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JACC Cardiovasc Imaging 2019 Mar 8. Epub 2019 Mar 8.

Service de Cardiologie, CIC-IT INSERM 1414, CHU Pontchaillou, Rennes, France; Service de médecine du sport et laboratoire de physiologie, Université Rennes 1, CHU Pontchaillou, Rennes, France.

The management of atrial fibrillation (AF) is not only a clinical challenge but also an imaging challenge. The role of different imaging modalities to estimate the thromboembolic risk in AF is a key clinical question. The present review summarizes the advances of myocardial imaging in the stratification of thromboembolic risk, diagnosis, and management of left atrial thrombosis in patients with AF. Read More

Clin Cardiol 2019 Mar 15. Epub 2019 Mar 15.

Thrombosis Research Institute, London, United Kingdom.

Background: Atrial fibrillation (AF) is an important preventable cause of stroke. Anticoagulation (AC) therapy can reduce this risk. However, prescribing patterns and outcomes in patients with non-valvular atrial fibrillation (NVAF) from Latin American countries are poorly described. Read More

Anatol J Cardiol 2019 Mar;21(Suppl 1):1-40

Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir-Turkey.

Natriuretic peptides have long been introduced into clinical practice. These biomarkers have certainly been shown to provide useful information in the diagnosis, prognosis and risk stratification in heart failure and also may have a role in the guidance of heart failure therapy. Although, there are some limitations in using of these markers such as lack of specificity, aging, renal dysfunction or obesity, among the huge number of candidates for heart failure biomarkers, only natriuretic peptides are currently widely used in daily clinical practice in heart failure. Read More

J Am Med Dir Assoc 2019 Mar 7. Epub 2019 Mar 7.

Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Objectives: Factors that influence decision of non-vitamin K antagonist oral anticoagulants (NOACs) use among older atrial fibrillation (AF) patients in long-term care (LTC) facilities have not been well studied. The aim of this study was to assess whether increased frailty influenced physicians to prescribe NOACs over warfarin.

Design: We retrospectively reviewed the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada, in May 2015. Read More

Europace 2019 Mar 6. Epub 2019 Mar 6.

Department of Cardiology, Rijnstate Hospital Arnhem, Arnhem, The Netherlands.

Atrial fibrillation (AF), is the most common sustained arrhythmia and is associated with a substantial increase in morbidity and mortality. Several studies have demonstrated sex-related differences in various aspects, including age at diagnosis, clinical manifestations, management and prognosis. These dissimilarities may dictate different approaches to management and could translate to differences in outcomes. Read More

Pract Neurol 2019 Mar 2. Epub 2019 Mar 2.

Stroke Research Centre, University College London Queen Square Institute of Neurology, London, UK

Neurologists and stroke physicians will be familiar with atrial fibrillation as a major cause of ischaemic stroke, and the role of anticoagulation in preventing cardioembolic stroke. However, making decisions about anticoagulation for individual patients remains a difficult area of clinical practice, balancing the serious risk of ischaemic stroke against that of major bleeding, particularly intracranial haemorrhage. Atrial fibrillation management requires interdisciplinary collaboration with colleagues in cardiology and haematology. Read More

Medicine (Baltimore) 2019 Feb;98(8):e14578

Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong.

Heart failure (HF) complicating ST-segment elevation myocardial infarction (STEMI) is recognized as an ominous complication. The HAS-BLED and Outcomes Registry for Better Informed Treatment (ORBIT) scores are used to assess the bleeding risk in patients with anticoagulated atrial fibrillation. This study aimed to investigate the relationship of the ORBIT and HAS-BLED scores with Killip class 3-4 in patients with STEMI. Read More

J Arrhythm 2019 Feb 20;35(1):25-32. Epub 2018 Nov 20.

Department of Cardiology Ospedale "Ferrari" Castrovillari (CS) Italy.

