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Vascular Health and Risk Management

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https://www.readbyqxmd.com/read/29445287/patient-knowledge-on-stroke-risk-factors-symptoms-and-treatment-options
#1
Kashif Waqar Faiz, Antje Sundseth, Bente Thommessen, Ole Morten Rønning
Background: Public campaigns focus primarily on stroke symptom and risk factor knowledge, but patients who correctly recognize stroke symptoms do not necessarily know the reason for urgent hospitalization. The aim of this study was to explore knowledge on stroke risk factors, symptoms and treatment options among acute stroke and transient ischemic attack patients. Methods: This prospective study included patients admitted to the stroke unit at the Department of Neurology, Akershus University Hospital, Norway...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29440909/clinical-characteristics-patterns-of-lipid-lowering-medication-use-and-health-care-resource-utilization-and-costs-among-patients-with-atherosclerotic-cardiovascular-disease
#2
Thomas P Power, Xuehua Ke, Zhenxiang Zhao, Nicole Gidaya Bonine, Mark J Cziraky, Michael Grabner, John J Barron, Ralph Quimbo, Burkhard Vangerow, Peter P Toth
Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29391805/role-of-rivaroxaban-in-the-management-of-atrial-fibrillation-insights-from-clinical-practice
#3
REVIEW
Kavitha Vimalesvaran, Seth J Dockrill, Diana A Gorog
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and it leads to significant morbidity and mortality, predominantly from ischemic stroke. Vitamin K antagonists, mainly warfarin, have been used for decades to prevent ischemic stroke in AF, but their use is limited due to interactions with food and other drugs, as well as the requirement for regular monitoring of the international normalized ratio. Rivaroxaban, a direct factor Xa inhibitor and the most commonly used non-vitamin K oral anticoagulant, avoids many of these challenges and is being prescribed with increasing frequency for stroke prevention in non-valvular AF...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29343965/postural-tachycardia-syndrome-current-perspectives
#4
REVIEW
Rachel Wells, Andrew J Spurrier, Dominik Linz, Celine Gallagher, Rajiv Mahajan, Prashanthan Sanders, Amanda Page, Dennis H Lau
Postural tachycardia syndrome (POTS) is the combination of an exaggerated heart rate response to standing, in association with symptoms of lightheadedness or pre-syncope that improve when recumbent. The condition is often associated with fatigue and brain fog, resulting in significant disruptions at a critical time of diagnosis in adolescence and young adulthood. The heterogeneity of the underlying pathophysiology and the variable response to therapeutic interventions make management of this condition challenging for both patients and physicians alike...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29270016/extracorporeal-ultrafiltration-for-acute-heart-failure-patient-selection-and-perspectives
#5
REVIEW
Valentina Milazzo, Nicola Cosentino, Giancarlo Marenzi
Most patients presenting with acute heart failure (AHF) show signs and symptoms of fluid overload, which are closely associated with short-term and long-term outcomes. Ultrafiltration is an extremely appealing strategy for patients with AHF and concomitant overt fluid overload not fully responsive to diuretic therapy. However, although there are several theoretical beneficial effects associated with ultrafiltration, published reports have shown controversial findings. Differences in selection of the study population and in ultrafiltration indications and protocols, and high variability in the pharmacologic therapy used for the control group could explain some of these conflicting results...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29263674/practical-guidance-on-the-use-of-laboratory-testing-in-the-management-of-bleeding-in-patients-receiving-direct-oral-anticoagulants
#6
REVIEW
Hugo Ten Cate, Yvonne Mc Henskens, Marcus D Lancé
Direct oral anticoagulants (DOACs) have demonstrated a favorable benefit-risk profile in several thromboembolic disorders and are increasingly used in routine clinical practice. A number of real-world studies on DOACs are ongoing, and data published so far have shown broadly similar outcomes to those demonstrated in the respective phase III trials. Despite their beneficial attributes, bleeding risk (as with any other anticoagulants) is often a concern for physicians when prescribing DOACs, particularly in elderly patients, those with significant comorbidities, and other high-risk patient populations...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29225469/pelvic-vein-incompetence-clinical-perspectives
