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https://www.readbyqxmd.com/read/28645181/the-clinical-benefits-of-perioperative-antioxidant-vitamin-therapy-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#1
Jun Geng, Ju Qian, Weijun Si, Hao Cheng, Fuhai Ji, Zhenya Shen
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016...
June 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#2
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28643004/effectiveness-and-safety-of-apixaban-therapy-in-daily-care-patients-with-atrial-fibrillation-results-from-the-dresden-noac-registry
#3
Sindy Helmert, Sandra Marten, Heike Mizera, Antje Reitter, Kurtulus Sahin, Luise Tittl, Jan Beyer-Westendorf
The effectiveness and safety of apixaban for stroke prevention in atrial fibrillation (SPAF) demonstrated in ARISTOTLE needs to be confirmed in daily care. To evaluate effectiveness and safety of apixaban therapy in SPAF patients in daily care, we used data from an ongoing, prospective, non-interventional registry of more than 3000 patients on novel oral anticoagulants in daily care. Between 1 December 2012 and 31 August 2015, 514 patients receiving apixaban were enrolled. During a mean follow-up of 803.5 ± 228...
June 22, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28642017/patterns-of-care-and-temporal-trends-in-ischemic-stroke-management-a-brazilian-perspective
#4
Monique Bueno Alves, Gisele Sampaio Silva, Renata Carolina Acri Miranda, Rodrigo Meireles Massaud, Andreia Maria Heins Vaccari, Miguel Cendoroglo-Neto, Solange Diccini
BACKGROUND AND PURPOSE: Demonstration of an improvement process of quality indicators in stroke care is essential to obtain certification as a primary stroke center (PSC). Our aim was to evaluate factors that influence temporal trends in quality indicators of ischemic stroke (IS) in a Brazilian hospital. METHODS: We evaluated patients discharged with IS from a tertiary hospital from January 2009 to December 2013. Ten predefined performance measures selected by the Get With the Guidelines-Stroke program were assessed...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28639003/the-crucial-role-of-activin-a-alk4-pathway-in-the-pathogenesis-of-ang-ii-induced-atrial-fibrosis-and-vulnerability-to-atrial-fibrillation
#5
Qian Wang, Ying Yu, Pengpai Zhang, Yihe Chen, Changyi Li, Jie Chen, Yuepeng Wang, Yigang Li
Atrial fibrosis, the hallmark of structural remodeling associated with atrial fibrillation (AF), is characterized by abnormal proliferation of atrial fibroblasts and excessive deposition of extracellular matrix. Transforming growth factor-β1 (TGF-β1)/activin receptor-like kinase 5 (ALK5)/Smad2/3/4 pathway has been reported to be involved in the process. Recent studies have implicated both activin A and its specific downstream component activin receptor-like kinase 4 (ALK4) in stimulating fibrosis in non-cardiac organs...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#6
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28627951/the-safety-of-bruton-s-tyrosine-kinase-inhibitors-for-the-treatment-of-chronic-lymphocytic-leukemia
#7
Phu N Tran, Susan O'Brien
The approval of ibrutinib has revolutionized the therapeutic landscape of chronic lymphocytic leukemia (CLL). Currently ibrutinib is indicated for patients that are both treatment naïve as well as those with relapsed CLL. Ibrutinib is generally well-tolerated with durable responses that improve over time in most patients. Important toxicities include atrial fibrillation and bleeding. Areas Cover: This review covers the pharmacokinetics, pharmacodynamics, safety and efficacy of ibrutinib in the treatment of CLL...
