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Source: The American Journal of Medicine
Condition: Heart Failure
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Total 20 results found since Jan 2013.
Paroxysmal AV Block
A 69 year old woman with a history of congestive heart failure and stroke presented to the emergency room with sudden onset lightheadedness leading to a fall at the grocery store and sustaining head trauma. On physical examination, she was alert and in mild distress. Her HR was 72 beats per minute and blood pressure was 196/70. A 12 lead electrocardiogram (ECG) showed normal sinus rhythm, first degree atrioventricular (AV) block and right bundle branch block. She was admitted for management of subdural hematoma which was noted on CT scan.
Source: The American Journal of Medicine - December 7, 2022 Category: General Medicine Authors: Tharian S. Cherian, Amit Thosani Tags: ECG image of the month Source Type: research
Oral Anticoagulant Use for Patients with Atrial Fibrillation with Concomitant Anemia and/or Thrombocytopenia
Atrial fibrillation is the most common sustained cardiac arrhythmia in clinical practice, which is associated with an increased risk of thromboembolism, heart failure and mortality.1 Previous studies in atrial fibrillation patients have reported that abnormal hemoglobin and platelet counts may be associated with adverse events. However, these studies that specifically examined the associations between hemoglobin and platelet levels and adverse outcomes reported conflicting data.2-5 Although warfarin effectively reduces the risk of ischemic stroke by 64% compared to placebo/control,6 and non-vitamin K antagonist oral antico...
Source: The American Journal of Medicine - April 2, 2022 Category: General Medicine Authors: Yung-Hsin Yeh, Yi-Hsin Chan, Shao-Wei Chen, Shang-Hung Chang, Chun-Li Wang, Chi-Tai Kuo, Gregory Y.H. Li, Shih-Ann Chen, Tze-Fan Chao Tags: Clinical Research Study Source Type: research
Effects of Anticoagulation on Low-Density Lipoprotein-Cholesterol and Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation
The study by Omelchenko et al1 concluded that, unlike the general population, low-density lipoprotein-cholesterol (LDL-C) levels were not associated with ischemic stroke risk among patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). To arrive at this conclusion, they retrospectively analyzed data of 21,229 patients with a first-time diagnosis of nonvalvular atrial fibrillation treated with DOACs categorized according to the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category, ...
Source: The American Journal of Medicine - September 28, 2021 Category: General Medicine Authors: Zeeshan H. Ismail, Zekarias T. Asnake, Joshua K. Salabei Tags: Letter Source Type: research
A comprehensive cardiovascular-renal-metabolic risk reduction approach to patients with Type 2 Diabetes Mellitus
Cardiovascular disease remains the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus, despite decades of research into risk reduction strategies (1,2). While myocardial infarction and ischemic stroke are the most recognized drivers of mortality in this population, less well-appreciated forms of cardiovascular disease, including heart failure and peripheral arterial disease, also contribute significantly to this risk (3-5). Further, the development of renal disease among patients with type 2 diabetes mellitus is common (6), and it drastically increases the risk of cardiovascular disease a...
Source: The American Journal of Medicine - May 21, 2021 Category: General Medicine Authors: Neha J. Pagidipati, Dr. Prakash Deedwania Tags: Review Source Type: research
Oral Anticoagulation Use in High-Risk Patients Is Improved by Elimination of False-Positive and Inactive Atrial Fibrillation Cases
Multiple registries have reported that>40% of high-risk atrial fibrillation patients are not taking oral anticoagulants. The purpose of our study was to determine the presence or absence of active atrial fibrillation and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 y, Diabetes mellitus, prior Stroke [or transient ischemic attack or thromboembolism], Vascular disease, Age 65-74 y, Sex category) risk factors to accurately identify high-risk atrial fibrillation (CHA2DS2-VASc ≥2) patients requiring oral anticoagulants and the magnitude of the anticoagulant treatment gap.
Source: The American Journal of Medicine - December 23, 2020 Category: General Medicine Authors: Gerald V. Naccarelli, Mohammed Ruzieh, Deborah L. Wolbrette, Mauricio Sendra-Ferrer, John van Harskamp, Barbara Bentz, Gregory Caputo, Nathan McConkey, Kevin Mills, Stephen Wasemiller, Jovan Plamenac, Douglas Leslie, Frendy D. Glasser, Thomas W. Abendroth Tags: Clinical Research Study Source Type: research
Peripheral arterial disease in patients with atrial fibrillation: The Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study.
Atrial fibrillation and peripheral arterial disease are two conditions associated with high risk of cardiovascular and cerebrovascular complications and mortality.1 –5 There is evidence that coexistence of both these clinical conditions can result to an additive risk of adverse events.6 Indeed, atherosclerotic vascular disease has been linked with stroke, thromboembolism and death in subjects with atrial fibrillation and has been therefore included as one of the components of risk scores, such as the CHA2DS2-VASc score (Congestive Heart failure, Hypertension Age> 75 years, DM, Stroke, Vascular disease) in order to strati...
Source: The American Journal of Medicine - September 17, 2020 Category: General Medicine Authors: Antonios Vitalis, Alena Shantsila, Marco Proietti, Rajiv K. Vohra, Mark Kay, Brian Olshansky, Gregory Y.H. Lip Source Type: research
Contemporary Meta-Analysis of Extended Direct Acting Oral Anticoagulant Thromboprophylaxis to Prevent Venous Thromboembolism Among Hospitalized Patients
There are over 36 million medical hospitalizations each year in the United States, with the majority being for acute medical illness.1 Cancer, chronic obstructive pulmonary disease, congestive heart failure, stroke and myocardial infarction are some of the most common indications for hospitalization and are additionally risk factors for venous thromboembolism.2 With over 900,000 patients suffering from venous thromboembolism each year, excess thrombosis causes a large medical and financial burden to patients and the health care system.
