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Atrial fibrillation in dialysis

Wasl Al-Adsani, Ali Ahmad, Mohammad Al-Mousa
Background: Brucellosis is a bacterial infection, caused by the nonmotile gram-negative aerobic coccobacilli. The clinical manifestation of brucellosis is variable, ranging from mild disease to severe disease. The gold standard test to confirm the diagnosis of brucellosis is assaying blood, bone marrow, or other body fluids or by tissue culture. Preferred first-line treatment in adults with uncomplicated, nonlocalized disease consists of doxycycline-aminoglycoside combination. The recommended duration of treatment is 6 weeks...
2018: Infection and Drug Resistance
Jordanne Feldberg, Param Patel, Ashley Farrell, Sylvia Sivarajahkumar, Karen Cameron, Jennifer Ma, Marisa Battistella
Background: There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronic kidney disease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin. Methods: We conducted a systematic review of randomized controlled trials, cohort studies and case series, and searched electronic databases from 1946 to 2017...
March 2, 2018: Nephrology, Dialysis, Transplantation
Ian Jun Yan Wee, Thomas Stonier, Michael Harrison, Andrew M T L Choong
BACKGROUND: The carotid artery is a novel access route for transcatheter aortic valve implantation (TAVI), especially useful in patients unsuitable for traditional access routes including transfemoral (TF), subclavian, transapical (TAp), and aortic (TAo). This systematic review summarizes the evidence on TAVI via the carotid artery for its efficacy and safety. METHODS: A systematic review was conducted as per the Preferred Reporting Instructions for Systematic Reviews and Meta-analysis (PRISMA) guidelines on three online databases: Medline (via Pubmed), SCOPUS, and Cochrane Database...
February 27, 2018: Journal of Cardiology
Kathrine Parker, Sandip Mitra, Jecko Thachil
There is an increasing understanding of the risks from atrial fibrillation (AF) in the current era. In patients with end-stage renal disease (ESRD) on dialysis, the prevalence of AF is significantly higher compared to the general population and those with earlier stages of CKD. Although anticoagulation of these patients may seem appropriate, there is a lack of conclusive evidence that it provides the same protection from thromboembolic complications as it does in patients not on dialysis. In addition, the increased risk of bleeding in patients requiring dialysis makes the use of anticoagulants less favourable...
February 22, 2018: British Journal of Haematology
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Ran Abuhasira, Yuval Mizrakli, Avi Shimony, Victor Novack, Alla Shnaider, Yosef S Haviv
Atrial fibrillation (AF) is highly prevalent in dialysis patients, however whether its impact differs between patients on haemodialysis (HD) vs. peritoneal dialysis (PD) is unknown. We aimed to compare the association of AF and clinical outcomes in different dialysis modalities. We performed a population based retrospective cohort study, including adult patients who initiated dialysis between the years 2002 and 2015. Clinical, echocardiographic and laboratory data were reviewed and correlated with outcomes in HD vs...
February 14, 2018: Scientific Reports
Shankar Kumar, Simon de Lusignan, Andrew McGovern, Ana Correa, Mariya Hriskova, Piers Gatenby, Simon Jones, David Goldsmith, A John Camm
OBJECTIVE: To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrial fibrillation and chronic kidney disease. DESIGN: Propensity matched, population based, retrospective cohort analysis from January 2006 through December 2016. SETTING: The Royal College of General Practitioners Research and Surveillance Centre database population of almost 2...
February 14, 2018: BMJ: British Medical Journal
Prabir Roy-Chaudhury, Jim A Tumlin, Bruce A Koplan, Alexandru I Costea, Vijay Kher, Don Williamson, Saurabh Pokhariyal, David M Charytan
Sudden death is one of the more frequent causes of death for hemodialysis patients, but the underlying mechanisms, contribution of arrhythmia, and associations with serum chemistries or the dialysis procedure are incompletely understood. To study this, implantable loop recorders were utilized for continuous cardiac rhythm monitoring to detect clinically significant arrhythmias including sustained ventricular tachycardia, bradycardia, asystole, or symptomatic arrhythmias in hemodialysis patients over six months...
January 27, 2018: Kidney International
Line Melgaard, Thure Filskov Overvad, Flemming Skjøth, Jeppe Hagstrup Christensen, Torben Bjerregaard Larsen, Gregory Y H Lip
AIMS: The aim of this study was to assess the prognostic value of chronic kidney disease (CKD) in relation to ischaemic stroke, intracranial haemorrhage, major bleeding, and all-cause death in heart failure patients without atrial fibrillation. METHODS AND RESULTS: In this observational cohort study, heart failure patients without atrial fibrillation were identified using Danish nationwide registries. Risk of stroke, major haemorrhage, and death were calculated after 1 and 5 years to compare patients with and without CKD, ±dialysis [dialysis: CKD with renal replacement therapy (CKD-RRT); no dialysis: CKD-no RRT]...
