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Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry 被引量:3
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作者 Rungroj Krittayaphong Arintaya Phrommintikul +6 位作者 Pornchai Ngamjanyaporn Khanchai Siriwattana Wiwat Kanjanarutjawiwat Thoranis Chantrarat Roj Rojjarekampai Pontawee Kaewcomdee Patthrapon Sonkhammee 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2019年第3期242-250,共9页
Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fib... Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fibrillation.Methods A multicenter registry of patients with non-valvular atrial fibrillation was conducted during 2014 to 2017 in Thailand.Demographic,medical history,antithrombotic medication,non-antithrombotic medication,and laboratory data were collected and analyzed.Data were compared between the older adult (≥ 65 years) and younger adult (< 65 years) groups.The reasons why anticoagulant was not prescribed were collected,and predictive factors were identified.Results A total of 3218 patients (1873 males) with an average age of 67.3 ± 11.3 years were included.Almost two-thirds (61.0%) of patients were in the older adult group.Anticoagulant was prescribed in 2422 patients (75.3%): 81.4% in the older adult group and 65.7% in the younger adult group.The three main reasons for not prescribing anticoagulant were already taking antiplatelets,patient refusal,and bleeding risk.These reasons were more common in older adults as compared to younger adults.Multivariate analysis revealed current use of antiplatelets to be the most important factor that predict the non-prescription of anticoagulant in older population.Conclusions The prevalence of anticoagulant prescription among older Thai adults with atrial fibrillation is 81.4%.Taking antiplatelet drugs was found to be the strongest reason that predicts the non-prescription of anticoagulant in this patient population.A guideline should be developed to optimize the use of anticoagulant and antiplatelet in older adults. 展开更多
关键词 ANTICOAGULANT use MULTICENTER REGISTRY non-valvular atrial fibrillation OLDER THAI ADULTS
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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation 被引量:2
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作者 Gines Elvira-Ruiz Cesar Caro-Martinez +10 位作者 Pedro JoseFlores-Blanco Juan JoseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola JoseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第3期141-148,I0005-I0007,共11页
Background The identification of modifiable bleeding risk factors may be of relevance.The aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(... Background The identification of modifiable bleeding risk factors may be of relevance.The aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December 2016.AS was defined as moderate or severe according to European echocardiography guidelines criteria.HASBLED,ATRIA and ORBIT scores were used to evaluate the bleeding risk.MB was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of follow-up.Results 168(5.8%)patients had AS.Patients with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest one.Discrimination and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of follow-up.Conclusions In this population,AS was associated with an increased risk for MB at midterm follow-up.The three scoring systems showed a moderate discriminatory ability for MB.Moreover,the addition of AS was associated with a significant improvement in their predictive accuracy.We suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment. 展开更多
关键词 ANTICOAGULANTS Aortic STENOSIS atrial fibrillation Major BLEEDING Valvular disease
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Dabigatran,rivaroxaban,and apixaban are superior to warfarin in Asian patients with non-valvular atrial fibrillation:An updated metaanalysis 被引量:4
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作者 Wei-Jia Li Paraschos Archontakis-Barakakis +7 位作者 Leonidas Palaiodimos Dimitrios Kalaitzoglou Lazaros Tzelves Apostolos Manolopoulos Yu-Chiang Wang Stefanos Giannopoulos Robert Faillace Damianos G Kokkinidis 《World Journal of Cardiology》 2021年第4期82-94,共13页
