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Cardiology and Therapy

Daniel O'Dea, Jacqueline Whetteckey, Naitee Ting
INTRODUCTION: In the pivotal RE-LY trial, dabigatran etexilate (DE) at the dose of 150-mg twice daily (BID), significantly reduced total stroke and ischemic stroke compared with warfarin in patients with non-valvular atrial fibrillation (NVAF), while the 110-mg BID dose had efficacy equivalent to warfarin, and major bleeds were significantly reduced. Both DE regimens were generally well tolerated; however, approximately 4% of the patients discontinued treatment with DE due to gastrointestinal (GI) discomfort...
October 5, 2016: Cardiology and Therapy
Sandeep A Saha, Kousik Krishnan, Christopher Madias, Richard G Trohman
A 34-year-old man with Brugada syndrome (BrS) presented with electrical storm, manifested as multiple appropriate shocks from his implantable cardioverter-defibrillator over a period of 7 hours. He had not tolerated prior treatment with quinidine, and had self-discontinued cilostazol citing persistent palpitations. After stabilization with intravenous isoproterenol, an electrophysiology study was performed but no spontaneous or induced ventricular ectopic beats were identified. A three-dimensional (3D) endocardial electro-anatomic map of the right ventricular outflow tract (RVOT), pulmonic valve, and pulmonary artery, as well as a 3D epicardial map of the RVOT, were created...
September 19, 2016: Cardiology and Therapy
Sanjay Kalra, Rakesh Sahay, Manash P Baruah
No abstract text is available yet for this article.
September 12, 2016: Cardiology and Therapy
Sanjay Kalra
: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of drugs that have been extensively investigated for the treatment of hyperglycemia in type 2 diabetes mellitus (T2DM). These drugs reduce hyperglycemia by blocking renal glucose reabsorption, thereby promoting increased renal glucose excretion. Beyond glycemic control, these drugs have other beneficial effects on cardiovascular (CV) risk factors. The present review discusses the potential role of SGLT2 inhibitors in treating CV complications (acute and chronic) associated with T2DM...
August 18, 2016: Cardiology and Therapy
Abdelhakim Allali, Mohamed Abdel-Wahab, Gert Richardt
We report a case of a 65-year-old female patient treated with an everolimus-eluting bioresorbable scaffold (BRS) after rotational atherectomy of a severely calcified lesion of the left anterior descending coronary artery. The implanted BRS restenosed 10 months after implantation and was treated with a scoring balloon followed by drug-eluting balloons with good immediate and long-term results. To the best of our knowledge, this is the first report of a balloon-only treatment of a restenosis occurring more than 6 months after BRS implantation; angiographic and optical coherence tomography images after treatment and at two-year follow-up are presented...
July 29, 2016: Cardiology and Therapy
Carme Pinyol, Jose M Cepeda, Inmaculada Roldan, Vanesa Roldan, Silvia Jimenez, Paloma Gonzalez, Javier Soto
INTRODUCTION: Economic evaluations are becoming increasingly important due to limitations in economic resources, the expense of many new treatments, the need to allocate health spending as effectively as possible, and the need to inform decision makers. Based on the data from the apixaban studies (ARISTOTLE and AVERROES), several economic evaluations have been performed in various countries to demonstrate the efficacy of apixaban versus warfarin and aspirin or other new oral anticoagulants (NOACs) for preventing stroke in patients with non-valvular atrial fibrillation (NVAF)...
July 25, 2016: Cardiology and Therapy
Sufyan Benamer, Debbie Lusty, Tamara Everington
INTRODUCTION: Direct current cardioversion (DCCV) is considered as the most effective treatment for atrial fibrillation (AF). AF is associated with an increased risk of thromboembolism, and DCCV may increase this risk. The current recommendation is, therefore, to anticoagulate for at least 3 weeks before DCCV and 4 weeks after the procedure. METHODS: A retrospective study of patients referred for elective DCCV as treatment for AF in Hampshire Hospitals NHS Foundation Trust was performed to compare the safety and efficacy of dabigatran with warfarin in this setting...
