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https://www.readbyqxmd.com/read/29754652/risk-of-cardiovascular-events-and-incident-atrial-fibrillation-in-patients-without-prior-atrial-fibrillation-implications-for-expanding-the-indications-for-anticoagulation
#1
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, Nilay D Shah, Peter A Noseworthy
BACKGROUND: There is growing interest in the role for non-vitamin K antagonist oral anticoagulants (NOACs) in patients without atrial fibrillation (AF). We aimed to provide a comprehensive assessment of the risks of ischemic stroke, myocardial infarction (MI), AF, and major bleeding in patients without previously diagnosed AF. METHODS: Using a large US administrative database, we identified 6,495,875 patients ≥50 years between January 1, 2011, and September 30, 2016, who were not diagnosed with AF and were not treated with oral anticoagulants or nonaspirin antiplatelet agents...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29724356/coronary-artery-disease-in-patients-%C3%A2-80-years-of-age
#2
REVIEW
Mahesh V Madhavan, Bernard J Gersh, Karen P Alexander, Christopher B Granger, Gregg W Stone
Coronary artery disease (CAD) is a major cause of morbidity and mortality in patients ≥80 years of age. Nonetheless, older patients have typically been under-represented in cardiovascular clinical trials. Understanding the pathophysiology, epidemiology, and optimal means of diagnosis and treatment of CAD in older adults is crucial to improving outcomes in this high-risk population. A patient-centered approach, taking into account health status, functional ability and frailty, cognitive skills, and patient preferences is essential when caring for older adults with CAD...
May 8, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29678813/prognostic-significance-of-nuisance-bleeding-in-anticoagulated-patients-with-atrial-fibrillation
#3
Emily C O'Brien, DaJuanicia N Holmes, Laine E Thomas, Gregg C Fonarow, Larry A Allen, Bernard J Gersh, Peter R Kowey, Daniel E Singer, Michael D Ezekowitz, Gerald V Naccarelli, Jack E Ansell, Paul S Chan, Kenneth W Mahaffey, Alan S Go, James V Freeman, James A Reiffel, Eric D Peterson, Jonathan P Piccini, Elaine M Hylek
Background -Bleeding is commonly cited as a reason for stopping oral anticoagulants (OAC). Whether minor bleeding events ("nuisance bleeding", NB) in patients with atrial fibrillation (AF) on OAC are associated with OAC discontinuation, major bleeding and stroke/systemic embolism (SSE), is unknown. Methods -Within the ORBIT-AF prospective, outpatient registry, we identified 6771 patients ≥18 years of age at 172 sites with AF and eligible followup visits. NB was ascertained from the medical record and was defined as minor bleeding that did not require medical attention (e...
April 20, 2018: Circulation
https://www.readbyqxmd.com/read/29669787/rediscovering-the-orbit-of-pci-after-orbita
#4
Deepak L Bhatt, Bernard J Gersh, Ph Gabriel Steg, Robert A Harrington, Stephan Windecker
The publication of the Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) trial generated an immense amount of discussion, debate, and controversy.1 The editorialists posed in their title whether the ORBITA trial is the "Last nail in the coffin for PCI in stable angina?"2 The ensuing press coverage has been extensive, though mostly one-sided and largely following the negative tone set by the editorial. The exchange on social media has been at times vitriolic, both pro and con - the number of Tweets of the article (1716 as of February 25, 2018) now exceeds the number of patients enrolled by over seven-fold...
April 18, 2018: Circulation
https://www.readbyqxmd.com/read/29666071/b-type-natriuretic-peptide-assessment-in-patients-undergoing-revascularization-for-left-main-coronary-artery-disease-analysis-from-the-excel-trial
#5
Björn Redfors, Shmuel Chen, Aaron Crowley, Ori Ben-Yehuda, Bernard J Gersh, Nicholas J Lembo, W Morris Brown, Adrian P Banning, David P Taggart, Patrick W Serruys, Arie Pieter Kappetein, Joseph F Sabik, Gregg W Stone
Background -Elevated B-type natriuretic peptide (BNP) is reflective of impaired cardiac function and is associated with worse prognosis among patients with coronary artery disease (CAD). We sought to assess the association between baseline BNP, adverse outcomes, and the relative efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with left main (LM) CAD. Methods -The EXCEL trial randomized patients with LMCAD and low or intermediate SYNTAX scores to PCI with everolimus-eluting stents versus CABG...
