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Cardiac Surgery in Indigenous Australians: Early Onset Cardiac Disease with follow-up Challenges
Conclusions: The mean age of 52 years at which Indigenous patients have cardiac surgery is significantly low compared to non-Indigenous patients. Indigenous patients have multiple risk factors for cardiac disease and with a large number requiring emergency surgery. Although surgical outcome in the short term is favourable, a large number of patients are lost to follow-up. The use of mechanical valve and warfarin should be individualised. Strategic post-operative follow-up mechanisms are needed to address these issues.
Source: Heart, Lung and Circulation - February 24, 2014 Category: Cardiology Authors: M.P. Matebele, S. Rohde, A. Clarke, J.F. Fraser Tags: Original Articles Source Type: research

Influencing Factors for Early Acute Cerebrovascular Accidents in Patients with Stroke History following Off-pump Coronary Artery Bypass Grafting
Conclusions: This study indicated that patients with severe bilateral carotid stenosis, the left ventricular ejection fraction ≤35%, the postoperative acute myocardial infarction, postoperative atrial fibrillation and postoperative hypotension were more likely to suffer from early acute cerebrovascular accidents when they received OPCAB. Application of Enclose® II proximal anastomotic device may decrease the incidence of early acute cerebrovascular accidents during OPCAB.
Source: Heart, Lung and Circulation - February 10, 2014 Category: Cardiology Authors: Bin Wang, Ming Jia, Shijie Jia, Jiuhe Wan, Xiao Zhou, Zhimin Luo, Ye Zhou, Jianqun Zhang Tags: Original Articles Source Type: research

Clopidogrel is safer than ticagrelor in regard to bleeds: A closer look at the PLATO trial
Conclusions: Clopidogrel is safer than ticagrelor in regard to bleeding. Additionally, ticagrelor's purported faster antiplatelet ‘offset’ is substantially longer than its pharmacokinetics indicate. Considering the fact that the mortality, stent thrombosis and myocardial infarction ‘benefit’ of ticagrelor have recently been challenged, and that the increase in stroke on ticagrelor has recently been shown to be worse than originally published, the decision to use ticagrelor over clopidogrel in the face of a higher risk for bleeds is not advised.
Source: International Journal of Cardiology - July 31, 2013 Category: Cardiology Authors: James J. DiNicolantonio, Fabrizio D'Ascenzo, Ales Tomek, Saurav Chatterjee, Asfandyar K. Niazi, Giuseppe Biondi-Zoccai Tags: Editorials Source Type: research

Comparison of the Efficacy and Safety of Two Rivaroxaban Doses in Acute Coronary Syndrome (from ATLAS ACS 2–TIMI 51)
In conclusion, the 2 doses of rivaroxaban reduced cardiovascular events in patients with recent acute coronary syndromes treated with antiplatelet therapies; however, the 2.5-mg dose was associated with lower mortality and fewer bleeding complications than the 5-mg dose. Thus, the addition of rivaroxaban 2.5 mg twice daily offers a more favorable balance of efficacy and safety in patients with recent acute coronary syndromes.
Source: The American Journal of Cardiology - May 28, 2013 Category: Cardiology Authors: Jessica L. Mega, Eugene Braunwald, Stephen D. Wiviott, Sabina A. Murphy, Alexei Plotnikov, Nina Gotcheva, Mikhail Ruda, C. Michael Gibson Tags: Coronary Artery Disease Source Type: research

Abstract 250: Economic Burden of Mortality and Cardiovascular Events among Patients with Acute Coronary Syndromes in a Commercial Health Plan Poster Session III
Conclusion: Our findings suggest that a modest 10% increase in anticoagulant use among patients with ACS would reduce mortality, MI, ST and related healthcare costs by 4%, 0.7%, and 3%, respectively. Addition of anticoagulation therapy potentially reduces the incidence of ACS-related mortality, MI, ST and associated healthcare costs to a commercial health plan, and benefits from anticoagulation use should be balanced against the risk of bleeding.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ogden, K., Patel, A. A., Mody, S. H., Veerman, M., Crivera, C., Quock, T. P. Tags: Poster Session III Source Type: research

Rivaroxaban in Patients Stabilized After a ST-Segment Elevation Myocardial Infarction: Results From the ATLAS ACS-2–TIMI-51 Trial (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51)
Objectives: The present analysis reports on the pre-specified subgroup of ST-elevation myocardial infarction (STEMI) patients, in whom anticoagulant therapy has been of particular interest. Background: In ATLAS ACS-2–TIMI-51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51), rivaroxaban reduced cardiovascular events across the spectrum of acute coronary syndrome (ACS). Methods: Seven thousand eight hundred seventeen patients in ATLAS ACS-2-TIMI 51 presented with a STEMI. After being stabilized (1 to 7 d...
Source: Journal of the American College of Cardiology - May 1, 2013 Category: Cardiology Authors: Jessica L. Mega, Eugene Braunwald, Sabina A. Murphy, Alexei N. Plotnikov, Paul Burton, Robert Gabor Kiss, Alexander Parkhomenko, Michal Tendera, Petr Widimsky, C. Michael Gibson Tags: Coronary Artery Disease Source Type: research

Rivaroxaban in Patients Stabilized After a ST-Segment Elevation Myocardial Infarction Results From the ATLAS ACS-2–TIMI-51 Trial (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51)
ObjectivesThe present analysis reports on the pre-specified subgroup of ST-elevation myocardial infarction (STEMI) patients, in whom anticoagulant therapy has been of particular interest.BackgroundIn ATLAS ACS-2–TIMI-51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51), rivaroxaban reduced cardiovascular events across the spectrum of acute coronary syndrome (ACS).MethodsSeven thousand eight hundred seventeen patients in ATLAS ACS-2-TIMI 51 presented with a STEMI. After being stabilized (1 to 7 days), they un...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - April 29, 2013 Category: Cardiology Source Type: research

Rivaroxaban: an oral factor xa inhibitor.
CONCLUSIONS: Based on the findings of the studies reported in this review, rivaroxaban is an effective option for the prevention of VTE after orthopedic surgery, stroke prevention for nonvalvular AF, and treatment of VTE. At this time, rivaroxaban cannot be recommended for secondary risk reduction after ACS because of the increased bleeding risk. PMID: 23328267 [PubMed - in process]
Source: Clinical Therapeutics - January 1, 2013 Category: Drugs & Pharmacology Authors: Thomas TF, Ganetsky V, Spinler SA Tags: Clin Ther Source Type: research

Renal dysfunction and long-term risk of ischemic and hemorrhagic stroke following coronary artery bypass grafting
Conclusions: Renal dysfunction is associated with increased long-term risk of stroke after primary isolated CABG. The impact of renal dysfunction on risk of stroke appears to be similar for both men and women.
Source: International Journal of Cardiology - December 6, 2012 Category: Cardiology Authors: Martin J. Holzmann, Erik Ahlbäck, Anders Jeppsson, Ulrik Sartipy Tags: Original Articles Source Type: research

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