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https://www.readbyqxmd.com/read/28938309/successful-treatment-with-dabigatran-for-consumptive-coagulopathy-associated-with-extensive-vascular-malformations
#1
Atsushi Yasumoto, Ryohei Ishiura, Mitsunaga Narushima, Yutaka Yatomi
: Vascular malformation is occasionally complicated by consumptive coagulopathy, known as localized intravascular coagulopathy (LIC), which is characterized by a reduced fibrinogen level, an elevated D-dimer level and a normal platelet count. We report the case of a 17-year-old Japanese girl who presented with LIC secondary to extensive vascular malformations, whose condition had progressed to disseminated intravascular coagulation (DIC). She suddenly presented with severe anaemia, despite the absence of obvious bleeding, and she began to require regular red blood cell (RBC) transfusions...
September 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#2
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28936235/health-literacy-and-atrial-fibrillation-relevance-and-future-directions-for-patient-centred-care
#3
Konstantinos N Aronis, Brittany Edgar, Wendy Lin, Maria Auxiliadora Parreiras Martins, Michael K Paasche-Orlow, Jared W Magnani
Atrial fibrillation (AF) is a common cardiac arrhythmia with significant clinical outcomes, and is associated with high medical and social costs. AF is complicated for patients because of its specialised terminology, long-term adherence, symptom monitoring, referral to specialty care, array of potential interventions and potential for adversity. Health literacy is a frequently under-recognised, yet fundamental, component towards successful care in AF. Health literacy is defined as the capacity to obtain, process and understand health information, and has had markedly limited study in AF...
2017: European Cardiology
https://www.readbyqxmd.com/read/28935034/persistence-with-dabigatran-therapy-at-2%C3%A2-years-in-patients-with-atrial-fibrillation
#4
Miney Paquette, Lionel Riou França, Christine Teutsch, Hans-Christoph Diener, Shihai Lu, Sergio J Dubner, Chang Sheng Ma, Kenneth J Rothman, Kristina Zint, Jonathan L Halperin, Menno V Huisman, Gregory Y H Lip, Robby Nieuwlaat
BACKGROUND: Guidelines recommend long-term oral anticoagulation therapy for stroke prevention in patients with atrial fibrillation (AF). Treatment discontinuation rates in vitamin K antagonist (VKA)-treated patients are high but may be lower with non-VKA oral anticoagulant agents. OBJECTIVES: The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up. METHODS: Consecutive patients newly diagnosed with AF and ≥1 stroke risk factor were followed up for 2 years...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28933196/symptoms-acceptance-of-illness-and-health-related-quality-of-life-in-patients-with-atrial-fibrillation
#5
Beata Jankowska-Polańska, Aleksandra Kaczan, Katarzyna Lomper, Dariusz Nowakowski, Krzysztof Dudek
INTRODUCTION: Acceptance of illness plays a key role, allowing the patient to adapt to the disease and its treatment, and to maintain their health-related quality of life (HRQOL) despite chronic conditions. AIM: The aim of the study was to assess the relationship between severity of arrhythmia symptoms, acceptance of illness and HRQOL in patients with atrial fibrillation. METHODS: The study included 99 patients (mean age 64.6) treated for atrial fibrillation...
September 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#6
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28929326/the-involvement-of-pharmacies-in-the-screening-of-undiagnosed-atrial-fibrillation
#7
Pietro Amedeo Modesti, Gianni Donigaglia, Plinio Fabiani, Nicola Mumoli, Andrea Colella, Maria Boddi
Early identification of atrial fibrillation (AF) is now a priority in cardiovascular prevention because AF is common although often asymptomatic, and is associated with poor outcomes that are highly preventable with appropriate medical treatment. In Italy, AF prevalence among subjects aged ≥65 years ranges from 5 to 6% in observational studies based on the diagnosis recorded by general practitioners to 10-11% in studies where ECG screening is routinely offered. It is thus evident that a large number of subjects are not detected by conventional approach, and new strategies are required to increase early detection of AF...
September 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28929066/surgical-treatment-of-retrosternal-goitre
#8
Kiera Welman, Richard Heyes, Paras Dalal, Sarah Hough, Marciano Bunalade, Vladimir Anikin
This study aims to evaluate surgical approaches to the management of retrosternal goitre. Between 2004 and 2014, 35 patients (eight males; mean age 67.4 ± 10.9 years) with retrosternal goitre (mainly right-sided in 9, left-sided in 14 and bilateral in 12) underwent surgery. A palpable neck mass was found in 11 (31.4%), stridor in 10 (28.6%) and thyrotoxicosis in 4 (11.4%) cases. 4 (11.4%) patients were asymptomatic. Tracheal compression was detected radiologically in 27 (77.2%) patients with deviation in 18 (51...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929012/current-practice-in-the-management-of-new-onset-atrial-fibrillation-in-critically-ill-patients-a-uk-wide-survey
#9
Chung Shen Chean, Daniel McAuley, Anthony Gordon, Ingeborg Dorothea Welters
BACKGROUND: New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. METHODS: We designed a short user-friendly online questionnaire...
