Stroke prevention in the high-risk atrial fibrillation patient: Medical management.

Abstract:

:Medical management of patients with atrial fibrillation (AF) at high risk for stroke is limited by problems of imperfect tools for assessment of thromboembolism and bleeding risks. Improved instruments, such as the CHA₂DS₂VASc and HAS-BLED risk stratification scores, have been incorporated into European practice guidelines. Until recently, the most effective therapy for stroke prevention has been anticoagulation with a vitamin K antagonist, but new oral anticoagulants in development, antiarrhythmic drugs that reduce adverse cardiovascular events in patients with AF, and interventional techniques for occlusion of the left atrial appendage represent promising options for stroke prevention. These new strategies will need focused evaluation in the most challenging AF patients-those with a high risk of bleeding, prior thromboembolism, or thrombosis-prone surfaces such as mechanical heart valve prostheses or drug-eluting coronary stents, for whom the limitations of currently available treatment options and a paucity of data are particularly acute.

journal_name

Curr Cardiol Rep

authors

Broukhim M,Halperin JL

doi

10.1007/s11886-010-0148-z

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

9-17

issue

1

eissn

1523-3782

issn

1534-3170

journal_volume

13

pub_type

杂志文章,评审
  • Beta-adrenergic blocking drugs as antifibrillatory agents.

    abstract::Beta-Adrenergic blockade is associated with a significant reduction in mortality in most patients with structural heart disease. Clinical trial data involving patients after myocardial infarction or with congestive heart failure demonstrate that a reduction in sudden death accounts for much of the observed mortality r...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-002-0043-3

    authors: Reiter MJ

    更新日期:2002-09-01 00:00:00

  • Large-Scale Genomic Biobanks and Cardiovascular Disease.

    abstract:PURPOSE OF REVIEW:Cardiovascular disease is a leading cause of morbidity and mortality worldwide and is the focus of extensive biomedical research. Large genetic consortia combining data from many traditional prospective cohort and ascertained case-control study designs have facilitated the discovery of genetic associa...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-018-0969-8

    authors: Small AM,O'Donnell CJ,Damrauer SM

    更新日期:2018-03-08 00:00:00

  • Aortic Stenosis, a Left Ventricular Disease: Insights from Advanced Imaging.

    abstract::Aortic stenosis (AS) is the most common primary valve disorder in the elderly with an increasing prevalence. It is increasingly clear that it is also a disease of the left ventricle (LV) rather than purely the aortic valve. The transition from left ventricular hypertrophy to fibrosis results in the eventual adverse ef...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-016-0753-6

    authors: Badiani S,van Zalen J,Treibel TA,Bhattacharyya S,Moon JC,Lloyd G

    更新日期:2016-08-01 00:00:00

  • Ischemic heart disease and the Mediterranean diet.

    abstract::Lifestyle modification is primary in cardiovascular (CV) disease prevention. A major contribution is the Mediterranean diet (MedDiet), defined by two of seven components. Italian investigators determined a significant decrease in peripheral arterial disease of 56 % for a high score. Multiple specific CV risk factors a...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-014-0491-6

    authors: Whayne TF Jr

    更新日期:2014-01-01 00:00:00

  • Correction to: Review of Transthyretin Silencers, Stabilizers, and Fibril Removal Agents in the Treatment of Transthyretin Cardiac Amyloid.

    abstract::On page 2 of the original publication, in the section on TTR Silencers dosing of patisiran in the APOLLO study was stated as being given every 3 months; this is inaccurate as patisiran was dosed every 3 weeks in the APOLLO study. ...

    journal_title:Current cardiology reports

    pub_type: 已发布勘误

    doi:10.1007/s11886-020-01426-7

    authors: Hough A,Wearden J,de Almeida K,Kaiser S

    更新日期:2020-09-28 00:00:00

  • Exercise: friend or foe in adult congenital heart disease?

