Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Oct 2019
Multicenter StudyDabigatran Reversal With Idarucizumab in Patients With Renal Impairment.
Dabigatran and idarucizumab, its reversal agent, are renally cleared. ⋯ Idarucizumab completely reverses dabigatran in >98% of patients regardless of renal function. Although re-elevation of dabigatran levels within 12 to 24 h is more common with renal impairment, the time to bleeding cessation and the extent of hemostasis during procedures are similar. (Reversal of Dabigatran Anticoagulant Effect With Idarucizumab; NCT02104947).
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter Study Observational StudyThromboembolic Risk After Atriopulmonary, Lateral Tunnel, and Extracardiac Conduit Fontan Surgery.
Thromboembolic events contribute greatly to morbidity and mortality following Fontan surgery for univentricular hearts. ⋯ The EC Fontan was independently associated with a lower thromboembolic risk after controlling for time-varying effects of atrial arrhythmias and thromboprophylaxis.
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter StudyPredicting Major Adverse Events in Patients With Acute Myocardial Infarction.
Early and accurate detection of short-term major adverse cardiac events (MACE) in patients with suspected acute myocardial infarction (AMI) is an unmet clinical need. ⋯ The ESC hs-cTn 0/1 h algorithm better balanced efficacy and safety in the prediction of MACE, whereas the extended algorithm is the preferred option for the rule-out of 30-day MACE + UA. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE]; NCT00470587).
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J. Am. Coll. Cardiol. · Aug 2019
Multicenter StudyDigoxin Discontinuation and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction.
The deleterious effects of discontinuation of digoxin on outcomes in ambulatory patients with chronic heart failure (HF) with reduced ejection fraction (HFrEF) receiving angiotensin-converting enzyme inhibitors are well-documented. ⋯ Among hospitalized older patients with HFrEF on more contemporary guideline-directed medical therapies, discontinuation of pre-admission digoxin therapy was associated with poor outcomes.
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J. Am. Coll. Cardiol. · Jul 2019
Multicenter StudyPrevalence of Infective Endocarditis in Enterococcus faecalis Bacteremia.
Enterococcus faecalis is the third most frequent cause of infective endocarditis (IE). Despite this, no systematic prospective echocardiography studies have examined the prevalence of IE in patients with E. faecalis bacteremia. ⋯ This study revealed a high prevalence of 26% definite IE in patients with E. faecalis bacteremia, suggesting that echocardiography should be considered in all patients with E. faecalis bacteremia.