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By César Gerardo Martínez Hernández General and Nuclear Cardiologist
L Zhang, Y Long, H Xiao, J Yang, P Toulon, Z Zhang
Individualized anticoagulation management and improvement of the safety and effectiveness of oral anticoagulant have always been the focus of clinicians' attention. D-dimer, a sensitive marker of thrombosis and coagulation activation, is not only traditionally used in the diagnosis of venous thromboembolism, acute aortic dissection, and disseminated intravascular coagulation but can also be used as a helpful marker in the management of oral anticoagulant, including evaluating the anticoagulation quality, predicting clinical outcomes, and determining the optimal duration and intensity of anticoagulation...
May 27, 2018: International Journal of Laboratory Hematology
Dimitrios Farmakis, Periklis Davlouros, Gregory Giamouzis, George Giannakoulas, Athanasios Pipilis, Georgios Tsivgoulis, John Parissis
Direct or new oral anticoagulants (NOACs), including the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, have recently revolutionized the field of antithrombotic therapy for stroke and systemic embolism prevention in nonvalvular atrial fibrillation (NVAF). Randomized controlled trials have shown that these agents have at least comparable efficacy with vitamin K antagonists along with superior safety, at least in what concerns intracranial hemorrhage...
2018: Cardiology
Inder S Anand, Pankaj Gupta
Anemia and iron deficiency are important and common comorbidities that often coexist in patients with heart failure. Both conditions, together or independently, are associated with poor clinical status and worse outcomes. Whether anemia and iron deficiency are just markers of heart failure severity or whether they mediate heart failure progression and outcomes and therefore should be treated is not entirely clear. Treatment of anemia in patients with heart failure with erythropoiesis-stimulating agents has been evaluated intensively during the past several years...
July 3, 2018: Circulation
Konstantinos C Siontis, Xiaosong Zhang, Ashley Eckard, Nicole Bhave, Doug E Schaubel, Kevin He, Anca Tilea, Austin G Stack, Rajesh Balkrishnan, Xiaoxi Yao, Peter A Noseworthy, Nilay D Shah, Rajiv Saran, Brahmajee K Nallamothu
Background -Patients with end-stage kidney disease (ESKD) on dialysis were excluded from clinical trials of direct oral anticoagulants for atrial fibrillation (AF). Recent data have raised concern regarding the safety of dabigatran and rivaroxaban, but apixaban has not been evaluated despite current labeling supporting its use in this population. The goal of this study was to determine patterns of apixaban use and its associated outcomes in dialysis-dependent ESKD patients with AF. Methods -We performed a retrospective cohort study of Medicare beneficiaries included in the United States Renal Data System (October 2010 to December 2015)...
June 28, 2018: Circulation
Nishank Jain, Robert F Reilly
Oral anticoagulants are commonly used drugs in patients with CKD and patients with ESKD to treat atrial fibrillation to reduce stroke and systemic embolism. Some of these drugs are used to treat or prevent deep venous thrombosis and pulmonary embolism in patients with CKD who undergo knee and hip replacement surgeries. Warfarin is the only anticoagulant that is approved for use by the Food and Drug Administration in individuals with mechanical heart valves. Each oral anticoagulant affects the coagulation profile in the laboratory uniquely...
May 25, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Yogen Singh, Cécile Tissot
The hemodynamic changes during the first few breaths after birth are probably the most significant and drastic adaptation in the human life. These changes are critical for a smooth transition of fetal to neonatal circulation. With the cord clamping, lungs take over as the source of oxygenation from placenta. A smooth transition of circulation is a complex mechanism and primarily depends upon the drop in pulmonary vascular resistance (PVR) and increase in systemic vascular resistance (SVR). Understanding the normal transition physiology and the adverse adaptation is of utmost importance to the clinicians looking after neonates...