June 19, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28625370/rationale-and-design-of-the-apixaban-for-the-reduction-of-thrombo-embolism-in-patients-with-device-detected-sub-clinical-atrial-fibrillation-artesia-trial
#8
Renato D Lopes, Marco Alings, Stuart J Connolly, Heather Beresh, Christopher B Granger, Juan Benezet Mazuecos, Giuseppe Boriani, Jens C Nielsen, David Conen, Stefan H Hohnloser, Georges H Mairesse, Philippe Mabo, A John Camm, Jeffrey S Healey
BACKGROUND: Device-detected subclinical atrial fibrillation (AF) refers to infrequent, short-lasting, asymptomatic AF that is detected only with long-term continuous monitoring. Subclinical AF is common and associated with an increased risk of stroke; however, the risk of stroke with subclinical AF is lower than for clinical AF, and very few patients with subclinical AF alone have been included in large AF anticoagulation trials. The net benefit of anticoagulation in patients with subclinical AF is unknown...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619293/efficacy-and-safety-of-traditional-chinese-medicine-on-thromboembolic-events-in-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#9
REVIEW
Zhangsheng Wang, Zeng Tang, Wenqing Zhu, Lei Ge, Junbo Ge
OBJECTIVES: Traditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF). METHODS: Potential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28611206/pulmonary-vein-isolation-alone-versus-additional-linear-ablation-in-patients-with-persistent-atrial-fibrillation-converted-to-paroxysmal-type-with-antiarrhythmic-drug-therapy-a-multicenter-prospective-randomized-study
#10
Hee Tae Yu, Jaemin Shim, Junbeom Park, In-Soo Kim, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Young-Hoon Kim, Hui-Nam Pak
BACKGROUND: Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. METHODS AND RESULTS: We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28607609/efficacy-of-ranolazine-in-preventing-atrial-fibrillation-following-cardiac-surgery-results-from-a-meta-analysis
#11
REVIEW
Chintan Trivedi, Ankit Upadhyay, Kinjal Solanki
BACKGROUND: Atrial fibrillation (AF) is a common complication after cardiac surgery. Ranolazine is a Food and Drug Administration approved anti-ischemic drug, which also has anti-arrhythmic properties. Recent studies have demonstrated the benefit of ranolazine in preventing post-operative AF (POAF) in patients undergoing cardiac surgery. Hence, we performed a meta-analysis of published studies comparing ranolazine plus standard therapy versus standard therapy for POAF prevention in patients undergoing cardiac surgery...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28606562/the-efficacy-and-safety-of-3-types-of-interventions-for-stroke-prevention-in-patients-with-cardiovascular-and-cerebrovascular-diseases-a-network-meta-analysis
#12
Qian Sun, Shumei Chang, Songtao Lu, Yajing Zhang, Yajun Chang
PURPOSE: The goal of this study was to compare the relative efficacy and safety of different types of interventions for stroke prevention in patients with cardiovascular and cerebrovascular diseases. METHODS: This network meta-analysis (NMA) was conducted with a random effects model of Bayesian framework using Stata version 12.0. Odds ratios (ORs) and their credible intervals (CrIs) were applied for the efficacy and safety evaluation of various medical interventions, including aspirin, dipyridamole, ticlopidine, warfarin, and apixaban...
June 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28606079/costs-of-major-intracranial-gastrointestinal-and-other-bleeding-events-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#13
Marie Jakobsen, Christophe Kolodziejczyk, Eskild Klausen Fredslund, Peter Bo Poulsen, Lars Dybro, Søren Paaske Johnsen
BACKGROUND: Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28604139/major-bleeding-risk-and-healthcare-economic-outcomes-of-nonvalvular-atrial-fibrillation-patients-newly-initiated-with-oral-anticoagulant-therapy-in-the-real-world-setting
#14
Jay Lin, Jeffrey Trocio, Kiran Gupta, Jack Mardekian, Melissa Lingohr-Smith, Brandy Menges, Min You, Anagha Nadkarni
AIMS: This study compared the risk for major bleeding (MB) and healthcare economic outcomes of patients with nonvalvular atrial fibrillation (NVAF) after initiating treatment with apixaban versus rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients who initiated apixaban, rivaroxaban, dabigatran, or warfarin were identified from the IMS Pharmetrics Plus database (1/1/2013-9/30/2015). Propensity score matching (PSM) was used to balance differences in patient characteristics between study cohorts: patients treated with apixaban versus rivaroxaban, apixaban versus dabigatran, and apixaban versus warfarin...
June 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28602672/surgical-and-hybrid-ablation-of-atrial-fibrillation
#15
REVIEW
Reece A Davies, Saurabh Kumar, Richard B Chard, Stuart P Thomas
Atrial fibrillation (AF) is the most common arrhythmia in humans and is known to be associated with an increased risk of stroke, dementia, heart failure and mortality. Non-pharmacological therapy with ablation using either surgical or percutaneous techniques is recommended in drug refractory AF. Early attempts to devise procedures to ablate AF and restore sinus rhythm culminated with the Cox-Maze procedure, the first truly successful procedure. Since then, ablation surgery has been conducted predominately as a concomitant procedure...
