International journal of cardiology
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Multicenter Study
Pattern of atrial fibrillation and risk of outcomes: the Loire Valley Atrial Fibrillation Project.
Risk of stroke and thromboembolism (TE) in patients with non-valvular atrial fibrillation (NVAF) is categorised in stroke risk stratification scores. The role of pattern of NVAF in risk prediction is unclear in contemporary 'real world' cohorts. ⋯ In this large 'real world' NVAF cohort, rates of stroke, TE, death and bleeding differed significantly by patterns of NVAF. However, only previous stroke, age, heart failure and vascular disease (not pattern of NVAF) independently increased risk of adverse outcomes in multivariate analyses. Thus, stroke risk is similar across all patterns of NVAF and antithrombotic therapy should be based on clinical risk factors, not on arrhythmia pattern.
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Randomized Controlled Trial
Central and peripheral quadriceps fatigue in congestive heart failure.
The clinical syndrome of heart failure includes exercise limitation that is not directly linked to measures of cardiac function. Quadriceps fatigability may be an important component of this and this may arise from peripheral or central factors. ⋯ The quadriceps is more susceptible to fatigue, with a similar fall in TwQ occurring in CHF patients at lower levels of exercise. This is associated with no change in voluntary activation but a lesser degree of depression of quadriceps motor evoked potential.
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Observational Study
Examining the relation between post myocardial infarction depression and cardiovascular prognosis using a validated prediction model for post myocardial mortality.
The presence of depressive symptoms after myocardial infarction (MI) is associated with worsened cardiovascular (CV) prognosis. To date, it remains unclear to what extent the relationship between post-MI depression and prognosis is confounded by factors related to prognosis. We assessed the relationship between depression and prognosis while adjusting for a well validated risk score for mortality after a MI. ⋯ GRACE score was positively associated with somatic/affective depressive symptoms. GRACE score explained only partly the association between (somatic/affective) depressive symptoms and CV prognosis.
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The benefit of early surgery for IE is yet to be determined in non-Western countries. We conducted this study to evaluate the role of early surgery in infective endocarditis (IE) in Japan. ⋯ Early surgery for NVE is associated with improved survival in a wide range of clinical subgroups in Japan. In PVE a survival benefit of early surgery is not clear.
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The inflammatory biomarkers soluble urokinase plasminogen activator receptor (suPAR) and C-reactive protein (CRP) independently predict cardiovascular disease (CVD). The prognostic implications of suPAR and CRP combined with Framingham Risk Score (FRS) have not been determined. ⋯ suPAR provides prognostic information of CVD risk beyond FRS and improves risk prediction substantially when combined with CRP in this setting.