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Blood Pressure at Six Months after Acute Myocardial Infarction and Outcomes at Two Years: The Perils Associated with Excessively Low Blood Pressures
ConclusionsLow blood pressure achieved with beta-blocker and renin-angiotensin-aldosterone blocker at 6-month was associated with an increased risk of all-cause mortality independently of confounding factors in patients with AMI. This finding suggests that caution should be taken for patients with AMI who use blood pressure-lowering treatments.
Source: Canadian Journal of Cardiology - February 9, 2020 Category: Cardiology Source Type: research

Medical Management of Left Ventricular Assist Device Patients: A Practical Guide for the Nonexpert Clinician
This article provides a concise overview of the medical management of LVAD patients for nonexpert clinicians. Our presentation includes the basics of LVAD physiology, design, and operation, patient selection and assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances, such as noncardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood pressure and heart rate assessment, LVAD “hum” auscultation, driveline and insertion site inspection, and device parameter recording. Im...
Source: Canadian Journal of Cardiology - February 7, 2020 Category: Cardiology Source Type: research

Biological agents reduce cardiovascular events in rheumatoid arthritis non-responsive to tumor necrosis factor-inhibitors – a national cohort study
ConclusionsRA TNFi non-responder patients who received second line tocilizumab or abatacept had more benefit on CV events prevention compared with rituximab.
Source: Canadian Journal of Cardiology - January 16, 2020 Category: Cardiology Source Type: research

Flow, Reflected by Stroke Volume Index, Is a Risk Marker in High-Gradient Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Replacement
ConclusionsSVi can further characterize patients with HG-AS and may help to identify those who are at increased risk after TAVR.RésuméContexteDes outils sont nécessaires pour dépister les patients exposés à un risque accru à la suite d’un remplacement valvulaire aortique par cathéter (RVAC). Le volume systolique indexé (VSI) est une mesure échocardiographique utilisée dans les cas de sténose aortique à faible gradient. Nous avons vérifié si un faible VSI était un marqueur de risque accru chez les patients présentant une sténose aortique à gradient élevé et avons évalué comment la relation entre le ...
Source: Canadian Journal of Cardiology - December 24, 2019 Category: Cardiology Source Type: research

Predictors of Cumulative Health Care Costs Associated with Transcatheter Aortic Valve Replacement in Severe Aortic Stenosis
ConclusionsThis analysis shows that there are 3 distinct phases of cost accumulation from referral to post-TAVR with some potentially modifiable cost drivers in each phase.
Source: Canadian Journal of Cardiology - December 18, 2019 Category: Cardiology Source Type: research

Clinical impact of valvular heart disease in elderly patients admitted for acute coronary syndrome: insights from the Elderly-ACS 2 Study
ConclusionsIn a contemporary cohort of elderly patients admitted for ACS, VHD was found in one out of five subjects and had an independent, consistent impact on prognosis.
Source: Canadian Journal of Cardiology - November 21, 2019 Category: Cardiology Source Type: research

Short and long-term outcomes of medically treated isolated left-sided endocarditis: a retrospective study with 5-year longitudinal follow-up
ConclusionNon-operative management of LSIE carries a poor prognosis but may have a role in select cases. Surgical management remains the mainstay for patients with clear surgical indications, including severe regurgitation and PVE. Further prospective analyses are required to better delineate appropriate patient selection for non-surgical management.
Source: Canadian Journal of Cardiology - November 6, 2019 Category: Cardiology Source Type: research

Outcomes Among Clopidogrel, Prasugrel, and Ticagrelor in ST-Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention From the TOTAL Trial
ConclusionsIn this observational analysis of STEMI patients who underwent primary percutaneous coronary intervention, ticagrelor was associated with improved outcomes compared with clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.RésuméContexteIl n’existe pas d’analyse robuste comparant les inhibiteurs P2Y12 à prise orale (clopidogrel, prasugrel et ticagrélor) chez les patients ayant subi un infarctus du myocarde avec élévation du segment ST (STEMI) traités par une intervention coronaire percutanée (ICP) primaire. Nous avons entrepris d’évaluer les rés...
Source: Canadian Journal of Cardiology - October 9, 2019 Category: Cardiology Source Type: research

