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Triple Therapy for Atrial Fibrillation and Percutaneous Coronary Intervention A Contemporary Review
Chronic oral anticoagulant therapy is recommended (class I) in patients with mechanical heart valves and in patients with atrial fibrillation with a CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65 to 74 years, Sex category) score ≥1. When these patients undergo percutaneous coronary intervention with stenting, treatment with aspirin and a P2Y12 receptor inhibitor also becomes indicated. Before 2014, guidelines recommended the use of triple therapy (vitamin K antagonists, aspirin, and clopidog...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - September 15, 2014 Category: Cardiology Source Type: research

Poor adherence to anticoagulation guidelines in patients with non-valvular atrial fibrillation treated in a tertiary cardiology unit
Conclusions Few patients who require anticoagulation receive it in accordance with the guidelines even in a tertiary cardiology unit. There are many impediments to the effective use of VKA for stroke prevention among patients with AF.
Source: Heart Asia - April 21, 2015 Category: Cardiology Authors: Kew, G. S., Tan, M., Lim, T. W. Tags: Original research Source Type: research

Cardiovascular risk stratification in patients with non-valvular atrial fibrillation: the 2MACE score
Abstract Recent findings suggest that patients with non-valvular atrial fibrillation (AF), in addition to having a high risk for ischemic stroke, are also at risk for myocardial infarction (MI). The aim of the study was to combine factors predicting Major Adverse Cardiovascular Events (MACE) in AF patients, including fatal/nonfatal MI, cardiac revascularization, and cardiovascular death, into a simple risk score. Predictors of MACE were obtained from a prospective observational cohort study, including 1019 AF patients taking vitamin K antagonists from the Atherothrombosis Center, of Sapienza University of Rome. Th...
Source: Internal and Emergency Medicine - October 15, 2015 Category: Emergency Medicine Source Type: research

Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life.
CONCLUSION: Patients given rivaroxaban and apixaban in clinical practice have a higher thrombotic and hemorrhagic risk in comparison with patients given dabigatran or VKAs. A considerable proportion of patients receive reduced doses of NOACs. PMID: 27394924 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 5, 2016 Category: Internal Medicine Authors: Giustozzi M, Vedovati MC, Verdecchia P, Pierpaoli L, Verso M, Conti S, Cianella F, Marchesini E, Filippucci E, Agnelli G, Becattini C Tags: Eur J Intern Med Source Type: research

Can echocardiography improve the prediction of thromboembolic risk in atrial fibrillation? Evidences and perspectives
AbstractAtrial fibrillation is the most common arrhythmia and its prevalence is expected to further increase. Patients with atrial fibrillation have an increased risk of stroke (fivefold increased risk), heart failure, and death. In patients with non-valvular atrial fibrillation, the most recent guidelines recommend the use of the CHA2DS2-VASc (congestive heart failure, arterial hypertension, age  >  75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65–74 years, sex category) scoring system to identify those who may benefit from oral anticoagulant treatment. Guidelines recommen...
Source: Internal and Emergency Medicine - March 1, 2020 Category: Emergency Medicine Source Type: research

Direct Oral Anticoagulants in Cardiac Amyloidosis –Associated Heart Failure and Atrial Fibrillation
Atrial fibrillation (AF) is present in approximately 40% of patients with cardiac amyloidosis.1 AF in the setting of cardiac amyloidosis is associated with a significant risk of stroke and systemic thromboembolism regardless of the patient's CHA ₂DS₂-VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score.2 Although current guidelines recommend anticoagulation therapy in all patients with cardiac amyloidosis and AF, data about the comparative effectiveness and safety of vitamin K antagonists (VKAs) ...
Source: The American Journal of Cardiology - November 27, 2021 Category: Cardiology Authors: Amgad Mentias, Paulino Alvarez, Pulkit Chaudhury, Michael Nakhla, Rohit Moudgil, Mohamad Kanj, Mazen Hanna, Milind Y. Desai Source Type: research

Effects of Sleepiness on Survival in Japanese Hemodialysis Patients: J-DOPPS Study
Sleep disorder and poor sleep quality are common in chronic hemodialysis (HD) patients. They have been claimed as a cause of morbidity and mortality. The relationship between the degree of sleepiness and survival has not been studied. We studied the degree of sleepiness in 1,252 adult HD patients (age ≥20 years) recruited into the Dialysis Outcomes Practice Pattern Study in Japan (J-DOPPS III), using the Japanese version of the Epworth Sleepiness Scale (JESS) questionnaire. Demographic data were presented for three subgroups: low, intermediate, and high JESS score. Cox proportional hazard regression analysis was performe...
Source: Nephron Clinical Practice - January 8, 2015 Category: Urology & Nephrology Source Type: research

