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Mashup Score: 0
Background The circadian variation pattern of sudden cardiac arrest (SCA) occurred in Chinese community including both community healthcare centres and primary hospitals remains unknown. This study analysed the circadian variation of SCA in the Chinese community. Methods Data between 2018 and 2022 from the remote ECG diagnosis system of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine were analysed to examine the circadian rhythm of SCA, stratified by initial shockable (ventricular tachycardia or ventricular fibrillation) versus non-shockable (asystole or pulseless electrical activity) rhythm. Results Among 10 210 cases of SCA, major cases (8736, 85.6%) were non-shockable and 1474 (14.4%) cases were shockable. The circadian rhythm of SCA was as follows: peak time was from 08:00 to 11:59 (30.1%), while deep valley was from 00:00 to 03:59 (7.5%). The proportions of events by non-shockable and shockable events were similar and both reached their peak from 08:
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet
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Mashup Score: 0
Background Heart failure (HF) is not included in atrial fibrillation (AF) bleeding risk prediction scores, reflecting uncertainty regarding its importance as a risk factor for major haemorrhage. We aimed to report the relative risk of first major haemorrhage in people with HF and AF compared with people with AF without HF (‘AF only’). Methods English primary care cohort study of 2 178 162 people aged ≥45 years in the Clinical Practice Research Datalink from January 2000 to December 2018, linked to secondary care and mortality databases. We used traditional survival analysis and competing risks methods, accounting for all-cause mortality and anticoagulation. Results Over 7.56 years median follow-up, 60 270 people were diagnosed with HF and AF of whom 4996 (8.3%) had a major haemorrhage and 36 170 died (60.0%), compared with 8256 (6.4%) and 34 375 (27.2%), respectively, among 126 251 people with AF only. Less than half those with AF were prescribed an anticoagulant (45.6% from 2014 onwar
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Heart failure and major haemorrhage in people with atrial fibrillation. @drkarthik2010 @NarasimhanEP1 @DCR_Dr @DrGJustinPaul1 @BoopathyCardio @mvaduganathan @DrRajeevagarwa3 @TRMuralidharan1.https://t.co/T09aU4onKT https://t.co/ewAErqbTgo
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Mashup Score: 0Cardiac remodelling in patients with atrial fibrillation and obstructive sleep apnoea - 1 day(s) ago
Background Obstructive sleep apnoea (OSA) can cause left atrial (LA) and left ventricular (LV) remodelling, which is linked to atrial fibrillation (AF). Whether continuous positive airway pressure (CPAP) can reverse LA and LV remodelling in patients with OSA and paroxysmal AF (PAF) has yet to be studied. We assessed the impact of CPAP treatment on LA and LV size and function in patients with OSA and PAF before and after catheter ablation. Methods In a randomised controlled trial, we screened patients with PAF for OSA. We enrolled patients with an Apnoea–Hypopnoea Index ≥15/hour. The burden of AF was monitored by an implantable loop recorder in all patients. Patients were then randomised to CPAP treatment or standard care. Transthoracic echocardiography was performed at baseline and after 6 and 12 months to assess LV and LA function and remodelling with advanced echocardiographic imaging techniques. Results We enrolled 109 patients (63±7 years, body mass index 29.6±4.3, 76% men). 83 pat
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Cardiac remodelling in patients with atrial fibrillation and obstructive sleep apnoea.@drkarthik2010 @BoopathyCardio @NarasimhanEP1 @DCR_Dr https://t.co/3f8zbf9ATx https://t.co/DPQYJC3Wlk
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Mashup Score: 0Effect of aortic valve phenotype and sex on aorta dilation in patients with aortic stenosis - 2 day(s) ago
Background Bicuspid aortic valve (BAV) is often associated with a concomitant aortopathy. However, few studies have evaluated the effect of the aortic valve (AV) phenotype on the rate of dilation of the aorta. This study aimed to compare the progression rate of aorta dimensions according to AV phenotype (BAV vs tricuspid AV (TAV)), fusion type and sex in patients with aortic stenosis (AS). Methods 310 patients with AS (224 TAV and 86 BAV) recruited in the Metabolic Determinants of the Progression of Aortic Stenosis study (PROGRESSA, [NCT01679431][1]) were included in this analysis. Doppler echocardiography was performed annually to assess AS severity and measure ascending aorta (AA) dimensions. Baseline and last follow-up visit measurements were used to assess the annualised change. Results Median AA annualised change was larger in BAV versus TAV (0.33±0.65 mm/year vs 0.21±0.56 mm/year, p=0.04). In the whole cohort, BAV phenotype and higher low-density lipoprotein (LDL) levels were sig
