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atrial fibrilation and coronary syndroms

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https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#1
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29426281/primary-percutaneous-coronary-intervention-during-st-elevation-myocardial-infarction-in-prosthetic-valve-endocarditis-a-case-report
#2
Alfonso Campanile, Guido Tavazzi, Francesco Caprioglio, Fausto Rigo
BACKGROUND: Infective endocarditis (IE) is still a condition with high mortality and morbidity, especially in the elderly, and in patients with prosthetic valves. The concept of "time-to-therapy" plays a key role for the prompt management of IE and related complications, and the currently available multimodality imaging may play a key role in this setting. Myocardial ischemia due to extrinsic coronary compression from an aortic abscess is an extremely rare condition where the optimal therapeutic strategy has not been defined yet...
February 9, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29421988/high-density-lipoprotein-cholesterol-hdl-c-levels-independently-correlates-with-cardiac-arrhythmias-and-atrial-fibrillation
#3
Farzin Brian Boudi, Nicholas Kalayeh, Mohammad Reza Movahed
OBJECTIVE: Acute coronary syndrome is frequently complicated by rhythm disturbances, yet any association between high-density lipoprotein (HDL) cholesterol levels and arrhythmias in the setting of non-ST-segment elevation myocardial infarction (non-STEMI) is uncertain. The goal of this study was to evaluate any association between HDL-cholesterol levels and arrhythmias in the setting of non-STEMI. METHODS: Retrospective data from Phoenix Veterans Affair Medical Center records were utilized for our study...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29415954/antiplatelet-therapy-in-acs-patients-comparing-appropriate-p2y12-inhibition-by-clopidogrel-to-the-use-of-new-p2y12-inhibitors
#4
Jessica Ristorto, Nathan Messas, Benjamin Marchandot, Marion Kibler, Sébastien Hess, Nicolas Meyer, Michael Schaeffer, Nicolas Tuzin, Patrick Ohlmann, Laurence Jesel, Olivier Morel
AIM: In percutaneous coronary intervention (PCI)-treated acute coronary syndrome (ACS) patients on clopidogrel therapy, high on-treatment platelet adenosine diphosphate (ADP) reactivity was observed in numerous studies, with significant increases in non-fatal myocardial infarction, definite/probable stent thrombosis, or cardiovascular mortality. Compared to clopidogrel, prasugrel and ticagrelor provide more potent platelet inhibition. Whether new P2Y12 inhibitors reduce thrombotic events in a similar manner compared to the rate observed with appropriate P2Y12 inhibition by clopidogrel must still be determined...
February 8, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29407080/arterial-hypertension-in-patients-with-atrial-fibrillation-in-europe-a-report-from-the-eurobservational-research-programme-pilot-survey-on-atrial-fibrillation
#5
G A Dan, E Badila, E Weiss, C Laroche, G Boriani, A Dan, L Tavazzi, A P Maggioni, H J Crijns, R Popescu, D Blommaert, W Streb, G Y H Lip
BACKGROUND: Hypertension (HTN) is the most prevalent co-morbidity among atrial fibrillation (AF) patients; the relationship between the two is bidirectional, with an incremental effect on adverse outcomes. PURPOSE: To study clinical features, treatment patterns and 1year outcomes amongst AF patients with HTN in the EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry, a prospective multi-national survey conducted by the European Society of Cardiology in 9 European countries...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29391805/role-of-rivaroxaban-in-the-management-of-atrial-fibrillation-insights-from-clinical-practice
#6
REVIEW
Kavitha Vimalesvaran, Seth J Dockrill, Diana A Gorog
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and it leads to significant morbidity and mortality, predominantly from ischemic stroke. Vitamin K antagonists, mainly warfarin, have been used for decades to prevent ischemic stroke in AF, but their use is limited due to interactions with food and other drugs, as well as the requirement for regular monitoring of the international normalized ratio. Rivaroxaban, a direct factor Xa inhibitor and the most commonly used non-vitamin K oral anticoagulant, avoids many of these challenges and is being prescribed with increasing frequency for stroke prevention in non-valvular AF...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29372080/troponin-testing-in-the-emergency-department-real-world-experience
#7
Mohammed Al-Maskari, Mahmoud Al-Makhdami, Hatim Al-Lawati, Hafidh Al-Hadi, Sunil K Nadar
Objectives: The aim of this study was to examine patterns of troponin testing in the emergency department of a large tertiary care hospital in Oman and to determine its effect on patient management, including length of hospital stay (LOS). Methods: This retrospective study analysed the medical records of all adult patients undergoing troponin testing in the emergency department of the Sultan Qaboos University Hospital, Muscat, Oman, during the month of July 2015...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29371870/persian-registry-of-cardiovascular-disease-prove-design-and-methodology
