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https://www.readbyqxmd.com/read/29329826/gender-differences-in-presentation-treatment-and-in-hospital-outcome-of-patients-admitted-with-heart-failure-complicated-by-atrial-fibrillation-from-the-get-with-the-guidelines-heart-failure-gwtg-hf-registry
#1
Mitra Daneshvar, Nayan Desai, John Andriulli, Matthew Ortman, Eben Eno, Krystal Hunter, Andrea M Russo
Almost 25% of patients with heart failure (HF) have coexisting atrial fibrillation (AF), the latter of which may increase morbidity and mortality. Despite the high prevalence of HF with concomitant AF, this subgroup of patients remains understudied. This study examines gender differences in presentation, treatment and in-hospital outcome of patients with HF and AF. The Get With the Guidelines-Heart Failure (GWTG-HF) database enrolled 6,496 patients with HF who presented to Cooper University Hospital from 2005 to 2012...
January 9, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29321704/efficacy-and-safety-of-warfarin-experience-in-a-stroke-polyclinic-in-stroke-patients
#2
Eda Çoban, Dursun Kirbaş, Dilek Atakli, Aysun Soysal
Introduction: Cardioembolic stroke is associated with high morbidity and mortality, with an increased risk of recurrent stroke. Oral anticoagulation is highly effective in reducing the risk of stroke and mortality compared with placebo. Our study aimed to highlight the safety and efficacy of warfarin by analyzing the 20-year follow-up of patients on warfarin therapy. Methods: A retrospective observational study was performed with ischemic stroke patients receiving warfarin at our stroke polyclinic between 1992 and 2012...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#3
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29306591/the-frequency-and-risk-factors-for-ischemic-stroke-in-myotonic-dystrophy-type-1-patients
#4
Kosuke Yoshida, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Takashi Kimura
INTRODUCTION: Patients with myotonic dystrophy type 1 have several cardiac abnormalities, especially myocardial conduction disorders. Few studies have investigated cerebral infarction. We investigated the frequency of both symptomatic and asymptomatic ischemic strokes in patients with myotonic dystrophy type 1. METHODS: Patients who were diagnosed with myotonic dystrophy type 1 using genetic testing or clinical examinations at Asahikawa Medical Center were included...
January 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29301756/outcomes-of-patients-with-atrial-fibrillation-newly-recommended-for-oral-anticoagulation-under-the-2014-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guideline
#5
Matthew P Gray, Samir Saba, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: In March 2014, the American Heart Association updated their guidelines for the management of oral anticoagulation (OAC) in atrial fibrillation, recommending OAC for all patients with CHA2DS2-VASc ≥2. Previously, only patients with CHADS2 ≥2 were recommended for anticoagulation. This study compared effectiveness and safety outcomes of OAC among patients who would receive OAC using the 2014 guidelines but not the 2011 guidelines. METHODS AND RESULTS: Using claims data from a 5% sample of 2013-2014 Medicare beneficiaries, we identified patients with initially diagnosed atrial fibrillation between 2013 and 2014 and selected those who would receive OAC under the 2014 guidelines but not the 2011 guidelines (those with CHA2DS2-VASc score ≥2 or CHADS2 score <2)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29288496/cha2-ds2-vasc-scores-for-outcomes-prediction-in-acute-ischemic-stroke
#6
Chun-Hung Su, Teng-Fu Tsao, An-Chih Chen, Kai-Wei Chang, Yi-Sun Yang, Kwo-Chang Ueng, Chin-Feng Tsai
BACKGROUND: The CHADS2 and CHA2 DS2 -VASc scores are clinical risk stratification instruments that are used clinically to assess the risk of stroke in patients with atrial fibrillation (AF). The aim of this study was to evaluate whether the pre-stroke CHADS2 and CHA2 DS2 -VASc scores could be useful for predicting infarction severity and long-term outcomes in patients of acute ischemic stroke. MATERIALS AND METHODS: This prospective study included all 1494 patients who had acute ischemic stroke without hemorrhagic transformation which were evidenced with magnetic resonance (MR) imaging during hospitalization...
December 29, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29273767/the-rs2108622-polymorphism-is-related-to-the-early-risk-of-ischemic-stroke-in-non-valvular-atrial-fibrillation-subjects-under-oral-anticoagulation
#7
L Colàs-Campàs, J L Royo, M V Montserrat, C Marzo, J Molina-Seguín, I Benabdelhak, S Cambray, F Purroy
Oral anticoagulant treatments, such as vitamin K antagonists (VKAs), are the main treatments administered to atrial fibrillation (AF) patients in order to prevent ischemic stroke (IS). However, the genes involved in the VKA metabolism can undergo variations in a single nucleotide (SNP). These SNPs may then affect the VKA target enzyme (VKORC1), VKA degradation enzyme (CYP2C9), and vitamin K bioavailability enzyme (CYP4F2). We genotyped these SNPs in a cohort of patients with non-valvular AF who were under VKA treatment after suffering an IS...
