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https://www.readbyqxmd.com/read/29904448/extended-duration-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-peripheral-arterial-disease-a-meta-analysis
#1
Hua Ling, Ebony Andrews, David Ombengi, Fang Li
Background: Patients with peripheral arterial disease (PAD) undergoing percutaneous coronary intervention (PCI) are at elevated risk of ischemic and bleeding events. However, the optimal duration of dual antiplatelet therapy (DAPT) after PCI in patients with PAD remains unclear. Methods: A systematic literature search was performed through June 2017 using PubMed, EMBASE and Cochrane databases with the following key terms: "dual antiplatelet therapy", "P2Y12 inhibitor", "myocardial infarction", "percutaneous coronary intervention", "stent", "peripheral arterial disease", and "ankle-brachial index"...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29903520/a-meta-analysis-of-randomized-controlled-trials-of-uninterrupted-periprocedural-anticoagulation-strategy-in-patients-undergoing-atrial-fibrillation-catheter-ablation
#2
Yating Zhao, Yao Lu, Yue Qin
BACKGROUND: In patients undergoing atrial fibrillation (AF) ablation, despite uninterrupted oral anticoagulants (OACs) have been recommended, no consensus has emerged regarding to whether uninterrupted novel oral anticoagulants (NOACs) are superior to uninterrupted vitamin K antagonists (VKAs) for the periprocedural antithrombotic management. This meta-analysis aimed to compare the efficacy and safety of uninterrupted NOACs and uninterrupted VKAs in patients undergoing AF ablation. METHODS: Databases were searched for articles published up to March 20, 2018...
June 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29903344/anticoagulation-and-antiplatelet-strategies-after-on-x-mechanical-aortic-valve-replacement
#3
John D Puskas, Marc Gerdisch, Dennis Nichols, Lilibeth Fermin, Birger Rhenman, Divya Kapoor, Jack Copeland, Reed Quinn, G Chad Hughes, Hormoz Azar, Michael McGrath, Michael Wait, Bobby Kong, Tomas Martin, E Charles Douville, Steven Meyer, Jian Ye, W R Eric Jamieson, Lance Landvater, Robert Hagberg, Timothy Trotter, John Armitage, Jeffrey Askew, Kevin Accola, Paul Levy, David Duncan, Bobby Yanagawa, John Ely, Allen Graeve
BACKGROUND: The burden oral anticoagulation is a limitation of mechanical valve prostheses. OBJECTIVES: The aim of this study was to test whether patients could be safely managed with dual-antiplatelet therapy (DAPT) (aspirin 325 mg and clopidogrel 75 mg) or lower warfarin after On-X mechanical aortic valve replacement (mAVR). METHODS: PROACT (Prospective Randomized On-X Anticoagulation Trial) (n = 576) is a multicenter (41 sites) noninferiority trial...
June 19, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29903028/feasibility-of-a-novel-synthetic-self-assembling-peptide-for-suture-line-haemostasis-in-cardiac-surgery
#4
Suresh Giritharan, Kareem Salhiyyah, Geoffrey M Tsang, Sunil K Ohri
BACKGROUD: To assess the feasibility and efficacy of PuraStat®, a novel haemostatic agent, in achieving suture line haemostasis in a wide range of cardiac surgical procedures and surgery of the thoracic aorta. METHODS: A prospective, non-randomised study was conducted at our institution. Operative data on fifty consecutive patients undergoing cardiac surgery where PuraStat® was utilised in cases of intraoperative suture line bleeding was prospectively collected...
June 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29901532/sampling-utility-of-the-convex-probe-endobronchial-ultrasound-visible-intrapulmonary-lesion
#5
Francisco A Almeida, Shameen Salam, Atul C Mehta, Luke Yuhico, Yash Sarda, Humberto Choi, Joseph C Cicenia, Thomas Gildea, Michael Machuzak, Peter Mazzone, Eduardo Oliveira, Sonali Sethi, Xiao-Feng Wang, Jordan P Reynolds
BACKGROUND: The value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the mediastinal staging of lung cancer has been well established. However, data regarding its utility in the diagnosis of intrapulmonary lesions has been sparse. This study assesses the sampling utility of convex probe EBUS-visible intrapulmonary lesions not visualized by the white-light bronchoscopy. METHODS: A retrospective analysis of EBUS-TBNA of EBUS-visible intrapulmonary lesions was performed between January 2010 and March 2015...