#8
Mahshid Givi, Nizal Sarrafzadegan, Mohammad Garakyaraghi, Ghasem Yadegarfar, Masoumeh Sadeghi, Alireza Khosravi, Amir Hossein Azhari, Mohammad Reza Samienasab, Davood Shafie, Mohammad Saadatnia, Hamidreza Roohafza, Navid Paydari, Azam Soleimani, Mohsen Hosseinzadeh, Seyed Abdulah Ahmadi, Leila Dehghani, Jamshid Najafian, Elham Andalib, Javad Shahabi, Mohammad Reza Sabri
BACKGROUND: Our aim was to create and establish a database called "Persian Registry Of cardioVascular diseasE (PROVE)" in order to be used for future research and in addition, as a tool to develop national guidelines for diagnosis, treatment, and prevention of cardiovascular disease (CVD). In this paper, the design and methodology of the PROVE pilot study will be discussed, launched in Isfahan, Iran, in 2015-2016. METHODS: Through establishing PROVE, patients' data were collected from hospitals and outpatient clinics prospectively or retrospectively and followed up for a maximum of three years based on the type of CVDs...
September 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29363352/anticoagulant-and-antiplatelet-therapy-choices-for-patients-with-atrial-fibrillation-one-year-after-coronary-stenting-or-acute-coronary-syndrome
#9
Christoph B Olivier, Mintu P Turakhia, Kenneth W Mahaffey
Guidelines recommend a combined anticoagulant and antiplatelet approach for patients with atrial fibrillation (AF) after coronary stenting (CS) or acute coronary syndrome (ACS). Finding the optimal balance of reducing ischemic risk and minimizing bleeding risk is challenging. Recent trials have evaluated a variety of regimens for up to one year for AF patients after CS/ACS. Little empiric evidence exists about the best antithrombotic strategy beyond one year. Areas covered: In this review two key areas are covered...
January 24, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29361983/cardiac-computed-tomography-in-patients-with-symptomatic-new-onset-atrial-fibrillation-rule-out-acute-coronary-syndrome-but-with-intermediate-pretest-probability-for-coronary-artery-disease-admitted-to-a-chest-pain-unit
#10
Matthias Koopmann, Liane Hinrichs, Jan Olligs, Michael Lichtenberg, Lars Eckardt, Dirk Böse, Stefan Möhlenkamp, Johannes Waltenberger, Frank Breuckmann
BACKGROUND: Atrial fibrillation (AF) and coronary artery disease (CAD) may be encountered coincidently in a large portion of patients. However, data on coronary artery calcium burden in such patients are lacking. Thus, we sought to determine the value of cardiac computed tomography (CCT) in patients presenting with new-onset AF associated with an intermediate pretest probability for CAD admitted to a chest pain unit (CPU). METHODS: Calcium scores (CS) of 73 new-onset, symptomatic AF subjects without typical clinical, electrocardiographic, or laboratory signs of acute coronary syndrome (ACS) admitted to our CPU were analyzed...
January 24, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29348012/coronary-embolus-an-underappreciated-cause-of-acute-coronary-syndromes
#11
REVIEW
Claire E Raphael, John A Heit, Guy S Reeder, Melanie C Bois, Joseph J Maleszewski, R Thomas Tilbury, David R Holmes
Coronary embolism is the underlying cause of 3% of acute coronary syndromes but is often not considered in the differential of acute coronary syndromes. It should be suspected in the case of high thrombus burden despite a relatively normal underlying vessel or recurrent coronary thrombus. Coronary embolism may be direct (from the aortic valve or left atrial appendage), paroxysmal (from the venous circulation through a patent foramen ovale), or iatrogenic (following cardiac intervention). Investigations include transesophageal echocardiography to assess the left atrial appendage and atrial septum and continuous electrocardiographic monitoring to assess for paroxysmal atrial fibrillation...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#12
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#13
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29336245/the-role-of-colchicine-in-pericardial-syndromes
#14
George Lazaros, Massimo Imazio, Antonio Brucato, Charalambos Vlachopoulos, Emilia Lazarou, Dimitrios Vassilopoulos, Dimitris Tousoulis
BACKGROUND: Colchicine is an old drug originally employed for the treatment of inflammatory disorders such as acute gout and familiar Mediterranean fever. METHODS: In the past few decades, colchicine has been at the forefront of the pharmacotherapy of several cardiac diseases, including acute and recurrent pericarditis, coronary artery disease, prevention of atrial fibrillation and heart failure. In this review, we have summarized the current evidence based medicine and guidelines recommendations in the specific context of pericardial syndromes...
