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    5831 results match your criteria Canadian Journal of Cardiology[Journal]

    1 OF 117

    Self-Management Interventions for Women with Cardiac Pain: A Systematic Review and Meta-Analysis.
    Can J Cardiol 2017 Dec 19. Epub 2017 Dec 19.
    Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
    Background: Cardiac pain is considered the primary indicator of coronary artery disease (CAD). Existing reviews lack appropriate numbers of women or sex-based subgroup analyses, or both; thus, the benefits of self-management (women with cardiac pain actively participating in their own care and treatment) remain uncertain.

    Methods: Using methods described by the Evidence for Policy and Practice Information and Co-ordinating Centre at the Institute of Education, 7 databases were systematically searched to examine and synthesize the evidence on self-management interventions for women with cardiac pain and cardiac pain equivalents, such as fatigue, dyspnea, and exhaustion. Read More

    Transcatheter Aortic Valve Replacement for Severe Aortic Regurgitation With Acute Refractory Cardiogenic Shock.
    Can J Cardiol 2018 Mar 6;34(3):342.e5-342.e7. Epub 2017 Dec 6.
    Cardiology Department, Institut Mutualiste Montsouris, Paris, France.
    From January 2013 to January 2017, 686 consecutive patients were referred to our centre for transcatheter aortic valve replacement, including 5 subjects with severe aortic regurgitation and acute refractory cardiogenic shock. These patients were contraindicated for surgical treatment by the heart team because of high surgical risk (median logistic EuroSCORE: 74.6/Society of Thoracic Surgeons score: 37. Read More

    Multiple Thromboembolic Events from a Left Atrial Appendage Occlusion Device.
    Can J Cardiol 2018 Mar 27;34(3):342.e13-342.e15. Epub 2017 Dec 27.
    Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address:
    Left atrial appendage occlusion devices are an alternative to oral anticoagulation in patients with nonvalvular atrial fibrillation who are at risk of ischemic stroke. Thromboprophylaxis after implantation is recommended, but the optimal regimen is unknown. We report a clinicopathologic case in which thrombus adherent to an incompletely endothelialized WATCHMAN device (Boston Scientific, Marlborough, MA) resulted in multiple thromboembolic events, contributing to a fatal outcome. Read More

    Zero-Contrast Percutaneous Coronary Intervention Guided by Dextran-Based Optical Coherence Tomography.
    Can J Cardiol 2018 Mar 22;34(3):342.e1-342.e3. Epub 2017 Nov 22.
    Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
    Individuals with advanced chronic kidney disease (CKD) and coronary artery disease are often denied percutaneous coronary intervention (PCI) because of an aversion to the risk of contrast-induced nephropathy. We present the case of a 76-year-old man with stage 4 CKD requiring coronary revascularization. Zero-contrast PCI was successfully performed using dextran-based optical coherence tomography (OCT) guidance. Read More

    Increased Susceptibility for Atrial and Ventricular Cardiac Arrhythmias in Mice Treated With a Single High Dose of Ibrutinib.
    Can J Cardiol 2018 Mar 7;34(3):337-341. Epub 2017 Dec 7.
    Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:
    Atrial fibrillation is a side effect of ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase used for treatment of B-cell lymphoproliferative disorders. We determined if single (2 or 10 mg/kg), or chronic (14 days) oral ibrutinib followed by 24-hour washout conferred susceptibility to electrically induced arrhythmias in 1-month-old male C57BL/6 mice. A single higher dose of ibrutinib increased arrhythmia inducibility. Read More

    The State of Cardiovascular Magnetic Resonance Imaging in Canada: Results from the CanSCMR Pan-Canadian Survey.
    Can J Cardiol 2018 Mar 27;34(3):333-336. Epub 2017 Dec 27.
    St Michael's Hospital and the Li Ka Shing Knowledge Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    Over the past 25 years, cardiovascular magnetic resonance imaging (CMR) has developed into an increasingly valuable imaging modality. CMR is now a routine clinical tool for the evaluation of cardiovascular structure and function. However, current patterns in the utilization of CMR in Canada are unknown as are data on important issues such as wait times and appropriate use of this technology. Read More

