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Atrial fibrillation in dialysis

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https://www.readbyqxmd.com/read/28211605/end-stage-renal-disease-and-severe-aortic-stenosis-does-valve-replacement-improve-one-year-outcomes
#1
Jose F Condado, Aneel Maini, Bradley Leshnower, Vinod Thourani, Jessica Forcillo, Chandan Devireddy, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Amy Simone, Patricia Keegan, Stamatios Lerakis, Peter C Block, Vasilis Babaliaros
BACKGROUND: Treatment for patients with end-stage renal disease (ESRD) and severe aortic stenosis (AS) includes balloon aortic valvuloplasty (BAV), surgical (SAVR), or transcatheter (TAVR) aortic valve replacement. We compared outcomes among these strategies. METHODS: A retrospective review of patients with ESRD undergoing treatment for severe AS between 07/2007 and 06/2015 was performed at our center. Patients were classified based on treatment: BAV-only, TAVR, or SAVR...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28146260/quality-of-life-outcomes-after-transcatheter-aortic-valve-replacement-in-an-unselected-population-a-report-from-the-sts-acc-transcatheter-valve-therapy-registry
#2
Suzanne V Arnold, John A Spertus, Sreekanth Vemulapalli, Zhuokai Li, Roland A Matsouaka, Suzanne J Baron, Amit N Vora, Michael J Mack, Matthew R Reynolds, John S Rumsfeld, David J Cohen
Importance: In clinical trials, transcatheter aortic valve replacement (TAVR) has been shown to improve symptoms and quality of life. As this technology moves into general clinical practice, evaluation of the health status outcomes among unselected patients treated with TAVR is of critical importance. Objective: To examine the short- and long-term health status outcomes of surviving patients after TAVR in the context of an unselected population. Design, Setting, and Participants: This observational cohort study included patients with severe aortic stenosis who underwent TAVR in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry from November 1, 2011, to March 31, 2016, at more than 450 clinical sites...
February 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#3
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28120282/treatment-of-atrial-fibrillation-with-warfarin-among-older-adults-with-end-stage-renal-disease
#4
Jingwen Tan, Sunjae Bae, Jodi B Segal, Junya Zhu, Dorry L Segev, G Caleb Alexander, Mara McAdams-DeMarco
BACKGROUND: There is increasing evidence questioning the use of warfarin for atrial fibrillation (AF) among older adults with end stage renal disease (ESRD). We assessed the patterns and determinants of warfarin utilization among these patients in the US. METHODS: We assembled a cohort of older adults (age ≥65) undergoing dialysis with incident AF from July 2007 to November 2011 from the US Renal Data System (USRDS). We used descriptive statistics to characterize warfarin utilization within 30 days of AF discharge, and logistic regression to quantify patient characteristics associated with warfarin initiation...
January 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#5
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27998917/national-trends-and-impact-of-acute-kidney-injury-requiring-hemodialysis-in-hospitalizations-with-atrial-fibrillation
#6
Lili Chan, Swati Mehta, Kinsuk Chauhan, Priti Poojary, Sagar Patel, Sumeet Pawar, Achint Patel, Ashish Correa, Shanti Patel, Pranav S Garimella, Narender Annapureddy, Shiv Kumar Agarwal, Umesh Gidwani, Steven G Coca, Girish N Nadkarni
BACKGROUND: Atrial fibrillation (AF) is a common cause for hospitalization, but there are limited data regarding acute kidney injury requiring dialysis (AKI-D) in AF hospitalizations. We aimed to assess temporal trends and outcomes in AF hospitalizations complicated by AKI-D utilizing a nationally representative database. METHODS AND RESULTS: Utilizing the Nationwide Inpatient Sample, AF hospitalizations and AKI-D were identified using diagnostic and procedure codes...
December 20, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27998624/warfarin-initiation-atrial-fibrillation-and-kidney-function-%C3%A2-comparative-effectiveness-and-safety-of%C3%A2-warfarin%C3%A2-in%C3%A2-older%C3%A2-adults%C3%A2-with-newly-diagnosed-atrial%C3%A2-fibrillation
#7
Min Jun, Matthew T James, Zhihai Ma, Jianguo Zhang, Marcello Tonelli, Finlay A McAlister, Braden J Manns, Pietro Ravani, Robert R Quinn, Natasha Wiebe, Vlado Perkovic, Stephen B Wilton, Wolfgang C Winkelmayer, Brenda R Hemmelgarn
BACKGROUND: The effectiveness and safety of warfarin use among patients with atrial fibrillation (AF) and reduced kidney function are uncertain. STUDY DESIGN: Community-based retrospective cohort study (May 1, 2003, to March 31, 2012) using province-wide laboratory and administrative data in Alberta, Canada. SETTING & PARTICIPANTS: 14,892 adults 66 years or older with new AF and a measurement of kidney function. Long-term dialysis patients or kidney transplant recipients were excluded...