The implantable loop recorder (ILR), also known as insertable cardiac monitor (ICM) is a subcutaneous device used for diagnosing heart rhythm disorders. These devices have been strongly improved and miniaturized during the last years showing several reliable features along with the availability of remote monitoring which improves the diagnostic timing and the follow-up strategy with a potential reduction of costs for health care. The recent advent of injectable ILRs makes the procedure even easier and more tolerated by patients. Read More

Front Neurol 2019 5;10:22. Epub 2019 Feb 5.

Health and Clinical Data Research Center, College of Public Health, Taipei Medical University, Taipei, Taiwan.

Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Read More

J Pharm Pract 2019 Feb 21:897190019828270. Epub 2019 Feb 21.

1 Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Background:: Direct oral anticoagulants (DOACs) have strict dosing guidelines, but recent studies indicate that inappropriate dosing is common, particularly in chronic kidney disease (CKD), for which it has been reported to be as high as 43%. Since 2011, the Veterans Health Administration (VA) has implemented anticoagulation management programs for DOACs, generally led by pharmacists, which has previously been shown to improve medication adherence.

Objective:: We investigated the prevalence of overdosing and underdosing of DOACs in the VA. Read More

Clin Pract Cases Emerg Med 2019 Feb 4;3(1):11-12. Epub 2019 Jan 4.

University of California, Irvine, Department of Emergency Medicine, Orange, California.

A 95-year-old female with a history of dementia and atrial fibrillation (not on anticoagulation) presented to the emergency department (ED) by ambulance from her skilled nursing facility due to hypoxia. Point-of-care ultrasound was performed, and showed evidence of a large mobile thrombus in the right ventricle on apical four-chamber view. Further evidence of associated right heart strain was seen on the corresponding parasternal short-axis view. Read More

Atherosclerosis 2019 Jan 24;283:13-18. Epub 2019 Jan 24.

Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan; Department of Information Management and Institute of Healthcare Information Management, National Chung Cheng University, Chiayi County, Taiwan. Electronic address:

Background And Aims: Stroke occurrence while on antiplatelet therapy, i.e., a breakthrough stroke, is often conveniently attributed to antiplatelet resistance. Read More

Pulm Circ 2019 Jan-Mar;9(1):2045894019834890

3 Department of Medicine, Queen's University, Kingston, ON, Canada.

Arrhythmias are increasingly recognized as serious, end-stage complications of pre-capillary pulmonary hypertension, including pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Although arrhythmias contribute to symptoms, morbidity, in-hospital mortality, and possibly sudden death in PAH/CTEPH, there remains a paucity of epidemiologic, pathophysiologic, and outcome data to guide management of these patients. This review summarizes the most current evidence on the topic: from the molecular mechanisms driving arrhythmia in the hypertrophied or failing right heart, to the clinical aspects of epidemiology, diagnosis, and management. Read More

J Cardiovasc Echogr 2018 Oct-Dec;28(4):207-217

Luigi Vanvitelli University, Monaldi Hospital, AORN Ospedali Dei Colli, Naples, Italy.

Mitral valve prolapse is generally a benign condition characterized by fibromyxomatous changes of the mitral leaflet with displacement into the left atrium and late-systolic regurgitation. Although it is an old clinical entity, it still arouses perplexity in diagnosis and clinical management. Complications, such as mitral regurgitation (MR), atrial fibrillation, congestive heart failure, endocarditis, ventricular arrhythmias, and sudden cardiac death (SCD), have been reported. Read More

Minerva Cardioangiol 2019 Feb 5. Epub 2019 Feb 5.

Department of Cardiology, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Crete, Greece -

Although atrial fibrillation (AF) is an arrhythmia with a variable clinical profile (symptomatic and asymptomatic episodes), the first symptomatic episode leads to its initial diagnosis in most cases. Nowadays, continuous and remote long- term cardiac rhythm monitoring is feasible by the use of implantable loop recorders. The data concerning the AF recurrences and progression after the first ECG- documented clinical AF episode demonstrates that a high percentage of patients may not suffer any other AF recurrence, or may present a low recurrence rate of the arrhythmia in the future. Read More

Ter Arkh 2018 Sep;90(9):48-52

Department of clinical and laboratory diagnostics, faculty of advanced physicians, Tyumen State Medical University, Tyumen, Russia.

