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Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women Epidemiology
Conclusions Women with the highest PTSD symptom levels had nearly a 2-fold increased risk of VTE compared to women without trauma exposure in fully adjusted models. Trauma exposure alone was also associated with elevated VTE risk. Trauma and PTSD symptoms may be associated with a hypercoagulable state. Treatment providers should be aware that women with trauma exposure and PTSD symptoms may be vulnerable to VTE.
Source: JAHA:Journal of the American Heart Association - May 11, 2016 Category: Cardiology Authors: Sumner, J. A., Kubzansky, L. D., Kabrhel, C., Roberts, A. L., Chen, Q., Winning, A., Gilsanz, P., Rimm, E. B., Glymour, M. M., Koenen, K. C. Tags: Epidemiology, Mental Health, Women Source Type: research

Incidence and Predictors of Complications During Cryoballoon Pulmonary Vein Isolation for Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions In a large contemporary cohort, cryoballoon PVI is associated with low procedural risk, including lower rates of PNI than previously reported. Older age and 23-mm balloon use were associated with PNI. Our low rate of PNI may reflect more sensitive detection methods, including compound motor action potential monitoring and forced double-deflation.
Source: JAHA:Journal of the American Heart Association - July 20, 2016 Category: Cardiology Authors: Guhl, E. N., Siddoway, D., Adelstein, E., Bazaz, R., Mendenhall, G. S., Nemec, J., Saba, S., Schwartzman, D., Voigt, A., Wang, N. C., Jain, S. K. Tags: Arrhythmias, Catheter Ablation and Implantable Cardioverter-Defibrillator, Electrophysiology, Atrial Fibrillation Arrhythmia and Electrophysiology Source Type: research

Atrial Fibrillation Patients Treated With Long-Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long-Term Warfarin for Other Indications Cardiovascular Surgery
Conclusions The presence of AF significantly increases risk of dementia, including Alzheimer's disease, compared with matched patients receiving warfarin anticoagulation for other reasons. Quality of anticoagulation management remains an important risk factor for dementia in all patients.
Source: JAHA:Journal of the American Heart Association - July 10, 2016 Category: Cardiology Authors: Bunch, T. J., May, H. T., Bair, T. L., Crandall, B. G., Cutler, M. J., Day, J. D., Jacobs, V., Mallender, C., Osborn, J. S., Stevens, S. M., Weiss, J. P., Woller, S. C. Tags: Arrhythmias, Electrophysiology, Atrial Fibrillation Cardiovascular Surgery Source Type: research

Impact of Blood Pressure Control on Thromboembolism and Major Hemorrhage in Patients With Nonvalvular Atrial Fibrillation: A Subanalysis of the J-RHYTHM Registry Arrhythmia and Electrophysiology
Conclusions BP control appears to be more important than a history of hypertension and baseline BP values at preventing thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation. Clinical Trial Registration URL: http://www.umin.ac.jp/ctr. Unique identifier: UMIN000001569.
Source: JAHA:Journal of the American Heart Association - September 11, 2016 Category: Cardiology Authors: Kodani, E., Atarashi, H., Inoue, H., Okumura, K., Yamashita, T., Otsuka, T., Tomita, H., Origasa, H., the J-RHYTHM Registry Investigators Tags: Atrial Fibrillation, High Blood Pressure, Hypertension, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Impact of Blood Pressure Control on Thromboembolism and Maȷor Hemorrhage in Patients With Nonvalvular Atrial Fibrillation: A Subanalysis of the J-RHYTHM Registry Arrhythmia and Electrophysiology
BackgroundTo clarify the influence of hypertension and blood pressure (BP) control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J‐RHYTHM Registry was performed.Methods and ResultsA consecutive series of outpatients with atrial fibrillation was enrolled from 158 institutions. Of 7937 patients, 7406 with nonvalvular atrial fibrillation (70.8% men, 69.8±10.0 years) were followed for 2 years or until an event occurred. Hypertension was defined as a systolic BP ≥140 mm Hg, a diastolic BP ≥90 mm Hg, a history of hypertension, and/or antihyperten...
Source: JAHA:Journal of the American Heart Association - September 11, 2016 Category: Cardiology Authors: Kodani, E., Atarashi, H., Inoue, H., Okumura, K., Yamashita, T., Otsuka, T., Tomita, H., Origasa, H. Tags: Atrial Fibrillation, High Blood Pressure, Hypertension, Intracranial Hemorrhage, Ischemic Stroke Original Research Source Type: research

