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https://www.readbyqxmd.com/read/28077507/stroke-and-mortality-risk-in-patients-with-various-patterns-of-atrial-fibrillation-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction-48
#1
Mark S Link, Robert P Giugliano, Christian T Ruff, Benjamin M Scirica, Heikke Huikuri, Ali Oto, Andrea E Crompton, Sabina A Murphy, Hans Lanz, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
BACKGROUND: Whether the pattern of atrial fibrillation (AF) modifies the risk/benefit of anticoagulation is controversial. In ENGAGE AF-TIMI 48 trial (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48), the factor Xa inhibitor edoxaban was noninferior to warfarin in preventing stroke or systemic embolic events and significantly reduced bleeding and cardiovascular mortality. However, detailed analyses by AF pattern have not been reported...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28077384/predictors-of-nonuse-of-a-high-potency-statin-after-an-acute-coronary-syndrome-insights-from-the-stabilization-of-plaques-using-darapladib-thrombolysis-in-myocardial-infarction-52-solid-timi-52-trial
#2
Alon Eisen, Christopher P Cannon, Eugene Braunwald, Dylan L Steen, Jing Zhou, Erica L Goodrich, KyungAh Im, Anthony J Dalby, Jindrich Spinar, Shruti Daga, Mary Ann Lukas, Michelle L O'Donoghue
BACKGROUND: High-potency statins reduce cardiovascular events after acute coronary syndromes but remain underused in clinical practice. We examined predictors of nonuse of high-potency statins after acute coronary syndromes. METHODS AND RESULTS: The Stabilization of pLaques usIng Darapladib-Thrombolysis in Myocardial Infarction (SOLID-TIMI 52) trial enrolled patients after an acute coronary syndrome in 36 countries between 2009 and 2011. Statin use was strongly encouraged throughout the trial, and statin potency was at the discretion of the treating physician...
January 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28064150/a-novel-risk-prediction-score-in-atrial-fibrillation-for-a-net-clinical-outcome-from-the-engage-af-timi-48-randomized-clinical-trial
#3
Christina L Fanola, Robert P Giugliano, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
AIMS: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. METHODS AND RESULTS: ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063138/are-biventricular-systolic-functions-impaired-in-patient-with-coronoray-slow-flow-a-prospective-study-with-three-dimensional-speckle-tracking
#4
Tuğba Kemaloğlu Öz, Mehmet Eren, Işıl Atasoy, Tayfun Gürol, Özer Soylu, Bahadır Dağdeviren
The newly developed three dimensional speckle-tracking echocardiography (3D-STE) technology provides quick and comprehensive quantitative assessment of biventricular myocardial dynamics. The impact of coronary slow flow phenomenon (CSFP) on biventricular functions has not been comprehensively evaluated using this new technology. Therefore, the aim of this study was to evaluate the effects of CSFP on biventricular systolic functions using 3D-STE. Forty patients with CSFP and otherwise normal coronary arteries (NCAs) and 40 age- and sex-matched controls with normal coronary angiograms (CAGs) were prospectively enrolled...
January 6, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28063023/vorapaxar-the-current-role-and-future-directions-of-a-novel-protease-activated-receptor-antagonist-for-risk-reduction-in-atherosclerotic-disease
#5
REVIEW
Rebecca J Gryka, Leo F Buckley, Sarah M Anderson
INTRODUCTION: Despite the current standard of care, patients with cardiovascular disease remain at a high risk for recurrent events. Inhibition of thrombin-mediated platelet activation through protease-activated receptor-1 antagonism may provide reductions in atherosclerotic disease beyond those achievable with the current standard of care. OBJECTIVE: Our primary objective is to evaluate the clinical literature regarding the role of vorapaxar (Zontivity™) in the reduction of cardiovascular events in patients with a history of myocardial infarction and peripheral artery disease...