BACKGROUND Most of the randomized clinical trials that led to the wide use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation(AF)originated from western countrie... BACKGROUND Most of the randomized clinical trials that led to the wide use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation(AF)originated from western countries.AIM To systematically review and quantitatively synthesize the real-world data regarding the efficacy and safety of dabigatran,rivaroxaban,and apixaban compared to warfarin for stroke prevention in Asian patients with non-valvular AF.METHODS Medline,Cochrane,and ClinicalTrial.gov databases were reviewed.A randomeffect model meta-analysis was used and I-square was utilized to assess the heterogeneity.The primary outcome was ischemic stroke.The secondary outcomes were all-cause mortality,major bleeding,intracranial hemorrhage,and gastrointestinal bleeding.RESULTS Twelve studies from East Asia or Southeast Asia and 441450 patients were included.Dabigatran,rivaroxaban,and apixaban were associated with a significant reduction in the incidence of ischemic stroke[hazard ratio(HR)=0.78,95%confidence interval(CI):0.65-0.94;HR=0.79,95%CI:0.74-0.85,HR=0.70,95%CI:0.62-0.78;respectively],all-cause mortality(HR=0.68,95%CI:0.56-0.83;HR=0.66,95%CI:0.52-0.84;HR=0.66,95%CI:0.49-0.90;respectively),and major bleeding(HR=0.61,95%CI:0.54-0.69;HR=0.70,95%CI:0.54-0.90;HR=0.58,95%CI:0.43-0.78;respectively)compared to warfarin.CONCLUSION Dabigatran,rivaroxaban,and apixaban appear to be superior to warfarin in both efficacy and safety in Asians with non-valvular AF. 展开更多
关键词 Novel oral anticoagulant Direct oral anticoagulant atrial fibrillation Asian population DABIGATRAN RIVAROXABAN APIXABAN WARFARIN
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Association between big endothelin-1 and CHADS2/CHA2DS2-VASc scores in non-valvular atrial fibrillation 被引量:4
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作者 Li-Hui ZHENG Shang-Yu LIU +5 位作者 Feng HU Er-Peng LIANG Ling-Min WU Hong-Lei WANG Ammar M Killu Yan YAO 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2019年第11期812-817,共6页
Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little dat... Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little data about the association between big ET-1 and thromboembolism risk in atrial fibrillation(AF).We aimed to investigate the relationship between big ET-1 and CHADS2/CHA2DS2-VASc scores used for evaluating thromboembolic risk in patients with non-valvular AF.Methods The study population consisted of 238 consecutive AF patients(67.6%with paroxysmal AF and 32.4%with persistent AF).The patients were divided into two groups(high-or low-intermediate risk group)based on CHADS2 and CHA2 DS2-VASc scores(score≥2 or<2,respectively).Clinical,laboratory,and echocardiographic parameters were evaluated,and the CHADS2/CHA2DS2-VASc scores were compared between groups.The association between big ET-1 levels and CHADS2/CHA2DS2-VASc score was assessed.Multivariate logistic regression analysis was performed to identify independent predictors of CHADS2/CHA2DS2-VASc scores.Results The high CHADS2/CHA2DS2-VASc score group had older age,higher big ET-1 levels,and enlarged left atrial diameter than the low CHADS2/CHA2DS2-VASc score group(P<0.05).Multiple logistic regression analysis revealed that big ET-1 level was an independent determinant of high CHADS2/CHA2DS2-VASc scores[odds ratio(OR)=2.545 and OR=3.816;both P<0.05].Conclusions Our study indicates that in non-valvular AF,big ET-1 was significantly correlated with CHADS2/CHA2DS2-VASc scores and an independent predictor of high CHADS2/CHA2DS2-VASc scores.Big ET-1 may serve as a useful marker for risk stratification in this setting. 展开更多
关键词 atrial fibrillation CARDIAC risk factors Prevention STROKE
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Association between body mass index and the risk of bleeding in elderly patients with non-valvular atrial fibrillation taking dabigatran:a cohort study 被引量:2
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作者 Ming-Hui LI Li-Hua HU +7 位作者 Yu-Rong XIONG Yu YU Wei ZHOU Tao WANG Ling-Juan ZHU Xi LIU Hui-Hui BAO Xiao-Shu CHENG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第4期193-201,共9页
Background Uncertainty remains regarding the association between body mass index(BMI)and the risk of bleeding in patients with non-valvular atrial fibrillation(NVAF).We aimed to investigate the association between BMI... Background Uncertainty remains regarding the association between body mass index(BMI)and the risk of bleeding in patients with non-valvular atrial fibrillation(NVAF).We aimed to investigate the association between BMI and the risk of bleeding in elderly NVAF patients taking dabigatran.Methods A total of 509 elderly NVAF patients,who were being treated at twelve centers in China from February 2015 to December 2017 and taking dabigatran,were analyzed.The exposure and outcome variables were BMI at baseline and bleeding events within the subsequent six months,respectively.Cox proportional