    The Transcatheter Aortic Valve Implantation (TAVI) Quality Report: A Call to Arms for Improving Quality in Canada.
    Can J Cardiol 2018 Mar 22;34(3):330-332. Epub 2017 Nov 22.
    St Paul's Hospital, Centre for Heart Valve Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
    Transcatheter aortic valve implantation (TAVI) is a disruptive technology that has dramatically changed the way clinicians care for patients with aortic stenosis. In 15 short years, this technology has progressed from first-in-human to the standard of care for high-risk and inoperable patients with aortic stenosis. In 2016 the Canadian Cardiovascular Society published the first ever report of quality of care for TAVI in Canada. Read More

    Associations Between Complex PCI and Prasugrel or Clopidogrel Use in Patients With Acute Coronary Syndrome Who Undergo PCI: From the PROMETHEUS Study.
    Can J Cardiol 2018 Mar 27;34(3):319-329. Epub 2017 Dec 27.
    Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:
    Background: Potent P2Yinhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type.

    Methods: PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Read More

    2018 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Focused Update of the Guidelines for the Use of Antiplatelet Therapy.
    Can J Cardiol 2018 Mar 19;34(3):214-233. Epub 2017 Dec 19.
    Université de Montréal and Institut de Cardiologie de Montréal, Montréal, Quebec, Canada. Electronic address:
    Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence. Read More

    The Atherogenic Dyslipidemia Complex and Novel Approaches to Cardiovascular Disease Prevention in Diabetes.
    Can J Cardiol 2017 Dec 15. Epub 2017 Dec 15.
    Department of Medicine, Department of Physiology, Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada; Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    Despite the effectiveness of low-density lipoprotein (LDL)-lowering strategies for the treatment of diabetic dyslipidemia, significant residual risk of atherosclerotic cardiovascular disease remains. Residual risk might in part be explained by lipid abnormalities that go beyond LDL cholesterol elevation, collectively termed the "atherogenic dyslipidemia complex (ADC)," consisting of hypertriglyceridemia, elevated small dense LDL particles, reduced high-density lipoprotein cholesterol, and high-density lipoprotein particle numbers, increased remnant lipoproteins, and postprandial hyperlipidemia. In this review, we briefly discuss the pathophysiology of the typical dyslipidemia that occurs in insulin-resistant states including obesity, the metabolic syndrome, and type 2 diabetes. Read More

    Telehealth for Remote Stroke Management.
    Can J Cardiol 2017 Dec 27. Epub 2017 Dec 27.
    Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. Electronic address:
    Stroke is a leading cause of adult disability and the fourth leading cause of death in Canada. Most strokes are ischemic and functional outcome is highly time-dependent, making fast diagnosis and treatment initiation crucial. This poses a challenge in vast geographical areas where stroke neurology expertise is only available in urban centres. Read More

    Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms.
    Can J Cardiol 2017 Dec 11. Epub 2017 Dec 11.
    Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom. Electronic address:
    Hypertension and type 2 diabetes are common comorbidities. Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes. Moreover, patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals. Read More

    Sex Hormone Contributes to Sexually Dimorphic Susceptibility in CVB3-Induced Viral Myocarditis via Modulating IFN-γNK Cell Production.
    Can J Cardiol 2018 Jan 6. Epub 2018 Jan 6.
    Jiangsu Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Science, Soochow University, Suzhou, People's Republic of China. Electronic address:
    Background: Viral myocarditis is a widespread cardiac disease associated with inflammation and myocardial injury and is predominantly caused by coxsackievirus B3 (CVB3) infection in humans as well as in mice. CVB3-induced myocarditis shows sexually dimorphic sensitivity and is more prevalent in male mice. Our previous studies showed that natural killer (NK) cells played an indispensable role in CVB3-induced myocarditis, and female mice exhibited less pathological cardiac interferon gamma (IFN-γ)NK cell infiltration than did male mice. Read More