January 6, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28062625/high-sensitivity-troponin-i-in-stable-patients-with-atherosclerotic-disease-in-the-tra-2%C3%A2-p-timi-50-trial
#6
Alon Eisen, Marc P Bonaca, Petr Jarolim, Benjamin M Scirica, Harvey D White, Michal Tendera, Mikael Dellborg, Jose C Nicolau, Joao Morais, Keith A A Fox, Erin A Bohula, Sabina A Murphy, Eugene Braunwald, David A Morrow
BACKGROUND: Cardiac troponin I, measured with a high-sensitivity assay (hs-TnI), is well-established for risk prediction in acute coronary syndromes. However, its prognostic role in stable atherosclerotic disease, particularly for future myocardial infarction (MI), is less well defined. METHODS: We measured hs-TnI (Abbott ARCHITECT) in 15833 patients with prior MI, ischemic stroke, or peripheral arterial disease from the placebo-controlled Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)-Thrombolysis in Myocardial Infarction (TIMI) 50 trial of the platelet inhibitor vorapaxar, excluding patients with recent MI (<30 days)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062147/periprocedural-myocardial-infarction-during-percutaneous-coronary-intervention-in-an-academic-tertiary-centre-in-johannesburg
#7
Nqoba Tsabedze, Keir McCutcheon, Lancelot Mkhwanazi, Riaz Garda, Ahmed Vachiat, Rohan Ramjee, Jameel Moosa, Themba Maluleke, Gloria Mukeshimana, Saffiyyah Karolia, Dineo Mpanya, Pravin Manga
BACKGROUND: Percutaneous coronary intervention (PCI) is effective therapy for significant atherosclerotic coronary artery disease. Despite medical and technological advances in PCI, periprocedural myocardial infarction (PMI) remains a common complication. The frequency and factors associated with PMI have been well investigated in the developed world, yet there is a paucity of data from the developing world, especially Sub-Saharan Africa. METHODS: We prospectively enrolled 153 adult patients undergoing PCI at the Charlotte Maxeke Johannesburg Academic Hospital from the 1st of February 2014 to 31st October 2014...
December 30, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28061371/low-level-arsenic-exposure-via-drinking-water-consumption-and-female-fecundity-a-preliminary-investigation
#8
Michele L Susko, Michael S Bloom, Iulia A Neamtiu, Allison A Appleton, Simona Surdu, Cristian Pop, Edward F Fitzgerald, Doru Anastasiu, Eugen S Gurzau
High level arsenic exposure is associated with reproductive toxicity in experimental and observational studies; however, few data exist to assess risks at low levels. Even less data are available to evaluate the impact of low level arsenic exposure on human fecundity. Our aim in this pilot study was a preliminary evaluation of associations between low level drinking water arsenic contamination and female fecundity. This retrospective study was conducted among women previously recruited to a hospital-based case-control study of spontaneous pregnancy loss in Timiṣ County, Romania...
January 3, 2017: Environmental Research
https://www.readbyqxmd.com/read/28041999/occurrence-and-first-molecular-characterization-of-sarcocystis-spp-in-wild-boars-sus-scrofa-and-domestic-pigs-sus-scrofa-domesticus-in-romania-public-health-significance-of-the-isolates
#9
Kálmán Imre, Claudia Sala, Adriana Morar, Mirela Imre, Cătălin Ciontu, Ion Chisăliță, Andreea Dudu, Marius Matei, Gheorghe Dărăbuș
Domestic and wild pigs, as intermediate hosts, can harbor tissue cysts of three Sarcocystis species namely S. miescheriana, S. suihominis and S. porcifelis. Out of them, S. suihominis is zoonotic. Romania is a country with high consumption of raw and/or undercooked traditional pork products. This fact may greatly favor the acquiring of the zoonotic Sarcocystis infections by humans, as definitive host. Based on this consideration and in order to investigate the occurrence and public health significance of Sarcocystis spp...
