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atrial fibrilation and coronary syndroms

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https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#1
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29208494/bleeding-in-advanced-ckd-patients-on-antithrombotic-medication-a-critical-appraisal
#2
Alexandru Burlacu, Simonetta Genovesi, David Goldsmith, Patrick Rossignol, Alberto Ortiz, Philip A Kalra, Jolanta Małyszko, Maciej Banach, Mehmet Kanbay, Adrian Covic
Patients with advanced chronic kidney disease (CKD) are at an increased risk of bleeding, especially in the context of the complex therapeutic schemes of coronary artery disease (CAD) (from stable angina to acute coronary syndromes), atrial fibrillation or venous thromboembolism. The bleeding issue increases morbidity and mortality, a serious problem in daily medical practice. However, these patients are largely excluded from major randomized clinical trials, which results in the lack of medical evidence-based foundation for specific recommendations regarding antithrombotic treatment in a high bleeding risk setting...
December 2, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#3
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29168552/predictors-of-post-operative-atrial-fibrillation-in-patients-undergoing-isolated-coronary-artery-bypass-grafting
#4
Iwona Gorczyca-Michta, Kamil Michta, Edward Pietrzyk, Beata Wożakowska-Kapłon
BACKGROUND: Post-operative atrial fibrillation (POAF) is the most common cardiac arrhythmia occurring after coronary artery bypass grafting (CABG). Arrhythmia leads to prolonged hospitalization and may have impact on both short-term and long-term prognoses. AIM: The aim of this paper was the evaluation of the incidence of POAF in patients after CABG as well as the identification of its predictors. METHODS: The study was performed on 791 patients (selected from a group of 1031 patients who underwent CABG in the Clinical Department of Cardiology in years 2009-2011) who did not suffer from atrial fibrillation (AF) prior to isolated CABG...
November 23, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29129575/cardiovascular-events-and-target-organ-damage-in-primary-aldosteronism-compared-with-essential-hypertension-a-systematic-review-and-meta-analysis
#5
Silvia Monticone, Fabrizio D'Ascenzo, Claudio Moretti, Tracy Ann Williams, Franco Veglio, Fiorenzo Gaita, Paolo Mulatero
BACKGROUND: There is conflicting evidence, relying on heterogeneous studies, as to whether aldosterone excess is responsible for an increased risk of cardiovascular and cerebrovascular complications in patients with primary aldosteronism. We aimed to assess the association between primary aldosteronism and adverse cardiac and cerebrovascular events, target organ damage, diabetes, and metabolic syndrome, compared with the association of essential hypertension and these cardiovascular and end organ events, by integrating results of previous studies...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29113375/efficacy-and-safety-of-triple-versus-dual-antithrombotic-therapy-in-atrial-fibrillation-and-ischemic-heart-disease-a-systematic-review-and-meta-analysis
#6
Wengen Zhu, Linjuan Guo, Fadi Liu, Rong Wan, Yang Shen, Gregory Y H Lip, Kui Hong
The optimal antithrombotic regimen for patients with atrial fibrillation and ischemic heart disease remains unclear. Therefore, we aimed to compare the efficacy and safety of triple therapy (TT [an anticoagulant and 2 antiplatelet drugs]) with dual therapy (DAPT [2 antiplatelet drugs] or DT [an anticoagulant and a single antiplatelet drug]) in patients with atrial fibrillation and ischemic heart disease. We systematically searched the Cochrane Library, PubMed and Embase databases for all relevant studies up to August 2017...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#7
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#8
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
December 2017: Herz
https://www.readbyqxmd.com/read/29016832/contemporary-stroke-prevention-strategies-in-11%C3%A2-096-european-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-on-atrial-fibrillation-eorp-af-long-term-general-registry
#9
Giuseppe Boriani, Marco Proietti, Cécile Laroche, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Igor Diemberger, Luigi Tavazzi, Aldo P Maggioni, Gregory Y H Lip
Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed. Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84...
