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https://www.readbyqxmd.com/read/29329798/efficacy-of-warfarin-anticoagulation-and-incident-dementia-in-a-community-based-cohort-of-atrial-fibrillation
#1
Malini Madhavan, Tiffany Y Hu, Bernard J Gersh, Veronique L Roger, Jill Killian, Susan A Weston, Jonathan Graff-Radford, Samuel J Asirvatham, Alanna M Chamberlain
OBJECTIVE: To study the association between time in therapeutic range (TTR) during warfarin therapy and risk of dementia in a population-based cohort of incident atrial fibrillation (AF). PATIENTS AND METHODS: We conducted an observational population-based study of 2800 nondemented patients with incident AF from January 1, 2000, through December 31, 2010. The association of incident dementia with warfarin therapy and TTR was examined using Cox proportional hazards regression models...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#2
REVIEW
R Jay Widmer, Peter M Pollak, Malcolm R Bell, Bernard J Gersh, Nandan S Anavekar
Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#3
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
Aims: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. Methods and results: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
January 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#4
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29250279/baseline-demographics-safety-and-patient-acceptance-of-an-insertable-cardiac-monitor-for-atrial-fibrillation-screening-the-reveal-af-study
#5
Sergio Conti, James A Reiffel, Bernard J Gersh, Peter R Kowey, Rolf Wachter, Jonathan L Halperin, Rachelle E Kaplon, Erika Pouliot, Atul Verma
Given the high prevalence and risk of stroke associated with atrial fibrillation (AF), detection strategies have important public health implications. The ongoing prospective, single-arm, open-label, multicenter REVEAL AF trial is evaluating the incidence of previously undetected AF using an insertable cardiac monitor (ICM) in patients without prior AF or device implantation, but who could be at risk for AF due to their demographic characteristics, +/- non-specific but compatible symptoms. Enrollment required an elevated AF risk profile defined as CHADS2≥3 or CHADS2=2 plus one or more of the following: coronary artery disease, renal impairment, sleep apnea or chronic obstructive pulmonary disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29223431/international-trends-in-clinical-characteristics-and-oral-anticoagulation-treatment-for-patients-with-atrial-fibrillation-results-from-the-garfield-af-orbit-af-i-and-orbit-af-ii-registries
#6
MULTICENTER STUDY
Benjamin A Steinberg, Haiyan Gao, Peter Shrader, Karen Pieper, Laine Thomas, A John Camm, Michael D Ezekowitz, Gregg C Fonarow, Bernard J Gersh, Samuel Goldhaber, Sylvia Haas, Werner Hacke, Peter R Kowey, Jack Ansell, Kenneth W Mahaffey, Gerald Naccarelli, James A Reiffel, Alexander Turpie, Freek Verheugt, Jonathan P Piccini, Ajay Kakkar, Eric D Peterson, Keith A A Fox
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment. METHODS: Demographics, comorbidities, and stroke risk of the patients in the GARFIELD-AF (n=51,270), ORBIT-AF I (n=10,132), and ORBIT-AF II (n=11,602) registries were compared (overall N=73,004 from 35 countries). Stroke prevention therapies were assessed among patients with new-onset AF (≤6 weeks). RESULTS: Patients from GARFIELD-AF were less likely to be white (63% vs 89% for ORBIT-AF I and 86% for ORBIT-AF II) or have coronary artery disease (19% vs 36% and 27%), but had similar stroke risk (85% CHA2DS2-VASc ≥2 vs 91% and 85%) and lower bleeding risk (11% with HAS-BLED ≥3 vs 24% and 15%)...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29221502/impact-of-cardiorespiratory-fitness-on-frequency-of-atrial-fibrillation-stroke-and-all-cause-mortality
#7
Nasir Hussain, Bernard J Gersh, Karina Gonzalez Carta, Nóra Sydó, Francisco Lopez-Jimenez, Stephen L Kopecky, Randal J Thomas, Samuel J Asirvatham, Thomas G Allison
Benefits of cardiorespiratory fitness on cardiovascular health are well recognized, but the impact on incidence of atrial fibrillation (AF) and stroke, and, particularly, risk of stroke and mortality in patients with AF is less clear. From 1993 to 2010, patients referred for a treadmill exercise test (TMET) at the Mayo Clinic Rochester, MN, were retrospectively identified (N = 76,857). From this, 14,094 local residents were selected. Exclusions were age <18 years; history of heart failure, structural or valvular heart disease, AF or flutter, or stroke...