Epidemiologic insights on the role of fibroblast growth factor 23 in cardiovascular disease
Purpose of review: Fibroblast growth factor 23 (FGF23) regulates phosphate and vitamin D homeostasis and rises as kidney function declines. Animal studies have demonstrated direct and indirect effects of FGF23 that may promote heart disease. Herein, we review the recent epidemiologic literature evaluating the relationship between FGF23 and cardiovascular disease. Recent findings: In observational prospective studies, higher FGF23 associates with a greater risk of incident cardiovascular disease including ischemic heart disease, stroke, heart failure, and atrial fibrillation. These studies establish a temporal sequence of e...
Source: Current Opinion in Nephrology and Hypertension - April 14, 2015 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Myocardial Function in Saudi Adolescents with Vitamin D Deficiency, Tissue Doppler Imaging Study
This study was conducted to evaluate the effect of 25 (OH)D deficiency on the myocardial function and other echocardiographic variables in adolescent, using Tissue Doppler Imaging (TDI) and to correlate these parameters with 25 (OH)D level. The study included 84 healthy adolescents, consecutively selected from adolescents attending the outpatient clinic of Saad Specialist Hospital, KSA between September 2013 and October 2014. The study population was classified into two groups; vitamin D deficient group with 25(OH)D level less than 20 ng/mL and normal vitamin D (control group) with 25(OH)D equal or more than 30 ng/mL. Both...
Source: Journal of the Saudi Heart Association - June 26, 2015 Category: Cardiology Source Type: research

Myocardial function in Saudi adolescents with vitamin D deficiency: Tissue Doppler imaging study
This study was conducted to evaluate the effect of 25(OH)D deficiency on the myocardial function and other echocardiographic variables in adolescent, using tissue Doppler imaging (TDI) and to correlate these parameters with 25(OH)D level. The study included 84 healthy adolescents, consecutively selected from adolescents attending the outpatient clinic of Saad Specialist Hospital, KSA between September 2013 and October 2014. The study population was classified into two groups; vitamin D deficient group with 25(OH)D level less than 20ng/mL and normal vitamin D (control group) with 25(OH)D equal or more than 30ng/mL. Both gro...
Source: Journal of the Saudi Heart Association - July 17, 2015 Category: Cardiology Source Type: research

Is vitamin E supplementation effective in reducing mortality related to cardiovascular events in people with type 2 diabetes mellitus? A systematic review
Conclusions Although, two studies showed no benefit from vitamin E supplementation, the remaining studies demonstrated that vitamin E supplementation provided cardiovascular benefits in a specific diabetic subpopulation. The study population that derived a favorable outcome from vitamin E supplementation consisted of diabetic patients with the Hp 2–2 genotype. Hence, further studies should be conducted in diabetic populations with the Hp 2–2 genotype for identifying the definitive effects of vitamin E.
Source: IJC Metabolic and Endocrine - September 12, 2016 Category: Endocrinology Source Type: research

Effects of Sleepiness on Survival in Japanese Hemodialysis Patients: J-DOPPS Study
Sleep disorder and poor sleep quality are common in chronic hemodialysis (HD) patients. They have been claimed as a cause of morbidity and mortality. The relationship between the degree of sleepiness and survival has not been studied. We studied the degree of sleepiness in 1,252 adult HD patients (age ≥20 years) recruited into the Dialysis Outcomes Practice Pattern Study in Japan (J-DOPPS III), using the Japanese version of the Epworth Sleepiness Scale (JESS) questionnaire. Demographic data were presented for three subgroups: low, intermediate, and high JESS score. Cox proportional hazard regre ssion analysis was perform...
Source: Nephron Clinical Practice - October 25, 2017 Category: Urology & Nephrology Source Type: research

Preoperative Vitamin D Concentration and Cardiac, Renal, and Infectious Morbidity after Noncardiac Surgery
Conclusions Preoperative vitamin D was not associated with a composite of postoperative 30-day cardiac outcomes. However, there was a significant association between vitamin D deficiency and a composite of infectious complications and decreased kidney function. While renal effects were not clinically meaningful, the effect of vitamin D supplementation on infectious complications requires further study.
Source: Anesthesiology - December 13, 2019 Category: Anesthesiology Source Type: research

Mendelian randomization analysis of vitamin D in the secondary prevention of hypertensive-diabetic subjects: role of facilitating blood pressure control
ConclusionsGenetically predicted increase in Vit-D status [25(OH)D] may confer secondary protection against incident combined CVD events and myocardial infarction in a hypertensive-diabetic population where serological 25(OH)D deficiency is common, through facilitating blood pressure control.
Source: Genes and Nutrition - January 29, 2022 Category: Nutrition Source Type: research

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