Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2014
Comparative StudyClinical phenotype and outcome of hypertrophic cardiomyopathy associated with thin-filament gene mutations.
Mild hypertrophy but increased arrhythmic risk characterizes the stereotypic phenotype proposed for hypertrophic cardiomyopathy (HCM) caused by thin-filament mutations. However, whether such clinical profile is different from more prevalent thick-filament-associated disease is unresolved. ⋯ In adult HCM patients, thin-filament mutations are associated with increased likelihood of advanced LV dysfunction and heart failure compared with thick-filament disease, whereas arrhythmic risk in both subsets is comparable. Triphasic LV filling is particularly common in thin-filament HCM, reflecting profound diastolic dysfunction.
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J. Am. Coll. Cardiol. · Dec 2014
Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure.
Significant tricuspid regurgitation (TR) late after left heart valve procedure is frequent and associated with increased morbidity. Surgical correction carries a significant mortality risk, whereas the impact of TR on survival in these patients is unclear. ⋯ RV dysfunction, but not significant TR, is independently associated with survival late after left heart valve procedure.
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J. Am. Coll. Cardiol. · Dec 2014
Observational StudyNet clinical benefit of antithrombotic therapy in patients with atrial fibrillation and chronic kidney disease: a nationwide observational cohort study.
The balance between stroke reduction and increased bleeding associated with antithrombotic therapy among patients with atrial fibrillation (AF) and chronic kidney disease (CKD) is controversial. ⋯ CKD is associated with a higher risk of stroke/thromboembolism across stroke risk strata in AF patients. High-risk CKD patients (CHA₂DS₂-VASc ≥2) with AF benefit from warfarin treatment for stroke prevention.
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J. Am. Coll. Cardiol. · Dec 2014
Procedural results and safety of common interventional procedures in congenital heart disease: initial report from the National Cardiovascular Data Registry.
The National Cardiovascular Data Registry (NCDR) launched the IMPACT (Improving Pediatric and Adult Congenital Treatment) Registry in 2010. By 2013, its patient enrollment exceeded that of other current and historical congenital catheterization registries. ⋯ Contemporary community practice, procedural outcomes, and safety for 6 common congenital interventional procedures are reported. These benchmarks may be compared with individual center results and historical single-center and multicenter results.
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J. Am. Coll. Cardiol. · Dec 2014
Randomized Controlled Trial Multicenter Study Comparative StudyCoronary stent thrombosis with vorapaxar versus placebo: results from the TRA 2° P-TIMI 50 trial.
Vorapaxar, a novel thrombin receptor antagonist, reduces cardiovascular death and recurrent thrombotic events when added to standard antiplatelet therapy in patients with stable atherosclerotic vascular disease. ⋯ The rate of ARC definite ST in stable patients, the majority of whom were receiving DAPT, was approximately 1.4% at 3 years. In stable patients with coronary stenting receiving standard antiplatelet therapy, vorapaxar administered for long-term secondary prevention significantly reduced ARC definite ST, including very late ST. (Trial to Assess the Effects of Vorapaxar [SCH 530348; MK-5348] in Preventing Heart Attack and Stroke in Patients With Atherosclerosis [TRA 2° P-TIMI 50] [P04737]; NCT00526474).