January 31, 2018: ESC Heart Failure
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
Pierpaolo Chivasso, Vito D Bruno, Shakil Farid, Pietro Giorgio Malvindi, Amit Modi, Umberto Benedetto, Franco Ciulli, Yasir Abu-Omar, Massimo Caputo, Gianni D Angelini, Steve Livesey, Hunaid A Vohra
OBJECTIVES: An increasing number of octogenarians are referred to undergo mitral valve surgery for degenerative disease, and percutaneous approaches are being increasingly used in this subgroup of patients. We sought to determine the survival and its predictors after Mitral valve Surgery in Octogenarians (MiSO) in a multicenter UK study of high-volume specialized centers. METHODS: Pooled data from 3 centers were collected retrospectively. To identify the predictors of short-term composite outcome of 30 days mortality, acute kidney injury, and cerebrovascular accident, a multivariable logistic regression model was developed...
November 20, 2017: Journal of Thoracic and Cardiovascular Surgery
Jingwen Tan, Sunjae Bae, Jodi B Segal, Junya Zhu, G Caleb Alexander, Dorry L Segev, Mara McAdams-DeMarco
AIM: There is conflicting evidence regarding the safety and effectiveness of warfarin for atrial fibrillation (AF) treatment among older end-stage renal disease (ESRD) patients, and differences among subgroups are unclear. METHODS: Older dialysis patients who were newly diagnosed with AF (7/2007-12/2011) were identified in the United States Renal Data System. The adjusted hazard ratios (HR) of the outcomes (any stroke, ischemic stroke, major bleeding, severe gastrointestinal bleeding, and death) by time-varying warfarin use were estimated using Cox regression accounting for the inverse probability of treatment weight...
December 8, 2017: Nephrology
Hristo Todorov, Inka Janssen, Stefanie Honndorf, Daniela Bause, Antje Gottschalk, Silke Baasner, Thomas Volkert, Valentin Faerber, John F Stover, Martin Westphal, Björn Ellger
BACKGROUND: Although mortality after cardiac surgery has significantly decreased in the last decade, patients still experience clinically relevant postoperative complications. Among others, atrial fibrillation (AF) is a common consequence of cardiac surgery, which is associated with prolonged hospitalization and increased mortality. METHODS: We retrospectively analyzed data from patients who underwent coronary artery bypass grafting, valve surgery or a combination of both at the University Hospital Muenster between April 2014 and July 2015...
December 2, 2017: BMC Anesthesiology
Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HYPOTHESIS: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. METHODS: We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 2017: Clinical Cardiology
Carmen Sánchez Perales, Teresa Vázquez Sánchez, Daniel Salas Bravo, Sonia Ortega Anguiano, Eduardo Vázquez Ruiz de Castroviejo
Atrial fibrillation (AF) represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD). OBJECTIVE: To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia. METHODS: We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centres in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling...
November 9, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Eri Minamino-Muta, Takao Kato, Takeshi Morimoto, Tomohiko Taniguchi, Hiroki Shiomi, Kenji Nakatsuma, Shinichi Shirai, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Makoto Miyake, Chisato Izumi, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Eiji Tada, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Toshikazu Jinnai, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Yuko Morikami, Naritatsu Saito, Ryuzo Sakata, Kenji Minatoya, Takeshi Kimura
Whether patients with severe aortic stenosis (AS) die because of AS-related causes is an important issue for the management of these patients. We used data from CURRENT AS registry, a Japanese multicenter registry, to assess the causes of death in severe AS patients and to identify the factors associated with non-cardiac mortality. We enrolled 3815 consecutive patients with a median follow-up of 1176 days; the 1449 overall deaths comprised 802 (55.3%) from cardiac and 647 (44.7%) from non-cardiac causes. Heart failure (HF) (25...
November 7, 2017: Scientific Reports
Sathish Karmegam, Anupkumar Shetty
A 60-year-old African American man with end stage renal disease on hemodialysis (HD) for the past 2.5 years developed severe hyperparathyroidism. Other past medical history included atrial fibrillation, type II diabetes mellitus, hypertension, gout, pericardial effusion needing pericardial window, deep vein thrombosis, mitral insufficiency, and cardiomyopathy with implantable cardioversion device placement. His parathyroid hormone (PTH) level peaked at 4,191 pg/mL despite being on cinacalcet, sevelamer, and paricalcitol...
October 2017: Hemodialysis International
Farzaneh Banki, Chandni Kaushik, David Roife, Kyle G Mitchell, Charles C Miller
The aim of this study was to assess symptomatic recurrence in patients who underwent a laparoscopic repair of large hiatal hernia without an esophageal lengthening procedure. Patients who underwent a laparoscopic repair of a large hiatal hernia from September 2009 to September 2015 by a single surgeon were identified in the retrospective review. The patients were followed up prospectively by the operating surgeon using a structured questionnaire, administered by telephone, to assess the symptoms. Symptomatic recurrence was defined as the requirement for a reoperative procedure for symptomatic recurrent hiatal hernia...
2017: Seminars in Thoracic and Cardiovascular Surgery
Jolanta Malyszko, Paulina Lopatowska, Elzbieta Mlodawska, Dominika Musialowska, Jacek S Malyszko, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia of high clinical importance, occurring in 2% of the general population and in 19-24% in patients with chronic kidney disease. It is a well-known risk factor for cardiovascular morbidity and mortality. Kidney transplant recipients with a history of AF were associated with significantly higher rate of ischaemic strokes, graft failure and post-transplant mortality. AF occurs in over 7% of kidney transplant recipients in the first 3 years after transplantation and is associated with reduced graft and patient survival...
September 7, 2017: Nephrology, Dialysis, Transplantation
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
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