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https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#1
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28202628/effects-of-upgrade-versus-de-novo-cardiac-resynchronization-therapy-on-clinical-response-and-long-term-survival-results-from-a-multicenter-study
#2
Mate Vamos, Julia W Erath, Zsolt Bari, Denes Vagany, Sven P Linzbach, Tatsiana Burmistrava, Carsten W Israel, Gabor Z Duray, Stefan H Hohnloser
BACKGROUND: Benefits of cardiac resynchronization therapy (CRT) on morbidity and mortality in selected patients are well known. Although the number of upgrade procedures from single- or dual-chamber devices to CRT is increasing, there are only sparse data on the outcomes of upgrade procedures compared with de novo CRT. This study aimed to evaluate clinical response and survival in patients receiving de novo versus upgrade CRT defibrillator therapy. METHODS AND RESULTS: Prospectively collected outcome data were compared in patients undergoing de novo or upgrade CRT defibrillator implantation at 3 implant centers in Germany and Hungary...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28196797/left-atrial-structure-in-relationship-to-age-sex-ethnicity-and-cardiovascular-risk-factors-mesa-multi-ethnic-study-of-atherosclerosis
#3
Filip Zemrak, Bharath Ambale-Venkatesh, Gabriella Captur, Jonathan Chrispin, Ela Chamera, Mohammadali Habibi, Saman Nazarian, Saidi A Mohiddin, James C Moon, Steffen E Petersen, João A C Lima, David A Bluemke
BACKGROUND: Left atrial (LA) size is a marker of diastolic function and is associated with atrial fibrillation and cardiovascular outcomes. However, there are no large population studies measuring LA structure. The relationship of demographics and cardiovascular risk factors to LA size is largely unknown. This study aimed to determine associations of LA size with demographic factors, cardiac structure and function, and cardiovascular risk factors. METHODS AND RESULTS: LA volume indexed to body surface area was measured by cardiovascular magnetic resonance steady-state free precession and fast gradient echo cine long- and short-axis images in 2576 asymptomatic participants of MESA ([Multi-Ethnic Study of Atherosclerosis] 68...
February 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28191906/intracardiac-echocardiography-for-verification-for-left-atrial-appendage-thrombus-presence-detected-by-transesophageal-echocardiography-the-actionice-ii-study
#4
Jakub Baran, Beata Zaborska, Roman Piotrowski, Malgorzata Sikora-Frąc, Ewa Pilichowska-Paszkiet, Piotr Kułakowski
BACKGROUND: Transesophageal echocardiography (TEE) remains the gold standard for exclusion of left atrial appendage (LAA) thrombus in patients scheduled for direct electrical cardioversion (DEC) or atrial fibrillation (AF) ablation. Recently, intracardiac echocardiography (ICE) of the pulmonary artery (PA) has been shown to provide excellent LAA images and to be useful in verification of equivocal TEE findings. HYPOTHESIS: ICE of the PA may have a role in detecting false-positive TEE results...
February 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28183844/association-between-posterior-left-atrial-adipose-tissue-mass-and-atrial-fibrillation
#5
Alexander R van Rosendael, Aukelien C Dimitriu-Leen, Philippe J van Rosendael, Melissa Leung, Jeff M Smit, Antti Saraste, Juhani Knuuti, Rob J van der Geest, Britt W H van der Arend, Erik W van Zwet, Arthur J Scholte, Victoria Delgado, Jeroen J Bax
BACKGROUND: Epicardial adipose tissue located close to the atrial wall can change the electric conduction of the left atrium, potentially leading to atrial fibrillation (AF). The aim of this study was to assess whether an increased atrial adipose tissue mass posterior to the left atrium is related to AF independent of demographical and cardiovascular risk factors. METHODS AND RESULTS: Two hundred patients with AF and 200 patients without AF who underwent computed tomographic angiography were included...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#6
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28178304/atrial-fibrillation-among-patients-under-investigation-for-suspected-obstructive-sleep-apnea
#7
Tijn Hendrikx, Martin Sundqvist, Herbert Sandström, Carin Sahlin, Morteza Rohani, Faris Al-Khalili, Rolf Hörnsten, Anders Blomberg, Per Wester, Mårten Rosenqvist, Karl A Franklin
STUDY OBJECTIVES: Obstructive sleep apnea is common among patients with atrial fibrillation, but the prevalence and risk factors for atrial fibrillation among patients who are being investigated on suspicion of sleep apnea are not well known. The aim of the study was to estimate the prevalence of atrial fibrillation among patients investigated for suspected obstructive sleep apnea and to identify risk factors for atrial fibrillation among them. METHODS: The prevalence of atrial fibrillation was investigated among 201 patients referred for suspected obstructive sleep apnea...
