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https://www.readbyqxmd.com/read/28717071/anti-mitochondrial-m2-antibodies-enhance-the-risk-of-supraventricular-arrhythmias-in-patients-with-elevated-hepatobiliary-enzyme-levels
#1
Hiroki Konishi, Koji Fukuzawa, Shumpei Mori, Seimi Satomi-Kobayashi, Kunihiko Kiuchi, Atsushi Suzuki, Yoshihiko Yano, Akihiro Yoshida, Ken-Ichi Hirata
Objective Supraventricular arrhythmias are commonly detected in patients with anti-mitochondrial antibody M2 (AMA-M2)-associated myopathy. However, the prevalence of supraventricular arrhythmias in unselected AMA-M2-positive patients and the impact of AMA-M2 on supraventricular arrhythmias have yet to be fully investigated. Methods We analyzed 384 patients (116 men; age, 60 [48-69] years), who underwent AMA-M2 testing following the detection of elevated hepatobiliary enzymes. Supraventricular arrhythmias involving atrial fibrillation, atrial flutter, atrial tachycardia, sick sinus syndrome, and atrial standstill were confirmed by a 12-lead electrocardiogram, 24-hour ambulatory monitoring, and physician-assigned diagnoses within the three years before and two years after the AMA-M2 test...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28700481/a-multiparameter-model-predicting-in-hospital-mortality-in-malignant-cerebral-infarction
#2
Chien-Fu Chen, Ruey-Tay Lin, Hsiu-Fen Lin, A-Ching Chao
The early identification of patients with large hemisphere infarctions (LHIs) at risk of fatal brain edema may result in better outcomes. A quantitative model using parameters obtained at admission may be a predictor of in-hospital mortality from LHI.This prospective study enrolled all patients with LHI involving >50% of the middle cerebral artery (MCA) admitted to our neurological intensive care unit within 48 hours of symptom onset. Early clinical and radiographic parameters and the baseline CHADS2 score (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke [double weight]) were analyzed regarding their ability to predict patient outcomes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28699181/predicting-in-a-predicament-stroke-and-hemorrhage-risk-prediction-in-dialysis-patients-with-atrial-fibrillation
#3
REVIEW
Amber O Molnar, Manish M Sood
Whether to anticoagulate dialysis patients with atrial fibrillation is a common clinical dilemma with limited high-quality data to inform decision-making. While the efficacy and safety of anticoagulation for stroke prevention in dialysis patients with atrial fibrillation has long been debated and remains unclear, the more upstream issue of stroke risk assessment from atrial fibrillation has received relatively little attention. In the general population, a handful of risk scores to help predict stroke and hemorrhage risk in the setting of atrial fibrillation are widely validated and applied in clinical practice...
July 11, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28681678/chads2-risk-score-and-rate-of-stroke-or-systemic-embolism-and-major-bleeding-in-patients-with-non-valvular-atrial-fibrillation-receiving-non-vitamin-k-antagonist-oral-anticoagulants
#4
Walter VAN Mieghem, Patrizio Lancellotti
Randomized trials showed non-inferior or superior results of the non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin in patients with non-valvular atrial fibrillation (AF). Despite the absence of direct head-to-head comparisons between the different NOACs, certain molecules have been proposed for subgroups of patients based mainly on the perception of different bleeding risks. The CHADS2 score has been uniformly used in the inclusion criteria of these studies and shared similar risk factors as the haemorrhagic risk score HAS-BLED...
July 6, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28680116/predictive-value-of-chads2-and-cha2ds2-vasc-scores-for-acute-myocardial-infarction-in-patients-with-atrial-fibrillation
#5
Hui Pang, Bing Han, Qiang Fu, Zhenkun Zong
The presence of acute myocardial infarction (AMI) confers a poor prognosis in atrial fibrillation (AF), associated with increased mortality dramatically. This study aimed to evaluate the predictive value of CHADS2 and CHA2DS2-VASc scores for AMI in patients with AF. This retrospective study enrolled 5140 consecutive nonvalvular AF patients, 300 patients with AMI and 4840 patients without AMI. We identified the optimal cut-off values of the CHADS2 and CHA2DS2-VASc scores each based on receiver operating characteristic curves to predict the risk of AMI...
