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Jooyeon Lee, Joe Hong, Norma Dunn, Richard Gersh, Ronnie Swift
No abstract text is available yet for this article.
March 16, 2018: Journal of Clinical Psychopharmacology
Claire E Raphael, Mandeep Singh, Malcolm Bell, Daniel Crusan, Ryan J Lennon, Amir Lerman, Abhiram Prasad, Charanjit S Rihal, Bernard J Gersh, Rajiv Gulati
BACKGROUND: Women have higher rates of all-cause mortality after percutaneous coronary intervention. Whether this is because of greater age and comorbidity burden or a sex-specific factor remains unclear. METHODS AND RESULTS: We retrospectively assessed cause-specific long-term mortality after index percutaneous coronary intervention over 3 time periods (1991-1997, 1998-2005, and 2006-2012). Cause of death was determined using telephone interviews, medical records, and death certificates...
March 2018: Circulation. Cardiovascular Interventions
Subir Bhatia, Shilpkumar Arora, Sravya M Bhatia, Mohammed Al-Hijji, Yogesh N V Reddy, Parshva Patel, Charanjit S Rihal, Bernard J Gersh, Abhishek Deshmukh
BACKGROUND: Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS: Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD...
March 10, 2018: Journal of the American Heart Association
Benjamin A Steinberg, Peter Shrader, Karen Pieper, Laine Thomas, Larry A Allen, Jack Ansell, Paul S Chan, Michael D Ezekowitz, Gregg C Fonarow, James V Freeman, Bernard J Gersh, Peter R Kowey, Kenneth W Mahaffey, Gerald V Naccarelli, James A Reiffel, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for stroke prevention in atrial fibrillation (AF) but require lower doses in certain patients. We sought to describe the frequency, appropriateness (according to Food and Drug Administration labeling), and outcomes of patients prescribed reduced doses of NOACs in community practice. METHODS AND RESULTS: We analyzed data from the ORBIT-AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II) registry, a prospective, national, observational registry of AF patients...
February 16, 2018: Journal of the American Heart Association
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
Ioanna Kosmidou, Shmuel Chen, A Pieter Kappetein, Patrick W Serruys, Bernard J Gersh, John D Puskas, David E Kandzari, David P Taggart, Marie-Claude Morice, Paweł E Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Joseph F Sabik, Thomas McAndrew, Björn Redfors, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). OBJECTIVES: This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes. METHODS: In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG...
February 20, 2018: Journal of the American College of Cardiology
Fatma Gomaa, Maxim Gersh, Colleen Cavanaugh
Diverse species of Legionella and Legionella-like amoebal pathogens (LLAPs) have been identified as intracellular bacteria in many amoeboid protists. There are, however, other amoeboid groups such as testate amoeba for which we know little about their potential to host such bacteria. In this study we assessed the occurrence and diversity of Legionella spp. in cultures and environmental isolates of freshwater arcellinid testate amoebae species, Arcella hemispherica, Arcella intermedia, and Arcella vulgaris, via 16S rRNA gene sequence analyses and fluorescent in situ hybridization (FISH)...
February 14, 2018: Journal of Eukaryotic Microbiology
Richard Gersh
No abstract text is available yet for this article.
February 8, 2018: Human Reproduction
Dragos Vinereanu, Alice Wang, Hillary Mulder, Renato D Lopes, Petr Jansky, Basil S Lewis, Bernard J Gersh, Alvaro Avezum, Michael Hanna, Claes Held, Lars Wallentin, Christopher B Granger, John H Alexander
OBJECTIVE: To assess stroke/systemic embolism, major bleeding and other outcomes, and treatment effect of apixaban versus warfarin, in patients with atrial fibrillation (AF) and different types of valvular heart disease (VHD), using data from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS: There were 14 793 patients with known VHD status, categorised as having moderate or severe mitral regurgitation (MR) (n=3382), aortic regurgitation (AR) (n=842) or aortic stenosis (AS) (n=324); patients with moderate or severe mitral stenosis were excluded from the trial...
January 19, 2018: Heart: Official Journal of the British Cardiac Society
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
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
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
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
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
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% CHA2 DS2 -VASc ≥2 vs 91% and 85%) and lower bleeding risk (11% with HAS-BLED ≥3 vs 24% and 15%)...
December 2017: American Heart Journal
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
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
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
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
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
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