Aim: The aim of the study is to assess frequency, risk factors and in-hospital outcomes of acute kidney injury after coronary artery bypass grafting in patients with stable angina.

Materials And Methods: The study included patients with stable angina pectoris and indications for coronary artery bypass grafting. We examined 93 patients aged 58±7. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2366-2368

Dept. of Surgery, National Hospital Organization Osaka National Hospital.

An 82-year-old man receiving oral administration of warfarin for atrial fibrillation underwent distal gastrectomy for advanced gastric cancer. The postoperative diagnosis was pT3(SS)N2M1H1P0CY0, pStage Ⅳ,(HER2, score 3+)gastric cancer. He received chemotherapy for the treatment of multiple liver metastases, following which, he developed lymph node metastases. Read More

Chest 2019 Jan 23. Epub 2019 Jan 23.

Department of Health Statistics, Second Military Medical University, Shanghai; Tongji University School of Medicine, Shanghai, China. Electronic address:

Background: This study aimed to evaluate the prevalence of atrial fibrillation (AF) in hospital encounters with end-stage COPD on home oxygen admitted for COPD exacerbation.

Methods: We used the 2003 to 2014 Nationwide Inpatient Sample to conduct a retrospective analysis. This study included all patients ≥ 18 years of age with a primary diagnosis of COPD on home oxygen who were hospitalized for COPD exacerbation. Read More

J Am Coll Cardiol 2019 Jan;73(3):264-274

Cardiovascular Division, Mayo Clinic, Mayo Medical School, Rochester, Minnesota.

Background: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery.

Objectives: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term.

Methods: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. Read More

Am J Med 2019 Jan 16. Epub 2019 Jan 16.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark. Electronic address:

Background: The Atrial fibrillation Better Care (ABC) pathway has been proposed to streamline patient management in an integrated, holistic manner. Compliance to ABC resulted in lower incidence of cardiovascular events, but its impact on health-related costs has not been evaluated.

Methods: Exploratory analysis of costs related to cardiovascular events in the ATHERO-AF prospective cohort study including atrial fibrillation patients on vitamin K antagonists. Read More

Int J Cardiol 2019 Mar 2;279:126-132. Epub 2019 Jan 2.

University of Cape Town, Cape Town, South Africa. Electronic address:

Background: Peaks and troughs in cardiovascular events correlated with seasonal change is well established from an epidemiological perspective but not a clinical one.

Methods: Retrospective analysis of the recruitment, baseline characteristics and outcomes during minimum 12-month exposure to all four seasons in 1598 disease-management trial patients hospitalised with chronic heart disease. Seasonality was prospectively defined as ≥4 hospitalisations (all-cause) AND >45% of related bed-days occurring in any one season during median 988 (IQR 653, 1394) days follow-up. Read More

J Hum Hypertens 2019 Jan 10. Epub 2019 Jan 10.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, OX2 6GG, Oxford, England.

Atrial fibrillation (AF) affects ~3% of the general population and is twice as common with hypertension. Validation protocols for automated sphygmomanometers exclude people with AF, raising concerns over accuracy of hypertension diagnosis or management, using out-of-office blood pressure (BP) monitoring, in the presence of AF. Some devices include algorithms to detect AF; a feature open to misinterpretation as offering accurate BP measurement with AF. Read More

J Clin Med Res 2019 Jan 3;11(1):21-25. Epub 2018 Dec 3.

Department of Internal Medicine, Staten Island University Hospital Staten Island, 475 Seaview Ave, Staten Island, NY 10305, USA.

Background: "There is a high prevalence of obstructive sleep apnea (OSA) among patients with atrial fibrillation (AF). There is also strong evidence that proper OSA management can reduce AF recurrence." Polysomnography is the gold standard for OSA diagnosis, but screening tests, such as STOP-BANG, have been successful in identifying patients at risk for OSA. Read More

JAMA Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Surgery, University of Nebraska, Omaha.