    Sex Differences in Atrial Fibrillation.
    Can J Cardiol 2017 Dec 6. Epub 2017 Dec 6.
    Montreal Heart Institute, Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
    Atrial fibrillation (AF) is a chronic progressive disease characterized by exacerbations and remissions. It remains the most common sustained arrhythmia seen in clinical practice, and represents a major burden to health care systems. Similar to other cardiovascular conditions, significant sex-specific differences have been observed in the epidemiology (lower rate of prevalence in women, women present at a later age), pathophysiology (sex-related differences in AF triggers and substrate), clinical presentation (women are more likely symptomatic, with relatively more severe symptoms), and natural history. Read More

    The State of Affairs for Cardiovascular Health Research in Indigenous Women in Canada: A Scoping Review.
    Can J Cardiol 2017 Dec 5. Epub 2017 Dec 5.
    Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
    Cardiovascular disease (CVD) is the leading cause of death among Indigenous peoples in Canada. As rates of CVD rise, the impacts among the growing population of Indigenous women will emerge as an important health issue. The objective of this scoping review was to advance the state of knowledge about cardiovascular health research in Indigenous women in Canada. Read More

    Contemporary Emergency Department Management of Patients with Chest Pain: A Concise Review and Guide for the High-Sensitivity Troponin Era.
    Can J Cardiol 2018 Feb 2;34(2):98-108. Epub 2017 Dec 2.
    Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada.
    This article synthesizes current best evidence for the evaluation of patients with suspected acute coronary syndrome (ACS) using high-sensitivity troponin assays, enabling physicians to effectively incorporate them into practice. Unlike conventional assays, high-sensitivity assays can precisely measure blood cardiac troponin concentrations in the vast majority of healthy individuals, facilitating the creation of rapid diagnostic algorithms. Very low troponin concentrations on presentation accurately rule out acute myocardial infarction (AMI) and enable the discharge of approximately 20% of patients after a single test, whereas an additional 30%-40% of patients can be safely discharged after short-interval serial sampling in as little as 1 or 2 hours. Read More

    The de Winter ECG Pattern in the Absence of Acute Coronary Artery Occlusion.
    Can J Cardiol 2018 Feb 29;34(2):209.e1-209.e3. Epub 2017 Nov 29.
    Cardiology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
    A 26-year-old man presented to the emergency department with chest pain and electrocardiogram (ECG) changes compatible with the de Winter pattern. Emergent coronary angiography was used to rule out the presence of significant stenosis. Cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis. Read More

    Where you Live in Nova Scotia Can Significantly Impact Your Access to Lifesaving Cardiac Care: Access to Invasive Care Influences Survival.
    Can J Cardiol 2018 Feb;34(2):202-208
    Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada; Cardiovascular Research New Brunswick, New Brunswick Heart Centre, Saint John, New Brunswick, Canada. Electronic address:
    Background: Invasive cardiac care is the preferred method of treatment for patients with acute coronary syndromes (ACS) complicated by cardiogenic shock (CS). In Nova Scotia, invasive cardiac care is only available in Halifax at the Queen Elizabeth II Health Sciences Centre (QEII-HSC).

    Methods: All consecutive patients diagnosed with ACS and CS in 2009-2013 in Nova Scotia were included. Read More

    A Population-Based Study of Syncope in the Young.
    Can J Cardiol 2018 Feb 11;34(2):195-201. Epub 2017 Dec 11.
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. Electronic address:
    Background: The prevalence, hospitalization patterns, and outcomes of pediatric and adolescent syncope have not been rigorously characterized.

