Clinical cardiology
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Clinical cardiology · Jun 2013
ReviewAdvances in stroke prevention in atrial fibrillation: enhanced risk stratification combined with the newer oral anticoagulants.
Patients with atrial fibrillation (AF) have an increased stroke risk compared with those in sinus rhythm, although the absolute risk for individual patients is modulated by the presence of various additional risk factors. Patient selection for oral anticoagulation for stroke prevention is based on risks of stroke and bleeding. Although CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack) is the most widely used scheme for evaluating stroke risk in patients with AF, several other stroke risk factors are not included; therefore, many patients' stroke risk may be underestimated, contributing to the underuse of anticoagulants. ⋯ Implementation of CHA2 DS2 -VASc may also result in an increased proportion of patients receiving anticoagulation. The emergence of newer oral anticoagulants that can be given without routine coagulation monitoring, with improved benefit-risk profiles vs vitamin K antagonists, promises to simplify therapy for patients with AF at risk of stroke. This, coupled with advances in stroke risk stratification, is expected to improve patient outcomes and reduce the burden of AF-related stroke.
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Clinical cardiology · Jun 2013
Multicenter Study Observational StudyIncremental predictive value of red cell distribution width for 12-month clinical outcome after acute myocardial infarction.
The incremental predictive value of red cell distribution width (RDW) for major adverse cardiac events (MACEs) has not been fully investigated in patients with acute myocardial infarction (AMI). ⋯ In post-myocardial infarction patients, baseline RDW levels at admission could provide incremental predictive value to established risk factors for predicting 12-month MACEs.