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Source: Clinical Cardiology
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Total 111 results found since Jan 2013.
Thromboembolic risk and effect of oral anticoagulation according to atrial fibrillation patterns: A systematic review and meta ‐analysis
The objectives of the meta‐analysis were to investigate different impact on outcomes of pxAF and non‐pxAF, with and without OAC. Two reviewers searched for prospective studies on risk of stroke and systemic embolism (SE) in pxAF and non‐pxAF, with and without OAC. Quality of evidence was assessed according to GRADE approach. Stroke combined with SE was the main outcome. Meta‐regression was performed to evaluate OAC effect on stroke and SE incidence rate. We identified 18 studies. For a total of 239 528 patient‐years of follow‐up. The incidence rate of stroke/SE was 1.6% (95% confidence interval [CI]: 1.3%‐2...
Source: Clinical Cardiology - April 1, 2017 Category: Cardiology Authors: Alessio Lilli, Andrea Di Cori, Valerio Zac à Tags: REVIEWS Source Type: research
Rationale and design of REDUCE ‐IT: Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial
Residual cardiovascular risk persists despite statins, yet outcome studies of lipid‐targeted therapies beyond low‐density lipoprotein cholesterol (LDL‐C) have not demonstrated added benefit. Triglyceride elevation is an independent risk factor for cardiovascular events. High‐dose eicosapentaenoic acid (EPA) reduces triglyceride‐rich lipoproteins without raising LDL‐C. Omega‐3s have postulated pleiotropic cardioprotective benefits beyond triglyceride‐lowering. To date, no large, multinational, randomized clinical trial has proved that lowering triglycerides on top of statin therapy improves cardiovascular ou...
Source: Clinical Cardiology - March 14, 2017 Category: Cardiology Authors: Deepak L. Bhatt, Ph. Gabriel Steg, Eliot A. Brinton, Terry A. Jacobson, Michael Miller, Jean ‐Claude Tardif, Steven B. Ketchum, Ralph T. Doyle, Sabina A. Murphy, Paresh N. Soni, Rene A. Braeckman, Rebecca A. Juliano, Christie M. Ballantyne, Tags: TRIAL DESIGNS Source Type: research
Controversies in postoperative atrial fibrillation after noncardiothoracic surgery: clinical and research implications
Post operative atrial fibrillation after non‐cardiothoracic surgery is an increasingly common problem. There is little high quality data to guide clinicians in risk prediction as well as short term and long term management. There appears to be a significant risk of recurrent atrial fibrillation and stroke but effective screening strategies have not been tested. In this commentary, we delineate various controversies in the management of post operative atrial fibrillation and briefly review the available evidence. Prospective studies in this clinically important area of cardiology should be encouraged.
Source: Clinical Cardiology - March 7, 2017 Category: Cardiology Authors: Srikanth Vallurupalli, Anusha Shanbhag, Jawahar L. Mehta Tags: Reviews Source Type: research
Intracardiac echocardiography for verification for left atrial appendage thrombus presence detected by transesophageal echocardiography: the ActionICE II study
ConclusionsWith TEE, a false positive of an LAA thrombus may be indicated, especially when a thrombus is described as soft rather than solid. Our study suggests that ICE may be a valuable option for verification of a TEE‐based diagnosis of a thrombus.
Source: Clinical Cardiology - February 12, 2017 Category: Cardiology Authors: Jakub Baran, Beata Zaborska, Roman Piotrowski, Malgorzata Sikora ‐Frąc, Ewa Pilichowska‐Paszkiet, Piotr Kułakowski Tags: CLINICAL INVESTIGATIONS Source Type: research
Trends and outcomes of infective endocarditis in patients on dialysis
We examined outcomes of 44 816 patients with IE on dialysis and 202 547 patients with IE not on dialysis from the Nationwide Inpatient Sample database from 2006 thorough 2011. Dialysis patients were younger (59 ± 15 years vs 62 ± 18 years) and more likely to be female (47% vs 40%) and African‐American (47% vs 40%; all P < 0.001). Hospitalizations for IE in the dialysis group increased from 175 to 222 per 10 000 patients (P
trend = 0.04). Staphylococcus aureus was the most common microorganism isolated in both dialysis (61%) and nondialysis (45%) groups. IE due to S aureus (adjusted odds ratio [aOR]...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Nirmanmoh Bhatia, Sahil Agrawal, Aakash Garg, Divyanshu Mohananey, Abhishek Sharma, Manyoo Agarwal, Lohit Garg, Nikhil Agrawal, Amitoj Singh, Sudip Nanda, Jamshid Shirani Tags: QUALITY AND OUTCOMES Source Type: research
Patterns and predictors of lipid ‐lowering therapy in patients with atherosclerotic cardiovascular disease and/or diabetes mellitus in 2014: Insights from a large US managed‐care population
ConclusionsIn 2014, only 49% of patients with ASCVD and 40% with only DM had evidence for a filled statin prescription. Those with indications of ischemic stroke, PAD, and DM were less likely to receive statins than those with coronary conditions. Other characteristics such as advanced age, female sex, and noncardiac conditions predicted less statin utilization, thereby representing good targets for quality improvement.
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Dylan L. Steen, Irfan Khan, Laura Becker, JoAnne M. Foody, Katherine Gorcyca, Robert J. Sanchez, Robert P. Giugliano Tags: CLINICAL INVESTIGATIONS Source Type: research
Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research
Correlation between cardiac rhythm, left atrial appendage flow velocity, and CHA2DS2 ‐VASc score: Study based on transesophageal echocardiography and 2‐dimensional speckle tracking
ConclusionsAF rhythm caused a sharp decrease in LAA‐FV independent of CHA2DS2‐VASc score. In SR, the CHA2DS2‐VASc score correlated negatively with LAA‐FV. LA strain was a predictor of LAA‐FV in both SR and AF rhythm.