September 14, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28986061/adverse-cardiovascular-outcomes-in-atrial-fibrillation-validation-of-the-new-2mace-risk-score
#10
Marija Polovina, Dijana Đikić, Ana Vlajković, Matej Vilotijević, Ivan Milinković, Milika Ašanin, Miodrag Ostojić, Andrew J S Coats, Petar M Seferović
BACKGROUND: In addition to thromboembolism, atrial fibrillation (AF) may also predispose to major adverse cardiovascular events (MACE) attributable to coronary artery disease (CAD), including myocardial infarction (MI). The 2MACE score (2 points - Metabolic syndrome and Age≥75years, 1 point - MI/revascularization, Congestive heart failure/ejection-fraction <40%, and thrombo-Embolism) was recently proposed to help identify AF patients at risk of MACE. We assessed the predictive validity of the 2MACE score for MACE occurrence in AF patients free of CAD at baseline...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28972004/prevention-of-stroke-with-the-addition-of-ezetimibe-to-statin-therapy-in-patients-with-acute-coronary-syndrome-in-improve-it
#11
Erin A Bohula, Stephen D Wiviott, Robert P Giugliano, Michael A Blazing, Jeong-Gun Park, Sabina A Murphy, Jennifer A White, Francois Mach, Frans J Van de Werf, Anthony J Dalby, Harvey D White, Andrew M Tershakovec, Christopher P Cannon, Eugene Braunwald
Background -Patients who experience an acute coronary syndrome (ACS) are at heightened risk of recurrent ischemic events, including stroke. Ezetimibe improved cardiovascular outcomes when added to statin therapy in patients stabilized after ACS. We investigated the efficacy of the addition of ezetimibe to simvastatin for the prevention of stroke and other adverse cardiovascular events in IMPROVE-IT, with a focus on patients with a stroke prior to randomization. Methods -Post-ACS patients were randomized to placebo/simvastatin or ezetimibe/simvastatin and followed for a median of 6 years...
September 30, 2017: Circulation
https://www.readbyqxmd.com/read/28969538/triple-therapy-versus-dual-antiplatelet-therapy-for-patients-with-atrial-fibrillation-and-acute-coronary-syndromes-a-systematic-literature-review
#12
Aimee Louise Fake, Anil Ranchord, Scott Harding, Peter Larsen
BACKGROUND: Patients with acute coronary syndromes (ACS) and a history of atrial fibrillation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS. METHODS: We searched Medline, Medline pending, EMBASE and Evidence-Based Medicine Reviews databases for studies published between January 2000 to December 2016 in AF patients with ACS that compared DAPT and TT that reported ischaemic and/or bleeding outcomes...
September 27, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28929616/noninvasive-assessment-of-left-ventricular-end-diastolic-pressure-by-deceleration-time-of-early-diastolic-mitral-annular-velocity-in-patients-with-heart-failure
#13
Kazushi Takemoto, Kumiko Hirata, Takeshi Hozumi, Takashi Tanimoto, Makoto Orii, Yasutsugu Shiono, Yoshiki Matsuo, Yasushi Ino, Hironori Kitabata, Takashi Kubo, Atsushi Tanaka, Takashi Akasaka
OBJECTIVE: To examine the diagnostic ability of the deceleration time of early mitral annular velocity (e'DT) as determined by tissue Doppler velocity image, a method for assessing LV filling pressure. BACKGROUNDS: Estimation of LV filling pressure by Doppler echocardiography requires a combination of various parameters. Therefore, there remains a need for a simple index in LV filling pressure estimation. The e' is known to be reduced and delayed with increased LV filling pressure during development of heart failure...
September 2017: Echocardiography
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#14
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28912212/risk-stratification-using-the-cha2ds2-vasc-score-in-takotsubo-syndrome-data-from-the-takotsubo-italian-network
#15
Guido Parodi, Fernando Scudiero, Rodolfo Citro, Angelo Silverio, Benedetta Bellandi, Concetta Zito, Francesco Antonini-Canterin, Fausto Rigo, Chiara Zocchi, Eduardo Bossone, Jorge Salerno-Uriarte, Federico Piscione, Carlo Di Mario
BACKGROUND: The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients. METHODS AND RESULTS: Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry...
