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https://www.readbyqxmd.com/read/28883841/antiplatelet-and-anticoagulant-therapy-in-elderly-people-with-type-2-diabetes-mellitus-in-poland-based-on-the-polsenior-study
#1
Beata Łabuz-Roszak, Agnieszka Machowska-Majchrzak, Michał Skrzypek, Małgorzata Mossakowska, Jerzy Chudek, Andrzej Więcek, Maciej Wawrzyńczyk, Beata Łącka-Gaździk, Krystyna Pierzchała
INTRODUCTION: Type 2 diabetes mellitus (T2DM) is an important and common cardiovascular risk factor. The purpose of the study was to evaluate the frequency of use of oral antiplatelet drugs (OAPs) and oral anticoagulant drugs (OACs) among the elderly with T2DM in Poland. MATERIAL AND METHODS: The study was based on the data collected in the Polish national PolSenior study. RESULTS: Among 4979 PolSenior participants aged 65 and over, 883 (17...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28882229/care-patterns-and-outcomes-in-atrial%C3%A2-fibrillation-patients-with-and-without-diabetes-orbit-af-registry
#2
MULTICENTER STUDY
Justin B Echouffo-Tcheugui, Peter Shrader, Laine Thomas, Bernard J Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini, Gregg C Fonarow
BACKGROUND: Diabetes is a well-established risk factor for thromboembolism in patients with atrial fibrillation (AF), but less is known about how diabetes influences outcomes among AF patients. OBJECTIVES: This study assessed whether symptoms, health status, care, and outcomes differ between AF patients with and without diabetes. METHODS: The cohort study included 9,749 patients from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry, a prospective, nationwide, outpatient registry of patients with incident and prevalent AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28854077/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-for-newly-diagnosed-and-treatment-naive-atrial-fibrillation-patients-an-update-using-2013-2014-data
#3
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Few studies have assessed adherence to non-vitamin K antagonist oral anticoagulants (NOACs), especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To compare adherence and treatment patterns among NOACs for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Incident and treatment-naive NVAF patients were identified during 2013-2014 from a large claims database in this retrospective cohort study...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28851729/assessment-of-remote-heart-rhythm-sampling-using-the-alivecor-heart-monitor-to-screen-for-atrial-fibrillation-the-rehearse-af-study
#4
Julian P J Halcox, Kathie Wareham, Antonia Cardew, Mark Gilmore, James P Barry, Ceri Phillips, Michael B Gravenor
Background -Asymptomatic atrial fibrillation (AF) is increasingly common in the aging population and implicated in many ischemic strokes. Earlier identification of AF with appropriate anticoagulation may decrease stroke morbidity and mortality. Methods -We conducted a randomized controlled trial of AF screening using an AliveCor Kardia monitor attached to a WiFi-enabled iPod to obtain ECGs (iECGs) in ambulatory patients. Patients ≥65 years of age with a CHADS-VASc score ≥2 free from AF were randomized to the iECG arm or routine care (RC)...
August 28, 2017: Circulation
https://www.readbyqxmd.com/read/28844514/comparison-of-the-cha2ds2-vasc-chads2-has-bled-orbit-and-atria-risk-scores-in-predicting-non-vitamin-k-antagonist-oral-anticoagulants-associated-bleeding-in-patients-with-atrial-fibrillation
#5
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, David M Kent, Nilay D Shah, Neena S Abraham, Peter A Noseworthy
The increasing adoption of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart failure, hypertension, Age ≥75 [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74, and Sex [female] [CHA2DS2-VASc] and Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] [CHADS2]) and 3 bleeding risk scores (hypertension, abnormal renal/liver function [1 point each], stroke, bleeding history or predisposition, labile INR, elderly [...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#6
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28805957/stroke-or-left-atrial-thrombus-prediction-using-antithrombin-iii-and-mean-platelet-volume-in-patients-with-nonvalvular-atrial-fibrillation
#7
Seo-Won Choi, Bo-Bae Kim, Dong-Hyun Choi, Geon Park, Byung Chul Shin, Heesang Song, DongHun Kim, Dong-Min Kim
BACKGROUND: CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF). HYPOTHESIS: To determine the association of antithrombin III (AT-III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF...