Source: The American Journal of Medicine - March 5, 2020 Category: General Medicine Authors: Vikas Bhalla, Olivia F Lamping, Ahmed Abdel-Latif, Meenakshi Bhalla, Khaled Ziada, Susan S. Smyth Tags: Clinical Research Study Source Type: research
Take-Home Messages From the Recently Updated AHA/ACC Guidelines for Atrial Fibrillation
Atrial fibrillation and congestive heart failure (CHF) are “growth industries” in 21st-century industrial nations. The rapid growth of the geriatric population in these countries plays an important role in the ever-increasing number of patients seen with these 2 clinical entities. Patients with atrial fibrillation are seen on a daily basis in both the c linic and the hospital. The most devastating complication resulting from atrial fibrillation is cerebral arterial embolism with resultant stroke.
Source: The American Journal of Medicine - August 7, 2019 Category: General Medicine Authors: Joseph S. Alpert Tags: Commentary Source Type: research
Diastolic hypotension may attenuate benefits from intensive systolic targets: secondary analysis of a randomized controlled trial
The potential for harm due to excessive lowering of diastolic blood pressure as a result of antihypertensive treatment has been discussed for several decades.1 Numerous observational studies and secondary analyses of randomized data have suggested that treating diastolic blood pressure below a certain threshold may lead to adverse outcomes, including a higher incidence of coronary events, stroke, heart failure, and all-cause mortality.1 –6 Proposed mechanisms include reduced endocardial perfusion leading to coronary events,7 or flow limiting coronary stenosis.
Source: The American Journal of Medicine - June 12, 2018 Category: General Medicine Authors: Todd C. Lee, Rodrigo B. Cavalcanti, Emily G. McDonald, Louise Pilote, James M. Brophy Tags: A Clinical Research Study Source Type: research
Cardiovascular Protection in the Treatment of Type 2 Diabetes: A Review of Clinical Trial Results Across Drug Classes
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD) —namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity o f hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear.
Source: The American Journal of Medicine - May 26, 2017 Category: General Medicine Authors: Francesco Paneni, Thomas F. L üscher Tags: Clinical research study Source Type: research
The Reply
The authors thank Xue et al for their interest in our article titled “Association between Anemia, Bleeding, and Transfusion with Long-Term Mortality Following Non-Cardiac Surgery.”1 We share the authors' concern about the potential for residual confounding in this observational analysis of a large single-center surgical database. The initial analysis adjusted for age, sex, race, elective vs emergency/urgent surgery, procedure type, and the individual components of the Revised Cardiac Risk Index including coronary artery disease, heart failure, stroke/transient ischemic attack, creatinine>2 mg/dL, and diabetes mellitus.
Source: The American Journal of Medicine - August 21, 2016 Category: Journals (General) Authors: Nathaniel R. Smilowitz, Jeffrey S. Berger Tags: AJM online Source Type: research
Summer Syncope Syndrome Redux
The objective of the present study was to investigate whether the results of our prior study involving continued use of antihypertensive drugs at the same dosage in the summer as in the winter months for patients living in the Sonoran desert resulted in an increase in syncopal episodes during the hot summer months.
Source: The American Journal of Medicine - June 4, 2015 Category: Journals (General) Authors: Jennifer Juxiang Huang, Chirag Desai, Nirmal Singh, Natasha Sharda, Irbaz Riaz, Joseph Alpert Tags: Brief Observation Source Type: research
AFib in Special Populations
Abstract: For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This review addresses the clinical characteristics of each of these presentations in order. For all patients with AFib, of either gender or any age, the greatest risk is failure to prescrib...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: William J. French Tags: CME multimedia activities Source Type: research
CHA2DS2-VASc Score Is Directly Associated with the Risk of Pulmonary Embolism in Patients with Atrial Fibrillation
Conclusions: CHA2DS2-VASc score is directly associated with the incidence of pulmonary embolism in atrial fibrillation.
Source: The American Journal of Medicine - January 1, 2014 Category: Journals (General) Authors: Walid Saliba, Gad Rennert Tags: Clinical research studies Source Type: research
NSAID Use and Association with Cardiovascular Outcomes in Outpatients with Stable Atherothrombotic Disease
Abstract: Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatients with stable atherothrombotic disease.Methods: We analyzed 44,095 patients in the REduction of Atherothrombosis for Continued Health (REACH) registry with information on NSAID use and 4-year follow-up. Cox proportional hazard models, including NSAID use as a time-dependent covariate, were constructed and adjusted for key baseline characteristics. End points of...
Source: The American Journal of Medicine - November 25, 2013 Category: Journals (General) Authors: Payal Kohli, Ph. Gabriel Steg, Christopher P. Cannon, Sidney C. Smith, Kim A. Eagle, E. Magnus Ohman, Mark J. Alberts, Elaine Hoffman, Jianping Guo, Tabassome Simon, Emmanuel Sorbets, Shinya Goto, Deepak L. Bhatt, REACH Registry Investigators Tags: Clinical research studies Source Type: research