December 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27938887/years-of-life-lost-after-complications-of-coronary-artery-bypass-operations
#8
Robert E Freundlich, Michael D Maile, Mark M Hajjar, Joseph R Habib, Elizabeth S Jewell, Thomas Schwann, Robert H Habib, Milo Engoren
BACKGROUND: We currently have an incomplete understanding of which postoperative complications after coronary artery bypass grafting (CABG) are associated with long-term death. The purpose of this study was to find the associations between complications and attributable death. METHODS: Prospectively collected data on patient characteristics, risk factors, and complications of patients undergoing isolated CABG with 20-year follow-up were analyzed with a Cox regression model to calculate the overall hazard of dying associated with each postoperative complication...
December 6, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27928736/antiplatelet-agents-in-hemodialysis
#9
REVIEW
Massimiliano Migliori, Vincenzo Cantaluppi, Alessia Scatena, Vincenzo Panichi
Patients affected by cardiovascular disease (CVD) are treated with antiplatelet agents (AA) and/or anticoagulant drugs, which are fundamental in the management of stroke, coronary atherosclerotic disease, peripheral vascular disease and atrial fibrillation. CVD is the most important cause of death in chronic renal failure (CRF). Death rates from myocardial infarction (MI) and from all other cardiac causes exceed those for the general population. Incidence of MI in CRF is triple that in the general population...
December 8, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27897386/cardiovascular-and-stroke-risk-in-japanese-hemodialysis-patients-with-atrial-fibrillation
#10
Jumpei Hasegawa, Brian Bieber, Maria Larkina, Bruce M Robinson, Sachiko Wakai, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Takashi Akiba
Atrial fibrillation is one of the most common arrhythmias in hemodialysis patients. We evaluated its clinical outcomes among hemodialysis patients with atrial fibrillation in Japan. Using data derived from the Japanese Dialysis Outcomes and Practice Patterns Study, we analyzed backgrounds and outcomes among hemodialysis patients with and without atrial fibrillation in Japan. Among 7002 hemodialysis patients, the prevalence of atrial fibrillation was 5.7% and the incidence was 0.2 per 100 patient-years. Atrial fibrillation was independently associated with all-cause mortality (hazard ratio, 1...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#11
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27866651/cardiac-surgery-in-patients-with-previous-hepatic-or-renal-transplantation-a%C3%A2-pair-matched-study
#12
Mina Farag, Marina Nikolic, Rawa Arif, Bastian Schmack, Anton Sabashnikov, Mohamed Zeriouh, Aron-Frederik Popov, Arjang Ruhparwar, Matthias Karck, Alexander Weymann
BACKGROUND: The objective of this study was to compare outcomes of patients with previous solid organ transplant with those of a pair-matched population. METHODS: Data from our prospectively maintained cardiac surgery registry were obtained and identified 70 transplant recipients (21 hepatic, 49 renal) who were operated on at our department of cardiac surgery between 2000 and 2013; they formed the transplant group. Those patients were pair-matched regarding age, sex, and cardinal cardiac risk factors to form the pair-matched group...
November 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#13
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27855290/transcatheter-leadless-cardiac-pacing-the-new-alternative-solution
#14
Antoine Da Costa, Amandine Axiotis, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Zahi Afif, Jean Baptiste Guichard, Antoine Gerbay, Karl Isaaz
INTRODUCTION: A lack of information about the feasibility and safety of leadless pacemaker (LPMs) exists in a fragile population of patients with limited venous anatomy access or conventional pacemaker (PM) contraindication. Accordingly, the goal of this prospective observational study was to report our experience with this new leadless technology in a subset of patients with contraindication or limited venous access. METHODS AND RESULTS: Between May 2015 and July 2016, 14 patients were consecutively included...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27852694/warfarin-utilisation-and-anticoagulation-control-in-patients-with-atrial-fibrillation-and-chronic-kidney-disease
#15
Felix Yang, Jessica A Hellyer, Claire Than, Aditya J Ullal, Daniel W Kaiser, Paul A Heidenreich, Donald D Hoang, Wolfgang C Winkelmayer, Susan Schmitt, Susan M Frayne, Ciaran S Phibbs, Mintu P Turakhia
OBJECTIVE: To evaluate warfarin prescription, quality of international normalised ratio (INR) monitoring and of INR control in patients with atrial fibrillation (AF) and chronic kidney disease (CKD). METHODS: We performed a retrospective cohort study of patients with newly diagnosed AF in the Veterans Administration (VA) healthcare system. We evaluated anticoagulation prescription, INR monitoring intensity and time in and outside INR therapeutic range (TTR) stratified by CKD...
