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Source: Current Cardiology Reports
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Total 125 results found since Jan 2013.
Can Direct Oral Anticoagulants Be Used for Stroke Prevention Among Patients with Valvular Atrial Fibrillation?
AbstractPurpose of ReviewTo review the clinical evidence underlying the efficacy and safety of the use of direct oral anticoagulants (DOACs) for the treatment of patients with valvular atrial fibrillation (AF).Recent FindingsThe recent focused update to the 2014 AHA/ACC/HRS Atrial Fibrillation Guidelines defines valvular AF as AF in the setting of moderate-to-severe mitral stenosis (MS) and/or in the presence of a mechanical heart valve. Landmark clinical trials of DOACs in patients with AF systematically excluded these patient populations. However, there are trial data in both animals and humans regarding the use of DOACs...
Source: Current Cardiology Reports - August 30, 2019 Category: Cardiology Source Type: research
Endovascular Thrombectomy for Acute Ischemic Stroke
AbstractPurpose of ReviewTo review the current evidence supporting the use of endovascular thrombectomy (EVT) for the treatment of acute ischemic stroke (AIS) due to anterior circulation large vessel occlusion (LVO).Recent FindingsRecent advances in AIS management by EVT have led to significant reduction in morbidity and mortality in selected patients with LVO within the anterior circulation. Until recently, use of EVT was strictly based on time criteria, within 4.5 to 12 h of symptom onset with many patients presenting with “wake-up” stroke who were not considered for EVT. The positive results of the DAWN and DEFUSE...
Source: Current Cardiology Reports - August 29, 2019 Category: Cardiology Source Type: research
Stroke Risk in Atrial Fibrillation: Beyond the CHA 2 DS 2 -VASc Score
AbstractPurpose of ReviewStroke prevention is the cornerstone of atrial fibrillation (AF) management and the anticoagulation decision is currently based on CHA2DS2-VASc risk score. We discuss several novel risk factors besides those included in CHA2DS2-VASc score and alternative models for stroke prediction.Recent FindingsSeveral clinical markers including obstructive sleep apnea and renal failure, laboratory markers like brain natriuretic peptide, imaging criteria including left atrial appendage morphology, spontaneous echo contrast, and coronary artery calcium score may predict stroke in AF patients. Addition of African ...
Source: Current Cardiology Reports - July 26, 2019 Category: Cardiology Source Type: research
Left Atrial Occlusion Device Implantation: the Role of the Echocardiographer
AbstractPurpose of ReviewAtrial fibrillation is the most common arrhythmia worldwide and is a major risk factor for embolic stroke. For patients with atrial fibrillation who are unable to tolerate systemic anticoagulation, left atrial appendage (LAA) occlusion has been shown to mitigate stroke risk. In this article, we describe the vital role of the echocardiographer in intraprocedural guidance of percutaneous LAA occlusion procedures as well as in the pre- and post-procedure assessment of these patients.Recent FindingsA few percutaneously delivered devices for LAA exclusion from the systemic circulation are available in c...
Source: Current Cardiology Reports - June 9, 2019 Category: Cardiology Source Type: research
Secondary Prevention with Antithrombotic Therapies in Stable Ischemic Heart Disease Patients: a Review
In conclusion, the evidence thus far has not been significant enough for the American College of Cardiology to recommend the incorporation of oral anticoagulants in the management of stable ischemic heart disease patients, in contrast to aspirin and clopidogrel. As the antithrombotic and antiischemic properties of these newer agents seem evident, so does their potential for increase in risk of bleeding events. Doctors have to individually tailor antithrombotic medication decisions based on the patient ’s risk-benefit profile.
Source: Current Cardiology Reports - May 17, 2019 Category: Cardiology Source Type: research
Ethics and Bias in Clinical Trial Enrollment in Stroke
AbstractPurpose of ReviewTo familiarize the reader with ethical concerns and potential scientific bias in management and conduction of clinical stroke trials.Recent FindingsThe goal of clinical trials in stroke is to find effective interventions for stroke prevention, acute treatment, and rehabilitation and recovery. Acute trials must be designed in the context of the time-sensitivity of revascularization therapies. Standard ethical constraints apply. However, informed consent is hindered by tight time windows for reperfusion therapy and frequent cognitive impairment in patients. These might be mitigated by using visual de...
Source: Current Cardiology Reports - April 21, 2019 Category: Cardiology Source Type: research
Device Closure of Patent Foramen Ovale for Cryptogenic Stroke: Patient Selection and Outcomes According to New Randomized Trials
AbstractPurpose of ReviewThis review summarizes the most recent randomized clinical trials that studied the role of device-mediated patent foramen ovale (PFO) closure in patients after an ischemic stroke presumed to have been caused by a paradoxical embolism.Recent FindingsThree major randomized trials published in 2017 studied the strategy of using PFO closure for secondary prevention in patients between the ages of 18 and 60 who presented with an index stroke having characteristics of an embolic mechanism. All patients had a PFO that potentially could have enabled paradoxical embolism and other causes of stroke were excl...