hazards regression analysis was used to evaluate the association between BMI and the risk of bleeding.Moreover,the Cox proportional hazards regression with cubic spline functions and smooth curve fitting was conducted.Results During the six-month follow-up,50 participants experienced bleeding.Every 1 kg/m^2 increase in BMI was associated with a 12%increased risk of bleeding(P=0.021).Compared to those with BMI values in Tertile 1(<22.5 kg/m^2),the adjusted hazard ratio(HR)of bleeding for participants in Tertile 2(22.5–25.3 kg/m^2)and Tertile 3(>25.3 kg/m^2)were 2.71(95%CI:1.02–7.17)and 3.5(95%CI:1.21–8.70),respectively.The Ptrend-value was significant in all models.The adjusted smooth curve showed a linear association between BMI and bleeding.None of the stratified variables showed significant effect modification on the association between BMI and bleeding(Pinteraction>0.05).Conclusions BMI was significantly and positively associated with the risk of bleeding in elderly NVAF patients treated with dabigatran. 展开更多
关键词 atrial fibrillation BLEEDING BODY mass index DABIGATRAN
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Hyperuricemia predicted adverse outcomes in very elderly patients with non-valvular atrial fibrillation
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作者 Nan Cheng Aimin Dang 《中国循环杂志》 CSCD 北大核心 2018年第S01期146-146,共1页
Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvu... Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvular atrial fibrillation(NVAF).Methods Elderly patients(≥80 years)with NVAF admitted to our hospital from January 2009 to December 2015 were retrospectively studied and were followed up until April 2017. 展开更多
关键词 CARDIOVASCULAR disease non-valvular atrial fibrillation ELDERLY PATIENTS
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Analysis of the Impact Factors on a Stable Warfarin Dose in Extreme Elderly (Age ≥ 80 Years) Chinese Patients with Non-Valvular Atrial Fibrillation
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作者 Sen Wang Jun Wu +1 位作者 Chen Men Yan Guo 《World Journal of Cardiovascular Diseases》 2020年第5期329-336,共8页
Purpose: The aim of this study was to investigate non-genetic and genetic factors contributing to stable warfarin dose change in the extreme elderly patients with non-valvular atrial fibrillation. Methods: A total of ... Purpose: The aim of this study was to investigate non-genetic and genetic factors contributing to stable warfarin dose change in the extreme elderly patients with non-valvular atrial fibrillation. Methods: A total of 40 elderly patients with stable warfarin doses were included in this study. Clinical basic data, such as age, sex, body mass index, basic disease like hypertension, diabetes and coronary heart disease had been recorded. Two nucleotide polymorphisms about VKORC1-1639G^A and CYP2C9 1075A^C genes were detected via sequencing by hybridization. Results: The elderly patients with CYP2C9 1075A^C (CA) genotype needed less warfarin daily doses than those?with CYP2C9 1075A^C (AA) genotype (1.93 ± 0.79 mg/d VS 2.15 ± 0.64 mg/d), but there was no significant difference (p = 0.601). While the daily warfarin dose required for patients with VKORC1-1639G^A (AA) genotype was significantly lower than that for patients with VKORC1-1639G^A (GA) genotype (2.00 ± 0.67 mg/d VS 2.63 ± 0.38 mg/d, p = 0.012). VKORC1-1639G^A together with age and diabetes status accounted 41.7% for dose variability. The new algorithm was developed using multivariate linear regression analysis;the model was developed for: Dose = 7.731 – 0.056 * age + 0.527 * DM - 0.785 * VKORC1. Conclusions: VKORC1-1639G^A together with age and diabetes status might predict warfarin doses in age ≥ 80 years patients with non-valvularatrial fibrillation. In contrast, the polymorphism of CYP2C9 1075A^C was not associated with dose variability. 展开更多
关键词 EXTREME ELDERLY non-valvular atrial fibrillation VKORC1 CYP2C9
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Atrial Myocardial Deformation Changes in Patients with Non-Valvular Atrial Fibrillation
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作者 Mohamed Elnoamany Naglaa Fahim Mohsen Abdelfattah 《World Journal of Cardiovascular Diseases》 2021年第8期357-371,共15页