    Methods: Patients < 20 years presenting to an emergency department (ED) with a primary diagnosis of syncope (International Classification of Diseases, 10th revision, code R55) between fiscal year (FY) 2006/2007 and FY 2013/2014 in the province of Alberta, Canada were grouped according to discharge status from the ED, ie, (1) admitted to hospital and (2) discharged without admission. Temporal trends and differences in baseline characteristics, medication use, and outcomes between admitted and discharged patients were examined. Read More

    Cardiac Intensive Care Unit Management of Patients After Cardiac Arrest: Now the Real Work Begins.
    Can J Cardiol 2018 Feb;34(2):156-167
    Division of Cardiac Surgery, Western University/London Health Sciences Centre, London, Ontario, Canada; Critical Care Western, Western University/London Health Sciences Centre, London, Ontario, Canada. Electronic address:
    Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness. Read More

    New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department.
    Can J Cardiol 2018 Feb 29;34(2):132-145. Epub 2017 Nov 29.
    Department of Emergency Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota, USA. Electronic address:
    The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns). Read More

    Stroke Prevention for High-Risk Atrial Fibrillation in the Emergency Setting: The Emergency Physician Perspective.
    Can J Cardiol 2018 Feb 22;34(2):125-131. Epub 2017 Nov 22.
    Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Emergency Medicine, the Department of Medicine, and the Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address:
    Atrial fibrillation is a frequent reason for presentation to an emergency department (ED), and the number of these visits are increasing. This creates an opportunity to improve the suboptimal rate of oral anticoagulation (OAC) use in patients with atrial fibrillation who are at high risk of stroke. However, there are very few data on whether OAC initiation in the ED, compared with referral to the longitudinal health care provider to initiate it, results in better long-term use. Read More

    Percutaneous Fetal Atrial Balloon Septoplasty for Simple Transposition of the Great Arteries With an Intact Atrial Septum.
    Can J Cardiol 2018 Mar 15;34(3):342.e9-342.e11. Epub 2017 Dec 15.
    Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:
    We report the first ultrasonographically guided percutaneous balloon atrial septoplasty (BAS), to our knowledge, in a fetus with transposition of the great arteries and an intact ventricular and atrial septum (37 + 2 weeks). After vaginal delivery at 38 weeks, the infant had an elective septostomy (day 1) and an arterial switch procedure (day 7), with an uneventful postoperative course. For centres with experience in fetal cardiac interventions, fetal BAS is a superior management option compared with the alternatives for this high-risk physiology. Read More

    Profound Vasoplegia During Sacubitril/Valsartan Treatment After Heart Transplantation.
    Can J Cardiol 2018 Mar 11;34(3):343.e5-343.e7. Epub 2017 Dec 11.
    Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address:
    Vasoplegia occurs in up to 16% of patients who undergo heart transplantation (HT) and is associated with significant morbidity and mortality. We present a case of a 61-year-old man with ischemic cardiomyopathy receiving sacubitril/valsartan (Entresto; Novartis, Cambridge, MA) who developed profound hypotension after HT. He was treated with intravenous methylene blue and high-dose vasopressors, but developed acute kidney injury requiring dialysis and a prolonged stay in the intensive care unit. Read More

    High Leisure-Time Physical Activity Is Associated With Reduced Risk of Sudden Cardiac Death Among Men With Low Cardiorespiratory Fitness.
    Can J Cardiol 2018 Mar 11;34(3):288-294. Epub 2017 Dec 11.
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland.
    Background: We studied the independent and joint associations of leisure-time physical activity (LTPA) and cardiorespiratory fitness (CRF) with the risk of sudden cardiac death (SCD) among middle-aged men.

    Methods: The participants were 2656 randomly selected men aged 42-60 years at baseline who were followed for 19 years. LTPA was assessed using a questionnaire modified from the Minnesota LTPA Questionnaire and CRF using a respiratory gas exchange analyzer during maximal exercise test. Read More

    Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE).
    Can J Cardiol 2018 Mar 2;34(3):295-302. Epub 2018 Feb 2.
    McMaster University, Department of Health Research Methods, Evidence, and Impact, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada; McMaster University, Department of Medicine, Hamilton, Ontario, Canada. Electronic address:
    Background: Worldwide approximately 200 million adults undergo major surgery annually, of whom 8 million are estimated to suffer a myocardial injury after noncardiac surgery (MINS). There is currently no trial data informing the management of MINS. Antithrombotic agents such as direct oral anticoagulants might prevent major vascular complications in patients with MINS. Read More

