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antiplatelets vs anticoagulation in heart failure

Yan Dai, Jingang Yang, Zhan Gao, Haiyan Xu, Yi Sun, Yuan Wu, Xiaojin Gao, Wei Li, Yang Wang, Runlin Gao, Yuejin Yang
BACKGROUND: The incidence, clinical outcomes and antithrombotic treatment spectrum of atrial fibrillation (AF) in patients hospitalized with acute myocardial infarction (AMI) have not been well studied in Chinese population. METHODS: Twenty-six thousand five hundred ninety-two consecutive patients diagnosed with AMI were enrolled in CAMI registry from January 2013 to September 2014. After excluding 343 patients with uncertain AF status and 1,591 patients transferred out during hospitalization, 24,658 patients were finally included in this study and involved in analysis...
January 4, 2017: BMC Cardiovascular Disorders
Jeffrey J Teuteberg, Mark S Slaughter, Joseph G Rogers, Edwin C McGee, Francis D Pagani, Robert Gordon, Eduardo Rame, Michael Acker, Robert L Kormos, Christopher Salerno, Thomas P Schleeter, Daniel J Goldstein, Julia Shin, Randall C Starling, Thomas Wozniak, Adnan S Malik, Scott Silvestry, Gregory A Ewald, Ulrich P Jorde, Yoshifumi Naka, Emma Birks, Kevin B Najarian, David R Hathaway, Keith D Aaronson
OBJECTIVES: The purpose of this study was to determine the risk factors for ischemic in hemorrhage cerebrovascular events in patients supported by the HeartWare ventricular assist device (HVAD). BACKGROUND: Patients supported with left ventricular assist devices are at risk for both ischemic and hemorrhagic cerebrovascular events. METHODS: Patients undergoing implantation with a HVAD as part of the bridge-to-transplant trial and subsequent continued access protocol were included...
October 2015: JACC. Heart Failure
Jason C Simeone, Cliff Molife, Elizabeth Marrett, Feride Frech-Tamas, Mark B Effron, Beth L Nordstrom, Yajun E Zhu, Stuart Keller, Brian R Murphy, Kavita V Nair, George W Vetrovec, Robert L Page, Patrick L McCollam
OBJECTIVE: Our objective was to compare 1-year real-world healthcare resource utilization (HRU), associated charges, and antiplatelet treatment patterns among patients with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI) and treated with ticagrelor or prasugrel. METHODS: Using the ProMetis-Lx database, adult ACS-PCI patients treated with ticagrelor or prasugrel post-discharge were identified between 1 August 2011 and 31 May 2013 and propensity matched to adjust for baseline differences...
October 2015: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Ya-Guo Zheng, Tao Yang, Chang-Ming Xiong, Jian-Guo He, Zhi-Hong Liu, Qing Gu, Zhi-Hui Zhao, Xin-Hai Ni
BACKGROUND: Previous studies have demonstrated that platelet activation occurs in patients with pulmonary arterial hypertension (PAH). Mean platelet volume (MPV) and platelet distribution width (PDW) are two markers of platelet activation, and have recently been recognised as risk predictors of cardiovascular diseases. This study aimed to investigate whether MPV and PDW would be useful to reflect disease severity and predict prognosis in idiopathic PAH (IPAH). METHODS: MPV and PDW levels were measured in 82 IPAH patients without antiplatelet or anticoagulant treatment on admission and 82 healthy controls...
June 2015: Heart, Lung & Circulation
Sharven Taghavi, Carl Beyer, Halley Vora, Senthil N Jayarajan, Yoshiya Toyoda, Jay Dujon, Lars O Sjoholm, Abhijit Pathak, Thomas A Santora, Amy J Goldberg, Joseph F Rappold
This study examined outcomes in patients with left ventricular assist device (LVAD) and extracorporeal membrane oxygenation (ECMO) requiring noncardiac surgical procedures and identified factors that influence outcomes. All patients with mechanical circulatory support (MCS) devices at our institution from 2002 to 2013 undergoing noncardiac surgical procedures were reviewed. There were 148 patients requiring MCS during the study period, with 40 (27.0%) requiring 62 noncardiac surgical procedures. Of these, 29 (72...
November 2014: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Gregory Y H Lip, Cécile Laroche, Popescu Mircea Ioachim, Lars Hvilsted Rasmussen, Laura Vitali-Serdoz, Lucian Petrescu, Dan Darabantiu, Harry J G M Crijns, Paulus Kirchhof, Panos Vardas, Luigi Tavazzi, Aldo P Maggioni, Giuseppe Boriani
BACKGROUND: The EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot) provides systematic collection of contemporary data regarding the management and treatment of 3119 subjects with AF from 9 member European Society of Cardiology (ESC) countries. In this analysis, we report the development of symptoms, use of antithrombotic therapy and rate vs. rhythm strategies, as well as determinants of mortality and/or stroke/transient ischaemic attack (TIA)/peripheral embolism during 1-year follow-up in this contemporary European registry of AF patients...