August 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28760133/surface-ecg-interatrial-block-guided-treatment-for-stroke-prevention-rationale-for-an-attractive-hypothesis
#8
Antoni Bayés de Luna, Manuel Martínez-Sellés, Antoni Bayés-Genís, Roberto Elosua, Adrian Baranchuk
Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, cognitive impairment, and cardiovascular death. Some predisposing factors - as aging, diabetes, hypertension - induce and maintain electrophysiological and ultrastructural remodeling that usually includes fibrosis. Interatrial conduction disturbances play a crucial role in the initiation of atrial fibrosis and in its associated complications. The diagnosis of interatrial blocks (IABs) is easy to perform using the surface ECG...
July 31, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#9
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28747024/clinical-profile-and-outcomes-in-octogenarians-with-atrial-fibrillation-a-community-based-study-in-a-specific-european-health-care-area
#10
Moisés Rodríguez-Mañero, Estrella López-Pardo, Alberto Cordero, Omar Kredieh, María Pereira-Vazquez, Jose-Luis Martínez-Sande, Alvaro Martínez-Gomez, Carlos Peña-Gil, José Novo-Platas, Javier García-Seara, Pilar Mazón, Ricardo Laje, Isabel Moscoso, Alfonso Varela-Román, Jose María García-Acuña, José Ramón González-Juanatey
BACKGROUND: Age increases risk of stroke and bleeding. Clinical trial data have had relatively low proportions of elderly subjects. We sought to study a Spanish population of octogenarians with atrial fibrillation (AF) by combining different sources of electronic clinical records from an area where all medical centres utilized electronic health record systems. METHODS: Data was derived from the Galician Healthcare Service information system. RESULTS: From 383,000 subjects, AF was coded in 7990 (2...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#11
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28725983/dabigatran-and-vitamin-k-antagonists-use-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-a-cross-sectional-study-of-primary-care-based-electronic-health-records
#12
Bogdan Vlacho, Maria Giner-Soriano, Edurne Zabaleta-Del-Olmo, Albert Roso-Llorach, Ana García-Sangenís, Rosa Morros-Pedrós
PURPOSE: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). METHODS: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed...
July 19, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28724879/infectious-complications-in-patients-with-cardiac-implantable-electronic-devices-risk-factors-prevention-and-prognosis
#13
Anna Polewczyk, Wojciech Jacheć, Aneta Maria Polewczyk, Andrzej Tomasik, Marianna Janion, Andrzej Kutarski
INTRODUCTION    Cardiac device infections (CDI) are still a significant problem. The knowledge of risk factors for CDI is crucial both for preventing infections and reducing mortality. OBJECTIVES    The assesment of the risk factors and long term survival of patients with CDI. PATIENTS AND METHODS    The clinical data of 1837 patients (40.9% CDI) undergoing transvenous leads extraction (TLE) at a single institution from 2006 to 2015 was analyzed. We compared the clinical and procedure-related factors for all types of CDI: isolated pocket infection (IPI), isolated lead-related infective endocarditis (ILRIE) and PI+LRIE...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28709650/anticoagulation-control-in-warfarin-treated-patients-undergoing-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-enoxaparin-warfarin-in-patients-undergoing-cardioversion-of-atrial-fibrillation-trial
#14
RANDOMIZED CONTROLLED TRIAL
Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette
In the Edoxaban Versus Enoxaparin-Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin-warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open blinded end-point trial, we analyzed patients randomized to enoxaparin-warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; and impact on primary end points (composite of stroke, systemic embolic event[SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant nonmajor bleeding)...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28704407/variations-in-achievement-of-evidence-based-high-impact-quality-indicators-in-general-practice-an-observational-study
#15
Thomas A Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy
BACKGROUND: There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected 'big data' in the evaluation of healthcare. We developed a set of evidence-based 'high impact' quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). METHODS: Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89)...