July 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28645473/efficacy-and-safety-of-rivaroxaban-versus-warfarin-in-patients-taking-nondihydropyridine-calcium-channel-blockers-for-atrial-fibrillation-from-the-rocket-af-trial
#6
Jeffrey B Washam, Anne S Hellkamp, Yuliya Lokhnygina, Jonathan P Piccini, Scott D Berkowitz, Christopher C Nessel, Richard C Becker, Günter Breithardt, Keith A A Fox, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Daniel E Singer, Manesh R Patel
Non-dihydropyridine calcium channel blockers (non-DHP CCBs) possess combined P-glycoprotein and moderate CYP3A4 inhibition, which may lead to increased exposure of medications that are substrates for these metabolic pathways, such as rivaroxaban. We evaluated the use and outcomes of non-DHP CCBs in patients with atrial fibrillation (AF) in Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)...
May 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28634694/clinical-background-including-anticoagulant-therapy-in-patients-with-atrial-fibrillation-in-a-community-based-survey-the-saitama-af-registry
#7
Yasushi Wakabayashi, Yoshitaka Sugawara, Kanna Fujita, Takekuni Hayashi, Nahoko Ikeda, Tomio Umemoto, Hiroshi Wada, Kenichi Sakakura, Hiroshi Funayama, Takeshi Mitsuhashi, Hideo Fujita, Shin-Ichi Momomura
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and carries an increased risk of cardiogenic embolism. Oral anticoagulants (OACs) including warfarin and/or non-vitamin K antagonists can prevent the majority of these events. The Saitama AF Registry was a community-based survey of patients with AF in Saitama City, which represents an urban community in Japan. A total of 75 institutions participated in the registry and attempted to enroll consecutive patients with AF from September 2014 to August 2015...
June 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#8
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28577686/atrial-fibrillation-incrementally-increases-dementia-risk-across-all-chads2-and-cha2ds2vasc-strata-in-patients-receiving-long-term-warfarin
#9
Kevin G Graves, Heidi T May, Victoria Jacobs, Tami L Bair, Scott M Stevens, Scott C Woller, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, J Peter Weiss, T Jared Bunch
BACKGROUND: Patients with atrial fibrillation (AF) are at higher risk for developing dementia. Warfarin is a common therapy for the prevention of thromboembolism in AF, valve replacement, and thrombosis patients. The extent to which AF itself increases dementia risk remains unknown. METHODS: A total 6030 patients with no history of dementia and chronically anticoagulated with warfarin were studied. Warfarin management was provided through a Clinical Pharmacy Anticoagulation Service...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28572399/the-treatment-of-paroxysmal-atrial-fibrillation-in-uk-primary-care
#10
Andrea Isaew, Nicola Jaime Adderley, Ronan Ryan, David Fitzmaurice, Tom Marshall
OBJECTIVE: To determine whether patients with paroxysmal atrial fibrillation (AF) are less likely to be treated with anticoagulants than patients with persistent/permanent AF and to investigate trends in treatment between 2000 and 2015. UK and European guidelines recommend that anticoagulants are offered to all patients with AF at increased risk of stroke, irrespective of AF type. METHODS: Sixteen sequential cross-sectional analyses from 2000 to 2015 were carried out with index dates on 1st of May each year...
June 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28567670/severity-of-hypertension-correlates-with-risk-of-thromboembolic-stroke
#11
Hui Pang, Bing Han, Qiang Fu, Qiumei Cao
Hypertension plays a significant role in the development of atrial fibrillation (AF) and its complications. The coexistence of the two diseases increases the risk of thromboembolism events. Although CHADS2 and CHA2DS2-VASc scores have been used in the evaluation of the thromboembolism events in AF patients, the different levels of the blood pressure are not appropriately recognized. In this study, the 970 AF patients were divided into three groups according to the severity of hypertension. The CHADS2 and CHA2DS2-VASc scores in the patients of grade 3 hypertension were significantly higher than those of the patients with grade 1 and 2 hypertension, respectively (P < 0...
May 31, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#12
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develop atrial fibrillation after cavotricuspid isthmus (CTI) ablation. No uniform recommendations are available to guide anticoagulation regimes or electrocardiogram (ECG) monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland, and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: ablation strategy, oral anticoagulation (OAC) management, and ECG monitoring after successful CTI ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28532651/suboptimal-anticoagulant-management-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-warfarin-for-stroke-prevention
#13
Teruyuki Hirano, Hirokazu Kaneko, Sari Mishina, Feng Wang, Satoshi Morita
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with increasing prevalence in Japan. Although prothrombin time-international normalized ratio (PT-INR) targets for monitoring warfarin therapy in patients with nonvalvular AF (NVAF) are well defined, real-world patient characteristics and PT-INR levels remain unknown among Japanese patients with NVAF who initiate and continue warfarin (warfarin maintainers) versus those who switch from warfarin to direct oral anticoagulants (DOACs; warfarin switchers)...
