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Hypertension, ACS, Heart Failure, Atrial Fibrillation

Magnus T Jensen, Marta Pereira, Carla Araujo, Anti Malmivaara, Jean Ferrieres, Irene R Degano, Inge Kirchberger, Dimitrios Farmakis, Pascal Garel, Marina Torre, Jaume Marrugat, Ana Azevedo
AIMS: The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain)...
September 30, 2016: European Heart Journal. Acute Cardiovascular Care
Isabella Canavero, Anna Cavallini, Lucia Sacchi, Silvana Quaglini, Natale Arnò, Patrizia Perrone, Maria Luisa DeLodovici, Simona Marcheselli, Giuseppe Micieli
BACKGROUND: It has been widely reported that anticoagulants (ACs) are underused for primary and secondary prevention of ischemic stroke in patients with atrial fibrillation (AFib). Furthermore, precise evidence-based guidelines about the best timing for AC initiation after acute stroke are currently lacking. METHODS AND RESULTS: In this retrospective, observational study, we analyzed prescription trends in AFib patients with acute ischemic stroke who were hospitalized in four neurologic stroke units of our region (Lombardia, Italy)...
September 7, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
B L Loudon, N D Gollop, P R Carter, H Uppal, S Chandran, R Potluri
BACKGROUND: Traditional risk factors for cardiovascular disease (CVD) have been thoroughly investigated. We aimed to investigate the impact of comorbid cardiovascular risk factors and diseases on length of stay (LOS) and mortality in patients presenting with acute coronary syndromes (ACS). METHODS: We examined prevalence of CVD, LOS and mortality from 25,287 consecutive admissions for ACS from seven hospitals across North West England between 2000 and 2013 using the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) protocol using ICD-10 and OPCS-4 coding systems...
October 1, 2016: International Journal of Cardiology
Prashanth Panduranga, Kadhim Sulaiman, Ibrahim Al-Zakwani, Aouf AbdlRahman Alazzawi, Abraham Abraham, Prit Pal Singh, Narayan Anantha Narayan, Mamatha Punjee Rajarao, Mohammed Ahmed Khdir, Mohamad Abdlraheem, Aftab Ahmed Siddiqui, Hisham Soliman, Osama Abdellatif Elkadi, Ruchir Kumar Bichu, Kumayl Hasan Al Lawati
OBJECTIVES: We sought to describe the demographics, clinical characteristics, management and outcomes of patients in Oman with acute heart failure (AHF) as part of the Gulf aCute heArt failuRe rEgistry (CARE) project. METHODS: Data were analyzed from 988 consecutive patients admitted with AHF to 12 hospitals in Oman between 14 February and 14 November 2012. RESULTS: The mean age of our patients was 63±12 years. Over half (57%) were male and 95% were Omani citizens...
May 2016: Oman Medical Journal
Joakim Alfredsson, Karen P Alexander
Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults...
May 2016: Clinics in Geriatric Medicine
Narendra Singh, Milan Gupta
Randomized clinical trials (RCTs) remain the foundation for assessing and introducing evidence-based therapies into cardiovascular (CV) medicine. In 2015, a number of RCTs were reported and published that have great potential to improve CV outcomes and thus to change clinical practice. We highlight the results and implications of major RCTs in the areas of acute coronary syndrome (ACS), interventional cardiology, atrial fibrillation, lipids, heart failure, diabetes, and hypertension. Among the trials we discuss, PEGASUS and DAPT provide guidance regarding the potential benefits and hazards of longer-term dual-antiplatelet therapy after percutaneous coronary intervention (PCI) or myocardial infarction (MI)...
August 2016: Canadian Journal of Cardiology
Stacey Knight, Raymond O McCubrey, Zhong Yuan, Scott C Woller, Benjamin D Horne, T Jared Bunch, Viet T Le, Roger M Mills, Joseph B Muhlestein
OBJECTIVES: Randomized acute coronary syndrome (ACS) trials testing various antithrombotic (AT) regimens have largely excluded patients with coexisting conditions and indications for anticoagulation (AC). The purpose of this study is to examine the 2-year clinical outcomes of patients with ACS with indication for AC due to venous thromboembolism (VTE) during hospitalization for the ACS event or a prior or new diagnosis of atrial fibrillation (AF) with a CHADS2 (Congestive heart failure; Hypertension; Age; Diabetes; previous ischemic Stroke) score ⩾2...
