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Source: The American Journal of Cardiology
Condition: Ischemic Stroke
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Total 182 results found since Jan 2013.
Prevalence and Outcomes of Patients With Acute Ischemic Stroke and Concomitant Non –ST-Elevation Myocardial Infarction (Results from the National Inpatient Sample 2016 to 2019)
We examined hospitalized patients with acute ischemic stroke and a concomitant NSTEMI diagnosis who were included in the National Inpatient Sample 2016 to 2019. Acute ischemic stroke and NSTEMI were defined by using the Inter national Classification of Diseases, Tenth Revision codes. Patients with ST-elevation MI were excluded.
Source: The American Journal of Cardiology - August 26, 2023 Category: Cardiology Authors: Shivani Mehta, Roxana Mehran, Shahzad Hassan, Jasmeet Kaur, Anupam Sule, Camelia Arsene, Geetha Krishnamoorthy, Moyses Szklo Source Type: research
Meta-Analysis of the Outcomes of Peri-Device Leak After Left Atrial Appendage Closure
Left atrial appendage closure (LAAC) reduces the risk of thromboembolic stroke in atrial fibrillation. Peri-device leak (PDL) after LAAC may affect the subsequent risk of thromboembolism. We conducted a systematic review and meta-analysis to evaluate the effect of PDL after LAAC. We searched PubMed/Medline, Embase, and Google Scholar for studies reporting outcomes of PDL after LAAC from inception through October 2022. The primary outcome was the composite of stroke, transient ischemic attack (TIA), or systemic embolism (SE).
Source: The American Journal of Cardiology - August 10, 2023 Category: Cardiology Authors: Mostafa Reda Mostafa, Mohamed Magdi Eid, Mohamed Abuelazm, Ahmad Al-Abdouh, Mostafa Najim, Abdul Rhman Hassan, Amro A. El-Sakka, Sarath Lal Mannumbeth Renjithal, Muhammad Ahmed Malik, Sarah Mohamed, Mallory Balmer-Swain, Timir K. Paul, Andrew M. Goldsweig Source Type: research
Efficacy of Percutaneous Coronary Intervention With Synergy Stents in Patients Aged ≥75 Years: 1-Year Clinical Outcomes from the Synergy Elderly Registry
This study investigated the 12-month clinical outcomes of older patients who underwent percutaneous coronary intervention with new-generation drug-eluting stents according to ischemic risks. This prospective multicenter study targeted patients aged ≥75 years who underwent S-EES implantation. The primary and secondary end points included 12-month device-oriented composite end point (DOCE) (cardiovascular death, target vessel myocardial infarction, or target lesion revascularization) and major adverse cardiac and cerebrovascular events (MACCE s; all-cause death, myocardial infarction, target vessel revascularization, sten...
Source: The American Journal of Cardiology - August 1, 2023 Category: Cardiology Authors: Jong-Il Park, Seung-Jun Lee, Young-Joon Hong, Sang-Yong Yoo, Yong-Sung Seo, Eui Im, Jong-Kwan Park, Jin-Bae Lee, Yong-Joon Lee, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Byeong-Keuk Kim Source Type: research
Guideline-Directed Low-Density Lipoprotein Cholesterol Management After Acute Ischemic Stroke: Findings from a National Health Care Service
Patients with ischemic stroke are at high risk for future cardiovascular events and should be treated intensively with lipid-modifying agents. Combination lipid-lowering therapies are often needed to achieve updated guideline-directed treatment goals. However, real-world data on intensification of lipid-lowering therapies and attainment of low-density lipoprotein cholesterol (LDL-C) targets early after ischemic stroke are limited. We extracted data from the largest healthcare provider in Israel on patients hospitalized with acute ischemic stroke between January 2020 and February 2022.