#7
REVIEW
David M Riding, Vivak Hansrani, Charles McCollum
Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%-30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. In these patients, clinical management focuses on symptom control rather than treatment. It is possible that pelvic vein incompetence (PVI) is a cause of CPP, although the quality of studies investigating an association is generally low...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29200864/efficacy-of-noninvasive-cardiac-imaging-tests-in-diagnosis-and-management-of-stable-coronary-artery-disease
#8
REVIEW
Ify R Mordi, Athar A Badar, R John Irving, Jonathan R Weir-McCall, J Graeme Houston, Chim C Lang
The aim of this review was to discuss the current literature regarding the utility of noninvasive imaging in diagnosis and management of stable coronary artery disease (CAD) including recent data from large randomized trials assessing diagnosis and prognosis. Current guidelines recommend revascularization in patients with refractory angina and in those with potential prognostic benefit. Appropriate risk stratification through noninvasive assessment is important in ensuring patients are not exposed to unnecessary invasive coronary angiograms...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29200863/endothelial-dysfunction-assessment-by-flow-mediated-dilation-in-a-high-altitude-population
#9
Walter S Calderón-Gerstein, Antonio López-Peña, Raúl Macha-Ramírez, Astrid Bruno-Huamán, Roxana Espejo-Ramos, Stephany Vílchez-Bravo, María Ramírez-Breña, Milagros Damián-Mucha, Adriana Matos-Mucha
Introduction: Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo, Peru (3,250 meters above sea level). Methods: Participants included 61 patients: 28 cases and 33 controls. The cases were subjects with hypertension, diabetes mellitus, obesity, or a history of stroke or coronary artery disease...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29158679/treatment-of-pulmonary-hypertension-with-left-heart-disease-a-concise-review
#10
REVIEW
Anish Desai, Shilpa A Desouza
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29138570/erratum-quick-reference-guide-to-apixaban-corrigendum
#11
(no author information available yet)
[This corrects the article on p. 263 in vol. 13, PMID: 28744136.].
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29081661/managing-resistant-hypertension-focus-on-mineralocorticoid-receptor-antagonists
#12
REVIEW
Juan Carlos Yugar-Toledo, Rodrigo Modolo, Ana Paula de Faria, Heitor Moreno
Mineralocorticoid-receptor antagonists (MRAs) have proven to be effective in some types of hypertension, especially in resistant hypertension (RHTN). In this phenotype of hypertension, the renin-angiotensin-aldosterone pathway plays an important role, with MRAs being especially effective in reducing blood pressure. In this review, we show the relevance of aldosterone in RHTN, as well as some clinical characteristics of this condition and the main concepts involving its pathophysiology and cardiovascular damage...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29081660/implementing-clinical-process-management-of-vascular-wounds-in-a-tertiary-facility-impact-evaluation-of-a-performance-improvement-project
#13
Giampiero Avruscio, Ilaria Tocco-Tussardi, Greta Bordignon, Vincenzo Vindigni
BACKGROUND: Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. Efforts should be oriented toward the achievement of the most effective and efficient clinical management. The Angiology Unit at the University Hospital of Padova, Italy, developed a performance improvement project to enhance the quality of practice for vascular ulcers. METHODS: The project consisted in a multistep process comprising a critical revision of the previous clinical process management, staff education, tightening connections between operators and services, and creation of a position for a wound care nurse...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29066906/factors-associated-with-high-brachial-ankle-pulse-wave-velocity-in-non-hypertensive-and-appropriately-treated-hypertensive-patients-with-atherosclerotic-risk-factors
#14
Dai Ato, Toshitami Sawayama
While pulse wave velocity (PWV) correlates with blood pressure (BP), its extent differs between patients, and some cases of high PWV in normotensives are present. Moreover, PWV frequently remains high in hypertensive patients despite adequate BP control. The factors associated with such phenomena are yet to be elucidated. Here, we investigated the factors associated with brachial-ankle PWV (baPWV) in 107 patients whose systolic BP was under 140 mmHg at their latest baPWV measurement. There were 64 controlled hypertensives and 43 normotensives...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29042791/profile-of-sacubitril-valsartan-in-the-treatment-of-heart-failure-patient-selection-and-perspectives
