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Outcomes in elderly and young patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with bivalirudin versus heparin: pooled analysis from the EUROMAX and HORIZONS-AMI trials
Conclusions In a large group of elderly patients enrolled in the EUROMAX and HORIZONS-AMI trials, bivalirudin was associated with lower 30-day rates of non-CABG major bleeding, subacute ST and NACE, with similar 30-day rates of acute ST and mortality.
Source: American Heart Journal - August 18, 2017 Category: Cardiology Source Type: research

Impact of atrial fibrillation on outcomes of patients treated by transcatheter aortic valve implantation: A systematic review and meta-analysis
Conclusions AF is associated with impaired outcomes after TAVI, including mortality, stroke and - limited to new-onset AF - major bleedings. Compared to pre-existing AF, new-onset AF correlates with higher risk of early stroke and major bleedings. Improved management of AF in the TAVI setting, including tailored antithrombotic treatment strategies, remain a relevant need.
Source: American Heart Journal - July 15, 2017 Category: Cardiology Source Type: research

Growth-Differentiation Factor 15 and Risk of Major Bleeding in Atrial Fibrillation: Insights from the RE-LY Trial
Conclusions In patients with AF, GDF-15 is an independent risk indicator for major bleeding and all-cause mortality, but not for stroke. Therefore, GDF-15 seems useful as a specific marker of bleeding in patients with AF on oral anticoagulant treatment.
Source: American Heart Journal - June 8, 2017 Category: Cardiology Source Type: research

Probing oral anticoagulation in patients with atrial high rate episodes: Rationale and design of the Non –vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes (NOAH–AFNET 6) trial
Conclusion NOAH–AFNET 6 will provide robust information on the effect of oral anticoagulation in patients with atrial high rate episodes detected by implanted devices. Graphical abstract
Source: American Heart Journal - May 24, 2017 Category: Cardiology Source Type: research

Cardiovascular events and hospital resource utilization pre – and post–transcatheter mitral valve repair in high–surgical risk patients
Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year.
Source: American Heart Journal - May 10, 2017 Category: Cardiology Source Type: research

Probing oral anticoagulation in patients with atrial high rate episodes. Rationale and design of the Non vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes (NOAH – AFNET 6) trial
Conclusion NOAH – AFNET 6 will provide robust information on the effect of oral anticoagulation in patients with atrial high rate episodes detected by implanted devices. Graphical abstract
Source: American Heart Journal - May 4, 2017 Category: Cardiology Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Cangrelor reduces the risk of ischemic complications in patients with single-vessel and multi-vessel disease undergoing percutaneous coronary intervention: Insights from the CHAMPION PHOENIX trial
Conclusion In the CHAMPION PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. Clinical perspectives What's known? Cangrelor is a novel, intravenous, potent, and rapidly acting P2Y12 inhibitor that has been demonstrated to reduce the rate of ischemic events at 48hours in patients who received PCI compared with clopidogrel. What's new? In contrast to prior studies, we found that in this modern cohort, patients with SVD and MVD had a similar risk of i...
Source: American Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Use of prasugrel vs clopidogrel and outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention in contemporary clinical practice: Results from the PROMETHEUS study
Conclusions In contemporary clinical practice, patients receiving prasugrel tend to have a lower-risk profile compared with those receiving clopidogrel. The lower ischemic and bleeding events associated with prasugrel use were no longer evident after accounting for these baseline differences.
Source: American Heart Journal - April 1, 2017 Category: Cardiology Source Type: research

A prospective, randomized, open-label trial of 6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: June 2017 Source:American Heart Journal, Volume 188 Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark W. Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with second-generation drug eluting stents (DESs) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the safety of shorter DAPT dur...
Source: American Heart Journal - March 20, 2017 Category: Cardiology Source Type: research

The Assessment of the Watchman Device in Patients Unsuitable for Oral Anticoagulation (ASAP-TOO) trial
Publication date: Available online 15 March 2017 Source:American Heart Journal Author(s): David R. Holmes, Vivek Y. Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W. Bergmann, Boris Schmidt, Jacqueline Saw Background Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. Study objectives The ASAP-TOO...
Source: American Heart Journal - March 15, 2017 Category: Cardiology Source Type: research

Cangrelor reduces the risk of ischemic complications in patients with single and multi-vessel disease undergoing PCI: insights from the CHAMPION PHOENIX Trial
Conclusion In the CHAMPION-PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. Clinical Perspectives. What's known? Cangrelor is a novel, intravenous, potent, and rapidly-acting P2Y12 inhibitor, that has been demonstrated to reduce the rate of ischemic events at 48hours in patients who received PCI compared with clopidogrel. What's new? In contrast to prior studies, we found that in this modern cohort, patients with SVD and MVD had a similar risk of...
Source: American Heart Journal - March 9, 2017 Category: Cardiology Source Type: research

Use of Prasugrel versus Clopidogrel and Outcomes in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention in Contemporary Clinical Practice: Results from the PROMETHEUS Study
Conclusions In contemporary clinical practice, patients receiving prasugrel tend to have a lower-risk profile compared with those receiving clopidogrel. The lower ischemic and bleeding events associated with prasugrel use were no longer evident after accounting for these baseline differences.
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

A Prospective, Randomized, Open Label Trial of 6Months vs. 12Months Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation In ST-elevation Myocardial Infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: Available online 20 February 2017 Source:American Heart Journal Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Abstract. Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the sa...
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

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