December 22, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/29250279/baseline-demographics-safety-and-patient-acceptance-of-an-insertable-cardiac-monitor-for-atrial-fibrillation-screening-the-reveal-af-study
#8
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
https://www.readbyqxmd.com/read/29246672/recurrent-stroke-and-bleeding-events-after-acute-cardioembolic-stroke-analysis-using-japanese-healthcare-database-from-acute-care-institutions
#9
Masahiro Yasaka, Yukihiro Koretsune, Takeshi Yamashita, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: To understand the reality of patients who experienced a cardioembolic stroke (CES) is important because of the high incidence of recurrent stroke and the need to account for bleeding risk in relation to the need for anticoagulation treatment. We elucidated the current real-world medical care in patients who had a CES and identified the risk factors for recurrent stroke. METHODS AND RESULTS: The study comprised 9804 patients who were diagnosed with CES between April 2008 and September 2013 as identified in a healthcare database used by acute-care institutions in Japan...
December 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29233496/identifying-warfarin-control-with-stroke-and-bleed-risk-scores
#10
Nijole Bernaitis, Chi Keong Ching, Tony Badrick, Shailendra Anoopkumar-Dukie
Warfarin decreases stroke risk in atrial fibrillation patients, with efficacy and safety impacted by the quality of warfarin control, as measured by time in therapeutic range (TTR). Stroke and bleed risk scores are calculated prior to commencing warfarin, so it would be beneficial if these scores also identified likely warfarin control. Some studies have investigated CHADS2, CHA2DS2VASc, and HASBLED individually for this purpose, but application of all scores to diverse ethnic populations and at sites with differing overall control has not been investigated...
November 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29223441/edoxaban-for-the-management-of-elderly-japanese-patients-with-atrial-fibrillation-ineligible-for-standard-oral-anticoagulant-therapies-rationale-and-design-of-the-eldercare-af-study
#11
RANDOMIZED CONTROLLED TRIAL
Ken Okumura, Gregory Y H Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita
Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29202886/rhythm-and-rate-control-of-atrial-fibrillation-in-the-emergency-department-a-large-community-based-observational-study
#12
Cameron J Gilbert, Paul Angaran, Zana Mariano, Theresa Aves, Paul Dorian
OBJECTIVE: Atrial fibrillation (AF) is the most common arrhythmia presentation to the emergency department (ED) and frequently results in admission to the hospital. Although rarely life-threatening and not usually an emergent condition, AF places a large burden on our health-care system. The objective of this study was to describe the practices of ED physicians in the management of AF in a large urban Canadian city. METHODS: From January 1, 2010 to December 31, 2010, patients with a primary diagnosis of AF were identified across 10 EDs in Toronto, Canada (N=2,609)...
December 5, 2017: CJEM
https://www.readbyqxmd.com/read/29185829/a-multi-hospital-analysis-of-predictors-of-oral-anticoagulation-prescriptions-for-patients-with-actionable-atrial-fibrillation-who-attend-the-emergency-department
#13
Joel A Scott-Herridge, Colette M Seifer, Ron Steigerwald, Glen Drobot, William F McIntyre
Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increase in the risk of ischemic stroke. The risk of stroke can be significantly decreased by oral anticoagulation (OAC). Our objective was to characterize the filling of OAC prescriptions for patients with actionable AF (new or existing AF with an indication for OAC but not prescribed) and determine the prevalence and predictors of guideline-appropriate therapy at 30 days. This is a multi-hospital, retrospective cohort study of patients who visited the Emergency Department (ED) and had a discharge diagnosis of AF...
November 29, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29177015/clinical-significance-of-atrial-high-rate-episodes-for-thromboembolic-events-in-japanese-population
#14
Hiroshi Kawakami, Takayuki Nagai, Makoto Saito, Shinji Inaba, Fumiyasu Seike, Kazuhisa Nishimura, Katsuji Inoue, Takafumi Okura, Takumi Sumimoto, Shigeki Uemura, Jitsuo Higaki, Shuntaro Ikeda
Objective: The clinical significance of atrial high-rate episodes (AHREs) detected by cardiac devices among patients with implantable pacemakers has recently emerged. However, the relationship between AHREs and ischaemic stroke and systemic embolism (SE) is not well understood in the Japanese population. Methods: This study included 343 patients with pacemakers capable of continuous atrial rhythm monitoring (167 males; mean age, 80±7 years). Atrial tachyarrhythmia detection was programmed to the nominal setting of each device, and AHRE was defined as any episode of sustained atrial tachyarrhythmia lasting for more than 6 min...
