Archives of cardiovascular diseases
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Arch Cardiovasc Dis · Apr 2018
The role of platelet reactivity assessment in dual antiplatelet prophylaxis after transcatheter aortic valve implantation.
Dual antiplatelet therapy (DAPT) is recommended prophylaxis after transcatheter aortic valve implantation (TAVI). The usefulness of platelet reactivity (PLTR) tests in predicting the safety of periprocedural DAPT in the TAVI population is unknown. ⋯ TAVI-related bleeding occurs mainly during the procedure or in the early postprocedural period. Testing of periprocedural clopidogrel PLTR, but not aspirin PLTR, seems useful because of its predictive value for TAVI-related bleeding. PLTR testing suggests that premedication with clopidogrel, enhanced response to clopidogrel early after TAVI and significant periprocedural drop in clopidogrel PLTR might increase the risk of TAVI-related bleeding.
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Arch Cardiovasc Dis · Mar 2018
Observational StudyReduction of radiation exposure in transcatheter atrial septal defect closure: How low must we go?
Cardiac catheterization relies on X-ray imaging. Most procedures are now standardized. Interventionists must strive to minimize radiation exposure to reduce the risk of induced cancers. ⋯ A low dose of radiation can be achieved for transcatheter ASD closure, even in complex ASDs, by following these recommendations: reduction of frame rate; avoidance of lateral view and cine acquisition; and limitation of fluoroscopic time by avoiding unnecessary manoeuvres and using echocardiographic guidance as much as possible.
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Arch Cardiovasc Dis · Feb 2018
Multicenter Study Observational StudyPrognostic impact of prepercutaneous coronary intervention TIMI flow in patients with ST-segment and non-ST-segment elevation myocardial infarction: Results from the FAST-MI 2010 registry.
Thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3 before percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) is associated with improved outcomes. However, no recent data are available on its impact beyond 1 year and/or by type of AMI. ⋯ TIMI flow grade 2/3 is observed more often in patients with NSTEMI; it is an independent predictor of early and late survival in patients with STEMI, but is not significantly related to early or long-term survival in patients with NSTEMI.
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Arch Cardiovasc Dis · Feb 2018
Multicenter StudyQuality of life and patient satisfaction in patients with atrial fibrillation on stable vitamin K antagonist treatment or switched to a non-vitamin K antagonist oral anticoagulant during a 1-year follow-up: A PREFER in AF Registry substudy.
Non-vitamin K antagonist oral anticoagulants (NOACs) are being introduced for stroke prevention in non-valvular Atrial Fibrillation (AF), and promise to be accepted better than Vitamin K Antagonists (VKAs) by patients, improving their Quality of Life (QoL). ⋯ At the beginning of NOAC prescriptions, European doctors tended to switch from VKAs to NOACs those patients at lower risk than "non-switchers". Complaints about bruising or bleeding, dissatisfaction with treatment, mobility problems and anxiety/depression traits appear to be related to - and may have influenced - the choice to switch from a VKA to a NOAC.