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Design and rationale of a pragmatic trial integrating routine screening for atrial fibrillation at primary care visits: The VITAL-AF trial
Publication date: Available online 22 June 2019Source: American Heart JournalAuthor(s): Jeffrey M. Ashburner, Steven J. Atlas, David D. McManus, Yuchiao Chang, Ana T. Trisini Lipsanopoulos, Leila H. Borowsky, Wyliena Guan, Wei He, Patrick T. Ellinor, Daniel E. Singer, Steven A. LubitzAbstractGiven the preventable morbidity and mortality associated with atrial fibrillation (AF), increased awareness of undiagnosed AF, and advances in mobile ECG technology, there is a critical need to assess the effectiveness of using such technology to routinely screen for AF in clinical practice. VITAL-AF is a pragmatic trial that will test...
Source: American Heart Journal - June 24, 2019 Category: Cardiology Source Type: research

Rationale and design of the randomized, controlled early valve replacement guided by biomarkers of left ventricular decompensation in asymptomatic patients with severe aortic stenosis (EVOLVED) trial
ConclusionThe EVOLVED trial is the first multicenter randomized controlled trial to compare early aortic valve replacement to routine care in asymptomatic patients with severe aortic stenosis and mid-wall LGE.
Source: American Heart Journal - March 15, 2019 Category: Cardiology Source Type: research

Rationale and design of the Apixaban for the reduction of thrombo-embolism in patients with Device-Detected Sub-Clinical Atrial Fibrillation (ARTESiA) trial
Publication date: Available online 24 April 2017 Source:American Heart Journal Author(s): Renato D. Lopes, Marco Alings, Stuart J. Connolly, Heather Beresh, Christopher B. Granger, Juan Benezet Mazuecos, Giuseppe Boriani, Jens C. Nielsen, David Conen, Stefan H. Hohnloser, Georges H. Mairesse, Philippe Mabo, A. John Camm, Jeffrey S. Healey Device-detected subclinical atrial fibrillation (AF) refers to infrequent, short-lasting, asymptomatic AF that is detected only with long-term continuous monitoring. Subclinical AF is common and associated with an increased risk of stroke; however, the risk of stroke with subclinical AF ...
Source: American Heart Journal - April 24, 2017 Category: Cardiology Source Type: research

Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial
Conclusion The LOOP study will evaluate health benefits and cost-effectiveness of ILR as a screening tool for AF to prevent stroke in patients at risk. Secondary objectives include identification of risk factors for the development of AF and characterization of arrhythmias in the population. The trial holds the potential to influence the future of stroke prevention.
Source: American Heart Journal - March 14, 2017 Category: Cardiology Source Type: research

Diabetes, diabetes severity, and coronary heart disease risk equivalence: REasons for Geographic and Racial Differences in Stroke (REGARDS)
Conclusions Participants with diabetes had lower risk of CHD events than did those with prevalent CHD. However, participants with severe diabetes had similar risk to those with prevalent CHD. Diabetes severity may need consideration when deciding whether diabetes is a CHD risk equivalent.
Source: American Heart Journal - September 5, 2016 Category: Cardiology Source Type: research

Diabetes, diabetes severity and coronary heart disease risk equivalence REasons for Geographic and Racial Differences in Stroke (REGARDS)
Conclusions Participants with diabetes had lower risk of CHD events than those with prevalent CHD. However, participants with severe diabetes had similar risk as those with prevalent CHD. Diabetes severity may need consideration when deciding whether diabetes is a CHD risk equivalent.
Source: American Heart Journal - August 11, 2016 Category: Cardiology Source Type: research

Rationale and design of the First Brazilian Cardiovascular Registry of Atrial Fibrillation: The RECALL study
This study will provide important information about demographics, practice patterns, treatments, and associated outcomes in patients with AF. The results of this registry will also allow Brazilian data to be put in perspective with other AF registries across the world and provide opportunities to improve care of patients with AF in Brazil.
Source: American Heart Journal - March 9, 2016 Category: Cardiology Source Type: research