2017: PloS One
https://www.readbyqxmd.com/read/28168435/is-obstructive-sleep-apnea-associated-with-the-presence-of-intracranial-cerebral-atherosclerosis
#8
Tae-Jin Song, Jung-Hyun Park, Kang Hyun Choi, Ju-Hee Kim, Yunseo Choi, Yoonkyung Chang, Hyeon Jin Kim, Jangsup Moon, Yong-Jae Kim, Hyang Woon Lee
PURPOSE: Intracranial cerebral atherosclerosis (ICAS) is one of critical atherosclerosis which closely related with stroke. Obstructive sleep apnea (OSA) is associated with systemic atherosclerosis, but it is unclear whether OSA is related with the presence of ICAS. We aimed to investigate the association between the presence of ICAS and severity of OSA in patients with suspected OSA. METHODS: This retrospective, cross-sectional study included 283 patients who suspected OSA (presence of one or more OSA-related symptom and high-risk category in Berlin questionnaire) and underwent polysomnography and brain magnetic resonance angiography (MRA)...
February 7, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28163048/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#9
REVIEW
Ohad Oren, Sheldon Goldberg
Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. Elucidation of the mechanisms of HFpEF is not complete. Recently, intriguing theories about the phenotypic importance of HFpEF (i.e. underlying diabetes mellitus, atrial fibrillation, obesity) have been suggested. However, it has yet to be determined if a targeted approach of that kind would help ameliorate symptoms or slow disease progression. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment...
February 2, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28159822/beta-blocker-use-is-associated-with-impaired-left-atrial-function-in-hypertension
#10
Mayank Sardana, Amer Ahmed Syed, Zeba Hashmath, Timothy S Phan, Maheswara R Koppula, Uzma Kewan, Zoubair Ahmed, Ravikantha Chandamuri, Swapna Varakantam, Ejaz Shah, Ryan Gorz, Scott R Akers, Julio A Chirinos
BACKGROUND: Impaired left atrial (LA) mechanical function is present in hypertension and likely contributes to various complications, including atrial arrhythmias, stroke, and heart failure. Various antihypertensive drug classes exert differential effects on central hemodynamics and left ventricular function. However, little is known about their effects on LA function. METHODS AND RESULTS: We studied 212 subjects with hypertension and without heart failure or atrial fibrillation...