Source: The American Journal of Cardiology - July 28, 2023 Category: Cardiology Authors: Barak Zafrir, Amir Aker, Ibrahim Naoum, Walid Saliba Source Type: research
Atrial Myopathy and Ischemic Stroke in Heart Failure With Preserved Ejection Fraction
We examined the hypothesis that atrial myopathy may be associated with ischemic stroke in patients with heart failure with preserved ejection fraction. This is an exploratory, post hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. Patients with sinus rhythm documented at baseline electrocardiogram and without known AF were included in this analysis.
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Kassem Farhat, Khaled Elkholey, Zain Ul Abideen Asad, Stavros Stavrakis Source Type: research
One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease
The concept of the polypill was first proposed in 2003 as a strategy to reduce cardiovascular risk by combining multiple therapeutic agents into a single daily pill. Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care.
Source: The American Journal of Cardiology - July 26, 2023 Category: Cardiology Authors: Rebecca J.C. Tran Source Type: research
A Commentary on “Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke”
Cryptogenic stroke, defined as acute ischemic stroke without a clear identifiable cause, accounts for approximately 1/3 of acute ischemic stroke cases. Undiagnosed atrial fibrillation (AF) is likely the leading underlying cause of such presentations; hence, cardiac rhythm monitoring is key to the diagnostic work-up. Commonly, long-term monitoring (LTM) using implantable cardiac monitors (ICMs) is indicated after a negative period of short-term monitoring (STM). However, the low diagnostic yield of STM prompts the question: would directly proceeding to LTM represent a more cost-effective approach?
Source: The American Journal of Cardiology - July 22, 2023 Category: Cardiology Authors: Michael Griffin, Gregory Y.H. Lip Tags: Editorial Source Type: research
Gender Differences in Atrial Fibrosis and Cardiomyopathy Assessed by Left Atrial Low-Voltage Areas During Catheter Ablation of Atrial Fibrillation
This study aimed to delineate gender differences in the prevalence, predictors, and prognostic impact of left atrial low-voltage areas (LVAs). This observational study included 1,488 consecutive patients who underwent initial ablation for AF. Voltage mapping was performed after pulmonary vein isolation during sinus rhythm.
Source: The American Journal of Cardiology - July 21, 2023 Category: Cardiology Authors: Masaharu Masuda, Yasuhiro Matsuda, Hiroyuki Uematsu, Ayako Sugino, Hirotaka Ooka, Satoshi Kudo, Subaru Fujii, Mitsutoshi Asai, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yosuke Hata, Taku Toyoshima, Naoko Higashino, Sho Source Type: research
Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke
Implantable cardiac monitors are routinely placed for long-term monitoring (LTM) after a period of negative short-term monitoring (STM) to increase atrial fibrillation (AF) detection after a cryptogenic stroke or transient ischemic attack (TIA). Optimizing AF monitoring after a cryptogenic stroke is critical to improve outcomes and reduce costs. We sought to compare the diagnostic yield of STM versus LTM, assess the impact of routine STM on hospitalization length of stay, and perform a financial analysis comparing the current model to a theoretical model wherein patients can proceed directly to LTM.
Source: The American Journal of Cardiology - July 11, 2023 Category: Cardiology Authors: Samuel J. Apple, David Flomenbaum, Matthew Parker, Sanya Chhikara, Aaron Stolarov, Jack Moser, Sheetal Vasundara Mathai, Jiyoung Seo, Neal Ferrick, Jay J. Chudow, Luigi Di Biase, Andrew Krumerman, Kevin J. Ferrick Source Type: research
Should Pleiotropic Effects of Antiplatelet Agents Be Considered for Acute Coronary Syndrome?
When he coined the phrase, “A man is as old as his arteries,” Dr. Williams Osler anticipated the concept of the spectrum cardiovascular disease (CVD) by a century. The populations of many countries are becoming older, which has also led to the number of patients suffering from CVD to increase. Global rates of CVD such as ischemic heart disease (IHD) and stroke have been rising since the 1970s and the leading 2 causes of years of life lost in 2017 may continue to be the same in 2040.1 About 9 million deaths were because of IHD in 2017.