Source: Clinical Cardiology - November 30, 2016 Category: Cardiology Authors: Kun Zuo, Lanlan Sun, Xinchun Yang, Xiuzhang Lyu, Kuibao Li Tags: CLINICAL INVESTIGATIONS Source Type: research
Impact of prior permanent pacemaker on long ‐term clinical outcomes of patients undergoing percutaneous coronary intervention
Conclusions
PPM has no effect on all‐cause mortality in patients undergoing first PCI but significantly increases the HF‐associated hospitalization rate, especially in ACS patients.
Source: Clinical Cardiology - November 22, 2016 Category: Cardiology Authors: Yan ‐Jie Li, Wei‐Wei Zhang, Xiao‐Xiao Yang, Ning Li, Xing‐Biao Qiu, Xin‐Kai Qu, Wei‐Yi Fang, Yi‐Qing Yang, Ruo‐Gu Li Tags: Clinical Investigations Source Type: research
Direct oral anticoagulants in patients with atrial fibrillation and renal impairment, extremes in weight, or advanced age
A growing number of patients with an indication for stroke prevention in atrial fibrillation have kidney‐, age‐, or weight‐related alterations in pharmacokinetics that affect dosing of direct oral anticoagulants. Because these patients were excluded from or comprised a small number of patients in clinical trials, there is a lack of evidence to guide clinicians. As a consequence, many patients do not receive oral anticoagulation despite a high risk for atrial fibrillation–related stroke. Here, we present a review of direct oral anticoagulant pharmacokinetics and a review of the available clinical evidence in patient...
Source: Clinical Cardiology - October 6, 2016 Category: Cardiology Authors: Leo F. Buckley, Eva Rybak, Ahmed Aldemerdash, Judy W.M. Cheng, John Fanikos Tags: Review Source Type: research
Efficacy and safety of dabigatran, rivaroxaban, and warfarin for stroke prevention in Chinese patients with atrial fibrillation: the Hong Kong Atrial Fibrillation Project
ConclusionsIn Chinese AF patients, the benefits of warfarin therapy for stroke prevention and ICH reduction depend on TTR. Of the treatments compared, dabigatran, as well as rivaroxaban 20 mg daily, was associated with lowest ischemic stroke and ICH rates.
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Wen ‐Hua Li, Duo Huang, Chern‐En Chiang, Chu‐Pak Lau, Hung‐Fat Tse, Esther W. Chan, Ian C.K. Wong, Gregory Y. H. Lip, Pak‐Hei Chan, Chung‐Wah Siu Tags: Clinical Investigations Source Type: research
Rationale and design of the BAYES (Interatrial Block and Yearly Events) registry
The prevalence of interatrial block (IAB) is high in the elderly, particularly in those with heart disease. Despite this high prevalence—and the association of IAB with the risk of atrial fibrillation (AF), stroke, and cognitive decline—little information exists about the prognosis of older patients with IAB. P‐wave duration and morphology are associated with risk of developing AF, stroke, and cognitive decline in elderly patients with structural heart disease. The aim of the Interatrial Block and Yearly Events (BAYES) registry is to assess the impact of IAB on the risk of AF and stroke during 3 years of follow‐up....
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Manuel Mart ínez‐Sellés, Adrian Baranchuk, Roberto Elosua, Antonio Bayés Luna Tags: Trial Designs Source Type: research
Special considerations for therapeutic choice of non –vitamin K antagonist oral anticoagulants for Japanese patients with nonvalvular atrial fibrillation
Nonvalvular atrial fibrillation (AF) is a risk factor for stroke in elderly patients. Although warfarin has been used to prevent AF‐associated stroke for more than 50 years, non–vitamin K antagonist oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban recently have been developed to overcome the disadvantages of warfarin. Based on the results of NOAC clinical trials, Savelieva and Camm made recommendations regarding selection of NOACs in patients with nonvalvular AF. Recent accumulating evidence indicates that NOACs work differently in Asian and non‐Asian individuals. In this review, ...
Source: Clinical Cardiology - August 31, 2016 Category: Cardiology Authors: Ken Okumura, Masatsugu Hori, Norio Tanahashi, A. John Camm Tags: Reviews Source Type: research
Design and Rationale of the RE ‐DUAL PCI Trial: A Prospective, Randomized, Phase 3b Study Comparing the Safety and Efficacy of Dual Antithrombotic Therapy With Dabigatran Etexilate Versus Warfarin Triple Therapy in Patients With Nonvalvular Atrial Fibrillation Who Have Undergone Percutaneous Coronary Intervention With Stenting
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest‐sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking. The RE‐DUAL PCI trial (NCT...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Christopher P. Cannon, Savion Gropper, Deepak L. Bhatt, Stephen G. Ellis, Takeshi Kimura, Gregory Y.H. Lip, Ph. Gabriel Steg, Jurri ën M. Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M. Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll Tags: Trial Designs Source Type: research
Residual Ischemic Risk and Its Determinants in Patients With Previous Myocardial Infarction and Without Prior Stroke or TIA: Insights From the REACH Registry
ConclusionsIn this study, residual ischemic risk after MI accrued progressively up to 4 years of follow‐up, emphasizing the value of intensive secondary prevention strategies to minimize residual risk.
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: J érémie Abtan, Deepak L. Bhatt, Yedid Elbez, Emmanuel Sorbets, Kim Eagle, Yasuo Ikeda, David Wu, Mary E. Hanson, Hakima Hannachi, Puneet K. Singhal, Philippe Gabriel Steg, Gregory Ducrocq, Tags: Clinical Investigations Source Type: research
