Clinical cardiology
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Clinical cardiology · Nov 2011
Pharmacologic prophylaxis for venous thromboembolism and 30-day outcomes among older patients hospitalized with heart failure: an analysis from the ADHERE national registry linked to Medicare claims.
Hospitalized medically ill patients are at greater risk for venous thromboembolism (VTE). Although pharmacologic prophylaxis regimens have reduced VTE risk in medically ill patients, associations with early postdischarge adverse clinical outcomes among patients with heart failure are unknown. ⋯ Pharmacologic VTE prophylaxis is provided to one-third of older patients hospitalized with heart failure. Treatment with LMWH or UFH did not have a statistically significant association with 30-day postdischarge outcomes.
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Clinical cardiology · Oct 2011
Mildly decreased glomerular filtration rate is associated with poor coronary collateral circulation in patients with coronary artery disease.
The aim of this study was to evaluate the association between mildly decreased glomerular filtration rate (GFR) and coronary collateral circulation (CCC). ⋯ We found that CCC was worse in patients with mildly decreased GFR compared to patients with normal GFR in patients with coronary artery disease.
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Clinical cardiology · Oct 2011
Comparative StudyComparison of ventricular tachyarrhythmia characteristics in patients with idiopathic dilated or ischemic cardiomyopathy and defibrillators implanted for primary prevention.
Implantable cardioverter-defibrillator (ICD) therapy for primary prevention is well established in ischemic cardiomyopathy (ICM). Data on the role of ICDs in patients with dilated cardiomyopathy (DCM) and no history of ventricular tachyarrhythmia (VT/VF) are more limited. ⋯ DCM patients with prophylactic ICDs implanted due to heart failure and patients fulfilling MADIT criteria reveal comparable patterns of VT/VF/ES events during long-term follow-up. Incidence, mean number of events, and time to first event did not differ significantly. Findings support the current guidelines for prophylactic ICD therapy in DCM patients with heart failure.
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Clinical cardiology · Oct 2011
Prevalence and predictors of warfarin use in patients with atrial fibrillation at low or intermediate risk and relation to thromboembolic events.
According to the American College of Cardiology/American Heart Association/European Society of Cardiology guidelines, the choice of aspirin or warfarin to prevent thromboembolic events (TEs) in patients with nonrheumatic atrial fibrillation (AF) should be based on the CHADS(2) score. The purpose of this study was to determine the predictors of warfarin use in patients with AF at low (CHADS(2) =0) or intermediate (CHADS(2) =1) risk for TEs. ⋯ Although either aspirin or warfarin is recommended to prevent TEs in patients with AF at intermediate risk for TEs, warfarin is preferred in the majority of patients in general practice. Lack of warfarin use is associated with a higher risk of TEs in intermediate-risk patients with AF. The adoption of new oral anticoagulants that have lower risk of major hemorrhage than warfarin for low- or intermediate-risk AF patients remains to be determined.
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Clinical cardiology · Sep 2011
ReviewWhat do the 2011 American Heart Association guidelines tell us about prevention of cardiovascular disease in women?
The 2011 Update of the American Heart Association's Cardiovascular Disease Prevention Guideline for Women is designed to help women and their physicians understand cardiovascular Disease (CVD) risks and undertake practical steps that are most effective in preventing heart disease and stroke. Defining a woman's risk status and improving her adherence to preventive lifestyle behaviors and medications is the best strategy to lower the burden of CVD in women.