July 25, 2016: Cardiology and Therapy
Rasmus Kapalu Broge Richelsen, Thure Filskov Overvad, Svend Eggert Jensen
Drug-eluting balloons (DEBs) have emerged as a new application in percutaneous coronary intervention. DEBs have proven successful in the treatment of in-stent restenosis, but their role in de novo lesions is less clear. This paper provides a review of the current studies where DEBs have been used in coronary de novo lesions, either as part of a DEB-only strategy or in combination with another device, mainly a bare metal stent (BMS). By searching Pubmed and Embase we were able to identify 52 relevant studies, differing in design, intervention, and clinical setting, including patients with small vessel disease, bifurcation lesions, complex long lesions, acute myocardial infarction, diabetes mellitus, and elderly...
July 6, 2016: Cardiology and Therapy
Claire McCune, Peter McKavanagh, Ian B A Menown
INTRODUCTION: Multiple significant, potentially practice changing clinical trials in cardiology have been conducted and subsequently presented throughout the past year. METHODS: In this paper, the authors have reviewed and contextualized significant cardiovascular clinical trials presented at major international conferences of 2015 including American College of Cardiology, European Association for Percutaneous Cardiovascular Interventions, American Diabetes Association, European Society of Cardiology, Transcatheter Cardiovascular Therapeutics, Heart Rhythm Congress, and the American Heart Association Scientific Sessions...
June 8, 2016: Cardiology and Therapy
Chur Chin, Yu Shin Park
INTRODUCTION: In our previous study, we found that negatively charged gold nanoparticles with spermidine have the potential of blocking inwardly rectifying potassium channels (Kir), both at the cellular and the tissue level. METHODS: For the purpose of the present study, we purified the cytoplasmic domain of the Kir 3.1 receptor from Escherichia coli. Using single particles with surface coating by transmission electron microscopy, we identified the gold nanoparticles at the cytoplasmic side of the human Kir channel...
June 2016: Cardiology and Therapy
Ajay Vallakati, Abhishek Sharma, Mohammed Madmani, Madhu Reddy, Arun Kanmanthareddy, Sampath Gunda, Dhanunjaya Lakkireddy, William R Lewis
INTRODUCTION: Novel oral anticoagulants (NOACs) have been approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). A large number of patients are on NOACs when they present for AF ablation. We intended to evaluate the safety and efficacy of NOACs for AF ablation during the periprocedural period by performing a meta-analysis of trials comparing NOACs with warfarin. METHODS: Studies comparing NOACs (dabigatran and rivaroxaban) with warfarin as periprocedural anticoagulants for AF ablation were identified using an electronic search...
June 2016: Cardiology and Therapy
Luis Rodríguez Padial, Gonzalo Barón-Esquivias, Antonio Hernández Madrid, Domingo Marzal Martín, Vicente Pallarés-Carratalá, Alejandro de la Sierra
No abstract text is available yet for this article.
June 2016: Cardiology and Therapy
Luis Rodríguez Padial, Gonzalo Barón-Esquivias, Antonio Hernández Madrid, Domingo Marzal Martín, Vicente Pallarés-Carratalá, Alejandro de la Sierra
UNLABELLED: Cardiovascular diseases are the leading cause of death in the world. Coronary artery diseases, atrial fibrillation or hypertensive heart disease, are among the most important cardiovascular disorders. Hypertension represents a significant risk factor for cardiovascular mortality; thus, control of high blood pressure has become a priority to prevent major complications. Although the choice of drugs for treating hypertension remains controversial, extensive clinical evidences point to calcium channel blockers as first-line agents...
June 2016: Cardiology and Therapy
Zachary A Stacy, William B Call, Aaron P Hartmann, Golden L Peters, Sara K Richter
Historically, vitamin K antagonists have been the only class of oral anticoagulants available. Despite our experience with warfarin over the past 60 years, its use is associated with several pharmacokinetic and clinical disadvantages including unpredictable dosing, frequent monitoring, and delayed onset and offset. Edoxaban, an oral direct Xa inhibitor, may provide clinicians with an additional option in patients requiring chronic anticoagulation. This review examines the pharmacology and clinical data of edoxaban as a therapeutic alternative...