2018: Frontiers in Pediatrics
David J Murphy, Munaib Din, Fadi G Hage, Eliana Reyes
Over recent years, new evidence has led a rethinking of the available guidance on the diagnosis and management of infective endocarditis (IE). This review compares the most recently available guidance provided by the American Heart Association (AHA) IE Writing Committee, and the Task Force for the management of IE of the European Society of Cardiology (ESC). This represents the sixth of a new series of comparative guidelines review published in the Journal.
June 19, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
S G E Howard Luke, Barden Steven, Condliffe Robin, Connolly Vincent, W H Davies Christopher, Donaldson James, Everett Bernard, Free Catherine, Horner Daniel, Hunter Laura, Kaler Jasvinder, Nelson-Piercy Catherine, O'Dowd Emma, Patel Raj, Preston Wendy, Sheares Karen, Tait Campbell
No abstract text is available yet for this article.
July 2018: Thorax
Dimitrios Asvestas, Gary Tse, Adrian Baranchuk, George Bazoukis, Tong Liu, Athanasios Saplaouras, Panagiotis Korantzopoulos, Christina Goga, Michael Efremidis, Antonios Sideris, Konstantinos P Letsas
Several clinical, electrocardiographic (ECG) and electrophysiological markers have been proposed to provide optimal risk stratification in patients with Brugada syndrome (BrS). Of the different markers, only a spontaneous type 1 ECG pattern has clearly shown a sufficiently high predictive value. This review article highlights specific ECG markers based on depolarization and/or repolarization that have been associated with an increased risk of arrhythmic events in patients with BrS.
March 2018: IJC Heart & Vasculature
Kartik Kansagra, Joseph Kang, Matthew-Czar Taon, Suvranu Ganguli, Ripal Gandhi, George Vatakencherry, Cuong Lam
The anatomy of aortic aneurysms from the proximal neck to the access vessels may create technical challenges for endovascular repair. Upwards of 30% of patients with abdominal aortic aneurysms (AAA) have unsuitable proximal neck morphology for endovascular repair. Anatomies considered unsuitable for conventional infrarenal stent grafting include short or absent necks, angulated necks, conical necks, or large necks exceeding size availability for current stent grafts. A number of advanced endovascular techniques and devices have been developed to circumvent these challenges, each with unique advantages and disadvantages...
April 2018: Cardiovascular Diagnosis and Therapy
Thomas F Lüscher
No abstract text is available yet for this article.
June 21, 2018: European Heart Journal
Thomas F Lüscher
No abstract text is available yet for this article.
June 7, 2018: European Heart Journal
Christopher J R Gough, Jerry P Nolan
Adrenaline has been used in the treatment of cardiac arrest for many years. It increases the likelihood of return of spontaneous circulation (ROSC), but some studies have shown that it impairs cerebral microcirculatory flow. It is possible that better short-term survival comes at the cost of worse long-term outcomes. This narrative review summarises the rationale for using adrenaline, significant studies to date, and ongoing research.
May 29, 2018: Critical Care: the Official Journal of the Critical Care Forum
Jelena-Rima Ghadri, Ilan Shor Wittstein, Abhiram Prasad, Scott Sharkey, Keigo Dote, Yoshihiro John Akashi, Victoria Lucia Cammann, Filippo Crea, Leonarda Galiuto, Walter Desmet, Tetsuro Yoshida, Roberto Manfredini, Ingo Eitel, Masami Kosuge, Holger M Nef, Abhishek Deshmukh, Amir Lerman, Eduardo Bossone, Rodolfo Citro, Takashi Ueyama, Domenico Corrado, Satoshi Kurisu, Frank Ruschitzka, David Winchester, Alexander R Lyon, Elmir Omerovic, Jeroen J Bax, Patrick Meimoun, Guiseppe Tarantini, Charanjit Rihal, Shams Y-Hassan, Federico Migliore, John D Horowitz, Hiroaki Shimokawa, Thomas Felix Lüscher, Christian Templin
The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approach, which may facilitate correct and timely diagnosis. Furthermore, the document covers areas where controversies still exist in risk stratification and management of TTS. Based on available data the document provides recommendations on optimal care of such patients for practising physicians...