August 2016: Therapeutic Advances in Cardiovascular Disease
Elisa Danese, Giuseppe Lippi, Martina Montagnana
BACKGROUND: The red blood cell distribution width (RDW) is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). Emerging evidence suggests that, besides RBC abnormalities, many human disorders may be frequently associated with a high degree of anisocytosis. METHODS: In this narrative review, we analyzed the current scientific literature about the putative role and the potential epidemiologic association between RDW and cardiovascular diseases...
October 2015: Journal of Thoracic Disease
Miroslav Pernický, Juraj Papinčák, Adriana Reptová, Soňa Kiňová, Ján Murín
UNLABELLED: The case study describes a case of 49-year-old man with morbid obesity since childhood (BMI 40 kg/m2), arterial hypertension (approx. since aged 15, treated since 2004), dyslipidemia (since 2006), type 2 diabetes mellitus (since 2006, on insulin therapy since 2008) and smoking (until 2011, 20 cigarettes a day). TREATMENT: 16 types of medication, 8 for hypertension, statin, therapy for diabetes, aspirin, allopurinol. In 2010 (when aged 45) hospitalized in our clinic with dyspnoea and chest pain with a high pressure reading of 180/110 mm Hg (identified symptoms of heart failure with LV ejection fraction of 33 %, in NYHA II functional class, echocardiographically: left atrium: 46 mm, left ventricular chamber size in diastole: 70 mm, interventricular septum: 12 mm, septal hypokinesis, Doppler ultrasonography of lower limb arteries (calcification, diffuse atherosclerotic changes, absent stenosis), CT coronary angiography (significant stenosis of the left coronary artery)...
May 2015: Vnitr̆ní Lékar̆ství
Òscar Miró, Alfons Aguirre, Pablo Herrero, Javier Jacob, Francisco Javier Martín-Sánchez, Pere Llorens
OBJECTIVE: To evaluate the precipitating factors (PF) associated with acute heart failure and their association with medium-term prognosis. PATIENTS AND METHODS: Multipurpose prospective study from the EAHFE Registry. We included as PF: infection, rapid atrial fibrillation (RAF), anaemia, hypertensive crisis, non-adherence to diet or drug therapy and non-ST-segment-elevation acute coronary syndrome (NSTEACS). Patients without PF were control group. Hazard ratios (HR) crudes and adjusted for reconsultations and mortality at 90 days were calculated...
November 6, 2015: Medicina Clínica
Peter McKavanagh, Claire McCune, Ian B Menown
INTRODUCTION: Over the last year, multiple, potentially practice-changing, cardiology trials or studies have been published or presented at international meetings including the American College of Cardiology, European Association for Percutaneous Cardiovascular Interventions, European Society of Cardiology, Transcatheter Cardiovascular Therapeutics, Heart Failure Congress, Heart Rhythm Society, Heart Failure Society of America, American Society of Hypertension and the American Heart Association...
June 2015: Cardiology and Therapy
Clare L Atzema, Saba Khan, Hong Lu, Yvon E Allard, Storm J Russell, Mario R Gravelle, Julie Klein-Geltink, Peter C Austin
BACKGROUND: The burden of cardiovascular disease in the Métis, Canada's fastest growing Aboriginal group, is not well studied. We determined rates of five cardiovascular diseases and associated outcomes in Ontario Métis, compared to the general Ontario population. METHODS: Métis persons were identified using the Métis Nation of Ontario Citizenship Registry. Métis citizens aged 20-105 were linked to Ontario health databases for the period of April 2006 to March 2011...
2015: PloS One
Rosa Parisi, Martin K Rutter, Mark Lunt, Helen S Young, Deborah P M Symmons, Christopher E M Griffiths, Darren M Ashcroft
The association between psoriasis and risk of major cardiovascular (CV) events (myocardial infarction, acute coronary syndrome, unstable angina, and stroke) is unclear. A cohort study with 48,523 patients with psoriasis and 208,187 controls was conducted. During a median follow-up of 5.2 years, 1,257 patients with psoriasis (2.59%) had a major CV event, compared with 4,784 controls (2.30%). In the multivariable analysis, inflammatory arthritis hazard ratio (HR) 1.36 (1.18-1.58), diabetes HR 1.18 (1.06-1.31), chronic kidney disease HR 1...