Individual Components of the Romhilt-Estes Left Ventricular Hypertrophy Score Differ in Their Prediction of Cardiovascular Events: the Atherosclerosis Risk in Communities (ARIC) Study
Conclusions The R-E score is predictive of CVD outcomes. The six R-E score components differ in their associations with different CVD outcomes, indicating that they may be electrical biomarkers of different physiological events within the myocardium. Graphical abstract
Source: American Heart Journal - October 4, 2015 Category: Cardiology Source Type: research

Cardiovascular prognosis in patients with type 2 diabetes: Contribution of heart and kidney subclinical damage
Conclusions Electrocardiographic LVH is complementary to kidney damage for MACE prediction in T2D.
Source: American Heart Journal - December 9, 2014 Category: Cardiology Source Type: research

Improving outcomes in patients with atrial fibrillation: Rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial
Conclusion EAST will determine whether rhythm control therapy, when applied early after the initial diagnosis of AF, can prevent cardiovascular complications associated with AF.
Source: American Heart Journal - October 20, 2014 Category: Cardiology Source Type: research

Finding atrial fibrillation in stroke patients: Randomized evaluation of enhanced and prolonged Holter monitoring—Find-AFRANDOMISED —rationale and design
Background: Detecting paroxysmal atrial fibrillation (AF) in patients with ischemic strokes presenting in sinus rhythm is challenging because episodes are often short, occur randomly, and are frequently asymptomatic. If AF is detected, recurrent thromboembolism can be prevented efficiently by oral anticoagulation. Numerous uncontrolled studies using various electrocardiogram (ECG) devices have established that prolonged ECG monitoring increases the yield of AF detection, but most established procedures are time-consuming and costly. The few randomized trials are mostly limited to cryptogenic strokes. The optimal method, du...
Source: American Heart Journal - July 7, 2014 Category: Cardiology Authors: Mark Weber-Krüger, Götz Gelbrich, Raoul Stahrenberg, Jan Liman, Pawel Kermer, Gerhard F. Hamann, Joachim Seegers, Klaus Gröschel, Rolf Wachter, Find-AFRANDOMISED investigators Tags: Trial Designs Source Type: research

PROspective Multicenter Imaging Study for Evaluation of chest pain: Rationale and design of the PROMISE trial
Conclusion: Multispecialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient. The PROMISE trial will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomical testing in symptomatic patients with suspected CAD. Quality of life, resource use, cost-effectiveness, and radiation exposure will be assessed.
Source: American Heart Journal - March 20, 2014 Category: Cardiology Authors: Pamela S. Douglas, Udo Hoffmann, Kerry L. Lee, Daniel B. Mark, Hussein R. Al-Khalidi, Kevin Anstrom, Rowena J. Dolor, Andrzej Kosinski, Mitchell W. Krucoff, Daniel W. Mudrick, Manesh R. Patel, Michael H. Picard, James E. Udelson, Eric J. Velazquez, Lawton Tags: Trial Design Source Type: research

Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: Findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry
Conclusions: Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefit outweighed the potential harm posed by the relative contraindication.
Source: American Heart Journal - January 6, 2014 Category: Cardiology Authors: Emily C. O'Brien, DaJuanicia N. Holmes, Jack E. Ansell, Larry A. Allen, Elaine Hylek, Peter R. Kowey, Bernard J. Gersh, Gregg C. Fonarow, Christopher R. Koller, Michael D. Ezekowitz, Kenneth W. Mahaffey, Paul Chang, Eric D. Peterson, Jonathan P. Piccini, Tags: Electrophysiology Source Type: research

Improving outcomes in patients with atrial fibrillation: Rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial
Conclusion: EAST will determine whether rhythm control therapy, when applied early after the initial diagnosis of AF, can prevent cardiovascular complications associated with AF.
Source: American Heart Journal - August 1, 2013 Category: Cardiology Authors: Paulus Kirchhof, Günter Breithardt, A. John Camm, Harry J. Crijns, Karl-Heinz Kuck, Panos Vardas, Karl Wegscheider Tags: Trial Design Source Type: research