonexistent. Clinical end point studies such as these require large sample sizes, long-term follow-up measured in years, and high levels of dietary adherence to attain a valid result. These studies are difficult and expensive to conduct and are consequently rare. An important exception was the PREDIMED Study wherein a Mediterranean diet supplemented with extravirgin olive oil or nuts reduced the incidence of major CVD events (mostly...
Source: JAMA - December 17, 2014 Category: Journals (General) Source Type: research
The Diagnosis and Management of Mild Cognitive Impairment A Clinical Review
ImportanceCognitive decline is a common and feared aspect of aging. Mild cognitive impairment (MCI) is defined as the symptomatic predementia stage on the continuum of cognitive decline, characterized by objective impairment in cognition that is not severe enough to require help with usual activities of daily living.ObjectiveTo present evidence on the diagnosis, treatment, and prognosis of MCI and to provide physicians with an evidence-based framework for caring for older patients with MCI and their caregivers.Evidence AcquisitionWe searched PubMed for English-language articles in peer-reviewed journals and the Cochrane Li...
Source: JAMA - December 17, 2014 Category: Journals (General) Source Type: research
Oral Anticoagulants and the Risk of Intracranial Hemorrhage
Conclusions and Relevance Novel oral anticoagulants are uniformly associated with an overall reduced risk of ICH when used for stroke prevention in atrial fibrillation. Any of the currently available NOACs can be considered first line for patients at high risk for ICH.JAMA Neurol. 2013;70(12):1486-1490. doi:10.1001/jamaneurol.2013.4021.
Source: JAMA - December 17, 2014 Category: Journals (General) Source Type: research
Cause-Specific Risk of Hospital Admission Related to Extreme Heat in Older Adults
ImportanceHeat exposure is known to have a complex set of physiological effects on multiple organ systems, but current understanding of the health effects is mostly based on studies investigating a small number of prespecified health outcomes such as cardiovascular and respiratory diseases.ObjectivesTo identify possible causes of hospital admissions during extreme heat events and to estimate their risks using historical data.Design, Setting, and PopulationMatched analysis of time series data describing daily hospital admissions of Medicare enrollees (23.7 million fee-for-service beneficiaries [aged ≥65 years] per year; 8...
Source: JAMA - December 24, 2014 Category: Journals (General) Source Type: research
Association Between Hospitalization for Pneumonia and Subsequent Risk of Cardiovascular Disease
Conclusions and RelevanceHospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD.
Source: JAMA - January 20, 2015 Category: Journals (General) Source Type: research
Effect of Creatine Monohydrate on Clinical Progression in Patients With Parkinson Disease A Randomized Clinical Trial
ImportanceThere are no treatments available to slow or prevent the progression of Parkinson disease, despite its global prevalence and significant health care burden. The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease program was established to promote discovery of potential therapies.ObjectiveTo determine whether creatine monohydrate was more effective than placebo in slowing long-term clinical decline in participants with Parkinson disease.Design, Setting, and PatientsThe Long-term Study 1, a multicenter, double-blind, parallel-group, placebo-controlled, 1:1 randomized eff...
Source: JAMA - February 10, 2015 Category: Journals (General) Source Type: research
Association of NSAID Use With Risk of Bleeding and Cardiovascular Events in Patients Receiving Antithrombotic Therapy After Myocardial Infarction
Conclusions and RelevanceAmong patients receiving antithrombotic therapy after MI, the use of NSAIDs was associated with increased risk of bleeding and excess thrombotic events, even after short-term treatment. More research is needed to confirm these findings; however, physicians should exercise appropriate caution when prescribing NSAIDs for patients who have recently experienced MI.
Source: JAMA - February 24, 2015 Category: Journals (General) Source Type: research
Inconsistent Units of Measure
This article was corrected online.
Source: JAMA - February 24, 2015 Category: Journals (General) Source Type: research
Antiplatelet Therapy Duration Following Bare Metal or Drug-Eluting Coronary Stents The Dual Antiplatelet Therapy Randomized Clinical Trial
ImportanceDespite antirestenotic efficacy of coronary drug-eluting stents (DES) compared with bare metal stents (BMS), the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Although dual antiplatelet therapy (DAPT) beyond 1 year provides ischemic event protection after DES, ischemic event risk is perceived to be less after BMS, and the appropriate duration of DAPT after BMS is unknown.ObjectiveTo compare (1) rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE; composite of death, myocardial infarction, or stroke) after 30 vs 12 months of thienopyridine in pati...
Source: JAMA - March 17, 2015 Category: Journals (General) Source Type: research
Mariner
Three minutes after pressing in with the scalpelA sea of yellow fat becomes my Faraway night and bow-crashing dip and swellA mist of chemicals washes over with each silver stroke
Source: JAMA - March 17, 2015 Category: Journals (General) Source Type: research
Endovascular Therapy for Atherosclerotic Intracranial Arterial Stenosis Back to the Drawing Board
This Editorial discusses the need for more randomized clinical trials to evaluate therapeutic approaches for stroke prevention in patients with intracranial arterial stenosis.
Source: JAMA - March 24, 2015 Category: Journals (General) Source Type: research
Acute Stroke Intervention: A Systematic Review
This systematic review summarizes the pathophysiology of acute brain ischemia and infarction and available reperfusion treatments.
Source: JAMA - April 14, 2015 Category: Journals (General) Source Type: research