<strong>Background:</strong> <span style="white-space:normal;"><span style="font-family:;" "="">Atrial fibrillation (AF) is the most common cardiac arrhythmia... <strong>Background:</strong> <span style="white-space:normal;"><span style="font-family:;" "="">Atrial fibrillation (AF) is the most common cardiac arrhythmia. It increases cardiovascular morbidity, especially embolic stroke and mortality. Two-dimensional speckle tracking echocardiography (2D STE) is a useful method that has been used to detect changes in atrial myocardial deformation in AF patients.</span></span><span style="white-space:normal;"><span style="font-family:;" "=""> </span></span><span style="white-space:normal;"><b><span style="font-family:;" "="">Objectives:</span></b></span><span style="white-space:normal;"><span style="font-family:;" "=""> To study atrial myocardial deformation changes in patient with non</span></span><span style="white-space:normal;"><span style="font-family:;" "="">-</span></span><span style="white-space:normal;"><span style="font-family:;" "="">valvular AF using 2D STE.<b> Patients and Methods: </b>This study included 25 patients with non</span></span><span style="white-space:normal;"><span style="font-family:;" "="">-</span></span><span style="white-space:normal;"><span style="font-family:;" "="">valvular AF and 25 normal healthy controls. 2D STE was used for assessment of strain and strain rate of septal and free walls of both right atrium (RA) and LA and left ventricle (LV). <b>Results:</b> Mean LA septal and lateral strain and strain rate were significantly reduced in the AF group compared to the control group (-7.2% ± 5.2% vs. -20.4% ± 3.9%, -8.7% ± 8.8% vs. -21.7% ± 3.4%) and (-0.9 ± 0.5 S<sup>-1</sup> vs. -1.9 ± 0.4 S<sup>-1</sup>, –1.1 ± 0.6 S<sup>-1</sup> vs. -2.04 ± 0.3 S<sup>-1</sup>) respectively. Mean RA septal and lateral strain and strain rate were significantly reduced in the AF group compared to the control group (-5.9% ± 6.1% vs. -23.4% ± 4.5%, -8.9% ± 9.3% vs. -21.7% ± 3.4%) and (-0.98 ± 0.6 S<sup>-1</sup> vs. -1.9 ± 0.3 S<sup>-1</sup>, -1.3 ± 0.9 S<sup>-1</sup> vs. -2.1 ± 0.5 S<sup>-1</sup>) respectively. Mean LV global longitudinal strain (GLS) and strain rate were significantly reduced in the AF group compared to the control group (-8.8% ± 4.6% vs -19.6% ± 2.4%) and (-0.8 ± 0.3 S<sup>-1</sup> vs -1.5 ± 0.4 S<sup>-1</sup>) respectively (P <</span></span><span style="white-space:normal;"><span style="font-family:;" "=""> </span></span><span style="white-space:normal;"><span style="font-family:;" "="">0.001 for all). <b>Conclusion:</b> AF is a bi-atrial disease, LA and RA myocardial deformation properties as well as LV GLS and strain rate measured by 2D STE were significantly impaired in AF patients compared to healthy controls.</span></span> 展开更多
关键词 Myocardial Deformation non-valvular atrial fibrillation Speckle Tracking Echocardiography STRAIN Strain Rate
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Predictive value of serum uric acid on left atrial spontaneous echo contrast in non-valvular atrial fibrillation patients 被引量:3
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作者 Hong-Tao LIAO Fang-Zhou LIU +9 位作者 Yu-Mei XUE Xian-Zhang ZHAN Xian-Hong FANG Jun HUANG Wei WEI Fang RAO Hai DENG Yang LIU Wei-Dong LIN Shu-Lin WU 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2015年第6期641-646,共6页
Objectives To investigate the relationship between serum uric acid (SUA) and left atrial spontaneous echo contrast (LA-SEC) in non-valvular atrial fibrillation (AF) patients. Methods We retrospectively screened ... Objectives To investigate the relationship between serum uric acid (SUA) and left atrial spontaneous echo contrast (LA-SEC) in non-valvular atrial fibrillation (AF) patients. Methods We retrospectively screened 1,476 consecutive hospitalized patients with AF who underwent transesophageal echocardiography prior to radiofrequency catheter ablation, left atrial appendage closure and electric cardiover- sion at Guangdong General Hospital. Data on the clinical baseline characteristics of all patients were collected from electronic medical re- cords and analyzed. Results After exclusion of patients with left atrial thrombus, 1,354 patients entered into present study and 57 were LA-SEC. The mean female SUA level (380.88 ± 94.35 μmol/L vs. 323.37 ± 72.19μmol/L, P 〈 0.001) and male SUA level (416.97 ± 98.87 μmol/L vs. 367.88 + 68.50 μmol/L, P = 0.008) were both significantly higher in patients with LA-SEC than in the controls. The mean left atrial dimension (41.32 ± 5.12 mm vs. 36.12 ± 5.66 mm, P 〈 0.001) was markedly larger in patients with LA-SEC. In multivariate regression analysis, SUA level was an independent risk factor for LA-SEC (OR: 1.008, P 〈 0.001). In receiver operating characteristic curve analysis, the corresponding area under the curve for SUA predicting LA-SEC in female and male were 0.670 and 0.657, respectively. SUA level is significantly higher in non-valvular AF patients with LA-SEC. Conclusion SUA level is an independent risk factor and has a moderate predictive value for LA-SEC among non-valvular AF patients in Southern China. 展开更多