June 12, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29901447/long-term-effectiveness-and-safety-of-transcatheter-closure-of-patent-foramen-ovale-compared-with-antithrombotic-therapy-a-meta-analysis-of-6-randomised-clinical-trials-and-3560-patients-with-reconstructed-time-to-event-data
#6
Daniele Giacoppo, Nicola Caronna, Antonio H Frangieh, Jonathan Michel, Giuseppe Andò, Giuseppe Tarantini, Albert M Kasel, Davide Capodanno, Robert A Byrne
AIMS: Although three recent trials showed a significant stroke risk reduction after tPFOc, the impact on pooled evidence deserves attention and individual statistical power is limited. We aimed to pool available randomised clinical trials (RCT) to assess whether tPFOc is more effective and safe than antithrombotic therapy alone (ATA). METHODS AND RESULTS: Major electronic databases and tangential sources were searched and 6 trials (3560 patients) identified. At a median follow-up of 3...
June 12, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29901444/establishment-of-healing-profile-and-neointimal-transformation-in-the-new-polymer-free-biolimus-a9-coated-coronary-stent-by-longitudinal-sequential-optical-coherence-tomography-assessments-the-ego-biofreedom-study
#7
Stephen Wai Luen Lee, Frankie C C Tam, Kelvin K W Chan, Simon C C Lam, Shun-Ling Kong, Catherine P Shea, Michael K L Wong, Anthony Y T Wong, Arthur S Y Yung, Li-Wei Zhang, Yui-Ming Lam, Gary S Mintz, Ricardo A Costa, Hans-Peter Stoll, Akiko Maehara
AIMS: In patients at high bleeding risk treated with 1 month of dual antiplatelet therapy, the polymer-free, biolimus A9-coated BioFreedom stent (BFS) was found safer and more efficacious than bare metal stents. We used sequential optical coherence tomography (OCT) to assess the time course of strut coverage and neointimal transformation from 1 to 9 months. METHODS AND RESULTS: We randomly assigned 104 BFS recipients to 1 of 5 groups with angiography and OCT follow-up at 1, 2, 3, 4, or 5 months, together with another follow-up for all at 9 months...
June 12, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29900874/dabigatran-in-patients-with-myocardial-injury-after-non-cardiac-surgery-manage-an-international-randomised-placebo-controlled-trial
#8
P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. METHODS: In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries...
June 9, 2018: Lancet
https://www.readbyqxmd.com/read/29900001/transfusion-management-of-incident-dialysis-patients-in-canada-a-prospective-observational-study
#9
Aminu K Bello, Christine M Ribic, Serge H Cournoyer, Mercedeh Kiaii, Martine LeBlanc, Melanie Poulin-Costello, David N Churchill, Norman Muirhead
Background: Several studies have demonstrated harm associated with using erythropoiesis-stimulating agents (ESA) to achieve higher hemoglobin (Hb) levels. Subsequently, more conservative use of ESAs has changed anemia therapy in patients with chronic renal failure. Objective: The objectives were to identify transfusion rates in hemodialysis (HD) patients during the first year of therapy, to identify factors associated with the probability of transfusion, describe reasons for the transfusions, and identify the Hb values associated with each transfusion...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29899437/coil-assisted-retrograde-transvenous-obliteration-carto-an-alternative-treatment-option-for-refractory-hepatic-encephalopathy
#10
Edward Wolfgang Lee, Sammy Saab, Fady Kaldas, Savannah Fletcher, Ronald W Busuttil, Francisco Durazo, Justin P McWilliams, Joseph DiNorcia, Siddharth A Padia, Stephen T Kee
BACKGROUND: Overt hepatic encephalopathy (OHE) is a serious complication of liver dysfunction, which is associated with severe morbidity/mortality and healthcare resource utilization. OHE can be medically refractory due to spontaneous portosystemic shunts (SPSSs) and therefore a new treatment option for these SPSSs is critical. METHODS: This is a retrospective study of 43 patients with medically refractory OHE, who underwent CARTO (Coil-Assisted Retrograde Transvenous Obliteration) procedures between June 2012 and October 2016...
