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Specialty: Internal Medicine
Condition: Atrial Fibrillation

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Total 509 results found since Jan 2013.

Case-Based Discussion Regarding Challenges in Patient Selection and Procedural Planning in Left Atrial Appendage Occlusion
Atrial fibrillation (AF) accounts for most embolic strokes, especially in elderly individuals. Although anticoagulation is known to reduce the risk of embolic stroke, a significant proportion of patients have relative or absolute contraindications to anticoagulation. The left atrial appendage has been implicated as the major source of emboli in more than 90% of ischemic strokes in nonvalvular AF. Left atrial appendage occlusion offers an alternative for stroke prevention in patients with an elevated stroke risk (CHADS2 score ≥2 or CHA2DS2-VASc score ≥3) who have a rationale for avoiding long-term oral anticoagulation a...
Source: Mayo Clinic Proceedings - May 1, 2018 Category: Internal Medicine Authors: Sidakpal S. Panaich, Thomas Munger, Paul Friedman, Charanjit S. Rihal, David R. Holmes Tags: Review Source Type: research

Human serum albumin in cardiovascular diseases.
Abstract Cardiovascular diseases are the leading cause of death worldwide. Endothelial dysfunction, inflammation and oxidative stress are at the forefront in the onset and development of atherosclerosis and many cardiovascular diseases. Epidemiological evidence is that low serum albumin levels are linked to incident ischemic heart disease, heart failure, atrial fibrillation, stroke and venous thromboembolism, independent of risk factors, body mass index and inflammation. Hypoalbuminemia has also emerged as an independent prognosticator in many cardiovascular diseases, such as coronary artery disease, heart failure...
Source: European Journal of Internal Medicine - April 18, 2018 Category: Internal Medicine Authors: Arques S Tags: Eur J Intern Med Source Type: research

Stroke Prevention in AF: What are Your Options?
The path to reducing risk of stroke in AF patients is far from straight and narrow. A case and 3 questions test your clinical navigation skills.
Source: ConsultantLive - April 10, 2018 Category: Internal Medicine Authors: Payal Kohli, MD Tags: Atrial Fibrillation Source Type: news

Atrial Fibrillation had Less Impact on the Risk of Ischemic Stroke in Non-anticoagulated Patients Undergoing Hemodialysis: Insight from the RAKUEN study.
Conclusion A great impact on death, but not ischemic stroke, was observed in non-anticoagulated hemodialysis patients with AF in comparison to those without AF from the analysis of the RAKUEN study. PMID: 29607945 [PubMed - as supplied by publisher]
Source: Internal Medicine - April 4, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Fitting the right non-vitamin K antagonist oral anticoagulant to the right patient with non-valvular atrial fibrillation: An evidence-based choice.
Authors: Li Y, Pastori D, Lip GY Abstract Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing IS/SE with a lower rate of major bleeding. Various analyses from the large Phase III randomised trials demonstrated different efficacy and safety of NOACs in specific subgroups of patient...
Source: Annals of Medicine - April 4, 2018 Category: Internal Medicine Tags: Ann Med Source Type: research

Soluble Fibrin Monomer Complex and Prediction of Cardiovascular Events in Atrial Fibrillation: The Observational Murcia Atrial Fibrillation Project
ConclusionsIn AF patients taking VKAs, high SFMC levels were associated with the risk of adverse cardiovascular events, cardiovascular mortality and all-cause mortality. The addition of SFMC to the CHA2DS2-VASc score improved its predictive performance for these outcomes, but failed to show an improvement in clinical usefulness.
Source: Journal of General Internal Medicine - March 22, 2018 Category: Internal Medicine Source Type: research

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)
ConclusionsThe present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF. Trial registrationClinicalTrials.gov NCT02635685
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Lars O. Karlsson Source Type: research

Validation of a genetic risk score for atrial fibrillation: A prospective multicenter cohort study
ConclusionsProspective assessment of a GRS for AF identified participants with elevated risk of AF beyond established clinical criteria. Accordingly, a GRS for AF could be incorporated into overall risk assessment to better identify patients at the highest risk of developing AF, although further testing in larger populations is needed to confirm these findings. Trial registrationClinicalTrials.gov NCT01970969
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Evan D. Muse Source Type: research

Epidemiology of atrial fibrillation
ConclusionsAlthough the prevalence of AF worldwide is increasing steadily, large variation can be seen between studies and countries. Further epidemiological studies should be undertaken globally, especially in Asian and African countries so that a better and more accurate picture of the incidence and prevalence of AF can be captured, to enable stroke prevention strategies to be appropriately implemented to prevent or reduce the risk of stroke, the most severe consequence of AF.
Source: International Journal of Clinical Practice - March 1, 2018 Category: Internal Medicine Authors: Hanis Zulkifly, Gregory Y. H. Lip, Deirdre A. Lane Tags: PERSPECTIVE Source Type: research

Prophylactic LAA Closure for Stroke Prevention in AF: Is it Really As Good An Idea As We Thought?
Results of the largest study to assess impact of left atrial appendage closure during routine non-AF-related cardiac surgery raise a few new questions.  
Source: ConsultantLive - February 13, 2018 Category: Internal Medicine Authors: Payal Kohli, MD Tags: Atrial Fibrillation Cardiovascular Diseases Source Type: news

Lipoprotein(a) and Atrial Fibrillation: What Association?
A recent study finds an unexepcted association between the CVD biomarker lipoprotein(a), atrial fibrillation, and stroke.  
Source: ConsultantLive - February 12, 2018 Category: Internal Medicine Authors: Veronica Hackethal, MD Tags: Atrial Fibrillation Source Type: news

Antiplatelet therapy combined with acenocoumarol in relation to major bleeding, ischaemic stroke and mortality
ConclusionsIn AF patients, the risk of bleeding is higher when antiplatelet therapy is combined with acenocoumarol, but the risk of mortality and stroke was not significantly different from that of patients taking only acenocoumarol.
Source: International Journal of Clinical Practice - February 12, 2018 Category: Internal Medicine Authors: Jos é Miguel Rivera‐Caravaca, Francisco Marín, María Asunción Esteve‐Pastor, Mariano Valdés, Vicente Vicente, Vanessa Roldán, Gregory Y.H. Lip Tags: SHORT REPORT Source Type: research

A new clinical decision support tool for improving the adequacy of anticoagulant therapy and reducing the incidence of stroke in nonvalvular atrial fibrillation: A randomized clinical trial in primary care Erratum
No abstract available
Source: Medicine - February 1, 2018 Category: Internal Medicine Tags: Erratum Source Type: research

Improving patient adherence to secondary prevention medications 6 months after an acute coronary syndrome: observational cohort study
ConclusionsFailure to discharge patients on indicated therapies is the most important modifiable predictor of adherence failure 6 months after an ACS. Implementing protocols to automate prescription of indicated discharge therapies, has the potential to dramatically reduce non‐adherence in the 6 months following discharge.
Source: Internal Medicine Journal - January 18, 2018 Category: Internal Medicine Authors: D.B. Brieger, C. Chow, J. Gullick, K. Hyun, M. D'Souza, T. Briffa, Tags: Original Article Source Type: research

Integrative medicine on optimizing clopidogrel and aspirin therapy
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that theCYP2C19 gene mutation (CYP2C19*2 andCYP2C19*3) could affect> 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI). Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation (AF), and warfar...
Source: Chinese Journal of Integrative Medicine - January 15, 2018 Category: Internal Medicine Source Type: research