关键词 atrial fibrillation Echo contrast Left atrium Serum uric acid Thromboembolic events
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Effect of advanced age on plasma homocysteine levels and its association with ischemic stroke in non-valvular atrial fibrillation 被引量:13
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作者 Yan YAO Li-Jian GAO +4 位作者 Yong ZHOU Jing-Hua ZHAO Qiang LV Jian-Zeng DONG Mei-Sheng SHANG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2017年第12期743-749,共7页
Background Elevated homocysteine (Hcy) has been reported to be associated with cardiovascular events in atrial fibrillation (AF) pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unk... Background Elevated homocysteine (Hcy) has been reported to be associated with cardiovascular events in atrial fibrillation (AF) pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of ad- vanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecu- tive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65-74 years and aged over 75 years (15.7 ±4.6 μmol/L, 17.1 ±4.9 μmol/L, both P 〈 0.01 compared with the first four age groups). Hcy was much higher in AF patients than in controls at the same age group (all P 〈 0.05). The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65-74 years [odds ratios (OR): 1.742, 95% confidence interval (CI): 1.223-2.482, P = 0.002] and age ≥ 75 years (OR: 2.637, 95% CI: 1.605-4.335, P 〈 0.001) were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients. 展开更多
关键词 Advanced age atrial fibrillation HOMOCYSTEINE Ischemic stroke
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Predictive value of red cell distribution width on left atrial thrombus or left atrial spontaneous echo contrast in patients with non-valvular atrial fibrillation 被引量:5
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作者 Xian-Zhang ZHAN Wei-Dong LIN +10 位作者 Fang-Zhou LIU Yu-Mei XUE Hong-Tao LIAO Xin LI Xian-Hong FANG Hai DENG Jun HUANG Yang-Qiu LI Jo-Jo HAI Hung-Fat Tse Shu-Lin WU 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2018年第6期408-412,共5页
Objective To evaluate the predictive value of red cell distribution width (RDW) on left atrial thrombus (LAT) or left atrial spontane- ous echo contrast (LASEC) in patients with non-valvular atrial fibrillation ... Objective To evaluate the predictive value of red cell distribution width (RDW) on left atrial thrombus (LAT) or left atrial spontane- ous echo contrast (LASEC) in patients with non-valvular atrial fibrillation (AF). Methods We reviewed 692 patients who were diagnosed as non-valvular AF and underwent transesophageal echocardiography (TEE) in Guangdong Cardiovascular Institute from April 2014 to December 2015. The baseline clinical characteristics, laboratory test of blood routine, electrocardiograph measurements were analyzed. Results Eighty-four patients were examined with LAT/LASEC under TEE. The mean RDW level was significantly higher in LAT/LASEC patients compared with the non-LAT/LASEC patients (13.59% ± 1.07% ws. 14.34% ± 1.34%; P 〈 0.001). Receiver-operating characteristic curve analysis was performed and indicated the best RDW cut point was 13.16%. Furthermore, multivariate logistic regression analysis indicated that RDW level 〉 13.16% could be an independent risk factor for LAT/LASEC in patients with AF. Conclusion Elevated RDW level is associated with the presence of LAT/LASEC and could be with moderate predictive value for LAT/LASEC in patients with non-valvular AF. 展开更多
关键词 atrial fibrillation Left atrial spontaneous echo contrast Left atrial thrombus Red cell distribution width
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The relationship between polymorphisms of P-selectin genes and plasma P-selectin concentration with thrombosis in non-valvular atrial fibrillation of Kazakh ethnicity
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作者 Maerjiaen Bakeyi Zhi-Qiang Liu +3 位作者 Peng-Yi He Lei Zhang Yu-Chun Yang Muhuyati 《Journal of Hainan Medical University》 2020年第15期30-35,共6页