    abstract::Exercise training is beneficial in healthy adults as well as patients with acquired cardiovascular disease such as coronary artery disease and heart failure. While a reduced exercise capacity is common in adults with congenital heart disease, it is not clear if these patients stand to benefit from exercise training or...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-013-0416-9

    authors: Tutarel O,Gabriel H,Diller GP

    更新日期:2013-11-01 00:00:00

  • Cardiovascular Risk Assessment in Patients with Hypertriglyceridemia.

    abstract:PURPOSE OF REVIEW:Assessing the cardiovascular risk associated with hypertriglyceridemia can be challenging due to frequent confounding conditions such as hypertension, diabetes mellitus, and hyperlipidemia. We sought to quantify this risk by examining several meta-analyses as well as subgroup analyses of previously pu...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-018-1013-8

    authors: Evans MC,Stalam T,Miller M

    更新日期:2018-07-10 00:00:00

  • Imaging Approaches for Coronary Artery Anomalies: Purpose and Techniques.

    abstract:PURPOSE OF REVIEW:Comprehensive discussion of alternative techniques in imaging coronary artery anomalies (CAAs) in different diagnostic scenarios. RECENT FINDINGS:At primary screening, intramural course essentially correlates with stenosis and clinical repercussion in some types of CAAs. Potential clinical aims in im...

    journal_title:Current cardiology reports

    pub_type: 杂志文章

    doi:10.1007/s11886-019-1188-7

    authors: Angelini P

    更新日期:2019-07-29 00:00:00

  • Treatment of Bifurcation Lesions: Has DK Crush"ed" the Competition?

    abstract:PURPOSE:This paper reviews the double-kiss crush (DK crush) technique in coronary artery bifurcation lesions. The technical aspects of the procedure and the clinical data supporting its use are summarized. RECENT FINDINGS:Randomized studies support the adoption of DK technique in complex bifurcation lesions for both l...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-018-1024-5

    authors: Lynn BS,Hermiller JB

    更新日期:2018-09-01 00:00:00

  • PCSK9 Inhibitors: Treating the Right Patients in Daily Practice.

    abstract:PURPOSE OF REVIEW:Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a novel approach to low-density lipoprotein cholesterol (LDL-C) lowering. The potential role of PCSK9 inhibitors in clinical practice will be reviewed. RECENT FINDINGS:Clinical trials have demonst...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-017-0882-6

    authors: King P,Nicholls SJ

    更新日期:2017-08-01 00:00:00

  • Nuclear Imaging Guidance for Ablation of Ventricular Arrhythmias.

    abstract::Due to an increase in the number of patients with heart failure and ventricular arrhythmias, ventricular tachycardia ablation has a growing clinical role. Long-term success rates remain suboptimal and require creating a detailed electroanatomic map during the procedure to identify fibrotic areas responsible for arrhyt...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-015-0697-2

    authors: Duell J,Dilsizian V,Smith M,Chen W,Dickfeld T

    更新日期:2016-02-01 00:00:00

  • Stroke prevention in atrial fibrillation: atrial appendage closure.

    abstract::The left atrial appendage (LAA) is the primary nonvalvular cause of cardioembolic stroke in patients with atrial fibrillation (AF). Warfarin and direct thrombin inhibitors such as dabigatran are presumed to prevent formation of LAA thrombus, and are first-line treatments to prevent ischemic stroke in AF. However, thes...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-010-0162-1

    authors: Fuller CJ,Reisman M

    更新日期:2011-04-01 00:00:00

  • Heart Transplantation and Mechanical Circulatory Support in Adults with Congenital Heart Disease.

    abstract:PURPOSE OF REVIEW:To assess current management strategies for advanced heart failure in adults with congenital heart disease, including heart transplantation and mechanical circulatory support. RECENT FINDINGS:Current data demonstrate that adults with CHD generally experience higher short-term mortality after heart tr...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-018-1028-1

    authors: Serfas JD,Patel PA,Krasuski RA

    更新日期:2018-08-09 00:00:00

  • Physical training as an adjunct therapy in patients with congestive heart failure: patient selection, training protocols, results, and future directions.

