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Source: Canadian Journal of Cardiology
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Total 265 results found since Jan 2013.
Accelerated Vascular Aging as a Paradigm for Hypertensive Vascular Disease: Prevention and Therapy
Publication date: Available online 3 March 2016 Source:Canadian Journal of Cardiology Author(s): Matthias Barton, Marc Husmann, Matthias R. Meyer Aging is considered the most important non-modifiable risk factor for cardiovascular disease and death after age 28. Due to demographic changes the world population is expected to increase to 9 billion by the year 2050 and up to 12 billion by 2100, with several-fold increases among those 65 and older. Healthy aging and prevention of aging-related diseases and associated health costs have become part of political agendas of governments around the world. Atherosclerotic vascul...
Source: Canadian Journal of Cardiology - March 4, 2016 Category: Cardiology Source Type: research
The Development And Feasibility Assessment Of Canadian Quality Indicators For Atrial Fibrillation
Publication date: Available online 27 February 2016 Source:Canadian Journal of Cardiology Author(s): Jafna L. Cox, Sulan Dai, Yanyan Gong., Robert McKelvie, M. Sean McMurtry, Garth H. Oakes, Allan Skanes, Atul Verma, Stephen B. Wilton, D. George Wyse In 2010, the Canadian Cardiovascular Society (CCS) embarked on an initiative to develop pan-Canadian quality indicators (QIs) and standardized data definitions with the ultimate goal of monitoring, comparing, and contrasting national cardiovascular care and its outcomes. One of the first working groups to be established was tasked with identifying and then defining...
Source: Canadian Journal of Cardiology - February 28, 2016 Category: Cardiology Source Type: research
Novel Approaches in Primary Cardiovascular Disease Prevention: The HOPE-3 Trial Rationale, Design, and Participants' Baseline Characteristics
Conclusions The HOPE-3 trial will provide new information on cholesterol and BP lowering in intermediate-risk populations with average cholesterol and BP levels and is expected to inform approaches to primary prevention worldwide (HOPE-3 ClinicalTrials.gov NCT00468923).
Source: Canadian Journal of Cardiology - February 25, 2016 Category: Cardiology Source Type: research
Left Atrial Appendage Closure for Atrial Fibrillation Is Safe and Effective After Intracranial or Intraocular Hemorrhage
Conclusions In our consecutive series, LAA closure was found to be safe and effective in patients with AF and a history of ICH or IOH.
Source: Canadian Journal of Cardiology - February 25, 2016 Category: Cardiology Source Type: research
Cost-Effectiveness of Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation Patients with Contraindications to Anticoagulation
Conclusions LAAC is a novel stroke preventative therapy for non-valvular AF and is a cost-effective alternative to aspirin in patients with contraindications to OAC. Teaser We sought to evaluate the cost-effectiveness of left atrial appendage closure (LAAC) compared to aspirin in atrial fibrillation patients with contraindications to oral anticoagulation (OAC). A probabilistic patient-level Markov microsimulation model with lifetime horizon was performed. Aspirin was less effective than LAAC, with average discounted lifetime cost of $38,974±18,783 for aspirin and $30,748±11,600 for LAAC. LAAC was dominant, being more eff...
Source: Canadian Journal of Cardiology - February 25, 2016 Category: Cardiology Source Type: research
AF Genetics: Is There a Practical Clinical Value Now or In The Future?
Publication date: Available online 12 February 2016 Source:Canadian Journal of Cardiology Author(s): William J. Hucker, Harsimran Saini, Steven A. Lubitz, Patrick T. EllinorTeaser Atrial fibrillation (AF) is heritable and in recent years many genetic loci have been associated with the arrhythmia. Current efforts are directed at determining if AF genetic data can be used to refine clinical risk prediction, predict response to medical or procedural treatments, or help to determine the sequelea of AF such as heart failure and stroke.
Source: Canadian Journal of Cardiology - February 12, 2016 Category: Cardiology Source Type: research
A risk assessment tool incorporating new biomarkers for cardiovascular events in acute coronary syndromes: the Organization to Assess Strategies in Ischemic Syndromes (OASIS) risk score
Conclusions The addition of NT-proBNP and hemoglobin A1C to 5 standard variables creates a 7-variable risk score that improves prediction of cardiovascular events at 1 year and aids in risk-based selection of NSTEACS patients for dual antiplatelet therapy. Teaser Several new biomarkers improve risk stratification in non-ST-segment elevation ACS, however they are not integrated into risk prediction tools. A risk score to predict CV death/MI/stroke was developed by incorporating new biomarkers with standard variables. The addition of NT-proBNP and hemoglobin A1C to 5 standard variables (age, prior MI/stroke, sex, ST-segment ...