Source: Current Cardiology Reports - April 21, 2019 Category: Cardiology Source Type: research
Lifestyle Interventions to Prevent Cardiovascular Events After Stroke and Transient Ischemic Attack
AbstractPurpose of ReviewTo summarize lifestyle interventions including pharmacological and non-pharmacological methods targeting modifiable risk factors and their impact on the future cardiovascular events in patients who have suffered transient ischemic attack (TIA) and/or ischemic stroke (IS).Recent FindingsThe latest research indicates that secondary prevention measures can decrease the risk of recurrent stroke, cardiovascular events, and even death. Modifiable risk factors also require behavioral change which can be challenging.SummaryThere is limited data demonstrating the impact of lifestyle interventions, alone or ...
Source: Current Cardiology Reports - April 21, 2019 Category: Cardiology Source Type: research
Rationale and Current Evidence for Testing Iron Chelators for Treating Stroke
AbstractPurpose of ReviewTo discuss the mechanisms of iron regulation in the brain and the pathophysiological role of deregulation of iron homeostasis following a stroke, and to review existing evidence supporting the potential role of iron chelators in the treatment of ischemic and hemorrhagic stroke.Recent FindingsIn recent years, accumulating evidence has highlighted the role of neuroinflammation in neurological injury after ischemic and hemorrhagic stroke, and that free iron is central to this process. Via the Fenton reaction, free iron catalyzes the conversion of superoxide ion and hydrogen peroxide into hydroxyl radi...
Source: Current Cardiology Reports - March 3, 2019 Category: Cardiology Source Type: research
Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention after Acute Coronary Syndromes: a Review
AbstractPurpose of ReviewAs the management of acute coronary syndrome (ACS) continues to evolve, many old practices proved to be of a little benefit and other approaches established the new pillars of modern medicine. Treating ACS patients with dual antiplatelet therapy (DAPT) for a year by combining aspirin and a P2Y12 inhibitor (clopidogrel, ticagrelor, or prasugrel) has resulted in better outcomes and is currently the standard of therapy. However, owing to the persistent activation of the coagulation cascade, patients may continue to experience recurrent ischemia and high mortality rates despite compliance with the dual...
Source: Current Cardiology Reports - January 28, 2019 Category: Cardiology Source Type: research
Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS
AbstractThe treatment of patients requiring anticoagulation who develop acute coronary syndrome (ACS) and/or require percutaneous coronary intervention (PCI) must balance the reduction in major adverse cardiovascular events, stroke, and major bleeding. The development of direct oral anticoagulants (DOACs) for the treatment of atrial fibrillation has ushered in an era of potential treatment options for these complex patients.Purpose of ReviewTo review the clinical evidence underlying the use of DOACs for the treatment of patients with atrial fibrillation and ACS or PCI.Recent FindingsThree trials studied this particular pat...
Source: Current Cardiology Reports - January 12, 2019 Category: Cardiology Source Type: research
The Impact of Diet and Lifestyle on Atrial Fibrillation
AbstractPurpose of ReviewAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans, affecting more than 33 million people globally. Its association with complex, resource intensive medical conditions such as stroke, heart failure and dementia have had profound impacts across existing health care structures. The global prevalence of AF has enjoyed significant growth despite significant improvement in our armamentarium for arrhythmia treatment.Recent FindingsEfforts aimed at curtailing the incidence, prevalence, or progression of AF have prompted re-evaluation of traditional frameworks for understand...
Source: Current Cardiology Reports - October 12, 2018 Category: Cardiology Source Type: research
Role of Echocardiography in Assessment of Cardioembolic Sources: a Strong Diagnostic Resource in Patients with Ischemic Stroke
AbstractPurpose of ReviewThis review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).Recent FindingsStroke is the third leading cause of death in industrial countries, and 15 –40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improving lo...
Source: Current Cardiology Reports - October 11, 2018 Category: Cardiology Source Type: research
Long Working Hours and Risk of Cardiovascular Disease
AbstractPurpose of ReviewTo summarize the evidence on the relationship between long working hours and cardiovascular disease, such as coronary heart disease and stroke.Recent FindingsLarge-scale meta-analyses with published and individual participant observational data on more than 740,000 men and women free of cardiovascular disease report a link between long working hours ( ≥ 55 h a week) and the onset of cardiovascular events. Our meta-analytic update of summary evidence suggests a 1.12-fold (95% CI 1.03–1.21) increased risk associated with coronary heart disease and a 1.21-fold (95% CI 1.01–1.45) increased ris...
Source: Current Cardiology Reports - October 1, 2018 Category: Cardiology Source Type: research