September 2015: Journal of Investigative Dermatology
Philippe Le Corvoisier, Sylvie Bastuji-Garin, Bertrand Renaud, Isabelle Mahé, Jean-François Bergmann, Herve Perchet, Elena Paillaud, Dominique Mottier, Olivier Montagne
BACKGROUND: Among patients admitted for acute decompensated heart failure (ADHF), half are aged 75 years or over. The high prevalence of co-morbidities and functional impairments in this age group may affect patient outcomes. OBJECTIVE: To assess the association between co-morbidities, functional status and in-hospital mortality in patients with ADHF aged ≥75 years. DESIGN: A prospective, multicentre cohort study. SETTING: Five French hospitals...
March 2015: Age and Ageing
Andrew H McNeice, Neil M McAleavey, Ian B A Menown
Multiple, potentially practice-changing cardiology trials have been presented or published over the past year. In this paper, we summarize and place in clinical context, new data regarding management of acute coronary syndrome and ST-elevation myocardial infarction (copeptin assessment, otamixaban, cangrelor, prasugrel, sodium nitrite, inclacumab, ranolazine, preventive coronary intervention of non-culprit lesions, immediate thrombolytic therapy versus transfer for primary intervention), new coronary intervention data (thrombectomy, radial access, pressure wire fractional flow reserve, antiplatelet therapy duration and gene-guidance, permanent and biodegradable polymers, coronary bifurcation and strategies), and coronary artery bypass data (off pump vs...
August 2014: Advances in Therapy
Emily M Hawes, Anthony J Viera
The risks of bleeding and thrombosis should be considered in decisions on whether to initiate anticoagulation therapy. Oral anticoagulation is indicated for patients with nonvalvular atrial fibrillation who are at intermediate or high risk of stroke (CHADS2 [Congestive heart failure, Hypertension, Age at least 75 years, Diabetes, previous Stroke or transient ischemic attack] score of 1 or higher). Apixaban, dabigatran, rivaroxaban, or warfarin can be considered for the prevention of stroke and systemic embolism in these patients...
July 2014: FP Essentials
Emily M Hawes, Anthony J Viera
Anticoagulation is an important component of the management strategy for several common medical conditions. It is indicated for the prevention of recurrent thrombosis in patients with venous thromboembolism (VTE), which includes deep venous thrombosis and pulmonary embolism, and ischemic stroke. Many surgical procedures also put patients at increased risk of VTE. Patients undergoing major orthopedic surgery should receive short-term anticoagulation. The Caprini Risk Assessment Model score can be used to estimate VTE risk and guide anticoagulation therapy recommendations for most nonorthopedic surgical patients...
July 2014: FP Essentials
Carlos Galvão Braga, Vítor Ramos, Catarina Vieira, Juliana Martins, Sílvia Ribeiro, António Gaspar, Alberto Salgado, Pedro Azevedo, Miguel Alvares Pereira, Sónia Magalhães, Adelino Correia
INTRODUCTION: New-onset atrial fibrillation (AF) frequently complicates myocardial infarction, with an incidence of 6-21%. OBJECTIVE: To assess the predictors and prognosis of new-onset AF during acute coronary syndromes (ACS). METHODS: We performed a retrospective observational cohort study including 902 consecutive patients (mean age 64 years, 77.5% male) admitted to a single center over a two-year period, with a six-month follow-up. RESULTS: AF rhythm was identified in 13...
May 2014: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Larry M Flores-Solís, Juan L Hernández-Domínguez
BACKGROUND: Elevations of cardiac troponin I (cTnI) not associated with acute coronary syndrome (ACS) have been reported in patients with chronic kidney disease (CKD) stage 5 or end-stage renal disease (ESRD). The aim of this study was to determine the prevalence of elevated cTnI in patients with CKD stage 3 to 5 in conditions other than ACS. METHODS: The study population consisted of 426 patients with CKD stage 3 to 5 (estimated glomerular filtration rate < 60 mL/minute/1...
2014: Clinical Laboratory
Manuel Almendro-Delia, María José Valle-Caballero, Juan C Garcia-Rubira, Blanca Muñoz-Calero, Angel Garcia-Alcantara, Antonio Reina-Toral, José Benítez-Parejo, Rafael Hidalgo-Urbano
AIMS: The prognostic ability of atrial fibrillation (AF) in acute coronary syndromes (ACS) is unclear. Studies regarding patient outcomes with respect to the timing of AF are scarce and conflicting. The present study aimed to determine the frequency, predictors and impact on clinical outcome of AF in patients with ACS. METHODS: We analysed 39,237 consecutive patients with ACS included in the ARIAM registry between January /2001 and December 2011. Patients with AF were compared with patients in sinus rhythm...
June 2014: European Heart Journal. Acute Cardiovascular Care
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