February 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28151869/effect-of-statin-use-on-clinical-outcomes-in-ischemic-stroke-patients-with-atrial-fibrillation
#11
Yi-Ling Wu, Jeffrey L Saver, Pei-Chun Chen, Jiann-Der Lee, Hui-Hsuan Wang, Neal M Rao, Meng Lee, Bruce Ovbiagele
It remains unclear whether statin therapy should be applied to ischemic stroke patients with atrial fibrillation. The objective of this study was to clarify whether statin therapy can influence the prognosis in recent ischemic stroke patients with atrial fibrillation.We identified ischemic stroke patients with atrial fibrillation between 2001 and 2011 from Taiwan National Health Insurance Database. Patients not treated with statins during the first 90 days after the index stroke were matched to patients treated with statins in the first 90 days in a 2:1 ratio on the basis of age, sex, hypertension, diabetes mellitus, ischemic heart disease, heart failure, estimated National Institutes of Health Stroke Scale, use of anticoagulant, and year of their entry into the cohort...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149081/not-only-the-sugar-early-infarct-sign-hyperdense-middle-cerebral-artery-age-neurologic-deficit-score-but-also-atrial-fibrillation-is-predictive-for-symptomatic-intracranial-hemorrhage-after-intravenous-recombinant-tissue-plasminogen-activator
#12
Sombat Muengtaweepongsa, Pornpoj Prapa-Anantachai, Pornpat A Dharmasaroja
BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is the most unwanted adverse event in patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (i.v. rt-PA). Many tool scores are available to predict the probability of sICH. Among those scores, the Sugar, Early infarct sign, hyperDense middle cerebral artery, Age, Neurologic deficit (SEDAN) gives the highest area under the curve-receiver operating characteristic value. OBJECTIVE: We aimed to examine any factors other than the SEDAN score to predict the probability of sICH...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28148612/cardioembolic-stroke-a-case-study
#13
Lisa A Babkair
Cardioembolic stroke is a critical health condition that requires immediate intervention. Cardiac emboli are the most common type of embolism and account for 14% to 30% of all ischemic strokes. Atrial fibrillation is the most common cause of cardioembolic strokes, and its prevalence increases substantially with age. Other factors that increase the risk for cardioembolic stroke include hypertension, diabetes mellitus, hyperlipidemia, cardiac disease, and lifestyle choices. General supportive care and treatment of the acute phase and subsequent complications should be started immediately...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28139384/comorbidity-effects-on-shoulder-arthroplasty-costs-analysis-of-a-nationwide-private-payer-insurance-data-set
#14
Samuel Rosas, Karim G Sabeh, Leonard T Buller, Tsun Yee Law, Steven P Kalandiak, Jonathan C Levy
BACKGROUND: The purpose of this study was to evaluate the effect of common medical comorbidities on the reimbursements of different shoulder arthroplasty procedures. METHODS: We conducted a retrospective query of a single private payer insurance claims database using PearlDiver (Warsaw, IN, USA) from 2010 to 2014. Our search included the Current Procedural Terminology codes and International Classification of Diseases, Ninth Revision codes for total shoulder arthroplasty (TSA), hemiarthroplasty, and reverse shoulder arthroplasty (RSA)...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28127215/use-of-short-term-steroids-in-the-prophylaxis-of-atrial-fibrillation-after-cardiac-surgery
#15
Zeyad Al-Shawabkeh, Khalid Al-Nawaesah, Razi Abu Anzeh, Hael Al-Odwan, Wasfi Azyoud Bashar Al-Rawashdeh, Haetham Altaani
OBJECTIVES: To assess the effectiveness of corticosteroids in the prophylaxis of postoperative atrial fibrillation (AF) in patients undergoing elective coronary artery bypass grafting or valvular heart surgery in terms of reducing its incidence and decreasing the length of hospital stay. METHODS: This prospective double blinded randomized study was conducted at Queen Alia Heart Institute (Amman, Jordan) from June 2014 to June 2015 on 340 patients who underwent their first on-pump elective coronary artery bypass grafting (CABG) alone or combined with valvular surgery...
January 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28102478/influence-of-inflammation-and-atherosclerosis-in-atrial-fibrillation
#16
REVIEW
Rose Mary Ferreira Lisboa da Silva
BACKGROUND: Inflammation markers have been associated with cardiovascular diseases including atrial fibrillation. This arrhythmia is the most frequent, with an incidence of 38/1000 person-years. PURPOSE OF REVIEW: The aims of this study are to discuss the association between inflammation, atherosclerosis and atrial fibrillation and its clinical implications. Atherosclerosis is a chronic inflammatory disease and inflammation is a triggering factor of atherosclerotic plaque rupture...