Objective:To explore the relationship between polymorphisms in rs1800807 and rs1800808 locies of P-selectin gene and plasma concentrations of soluble P-selectin(sPs)and non-valvular atrial fibrillation(Af)coupled with... Objective:To explore the relationship between polymorphisms in rs1800807 and rs1800808 locies of P-selectin gene and plasma concentrations of soluble P-selectin(sPs)and non-valvular atrial fibrillation(Af)coupled with thrombosis in Kazakh ethnicity.Methods:This was a case-control study,enrolling hospitalized Kazakh Af patients with and without thrombosis and healthy subjects.PCR-RFLP method was used to analyze the polymorphisms of the locies,and ELISA method was to measure plasma sPs concentrations.Subjects were divided into Af thrombosis,only Af and control groups.Results:We enrolled 42 Af thrombosis,156 only Af and 307 control subjects.Carriers of GG genotype of the loci rs1800807 was the highest in Af thrombosis,followed by only Af and the lowest in the control groups(69 vs 23.7 vs 18.2%,P<0.001).Carriers of TT genotype of the loci rs1800808 was the highest in Af thrombosis,followed by only Af and the lowest in the control groups(31.0 vs 13.5 vs 8.1%,P<0.001).Plasma sPs concentrations was the highest in Af thrombosis group,followed by only Af group and the lowest in the control(52.20 vs 34.04 vs 35.85pg/mL,P<0.001).Plasma sPs concentrations were significantly higher in the carriers of GG genotypes of the loci rs1800807 than in those of CC and CG genotypes(45.75 vs 33.86 vs 39.26pg/mL,P<0.001)and also significantly higher in the carries of TT of the loci rs1800808 than in those of CC and CT(43.16 vs 36.74 vs 39.08pg/mL,P<0.001).GG type of rs1800807 loci(OR=3.35,95%CI:2.03-5.55)and TT type of rs1800808(OR=2.19,95%CI:1.65-2.90)showed significantly higher odd's ratio for Af thrombosis,compared with the wild genotype and the highest tertile of plasma sPs aslo showed higher odd's ratio(OR=1.31,95CI%:1.12-1.93),compared with the lowest tertile.Conclusion:polymorphisms of the locies of the PS gene were observed to exist in Af patients with thrombosis and with higher concentrations of plamsa sPs,suggesting their involvement in Af and thrombosis in Kazakh subjects. 展开更多
关键词 Soluble P-selectin THROMBOSIS non-valvular atrial fibrillation
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Atrial fibrillation and prediabetes:A liaison that merits attention! 被引量:2
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作者 Akash Batta Juniali Hatwal 《World Journal of Diabetes》 SCIE 2024年第7期1645-1647,共3页
Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key role.The resultant vicious cycle which sets in culminates in a higher ather... Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key role.The resultant vicious cycle which sets in culminates in a higher atherogenicity and thermogenicity of the vascular system resulting in increased major adverse cardiac or cerebrovascular event(MACCE)events.However,the same has not convincingly been verified in real-world settings.In the recent retrospective study by Desai et al amongst AF patients being admitted to hospitals following MACCE,prediabetes emerged as an independent risk factor for MACCE after adjusting for all confounding variables.However,certain questions like the role of metformin,quantifying the risk for MACCE amongst prediabetes compared to diabetes,the positive impact of reversion to normoglycemia remain unanswered.We provide our insights and give future directions for dedicated research in this area to clarify the exact relationship between the two. 展开更多
关键词 atrial fibrillation Major adverse cardiac or cerebrovascular event PREDIABETES Diabetes Stroke Heart failure DYSGLYCEMIA METFORMIN
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Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation 被引量:1
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作者 Fu-Wei XING Li-Hua ZHANG +4 位作者 Hai-Bo ZHANG Xue-Ke BAI Dan-Li HU Xin ZHENG Jing LI 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2021年第9期728-738,共11页
OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ej... OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF. 展开更多
关键词 BETA-BLOCKERS and 1-year clinical outcomes in HOSPITALIZED heart failure PATIENTS with atrial fibrillation
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Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine
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作者 Liuba Fusco Zefferino Palamà +5 位作者 Antonio Scarà Alessio Borrelli Antonio Gianluca Robles Gabriele De Masi DeLuca Silvio Romano Luigi Sciarra 《World Journal of Cardiology》 2024年第5期231-239,共9页
The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrilla... The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral hemorrhage.Nevertheless,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke risk.The prevalence of both CAA and AF is expected to rise,due to the aging of the population.This clinical dilemma is becoming increasingly common.In patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific literature.This review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm. 展开更多