    An Invasive vs a Conservative Approach in Elderly Patients with Non-ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis.
    Can J Cardiol 2018 Mar 5;34(3):274-280. Epub 2017 Dec 5.
    Department of Cardiology, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Department of Medicine, Griffith University, Gold Coast, Queensland, Australia; Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia. Electronic address:
    Background: Elderly (≥ 75 years) patients form a large sub-group of non-ST-segment elevation myocardial infarction (NSTEMI) population but are vastly under-represented in trials. Thus, the benefits of an early angiography in the elderly remain unclear. In this systematic review, we compared outcomes of "invasive" and "conservative" strategies of NSTEMI management in elderly patients. Read More

    Aortic Arch Reconstructive Surgery With Conventional Techniques vs Frozen Elephant Trunk: A Systematic Review and Meta-Analysis.
    Can J Cardiol 2018 Mar 26;34(3):262-273. Epub 2017 Dec 26.
    Division of Cardiac Surgery, Department of Surgery, Western University, Lawson Health Research Institute, London, Ontario, Canada. Electronic address:
    Background: Frozen elephant trunk (FET) surgery offers a new alternative in the management of complex thoracic aortic aneurysms and dissections. We performed a systematic review and meta-analysis of comparator observational studies evaluating the efficacy of FET compared with conventional aortic arch surgery, primarily focusing on mortality and stroke as well as the secondary outcomes of spinal cord ischemia, major bleeding, and operative time.

    Methods: We searched MEDLINE, EMBASE, PubMed, and the Cochrane Library for trials and studies comparing the FET technique with conventional surgery in patients with aortic aneurysms or dissections, or both. Read More

    Successful Treatment of Type 1 Cryoglobulinemic Vasculitis With Cardiac Involvement.
    Can J Cardiol 2018 Mar 28;34(3):343.e1-343.e3. Epub 2017 Dec 28.
    Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:
    Cryoglobulinemic vasculitis is a rare and frequently fatal type of myocarditis. Cardiac manifestations in type 1 cryoglobulinemic vasculitis have never been reported to our knowledge. We report a rare case of type 1 cryoglobulinemic vasculitis with cardiac involvement in a patient who experienced progressive heart failure during the diagnosis. Read More

    Epidemiology of Kawasaki Disease in Canada 2004 to 2014: Comparison of Surveillance Using Administrative Data vs Periodic Medical Record Review.
    Can J Cardiol 2018 Mar 15;34(3):303-309. Epub 2017 Dec 15.
    Labatt Family Heart Centre, Department of Pediatrics, The University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:
    Background: We have previously documented an increase in the incidence of Kawasaki disease (KD) in Ontario followed by a stabilization from 1995 to 2006. We sought to validate the estimation of incidence of KD using administrative data and to describe the epidemiology of KD across Canada from 2004 to 2014.

    Methods: We queried the Canadian Hospital Discharge Database for hospital admissions associated with a discharge diagnosis of KD. Read More

    Assessment and Management of the Left Atrial Appendage Thrombus in Patients With Nonvalvular Atrial Fibrillation.
    Can J Cardiol 2018 Mar 15;34(3):252-261. Epub 2017 Dec 15.
    McGill University Health Centre, Montreal, Quebec, Canada; Research Institute of McGill University Health Centre, Montreal, Quebec, Canada; Hôpital Sacré-Coeur de Montréal, Montreal, Quebec, Canada. Electronic address:
    Background: Intracardiac thrombi arising in the left atrial appendage (LAA) are the principal cause of stroke in nonvalvular atrial fibrillation (AF). Predicting the presence of LAA thrombi is of vital importance in stratifying patients that would need further LAA imaging prior to cardioversion or AF ablation.