June 7, 2018: European Heart Journal
Geogy Vatakencherry, Chris Molloy, Neil Sheth, Millie Liao, Cuong Ken Lam
Percutaneous endovascular aortic repair (EVAR) has transformed the field of aortic repair. As techniques and devices improve, interventionalists continue to expand the boundaries of what is possible, enabling these life-saving procedures to be performed on a wider range of more technically challenging cases. This article discusses endovascular access considerations for EVAR including; ultrasound guidance, preclose technique, access vessel options, innovative devices, and bailout strategies that interventionalists should be familiar with to optimize patient outcomes...
April 2018: Cardiovascular Diagnosis and Therapy
Jelena-Rima Ghadri, Ilan Shor Wittstein, Abhiram Prasad, Scott Sharkey, Keigo Dote, Yoshihiro John Akashi, Victoria Lucia Cammann, Filippo Crea, Leonarda Galiuto, Walter Desmet, Tetsuro Yoshida, Roberto Manfredini, Ingo Eitel, Masami Kosuge, Holger M Nef, Abhishek Deshmukh, Amir Lerman, Eduardo Bossone, Rodolfo Citro, Takashi Ueyama, Domenico Corrado, Satoshi Kurisu, Frank Ruschitzka, David Winchester, Alexander R Lyon, Elmir Omerovic, Jeroen J Bax, Patrick Meimoun, Guiseppe Tarantini, Charanjit Rihal, Shams Y-Hassan, Federico Migliore, John D Horowitz, Hiroaki Shimokawa, Thomas Felix Lüscher, Christian Templin
Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology...
June 7, 2018: European Heart Journal
Li Bai, Qiongsi Li, Jun Wang, Eric Lavigne, Antonio Gasparrini, Ray Copes, Abderrahmane Yagouti, Richard T Burnett, Mark S Goldberg, Sabit Cakmak, Hong Chen
OBJECTIVE: To assess the associations between ambient temperatures and hospitalisations for coronary heart disease (CHD) and stroke. METHODS: Our study comprised all residents living in Ontario, Canada, 1996-2013. For each of 14 health regions, we fitted a distributed lag non-linear model to estimate the cold and heat effects on hospitalisations from CHD, acute myocardial infarction (AMI), stroke and ischaemic stroke, respectively. These effects were pooled using a multivariate meta-analysis...
April 2018: Heart: Official Journal of the British Cardiac Society
S Claiborne Johnston, J Donald Easton, Mary Farrant, William Barsan, Robin A Conwit, Jordan J Elm, Anthony S Kim, Anne S Lindblad, Yuko Y Palesch
Background Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population. Methods In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone...
May 16, 2018: New England Journal of Medicine
Lorenz Räber, Gary S Mintz, Konstantinos C Koskinas, Thomas W Johnson, Niels R Holm, Yoshinubo Onuma, Maria D Radu, Michael Joner, Bo Yu, Haibo Jia, Nicolas Menevau, Jose M de la Torre Hernandez, Javier Escaned, Jonathan Hill, Francesco Prati, Antonio Colombo, Carlo di Mario, Evelyn Regar, Davide Capodanno, William Wijns, Robert A Byrne, Giulio Guagliumi
This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified...
May 22, 2018: European Heart Journal
Michał Hawranek, Michal O Zembala, Mariusz Gasior, Tomasz Hrapkowicz, Łukasz Pyka, Daniel Cieśla, Marian Zembala
Aims: To compare coronary artery bypass grafting (CABG) with percutaneous coronary interventions (PCI) in patients with heart failure with reduced ejection fraction (HFrEF) and multivessel coronary artery disease. Methods: 1213 patients were selected from institutional databases, 761 and 452 in CABG and PCI group respectively. Only the subjects with left ventricle ejection fraction ≤ 35% and multivessel coronary artery disease were included to the study. The primary outcome measure was long-term all-cause death, the secondary outcomes were recurrent myocardial infarction, urgent repeat revascularization and stroke...
April 20, 2018: Oncotarget
2018-05-28 14:19:46
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