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Effect of aortic valve phenotype and sex on aorta dilation in patients with aortic stenosis.@drkarthik2010 @BoopathyCardio @TCTMD @PPibarot @tavrkapadia https://t.co/GYQG8cL7bw https://t.co/G0EOiyRGnq
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Mashup Score: 2
Introduction Atrial fibrillation (AF) is associated with a fivefold increased risk of stroke. Oral anticoagulation reduces the risk of stroke, but AF is elusive. A machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) developed to predict incident AF within 6 months using data in primary care electronic health records (EHRs) could be used to guide AF screening. The objectives of the FIND-AF pilot study are to determine yields of AF during ECG monitoring across AF risk estimates and establish rates of recruitment and protocol adherence in a remote AF screening pathway. Methods and analysis The FIND-AF Pilot is an interventional, non-randomised, single-arm, open-label study that will recruit 1955 participants aged 30 years or older, without a history of AF and eligible for oral anticoagulation, identified as higher risk and lower risk by the FIND-AF risk score from their primary care EHRs, to a period of remote ECG monitoring with a Zenicor-E
Source: openheart.bmj.comCategories: General Medicine News, Cardiology News and JournTweet-
Future Innovations in Novel Detection for Atrial Fibrillation (FIND-AF): pilot study of an electronic health record machine learning algorithm-guided intervention to identify undiagnosed atrial fibrillation https://t.co/YUFl3DU92X
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Mashup Score: 2
Background Inflammation plays a pivotal role in atherogenesis and is a causal risk factor for atherosclerotic cardiovascular disease. Non-invasive coronary CT angiography (CCTA) enables evaluation of coronary plaque phenotype. This study investigates the relationship between a comprehensive panel of inflammatory markers and short-term plaque progression on serial CCTA imaging, hypothesising that inflammation is associated with increased plaque volume. Methods A total of 161 patients aged ≥40 years with stable multivessel coronary artery disease were included, who underwent CCTA at baseline and 12 months follow-up. Baseline plasma levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein and other inflammatory markers were measured. Plaque volumes were assessed using semiautomated software, calculating total, noncalcified, calcified and low-attenuation noncalcified plaque volumes. Linear regression models, adjusted for ASSIGN score, segment involvement score and body mass inde
Source: openheart.bmj.comCategories: General Medicine News, Cardiology News and JournTweet-
Interleukin 6 plasma levels are associated with progression of coronary plaques. https://t.co/AYP7apsvnQ @drkarthik2010 @drpablocorral @DrRajeevagarwa3 @atherosociety https://t.co/b0tfDpxDbX
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Mashup Score: 5
Aims To assess the diagnostic accuracy of dobutamine stress echocardiography (DSE) in symptomatic patients with a low to intermediate pretest probability of obstructive coronary artery disease (CAD) and a positive coronary CT angiography (CCTA). Methods We prospectively enrolled 104 consecutive patients undergoing coronary angiography for symptoms of stable CAD and a CCTA indicative of obstructive CAD. The diagnostic performance of DSE was evaluated against two intracoronary pressure indices: (a) fractional flow reserve (FFR) with a cut-off of ≤0.80 and (b) instantaneous wave-free ratio (iFR) with a cut-off of ≤0.89, indicating haemodynamically significant stenoses. Results Of 102 patients, 46 (45%) had at least one significant lesion as defined by FFR, as did 37 (36%) as defined by iFR. DSE showed positive results in 33% (34/102) of cases. The discriminative power of DSE for detecting significant CAD was moderate, with areas under the curve of 0.63 (p=0.024) compared with FFR and 0.64