2017: PeerJ
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#10
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28927171/evolving-quality-standards-for-large-scale-registries-the-garfield-af-experience
#11
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
Aims: Registries have the potential to capture treatment practices and outcomes in populations beyond the constraints of clinical trial settings. The value of data obtained depend critically upon robust quality standards (including source data verification [SDV] and training); features that are commonly absent from registries. This article outlines the quality standards developed for Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Methods and Results: GARFIELD-AF comprises ∼57 000 patients prospectively recruited over 6...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28925907/atrial-fibrillation-ablation-increases-inflammation-chemokine-modulation-suppresses-activation-of-leukocytes-isolated-after-ablation
#12
Alexandra Lucas, Mohammad Al-Ani, Sriram Ambadapadi, Jordan R Yaron, Donghang Zheng, Adisson Fortunel, Maia Doroton-Guevara, Liying Liu, Sufi Morshed, Jay Fricker, William Miles, Matthew McKillop
AIMS: Atrial fibrillation (AF) ablation is associated with increased circulating markers of inflammation. Innate immune, or inflammation, pathways up-regulate mononuclear cell responses and may increase risk for recurrent arrhythmia. Chemokines and serine protease coagulation pathways both activate innate immune responses. Here, we measured inflammatory markers in peripheral blood samples from patients after cryoballoon and/or radiofrequency pulmonary vein isolation and assessed the capacity for inhibition of chemokine and serine protease pathways to block cell activation...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28925871/biomarkers-associated-with-atrial-fibrosis-and-remodeling
#13
Polychronis Dilaveris, Christos-Konstantinos Antoniou, Panagiota Manolakou, Eleftherios Tsiamis, Konstantinos Gatzoulis, Dimitris Tousoulis
Atrial fibrillation is the most common rhythm disturbance encountered in clinical practice. Although often considered as solely arrhythmic in nature, current evidence has established that atrial myopathy constitutes both the substrate and the outcome of atrial fibrillation, thus initiating a vicious, self-perpetuating cycle. This myopathy is triggered by stress-induced (including pressure/volume overload, inflammation, oxidative stress) responses of atrial tissue, which in the long term become maladaptive, and combines elements of both structural, especially fibrosis, and electrical remodeling, with contemporary approaches yielding potentially useful biomarkers of these processes...
September 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28925721/the-more-effective-treatment-of-atrial-fibrillation-applying-the-natural-compounds-as-nadph-oxidase-and-ion-channel-inhibitors
#14
Samira Barangi, A Wallace Hayes, Gholamreza Karimi
Atrial fibrillation (AF) is the most common cardiac arrhythmia that occurs because of several different risk factors, e.g., valvular heart disease, coronary artery disease, age ≥75 years, hypertension and diabetes mellitus. One key risk factor that results in AF, is oxidative stress. Evidence suggests that there is a correlation between oxidative processes and the genesis of AF. Oxidative stress occurs when the generation of reactive oxygen species (ROS) increase due to excessive activity of enzymes including NADPH oxidase (NOX) and xanthine oxidase; or its degradation decrease by dysfunctional antioxidant enzyme systems, such as superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx)...
September 19, 2017: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/28925012/a-new-negative-allosteric-modulator-ap14145-for-the-study-of-small-conductance-calcium-activated-potassium-channels
#15
Rafel Simó-Vicens, Jeppe E Kirchhoff, Bernardo Dolce, Lea Abildgaard Jensen, Tobias Speerschneider, Ulrik S Sørensen, Morten Grunnet, Jonas G Diness, Bo H Bentzen
BACKGROUND AND PURPOSE: Small conductance Ca(2+) -activated K(+) (KCa 2) channels represent a promising atrial-selective target for treatment of atrial fibrillation (AF). Here, we establish the mechanism of KCa 2 inhibition by the new compound AP14145. EXPERIMENTAL APPROACH: Using site directed mutagenesis binding determinants for AP14145 inhibition were explored. AP14145 selectivity and mechanism of action were investigated by patch clamp recordings of heterologously expressed KCa 2 channels...
September 19, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#16
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28921386/midterm-outcomes-of-two-staged-hybrid-ablation-of-persistent-and-long-standing-persistent-atrial-fibrillation-using-the-versapolar-epicardial-surgical-device-and-subsequent-catheter-ablation
#17
Petr Budera, Pavel Osmancik, Dalibor Herman, Jana Zdarska, David Talavera, Anna Mala, Radka Prochazkova, Zbynek Straka
PURPOSE: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy for patients with non-paroxysmal AF, although, data regarding mid-term outcomes are limited. METHODS: Patients with persistent or long-standing persistent AF were enrolled. Initially, a thoracoscopic, right-sided, epicardial ablation was performed, with a goal of creating a box lesion on the posterior wall of the left atrium; a novel versapolar radiofrequency (RF) catheter was used...
September 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#18
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28919290/utility-and-limitations-of-long-term-monitoring-of-atrial-fibrillation-using-an-implantable-loop-recorder
#19
Randall Lee, Suneet Mittal
Atrial fibrillation (AF) is the most common cardiac arrhythmia diagnosed and treated in the world. The treatment of patients' symptoms as well as the prevention of stroke and heart failure is dependent on accurate detection and characterization of AF. A variety of electrocardiographic (ECG) monitoring techniques are being used for these purposes. However, these intermittent ECG monitoring techniques have been shown to under diagnose AF events, while having limited ability to characterize AF burden and density...
September 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28918897/colchicine-for-primary-prevention-of-atrial-fibrillation-after-open-heart-surgery-systematic-review-and-meta-analysis
#20
Carsten Lennerz, Manish Barman, Mahmoud Tantawy, Mark Sopher, Peter Whittaker
BACKGROUND: Atrial fibrillation occurs frequently after open-heart surgery. It is associated with increased morbidity and mortality, longer hospital stays, and increased healthcare costs. Prophylactic administration of colchicine may mitigate post-operative atrial fibrillation (POAF). METHODS: We searched PubMed, ClinicalTrials.gov and CENTRAL databases to identify randomized controlled trials (RCTs) that; (1) compared prophylactic use of colchicine to placebo, or usual care, in patients with sinus rhythm who underwent elective open-heart surgery and (2) reported POAF-incidence...
September 1, 2017: International Journal of Cardiology
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