Source: The American Journal of Cardiology - July 10, 2023 Category: Cardiology Authors: Hideki Ishii Source Type: research
Atrial Cardiopathy: Redefining Stroke Risk Beyond Atrial Fibrillation
Atrial fibrillation (AF) and ischemic stroke are dual epidemics in society, both associated with poor clinical outcomes, patient disability, and significant healthcare expenditure. The conditions are interrelated and share complex causal pathways. Risk stratification algorithms such as the CHADS2 and CHA2DS2-VASc score offer predictive value in stroke and systemic embolism risk in the AF population, however, have limitations. Recent evidence suggests that an intrinsically prothrombotic atrial substrate may precede and promote AF and lead to thromboembolic events independent of the arrhythmia, allowing for a window of inter...
Source: The American Journal of Cardiology - June 28, 2023 Category: Cardiology Authors: Jessica Chu Zhang, Aditya Bhat Source Type: research
An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients With Atrial Fibrillation
The availability of direct oral anticoagulants (DOACs) with known lower bleeding risk compared with warfarin have raised questions about the role of left atrial appendage closure (LAAC). We aimed to perform a meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All studies directly comparing LAAC with DOACs up to January 2023 were included. The outcomes studied included the combined major adverse cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic events, major bleeding, CV mortality, and all-cause mortality.
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Haowen Jiang, Tian Hai Koh, Vijay Vengkat, Gao Fei, Zee Pin Ding, See Hooi Ewe, Ignasius Jappar, Soo Teik Lim, Jonathan Yap Source Type: research
Impact of a Novel Score to Predict Left Ventricular Diastolic Dysfunction After Catheter Ablation of Nonparoxysmal Atrial Fibrillation With Preserved Ejection Fraction
This study aimed to develop a novel risk score to predict LV diastolic dysfunction (LVDD) 12 months after AFCA (12-month LVDD) and to evaluate whether the risk score was associated with cardiovascular events (cardiovascular death, transient ischemic attack/stroke, myocardial infarction, or heart failure hospitalization). We studied 397 patients with nonparoxysmal AF with preserved ejectio n fraction who underwent initial AFCA (age: 69 years, women: 32%).
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Yasuyuki Egami, Hiroaki Nohara, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino, Jun Tanouchi Source Type: research
Comparison of Stroke and Bleeding Risk Profile in Patients With Atrial Fibrillation and Chronic Kidney Disease
This study explores the impact of glomerular filtration rate (GFR) in the embolic-hemorrhagic balance among a large cohort of patients with AF. The study cohort included 15,457 patients diagnosed with AF between January 2014 and April 2020. The risk of ischemic stroke and major bleeding was determined by competing risk regression.
Source: The American Journal of Cardiology - April 12, 2023 Category: Cardiology Authors: Jos é Antonio Parada Barcia, Sergio Raposeiras Roubin, Emad Abu-Assi, Pablo Domínguez Erquicia, Andrea Lizancos Castro, Lucía Rioboo Lestón, Juan Ocampo Míguez, Inmaculada González Bermúdez, Andrés Íñiguez-Romo Source Type: research
Probability of Cardioembolic vs. Atherothrombotic Pathogenesis of Cryptogenic Strokes in Older Patients
Some clinical, laboratory, ECG, and echocardiographic parameters could provide useful indications to assess the probability of cardioembolism or atherothrombosis in cryptogenic strokes. We retrospectively examined 290 patients with ischemic stroke aged ≥60 years, divided into 3 groups: strokes originating from large artery atherothrombosis (n = 92), cardioembolic strokes caused by paroxysmal atrial fibrillation (n = 88) and cryptogenic strokes (n = 110). In addition to echocardiographic and routine clinical-laboratory variables, neutrophi l:lymphocyte ratio, red blood cell distribution width, mean platelet volume,...
Source: The American Journal of Cardiology - February 1, 2023 Category: Cardiology Authors: Antonio Muscari, Eleonora Evangelisti, Luca Faccioli, Paola Forti, Marco Ghinelli, Giovanni M. Puddu, Luca Spinardi, Giovanni Barbara Source Type: research