May 18, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28597249/differential-regulation-of-protein-phosphatase-1-pp1-isoforms-in-human-heart-failure-and-atrial-fibrillation
#16
Stefanie Meyer-Roxlau, Simon Lämmle, Annett Opitz, Stephan Künzel, Julius P Joos, Stefan Neef, Karolina Sekeres, Samuel T Sosalla, Friedrich Schöndube, Konstantin Alexiou, Lars S Maier, Dobromir Dobrev, Kaomei Guan, Silvio Weber, Ali El-Armouche
Protein phosphatase 1 (PP1) is a key regulator of important cardiac signaling pathways. Dysregulation of PP1 has been heavily implicated in cardiac dysfunctions. Accordingly, pharmacological targeting of PP1 activity is considered for therapeutic intervention in human cardiomyopathies. Recent evidence from animal models implicated previously unrecognized, isoform-specific activities of PP1 in the healthy and diseased heart. Therefore, this study examined the expression of the distinct PP1 isoforms PP1α, β, and γ in human heart failure (HF) and atrial fibrillation (AF) and addressed the consequences of β-adrenoceptor blocker (beta-blocker) therapy for HF patients with reduced ejection fraction on PP1 isoform expression...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28595862/safety-and-efficacy-of-uninterrupted-apixaban-therapy-versus-warfarin-during-atrial-fibrillation-ablation
#17
Ruchit R Shah, Ajay Pillai, Pascha Schafer, David Meggo, Tom McElderry, Vance Plumb, Takumi Yamada, Vineet Kumar, Harish Doppalapudi, Alicia Gunter, Emily Pentecost, William R Maddox
Thromboembolic cerebrovascular accident remains a rare but potentially devastating complication of catheter-based atrial fibrillation (AF) ablation. Uninterrupted oral anticoagulant therapy with warfarin has become the standard of care when performing catheter-based AF ablation. Compared with warfarin, apixaban, a factor Xa inhibitor, has been shown to reduce the risk of stroke and major bleeding in nonvalvular AF. With an increase in apixaban use for stroke prophylaxis in patients with AF, there is an increased interest in the safety and efficacy of uninterrupted apixaban therapy during AF ablation...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28586103/minimal-configuration-of-body-surface-potential-mapping-for-discrimination-of-left-versus-right-dominant-frequencies-during-atrial-fibrillation
#18
M Rodrigo, A M Climent, A Liberos, F Fernández-Aviles, F Atienza, M S Guillem, O Berenfeld
BACKGROUND: Ablation of drivers maintaining Atrial Fibrillation (AF) has been demonstrated as an effective therapy. Drivers in the form of rapidly-activated atrial regions can be non-invasively localized to either left or right atria (LA, RA) with Body Surface Potential Mapping (BSPM) systems. This study quantifies the accuracy of Dominant Frequency (DF) measurements from reduced-leads BSPM systems and assesses the minimal configuration required for ablation guidance. METHODS: Nine uniformly distributed lead sets of 8 to 66 electrodes were evaluated...
June 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28577686/atrial-fibrillation-incrementally-increases-dementia-risk-across-all-chads2-and-cha2ds2vasc-strata-in-patients-receiving-long-term-warfarin
#19
Kevin G Graves, Heidi T May, Victoria Jacobs, Tami L Bair, Scott M Stevens, Scott C Woller, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, J Peter Weiss, T Jared Bunch
BACKGROUND: Patients with atrial fibrillation (AF) are at higher risk for developing dementia. Warfarin is a common therapy for the prevention of thromboembolism in AF, valve replacement, and thrombosis patients. The extent to which AF itself increases dementia risk remains unknown. METHODS: A total 6030 patients with no history of dementia and chronically anticoagulated with warfarin were studied. Warfarin management was provided through a Clinical Pharmacy Anticoagulation Service...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28575490/ultrasound-guided-versus-conventional-femoral-venipuncture-for-catheter-ablation-of-atrial-fibrillation-a-multicentre-randomized-efficacy-and-safety-trial-ultra-fast-trial
#20
Kenichiro Yamagata, Dan Wichterle, Tomáš Roubícek, Patrik Jarkovský, Yuriko Sato, Takamichi Kogure, Petr Peichl, Petr Konecný, Helena Jansová, Pavel Kucera, Bashar Aldhoon, Robert Cihák, Yoichi Sugimura, Josef Kautzner
Aims: Complications of catheter ablation for atrial fibrillation (AF) are frequently related to vascular access. We hypothesized that ultrasound-guided (USG) venipuncture may facilitate the procedure and reduce complication rates. Methods and results: We conducted a multicentre, randomized trial in patients undergoing catheter ablation for AF on uninterrupted anticoagulation therapy. The study enrolled consecutive 320 patients (age: 63 ± 8 years; male: 62%) and were randomized to USG or conventional venipuncture in 1:1 fashion...
May 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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