International journal of cardiology
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Multicenter Study Observational Study Pragmatic Clinical Trial
NOACs and atrial fibrillation: Incidence and predictors of left atrial thrombus in the real world.
Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2DS2-VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban. ⋯ The incidence of LAA thrombus in a cohort of patients anticoagulated with NOACs is low but not negligible, in any case similar among the 3 drugs. Preprocedural TOE should be considered in patients with a CHA2DS2-VASc score>3.
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Multicenter Study Comparative Study
Short and long-term prognostic value of hyponatremia in heart failure with preserved ejection fraction versus reduced ejection fraction: An analysis of the Korean Acute Heart Failure registry.
Hyponatremia is a well-known risk factor for worse outcomes in heart failure (HF) patients. The impact of hyponatremia according to the ejection fraction (EF) is unclear. We evaluated the prognostic value of hyponatremia according to HF type. ⋯ Hyponatremia is independent of HF type. Hyponatremia is a significant risk factor for adverse in-hospital outcomes; however its long-term prognostic value is only limited to patients with HFrEF, but not for those with HFpEF.
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Multicenter Study Observational Study
Use of statins and adverse outcomes in patients with atrial fibrillation: An analysis from the EURObservational Research Programme Atrial Fibrillation (EORP-AF) general registry pilot phase.
Despite oral anticoagulation being highly effective in reducing stroke and thromboembolism, patients with atrial fibrillation (AF) still have a significant residual excess in mortality risk. Additional management strategies are needed to reduce the mortality risk seen in AF patients. ⋯ Statin use in AF patients was associated with improved outcomes, with an independent association with a lower risk of all-cause death at 1-year follow-up.
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Multicenter Study
Influence of renal dysfunction phenotype on mortality in decompensated heart failure with preserved and mid-range ejection fraction.
Natriuretic peptides or the blood urea nitrogen to creatinine ratio (BUN/creat) can identify high- vs low-risk renal impairment (RI) in patients with heart failure and reduced ejection fraction (HF-REF). However, the situation in HF patients with preserved ejection fraction (HF-PEF) and mid-range ejection fraction (HF-MREF) remains unclear. ⋯ In this clinical cohort of acute decompensated HF-PEF and HF-MREF patients, the combined use of NT-proBNP and BUN/creat stratifies patients with RI into groups with significantly different prognoses.
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Transcatheter Aortic Valve Implantation (TAVI) can be performed via the transaxillary approach, but data about complications and procedural outcome is limited. ⋯ We investigated In 100 consecutive patients undergoing percutaneous transaxillary transcatheter aortic valve implantation thereby demonstrating that this approach is technically feasible and safe with acceptable numbers of minor vascular complications.