Importance: Randomized clinical trials have demonstrated that patients with asymptomatic carotid stenosis are eligible for carotid endarterectomy (CEA) if the 30-day surgical complication rate is less than 3% and the patient's life expectancy is at least 5 years.

Objective: To develop a risk prediction tool to improve patient selection for CEA among patients with asymptomatic carotid stenosis.

Design, Setting, And Participants: In this cohort study, veterans 65 years and older who received both carotid imaging and CEA in the Veterans Administration between January 1, 2005, and December 31, 2009 (n = 2325) were followed up for 5 years. Read More

Heart Surg Forum 2018 12 13;21(6):E489-E496. Epub 2018 Dec 13.

Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Background: Atrial fibrillation (AF) is common after cardiac surgery and contributes to increased morbidity and mortality. Our objective was to derive and validate a predictive model for AF after CABG in patients, incorporating novel echocardiographic and laboratory values.

Methods: We retrospectively reviewed patients at our institution without preexisting dysrhythmia who underwent on-pump, isolated CABG from 2011-2015. Read More

Ann Transl Med 2018 Dec;6(23):460

Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.

Takotsubo cardiomyopathy (TTC) was first described in Japan in the 1980s. It is described as an acute but often reversible left ventricular (LV) dysfunction mainly triggered by emotional or physical stress. Multiple variants of TTC have been reported including reverse Takotsubo cardiomyopathy (rTTC) which is a variant characterized by the basal akinesis/hypokinesis associated with apical hyperkinesis that resolves spontaneously. Read More

Med Sci Monit 2019 Jan 2;25:52-60. Epub 2019 Jan 2.

Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China (mainland).

BACKGROUND Effective early management of cerebral infarction patients with transient ischemic attack (TIA) is undermined by an inability to predict who is at highest risk of stroke. MATERIAL AND METHODS A total of 577 TIA patients with symptoms lasting no more than 1 hour were prospectively investigated and divided into a TIA group and a transient symptoms associated with infarction (TSI) group based on diffusion-weighted magnetic resonance imaging findings after hospital admission. The baseline characteristics, symptoms of TIA, features of disease onset, and findings from clinical examinations were compared between the 2 groups. Read More

Indian Heart J 2018 Dec 19;70 Suppl 3:S68-S73. Epub 2018 May 19.

IGMC, Shimla, HP, India.

Objective: To report the prevalence, risk factors and consequences of atrial fibrillation (AF) in patients of rheumatic heart disease (RHD).

Methods: The Himachal Pradesh- Rheumatic Fever/Rheumatic Heart Disease (HP-RF/RHD) Registry database of 1918 patients was analyzed. AF was diagnosed with 12-lead ECG recording at entry in to the registry. Read More

J Am Heart Assoc 2019 Jan;8(1):e010959

2 Heart Research Institute Charles Perkins Centre The University of Sydney Australia.

Background This eH ealth implementation study aimed to evaluate strategies to promote opportunistic atrial fibrillation ( AF ) screening using electronic screening prompts and improve treatment using electronic decision support ( EDS ) software. Methods and Results An electronic screening prompt appeared whenever an eligible patient's (aged ≥65 years, no AF diagnosis) medical record was opened in participating general practices. General practitioners and practice nurses offered screening using a smartphone ECG, with validated AF algorithm. Read More

Neurologist 2019 Jan;24(1):37-39

Departments of Neurology.

Objective: Illustrates the importance of differentiating limb-shaking transient ischemic attack (LS-TIA) from focal seizures and carefully selecting patients for intracranial stenting.

Background: LS-TIA is associated with severe carotid stenosis or occlusion, often precipitated by cerebral hypoperfusion. A case study of 313 patients with symptomatic intracranial artery stenosis/occlusion reported 11% with LS-TIA. Read More

Case Rep Vasc Med 2018 21;2018:6273538. Epub 2018 Nov 21.

AtlantiCare Regional Medical Center, USA.

