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Source: JAMA
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Total 276 results found since Jan 2013.
Trends in Carotid Revascularization Procedures —Reply
In Reply Dr Hussain and colleagues point out interesting comparisons in carotid revascularization trends in Ontario, Canada, and in the US Medicare population, including similar 30-day stroke or death outcomes after carotid endarterectomy and stenting. We agree that differing reimbursement policies in the United States and Canada may account for differing patterns of carotid stenting after 2006. A noted difference is the lower receipt of procedures among symptomatic patients in the United States vs Ontario. However, such variation is expected because the approach to asymptomatic treatment has been shown to vary among Western countries.
Source: JAMA - January 16, 2018 Category: General Medicine Source Type: research
Left Atrial Appendage Occlusion for Prevention of Thromboembolic Events
More than 600 000 patients in the United States undergo cardiac operations each year, including coronary artery bypass graft operations, valve repair or replacement procedures, or other more complex operations. Patients with atrial fibrillation (AF) who undergo these procedures are at risk for postoperative th romboembolic complications, with the left atrial appendage being a common site of thrombus formation. Occlusion of the left atrial appendage may reduce the risk of thromboembolic stroke and can be performed intraoperatively at the time of cardiac operations. The most common surgical approaches to ac hieve left atr...
Source: JAMA - January 23, 2018 Category: General Medicine Source Type: research
Orpheus ’ Descent Into the Neurointensive Care Unit
This Arts and Medicine essay describes a 2014 staging of the operaOrph ée et Eurydice , directed by Romeo Castellucci, in which Eurydice ’s residence in the Underworld is represented by a patient with locked-in syndrome from a vertebrobasilar stroke.
Source: JAMA - January 23, 2018 Category: General Medicine Source Type: research
Organ Dysfunction After Individualized or Standard Blood Pressure Management
To the Editor Dr Futier and colleagues concluded that management targeting an individualized SBP minimized the risk of postoperative organ dysfunction compared with standard management. The authors used a composite primary outcome. Composite outcomes should include components that are of comparable severity and occur with similar frequency. It was not appropriate to combine the less severe and more common RIFLE (risk, injury, failure, loss of kidney function, and end-stage kidney disease) stage risk with the more severe and less common myocardial infarction, nor a Glasgow Coma Scale score of 14 or less with stroke. The inc...
Source: JAMA - February 20, 2018 Category: General Medicine Source Type: research
Precision Medicine and Progress in the Treatment of Hutchinson-Gilford Progeria Syndrome
Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare autosomal dominant genetic disorder, with an incidence of 1 in 4 million live births, for which there is no known cure. Children with HGPS appear normal at birth but present in infancy with severe failure to thrive, accompanied by a prematurely aged appearance, alopecia, and progressive lipoatrophy, joint contractures, skeletal dysplasia, and atherosclerosis, although intellectual development is normal. Accelerated cardiovascular disease results in death due to myocardial infarction or stroke at an average age of 14.6 years.
Source: JAMA - April 24, 2018 Category: General Medicine Source Type: research
Effects of Vasopressin With vs Without Catecholamine Vasopressors on Adverse Outcomes in Patients With Shock
This meta-analysis compares the effects of vasopressin with vs without catecholamine vasopressors on atrial fibrillation, mortality, stroke, and other adverse outcomes in patients with distributive shock.
Source: JAMA - May 8, 2018 Category: General Medicine Source Type: research
Ankle Brachial Index Screening and Improving Peripheral Artery Disease Detection and Outcomes
Lower extremity peripheral artery disease (PAD) affects an estimated 8.5 million adults in the United States and 202 million adults worldwide. PAD consists of atherosclerosis of the lower extremity arteries, resulting in inadequate oxygen supply to lower extremity muscles during walking activity. People with PAD typically walk only 1 to 3 blocks before having to stop and rest because of ischemic leg symptoms. PAD is also a marker for the presence of atherosclerotic disease in the coronary and cerebrovascular arteries. Consistent with this phenomenon, people with PAD have higher rates of acute coronary events, ischemic stro...
Source: JAMA - July 10, 2018 Category: General Medicine Source Type: research
Cardiovascular Disease in India
Ischemic heart disease deaths are rising in India, particularly in rural areas and among young adults, while deaths from stroke have dropped in most parts of the country, according to a study inThe Lancet Global Health.
Source: JAMA - September 18, 2018 Category: General Medicine Source Type: research
Left Atrial Appendage Occlusion and Surgical Ablation for AF During Cardiac Surgery
To the Editor Dr Yao and colleagues identified an association between left atrial appendage occlusion (LAAO) and reduced risk of stroke and all-cause mortality after cardiac surgery in a large insurance database (75 782 patients). There are limitations of the study that require careful consideration.
Source: JAMA - October 16, 2018 Category: General Medicine Source Type: research
Left Atrial Appendage Occlusion and Surgical Ablation for AF During Cardiac Surgery —Reply
In Reply Dr Coyan and colleagues point out that LAAO and surgical ablation of AF are often performed together, and they raise a question whether surgical ablation, rather than LAAO, was responsible for the association with reduced risks of stroke and mortality in our study. We believe that surgical AF ablation is unlikely to have influenced our findings.
Source: JAMA - October 16, 2018 Category: General Medicine Source Type: research
Benefits May Persist After Antihypertensive and Statin Treatment
Patients with hypertension may benefit from antihypertensive treatment with a calcium channel blocker and a lipid-lowering statin years after taking the medications, reported a long-term follow-upstudy in theLancet. Patients who received amlodipine-based antihypertensive treatment had fewer stroke deaths —independent of blood pressure levels—and patients taking lipid-lowering atorvastatin had fewer cardiovascular deaths.
Source: JAMA - October 23, 2018 Category: General Medicine Source Type: research
Hypertension —A Public Health Challenge of Global Proportions
This issue ofJAMA, from illustrated cover to in-depth content, is dedicated to hypertension, a worldwide problem of enormous consequence. High blood pressure affects more than 1 billion people worldwide, and that number is increasing. Untreated or uncontrolled, hypertension is the single largest contributor to cardiovascular disease, causing stroke, heart failure, coronary artery disease, and kidney disease, and also is a major contributor to kidney disease. Progress over the last several decades has led to increased understanding of the relationship between blood pressure and health outcomes and to the development of mult...
Source: JAMA - November 6, 2018 Category: General Medicine Source Type: research
Association Between Young Adult Hypertension and Cardiovascular Events in Middle Age
This cohort study investigates associations between blood pressure classifications defined by the 2017 ACC/AHA guidelines in adults younger than 40 years and long-term CVD events including myocardial infarction, heart failure, and stroke.
Source: JAMA - November 6, 2018 Category: General Medicine Source Type: research
Association of Aspirin Use for Primary Prevention of CVD With Cardiovascular Events and Bleeding
This meta-analysis estimates the association between use of aspirin for primary prevention of cardiovascular disease and the rate of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, and bleeding.
Source: JAMA - January 22, 2019 Category: General Medicine Source Type: research
Clinical Considerations for Aspirin Use for Primary Prevention in 2019
Reducing platelet activity with aspirin and other antiplatelet agents is an important factor in the prevention and management of atherothrombotic vascular events. For this indication, aspirin has both beneficial and potentially harmful effects; it can diminish or reverse thrombus formation (eg, in the setting of acute myocardial infarction or stroke), but it also increases the risk of bleeding.
Source: JAMA - January 22, 2019 Category: General Medicine Source Type: research