September 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28890872/cardiac-troponin-and-outcome-in-decompensated-heart-failure-with-preserved-ejection-fraction
#16
Mohammad Thawabi, Amer Hawatmeh, Sarah Studyvin, Habib Habib, Fayez Shamoon, Marc Cohen
BACKGROUND: Cardiac troponin (cTn) has been established as an effective prognostic marker in acute heart failure (HF) with predominantly reduced ejection fraction. However, it's prognostic value in heart failure with preserved ejection fraction (HFpEF) is unclear. The aim of this study is to describe the prognostic role of troponin I in patients hospitalized for HFpEF decompensation. METHODS: We included 363 consecutive patients admitted for HFpEF decompensation that was not associated with acute coronary syndrome (ACS)...
August 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28867245/proposal-of-a-novel-clinical-score-to-predict-heart-failure-incidence-in-long-term-survivors-of-acute-coronary-syndromes
#17
Moisés Rodríguez-Mañero, Alberto Cordero, Omar Kreidieh, Jose Mª García-Acuña, Jose Seijas, Rosa María Agra-Bermejo, Charigan Abou-Jokh, Leyre Álvarez-Rodríguez, Diego Álvarez-Iglesias, Ramón López-Palop, Belen Cid, Pilar Carrillo, Jose R González-Juanatey
INTRODUCTION: HF remains a frequent complication following MI and adversely affects prognosis. The objective of this study was to identify predictors of HF following MI and to design a risk score for its prediction. METHODS: Retrospective study of all consecutive patients admitted for MI. Primary end point was time to incident HF. Patients with previous history of HF were excluded. Death was modelled as competing risk. RESULTS: 5737 patients were included...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28860319/reducing-the-global-burden-of-cardiovascular-disease-part-2-prevention-and-treatment-of-cardiovascular-disease
#18
REVIEW
Darryl P Leong, Philip G Joseph, Martin McKee, Sonia S Anand, Koon K Teo, Jon-David Schwalm, Salim Yusuf
In this second part of a 2-part series on the global burden of cardiovascular disease, we review the proven, effective approaches to the prevention and treatment of cardiovascular disease. We specifically review the management of acute cardiovascular diseases, including acute coronary syndromes and stroke; the care of cardiovascular disease in the ambulatory setting, including medical strategies for vascular disease, atrial fibrillation, and heart failure; surgical strategies for arterial revascularization, rheumatic and other valvular heart disease, and symptomatic bradyarrhythmia; and approaches to the prevention of cardiovascular disease, including lifestyle factors, blood pressure control, cholesterol-lowering, antithrombotic therapy, and fixed-dose combination therapy...
September 1, 2017: Circulation Research
https://www.readbyqxmd.com/read/28838473/safety-and-efficacy-of-polymer-free-biolimus-a9-coated-versus-bare-metal-stents-in-orally-anticoagulated-patients-2-year-results-of-the-leaders-free-oral-anticoagulation-substudy
#19
Didier Carrié, Ian Menown, Keith Oldroyd, Samuel Copt, Suneel Talwar, Luc Maillard, Marie-Claude Morice, Lim Soo Teik, Irene Lang, Philip Urban
OBJECTIVES: The aim of this study was to compare the performance of drug-coated stents (DCS) versus bare-metal stents (BMS) in patients who are candidates for long-term oral anticoagulation (OAC) after percutaneous coronary interventions. BACKGROUND: The randomized controlled LEADERS FREE (A Randomized Clinical Evaluation of the BioFreedom™ Stent) trial demonstrated the superior safety and efficacy of a polymer-free biolimus A9 DCS compared with a similar BMS used with 1 month of dual antiplatelet therapy in 2,466 patients at high bleeding risk...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#20
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
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