December 14, 2014: European Heart Journal
Serik Bekbossynov, Assel Medressova, Muradym Murzagaliyev, Roman Salov, Saltanat Dzhetybayeva, Saltanat Andossova, Makhabbat Bekbossynova, Yuriy Pya
In Kazakhstan, geographical and cultural reasons do not favor the development of heart transplant activity. Thus, a surgical program for treatment of advanced, refractory heart failure was implemented, focusing the efforts on ventricular assist device (VAD) therapy. The program, supported and funded by the national healthcare system, is based on a single, highly specialized surgical Center for the operation, and on a regional infrastructure for outpatient follow-up. Regional VAD coordinators are educated by the National Center...
March 2014: Giornale Italiano di Cardiologia
Lexin Wang, Shane Curran, Patrick Ball, Fiona White
BACKGROUND: Despite the proven effectiveness of antiplatelet and anticoagulation treatment for atrial fibrillation (AF), their use has been suboptimal in practice, particularly in rural areas of Australia. OBJECTIVE: The aim of this study was to describe medication use in the management of AF in elderly hospitalized patients with comorbid congestive heart failure (CHF). METHODS: The hospital records of patients with a diagnosis of AF and CHF were reviewed in a rural Australian medical center...
December 2008: Current Therapeutic Research, Clinical and Experimental
William J French
For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: This review addresses the clinical characteristics of each of these presentations in order...
April 2014: American Journal of Medicine
Narjes Saheb Sharif-Askari, Syed Azhar Syed Sulaiman, Fatemeh Saheb Sharif-Askari, Ali Al Sayed Hussain, Sadeq Tabatabai, Arif Abdullatif Al-Mulla
AIMS: To compare the baseline characteristics, pharmacological treatment, and in-hospital outcomes across hospitalized heart failure (HF) patients with preserved LVEF (HF-PEF) and those with reduced LVEF (HF-REF). METHOD AND RESULTS: This was a prospective analysis of consecutive patients admitted with decompensated HF at two government hospitals in the United Arab Emirates, from 1 December 2011 to 30 November 2012. Multivariate factors of HF-PEF vs. HF-REF included elevated systolic blood pressure [odds ratio (OR) 1...
April 2014: European Journal of Heart Failure
Janusz Bednarski, Ewa Cieszewska, Aleksander Strzelecki, Krzysztof J Filipiak
BACKGROUND AND AIM: Retrospective evaluation of stroke risk in all patients with atrial fibrillation (AF) admitted to cardiology, internal medicine, and neurology wards in a single Polish district hospital in 2006 and 2010 using two risk stratification schemes, CHADS₂ vs. CHA₂DS₂VASc risk scores and identification of independent predictors of guideline-compliant oral anticoagulant (OAC) treatment. METHODS: We analysed case records of 613 patients with AF (including 300 patients in 2006 and 313 patients in 2010) treated in a district hospital - the John Paul II Western Hospital (Szpital Zachodni) in Grodzisk Mazowiecki, to evaluate their stroke risk and therapy prescribed at discharge...
2013: Kardiologia Polska
Soon Yong Suh, Woong Chol Kang, Pyung Chun Oh, Hanul Choi, Chan Il Moon, Kyounghoon Lee, Seung Hwan Han, Taehoon Ahn, In Suck Choi, Eak Kyun Shin
There are limited data on the optimal antithrombotic therapy for patients with atrial fibrillation (AF) who undergoing coronary stenting. We reviewed 203 patients (62.6 % men, mean age 68.3 ± 10.1 years) between 2003 and 2012, and recorded clinical and demographic characteristics of the patients. Clinical follow-up included major adverse cardiac and cerebrovascular events (MACCE) (cardiac death, myocardial infarction, target lesion revascularization, and stroke), stent thrombosis, and bleeding. The most commonly associated comorbidities were hypertension (70...
September 2014: Heart and Vessels
Aaron Yl Liew, John W Eikelboom, Stuart J Connolly, Martin O' Donnell, Robert G Hart
BACKGROUND AND PURPOSE: Heart failure is an independent risk factor for stroke. Anticoagulation is effective for prevention of cardio-embolic stroke secondary to atrial fibrillation or mechanical heart valves but is of uncertain benefit in heart failure patients. We performed this meta-analysis to obtain the best estimates of the efficacy and safety of warfarin as compared with antiplatelet therapy in patients with systolic heart failure who are in sinus rhythm. METHODS AND RESULTS: A systematic search was performed using PubMed and Central Register of Controlled Trials databases for all randomized controlled trials, which compare warfarin with antiplatelet therapy given for at least one-month in heart failure patients with sinus rhythm and report at least one of the following outcomes: ischemic stroke, death, myocardial infarction, hospitalization due to worsening heart failure, intracranial hemorrhage, and major hemorrhage...