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Dobutamine stress echocardiography after positive CCTA: diagnostic performance using fractional flow reserve and instantaneous wave-free ratio as reference standards. https://t.co/oriwkWEUe7. @drkarthik2010 @JEscaned. @MortonKern @purviparwani @BoopathyCardio https://t.co/HdEqJzou6E
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Mashup Score: 2
Background Oral anticoagulation (OAC) is key in stroke prevention in patients with atrial fibrillation (AF) but there is uncertainty regarding the optimal timing of OAC (re)initiation after stroke, as recent large randomised controlled trials have methodological weaknesses and excluded stroke patients on therapeutic anticoagulation at stroke onset as well as patients started on a vitamin K antagonist after stroke. The ‘1–3–6–12 days rule’, based on expert consensus and referring to stroke severity, was used in clinical practice to initiate OAC after acute ischaemic stroke or transient ischaemic attack (TIA) since publication in 2013. Methods We retrospectively assessed whether compliance to the ‘1–3–6–12 days rule’ was associated with the composite endpoint (recurrent stroke, systemic embolism, myocardial infarction, major bleeding or all-cause death). Results Among 708 registry patients with known AF before stroke and hospitalisation within 72 hours after stroke, 432 were anticoagulat
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Timing of oral anticoagulation in atrial fibrillation patients after acute ischaemic stroke and outcome. https://t.co/j9gP4HydNJ @drkarthik2010 @drjohnm @BMJ @American_Stroke @BoopathyCardio @CsiChennai https://t.co/m9geX16beG
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Mashup Score: 2
Background This present study aimed to investigate the impact of left atrial appendage (LAA) isolation on adverse clinical outcomes, with a further stratified analysis by biatrial (BA) and left atrial lesion sets, in patients with atrial fibrillation (AF) undergoing surgical ablation (SA) concurrent with mitral valve (MV) surgery. Methods We evaluated 875 patients (aged 65.1±12.0 years) who underwent SA of AF concomitant to MV surgery, excluding those with mechanical prostheses requiring lifelong anticoagulation, between 2005 and 2017 in five tertiary cardiac centres in South Korea. Of these, 458 had isolated the LAA, whereas the remainder (n=417) had the LAA preserved. Comparative risk of stroke, mortality and AF recurrence was assessed between the groups, considering death as a competing event. Inverse-probability treatment weighting was used for baseline adjustment. Results During the median follow-up of 57.4 months (IQR, 32.5–92.4 months), the adjusted risk of long-term stroke was
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Long- term effects of left atrial appendage isolation in surgical ablation of atrial fibrillation based on lesion set: a multi-centre propensity-score weighted study. https://t.co/yrkrKgTs4C @drkarthik2010 @BMJ @BoopathyCardio @drjohnm https://t.co/2ZP5oqTL98
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Mashup Score: 5Prehospital factors predicting mortality in patients with shock: state-wide linkage study - 26 day(s) ago
Background Patients with shock treated by emergency medical services (EMS) have high morbidity and mortality. Knowledge of prehospital factors predicting outcomes in patients with shock remains limited. We aimed to describe the prehospital predictors of mortality in patients with non-traumatic shock transported to hospital by EMS. Method This is a retrospective cohort study of consecutive ambulance attendances for non-traumatic shock in Victoria, Australia (January 2015–June 2019) linked with government-held administrative data (emergency, admissions and mortality records). Predictors of 30-day mortality were assessed using Cox proportional regressions. The primary outcome was 30-day all-cause mortality. Results Overall, 21 334 patients with non-traumatic shock (median age 69 years, 54.8% female) were successfully linked with state administrative records. Among this cohort, 9 149 (43%) patients died within 30-days. Compared with survivors, non-survivors had a longer median on-scene tim
Source: openheart.bmj.comCategories: General Medicine News, CardiologistsTweet-
Prehospital factors predicting mortality in patients with shock: state-wide linkage study.https://t.co/0bmKbX15XL @drkarthik2010 @BMJ @thiele_holger @CSWorkingGroup @BoopathyCardio @DrGJustinPaul1 https://t.co/VUCZvV1vIQ
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Circadian variation pattern of sudden cardiac arrest occurred in Chinese community.@drkarthik2010 @NarasimhanEP1 @DrGJustinPaul1 @DCR_Dr https://t.co/wrZT6JGMdq https://t.co/Q79OlBBRvV