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Stroke, myocardial infarction

Hyunwook Kwon, Hong-Kyu Kim, Sun U Kwon, Seung-Whan Lee, Min-Ju Kim, Jee Won Park, Minsu Noh, Youngjin Han, Tae-Won Kwon, Yong-Pil Cho
This study aimed to test the hypothesis that the risk of major adverse cardiovascular events (MACE) is similar for subjects with asymptomatic mild and moderate carotid artery stenosis (CAS). We enrolled a total of 453 subjects with asymptomatic CAS (30-69%) detected on baseline screening Doppler ultrasound (DUS) examination between January 2008 and December 2010. The follow-up DUS findings and MACE occurrence (fatal or nonfatal myocardial infarction or stroke and all-cause mortality) were compared between subjects with mild (30-49%) and moderate (50-69%) CAS during the 8-year follow-up period...
March 16, 2018: Scientific Reports
Lin Yang, Jianlin Liu, Guangyu Qi, Yanzi Li, Yamin Liu
This study aims to investigate the complication and middle-term outcome of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in Chinese patients, which was a retrospective case-control study and perioperative complications and 2-year end points were analyzed. Follow-up was done by a certified doctor, and restenosis was detected by ultrasound. Operation success rate were 100% in two groups. CAS showed the higher incidence rate of all stroke/TIA at 30days post-procedure (7.89% VS 1.85%, P = 0...
March 16, 2018: Scientific Reports
Marieke A Hillaert, Hester M den Ruijter, Imo E Hoefer, Eef G Lentjes, Gert J de Borst, Jean-Paul P M de Vries, Pieter A Doevendans, Gerard Pasterkamp, Leo Timmers
BACKGROUND: The renin-angiotensin-aldosterone system is increasingly being recognized to play an important role in the development and clinical course of cardiovascular diseases. Renin-angiotensin-aldosterone system activation is associated with clinical outcome in various populations of cardiovascular patients, such as patients with coronary artery, peripheral artery, and cerebrovascular disease. In this study, we investigated the associations between plasma renin and aldosterone concentrations and atherosclerotic plaque characteristics and secondary vascular events in patients undergoing carotid endarterectomy...
March 13, 2018: Journal of Vascular Surgery
Yih-Ru Chen, Fang-I Hsieh, Chi-Ching Chang, Nai-Fang Chi, Hsin-Chiao Wu, Hung-Yi Chiou
There are still debates on the association of increased cardiovascular risk with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA) because of inconsistent results. Therefore, our study aims to evaluate the transient effects of selective and nonselective NSAIDs on the risk of stroke and acute myocardial infarction (AMI) in patients with RA. We conducted a case-crossover study of 5,921 stroke or AMI patients with co-morbidity of RA. All cases were identified from the Taiwan National Health Insurance Database between January 1, 2006, and December 31, 2011, according to the International Classification of Diseases, 9th Revision and Clinical Modification diagnosis codes from inpatient claims...
February 12, 2018: American Journal of Cardiology
Pil Hyung Lee, Jae-Kwan Song, Jong S Kim, Ran Heo, Sahmin Lee, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Sun U Kwon, Dong-Wha Kang, Dongwhane Lee, Hyuk Sung Kwon, Sung-Cheol Yun, Byung Joo Sun, Jae-Hyeong Park, Jae-Hwan Lee, Hye Seon Jeong, Hee-Jung Song, Jei Kim, Seung-Jung Park
BACKGROUND: Recent reports showing the favorable role of patent foramen ovale (PFO) closure in patients with cryptogenic stroke have raised the issue of selecting optimal candidates. OBJECTIVES: We evaluated whether the benefits of PFO closure can be determined based on the morphologic characteristics of the PFO, as evaluated by transesophageal echocardiography. METHODS: Patients with cryptogenic stroke and high-risk PFO were divided between a transcatheter PFO closure and a medication-only group...
February 28, 2018: Journal of the American College of Cardiology
Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-Il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients with acute coronary syndrome. However, available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. We aimed to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population...