关键词 ANTICOAGULATION atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage STROKE Watchman Secondary prevention Left atrial appendage closure
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Pharmacological Treatment for Atrial Fibrillation—Modalities in Equines and Companion Animals
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作者 Ina Cojoaca 《Open Journal of Veterinary Medicine》 CAS 2024年第10期257-303,共47页
Cardiac arrhythmias are probably more common in horses than in any other domestic animal species where poor performance and exercise intolerance is the most frequent clinical complaint. Atrial fibrillation is a type o... Cardiac arrhythmias are probably more common in horses than in any other domestic animal species where poor performance and exercise intolerance is the most frequent clinical complaint. Atrial fibrillation is a type of cardiac arrhythmia that appears as a common finding during medical examinations in humans, large breed dogs and horses. Clinical presentations are of a particular value in racehorses in high performing activities. Atrial fibrillation is characterized by an irregular heart rhythm, secondary to a primary disease or without any sign of comorbidity. The generation and maintenance of Atrial Fibrillation requires a substrate. Some breeds have a genetic predisposition to developing Atrial Fibrillation. Most cases of Atrial Fibrillation are of the paroxysmal type and self-regulate within a few hours to days without the need for treatment. The focus of this study is on the arrhythmic agents that are used for the treatment of Atrial Fibrillation, therefore other arrhythmic agents may not be included, or are included to demonstrate their effect on increasing, inhibiting or decreasing efficacy when used together with medications for the treatment of Atrial Fibrillation. The “working horse” for the pharmacological treatment of Atrial Fibrillation is Quinidine. 展开更多
关键词 atrial fibrillation ARRYTHMIA Equine Cardiology Poor Performance Pharmacological Treatment QUINIDINE Genetic Predisposition Sinus Rhythm
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Atrial fibrillation in the elderly 被引量:9
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作者 Pablo Díez-Villanueva Fernando Alfonso 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2019年第1期49-53,共5页
Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocar... Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocardiogram before AF onset in some patients.Once this arrhythmia is diagnosed,antithrombotic therapy is mandatory in most cases,as this is the only treatment that has demonstrated to improve survival.Age increases both the risk of thromboembolic and bleeding complications,while benefits from anticoagulant therapy outweigh that from bleeding in most scenarios,also in very elderly patients.However,elderly patients with AF are often undertreated.Non-vitamin K antagonist oral anticoagulants have emerged as an alternative to vitamin K antagonists,with significant less adverse events and better profile in terms of efficacy and safety.Other conditions related to age should be carefully evaluated in these patients(including frailty,comorbidity and polypharmacy)to ensure an individualized clinical and therapeutic approach. 展开更多
关键词 atrial fibrillation ANTITHROMBOTIC therapy FRAILTY Non-vitamin K ANTAGONIST oral ANTICOAGULANTS The elderly
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Reduction of radiation exposure in catheter ablation of atrial fibrillation: Lesson learned
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作者 Roberto De Ponti 《World Journal of Cardiology》 CAS 2015年第8期442-448,共7页
Over the last decades, the concern for the radiation injury hazard to the patients and the professional staff has increased in the medical community. Since there is no magnitude of radiation exposure that is known to ... Over the last decades, the concern for the radiation injury hazard to the patients and the professional staff has increased in the medical community. Since there is no magnitude of radiation exposure that is known to be completely safe, the use of ionizing radiation during medical diagnostic or interventional procedures should be as low as reasonably achievable(ALARA principle). Nevertheless, in cardiovascular medicine, radiation exposure for coronary percutaneous interventions or catheter ablation of cardiac arrhythmias may be high: for ablation of a complex arrhythmia, such as atrial fibrillation, the mean dose can be > 15 m Sv and in some cases > 50 m Sv. In interventional electrophysiology, although fluoroscopy has been widely used since the beginning to navigate catheters