January 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29169468/renal-outcomes-in-anticoagulated-patients-with-atrial-fibrillation
#8
Xiaoxi Yao, Navdeep Tangri, Bernard J Gersh, Lindsey R Sangaralingham, Nilay D Shah, Karl A Nath, Peter A Noseworthy
BACKGROUND: Lifelong oral anticoagulation, either with warfarin or a non-vitamin K antagonist oral anticoagulant (NOAC), is indicated for stroke prevention in most patients with atrial fibrillation (AF). Emerging evidence suggests that NOACs may be associated with better renal outcomes than warfarin. OBJECTIVES: This study aimed to compare 4 oral anticoagulant agents (apixaban, dabigatran, rivaroxaban, and warfarin) for their effects on 4 renal outcomes: ≥30% decline in estimated glomerular filtration rate (eGFR), doubling of the serum creatinine level, acute kidney injury (AKI), and kidney failure...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29141842/treatment-of-atrial-fibrillation-and-concordance-with-the-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guidelines-findings-from-orbit-af-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation
#9
Adam S Barnett, Sunghee Kim, Gregg C Fonarow, Laine E Thomas, James A Reiffel, Larry A Allen, James V Freeman, Gerald Naccarelli, Kenneth W Mahaffey, Alan S Go, Peter R Kowey, Jack E Ansell, Bernard J Gersh, Elaine M Hylek, Eric D Peterson, Jonathan P Piccini
BACKGROUND: It is unclear how frequently patients with atrial fibrillation receive guideline-concordant (GC) care and whether guideline concordance is associated with improved outcomes. METHODS AND RESULTS: Using data from ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), we determined how frequently patients received care that was concordant with 11 recommendations from the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation guidelines pertaining to antithrombotic therapy, rate control, and antiarrhythmic medications...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29128866/association-of-atrial-fibrillation-clinical-phenotypes-with-treatment-patterns-and-outcomes-a-multicenter-registry-study
#10
Taku Inohara, Peter Shrader, Karen Pieper, Rosalia G Blanco, Laine Thomas, Daniel E Singer, James V Freeman, Larry A Allen, Gregg C Fonarow, Bernard Gersh, Michael D Ezekowitz, Peter R Kowey, James A Reiffel, Gerald V Naccarelli, Paul S Chan, Benjamin A Steinberg, Eric D Peterson, Jonathan P Piccini
Importance: Atrial fibrillation (AF) is usually classified on the basis of the disease subtype. However, this characterization does not capture the full heterogeneity of AF, and a data-driven cluster analysis reveals different possible classifications of patients. Objective: To characterize patients with AF based on a cluster analysis and to evaluate the association between these phenotypes, treatment, and clinical outcomes. Design, Setting, and Participants: This cluster analysis used data from an observational cohort that included 9749 patients with AF who had been admitted to 174 US sites participating in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry...
November 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29122636/clinical-outcomes-and-history-of-fall-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-insights-from-the-aristotle-trial
#11
Meena P Rao, Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Dan Atar, Elaine M Hylek, Michael Hanna, Lars Wallentin, Renato D Lopes, Bernard J Gersh, Christopher B Granger
PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population. METHODS: Of the 18,201 patients in ARISTOTLE, 16,491 had information about history of falling - 753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29089455/echocardiographic-risk-factors-for-stroke-and-outcomes-in-patients-with-atrial-fibrillation-anticoagulated-with-apixaban-or-warfarin
#12
Dragos Vinereanu, Renato D Lopes, Hillary Mulder, Bernard J Gersh, Michael Hanna, Pedro G M de Barros E Silva, Dan Atar, Lars Wallentin, Christopher B Granger, John H Alexander
BACKGROUND AND PURPOSE: Few data exist on the long-term outcomes of patients with spontaneous echo contrast (SEC), left atrial/left atrial appendage (LA/LAA) thrombus, and complex aortic plaque (CAP), in patients with atrial fibrillation receiving oral anticoagulation. We explored the relationship between these 3 echocardiographic findings and clinical outcomes, and the comparative efficacy and safety of apixaban and warfarin for each finding. METHODS: Patients from the ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) with SEC, LA/LAA thrombus, or CAP diagnosed by either transthoracic or transesophageal echocardiography were compared with patients with none of these findings on transesophageal echocardiography...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29044400/erratum
#13
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
No abstract text is available yet for this article.
