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Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant: A case report
Rationale: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity, especially stroke and heart failure. There is also increasing awareness that atrial fibrillation is a major cause of embolic events which in 75% of cases are complicated by cerebrovascular accidents. Patient concerns: A 50-year-old woman with mitral bioprosthesis under warfarin for nonvalvular atrial fibrillation was referred to our Coronary Intensive Care Unit due to acute myocardial infarction without evidence of significant coronary artery stenosis. Diagnoses: Cardiovascular examination...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Clinical characteristics, triggering etiologies, and response of plasmapheresis in thrombotic microangiopathy in Taiwan
This study indicated the spectrum of underlying causes, extra-renal characteristics, and the response to plasmapheresis of patients with TMA in Taiwan. Of note, the poor clinical outcomes of plasmapheresis in patients with TMA might highlight the masked underlying etiology or worse disease condition that should be noticed.
Source: Medicine - May 21, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Predictors of bleeding event among elderly patients with mechanical valve replacement using random forest model: A retrospective study
Available classification tools and risk factors predicting bleeding events in elderly patients after mechanical valve replacement may not be suitable in Asian populations. Thus, we aimed to identify an accurate model for predicting bleeding in elderly patients receiving warfarin after mechanical valve replacement in a Korean population. In this retrospective cohort study, a random forest model was used to determine factors predicting bleeding events among 598 participants. Twenty-two descriptors were selected as predictors for bleeding. Steroid use was the most important predictor of bleeding events, followed by labile int...
Source: Medicine - May 14, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Analysis of individualized antiplatelet therapy for patients of acute coronary syndrome after percutaneous coronary intervention under the guidance of platelet function: A one-center retrospective cohort study
There is controversy in clinical application of antiplatelet drugs by monitoring platelet function. Therefore, we explored whether early and dynamic medication could bring better clinical outcomes for patients under the guidance of platelet function tests (PFT). In this retrospective cohort study, we analyzed the prognostic events of 1550 patients with acute coronary syndrome (ACS) at Tianjin People's Hospital in China. They received dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) from January 2017 to December 2018. The primary endpoint was based on the Bleeding Academic Research Consorti...
Source: Medicine - April 23, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Dual therapy with an oral non-vitamin K antagonist and a P2Y12 inhibitor vs triple therapy with aspirin, a P2Y12 inhibitor and a vitamin K antagonist for the treatment of diabetes mellitus patients with co-existing atrial fibrillation following percutaneous coronary intervention: A meta-analysis
Conclusions: DT with a NOAC and a P2Y12 inhibitor was associated with significantly less bleeding events without increasing the adverse cardiovascular outcomes when compared to TT with aspirin, a P2Y12 inhibitor and a Vitamin K antagonist for the treatment of DM patients with co-existing AF following PCI. Hence, DT is comparable in efficacy, but safer compared to TT. This interesting hypothesis will have to be confirmed in future studies.
Source: Medicine - April 16, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Effects of continuous use of metformin on cardiovascular outcomes in patients with type 2 diabetes after acute myocardial infarction: A protocol for systematic review and meta-analysis
Conclusions: This study expects to provide credible and scientific evidence for the efficacy and safety of metformin on cardiovascular outcomes after AMI in patients with T2DM. Registration number: 10.17605/OSF.IO/S3MBP.
Source: Medicine - April 16, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Assessment of lesion-associated myocardial ischemia based on fusion coronary CT imaging – the FUSE-HEART study: A protocol for non-randomized clinical trial
Conclusion: In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.
Source: Medicine - April 9, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Deceleration capacity for rapid risk stratification in patients suffering from acute ischemic stroke: A prospective exploratory pilot study
Deceleration capacitiy for rapid risk stratification in stroke patients Cerebral ischemia is a major cause of neurologic deficit and patients suffering from ischemic stroke bear a relevant risk of mortality. Identifying stroke patients at high mortality risk is of crucial clinical relevance. Deceleration capacity of heart rate (DC) as a parameter of cardiac autonomic function is an excellent predictor of mortality in myocardial infarction and heart failure patients. The aim of our study was to evaluate whether DC provides prognostic information regarding mortality risk in patients with acute ischemic stroke. From ...
Source: Medicine - April 2, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Effects of corticosteroids on new-onset atrial fibrillation after cardiac surgery: A meta-analysis of randomized controlled trials
Conclusion: Our review suggests that the efficacy of corticosteroid might be beneficial to POAF development in patients undergoing cardiac surgery. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Bivalirudin in patients undergoing percutaneous coronary intervention and independent predictors of postoperative adverse events in these patients: A real world retrospective study
The efficacy and safety of bivalirudin in percutaneous coronary intervention (PCI) has always been a hot topic in perioperative antithrombotic therapy, but there are still some controversies. So studies are needed to provide more evidence, especially the real world study which includes patients excluded from previous RCT studys. Our study aimed to investigate these information and analyze the independent predictors of postoperative adverse events. A retrospective study enrolled 1416 patients underwent PCI in Tianjin Chest Hospital from May 2016 to October 2017. The incidence of stent-thrombosis and net clinical adverse ...
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of time factor and patient characteristics on the efficacy of PCI vs CABG for left main coronary disease: A meta-analysis
Conclusions: The long-term benefit of CABG vs PCI on MACCE in patients with left main coronary disease is consistent across patients with different clinical characteristics. The relative benefit of CABG on MACCE is driven by that of CABG on unplanned revascularization, and becomes greater as time goes on.
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Effects of SGLT2 inhibitors on cardiovascular and renal outcomes in type 2 diabetes: A meta-analysis with trial sequential analysis
Conclusions: Compared with placebo, SGLT2 inhibitors conclusively reduce the risk of MACE, CVD or HHF, ACD, CVD, HHF, and KFP in patients with type 2 diabetes, whereas the effects of SGLT2 inhibitors on MI and stroke are not conclusive and need to be further assessed in future studies with the adequate sample size to reject or accept the effect size.
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
Conclusion: Early recognition and immediate treatment is important in different scenarios leading to thrombosis as the outcome. Additionally, addressing the unknown risks that could contribute to our traditional understanding of these causative mechanisms is important. The hypothesis of exacerbated damage caused by inflammatory and immunological endothelial systemic damage should further be explored to be able to delineate new possibilities in managing these conditions.
Source: Medicine - January 29, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Clinical outcomes of multivessel coronary artery disease patients revascularized by robot-assisted vs conventional standard coronary artery bypass graft surgeries in real-world practice
The treatment of patients with multivessel coronary artery disease (MVD) by coronary stenting (PCI) and the “gold standard” conventional coronary-artery bypass grafting (C-CABG) has been well explored in the literature. However, the clinical outcomes of robot-assisted CABG (R-CABG) vs C-CABG in MVD patients in real-world practice were unknown. We aimed to study the clinical outcomes of MVD patients who underwent R-CABG (robotic MIDCAB) and C-CABG at our institution between January 2005 and December 2013. A total of 516 MVD patients received CABG were recruited into this study. Among them, 281 patients received R-CAB...
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Efficacy and safety of pasireotide for Cushing's disease: A protocol for systematic review and meta-analysis
Conclusions: This systematic review and meta-analysis will provide clinical evidence for the efficacy and safety of pasireotide for CD, and inform our understanding of the value of pasireotide in improving CD clinical signs and symptoms. The conclusions drawn from this study may be beneficial to patients, clinicians, and health-related policy makers. Study registration number: INPLASY2020110070.
Source: Medicine - December 18, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

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