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cardiology and elderly care

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197 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27239021/comparison-of-1-year-outcome-in-patients-with-severe-aorta-stenosis-treated-conservatively-or-by-aortic-valve-replacement-or-by-percutaneous-transcatheter-aortic-valve-implantation-data-from-a-multicenter-spanish-registry
#1
Hugo González-Saldivar, Carlos Rodriguez-Pascual, Gonzalo de la Morena, Covadonga Fernández-Golfín, Carmen Amorós, Mario Baquero Alonso, Luis Martínez Dolz, Albert Ariza Solé, Gabriela Guzmán-Martínez, Juan José Gómez-Doblas, Antonio Arribas Jiménez, María Eugenia Fuentes, Laura Galian Gay, Martin Ruiz Ortiz, Pablo Avanzas, Emad Abu-Assi, Tomás Ripoll-Vera, Oscar Díaz-Castro, Eduardo P Osinalde, Manuel Martínez-Sellés
The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77...
July 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/15459762/-aortic-valve-stenosis
#2
REVIEW
F A Flachskampf, W G Daniel
Aortic valve stenosis is the most frequent reason for prosthetic valve replacement in adults. Its incidence increases with age. Development of the most frequent form, degenerative-calcific aortic stenosis, is related to atherosclerotic risk factors. The narrowing of the aortic valve orifice leads to creation of a systolic pressure drop, the gradient, between left ventricle and ascending aorta. The pressure overload from aortic stenosis causes concentric left ventricular hypertrophy and later heart failure. Typical symptoms of severe aortic stenosis include dyspnea, angina, and dizziness or syncope...
November 2004: Der Internist
https://www.readbyqxmd.com/read/28196633/old-and-new-oral-anticoagulants-food-herbal-medicines-and-drug-interactions
#3
REVIEW
Alessandro Di Minno, Beatrice Frigerio, Gaia Spadarella, Alessio Ravani, Daniela Sansaro, Mauro Amato, Joseph P Kitzmiller, Mauro Pepi, Elena Tremoli, Damiano Baldassarre
The most commonly prescribed oral anticoagulants worldwide are the vitamin K antagonists (VKAs) such as warfarin. Factors affecting the pharmacokinetics of VKAs are important because deviations from their narrow therapeutic window can result in bleedings due to over-anticoagulation or thrombosis because of under-anticoagulation. In addition to pharmacodynamic interactions (e.g., augmented bleeding risk for concomitant use of NSAIDs), interactions with drugs, foods, herbs, and over-the-counter medications may affect the risk/benefit ratio of VKAs...
February 5, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28164253/heart-failure-in-the-elderly-ten-peculiar-management-considerations
#4
Feras Bader, Bassam Atallah, Lisa F Brennan, Rola H Rimawi, Mohammed E Khalil
Chronic heart failure (HF) is a disease with significantly higher prevalence in the elderly or patients older than 65 years old. Typically, older patients have more risk factors for HF, more comorbidities, and are more likely to have recurrent admissions for acute decompensations. With HF burden on health care systems primarily related to hospital and nursing home costs, it is critical that elderly patients are approached with a clear understanding of certain unique clinical, laboratory, imaging, and pharmacokinetic differences that can alter their management and outcomes...
February 6, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28181201/management-of-hypertension-in-the-elderly-and-frail-elderly
#5
REVIEW
Claudio Ferri, Livia Ferri, Giovambattista Desideri
An elevated systolic but not diastolic blood pressure level represents a common finding in elderly patients and is associated with an increased risk for developing coronary artery disease, cerebrovascular disease, peripheral artery disease, progressive cognitive decline and renal failure. Although less frequently, elderly patients manifest not only with systolic but also diastolic hypertension. Also in this case, the elderly patient will present an increased risk for developing hypertension-related abnormalities...
March 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28059840/management-of-heart-failure-in-the-elderly
#6
Faisal Alghamdi, Michael Chan
PURPOSE OF REVIEW: Heart failure is a major chronic illness with no definitive cure. With improving healthcare and with an aging population in many countries, heart failure has become a common disease of the elderly. Pharmacological management of heart failure in the elderly remains a challenge. The syndrome of heart failure cannot be isolated from other comorbidities, which are very common in this population. The purpose of this review is to assist practicing clinicians to more effectively make decisions about management of heart failure in the elderly...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28011746/the-pharmacology-of-autonomic-failure-from-hypotension-to-hypertension
#7
REVIEW
Italo Biaggioni
Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by orthostatic hypotension, but supine hypertension is also a significant problem. Autonomic failure can result from impairment of central autonomic pathways (multiple system atrophy) or neurodegeneration of peripheral postganglionic autonomic fibers (pure autonomic failure, Parkinson's disease). Pharmacologic probes such as the ganglionic blocker trimethaphan can help us in the understanding of the underlying pathophysiology and diagnosis of these disorders...