March 9, 2018: Lancet
Giuseppe Gargiulo, Greta Carrara, Enrico Frigoli, Pascal Vranckx, Sergio Leonardi, Nestor Ciociano, Gianluca Campo, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Alessandro Iannone, Carlo Briguori, Giuseppe Andò, Gabriele Crimi, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Alessandro Lupi, Bernardo Cortese, Arturo Ausiello, Salvatore Ierna, Giovanni Esposito, Dennis Zavalloni, Andrea Santarelli, Gennaro Sardella, Simone Tresoldi, Nicoletta de Cesare, Alessandro Sciahbasi, Antonio Zingarelli, Paolo Tosi, Arnoud van 't Hof, Elmir Omerovic, Salvatore Brugaletta, Stephan Windecker, Marco Valgimigli
BACKGROUND: Contrasting evidence exists on the comparative efficacy and safety of bivalirudin and unfractionated heparin (UFH) in relation to the planned use of glycoprotein IIb/IIIa inhibitors (GPIs). OBJECTIVES: This study assessed the efficacy and safety of bivalirudin compared with UFH with or without GPIs in patients with acute coronary syndrome (ACS) who underwent invasive management. METHODS: In the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) program, 7,213 patients were randomly assigned to receive either bivalirudin or UFH with or without GPIs at discretion of the operator...
March 20, 2018: Journal of the American College of Cardiology
Narjeet S Khurmi, Yu-Hui Chang, D Eric Steidley, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Amit K Mathur
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of post-liver transplant death, and variable care patterns may affect outcomes. We aimed to describe epidemiology and outcomes of inpatient CVD care across U.S. hospitals. METHODS: Using a merged dataset from the 2002-2011 Nationwide Inpatient Sample and the American Hospital Association Annual Survey, we evaluated liver transplant patients admitted primarily with myocardial infarction (MI), stroke (CVA), congestive heart failure (CHF), dysrhythmias, cardiac arrest (CA), or malignant hypertension...
March 15, 2018: Liver Transplantation
Wuxiang Xie, Fanfan Zheng, Evangelos Evangelou, Ou Liu, Zhenchun Yang, Queenie Chan, Paul Elliott, Yangfeng Wu
OBJECTIVE: To systematically evaluate the efficacy of five commonly used blood pressure-lowering drugs in reducing cardiovascular events among patients with nonacute cardiovascular disease, but without heart failure. METHODS: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials on 18 March 2017. The primary outcome was fatal and nonfatal cardiovascular events, and the secondary outcomes were all-cause death, fatal and nonfatal myocardial infarction, and stroke...
March 14, 2018: Journal of Hypertension
Francesco Caso, Marco Tasso, Pasquale Ambrosino, Matteo Nicola, Dario Di Minno, Roberta Lupoli, Livio Criscuolo, Paolo Caso, Francesco Ursini, Antonio Del Puente, Raffaele Scarpa, Luisa Costa, Rosario Peluso
BACKGROUND: Psoriatic arthritis is a chronic inflammatory arthropathy that affects 14%-30% of patients with skin and/or nail psoriasis and leading to severe physical limitations and disability. It has been included in the group of spondyloarthropathy with which it shares clinical, radiologic, and serologic features in addition to familial and genetic relationship. Beyond skin and joint involvement, psoriatic arthritis is characterized by a high prevalence of extra-articular manifestation and comorbidities, such as autoimmune, infectious and neoplastic diseases...
March 13, 2018: Reviews on Recent Clinical Trials
R Rozemeijer, M Voskuil, J P Greving, M L Bots, P A Doevendans, P R Stella
BACKGROUND: Dual antiplatelet therapy (DAPT) remains the cornerstone therapy in the prevention of ischaemic events following drug-eluting stent (DES) implantation. Mandatory duration of DAPT after DES however, is a matter of debate. We aimed to evaluate safety and efficacy of short-term (up to 6 months) versus long-term (12 months) DAPT after DES implantation. METHODS: We searched PubMed, EMBASE, Cochrane databases, and international meetings for randomised clinical trials (RCTs) comparing short with long DAPT...