June 14, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29898848/oral-anti-xa-anticoagulation-after-trans-aortic-valve-implantation-for-aortic-stenosis-the-randomized-atlantis-trial
#11
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898844/an-open-label-2-%C3%A3-2-factorial-randomized-controlled-trial-to-evaluate-the-safety-of-apixaban-vs-vitamin-k-antagonist-and-aspirin-vs-placebo-in-patients-with-atrial-fibrillation-and-acute-coronary-syndrome-and-or-percutaneous-coronary-intervention-rationale
#12
Renato D Lopes, Amit N Vora, Danny Liaw, Christopher B Granger, Harald Darius, Shaun G Goodman, Roxana Mehran, Stephan Windecker, John H Alexander
BACKGROUND: The optimal antithrombotic strategy for patients with atrial fibrillation (AF) who develop acute coronary syndrome (ACS) and/or the need for percutaneous coronary intervention (PCI) is uncertain. The risk of bleeding is a major concern when oral anticoagulation is required to prevent stroke, and concomitant therapy with antiplatelet agents is required to minimize recurrent ischemic events. DESIGN: AUGUSTUS is an international, multicenter randomized trial with a 2 × 2 factorial design to compare apixaban with vitamin K antagonists and aspirin with placebo in patients with AF who develop ACS and/or undergo PCI and are receiving a P2Y12 inhibitor...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898836/impact-of-polyvascular-disease-on-patients-with-atrial-fibrillation-insights-from-rocket-af
#13
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
BACKGROUND: We investigated the impact of polyvascular disease in patients enrolled in ROCKET AF. METHODS: Cox regression models were used to assess clinical outcomes and treatment effects of rivaroxaban compared with warfarin in patients with atrial fibrillation and coronary, peripheral, or carotid artery disease, or any combination of the 3. RESULTS: A total of 655 (4.6%) patients had polyvascular disease (≥2 disease locations), and 3,391 (23...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29897437/influence-of-a-history-of-cancer-on-long-term-cardiovascular-outcomes-after-coronary-stent-implantation-an-observation-from-coronary-revascularization-demonstrating-outcome-study-kyoto-registry-cohort-2
#14
Kenji Nakatsuma, Hiroki Shiomi, Takeshi Morimoto, Hirotoshi Watanabe, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Koh Ono, Satoshi Shizuta, Takeshi Kimura
Aims: To evaluate the influence of a history of cancer on clinical outcomes in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI). Methods and Results: In the CREDO-Kyoto PCI/coronary bypass grafting (CABG) Registry Cohort-2, there were 12,180 CAD patients who received PCI with stents. There were 1109 patients with a history of cancer (cancer group), and 11,071 patients without cancer (non-cancer group). The cumulative 5-year incidences of cardiac death and heart failure (HF) hospitalization were significantly higher in the cancer group than in the non-cancer group (12...
April 20, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29896847/advanced-chronic-kidney-disease-relationship-to-outcomes-post-tavr-a-meta-analysis
#15
REVIEW
Nader Makki, Scott M Lilly
OBJECTIVE: Chronic kidney (CKD) is associated with worse outcomes in high-surgical risk patients undergoing transcatheter aortic valve replacement (TAVR). However, it is unclear whether this relationship is apparent in lower surgical risk patients. Herein we sought to analyze existing literature to assess whether or not advanced CKD is associated with increased mortality, or a greater incidence of adverse events (specifically major stroke, bleeding and vascular complications). METHODS: We searched PubMed and EMBASE (2008-2017) for relevant studies...