in the heart and the vessels and to monitor their position, the procedure is not based on fluoroscopic imaging. Therefore, nonfluoroscopic three-dimensional systems can be used to navigate electrophysiology catheters in the heart with no or minimal use of fluoroscopy. Although zerofluoroscopy procedures are feasible in limited series, there may be difficulties in using no fluoroscopy on a routine basis. Currently, a significant reduction in radiation exposure towards near zero-fluoroscopy procedures seems a simpler task to achieve, especially in ablation of complex arrhythmias, such as atrial fibrillation. The data reported in the literature suggest the following three considerations. First, the use of the non-fluoroscopic systems is associated with a consistent reduction in radiation exposure in multiple centers: the more sophisticated and reliable this technology is, the higher the reduction in radiation exposure. Second, the use of these systems does not automatically lead to reduction of radiation exposure, but an optimized workflow should be developed and adopted for a safe non-fluoroscopic navigation of catheters. Third, at any level of expertise, there is a specific learning curve for the operators in the non-fluoroscopic manipulation of catheters; however, the learning curve is shorter for more experienced operators compared to less experienced operators. 展开更多
关键词 CATHETER ablation atrial fibrillation Radiation exposure FLUOROSCOPY time Dose area product Electro-anatomic mapping
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Role of three-dimensional imaging integration in atrial fibrillation ablation 被引量:5
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作者 Roberto De Ponti Raffaella Marazzi +4 位作者 Domenico Lumia Giuseppe Picciolo Roberto Biddau Carlo Fugazzola Jorge A Salerno-Uriarte 《World Journal of Cardiology》 CAS 2010年第8期215-222,共8页
Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form,catheter ablation aimed at electrically disconnecting the pulmonary veins(PVs) has proved more effective than u... Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form,catheter ablation aimed at electrically disconnecting the pulmonary veins(PVs) has proved more effective than use of antiarrhythmic drugs in maintaining sinus rhythm during follow-up.On the other hand,this ablation procedure is complex,requires specific training and adequate clinical experience.A main challenge is represented by the need for accurate sequential positioning of the ablation catheter around each veno-atrial junction to deliver point-by-point radiofrequency energy applications in order to achieve complete and persistent electrical disconnection of the PVs.Imaging integration is a new technology that enables guidance during this procedure by showing a three-dimensional,pre-acquired computed tomography or magnetic resonance image and the relative real-time position of the ablation catheter on the screen of the electroanatomic system.Reports in the literature suggest that imaging integration provides accurate visual information with improvement in the procedure parameters and/or clinical outcomes of the procedure. 展开更多
关键词 CATHETER ablation atrial fibrillation Electroanatomic mapping MULTISLICE COMPUTED TOMOGRAPHY Magnetic resonance imaging
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Prognostic impact of atrial fibrillation on clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease 被引量:2
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作者 Nileshkumar J Patel Aashay Patel +16 位作者 Kanishk Agnihotri Dhaval Pau Samir Patel Badal Thakkar Nikhil Nalluri Deepak Asti Ritesh Kanotra Sabeeda Kadavath Shilpkumar Arora Nilay Patel Achint Patel Azfar Sheikh Neil Patel Apurva O Badheka Abhishek Deshmukh Hakan Paydak Juan Viles-Gonzalez 《World Journal of Cardiology》 CAS 2015年第7期397-403,共7页
Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac... Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac and major non-cardiac diseases. Morbidity and mortality associated with AF makes it a major healthcare burden. The objective of our article is to determine the prognostic impact of AF on acute coronary syndromes,heart failure and chronic kidney disease. Multiple studies have been conducted to determine if AF has an independent role in the overall mortality of such patients. Our review suggests that AF has an independent adverse prognostic impact on the clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease. 展开更多
关键词 atrial fibrillation Heart failure Chronic kidney disease Acute coronary SYNDROMES PROGNOSTIC IMPACT
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