March 14, 2018: Netherlands Heart Journal
Erin R Kulick, Gregory A Wellenius, Amelia K Boehme, Ralph L Sacco, Mitchell S Elkind
BACKGROUND AND PURPOSE: The evidence supporting the deleterious cardiovascular health effects of living near a major roadway is growing, although this association is not universal. In primary analyses, we hypothesized that residential proximity to a major roadway would be associated with incident ischemic stroke and that cardiovascular risk factors would modify that association. METHODS: NOMAS (The Northern Manhattan Study) is an ongoing, population-based cohort study designed to measure cardiovascular risk factors, stroke incidence, and other outcomes in a multiethnic urban population...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Francesca Maria Notarangelo, Giuseppe Maglietta, Paola Bevilacqua, Marco Cereda, Piera Angelica Merlini, Giovanni Quinto Villani, Paolo Moruzzi, Giampiero Patrizi, Guidantonio Malagoli Tagliazucchi, Antonio Crocamo, Angela Guidorossi, Filippo Pigazzani, Elisa Nicosia, Giorgia Paoli, Marco Bianchessi, Mario Angelo Comelli, Caterina Caminiti, Diego Ardissino
BACKGROUND: Clopidogrel is still frequently used in patients with acute coronary syndromes (ACS), but its efficacy is hampered by interpatient response variability, due to genetic polymorphisms associated with clopidogrel metabolism. OBJECTIVE: To evaluate whether selecting antiplatelet therapy (clopidogrel, prasugrel or ticagrelor) on the basis of a patient's genetic and clinical characteristics leads to better clinical outcomes in comparison with the standard of care, which bases the selection on clinical characteristics alone METHODS: Patients hospitalised for ACS were randomly assigned to standard of care or pharmacogenomic arm, which included the genotyping of ABCB1, CYP2C19*2, CYP2C19*17 using an ST Q3 system that provide the data within 70 minutes at each patient's bedside...
February 24, 2018: Journal of the American College of Cardiology
Pascal Desgranges, Hicham Kobeiter, Frederic Cochennec, Vania Tacher, Joseph Touma, Marek Majewski, Jean Marzelle, Éric Allaire, Jean-Pierre Becquemin
Abdominal aortic aneurysms (AAA), also called "silent killer" as they grow without symptoms until the final rupture, are the 3rd cause of cardiovascular deaths, after myocardial infarction and stroke. Surgery is the only efficient way of preventing aortic rupture. The initial technique, described by Charles Dubost in 1952 has evolved and results and provides fair long-term results: open repair (OR) is performed under general anesthesia, via a transperitoneal or a retroperitoneal approach. Laparoscopic repair aims to reduce the consequences of surgery, but its role is still debated due to limited experience and to variable results...
March 11, 2018: La Presse Médicale
Julio Rosenstock, Vlado Perkovic, John H Alexander, Mark E Cooper, Nikolaus Marx, Michael J Pencina, Robert D Toto, Christoph Wanner, Bernard Zinman, David Baanstra, Egon Pfarr, Michaela Mattheus, Uli C Broedl, Hans-Juergen Woerle, Jyothis T George, Maximilian von Eynatten, Darren K McGuire
BACKGROUND: Cardiovascular (CV) outcome trials in type 2 diabetes (T2D) have underrepresented patients with chronic kidney disease (CKD), leading to uncertainty regarding their kidney efficacy and safety. The CARMELINA® trial aims to evaluate the effects of linagliptin, a DPP-4 inhibitor, on both CV and kidney outcomes in a study population enriched for cardio-renal risk. METHODS: CARMELINA® is a randomized, double-blind, placebo-controlled clinical trial conducted in 27 countries in T2D patients at high risk of CV and/or kidney events...
March 14, 2018: Cardiovascular Diabetology
Young Hee Nam, Colleen M Brensinger, Warren B Bilker, Charles E Leonard, Scott E Kasner, Tilo Grosser, Xuanwen Li, Sean Hennessy
OBJECTIVE: To examine the comparative safety of individual NSAIDs when given concomitantly with clopidogrel. METHODS: We conducted a retrospective cohort study using Medicaid claims from five US states during 1999-2010, supplemented with Medicare claims for dual-enrollees. The exposure of interest was the first concomitant use of clopidogrel and one of the 10 selected NSAIDs after a 1-year baseline period. The outcomes were: all-cause mortality; acute myocardial infarction (AMI)/ischemic stroke; and gastrointestinal bleeding (GIB)/intracranial hemorrhage (ICH)...
