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https://www.readbyqxmd.com/read/28331926/cessation-of-oral-anticoagulation-is-an-important-risk-factor-for-stroke-and-mortality-in-atrial-fibrillation-patients
#1
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
Oral anticoagulation (OAC) is highly effective preventing stroke and mortality in AF, but withdrawal is common in the elderly, when high bleeding risk and when are difficulties achieving an optimal time in therapeutic range (TTR). We analysed the rate of OAC cessation, predisposing factors to cessation and the relation to clinical outcomes in a large 'real world' cohort of AF patients over a long follow-up period. Consecutive non-valvular AF outpatients clinically stables for six months were recruited. Rates of cardiovascular events, major bleeding and mortality were recorded and related to OAC cessation...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28330631/clinical-features-and-prognosis-in-patients-with-atrial-fibrillation-and-prior-stroke-comparing-the-fushimi-and-darlington-af-registries
#2
Hisashi Ogawa, Keitaro Senoo, Yoshimori An, Alena Shantsila, Eduard Shantsila, Deirdre A Lane, Andreas Wolff, Masaharu Akao, Gregory Y H Lip
BACKGROUND: Ethnic differences in clinical characteristics, stroke risk profiles and outcomes among atrial fibrillation (AF) patients may exist. We therefore compared AF patients with previous stroke from Japan and the United Kingdom (UK). METHODS: We compared clinical characteristics, stroke risk and outcomes among AF patients from the Fushimi AF registry who had experienced a previous stroke (Japan; n=688; 19.7%) and the Darlington AF registry (UK; n=428; 19.0%)...
March 16, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#3
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329215/triple-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-a-viewpoint
#4
Jennifer C V Gwyn, Mark R Thomas, Paulus Kirchhof
Patients undergoing percutaneous coronary intervention (PCI) are treated with dual antiplatelet therapy to reduce the risk of subsequent myocardial infarction (MI) and stent thrombosis. Approximately 5-10% of patients undergoing PCI also have atrial fibrillation (AF). Patients with AF have an additional requirement for anticoagulation, as dual antiplatelet therapy alone is insufficient to adequately reduce the risk of stroke in patients with AF. However, it is now well established that combining anticoagulants with dual antiplatelet therapy also causes a significant increase in the risk of bleeding...
March 13, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28329139/duration-of-device-detected-subclinical-atrial-fibrillation-and-occurrence-of-stroke-in-assert
#5
Isabelle C Van Gelder, Jeff S Healey, Harry J G M Crijns, Jia Wang, Stefan H Hohnloser, Michael R Gold, Alessandro Capucci, Chu-Pak Lau, Carlos A Morillo, Anne H Hobbelt, Michiel Rienstra, Stuart J Connolly
Background: ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis. Methods and results: ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models...
March 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329110/mid-term-outcomes-of-concomitant-surgical-ablation-of-atrial-fibrillation-in-patients-undergoing-cardiac-surgery-for-hypertrophic-cardiomyopathy%C3%A2
#6
Elisabetta Lapenna, Alberto Pozzoli, Michele De Bonis, Giovanni La Canna, Teodora Nisi, Simona Nascimbene, Luca Vicentini, Stefania Di Sanzo, Benedetto Del Forno, Davide Schiavi, Ottavio Alfieri
OBJECTIVES: Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and it is often poorly tolerated because of loss of atrial contraction and reduced filling time with rapid ventricular rates. Restoring sinus rhythm is of great clinical benefit to HCM patients. Very few data exist regarding surgical ablation of concomitant AF in this setting. The aim of this study was to evaluate the mid-term outcome of surgical AF ablation in patients who underwent cardiac surgery due to HCM...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28326589/risk-of-myocardial-infarction-in-patients-with-atrial-fibrillation-using-vitamin-k-antagonists-aspirin-or-direct-acting-oral-anticoagulants
#7
Leo M Stolk, Frank de Vries, Chiel Ebbelaar, Anthonius de Boer, Tom Schalekamp, Patrick Souverein, Arina Ten Cate-Hoek, Andrea M Burden
AIM: Direct-acting oral anticoagulants (DOACs) have become available for the prevention of stroke in patients with atrial fibrillation (AF). Conflicting results have been published on the risk of acute myocardial infarction (AMI) with the use of DOACs in comparison with vitamin K antagonists (VKAs). The objective of the present study was to evaluate the risk of AMI in patients with AF who are exposed to either VKAs, DOACs or low-dose (< 325 mg) aspirin. METHODS: We conducted a population-based cohort study using data from the Clinical Practice Research Datalink (2008-2014)...