Medical Management of LVAD Patients: A Practical Guide for the Non-Expert Clinician
This article provides a concise overview of the medical management of LVAD patients aimed for non-expert clinicians. Our presentation includes the basics of LVAD physiology, design and operation, patient selection, patient assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances such as non-cardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood-pressure and heart-rate assessment, LVAD ‘hum’ auscultation, driveline/insertion-site inspection, and device-parameter record...
Source: Canadian Journal of Cardiology - October 5, 2019 Category: Cardiology Source Type: research

Bleeding tolerance among patients with atrial fibrillation on oral anticoagulation
ConclusionsThe key determinants of the Bleeding Ratio among anticoagulated AF patients are age, prior thromboembolic and bleeding episodes. The study could support identification of AF patients who need additional effort to increase their acceptance of a life-long OAC therapy.
Source: Canadian Journal of Cardiology - September 18, 2019 Category: Cardiology Source Type: research

Flow, Reflected by Stroke Volume Index, is a Risk Marker in High Gradient Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Replacement
ConclusionsSVi can further characterise patients with HG-AS and may help to identify those who are at increased risk following TAVR.
Source: Canadian Journal of Cardiology - August 30, 2019 Category: Cardiology Source Type: research

Glomerular Filtration Rate-Specific Cutoffs Can Refine the Prognostic Value of Circulating Cardiac Biomarkers in Advanced Chronic Kidney Disease
ConclusionsAmong asymptomatic patients with advanced chronic kidney disease, optimal cutoffs for hs-cTnT and NT-proBNP differed according to GFR level and outperformed standard cutoffs for discrimination of cardiovascular risk.RésuméContexteÀ l’aune des valeurs seuils standard établies chez les adultes en bonne santé, on constate que les taux de troponines cardiaques hypersensibles et de propeptide natriurétique de type B N-Terminal (NT-proBNP) sont fréquemment élevés chez les patients présentant un débit de filtration glomérulaire (DFG) réduit. Les implications de cette observation restent à élucider. Nou...
Source: Canadian Journal of Cardiology - August 30, 2019 Category: Cardiology Source Type: research

GFR-specific cut-offs can refine the prognostic value of circulating cardiac biomarkers in advanced chronic kidney disease
ConclusionsAmong asymptomatic patients with advanced CKD, optimal cut-offs for hs-cTnT and NT-proBNP differed by GFR level and out-performed standard cut-offs for discrimination of cardiovascular risk.
Source: Canadian Journal of Cardiology - June 22, 2019 Category: Cardiology Source Type: research

Outcomes Among Clopidogrel, Prasugrel, And Ticagrelor In Stemi Patients Undergoing Primary Percutaneous Coronary Intervention From The Total Trial
ConclusionsIn this observational analysis of STEMI patients undergoing PPCI, ticagrelor was associated with improved outcomes compared to clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.
Source: Canadian Journal of Cardiology - May 8, 2019 Category: Cardiology Source Type: research

Statin Use in Primary Prevention: A Simple Trial-Based Approach Compared With Guideline-Recommended Risk Algorithms for Selection of Eligible Patients
ConclusionsThe pragmatic HOPE-3 trial approach identifies in an ethnically diverse primary prevention population individuals at intermediate risk who benefit from statin therapy using simple clinical characteristics without the need for complex, currently used risk assessment tools.RésuméIntroductionLes outils d’évaluation du risque de maladie cardiovasculaire permettent de repérer les patients qui pourraient bénéficier d’un traitement préventif. Nous avons donc comparé les résultats obtenus au moyen de l’algorithme d’évaluation du risque de l’American College of Cardiology/American Heart Association (A...
Source: Canadian Journal of Cardiology - April 27, 2019 Category: Cardiology Source Type: research

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