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Source: Current Cardiology Reports
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Total 125 results found since Jan 2013.
The Clinical Dilemma of Anticoagulation Use in Patients with Cerebral Amyloid Angiopathy and Atrial Fibrillation
AbstractPurpose of ReviewThis review highlights current management of patients with concomitant cerebral amyloid angiopathy (CAA) and atrial fibrillation (AF). We review quantifying risk of ischemic and hemorrhagic stroke as well as treatments to minimize future risk.Recent FindingsIschemic stroke risk in AF can be quantified by CHA2DS2-VASc and assessing left atrial echocardiographic characteristics. Patients deemed not low risk by CHA2DS2-VASC should be anticoagulated. CAA increases intracranial hemorrhage risk. CAA biomarkers include cortical microbleeds (CMBs), cortical superficial siderosis (cSS), convexal subarachnoi...
Source: Current Cardiology Reports - September 12, 2018 Category: Cardiology Source Type: research
Atrial Cardiopathy and Stroke Prevention
AbstractPurpose of ReviewMany patients with ischemic stroke have a stroke syndrome and neuroimaging findings consistent with embolism, but no evidence of atrial fibrillation. Recent data suggest that the pathological atrial substrate, oratrial cardiopathy, that underlies atrial fibrillation, rather than atrial fibrillation itself, may be an important cause of unexplained strokes. This paper will review the literature on the rationale and data behind the concept of atrial cardiopathy, its pathophysiology, suggested biomarkers of atrial cardiopathy, and therapeutic implications.Recent FindingsSeveral lines of evidence sugges...
Source: Current Cardiology Reports - September 12, 2018 Category: Cardiology Source Type: research
Does Left Atrial Appendage Amputation During Routine Cardiac Surgery Reduce Future Atrial Fibrillation and Stroke?
AbstractPurpose of ReviewStroke is the most feared complication of atrial fibrillation. To prevent stroke, left atrial appendage exclusion has been targeted, as it is the prevalent site for formation of heart thrombi during atrial fibrillation.We review the historic development of methods for exclusion of the left atrial appendage and the evidence to support its amputation during routine cardiac surgery.Recent FindingsEvidence is not yet sufficient to routinely recommend left atrial exclusion during heart surgery, despite a high prevalence of postoperative atrial fibrillation. Observational studies indicate that electrical...
Source: Current Cardiology Reports - August 31, 2018 Category: Cardiology Source Type: research
Assessment of Left Atrial Function by Echocardiography: Novel Insights
AbstractPurpose of ReviewTo review the current status of measuring left atrial functions with echocardiography and the ability of atrial functional analysis to predict cardiovascular outcomes.Recent FindingsAn increasing body of data suggests that left atrium (LA) function assessed with echocardiography provides incremental prognostic information in general and referral populations, and in patients with atrial fibrillation, stroke, heart failure, and ischemic and valvular heart disease. In addition to volumetric analysis and spectral and tissue Doppler, deformational (strain and strain rate) imaging has most recently been ...
Source: Current Cardiology Reports - August 27, 2018 Category: Cardiology Source Type: research
Treatment of Diabetes in Patients with Heart Failure
AbstractPurpose of ReviewThis review aims to summarize and discuss heart failure outcomes for current glucose-lowering agents in patients with type 2 diabetes mellitus.Recent FindingsCurrent regulations require cardiovascular outcomes trials for new glucose-lowering therapies to establish that there is no unacceptable increase in cardiovascular risk prior to approval. These cardiovascular outcomes trials include glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors. Overall, 87,162 patients have been studied in 10 published cardiovascular outcomes trials...
Source: Current Cardiology Reports - August 27, 2018 Category: Cardiology Source Type: research
Cardiovascular and Renal Outcomes of Newer Anti-Diabetic Medications in High-Risk Patients
AbstractPurpose of ReviewWe review the cardiovascular and renal outcomes and safety of newer anti-diabetic medications in high-risk patients. We examine the outcomes of the IRIS, EMPA-REG OUTCOME, CANVAS, LEADER, SAVOR-TIMI 53, and EXAMINE trials demonstrating the cardiovascular and renal benefits of thiazolidinediones, SGLT2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors.Recent FindingsDiabetes mellitus is a leading risk factor for cardiovascular disease with rising prevalence and disease burden. The microvascular and macrovascular complications of diabetes are well-recognized and include increased risk of cardiovascula...
Source: Current Cardiology Reports - June 21, 2018 Category: Cardiology Source Type: research
Current Endovascular Approach to the Management of Acute Ischemic Stroke
AbstractPurpose of ReviewThe review provides an overview of current endovascular management of patients with acute ischemic stroke in the light of recent landmark trials proving unequivocal benefit of the intervention.Recent FindingsSeveral randomized trials looking at selective groups of patients presenting after an acute ischemic stroke due to large vessel occlusion in the anterior circulation demonstrated an overwhelming benefit of the endovascular treatment compared to intravenous thrombolysis, leading to expedited changes in the American Heart Association/American Stroke Association guidelines. Nonetheless, there are ...