March 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28325919/sex-differences-in-the-clinical-features-risk-factors-and-outcomes-of-intracerebral-hemorrhage-a-large-hospital-based-stroke-registry-in-china
#8
Yonghong Xing, Zhongping An, Xianghui Zhang, Ning Yu, Wenjuan Zhao, Xianjia Ning, Jinghua Wang
Intracerebral hemorrhage (ICH) is common in China. However, the sex differences in clinical features, risk factors, and outcomes of ICH remain controversial. Between 2005 and 2014, we recruited patients with primary ICH in Tianjin, China, and evaluated sex differences in clinical features, risk factors, and outcomes at 3, 12, and 36 months after ICH. The 1,325 patients included 897 men (67.7%) and 428 women (32.3%). The mean age at ICH onset was younger among men (59.14 years) than among women (63.12 years, P < 0...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28322038/systematic-review-and-meta-analysis-on-the-impact-of-pre-operative-atrial-fibrillation-on-short-and-long-term-outcomes-after-aortic-valve-replacement
#9
Akshat Saxena, Sohaib A Virk, Sebastian Bowman, Paul G Bannon
BACKGROUND: This systematic review and meta-analysis was performed to evaluate the impact of preoperative atrial fibrillation (preAF) on early and late outcomes after aortic valve replacement (AVR). METHODS: Medline, EMBASE, and CENTRAL were systematically searched for studies that reported AVR outcomes according to the presence or absence of preAF. Data were independently extracted by two investigators; a meta-analysis was conducted according to predefined clinical endpoints...
March 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28322009/prognostic-importance-of-left-ventricular-mechanical-dyssynchrony-in-heart-failure-with-preserved-ejection-fraction
#10
Tor Biering-Sørensen, Sanjiv J Shah, Inder Anand, Nancy Sweitzer, Brian Claggett, Li Liu, Bertram Pitt, Marc A Pfeffer, Scott D Solomon, Amil M Shah
AIMS: Left ventricular mechanical dyssynchrony has been described in heart failure with preserved ejection fraction (HFpEF), but its prognostic significance is not known. METHODS AND RESULTS: Of 3445 patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, dyssynchrony analysis was performed on 424 patients (12%) by multiple speckle tracking echocardiography strain-based criteria. The primary dyssynchrony analysis was the standard deviation of the time to peak longitudinal strain (SD T2P LS)...
March 21, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#11
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28319424/rivaroxaban-in-patients-with-atrial-fibrillation-from-rocket-af-to-everyday-practice
#12
Gonzalo Barón-Esquivias, Francisco Marín, Marcelo Sanmartín
Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28317289/stroke-recurrence-in-patients-with-atrial-fibrillation-concomitant-carotid-artery-stenosis-doubles-the-risk
#13
H Lehtola, K E J Airaksinen, P Hartikainen, J E K Hartikainen, A Palomäki, I Nuotio, A Ylitalo, T Kiviniemi, P Mustonen
BACKGROUND AND PURPOSE: Atrial fibrillation (AF) and significant carotid artery stenosis (CAS) often coexist in patients with acute stroke but whether CAS affects the stroke recurrence rate in anticoagulated AF patients is largely unknown. The effect of concomitant CAS on both short- and long-term prognosis after stroke in patients with AF was evaluated. METHODS: The multicentre, retrospective FibStroke registry included AF patients with an ischaemic stroke or transient ischaemic attack (TIA) during 2003-2012...
March 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28317274/quality-of-warfarin-therapy-and-risk-of-stroke-bleeding-and-mortality-among-patients-with-atrial-fibrillation-results-from-the-nationwide-finwaf-registry
#14
Mika Lehto, Jussi Niiranen, Pasi Korhonen, Juha Mehtälä, Houssem Khanfir, Fabian Hoti, Riitta Lassila, Pekka Raatikainen
PURPOSE: The most important management strategy in atrial fibrillation (AF) patients is preventing stroke with oral anticoagulants. Warfarin is still used as a first-line anticoagulant, although non-vitamin K antagonist oral anticoagulants are currently recommended to manage AF. Using a large, unselected national sample of AF patients, we evaluated the relationships between quality of warfarin therapy and the risks of thromboembolism, bleeding complications, and mortality. METHODS: The nationwide FinWAF study included 54 568 AF patients taking warfarin...
