Clinical cardiology
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Clinical cardiology · Nov 2017
Dynamic changes of QTc interval and prognostic significance in takotsubo (stress) cardiomyopathy.
Prolonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high-risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role. ⋯ Prolonged QTc intervals at admission during a TTC episode could be associated with a higher risk of cardiovascular rehospitalization at follow-up. Dynamic increase of QTc intervals after admission are characterized by a trend toward a better prognosis.
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Clinical cardiology · Nov 2017
Review Meta AnalysisTranscatheter vs surgical aortic-valve replacement in low- to intermediate-surgical-risk candidates: A meta-analysis and systematic review.
The American and European expert documents recommend transcatheter aortic valve replacement (TAVR) for inoperable or high-surgical-risk patients with severe aortic stenosis. In comparison, efficacy of TAVR is relatively less studied in low- to intermediate-surgical-risk patients. We sought to discover whether TAVR can be as effective as surgical aortic valve replacement (SAVR) in low- to intermediate-surgical-risk candidates. ⋯ However, increased incidence of permanent pacemaker implantation and paravalvular leaks was observed with TAVR. TAVR can provide similar mortality outcome compared with SAVR in low- to intermediate-surgical-risk patients with critical aortic stenosis. However, both procedures are associated with their own array of adverse events.
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Clinical cardiology · Nov 2017
Comparative StudyApixaban, rivaroxaban, and dabigatran use in patients undergoing catheter ablation for atrial fibrillation using the second-generation cryoballoon.
Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. ⋯ Apixaban, rivaroxaban, and dabigatran, compared with uninterrupted VKA, did not show a higher risk for major bleeding or ischemic complications in patients undergoing PVI using the second-generation CB.
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Clinical cardiology · Nov 2017
Comparative StudyDoes education modify the effect of ethnicity in the expression of ideal cardiovascular health? The Baptist Health South Florida Employee Study.
Despite the progress made to decrease risk factors for cardiovascular diseases, disparities still exist. We examined how education and ethnicity interact to determine disparities in cardiovascular health (CVH) as defined by the American Heart Association. ⋯ Higher educational attainment had variable associations with achieved levels of ideal CVH across race/ethnic groups. Interventions to improve CVH should be tailored to meet the needs of target communities.
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Clinical cardiology · Nov 2017
Comparative Study Observational StudyTranscatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score-matched analysis.
Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). ⋯ In patients with advanced kidney disease, SAVR was associated with higher mortality and higher periprocedural complications, as compared with TAVR. Thus, benefits of TAVR could be extended in patients with advanced kidney disease who cannot undergo surgery.