Source: Current Cardiology Reports - May 7, 2018 Category: Cardiology Source Type: research
Current State of Left Atrial Appendage Closure
AbstractPurpose of ReviewAtrial fibrillation (AF), the most common sustained arrhythmia, is a major cause of stroke and systemic embolism, and is increasing in prevalence. Device closure of the left atrial appendage (LAA) represents a non-pharmacologic approach to stroke prevention in AF patients. This review presents the rationale for LAA closure (LAAC), describes current transcatheter approaches to LAAC, and summarizes the current evidence for LAAC for stroke prevention, highlighting the main randomized trials and the most recent data available.Recent FindingsMeta-analysis of randomized clinical trials demonstrates simil...
Source: Current Cardiology Reports - April 21, 2018 Category: Cardiology Source Type: research
Addressing Multimorbidity and Polypharmacy in Individuals With Atrial Fibrillation
The objectives of this review were to (1) discuss how multimorbidity and polypharmacy contributes to the complexity of management among individuals with AF and (2) identify any interventions to manage polypharmacy in relation to AF.Recent FindingsBased on the four landmark clinical trials of novel anticoagulants, the most common comorbidities with AF are hypertension, heart failure, diabetes, stroke and myocardial infarction. Polypharmacy was also found prevalent in 76.5% of patients with AF, with a median of six drugs per patient. Despite the consequences of polypharmacy in AF, there is very little evidence-based interven...
Source: Current Cardiology Reports - March 24, 2018 Category: Cardiology Source Type: research
Sleep and Cardio-Metabolic Disease
AbstractPurpose of ReviewThis review summarises and discusses the epidemiological evidence suggesting a causal relationship between sleep duration and cardio-metabolic risk and outcomes in population.Recent FindingsSleep duration is affected by a variety of cultural, social, psychological, behavioural, pathophysiological and environmental influences. Changes in modern society —like longer working hours, more shift-work, 24/7 availability of commodities and 24-h global connectivity—have been associated with a gradual reduction in sleep duration and sleeping patterns across westernised populations. We review the evidence...
Source: Current Cardiology Reports - September 19, 2017 Category: Cardiology Source Type: research
Telestroke
This study aims to describe the current state of telestroke clinical applications and policies, in addition to key technical and operational aspects of the telemedicine practice.Recent FindingsDelivery of telestroke services for neurovascular care expanded from the intravenous alteplase decision and administration in acute emergency department settings to a continuum of services in mobile and inpatient stroke units, intensive care units, virtual stroke clinics, rehabilitation, and clinical research. Telestroke cost-effectiveness is well established from multiple perspectives. Stroke centers, certification agencies, and nat...
Source: Current Cardiology Reports - August 7, 2017 Category: Cardiology Source Type: research
Update on Neurocritical Care of Stroke
AbstractPurpose of ReviewThis review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit.Recent FindingsNew studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations. More rapid automated CT perfusion and angiography may demonstrate a vascular penumbra for neuroendovascu...
Source: Current Cardiology Reports - June 23, 2017 Category: Cardiology Source Type: research
Does Supplementation with Omega-3 PUFAs Add to the Prevention of Cardiovascular Disease?
AbstractPurpose of ReviewOmega-3 fatty acids are increasingly used for the protection of cardiovascular disease. The main but not the sole mechanism of action is the reduction of triglyceride levels. In this review, we summarize the effect of omega-3 supplements on all-cause and cardiovascular mortality, myocardial infarction, and stroke from the relevant randomized controlled trials.Recent FindingsTwenty-one randomized controlled trials assessed omega-3 supplementation on mortality and cardiovascular-related outcomes. From these studies, as well as from the relevant meta-analyses, we found that omega-3 supplements do not ...
Source: Current Cardiology Reports - April 21, 2017 Category: Cardiology Source Type: research
Revascularization for Advanced Coronary Artery Disease in Type 2 Diabetic Patients: Choosing Wisely Between PCI and Surgery
AbstractPurpose of ReviewPatients with type 2 diabetes mellitus (T2DM) are at an increased risk of systemic atherosclerosis and advanced coronary artery disease (CAD). Herein, we review clinical trials comparing surgical to percutaneous revascularization in the context of the unique pathophysiology in this patient population, and seek to answer the question of optimal strategy of revascularization.Recent FindingsEarly studies showed a signal towards benefit of surgical revascularization over percutaneous revascularization in this group, but there was a paucity of randomized clinical trials (RCT) to directly support this fi...
Source: Current Cardiology Reports - April 3, 2017 Category: Cardiology Source Type: research
Can We Improve the Outcomes of Multivessel Disease Using Modified SYNTAX and Residual SYNTAX Scores?
AbstractPurpose of reviewIn spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings.Recent findingsRecently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good lon...
Source: Current Cardiology Reports - February 19, 2017 Category: Cardiology Source Type: research