#15
REVIEW
Srikanth Yandrapalli, Gabriela Andries, Medha Biswas, Sahil Khera
With an estimated prevalence of 5.8 million in the USA and over 23 million people worldwide, heart failure (HF) is growing in epidemic proportions. Despite the use of guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, angiotensin receptor blockers, and mineralocorticoid receptor antagonists for chronic systolic HF for almost two decades, HF remains a leading cause of morbidity, mortality, and health care expenditures. The Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial provided compelling evidence for the cardiovascular and mortality benefit of sacubitril/valsartan when compared to enalapril in patients with heart failure and reduced ejection fraction (HFrEF)...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29042790/evaluation-of-vitamin-d-levels-in-relation-to-coronary-ct-angiographic-findings-in-an-iranian-population
#16
Maryam Moradi, Ali Foroutanfar
BACKGROUND: Vitamin D deficiency, as a predisposing factor for coronary artery disease (CAD), is a subject of increasing interest. However, its role as a risk factor has not been proven. This study aimed to investigate the relationship between serum vitamin D levels and CAD. MATERIALS AND METHODS: Using a cross-sectional design, 180 patients who were candidates for coronary computed tomography angiography (CCTA) were selected. Serum levels of vitamin D were measured and compared with the results of CCTA (including calcium score, and presence and severity of coronary artery involvement due to atherosclerotic plaques)...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29033578/right-ventricular-systolic-function-in-hypertensive-heart-failure
#17
O A Oketona, M O Balogun, A O Akintomide, O E Ajayi, R A Adebayo, T O Mene-Afejuku, O T Oketona, O J Bamikole
BACKGROUND: Heart failure (HF) is a major cause of cardiovascular admissions and hypertensive heart failure (HHF) is the most common cause of HF admissions in sub-Saharan Africa, Nigeria inclusive. Right ventricular (RV) dysfunction is being increasingly recognized in HF and found to be an independent predictor of adverse outcomes in HF. This study aimed to determine the prevalence of RV systolic dysfunction in HHF by several echocardiographic parameters. METHODOLOGY: One hundred subjects with HHF were recruited consecutively into the study along with 50 age and sex-matched controls...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28919772/anti-pcsk9-antibodies-for-the-treatment-of-heterozygous-familial-hypercholesterolemia-patient-selection-and-perspectives
#18
REVIEW
Alberico Luigi Catapano, Angela Pirillo, Giuseppe Danilo Norata
Heterozygous familial hypercholesterolemia (FH) is a genetic disorder characterized by high low-density lipoprotein cholesterol levels from birth, which exposes the arteries to high levels of atherogenic lipoproteins lifelong and results in a significantly increased risk of premature cardiovascular events. The diagnosis of FH, followed by an appropriate and early treatment is critical to reduce the cardiovascular burden in this population. Phase I-III clinical trials showed the benefit of proprotein convertase subtilisin kexin 9 inhibitors, both alirocumab and evolocumab, in these patients with an average low-density lipoprotein cholesterol reduction ranging from -40% to -60%...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28860793/evaluation-of-bleeding-in-patients-receiving-direct-oral-anticoagulants
#19
REVIEW
Erika L Hellenbart, Kathleen D Faulkenberg, Shannon W Finks
Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28860792/endothelial-dysfunction-in-patients-with-buerger-disease
#20
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
We evaluated the endothelial function of patients with Buerger disease using peripheral arterial tonometry test, and examined the factors that are significantly correlated with the endothelial dysfunction in these patients. We performed the peripheral arterial tonometry test in 22 patients with Buerger disease. We recorded the patients' characteristics, including ankle brachial pressure index and reactive hyperemia index, which reflect the endothelial dysfunction. We divided the patients with Buerger disease into the conservative treatment and lumbar sympathectomy group...
2017: Vascular Health and Risk Management
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