2018: PloS One
Fenglong Xie, Lisandro D Colantonio, Jeffrey R Curtis, Meredith L Kilgore, Emily B Levitan, Keri L Monda, Monika M Safford, Ben Taylor, Mark Woodward, Paul Muntner
BACKGROUND: Cause of death is often not available in administrative claims data. OBJECTIVE: To develop claims-based algorithms to identify deaths due to fatal cardiovascular disease (CVD; ie, fatal coronary heart disease [CHD] or stroke), CHD, and stroke. METHODS: Reasons for Geographic and Racial Differences in Stroke (REGARDS) study data were linked with Medicare claims to develop the algorithms. Events adjudicated by REGARDS study investigators were used as the gold standard...
March 14, 2018: Pharmacoepidemiology and Drug Safety
Valerio De Stefano, Alessandra Carobbio, Vincenzo Di Lazzaro, Paola Guglielmelli, Alessandra Iurlo, Maria Chiara Finazzi, Elisa Rumi, Francisco Cervantes, Elena Maria Elli, Maria Luigia Randi, Martin Griesshammer, Francesca Palandri, Massimiliano Bonifacio, Juan-Carlos Hernandez-Boluda, Rossella Cacciola, Palova Miroslava, Giuseppe Carli, Eloise Beggiato, Martin H Ellis, Caterina Musolino, Gianluca Gaidano, Davide Rapezzi, Alessia Tieghi, Francesca Lunghi, Giuseppe Gaetano Loscocco, Daniele Cattaneo, Agostino Cortelezzi, Silvia Betti, Elena Rossi, Guido Finazzi, Bruno Censori, Mario Cazzola, Marta Bellini, Eduardo Arellano-Rodrigo, Irene Bertozzi, Parvis Sadjadian, Nicola Vianelli, Luigi Scaffidi, Montse Gomez, Emma Cacciola, Alessandro M Vannucchi, Tiziano Barbui
We analyzed 597 patients with myeloproliferative neoplasms (MPN) who presented transient ischemic attacks (TIA, n = 270) or ischemic stroke (IS, n = 327). Treatment included aspirin, oral anticoagulants, and cytoreductive drugs. The composite incidence of recurrent TIA and IS, acute myocardial infarction (AMI), and cardiovascular (CV) death was 4.21 and 19.2%, respectively at one and five years after the index event, an estimate unexpectedly lower than reported in the general population. Patients tended to replicate the first clinical manifestation (hazard ratio, HR: 2...
February 28, 2018: Blood Cancer Journal
Dennis T Ko, Harlan M Krumholz, Jack V Tu, Peter C Austin, Therese A Stukel, Maria Koh, Alice Chong, Jose Francisco de Melo, Cynthia A Jackevicius
BACKGROUND: Clopidogrel is one of the most commonly prescribed medications because of its ability to improve clinical outcomes for a broad range of cardiovascular conditions. After patent protection expired for Plavix in 2012, many healthcare systems adopted generic clopidogrel as a strategy to reduce healthcare costs. METHODS AND RESULTS: We conducted a population-based observational study to determine whether generic clopidogrel was noninferior to Plavix. Patients who were hospitalized with an acute coronary syndrome (ACS) from 2009 to 2014 in Ontario, Canada, >65 years, survived ≥7 days after discharge, were eligible for inclusion...
March 2018: Circulation. Cardiovascular Quality and Outcomes
Joshua A Beckman, Meredith S Duncan, Charles W Alcorn, Kaku So-Armah, Adeel A Butt, Matthew B Goetz, Hilary A Tindle, Jason Sico, Russel P Tracy, Amy C Justice, Matthew S Freiberg
Background -The effect of HIV on the development of peripheral artery disease (PAD) remains unclear. We investigated whether HIV infection is associated with an increased risk of PAD after adjustment for traditional atherosclerotic risk factors in a large cohort of HIV infected (HIV+) and demographically similar HIV uninfected veterans. Methods -We studied participants in the Veterans Aging Cohort Study from April 1, 2003 through December 31, 2014. We excluded participants with known prior PAD or prevalent cardiovascular disease (myocardial infarction, stroke, coronary heart disease, and congestive heart failure) and analyzed the effect of HIV status on the risk of incident PAD events after adjusting for demographics, PAD risk factors, substance use, CD4 cell count, HIV-1 RNA, and antiretroviral therapy...
March 13, 2018: Circulation
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