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The Disconnect between Novel Oral Anticoagulant Eligibility & Provincial Drug Coverage: An Albertan Anticoagulation Clinic Audit
Publication date: Available online 25 February 2015 Source:Canadian Journal of Cardiology Author(s): Sandeep K. Dhillon , M Sean McMurtry , Tammy J. Bungard Canadian practice guidelines for non-valvular atrial fibrillation (NVAF) recommend most patients receive a novel oral anticoagulant (NOAC) in preference to warfarin to prevent stroke, but not all patients have insurance that covers NOACs. The gap between optimal therapy and drug coverage is unknown. We retrospectively assessed eligibility for NOACs in those with NVAF at our single-centre Anticoagulation Clinic and ascertained whether provincial drug coverage would be...
Source: Canadian Journal of Cardiology - February 25, 2015 Category: Cardiology Source Type: research

CHA2DS2-VASC and CHADS2 Scores Predict Adverse Clinical Events in Pacemaker Patients with Sinus Node Dysfunction Independent of Atrial Fibrillation
Conclusion Both CHA2DS2-VASc and CHADS2 scores predict risk of death or stroke in patients with sick sinus syndrome, regardless of AF history. These scores could be risk stratification tools for clinical events that could respond to new therapies, i.e. anticoagulation or other interventions, even in the absence of AF. Teaser Currently, CHA2DS2-VASc and CHADS2 scores are tallied only for patients who have atrial fibrillation (AF). We found that these scores predict death and stroke independent of AF. The scores could be risk stratification tools for clinical events that could respond to new therapies, i.e. anticoagulation o...
Source: Canadian Journal of Cardiology - February 20, 2015 Category: Cardiology Source Type: research

Using the CHA2DS2-VASc score for stroke prevention in atrial fibrillation: A focus on vascular disease, females and simple practical application
Publication date: Available online 31 January 2015 Source:Canadian Journal of Cardiology Author(s): Peter Brønnum Nielsen , Flemming Skjøth , Lars Hvilsted Rasmussen , Torben Bjerregaard Larsen , Gregory Y.H. Lip
Source: Canadian Journal of Cardiology - February 6, 2015 Category: Cardiology Source Type: research

Impact of nocturnal intermittent hypoxia on left atrial appendage flow velocity in atrial fibrillation
Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.
Source: Canadian Journal of Cardiology - January 17, 2015 Category: Cardiology Source Type: research

Atrial Fibrillation Patients Categorized as “Not for Anticoagulation” According to the 2014 Canadian Cardiovascular Society Algorithm Are Not “Low Risk”
Conclusions Based on the 2014 CCS algorithm, the “OAC not recommended” subgroup can have a high 1-year stroke rate overall, showing that such patients are not “low risk.” Use of the ESC guideline approach (based on the CHA2DS2-VASc) offers refinement of stroke risk stratification in such patients.
Source: Canadian Journal of Cardiology - January 17, 2015 Category: Cardiology Source Type: research

Right Atrial Volume Is Superior to Left Atrial Volume for Prediction of Atrial Fibrillation Recurrence After Direct Current Cardioversion
Conclusions RAVI is superior to LAVI for the prediction of AF recurrence at 6 months after DCCV.
Source: Canadian Journal of Cardiology - January 17, 2015 Category: Cardiology Source Type: research

Association of inflammatory and hemostatic markers with stroke and thromboembolic event in atrial fibrillation: a systematic review and meta-analysis
Conclusions In conclusion, increased circulating PAI-1 and TAT levels were significantly associated with subsequent stroke in patients with AF, and D-dimer was associated with thromboembolic events in AF. Further epidemiological studies are needed to accumulate more evidence on the prognostic role of inflammatory and hemostatic markers in AF. Teaser The prognostic value of inflammatory and hemostatic markers in atrial fibrillation (AF) remains inconclusive. We conducted a systematic review and meta-analysis to evaluate the association of inflammatory and hemostatic markers with stroke and thromboembolic events in patients ...
Source: Canadian Journal of Cardiology - December 10, 2014 Category: Cardiology Source Type: research

New Directions in Cardiac Arrhythmia Management: Present Challenges and Future Solutions
Publication date: December 2014 Source:Canadian Journal of Cardiology, Volume 30, Issue 12, Supplement Author(s): Stanley Nattel , Jason Andrade , Laurent Macle , Lena Rivard , Katia Dyrda , Blandine Mondesert , Paul Khairy Cardiac arrhythmias are a major contributor to population morbidity and mortality. Enormous advances in arrhythmia management have occurred over the 60 years since the founding of the Montreal Heart Institute, but important challenges remain. The purpose of this article is to identify the areas of cardiac arrhythmia therapy that need improvement and to discuss the evolving approaches that promise solu...
Source: Canadian Journal of Cardiology - November 26, 2014 Category: Cardiology Source Type: research

Serum Uric Acid and Risk of Left Atrial Thrombus in Patients With Nonvalvular Atrial Fibrillation
Conclusions Hyperuricemia was a modest risk factor for LA thrombus, which might refine stratification of LA thrombus in patients with nonvalvular AF.
Source: Canadian Journal of Cardiology - November 4, 2014 Category: Cardiology Source Type: research

Progressive Increase in Peridevice Leakage After the Implantation of the Watchman Device on Long-term Serial Echocardiographic Follow-up
We report a case of progressive increase in peridevice leakage after Watchman device implantation on long-term transesophageal echocardiographic follow-up accompanied by stroke.
Source: Canadian Journal of Cardiology - November 4, 2014 Category: Cardiology Source Type: research

Aligning Health Care Policy With Evidence-Based Medicine: The Case for Funding Direct Oral Anticoagulants in Atrial Fibrillation
Publication date: October 2014 Source:Canadian Journal of Cardiology, Volume 30, Issue 10 Author(s): James A. Stone , Karen M. Earl , Blair J. O'Neill , Mukul Sharma , Thao Huynh , Kori Leblanc , Richard Ward , Philip A. Teal , Jafna L. Cox Misalignment between evidence-informed clinical care guideline recommendations and reimbursement policy has created care gaps that lead to suboptimal outcomes for patients denied access to guideline-based therapies. The purpose of this article is to make the case for addressing this growing access barrier to optimal care. Stroke prevention in atrial fibrillation (AF) is discussed as a...
Source: Canadian Journal of Cardiology - November 1, 2014 Category: Cardiology Source Type: research

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