May 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28529736/use-of-dabigatran-vs-warfarin-with-low-molecular-weight-heparin-bridging-in-catheter-ablation-for-atrial-fibrillation-patients-with-a-low-chads2-score
#14
Li Hao, Bing Rong, Fei Xie, Ming-Jie Lin, Jing-Quan Zhong
The purpose of the present study was to compare the efficacy and safety of dabigatran and interrupted warfarin with low-molecular-weight heparin bridging in non-valvular atrial fibrillation (AF) catheter ablation. Previously, there has been concerns that bridging therapy increases bleeding events without the benefit of stroke prevention. It has been suggested that bridging therapy should be considered only for patients at high-risk of thrombosis. Nevertheless, bridging therapy in AF patients with a low CHADS2 score may be safe and effective...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28528288/cancer-atrial-fibrillation-and-stroke
#15
REVIEW
Tess Fitzpatrick, Marc Carrier, Grégoire Le Gal
Cancer patients appear to be at increased risk for atrial fibrillation. Although surgery and chemotherapy exacerbate this risk, this association is observed even in the absence of any cancer-specific treatment. The underlying mechanism of this is likely multifactorial, but systemic inflammation and autonomic dysregulation are hypothesized to play critical roles. Cancer and atrial fibrillation are both independent risk factors for ischemic stroke; however, it is not clear whether this translates to an increased risk of stroke in patients with both comorbidities...
July 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#16
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#17
REVIEW
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
June 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28506981/contemporary-trends-in-oral-anticoagulant-prescription-in-atrial-fibrillation-patients-at-low-to-moderate-risk-of-stroke-after-guideline-recommended-change-in-use-of-the-chads2-to-the-cha2ds2-vasc-score-for-thromboembolic-risk-assessment-analysis-from-the-national
#18
David F Katz, Thomas M Maddox, Mintu Turakhia, Anil Gehi, Emily C O'Brien, Steven A Lubitz, Alexander Turchin, Gheorghe Doros, Lanyu Lei, Paul Varosy, Lucas Marzec, Jonathan C Hsu
BACKGROUND: Use of the CHA2DS2-VASc score instead of the CHADS2 score for thromboembolic risk stratification and initiation of oral anticoagulation (OAC) was recommended in the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines. We sought to define the proportion of patients with AF qualifying for and receiving OAC in contemporary practice by applying the CHA2DS2-VASc score to patients with a low CHADS2 score. METHODS AND RESULTS: Among patients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's outpatient Practice Innovation and Clinical Excellence registry (2008-2014) CHADS2 score of 0 or 1, we calculated the impact of adoption of the CHA2DS2-VASc score on the proportion of patients with an indication for OAC...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28483209/the-population-based-long-term-impact-of-anticoagulant-and-antiplatelet-therapies-in-low-risk-patients-with-atrial-fibrillation
#19
Anjani Golive, Heidi T May, Tami L Bair, Victoria Jacobs, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller, T Jared Bunch
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data, the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoagulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1, or 2 were studied...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28468510/safety-and-efficacy-of-bridging-with-low-molecular-weight-heparin-during-temporary-interruptions-of-warfarin-a-register-based-cohort-study
#20
Vilhelm Sjögren, Bartosz Grzymala-Lubanski, Henrik Renlund, Peter J Svensson, Anders Själander
Low-molecular-weight heparin (LMWH) is often recommended as a bridging therapy during temporary interruptions in warfarin treatment, despite lack of evidence. The aim of this study was to see whether we could find benefit from LMWH bridging. We studied all planned interruptions of warfarin within the Swedish anticoagulation register Auricula during 2006 to 2011. Low-molecular-weight heparin bridging was compared to nonbridging (control) after propensity score matching. Complications were identified in national clinical registers for 30 days following warfarin cessation, and defined as all-cause mortality, bleeding (intracranial, gastrointestinal, or other), or thrombosis (ischemic stroke or systemic embolism, venous thromboembolism, or myocardial infarction) that was fatal or required hospital care...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
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