    abstract::Exercise intolerance in patients with chronic heart failure (CHF) shows no correlation to the degree of left ventricular dysfunction. This surprising finding has directed attention to peripheral changes in CHF: reduced endothelium-dependent vasodilation and altered skeletal muscle metabolism. Physical exercise trainin...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-999-0041-9

    authors: Hambrecht R,Gielen S,Schuler G

    更新日期:1999-05-01 00:00:00

  • Genetic determinants of drug response in heart failure.

    abstract::Heart failure management is complex and costly. Genetic variations that alter drug absorption, metabolism, and receptor-ligand interactions have the potential to modify drug response and safety. Evidence shows that genetic factors interact with numerous heart failure medications, including vasodilators, beta blockers,...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-008-0031-3

    authors: Lowes BD,Buttrick PM

    更新日期:2008-05-01 00:00:00

  • Clinical Application of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention for Stable Coronary Artery Disease.

    abstract::Revascularization in stable ischemic heart disease (SIHD) is indicated in patients on optimal medical therapy with angina and/or demonstrable ischemia and a significant stenosis in one or more epicardial coronary arteries. Angiography alone, however, cannot accurately determine the hemodynamic significance of coronary...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-016-0711-3

    authors: Parikh V,Agnihotri K,Kadavath S,Patel NJ,Abbott JD

    更新日期:2016-04-01 00:00:00

  • Renovascular hypertension in 2007: where are we now?

    abstract::Hypertension in patients with renovascular disease poses a major clinical challenge. Renal arterial disease accelerates hypertension by activation of multiple pressor systems. Although younger individuals with fibromuscular lesions often respond well to angioplasty with minor associated risks, care must be taken in ca...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/BF02938389

    authors: Textor SC

    更新日期:2007-11-01 00:00:00

  • Hypertension in Obesity and the Impact of Weight Loss.

    abstract:PURPOSE OF REVIEW:Several interrelated mechanisms promote the development of hypertension in obesity, often contributing to end organ damage including cardiovascular disease and chronic kidney disease. RECENT FINDINGS:The treatment of hypertension in obesity is complicated by a high prevalence of resistant hypertensio...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-017-0912-4

    authors: Cohen JB

    更新日期:2017-08-24 00:00:00

  • Sex-Related Differences in Dilated Cardiomyopathy with a Focus on Cardiac Dysfunction in Oncology.

    abstract:PURPOSE OF REVIEW:The aim of this report is to describe the main aspects of sex-related differences in non-ischemic dilated cardiomyopathies (DCM), focusing on chemotherapy-induced heart failure (HF) and investigating the possible therapeutic implications and clinical management applications in the era of personalized ...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-020-01377-z

    authors: D'Amario D,Camilli M,Migliaro S,Canonico F,Galli M,Arcudi A,Montone RA,Borovac JA,Crea F,Savarese G

    更新日期:2020-08-08 00:00:00

  • Revascularization for patients with severe coronary artery disease and left ventricular dysfunction.

    abstract::Heart failure is becoming increasingly prevalent, and currently coronary artery disease (CAD) is the primary cause of left ventricular (LV) systolic dysfunction. A potential therapeutic option for patients with severe CAD and LV dysfunction is a strategy of revascularization. In this review, we summarize the available...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-006-0055-5

    authors: Ghose T,Thompson RC

    更新日期:2006-07-01 00:00:00

  • 25 by 25: Achieving Global Reduction in Cardiovascular Mortality.

    abstract::Four non-communicable diseases-cardiovascular disease, chronic respiratory disease, diabetes mellitus, and cancer-account for over 60 % of all deaths globally. In recognition of this significant epidemic, the United Nations set forth a target of reducing the four major NCDs by 25 % by 2025. Cardiovascular disease alon...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-015-0679-4

    authors: Dugani S,Gaziano TA

    更新日期:2016-01-01 00:00:00

  • Leadless Cardiac Pacemakers: Pacing Paradigm Change.

    abstract::Traditional transvenous approach for permanent cardiac pacing can be associated with significant acute and chronic complications related partly to either the insertion of transvenous lead or subcutaneous placement of pacemaker device. We summarize the current status of a novel self-contained leadless cardiac pacemaker...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-015-0619-3

    authors: Neuzil P,Reddy VY

    更新日期:2015-08-01 00:00:00

  • Recognizing and improving health care disparities in the prevention of cardiovascular disease in women.