November 15, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27769175/warfarin-use-and-stroke-bleeding-and-mortality-risk-in-patients-with-end-stage-renal-disease-and-atrial-fibrillation-a-systematic-review-and-meta-analysis
#16
Jingwen Tan, Shuiqing Liu, Jodi B Segal, G Caleb Alexander, Mara McAdams-DeMarco
BACKGROUND: Patients with end stage renal disease (ESRD), including stage 5 chronic kidney disease (CKD), hemodialysis (HD) and peritoneal dialysis (PD), are at high risk for stroke-related morbidity, mortality and bleeding. The overall risk/benefit balance of warfarin treatment among patients with ESRD and AF remains unclear. METHODS: We systematically reviewed the associations of warfarin use and stroke outcome, bleeding outcome or mortality in patients with ESRD and AF...
October 21, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27760636/-safety-and-efficacy-of-off-pump-coronary-artery-bypass-grafting-in-octogenarians
#17
T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27742825/atrial-fibrillation-and-chronic-kidney-disease-struggling-through-thick-and-thin
#18
REVIEW
Simardeep Gill, Min Jun, Pietro Ravani
The prevalence of atrial fibrillation and the risk of stroke display an age-related increase in the chronic kidney disease (CKD) population. Evidence from large randomized controlled trials conducted in the general population supports the use of anticoagulation to reduce the risk of stroke in the setting of non-valvular atrial fibrillation. However, data in the non-dialysis-dependent and dialysis-dependent CKD populations are limited largely to observational studies, which demonstrate conflicting results regarding the risk-benefit profile of anticoagulation...
October 14, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27712776/late-outcomes-of-transcatheter-aortic-valve-replacement-in-high-risk-patients-the-france-2-registry
#19
Martine Gilard, Hélène Eltchaninoff, Patrick Donzeau-Gouge, Karine Chevreul, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lievre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Didier Tchetche, Didier Carrié, Dominique Himbert, Bernard Albat, Alain Cribier, Arnaud Sudre, Didier Blanchard, Gilles Rioufol, Frederic Collet, Remi Houel, Pierre Dos Santos, Nicolas Meneveau, Said Ghostine, Thibaut Manigold, Philippe Guyon, Dominique Grisoli, Herve Le Breton, Stephane Delpine, Romain Didier, Xavier Favereau, Geraud Souteyrand, Patrick Ohlmann, Vincent Doisy, Gilles Grollier, Antoine Gommeaux, Jean-Philippe Claudel, Francois Bourlon, Bernard Bertrand, Marc Laskar, Bernard Iung
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up. OBJECTIVES: This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. METHODS: The FRANCE-2 registry prospectively included all TAVRs performed in France...
October 11, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27688260/echocardiographic-associates-of-atrial-fibrillation-in-end-stage-renal-disease
#20
Liselotte C R Hensen, Victoria Delgado, Suzanne E van Wijngaarden, Melissa Leung, Mihaly K de Bie, Maurits S Buiten, Martin J Schalij, Jos J Van de Kerkhof, Ton J Rabelink, Joris I Rotmans, J Wouter Jukema, Jeroen J Bax
BACKGROUND: The prevalence of atrial fibrillation (AF) in end-stage renal disease (ESRD) patients is relatively high. The present study evaluated the association between left atrial (LA) remodelling, including an increased size and myocardial fibrosis, and slow LA conduction and the occurrence of AF. METHODS: In 171 ESRD patients enrolled in the Implantable Cardioverter Defibrillators in Dialysis patients (ICD2) trial, the LA dimensions, LA conduction delay [as reflected by the time difference between P-wave onset on surface electrocardiogram and A'-wave on tissue Doppler imaging (PA-TDI)] and LA function were compared between patients who exhibited AF versus patients without AF...
September 29, 2016: Nephrology, Dialysis, Transplantation
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