December 29, 2016: Acta Tropica
https://www.readbyqxmd.com/read/28041711/bifurcation-lesions-involved-in-the-recanalization-process-of-coronary-chronic-total-occlusions-incidence-treatment-and-clinical-implications
#10
Soledad Ojeda, Manuel Pan, Alejandro Gutiérrez, Miguel Romero, Jorge Chavarría, Javier Suárez de Lezo, Francisco Mazuelos, Laura Pardo, Francisco Hidalgo, Francisco Carrasco, José Segura, Enrique Durán, Carlos Ferreiro, José J Sánchez, Sara Rodríguez, Jesús Oneto, Jose Suárez de Lezo
BACKGROUND: The presence of a bifurcation (BL) in the context of a coronary chronic total occlusion (CTO) represents an additional difficulty. This study analyzes the incidence of BLs in CTO recanalization, the treatment, predictors of bifurcation technical success and their clinical impact. METHODS AND RESULTS: BLs with a side branch (SB) ≥2.0mm located proximally, distally or within the occluded segment were observed in 130 (33%) of 391 CTO. Provisional stenting was the strategy more frequently used (94%)...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28038815/circadian-variation-in-acute-myocardial-infarct-size-assessed-by-cardiovascular-magnetic-resonance-in-reperfused-stemi-patients
#11
Heerajnarain Bulluck, Jennifer Nicholas, Gabriele Crimi, Steven K White, Andrew J Ludman, Silvia Pica, Claudia Raineri, Hector A Cabrera-Fuentes, Derek Yellon, Jose Rodriguez-Palomares, David Garcia-Dorado, Derek J Hausenloy
OBJECTIVE: Clinical studies using serum cardiac biomarkers to investigate a circadian variation in acute myocardial infarct (MI) size in ST-segment elevation myocardial infarction (STEMI) patients reperfused by primary percutaneous coronary intervention (PPCI) have produced mixed results. We aimed to investigate this phenomenon using acute MI size measured by cardiovascular magnetic resonance (CMR). METHODS: Patient-level data was obtained from 4 randomized controlled trials investigating the MI-limiting effects of cardioprotective therapies in this pooled analysis...
December 19, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#12
Xiao-Hui Chen, Hui-Lin Jiang, Yun-Mei Li, Cangel Pui Yee Chan, Jun-Rong Mo, Chao-Wei Tian, Pei-Yi Lin, Colin A Graham, Timothy H Rainer
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28032482/population-pharmacokinetics-of-edoxaban-in-japanese-atrial-fibrillation-patients-with-severe-renal-impairment
#13
Takako Shimizu, Masaya Tachibana, Tetsuya Kimura, Tomohiko Kumakura, Kazutaka Yoshihara
This is a population pharmacokinetic (PopPK) analysis to predict PK of edoxaban, a direct-acting oral anticoagulant, in nonvalvular atrial fibrillation (NVAF) patients with severe renal impairment (SRI; creatinine clearance [CLcr ] <30 mL/min). Data from a phase 3 study recently conducted in Japanese NVAF patients (n = 90), including patients with SRI, were used to update the ENGAGE PopPK model that had been developed based on pooled data from the phase 3 ENGAGE AF-TIMI 48 study and 13 phase 1 PK studies, which included few patients with SRI...
December 29, 2016: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28029531/a-novel-risk-model-including-vascular-access-site-for-predicting-30-day-mortality-after-primary-pci-the-alpha-score
#14
Istvan Hizoh, Zalan Gulyas, Dominika Domokos, Gyongyver Banhegyi, Zsuzsanna Majoros, Laszlo Major, Timea Ratkai, Robert Gabor Kiss
BACKGROUND: The mortality benefit of transradial primary PCI has been shown by several studies. Previous risk models have not considered access site as a candidate predictor and many of them were developed using low risk populations of randomized trials. We conducted a prospective cohort study to construct and validate an admission risk model including access site as candidate variable for predicting 30-day mortality after primary PCI. METHODS: We analyzed data of 1255 patients using variables readily available at presentation...
October 14, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28004268/dietary-intake-and-major-food-sources-of-polyphenols-in-people-with-type-2-diabetes-the-tosca-it-study
#15
M Vitale, M Masulli, A A Rivellese, E Bonora, F Cappellini, A Nicolucci, S Squatrito, D Antenucci, A Barrea, C Bianchi, F Bianchini, L Fontana, P Fornengo, F Giorgino, A Gnasso, E Mannucci, A Mazzotti, R Nappo, A P Palena, P Pata, G Perriello, S Potenziani, R Radin, L Ricci, F Romeo, C Santini, M Scarponi, R Serra, A Timi, A A Turco, M Vedovato, D Zavaroni, S Grioni, G Riccardi, O Vaccaro
PURPOSE: Proper evaluation of polyphenols intake at the population level is a necessary step in order to establish possible associations with health outcomes. Available data are limited, and so far no study has been performed in people with diabetes. The aim of this work was to document the intake of polyphenols and their major food sources in a cohort of people with type 2 diabetes and in socio-demographic subgroups. METHODS: We studied 2573 men and women aged 50-75 years...