    abstract::Innate differences in gender physiology result in unique exposures, risk, and protection that are specific to women. Recognition and appreciation of these differences results in better treatment adaptations for women and better outcomes. Disparities between genders in the treatment of major cardiovascular risk factors...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-010-0135-4

    authors: Jarvie JL,Foody JM

    更新日期:2010-11-01 00:00:00

  • Management of carotid artery disease in the high-risk patient with emphasis on the SAPPHIRE study.

    abstract::Ischemic stroke threatens public health dramatically, and demographic changes promise to continue this epidemic. Although medical advances in risk factor modification, hypertensive control, and antiplatelet therapy have mitigated morbidity and mortality of cerebrovascular disease somewhat, stroke still costs billions ...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-007-0005-x

    authors: Rajagopal V,Yadav JS

    更新日期:2007-03-01 00:00:00

  • Complementary Role of Echocardiography and Cardiac Magnetic Resonance in Hypertrophic Cardiomyopathy.

    abstract:PURPOSE OF REVIEW:This review discusses the complementary roles of echocardiography and cardiac magnetic resonance in the diagnosis and management of patients with hypertrophic cardiomyopathy (HCM). RECENT FINDINGS:Imaging using novel echocardiographic techniques and cardiac magnetic resonance (CMR) imaging in HCM has...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-017-0897-z

    authors: Hindieh W,Chan R,Rakowski H

    更新日期:2017-09-01 00:00:00

  • Low-density Lipoprotein-Cholesterol Lowering Strategies for Prevention of Atherosclerotic Cardiovascular Disease: Focus on siRNA Treatment Targeting PCSK9 (Inclisiran).

    abstract:PURPOSE OF REVIEW:The aim of low-density lipoprotein-cholesterol (LDL-C) lowering therapies is to safely achieve a consistent and long-term reduction in exposure of the vasculature to atherogenic lipoproteins in order to reduce the risk of atherosclerotic cardiovascular (CV) disease and the associated CV events, such a...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-020-01427-6

    authors: Sinning D,Landmesser U

    更新日期:2020-10-21 00:00:00

  • Atrial fibrillation ablation in octogenarians: where do we stand?

    abstract::The prevalence of atrial fibrillation increases significantly with age, affecting nearly 10 % of adults greater than 80 years of age. Complications from atrial fibrillation, including stroke, also increase with age. Medical therapy includes anticoagulation, ventricular rate control, and if symptoms persist, maintenanc...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-013-0406-y

    authors: Stepanyan G,Gerstenfeld EP

    更新日期:2013-10-01 00:00:00

  • Hypertension in black patients: special issues and considerations.

    abstract::The excess risk of hypertension in black Americans continues to be a major health concern. Although there is considerable information regarding these disease trends, much of the major underpinnings of the etiology of hypertension remain unclear. The excess mortality in blacks due to heart disease, renal failure, and s...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-004-0048-1

    authors: Nesbitt SD

    更新日期:2004-11-01 00:00:00

  • Evaluating presynaptic and postsynaptic innervation in heart failure.

    abstract::Congestive heart failure increasingly contributes to the overall morbidity and mortality associated with cardiovascular disease. Although significant advances in therapies allow patients to feel better and have improved functional status and survival, not all patients respond equally to these therapies. Moreover, for ...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-009-0021-0

    authors: Chen GP,Caldwell JH

    更新日期:2009-03-01 00:00:00

  • The Role of Manual Aspiration Thrombectomy in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI.

    abstract::In STEMI, primary PCI restores macrovascular coronary blood flow effectively but microvascular perfusion remains a challenge. Thrombus has the potential to embolize to the microvasculature limiting effective coronary blood flow. Thrombus burden is associated with a higher mortality and manual aspiration thrombectomy h...

    journal_title:Current cardiology reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11886-016-0707-z

    authors: Alak A,Jolly SS

    更新日期:2016-03-01 00:00:00