January 2017: Pharmacological Reviews
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#8
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/28008269/perioperative-management-of-direct-oral-anticoagulants-doacs-a-systemic-review
#9
REVIEW
Tagore Sunkara, Emmanuel Ofori, Vadim Zarubin, Megan E Caughey, Vinaya Gaduputi, Madhavi Reddy
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27899849/statin-therapy-review-of-safety-and-potential-side-effects
#10
REVIEW
Satish Ramkumar, Ajay Raghunath, Sudhakshini Raghunath
BACKGROUND: Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#11
REVIEW
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27896543/vitamin-k-antagonists-relative-strengths-and-weaknesses-vs-direct-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation
#12
REVIEW
Andreas Zirlik, Christoph Bode
Vitamin K antagonists (VKAs) have been the mainstay of anticoagulation therapy for more than 50 years. VKAs are mainly used for the prevention of stroke in patients with atrial fibrillation (AF) and the treatment and secondary prevention of venous thromboembolism. In the past 5 years, four new agents-the direct factor Xa inhibitors apixaban, edoxaban and rivaroxaban and the direct thrombin inhibitor dabigatran [collectively known as direct oral anticoagulants (DOACs) or non-VKA oral anticoagulants]-have been approved for these and other indications...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27781063/efficacy-and-safety-of-novel-anticoagulants-in-the-elderly
#13
REVIEW
Nikolaos Karamichalakis, Stamatis Georgopoulos, Konstantinos Vlachos, Ioannis Liatakis, Michael Efremidis, Antonios Sideris, Konstantinos P Letsas
Atrial fibrillation and venous thromboembolism (VTE) are common disorders associated with maleficent thrombotic events, particularly in the elderly patients. Polypharmacy, co-morbidities, and altered pharmacokinetics, often present in these patients, render the use of anticoagulants quite challenging. Novel oral anticoagulants (NOACs) have recently emerged as alternatives to Vitamin K Antagonists (VKAs) and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use...
August 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27693804/emergency-management-of-severe-hyperkalemia-guideline-for-best-practice-and-opportunities-for-the-future
#14
REVIEW
Patrick Rossignol, Matthieu Legrand, Mikhail Kosiborod, Steven M Hollenberg, W Frank Peacock, Michael Emmett, Murray Epstein, Csaba P Kovesdy, Mehmet Birhan Yilmaz, Wendy Gattis Stough, Etienne Gayat, Bertram Pitt, Faiez Zannad, Alexandre Mebazaa
Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia...
November 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27708278/neurohormonal-activation-in-heart-failure-with-reduced-ejection-fraction
#15
REVIEW
Justin Hartupee, Douglas L Mann
Heart failure with reduced ejection fraction (HFrEF) develops when cardiac output falls as a result of cardiac injury. The most well-recognized of the compensatory homeostatic responses to a fall in cardiac output are activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS). In the short term, these 'neurohormonal' systems induce a number of changes in the heart, kidneys, and vasculature that are designed to maintain cardiovascular homeostasis. However, with chronic activation, these responses result in haemodynamic stress and exert deleterious effects on the heart and the circulation...
January 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27836926/new-horizons-the-management-of-hypertension-in-people-with-dementia
#16
REVIEW
Jennifer Kirsty Harrison, Veronika Van Der Wardt, Simon Paul Conroy, David J Stott, Tom Dening, Adam Lee Gordon, Pip Logan, Tomas James Welsh, Jaspal Taggar, Rowan Harwood, John R F Gladman
The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful. Robust evidence is scant, trials of antihypertensive medications have generally excluded those with dementia. Observational data show changes in risk association over the life course, with high BP being a risk factor for cognitive decline in mid-life, while low BP is predictive in later life...
November 2016: Age and Ageing
https://www.readbyqxmd.com/read/27884237/diastolic-dysfunction-and-hypertension
#17
REVIEW
Wilson Nadruz, Amil M Shah, Scott D Solomon
Left ventricular (LV) diastolic dysfunction (LVDD) is characterized by alterations in LV diastolic filling, and is a strong predictor of cardiovascular events and heart failure. Hypertension is the most important risk factor for LVDD in the community and promotes LVDD through several mechanisms, including hemodynamic overload and myocardial ischemia. Associated factors such as age, ethnicity, dietary sodium, obesity, diabetes mellitus, and chronic kidney disease also contribute to LVDD in hypertensive individuals...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27625113/measurement-and-reversal-of-the-direct-oral-anticoagulants
#18
REVIEW
Bethany T Samuelson, Adam Cuker
Direct oral anticoagulants (DOACs) offer noninferior efficacy and improved safety compared to vitamin K antagonists (VKAs) for the prevention and treatment of venous thromboembolism and for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Unlike VKAs, DOACs do not require routine laboratory monitoring of anticoagulant effect and dose adjustment. In certain situations, however, laboratory assessment of anticoagulant effect may be desirable. Here we review the utility of currently available assays for assessment of DOAC effect and recommend an optimal assessment strategy for each drug, including calibrated dilute thrombin time or ecarin-based assays for dabigatran and calibrated anti-Xa activity assays for the factor Xa inhibitors...
January 2017: Blood Reviews
https://www.readbyqxmd.com/read/27910092/management-of-atrial-fibrillation-in-elderly-adults
#19
Yaanik Desai, Mikhael F El-Chami, Angel R Leon, Faisal M Merchant
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms...
January 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27864240/new-horizons-in-orthostatic-hypotension
#20
REVIEW
James Frith, Steve W Parry
BACKGROUND: orthostatic hypotension (OH) is a common disabling condition associated with increased morbidity and mortality. Much of the evidence available is derived from younger populations with chronic neurological disease leading to uncertainty for the diagnosis and management of older people. OBJECTIVE: to provide an overview of recent and emerging evidence for the diagnosis, management and prognosis of OH in older persons. METHODS: a narrative review of recent studies, emerging therapies and relevant regulatory updates...
November 17, 2016: Age and Ageing
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