Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Apr 2012
Comparative StudyTranscatheter vs. surgical aortic valve replacement: a retrospective analysis assessing clinical effectiveness and safety.
To compare, in terms of clinical effectiveness and safety, patients who underwent transcatheter aortic valve implantation (TAVI) with those who underwent surgical aortic valve replacement (S-AVR) for the treatment of severe aortic stenosis during the same period. ⋯ TAVI morbidity and mortality registered in this series are lower than those estimated for conventional surgery in high-risk patients and compare to those associated with S-AVR in good surgical candidates.
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J Cardiovasc Med (Hagerstown) · Apr 2012
Endovascular treatment of descending thoracic aortic rupture: mid- to long-term results in a single-centre registry.
To update our experience with descending thoracic aortic rupture (DTAR) endovascular repair over a 6-year period. ⋯ Although this study is not a comparative analysis of DTAR, mortality and morbidity rates were lower than previously reported with emergent open surgical repair. One-year treatment results indicate a low incidence of graft-related complications. Endovascular treatment of the thoracic aortic rupture should be considered feasible and well tolerated in the short and medium term.
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J Cardiovasc Med (Hagerstown) · Mar 2012
Multicenter StudyElderly patients with acute coronary syndromes admitted to Italian intensive cardiac care units: a Blitz-3 Registry sub-analysis.
Guideline-recommended therapies for acute coronary syndromes (ACS) derive from randomized trials in which elderly patients are underrepresented. Although numbers of this population are increasing, they are largely undertreated in the real world. ⋯ In a nationwide survey, age impacts on care. The elderly with ACS have a higher risk profile but receive less guideline-recommended care than younger patients. Thus, further improvements in care of this population should be pursued.
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J Cardiovasc Med (Hagerstown) · Feb 2012
ReviewCost-effectiveness of pharmacologic and invasive therapies for stroke prophylaxis in atrial fibrillation.
Atrial fibrillation is an abnormal heart rhythm characterized by rapid, disorganized activation (fibrillation) of the left and right atria of the heart, and is responsible for 15% of 700,000 strokes in the United States each year. There are multiple pharmacologic and nonpharmacologic therapies used for stroke prevention in atrial fibrillation, including vitamin K antagonists such as warfarin, antiplatelet agents such as aspirin and clopidogrel, and newer agents such as dabigatran, rivaroxaban and apixaban. ⋯ In this article, we review the principles of CEA and identify 11 articles that examine CEA of stroke prophylaxis strategies in atrial fibrillation. Although most studies evaluate aspirin and warfarin across a variety of atrial fibrillation stroke risk profiles, we also review new literature on new pharmacologic therapies such as direct thrombin inhibitors and discuss the potential value of device-based therapies.
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Atrial fibrillation (AF) is a common arrhythmia associated with substantial morbidity and mortality, particularly due to thromboembolic strokes, the prevalence of which is expected to rise over the next few decades. This article reviews the complex mechanisms behind thromboembolism, compares the newer risk stratification models for identifying those at risk for stroke or bleeding, and highlights the potential advantages and disadvantages of available therapies. ⋯ There is also discussion on non pharmacological therapies such as left atrial appendage ligation and occlusion devices. This article is intended to help clinicians gain a better understanding of available risk stratification tools and therapies available for prevention of stroke in patients with atrial fibrillation.