June 12, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29895520/clinical-update-on-thrombolytic-use-in-pulmonary-embolism-a-focus-on-intermediate-risk-patients
#16
Hannah Eberle, Raquel Lyn, Tamara Knight, Emily Hodge, Mitchell Daley
PURPOSE: Current literature on clinical controversies surrounding the use of thrombolytic agents in patients with intermediate-risk pulmonary embolism (PE) is reviewed. SUMMARY: PE is a major cause of morbidity and mortality. When used in conjunction with anticoagulation, thrombolysis has been shown to reduce hemodynamic decompensation in select patients, but thrombolytic therapy is associated with high risks of bleeding and intracranial hemorrhage and its role in treating patients with intermediate-risk PE remains controversial...
June 12, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29894362/video-assisted-thoracoscopic-monitoring-of-laser-lead-extraction-by-femoral-route
#17
Luca Bontempi, Francesca Vassanelli, Manuel Cerini, Lorenza Inama, Gianfranco Mitacchione, Daniele Giacopelli, Antonio Curnis
A 72-year-old man with a dual-chamber implantable defibrillator was referred to our center for transvenous lead extraction because of pocket infection and presence of an abandoned lead. We decided to proceed with a video-assisted thoracoscopic approach because of patient history and documented complete occlusion of the right subclavian vein. During the use of excimer laser for persistent adhesions, the ventricular lead broke down at the level of cavoatrial junction. To successfully remove the remaining portion of lead, we decided to use the excimer laser by femoral route...
June 11, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29893840/translating-guidelines-into-practice-for-the-management-of-atrial-fibrillation-results-of-an-european-heart-rhythm-association-survey
#18
Gheorghe-Andrei Dan, Konstantinos Iliodromitis, Daniel Scherr, Francisco Marín, Radoslaw Lenarczyk, Heidi L Estner, Marcin Kostkiewicz, Nikolaos Dagres, Gregory Y H Lip
Despite the huge progress made in the both understanding the mechanisms and the management of atrial fibrillation (AF) this arrhythmia still represents an important health and social burden. Atrial fibrillation is increasing in frequency and is a major cause of death, stroke, heart failure, cognitive decline, and hospitalizations. New data have emerged emphasizing the multidisciplinary approach to better management of this common arrhythmia. Despite the availability of AF management guidelines, practice among European centres may differ from the current guideline recommendations...
June 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29893516/stool-patterns-and-symptoms-of-disordered-anorectal-function-in-patients-with-inflammatory-bowel-diseases
#19
Paweł W Petryszyn, Leszek Paradowski
BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC) typically clinically manifest with symptoms like chronic diarrhea, cramps, abdominal pain, and rectal bleeding. However, symptoms of abnormal anorectal function seem to be of equal importance, regardless of the presence or absence of perianal disease. OBJECTIVES: The aim of this study was to assess stool patterns and the prevalence of symptoms of disordered anorectal function, particularly urgency and fecal incontinence, and their severity in patients with inflammatory bowel diseases (IBDs)...
June 12, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29892257/focused-neuro-otological-review-of-superficial-siderosis-of-the-central-nervous-system
#20
Aran Yoo, Jonathan Jou, Jeffrey D Klopfenstein, Jorge C Kattah
Background: Infratentorial siderosis (iSS) is a progressive degenerative disorder targeting primarily the cerebellum and cranial nerve eighth; therefore, progressive ataxia and its neuro-otological findings are common. Toxicity from hemosiderin involves selectively vulnerable neurons and glia in these posterior fossa structures. Other neurologic findings may be present, though our focus relates to the cochlea-vestibular cerebellar involvement. Radiographic evidence of siderosis may be the result of recurrent, albeit covert bleeding in the subarachnoid space, or the consequence of an overt post-traumatic or aneurysmal subarachnoid hemorrhage (SAH)...
2018: Frontiers in Neurology
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