June 2016: Cardiology and Therapy
Tu N Nguyen, Dominic Pepperell, Marie-Christine Morel-Kopp, Robert G Cumming, Christopher Ward, Sarah N Hilmer
INTRODUCTION: Frailty is associated with changes in inflammation, coagulation, and possibly platelet function. Aspirin is still prescribed for stroke prevention in older patients with atrial fibrillation, although not recommended by current guidelines. In frail older people, it is unclear whether platelet aggregability and response to aspirin are altered. This study aims to investigate the effects of frailty and chronological age on platelet aggregability and on responses to aspirin in older patients with atrial fibrillation...
June 2016: Cardiology and Therapy
Christian Cadeddu, Silvio Nocco, Lucia Cugusi, Martino Deidda, Orru Fabio, Stefano Bandino, Efisio Cossu, Michela Incani, Marco Giorgio Baroni, Giuseppe Mercuro
INTRODUCTION: In patients affected by insulin resistance (IR), metformin (MET) therapy has been shown to exert its positive effects by improving glucose tolerance and preventing the evolution to diabetes. Recently, it was shown that the addition of metformin to physical training did not improve sensitivity to insulin or peak oxygen consumption (peak VO2). The purpose of this study was to establish the effect of metformin and exercise, separately or in combination, on systolic left ventricular (LV) function in individuals with IR...
June 2016: Cardiology and Therapy
Erika von Vajna, Ruhaniyah Alam, Tsz-Yin So
Common treatment options for deep vein thrombosis and venous thromboembolism in the pediatric population include unfractionated heparin, low molecular weight heparin, and warfarin. Other alternatives are bivalirudin, argatroban, and fondaparinux. Warfarin is the only approved oral option, but an oral agent without frequent monitoring would be optimal for pediatric patients. Thus, there is an increasing need for new anticoagulation options in this population. None of the current direct oral anticoagulants have FDA-approved indications and dosing in children...
June 2016: Cardiology and Therapy
Anthony A Bavry, Islam Y Elgendy, Ahmed Mahmoud, Manoj P Jadhav, Tianyao Huo, Marian C Limacher, Carl J Pepine
INTRODUCTION: Prior studies suggested that a routine invasive approach in the management of non-ST-elevation acute coronary syndrome (NSTE-ACS) is beneficial in men, but the data are less conclusive in women. One study conducted exclusively in women found that routine invasive therapy was associated with a markedly increased risk of major bleeding. This pilot randomized controlled trial compared the safety of a routine invasive versus a selective invasive strategy among women. METHODS: Women with NSTE-ACS and an additional high-risk characteristic were randomized to a routine invasive versus a selective invasive strategy...
June 2016: Cardiology and Therapy
Julia Kebernik, John Jose, Mohamed Abdel-Wahab, Björn Stöcker, Volker Geist, Gert Richardt
INTRODUCTION: Limited data exist on the outcomes after left atrial appendage closure (LAAC) with the Amplatzer™ Cardiac Plug (ACP; St. Jude Medical, Minneapolis, MN, USA) in patients with atrial fibrillation (AF) with very high stroke and bleeding risks, the subset expected to benefit most from this procedure. The objective of this study was to report clinical outcomes after LAAC with the ACP device in a very high stroke and bleeding risk cohort of patients with non-valvular AF and contraindications to oral anticoagulation (OAC)...
December 2015: Cardiology and Therapy
Peter McKavanagh, Gerard Walls, Claire McCune, Jonathon Malloy, Mark T Harbinson, Peter A Ball, Patrick M Donnelly
Cardiac computerized tomography (CT) has evolved from a research tool to an important diagnostic investigation in cardiology, and is now recommended in European, US, and UK guidelines. This review is designed to give the reader an overview of the current state of cardiac CT. The role of cardiac CT is multifaceted, and includes risk stratification, disease detection, coronary plaque quantification, defining congenital heart disease, planning for structural intervention, and, more recently, assessment of ischemia...
December 2015: Cardiology and Therapy
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