2017: PloS One
https://www.readbyqxmd.com/read/28692742/vitamin-k-antagonists-with-or-without-long-term-antiplatelet-therapy-in-outpatients-with-stable-coronary-artery-disease-and-atrial-fibrillation-association-with-ischemic-and-bleeding-events
#16
Gilles Lemesle, Gregory Ducrocq, Yedid Elbez, Eric Van Belle, Shinya Goto, Christopher P Cannon, Christophe Bauters, Deepak L Bhatt, Philippe Gabriel Steg
BACKGROUND: It remains uncertain whether patients with atrial fibrillation (AF) requiring long-term oral anticoagulation (OAC) and with stable coronary artery disease (CAD) should receive antiplatelet therapy (APT) in addition to OAC. HYPOTHESIS: APT in addition to OAC would be more effective than OAC alone in preventing ischaemic events in such patients. METHODS: In the international REduction of Atherothrombosis for Continued Health (REACH) Registry including 68 236 outpatients with or at risk for atherothrombosis, we identified 2347 patients with stable CAD and AF receiving vitamin K antagonists (VKA)...
July 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28678986/association-of-a-family-history-of-atrial-fibrillation-with-incidence-and-outcomes-of-atrial-fibrillation-a-population-based-family-cohort-study
#17
Shang-Hung Chang, Chang-Fu Kuo, I-Jun Chou, Lai-Chu See, Kuang-Hui Yu, Shue-Fen Luo, Lu-Hsiang Huang, Weiya Zhang, Michael Doherty, Ming-Shien Wen, Chi-Tai Kuo, Yung-Hsin Yeh
Importance: The heritability of atrial fibrillation (AF), the contribution of genetic and environmental factors, and the association of a family history of AF with prognosis are unclear. Objectives: To measure genetic and environmental factors in the familial aggregation of AF and to estimate the association of a family history of AF with major adverse cardiovascular events (MACE). Design, Setting, and Participants: In this Taiwanese nationwide population-based study among more than 23 million people, a custom data set was obtained using the data of all patients having a diagnosis of AF recorded between January 1996 and December 2013 in the Taiwan National Health Insurance Research Database...
August 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28671805/valvular-heart-disease-in-adults-management-of-native-valve-disease
#18
REVIEW
Xin Zhang, Steven M Hollenberg
Patients with valvular heart disease (VHD) should be treated for diabetes, hypertension, and hyperlipidemia. They also should receive therapy for left ventricular dysfunction, undergo interval echocardiography, and participate in aerobic exercise. Valve replacement should be considered for patients with aortic stenosis (AS) and syncope, presyncope, heart failure, angina, or severe AS with left ventricular dysfunction. Valve replacement is performed with open or transcatheter procedures; the latter are preferred for patients with high surgical risk...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28666358/shifting-to-a-non-vitamin-k-antagonist-oral-anticoagulation-agent-from-vitamin-k-antagonist-in-atrial-fibrillation
#19
Emil L Fosbøl, Naja Emborg Vinding, Morten Lamberts, Laila Staerk, Anna Gundlund, Kasper Gadsbøll, Lars Køber, Gunnar H Gislason, Jonas Bjerring Olesen
Aims: After non-vitamin K antagonist (VKA) oral anticoagulation agents (NOAC) have been approved for thrombo-embolic prophylaxis in non-valvular atrial fibrillation (NVAF), utilization of oral anticoagulants (OAC) in NVAF has changed. Contemporary shifting from a VKA to a NOAC (dabigatran, rivaroxaban, or apixaban) has not been quantified, and could help assess whether these drugs are used according to recommendations. Methods and results: Using Danish nationwide registries, we identified all VKA-experienced NVAF patients initiating a NOAC from 22 August 2011 to 31 December 2015 (shifters) and all VKA-experienced NVAF patients who were not switched to NOACs (non-shifters)...
June 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28662919/risk-factor-management-and-atrial-fibrillation-clinics-saving-the-best-for-last
#20
REVIEW
Rajiv Mahajan, Rajeev K Pathak, Anand Thiyagarajah, Dennis H Lau, Francis E Marchlinski, Sanjay Dixit, John D Day, Jeroen M L Hendriks, Melinda Carrington, Jonathan M Kalman, Prashanthan Sanders
Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality worldwide. Management of AF is a complex process involving: 1) the prevention of thromboembolic complications with anticoagulation; 2) rhythm control; and 3) the detection and treatment of underlying heart disease. However, cardiometabolic risk factors, such as obesity, hypertension, diabetes mellitus, and obstructive sleep apnoea, have been proposed as contributors to the expanding epidemic of atrial fibrillation (AF). Thus, a fourth pillar of AF care would include aggressive targeting of interdependent, modifiable cardiovascular risk factors as part of an integrated care model...
September 2017: Heart, Lung & Circulation
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