March 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28316004/effect-of-the-fxa-inhibitors-rivaroxaban-and-apixaban-on-platelet-activation-in-patients-with-atrial-fibrillation
#15
B Steppich, F Dobler, L C Brendel, G Hessling, S L Braun, A L Steinsiek, I Deisenhofer, A Hyseni, M Roest, I Ott
Rivaroxaban and Apixaban, increasingly used for stroke prevention in non-valvular atrial fibrillation (AF), might impact platelet reactivity directly or indirectly. By inhibition of Factor Xa (FXa) they preclude not only generation of relevant thrombin amounts but also block signalling of FXa via protease activated receptors. However, weather FXa-inhibition affects platelet haemostasis remains incompletely known. One hundred and twenty-eight patients with AF on chronic anticoagulation with either Rivaroxaban or Apixaban for at least 4 weeks were included in the study...
March 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28314139/patients-experiences-of-atrial-fibrillation-and-non-vitamin-k-antagonist-oral-anticoagulants-noacs-and-their-educational-needs-a-qualitative-study
#16
Danielle E Clarkesmith, Gregory Y H Lip, Deirdre A Lane
PURPOSE: Qualitative research on atrial fibrillation (AF) patient's experiences and perceptions of taking the non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention is limited. This study explores patients' experiences of dabigatran and their recommendations for development of educational materials. PATIENTS AND METHODS: Semi-structured individual interviews with 8 warfarin-naive and 8 warfarin-experienced AF patients, using qualitative deductive thematic analysis...
March 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28302997/platelets-cellular-and-functional-characteristics-in-patients-with-atrial-fibrillation-a-comprehensive-meta-analysis-and-systematic-review
#17
Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Anton Sabashnikov, Aron-Frederik Popov, Seyed Jalil Mirhosseini, Luis Nombela-Franco, Luca Testa, Mohammadreza Lotfaliani, Mohamed Zeriouh, Tong Liu, Hamidreza Dehghan, Senol Yavuz, Michel Pompeu Barros de Oliveira Sá, William L Baker, Jae-Sik Jang, Mengqi Gong, Umberto Benedetto, Pascal M Dohmen, Fabrizio D'Ascenzo, Abhishek J Deshmukh, Giuseppe Biondi-Zoccai, Hugh Calkins, Gregg W Stone, Integrated Meta-Analysis Of Cardiac Surgery And Cardiology-Group Imcsc-Group
BACKGROUND This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of platelet cellular and functional characteristics including platelet count (PC), MPV, platelet distribution width (PDW), platelet factor 4, beta thromboglobulin (BTG), and p-selectin with the occurrence of atrial fibrillation (AF) and consequent stroke. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating platelet characteristics in patients with paroxysmal, persistent and permanent atrial fibrillations...
March 17, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28302547/feasibility-of-using-mobile-ecg-recording-technology-to-detect-atrial-fibrillation-in-low-resource-settings
#18
Grahame F Evans, Arianna Shirk, Peter Muturi, Elsayed Z Soliman
BACKGROUND: Screening for atrial fibrillation (AF), a major risk factor for stroke that is on the rise in Africa, is becoming increasingly critical. OBJECTIVES: This study sought to examine the feasibility of using mobile electrocardiogram (ECG) recording technology to detect AF. METHODS: In this prospective observational study, we used the Kardia Mobile ECG Recorder (AliveCor, Mountain View, California) to screen 50 African adults (66% women; mean age 54...
March 13, 2017: Global Heart
https://www.readbyqxmd.com/read/28302288/valvular-heart-disease-patients-on-edoxaban-or-warfarin-in-the-engage%C3%A2-af-timi-48-trial
#19
Raffaele De Caterina, Giulia Renda, Anthony P Carnicelli, Francesco Nordio, Marco Trevisan, Michele F Mercuri, Christian T Ruff, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) instead of vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and coexisting valvular heart disease (VHD) is of substantial interest. OBJECTIVES: This study explored outcomes in patients with AF with and without VHD in the ENGAGE AF-TIMI 48 (Effective Anticoagulation with factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial, comparing edoxaban with warfarin...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28302287/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-valvular-heart-disease
#20
Giulia Renda, Fabrizio Ricci, Robert P Giugliano, Raffaele De Caterina
BACKGROUND: Valvular heart disease (VHD) and atrial fibrillation (AF) often coexist. Phase III trials comparing non-vitamin K antagonist oral anticoagulants (NOACs) with warfarin excluded patients with moderate/severe mitral stenosis or mechanical heart valves, but variably included patients with other VHD and valve surgeries. OBJECTIVES: This study aimed to determine relative safety and efficacy of NOACs in patients with VHD. METHODS: We performed a meta-analysis of the 4 phase III AF trials of the currently available NOACs versus warfarin in patients with coexisting VHD to assess pooled estimates of relative risk (RR) and 95% confidence intervals (CIs) for stroke/systemic embolic events (SSEE), major bleeding, intracranial hemorrhage (ICH), and all-cause death...
March 21, 2017: Journal of the American College of Cardiology
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