International journal of cardiology
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Anticoagulantion therapy (OAT) represents the cornerstone to reduce thromboembolic events for atrial fibrillation (AF). Recent studies suggest that AF catheter ablation on top of OAT may be useful to further reduce the thromboembolic risk in AF patients. The aim of the present study is to compare the long-term risk of thromboembolic events and treatment-related complications in patients with AF treated by OAT strategies and catheter ablation. ⋯ AF catheter ablation significantly reduces the incidence of long-term thromboembolic events compared to both VKA and DOAC. This reduction is maintained in all CHADS2 score clusters and is strengthened by the concomitant reduction in hemorrhagic complications provided by AF ablation.
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In patients undergoing atrial fibrillation (AF) ablation, despite uninterrupted oral anticoagulants (OACs) have been recommended, no consensus has emerged regarding to whether uninterrupted novel oral anticoagulants (NOACs) are superior to uninterrupted vitamin K antagonists (VKAs) for the periprocedural antithrombotic management. This meta-analysis aimed to compare the efficacy and safety of uninterrupted NOACs and uninterrupted VKAs in patients undergoing AF ablation. ⋯ In patients undergoing AF ablation, uninterrupted NOACs is as effective as uninterrupted VKAs treatment, uninterrupted dabigatran (150 mg twice daily) may be superior to other uninterrupted OACs strategies.
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There is insufficient evidence to counsel patients with pulmonary hypertension undergoing altitude or air travel. We thus aimed to study hemodynamic response of patients with pulmonary arterial or chronic thromboembolic pulmonary hypertension (PAH/CTEPH) during changes in inspiratory oxygen partial pressure. ⋯ In patients with PAH/CTEPH, very short-term exposure to moderate hypoxia similar to 2600 m altitude or during commercial air travel did not deteriorate hemodynamics. These results encourage studying the response of PAH/CTEPH during daytrips to the mountain or air travel.
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Randomized Controlled Trial Multicenter Study
Rise of first follow-up sodium in patients hospitalized with acute heart failure is associated with better outcomes.
The prognostic effect of the direction of change in sodium (Na) level from admission to subsequent check in patients with acute heart failure (HF) has not been previously explored. ⋯ Rise of first follow-up Na in patients with HF decompensation and hyponatremia on admission is associated with favorable intermediate-term outcomes.
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Multicenter Study Pragmatic Clinical Trial
Hospital readmission following transcatheter aortic valve implantation in the real world.
There is limited data on hospital readmissions following transcatheter aortic valve implantation (TAVI). The aim of this study was to investigate hospital readmissions post-TAVI. ⋯ Readmission occurred in approximately one-fifth of patients post-TAVI and was associated with poor patient outcomes. Early readmission was mainly due to procedural complications, while late readmission was mainly determined by baseline comorbidities including a frailty criterion. Measures should be taken to reduce hospital readmissions and improve patient outcomes post-TAVI.