    Methods: We comprehensively searched PubMed from its inception to November 2017 for randomized controlled trials, cohort and case control studies, as well as for case series on LAA thrombi risk factors, imaging, prevention, and anticoagulation management in atrial fibrillation. Read More

    Personalized Anticoagulation: Guided Apixaban Dose Adjustment to Compensate for Pharmacokinetic Abnormalities Related to Short-Bowel Syndrome.
    Can J Cardiol 2018 Mar 27;34(3):342.e17-342.e19. Epub 2017 Dec 27.
    Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
    A 45-year-old woman who required lifelong anticoagulation for recurrent thrombosis had her therapeutic choices limited by heparin-induced thrombocytopenia and abnormal pharmacokinetics (greatly reduced absorption) resulting from short gut syndrome from extensive gut resection after mesenteric thrombosis. As an alternative to inconvenient and expensive injections of fondaparinux, personalized dosing of a direct oral anticoagulant was sought using clinical pharmacology techniques. Enteral absorption was ascertained with small test doses of apixaban, and the ability of supraconventional doses to deliver effective concentrations was verified. Read More

    Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not.
    Can J Cardiol 2018 Mar 26;34(3):310-318. Epub 2017 Dec 26.
    Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada; Division of Interventional Cardiology, Quebec Heart and Lung Institute and Laval University, Quebec City, Quebec, Canada. Electronic address:
    Background: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in France, the Netherlands, Belgium, and United Kingdom (RECHARGE) score in predicting acute and long-term outcomes.

    Methods: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017. The primary end point was target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization on follow-up. Read More

    Left Ventricular Strain in Chemotherapy-Naive and Radiotherapy-Naive Patients With Cancer.
    Can J Cardiol 2018 Mar 29;34(3):281-287. Epub 2017 Nov 29.
    Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin/Charité, Berlin, Germany; Department of Cardiology, DeutschesHerzzentrum Berlin (DHZB), Berlin, Germany.
    Background: We sought to investigate left ventricular (LV) function and mechanics in patients with cancer before they received chemotherapy or radiotherapy, as well as the relationship between cancer and reduced LV multidirectional strain in the whole study population.

    Methods: The retrospective study involved 122 chemotherapy- and radiotherapy-naive patients with cancer and 45 age- and sex-matched controls with a cardiovascular risk profile similar to that of the patients with cancer. All the patients underwent echocardiographic examination before introduction of chemotherapy or radiotherapy. Read More

    Radiotherapy for Patients with Cardiovascular Implantable Electronic Devices: A Review.
    Can J Cardiol 2018 Mar 6;34(3):244-251. Epub 2017 Dec 6.
    Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada. Electronic address:
    Because cardiovascular implantable electronic devices are increasingly indicated in older patients, and the burden of cancer is rising with the growth and aging of the world population, the management of patients with cardiac devices who require radiotherapy for cancer treatment is a timely concern. Device malfunctions might occur in as high as 3% of radiotherapy courses, posing a substantial issue in clinical practice. A nonsystematic comprehensive review was undertaken. Read More

    Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis in Women: Clinical Characteristics and Outcomes.
    Can J Cardiol 2017 Nov 11. Epub 2017 Nov 11.
    Department of Cardiology, Institut de Cardiologie de Montréal, Université de Montréal, Montréal, Canada. Electronic address:
    Aortic stenosis (AS), 1 of the most common valve diseases in developed countries, carries a poor prognosis if left untreated. Transcatheter aortic valve replacement (TAVR) has become the standard of care for high-risk and inoperable patients with severe aortic stenosis (AS). Women represent a significant proportion of patients with severe AS and demonstrate specific clinical, anatomic, and pathophysiological features that are evident both before and after valve replacement. Read More

    Blood Pressure-Lowering Targets in Patients With Diabetes Mellitus.
    Can J Cardiol 2017 Nov 3. Epub 2017 Nov 3.
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
    Diabetes is a highly prevalent medical condition that commonly coexists with hypertension. The presence of diabetes and hypertension significantly increases the risk of adverse cardiovascular events. Although compelling evidence exists from randomized controlled trials demonstrating that blood pressure (BP) reduction effectively prevents cardiovascular complications, optimal BP targets remain uncertain and continue to be the subject of ongoing controversy. Read More

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