Source: Canadian Journal of Cardiology - February 3, 2016 Category: Cardiology Source Type: research
Net Clinical Benefit of Dabigatran over Warfarin in Patients with Atrial Fibrillation Stratified by CHA2DS2-VASc Score and Time in Therapeutic Range
Conclusion The combination of CHA2DS2-VASc score and TTR facilitates patient prioritization for dabigatran. The best net clinical benefit for switching warfarin to dabigatran was found in those with both high CHA2DS2-VASc score and poor TTR. Teaser Non-vitamin K antagonist oral anticoagulants (NOAC) are now preferred to warfarin for stroke prevention in atrial fibrillation. In this study, we have shown that combination of CHA2DS2-VASc score and time in therapeutic range (TTR) facilitates patient prioritization for Dabigatran – one of the NOACs. The best net clinical benefit for switching from Dabigatran to warfarin was o...
Source: Canadian Journal of Cardiology - January 26, 2016 Category: Cardiology Source Type: research
The Adult with Repaired Coarctation: Need for Lifelong Surveillance
Discussion of these long-term complications is the focus of this article.
Source: Canadian Journal of Cardiology - January 21, 2016 Category: Cardiology Source Type: research
Transcranial Doppler is complementary to echocardiography for detection and risk stratification of patent foramen ovale
Conclusions Our findings suggest that TCD may be more sensitive than TEE for detection of RLS, which misses some cases with substantial right to left shunts, and may be valuable for prediction of recurrent stroke/TIA in patients with PFO. TCD complements TEE for management of suspected paradoxical embolism. Teaser We found that among patients with right-left shunt on transcranial Doppler (TCD), TEE was negative for RLS in 15% of patients, and of those 40% were large shunts (Grade 3). There was a trend to better prediction of recurrent stroke/TIA by TCD shunt grade than by right-left shunt on TEE, or atrial septal aneurysm ...
Source: Canadian Journal of Cardiology - December 18, 2015 Category: Cardiology Source Type: research
Values and preferences of physicians and patients with non-valvular atrial fibrillation receiving oral anticoagulation therapy for stroke prevention
Conclusions Real-world prescriptions do not reflect reported values, suggesting other factors influence patient-physician decision-making around OAC therapy. Data on self-reported adherence to OAC therapy and discordance in the use of OACs from prescribed regimens are concerning and warrant further investigation. Teaser Through a national survey we determined that the preferences of patients and physicians regarding oral anticoagulant (OAC) therapy for stroke prevention in atrial fibrillation differed, but largely focused on characteristics related to safety. However, real-world prescriptions do not reflect the reported va...
Source: Canadian Journal of Cardiology - November 10, 2015 Category: Cardiology Source Type: research
Time in Therapeutic Range and Percentage of INRs in Therapeutic Range as measure of quality of anticoagulation control in atrial fibrillation patients
Conclusions Amongst AF patients on warfarin, the PINRR is a user-friendly alternative to TTR, having a high sensitivity and positive predictive value in predicting TTR. As with TTRs, PINRR is associated with clinical adverse events, i.e. ischemic stroke and intracranial hemorrhage.
Source: Canadian Journal of Cardiology - November 6, 2015 Category: Cardiology Source Type: research
Standing on the Shoulders of Giants: J.A.P. Paré and the Birth of Cardiovascular Genetics
Publication date: November 2015 Source:Canadian Journal of Cardiology, Volume 31, Issue 11 Author(s): Srijita Sen-Chowdhry, William J. McKenna Sudden death and stroke afflicted a family from rural Quebec with such frequency as to be called the Coaticook curse by the local community. In Montreal in the late 1950s, a team of physicians led by J.A.P. Paré investigated this family for inherited cardiovascular disease. Their efforts resulted in an extensive and now classic description of familial hypertrophic cardiomyopathy. A quarter of a century later, the same family was the subject of linkage analysis and direct sequen...
Source: Canadian Journal of Cardiology - October 27, 2015 Category: Cardiology Source Type: research
The Risk Stratification and Stroke Prevention Therapy Care Gap in Canadian Atrial Fibrillation Patients
Conclusions In a large Canadian AF population, primary care physicians did not provide a stroke or bleeding risk in a substantial proportion of their AF patients. When estimates were provided, they were on the basis of a predictive stroke and bleeding risk index in less than half of the patients. Furthermore, there was under- and overestimation of stroke and bleeding risk in a substantial proportion of patients. As many as 1 in 3 patients receiving warfarin have their TTR < 60%. These findings suggest an opportunity to enhance knowledge translation to primary care physicians.
Source: Canadian Journal of Cardiology - October 23, 2015 Category: Cardiology Source Type: research
Beating Heart Minimally Invasive Mitral Valve Surgery in Patients with Patent Coronary Bypass Grafts
Conclusion Redo mitral surgery in patients with patent bypass grafts can safely be performed via minimally invasive mini-thoracotomy on a beating heart. The main benefits of this approach are to avoid the sternotomy and decrease the amount of postoperative blood loss. Teaser The aim of this study was to compare early outcomes of patients undergoing a beating heart minimally invasive mitral valve redo procedure and mitral redo surgery via sternotomy in the presence of patent bypass grafts. Beating mitral surgery can be safely done with comparable outcomes to the standard sternotomy approach.
Source: Canadian Journal of Cardiology - September 29, 2015 Category: Cardiology Source Type: research