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29030143/impact-of-atrial-fibrillation-on-outcomes-with-motor-vehicle-accidents
#14
Kanishk Agnihotri, N V Pothineni, Paris Charilaou, Vaibhav R Vaidya, Badal Thakkar, Vishal Goyal, Sabeeda Kadavath, Nileshkumar Patel, Apurva Badheka, Peter Noseworthy, Suraj Kapa, Paul Friedman, Bernard Gersh, Hakan Paydak, Abhishek Deshmukh
BACKGROUND: We examined the effect of AF a commonly encountered arrhythmia with significant morbidity on mortality following a motor vehicle accident (MVA) related hospitalization. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify patients with AF (ICD-9 CM 427.31) and MVA (ICD-9 CM E810.0-E819.9), considered separately and together, from 2003 through 2012. Baseline characteristics were identified and multilevel mixed model multivariate analysis was employed to verify the impact of AF on in-patient mortality in survivors...
October 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29028610/systematic-review-and-meta-analysis-of-dropout-rates-in-individual-psychotherapy-for-generalized-anxiety-disorder
#15
REVIEW
Elon Gersh, David J Hallford, Simon M Rice, Nikolaos Kazantzis, Hannah Gersh, Benji Gersh, Carolyn A McCarty
BACKGROUND: Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates. METHODS: A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD...
October 6, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/29020402/women-with-hypertrophic-cardiomyopathy-have-worse-survival
#16
Jeffrey B Geske, Kevin C Ong, Konstantinos C Siontis, Virginia B Hebl, Michael J Ackerman, David O Hodge, Virginia M Miller, Rick A Nishimura, Jae K Oh, Hartzell V Schaff, Bernard J Gersh, Steve R Ommen
Aims: Sex differences in hypertrophic cardiomyopathy (HCM) remain unclear. We sought to characterize sex differences in a large HCM referral centre population. Methods and results: Three thousand six hundred and seventy-three adult patients with HCM underwent evaluation between January 1975 and September 2012 with 1661 (45.2%) female. Kaplan-Meier survival curves were assessed via log-rank test. Cox proportional hazard regression analyses evaluated the relation of sex with survival...
September 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29020347/transcatheter-aortic-valve-implantation-in-lower-risk-patients-what-is-the-perspective
#17
Giuseppe Tarantini, Luca Nai Fovino, Bernard J Gersh
In the last decade, transcatheter aortic valve implantation (TAVI), a disruptive technology, has revolutionized the therapy of symptomatic severe aortic stenosis, and current guidelines state that the recommendations for TAVI and surgical aortic valve replacement (SAVR) are equivalent in patients at high-risk. Increased operator experience, technical advances in the new generation of transcatheter heart valves (THV) and excellent TAVI results in recently published randomized controlled trials have led to the expansion of TAVI indication as an alternative to SAVR in intermediate-risk subjects, given appropriate patient selection...
August 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28985078/kinetics-of-supersaturated-solution-with-restricted-size-of-precipitates-in-the-presence-of-dimer-adsorption-emission-and-monomer-monomer-agglomeration
#18
Gersh O Berim, Lana I Brim, Eli Ruckenstein
Kinetics of supersaturated solutions with restricted size of precipitating particles is considered using the microscopic theory which includes monomer-monomer agglomeration (MMA) and dimer adsorption/emission (DAE). It is shown that the system passes, during its evolution from initial to final state, through four consecutive stages. In stage I and stage III, the scaled size distribution of particles changes quickly with increasing time while in stage II and stage IV it is almost independent of time. It is argued that during stage II the system, at any rates of MMA and DAE, is in a regime similar to the asymptotic regime provided by the classical Lifshitz-Slyouzov-Wagner (LSW) theory where no restrictions on the size of the particles are imposed and MMA and DAE are not considered...
October 20, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28938965/impact-of-atrial-fibrillation-on-outcomes-of-patients-treated-by-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#19
REVIEW
Marco Mojoli, Bernard J Gersh, Alberto Barioli, Giulia Masiero, Paola Tellaroli, Gianpiero D'Amico, Giuseppe Tarantini
BACKGROUND: Conflicting data have been reported related to the impact of atrial fibrillation (AF) on the outcomes after transcatheter aortic valve implantation (TAVI). We aimed to assess the prognosis of TAVI-treated patients according to the presence of pre-existing or new-onset AF. METHODS: Studies published between April 2002 and November 2016 and reporting outcomes of pre-existing AF, new-onset AF, or sinus rhythm in patients undergoing TAVI were identified with an electronic search...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28927171/evolving-quality-standards-for-large-scale-registries-the-garfield-af-experience
#20
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
Aims: Registries have the potential to capture treatment practices and outcomes in populations beyond the constraints of clinical trial settings. The value of data obtained depend critically upon robust quality standards (including source data verification [SDV] and training); features that are commonly absent from registries. This article outlines the quality standards developed for Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Methods and Results: GARFIELD-AF comprises ∼57 000 patients prospectively recruited over 6...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
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