February 2014: International Journal of Stroke: Official Journal of the International Stroke Society
Moisés Rodríguez-Mañero, Vicente Bertomeu-González, Alberto Cordero, José Moreno-Arribas, Pilar Mazón, Lorenzo Fácila, Juan Cosín, Enrique Galve, Iñaki Lekuona, José R González-Juanatey, Vicente Bertomeu-Martínez
AIM: We sought to define trends in AF prevalence and its medical management using recent data based on data from two cross-sectional studies performed in a European country in 1999 and 2009. METHODS: CARDIOTENS 1999 and CARDIOTENS 2009 were two observational, cross-sectional, multicenter studies. Patients were recruited in from primary care and cardiology outpatient clinics. A total of 32 051 and 25 137 subjects were analyzed in the two studies, 1540 and 1524 of them, respectively, diagnosed with AF...
February 2013: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Ingrid Hopper, Marina Skiba, Henry Krum
AIM: Heart failure (HF) is a prothrombotic state, but current evidence does not support the routine use of aspirin, antiplatelet agents, or anticoagulation in these patients in sinus rhythm (SR). We conducted an updated meta-analysis comparing these medications on outcomes in HF. METHODS AND RESULTS: All randomized trials in patients with chronic HF and reduced ejection fraction (HFREF) in sinus rhythm (SR; n >100), in which the effect of aspirin, antiplatelet agents, or anticoagulants was determined, were prospectively evaluated...
January 2013: European Journal of Heart Failure
Ralph F Bosch, Wilhelm Kirch, Juergen-Detlef Theuer, David Pittrow, Annette Kohlhaußen, Stefan N Willich, Hendrik Bonnemeier
BACKGROUND: We aimed to describe the current management of patients with atrial fibrillation (AF) by cardiologists, and to identify predicting factors for a stable disease course. METHODS: 2753 consecutive patients with ECG-confirmed AF in the previous 12 months were documented in a 1-year observational (non-interventional) study from 616 centers. Stable disease was defined as having neither AF related intervention nor change in antiarrhythmic therapy in the previous 12 months...
August 10, 2013: International Journal of Cardiology
Lauren E Odum, Kelly A Cochran, Daniel S Aistrope, Kathleen A Snella
The association of atrial fibrillation and resultant thromboembolic stroke is readily recognized in the published literature. However, the identification and weight of other risk factors that increase stroke risk are varied. To predict which patients are at greatest risk for thromboembolic stroke, numerous risk stratification schemas have been developed to guide thromboprophylactic treatment decisions. The well-known CHADS(2) scoring system incorporates risk factors such as congestive heart failure, hypertension, age 75 years or older, diabetes mellitus, and previous stroke or transient ischemic attack...
March 2012: Pharmacotherapy
William Chan, Andrew E Ajani, David J Clark, Dion Stub, Nick Andrianopoulos, Angela L Brennan, Gishel New, Martin Sebastian, Rozanne Johnston, Antony Walton, Christopher M Reid, Anthony M Dart, Stephen J Duffy et al.
There are few data on the incidence and clinical outcomes of patients with atrial fibrillation (AF) treated in the era of percutaneous coronary intervention (PCI). We analyzed 30-day clinical outcomes in 3,307 consecutive patients with and without AF (sinus rhythm) undergoing PCI from January 2007 through December 2008 enrolled in a multicenter Australian registry. Periprocedural AF was present in 162 patients (4.9%). AF was associated with older age (74.1 ± 8.9 vs 63.9 ± 11.9 years, p <0.001), higher baseline serum creatinine (0...
February 15, 2012: American Journal of Cardiology
(no author information available yet)
BACKGROUND: Determinants of warfarin use and anticoagulation levels in atrial fibrillation (AF) patients have not been clarified thoroughly. METHODS AND RESULTS: A total of 6,324 patients with non-valvular AF and congestive heart failure, hypertension, age, diabetes, prior stroke (CHADS₂) score ≥ 1 were used to investigate determinants of warfarin use, and 6,932 patients with AF receiving warfarin were used to investigate determinants of international normalized ratio (INR) of prothrombin time...
2011: Circulation Journal: Official Journal of the Japanese Circulation Society
Ulrich Tebbe, Sebastian M Schellong, Sylvia Haas, Horst Eberhard Gerlach, Claudia Abletshauser, Christian Sieder, Peter Bramlage, Hanno Riess
BACKGROUND: Despite the elevated risk for developing venous thromboembolic events in patients with heart failure, there are no randomized, double-blind, controlled trial data on the comparison of low-molecular-weight heparin with unfractionated heparin (UFH) in this patient population. METHODS: This was a subgroup analysis of the CERTIFY trial, which included 3,239 nonsurgical, acutely ill medical patients 70 years or older. Patients were randomized to receive 3,000-U anti-Xa certoparin once daily or 5,000-IU UFH 3 times a day...
February 2011: American Heart Journal
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