Incidence and Predictors of Complications During Cryoballoon Pulmonary Vein Isolation for Atrial Fibrillation Arrhythmia and Electrophysiology
ConclusionsIn a large contemporary cohort, cryoballoon PVI is associated with low procedural risk, including lower rates of PNI than previously reported. Older age and 23‐mm balloon use were associated with PNI. Our low rate of PNI may reflect more sensitive detection methods, including compound motor action potential monitoring and forced double‐deflation.
Source: JAHA:Journal of the American Heart Association - July 20, 2016 Category: Cardiology Authors: Guhl, E. N., Siddoway, D., Adelstein, E., Bazaz, R., Mendenhall, G. S., Nemec, J., Saba, S., Schwartzman, D., Voigt, A., Wang, N. C., Jain, S. K. Tags: Arrhythmias, Catheter Ablation and Implantable Cardioverter-Defibrillator, Electrophysiology, Atrial Fibrillation Original Research Source Type: research

Atrial Fibrillation Patients Treated With Long-Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long-Term Warfarin for Other Indications Cardiovascular Surgery
BackgroundThe mechanisms behind the association of atrial fibrillation (AF) and dementia are unknown. We previously found a significantly increased risk of dementia in AF patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which AF itself increases dementia risk, in addition to long‐term anticoagulation exposure.Methods and ResultsA total of 10 537 patients anticoagulated with warfarin (target INR 2–3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included. Warfarin indication was for AF (n=...
Source: JAHA:Journal of the American Heart Association - July 10, 2016 Category: Cardiology Authors: Bunch, T. J., May, H. T., Bair, T. L., Crandall, B. G., Cutler, M. J., Day, J. D., Jacobs, V., Mallender, C., Osborn, J. S., Stevens, S. M., Weiss, J. P., Woller, S. C. Tags: Arrhythmias, Electrophysiology, Atrial Fibrillation Original Research Source Type: research

Outcomes Associated With Familial Versus Nonfamilial Atrial Fibrillation: A Matched Nationwide Cohort Study Arrhythmia and Electrophysiology
ConclusionsAlthough family history of AF is associated with increased likelihood for development of AF, once AF developed, long‐term risks of death and thromboembolic complications were similar in familial and nonfamilial AF patients.
Source: JAHA:Journal of the American Heart Association - November 18, 2016 Category: Cardiology Authors: Gundlund, A., Olesen, J. B., Staerk, L., Lee, C., Piccini, J. P., Peterson, E. D., Kober, L., Torp-Pedersen, C., Gislason, G. H., Fosbol, E. L. Tags: Atrial Fibrillation, Epidemiology Original Research Source Type: research

Histological Findings and Predictors of Cerebral Debris From Transcatheter Aortic Valve Replacement: The ALSTER Experience Arrhythmia and Electrophysiology
ConclusionThis study showed a high rate of embolic debris consisting of typical anatomic structures known to be altered in patients with aortic stenosis undergoing transcatheter aortic valve replacement. Female patients with diabetes mellitus have increased risk of embolic debris and should be protected by a cerebral protection system during transcatheter aortic valve replacement. Because valve tissue embolizes more often in patients with predilation, procedural planning should consider this finding. Both cerebral arteries (brachiocephalic trunk, left carotid artery) should be protected in the same way.
Source: JAHA:Journal of the American Heart Association - November 9, 2016 Category: Cardiology Authors: Schmidt, T., Akdag, O., Wohlmuth, P., Thielsen, T., Schewel, D., Schewel, J., Alessandrini, H., Kreidel, F., Bader, R., Romero, M., Ladich, E., Virmani, R., Schafer, U., Kuck, K.–H., Frerker, C. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Catheter-Based Coronary and Valvular Interventions, Treatment Original Research Source Type: research

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