January 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28079145/galectin-3-as-a-marker-of-interstitial-atrial-remodelling-involved-in-atrial-fibrillation
#17
Diana Hernández-Romero, Juan Antonio Vílchez, Álvaro Lahoz, Ana I Romero-Aniorte, Eva Jover, Arcadio García-Alberola, Rubén Jara-Rubio, Carlos M Martínez, Mariano Valdés, Francisco Marín
Remodelling in the atria could appear as a result of hypertension, diabetes or ischaemic heart disease. Galectin-3 (Gal-3) is a mediator of profibrotic pathways and a potential biomarker of cardiac remodelling. We prospectively recruited consecutive patients undergoing elective cardiac surgery. Preoperative Gal-3 levels were determined from serum samples, and the presence of fibrosis was assessed from atrial appendage tissue samples obtained during cardiac surgery. We included 100 patients with aortic valve or ischaemic heart diseases and 15 controls with permanent AF...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28069837/high-sensitive-cardiac-troponin-t-as-a-novel-predictor-for-recurrence-of-atrial-fibrillation-after-radiofrequency-catheter-ablation
#18
Koki Nakanishi, Shota Fukuda, Hajime Yamashita, Toshifumi Hasegawa, Michihiko Kosaka, Naoya Shirai, Kenei Shimada, Junichi Yoshikawa, Atsushi Tanaka
AIMS: We aimed to determine whether elevated serum high-sensitive cardiac troponin T (hs-TnT) levels predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). METHODS AND RESULTS: We included 125 consecutive patients with AF (paroxysmal, n = 79; persistent, n = 46) who underwent first-time PVI. Serum hs-TnT, high-sensitive C-reactive protein (hs-CRP), atrial natriuretic peptide, and plasma B-type natriuretic peptide levels were measured in venous samples collected before PVI...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28043673/renal-replacement-therapy-in-patients-with-acute-myocardial-infarction-rate-of-use-clinical-predictors-and-relationship-with-in-hospital-mortality
#19
Giancarlo Marenzi, Nicola Cosentino, Andrea Marinetti, Antonio M Leone, Valentina Milazzo, Mara Rubino, Monica De Metrio, Angelo Cabiati, Jeness Campodonico, Marco Moltrasio, Silvio Bertoli, Milena Cecere, Susanna Mosca, Ivana Marana, Marco Grazi, Gianfranco Lauri, Alice Bonomi, Fabrizio Veglia, Antonio L Bartorelli
OBJECTIVES: We evaluated the rate of use, clinical predictors, and in-hospital outcome of renal replacement therapy (RRT) in acute myocardial infarction (AMI) patients. METHODS: All consecutive AMI patients admitted to the Coronary Care Unit between January 1st, 2005 and December 31st, 2015 were identified through a search of our prospectively collected clinical database. Patients were grouped according to whether they required RRT or not. RESULTS: Two-thousand-eight-hundred-thirty-nine AMI patients were included...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28043667/a-sirtuin-1-mmp2-prognostic-index-for-myocardial-infarction-in-patients-with-advanced-coronary-artery-disease
#20
Ilias P Doulamis, Aspasia I Tzani, Panagiotis S Konstantopoulos, George Samanidis, Georgios Georgiopoulos, Konstantinos P Toutouzas, Despina N Perrea, Konstantinos G Perreas
BACKGROUND: Sirtuin 1 (SIRT1) appears to play a protective role against endothelial dysfunction and oxidative stress. Instead, matrix metalloproteinase 2 (MMP2) is involved in acute coronary events, by promoting tissue remodeling. This study sought to determine the clinical value of a prognostic index arising from the combination of these two biomarkers for myocardial infarction (MI) in patients with advanced coronary artery disease. METHODS: Eighty-one patients with advanced coronary artery disease planned for open heart surgery were prospectively enrolled...
March 1, 2017: International Journal of Cardiology
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