2017: Heart Asia
https://www.readbyqxmd.com/read/29174184/competitive-interaction-between-chronic-obstructive-pulmonary-disease-and-cha2ds2-vasc-score-in-predicting-incident-atrial-fibrillation
#15
Maria Perticone, Angela Sciacqua, Giovanni Tripepi, Sofia Miceli, Salvatore Corrao, Giorgio Sesti, Francesco Perticone
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. METHODS: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (>2 vs <2) and presence/absence of COPD...
November 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29160390/left-atrial-appendage-closure-with-amplatzer-cardiac-plug-in-nonvalvular-atrial-fibrillation-safety-and-long-term-outcome
#16
Marcio José Montenegro da Costa, Esmeralci Ferreira, Edgard Freitas Quintella, Bernardo Amorim, Alexandre Fuchs, Ricardo Zajdenverg, Hugo Sabino, Denilson Campos de Albuquerque
BACKGROUND: Atrial fibrillation (AF) is a cardiac arrhythmia with high risk for thromboembolic events, specially stroke. OBJECTIVE: To assess the safety of left atrial appendage closure (LAAC) with the Amplatzer Cardiac Plug for the prevention of thromboembolic events in patients with nonvalvular AF. METHODS: This study included 15 patients with nonvalvular AF referred for LAAC, 6 older than 75 years (mean age, 69.4 ± 9.3 years; 60% of the male sex)...
November 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29151509/in-paroxysmal-atrial-fibrillation-patients-the-neutrophil-to-lymphocyte-ratio-is-related-to-thrombogenesis-and-more-closely-associated-with-left-atrial-appendage-contraction-than-with-the-left-atrial-body-function
#17
Yukihiro Fukuda, Mitsunori Okamoto, Shunsuke Tomomori, Hiroya Matsumura, Takehito Tokuyama, Yukiko Nakano, Yasuki Kihara
Objective The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that can be used to detect atrial inflammatory changes, which may contribute to a reduced left atrial (LA) function and thrombosis. Our study aimed to determine whether or not the association of NLR with the LA appendage (LAA) function in relation to thrombogenesis differs from the association with the LA body function in paroxysmal atrial fibrillation (PAF) patients. Methods A total of 183 PAF patients were studied. The LA volume index, mitral flow velocity (A), and mitral annular motion velocity (A') were examined using transthoracic echocardiography...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29151480/the-refinement-of-risk-stratification-for-atrial-thrombus-or-spontaneous-echo-contrast-in-nonvalvular-atrial-fibrillation
#18
Wenna Ning, Yang Li, Chunyan Ma, Liangxian Qiu, Bo Yu
As for nonvalvular atrial fibrillation (NVAF) patients with left atrial thrombus or spontaneous echo contrast (LAT/SEC), we evaluated the additional predictive value of serum uric acid (SUA) and Left atrial diameter (LAD) for CHADS2 and CHA2DS2-VASc, and explored the influence from the level of SUA and LAD to LAT/SEC in moderate risk group. Thus, we put forward the concept of a borderline high risk group to guide clinical anticoagulant therapy in patients with NVAF.A total of 284 NVAF patients without the history of anticoagulant prior to hospitalization were enrolled...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29148592/oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#19
Kathrin Jobski, Falk Hoffmann, Stefan Herget-Rosenthal, Michael Dörks
AIMS: Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA. METHODS: Using claims data (2010-2014), we studied a cohort of new nursing home residents aged ≥ 65 years receiving OAC...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29122724/detection-of-new-atrial-fibrillation-in-patients-with-cardiac-implanted-electronic-devices-and-factors-associated-with-transition-to-higher-device-detected-atrial-fibrillation-burden
#20
Giuseppe Boriani, Taya V Glotzer, Paul D Ziegler, Mirko De Melis, Lorenza Mangoni di S Stefano, Milan Sepsi, Maurizio Landolina, Maurizio Lunati, Thorsten Lewalter, A John Camm
BACKGROUND: In patients with cardiac implanted electronic devices (CIEDs) detection of new atrial fibrillation (AF) is associated with an increased risk of stroke. OBJECTIVE: To characterize daily AF burden at first detection and the rate of temporal transition to higher device detected AF burden. METHODS: A pooled analysis of data from three prospective studies was analyzed and 6580 patients (mean age 68±12 years, 72% male) with no history of AF and no anticoagulants at baseline were identified...
November 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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