We present a case of a 78-year-old female with history of diastolic heart failure and paroxysmal atrial fibrillation on apixaban presenting with worsening shortness of breath. She underwent transesophageal echocardiogram showing severe aortic stenosis with a valve area of 0.8 cm2. Read More

Indian Heart J 2018 Nov - Dec;70(6):828-835. Epub 2018 Sep 12.

Thrombosis Research Institute, London, UK; University College London, London, UK.

Background: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry.

Methods And Results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). Read More

JACC Clin Electrophysiol 2018 Dec 1;4(12):1629-1637. Epub 2018 Nov 1.

Division of Cardiology, West Virginia School of Medicine, Morgantown, West Virginia.

Objectives: This study sought to assess the incidence and clinical impact of device related thrombus (DRT) following precautions left atrial appendage occlusion (LAAO).

Background: Device-related thrombus is a known complication of LAAO. However, data on the incidence of DRT and its impact on outcomes are limited. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13830

Department of Neurology & Pediatrics, Emory University, United States.

We evaluated the utility of left atrial volume index (LAVI) and markers of coagulation and hemostatic activation (MOCHA) in cryptogenic stroke (CS) patients to identify those more likely to have subsequent diagnosis of atrial fibrillation (AF), malignancy or recurrent stroke during follow-up.Consecutive CS patients who met embolic stroke of undetermined source (ESUS) who underwent transthoracic echocardiography and outpatient cardiac monitoring following stroke were identified from the Emory cardiac registry. In a subset of consecutive patients, d-dimer, prothrombin fragment 1. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13623

Cardiology Department, China-Japan Union Hospital of Jilin University.

Rationale: Anti-thrombosis therapy for atrial fibrillation (AF) management and stroke prevention is an important aspect of disease management. Novel oral anticoagulants (NOACs) are recommended by guidelines for AF management. However, if one can switch one NOAC to another when the former showed a poor effect has not been fully determined. Read More

Stroke 2018 Dec;49(12):2866-2871

From the Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Background and Purpose- A quarter of acute strokes occur in patients hospitalized for another reason. A stroke recognition instrument may be useful for non-neurologists to discern strokes from mimics such as seizures or delirium. We aimed to derive and validate a clinical score to distinguish stroke from mimics among inhospital suspected strokes. Read More

J Cardiovasc Med (Hagerstown) 2019 Feb;20(2):59-65

Heart Rhythm Management Center, Postgraduate program in Cardiac Electrophysiology and Pacing.

Background: The present study sought to evaluate the incidence of cerebrovascular events in a large cohort of patients with Brugada syndrome (BrS) analysing possible predictors, clinical characteristics and prognosis of cardioembolic events secondary to atrial fibrillation.

Methods: A total of 671 consecutive patients (age 42.1 ± 17. Read More

Clin Ter 2018 Nov-Dec;169(6):e287-e291

Internal Medicine, San Giuseppe Hospital, Empoli (Firenze), Italy.

Background: Guidelines recommend triple therapy (TT) with ACE inhibitors or ARBs, beta-blockers and mineralcorticoid receptor antagonists in symptomatic heart failure patients with ejection fraction <35 % (HFrEF). Nevertheless, many patients remain untreated. This study was aimed to evaluate the use of TT in HFrEF patients discharged from internal medicine wards of Tuscany, Italy. Read More

Liver Int 2018 Dec 7. Epub 2018 Dec 7.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Background & Aims: Nonalcoholic steatohepatitis (NASH) is associated with increased cardiovascular disease. Atrial fibrillation is a prominent risk marker for underlying cardiovascular disease with a prevalence of 2% in patients <65 years old. Atrial fibrillation prevalence in NASH is unknown. Read More

Am J Med Case Rep 2018 ;6(9):180-183

Department of Medicine, Division of Rheumatology, State University of New York, Downstate Medical Center/Health + Hospitals Kings County Brooklyn, NY 11203 USA.

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical features and variable clinical course. SLE tends to affect women during childbearing years and is characterized by multi-organ involvement. Cardiac complications in SLE, which have been described to occur in about 50% of the cases, contributes to significant morbidity and mortality in this population. Read More

J Stroke Cerebrovasc Dis 2019 Mar 5;28(3):774-781. Epub 2018 Dec 5.

Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan. Electronic address:

Background: Although, thrombectomy for stroke more than 6 hours after onset supported by automated perfusion computed tomography (CT) software (RAPID, iSchemaView) is effective, this software is not available in Japan. This study aimed to elucidate the efficacy of thrombectomy 6-24 hours after onset in our patient cohort using conventional imaging mismatch.

Methods: Of 586 ischemic stroke patients who underwent thrombectomy registered from January 2015 to December 2017, patients with occlusion of the intracranial internal carotid artery or middle cerebral artery, who had last been known to be well 6-24 hours earlier and who had a prestroke modified Rankin scale (mRS) score 0 or 1 were enrolled. Read More

Comput Biol Med 2019 Jan 22;104:310-318. Epub 2018 Nov 22.

Neural Engineering, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA; Center for Arrhythmia Research, University of Michigan, Ann Arbor, MI, USA.

Introduction: Atrial Fibrillation (AF) is the most common cardiac arrhythmia, presenting a significant independent risk factor for stroke and thromboembolism. With the emergence of m-Health devices, the importance of automatic detection of AF in an off-clinic setting is growing. This study demonstrates the performance of a bimodal classifier for distinguishing AF from sinus rhythm (SR) that could be used for automated detection of AF episodes. Read More

Int Heart J 2019 Jan 5;60(1):12-18. Epub 2018 Dec 5.

Department of Cardiovascular Medicine, Second Xiangya Hospital of Central South University.

Emery-Dreifuss muscular dystrophy (EDMD) is a group of hereditary muscular dystrophy syndrome caused by deficiency of genes encoding nuclear envelope proteins. Patients having EDMD show the triad of muscle dystrophy, joint contracture, and cardiac disease. In almost all patients, cardiac involvement is prevalent and is the most severe aspect of EDMD. Read More

J Atr Fibrillation 2018 Aug 31;11(2):2038. Epub 2018 Aug 31.

Department of Cardiology, Centre hospitalier Edmond Garcin, Aubagne, France.

Atrial fibrillation is the most common cardiac rhythm disorder observed in clinical practice. It carries high morbidity and mortality rates, primarily related to heart failure, stroke and death. Validation of noninvasive markers in the diagnosis of heart failure with preserved ejection fraction and risk stratification is relevant in this clinical setting. Read More

Curr Probl Cardiol 2018 Oct 17. Epub 2018 Oct 17.

Hypertrophic cardiomyopathy (HCM) is the most prevalent hereditary cardiac disease characterized by the presence of left ventricular and/or septal hypertrophy in the absence of other underlying cardiac disorders. Patients of HCM have a broad range of clinical presentation from being asymptomatic to severely ill condition requires hospitalization and urgent management. Broadly, HCM is classified in two variants: obstructive and nonobstructive. Read More

Cochrane Database Syst Rev 2018 11 27;11:CD012345. Epub 2018 Nov 27.

Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK, NR4 7TJ.

Background: Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear. Read More

Oncology (Williston Park) 2018 11;32(11):574-5

J Stroke Cerebrovasc Dis 2019 Mar 23;28(3):562-568. Epub 2018 Nov 23.

Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría y Departamento Paciente Crítico, Clínica Alemana de Santiago. Facultad de Medicina, Universidad del Desarrollo, Santiago and Departamento de Ciencias Neurológicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Background: Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients.

Methods: We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017. Read More

J Stroke Cerebrovasc Dis 2019 Mar 22;28(3):569-573. Epub 2018 Nov 22.

Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida.

Background: Despite ample clinical trial data demonstrating that oral anticoagulation (OAC) treatment is highly effective in reducing stroke for patients with atrial fibrillation (AF), OAC treatment remains underutilized in current clinical practice. Targeting hospitalist and emergency department providers with electronic decision support represents a potential quality improvement opportunity in the use of OAC medication in AF patients.

Methods: We conducted a 3-center study in which 2 sites utilized an electronic alert (EA) embedded in the electronic health record and 1 site provided usual care. Read More