January 15, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29332241/atrial-fibrillation-is-associated-with-sudden-cardiac-death-a-systematic-review-and-meta-analysis
#15
Pattara Rattanawong, Sikarin Upala, Tanawan Riangwiwat, Veeravich Jaruvongvanich, Anawin Sanguankeo, Wasawat Vutthikraivit, Eugene H Chung
PURPOSE: Recent studies suggest that atrial fibrillation (AF) is associated with increased cardiovascular risk and mortality including sudden cardiac death (SCD). According to the Cardiovascular Heath Study cohort, the incident rate of SCD was higher in the AF population (2.9 per 1000 per year) compared with non-AF controls (1.3 per 1000 per year). In this study, we performed a systematic review and meta-analysis to explore the association between AF and SCD. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to January 2017...
January 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29311288/coronary-embolism-among-st-segment-elevation-myocardial-infarction-patients-mechanisms-and-management
#16
Batric Popovic, Nelly Agrinier, Nidhal Bouchahda, Samuel Pinelli, Charles Henry Maigrat, Pierre Adrien Metzdorf, Christine Selton Suty, Yves Juillière, Edoardo Camenzind
BACKGROUND: Coronary artery embolism (CE) is recognized as an important nonatherosclerotic cause of ST-segment-elevation myocardial infarction. The objective was to describe clinical characteristics and long-term outcomes and to identify risks factors of CE in a large consecutive series of ST-segment-elevation myocardial infarction patients. METHODS AND RESULTS: We studied 1232 consecutive patients who presented with de novo ST-segment-elevation myocardial infarction...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29301583/which-factor-is-the-most-effective-one-in-metabolic-sydrome-on-the-outcomes-after-coronary-artery-bypass-graft-surgery-a-cohort-study-of-5%C3%A2-years
#17
Lijuan Wang, Xiangyang Qian, Mingya Wang, Xinran Tang, Hushan Ao
BACKGROUND: Metabolic Syndrome and diabetes mellitus are risk factors for cardiovascular disease. However, the effects of Metabolic Syndrome with or without diabetes on perioperative and long-term morbidity and mortality after Coronary Artery Bypass Graft remain unclear. METHODS: An retrospective study was performed on 1166 patients who received isolated primary Coronary Artery Bypass Graft in Fuwai hospital. They were divided into three groups: control, Metabolic Syndrome of three factors together with diabetes and Metabolic Syndrome of three factors without diabetes (n = 868, 76 and 222 respectively)...
January 4, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29295790/direct-oral-anticoagulants-an-update
#18
REVIEW
Ana Isabel Franco Moreno, Rosa María Martín Díaz, María José García Navarro
Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome...
December 30, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29275452/mild-troponin-elevation-in-patients-admitted-to-the-emergency-department-with-atrial-fibrillation-30-day-post-discharge-prognostic-significance
#19
João Augusto, Miguel Borges Santos, David Roque, Daniel Faria, Joana Urzal, José Morais, Victor Gil, Carlos Morais
Patients with atrial fibrillation (AF) often undergo troponin (Tn) testing in the emergency department (ED), but the clinical significance of mildly elevated values remains unclear. We evaluated short-term 30-day post-discharge outcomes in AF patients according to troponin levels. Out of 2181 AF patients evaluated in the ED (June 2014 to June 2015), we included consecutive admitted patients. Patients were grouped into those with normal Tn values (≤ 0.05 ng/mL), mild elevations (> 0.05-0.5 ng/mL, 10× URL) and marked elevations (> 0...
December 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29275065/reduced-time-in-therapeutic-range-and-higher-mortality-in-atrial-fibrillation-patients-taking-acenocoumarol
#20
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
PURPOSE: The efficacy and tolerability of vitamin K antagonists (VKAs) depends on the quality of anticoagulant control, reflected by the mean time in therapeutic range (TTR) of international normalized ratio 2.0 to 3.0. In the present study, we aimed to investigate the association between TTR and change in TTR (ΔTTR) with the risk of mortality and clinically significant events in a consecutive cohort of atrial fibrillation (AF) patients. METHODS: We included 1361 AF patients stable on VKAs (international normalized ratio 2...
December 20, 2017: Clinical Therapeutics
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