December 21, 2016: European Journal of Nutrition
https://www.readbyqxmd.com/read/27988513/relationship-between-serum-inflammatory-biomarkers-and-thrombus-characteristics-in-patients-with-st-segment-elevation-myocardial-infarction
#16
Giampaolo Niccoli, Alberto Menozzi, Davide Capodanno, Carlo Trani, Vasile Sirbu, Massimo Fineschi, Chiara Zara, Filippo Crea, Daniela Trabattoni, Francesco Saia, Elena Ladich, Giuseppe Biondi Zoccai, Guilherme Attizzani, Giulio Guagliumi
OBJECTIVES: To compare angiographic and optical coherence tomography (OCT) data pertinent to thrombi, along with the histologic characteristics of aspirated thrombi in patients presenting with ST elevation myocardial infarction (STEMI) with or without inflammation, as assessed by C-reactive protein (CRP) and myeloperoxidase (MPO). METHODS: In the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angioplasty) study, 140 patients with STEMI referred for primary percutaneous intervention were enrolled...
December 17, 2016: Cardiology
https://www.readbyqxmd.com/read/27982267/in-lab-upfront-use-of-tirofiban-may-reduce-the-occurrence-of-no-reflow-during-primary-percutaneous-coronary-intervention-a-pilot-randomized-study
#17
Igor Matos Lago, Gustavo Caires Novaes, André Vannucchi Badran, Rafael Brolio Pavão, Ricardo Barbosa, Geraldo Luiz de Figueiredo, Moysés de Oliveira Lima, Jorge Luiz Haddad, André Schmidt, José Antônio Marin
Background: Despite successful opening of culprit coronary artery, myocardial reperfusion does not always follows primary percutaneous coronary intervention (PPCI). Glycoprotein IIb/IIIa inhibitors are used in the treatment of no-reflow (NR), but their role to prevent it is unproven. Objective: To evaluate the effect of in-lab administration of tirofiban on the incidence of NR in ST-elevation myocardial infarction (STEMI) treated with PPCI. Methods: STEMI patients treated with PPCI were randomized (24 tirofiban and 34 placebo) in this double-blinded study to assess the impact of intravenous tirofiban on the incidence of NR after PPCI according to angiographic and electrocardiographic methods...
November 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27981367/-cardiac-causes-of-chest-pain
#18
C Wächter, B Markus, B Schieffer
Because of the life-threatening character and a high prevalence in emergency rooms, cardiac causes are important differential diagnoses of acute chest pain with the need for rapid clarification. In this context the working diagnosis "acute coronary syndrome" (ACS) plays a major role. In a synopsis of the clinical presentation, medical history, electrocardiogram and analysis of cardiac biomarkers, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris can be specified as entities of ACS...
December 15, 2016: Der Internist
https://www.readbyqxmd.com/read/27972096/ticagrelor-treatment-for-prevention-of-cardiovascular-events-in-high-risk-post-myocardial-infarction-patients-cost-effectiveness-analysis-using-evidence-from-the-pegasus-timi-54-trial
#19
P Moore, A Briggs, A Davies, M Sculpher, K Kun, E A Magnuson, D J Cohen, C Mellstrom
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27959713/prevention-of-bleeding-in-patients-with-atrial-fibrillation-undergoing-pci
#20
RANDOMIZED CONTROLLED TRIAL
C Michael Gibson, Roxana Mehran, Christoph Bode, Jonathan Halperin, Freek W Verheugt, Peter Wildgoose, Mary Birmingham, Juliana Ianus, Paul Burton, Martin van Eickels, Serge Korjian, Yazan Daaboul, Gregory Y H Lip, Marc Cohen, Steen Husted, Eric D Peterson, Keith A Fox
Background In patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) with placement of stents, standard anticoagulation with a vitamin K antagonist plus dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor and aspirin reduces the risk of thrombosis and stroke but increases the risk of bleeding. The effectiveness and safety of anticoagulation with rivaroxaban plus either one or two antiplatelet agents are uncertain. Methods We randomly assigned 2124 participants with nonvalvular atrial fibrillation who had undergone PCI with stenting to receive, in a 1:1:1 ratio, low-dose rivaroxaban (15 mg once daily) plus a P2Y12 inhibitor for 12 months (group 1), very-low-dose rivaroxaban (2...
22, 2016: New England Journal of Medicine
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