April 17, 2018: Circulation
https://www.readbyqxmd.com/read/29655825/hypertrophic-cardiomyopathy-clinical-update
#6
REVIEW
Jeffrey B Geske, Steve R Ommen, Bernard J Gersh
Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy, manifesting as left ventricular hypertrophy in the absence of a secondary cause. The genetic underpinnings of HCM arise largely from mutations of sarcomeric proteins; however, the specific underlying mutation often remains undetermined. Patient presentation is phenotypically diverse, ranging from asymptomatic to heart failure or sudden cardiac death. Left ventricular hypertrophy and abnormal ventricular configuration result in dynamic left ventricular outflow obstruction in most patients...
May 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29609898/real-time-pathophysiologic-correlates-of-left-atrial-appendage-thrombus-in-patients-who-underwent-transesophageal-guided-electrical-cardioversion-for-atrial-fibrillation
#7
Rowlens M Melduni, Bernard J Gersh, Waldemar E Wysokinski, Naser M Ammash, Paul A Friedman, David O Hodge, Krishnaswamy Chandrasekaran, Jae K Oh, Hon-Chi Lee
Although current guidelines advocate using the CHA2 DS2 -VASc score to assess the risk of stroke in patients with atrial fibrillation (AF), compared with transesophageal echocardiography (TEE), its ability to predict left atrial appendage thrombus (LAAT) is limited. We studied 3,324 consecutive patients with sustained AF from our prospective registry of patients who underwent first-time TEE-guided electrical cardioversion (ECV) from May 2000 through March 2012. The association of CHA2 DS2 -VASc score or TEE risk factors with the occurrence of LAAT was analyzed...
March 13, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29553994/the-risks-of-using-herbal-supplements-for-sexual-dysfunction-associated-with-psychotropic-medications-a-case-report-of-extenze-use-and-priapism
#8
Jooyeon Lee, Joe Hong, Norma Dunn, Richard Gersh, Ronnie Swift
No abstract text is available yet for this article.
June 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29540493/sex-differences-in-long-term-cause-specific-mortality-after-percutaneous-coronary-intervention-temporal-trends-and-mechanisms
#9
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
https://www.readbyqxmd.com/read/29525779/non-st-segment-elevation-myocardial-infarction-among-patients-with-chronic-kidney-disease-a-propensity-score-matched-comparison-of-percutaneous-coronary-intervention-versus-conservative-management
#10
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
https://www.readbyqxmd.com/read/29453305/frequency-and-outcomes-of-reduced-dose-non-vitamin-k-antagonist-anticoagulants-results-from-orbit-af-ii-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii
#11
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
https://www.readbyqxmd.com/read/29450741/utility-of-cardiac-computed-tomography-scanning-in-the-diagnosis-and-pre-operative-evaluation-of-patients-with-infective-endocarditis
#12
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
https://www.readbyqxmd.com/read/29447735/new-onset-atrial-fibrillation-after-pci-or-cabg-for-left-main-disease-the-excel-trial
#13
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
https://www.readbyqxmd.com/read/29443446/diverse-legionella-like-bacteria-associated-with-testate-amoebae-of-the-genus-arcella-arcellinida-amoebozoa
#14
Fatma Gomaa, Maxim Gersh, Colleen M 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
https://www.readbyqxmd.com/read/29432528/reply-false-positive-blood-hcg-test-following-corifollitropin-alfa-injection
#15
Richard Gersh
No abstract text is available yet for this article.
May 1, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29352007/outcomes-in-anticoagulated-patients-with-atrial-fibrillation-and-with-mitral-or-aortic-valve-disease
#16
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
https://www.readbyqxmd.com/read/29329798/efficacy-of-warfarin-anticoagulation-and-incident-dementia-in-a-community-based-cohort-of-atrial-fibrillation
#17
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...
February 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
#18
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...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#19
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
#20
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
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