Abstract:
AIMS:The impact of estimated glomerular filtration rate (eGFR) on adverse events in patients with mechanical heart valves (MHVs) is unknown. We analyzed the independent association of eGFR and thromboembolism (TE), major bleeding, and mortality in patients with MHV in an observational cohort study. METHODS AND RESULTS:All patients (n = 520) with MHV replacement on anticoagulation treatment were followed up prospectively regarding TE, major bleeding, and death at 2 anticoagulation centers during 2008 to 2011. The mean age was 69 years, 72% with aortic valve replacement, and time in therapeutic range 2.0 to 4.0 was 91%. The incidence of the combined end point of major bleeding, TE, and death increased sharply with each decreasing eGFR stratum: 5.5, 8.4, 16, and 32 per 100 patient-years for eGFR >60, 45 to 60, 30 to 45, and <30 mL/min per 1.73 m(2), respectively. After multivariate adjustment for comorbidities, every unit decrease in eGFR increased the risk of major bleeding by 2%, death by 3%, and the combined end point by 1%. There was no association between eGFR and TE. There was an increased proportion of international normalized ratio >3.0 and >4.0 and decreasing time in therapeutic range for each decreasing eGFR stratum (P < .001 for trend). The hazard ratios of the combined end point for eGFR <30, 30 to 45, and 45 to 60 mL/min per 1.73 m(2) were 3.2 (95% CI 1.8-5.6), 1.5 (95% CI 0.9-2.5), and 0.9 (95% CI 0.6-1.5), respectively, compared to eGFR >60 mL/min per 1.73 m(2). CONCLUSION:In patients with MHV on anticoagulation, eGFR is an independent predictor of major bleeding and death and not TE.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Labaf A,Grzymala-Lubanski B,Själander A,Svensson PJ,Stagmo Mdoi
10.1016/j.ahj.2015.06.016subject
Has Abstractpub_date
2015-09-01 00:00:00pages
559-65issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(15)00390-7journal_volume
170pub_type
杂志文章,多中心研究abstract::Angina pectoris before and after MI was evaluated in a sample of 729 men and women from a general population in whom MI developed during a 36-year period of follow-up. Relations of AP to subsequent CHD events and mortality after initial MI were analyzed by proportional hazards regression models and were adjusted for c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90406-8
更新日期:1996-07-01 00:00:00
abstract::A 35-year-old man suffered transmural diaphragmatic wall infarction immediately after receiving a nonpenetrating trauma to his chest. During subsequent months crippling angina pectoris developed and coronary arteriography was performed. A complete obstruction of the left circumflex coronary artery was demonstrated 2 c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80051-8
更新日期:1976-10-01 00:00:00
abstract::The purpose of this study was to determine the effect of age on the in-hospital mortality of all 30,972 patients undergoing coronary artery bypass graft (CABG) surgery in New York in 1991 and 1992. Mortality rates were relatively low for patients 40-49, 50-59, and 60-64, 65-69, and 70-74 years old (1.10%, 1.65%, 2.17%...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90750-1
更新日期:1994-12-01 00:00:00
abstract::A new translation of Roger's description of the clinical and anatomical findings in uncomplicated small VSD is presented. Reappraisal of Roger's observations in the light of our present understanding confirms that only our attitudes change; diseases remain the same. ...
journal_title:American heart journal
pub_type: 传,历史文章,杂志文章
doi:10.1016/0002-8703(79)90041-3
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure device...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.12.014
更新日期:2007-04-01 00:00:00
abstract::The distinction between idiopathic dilated cardiomyopathy and myocarditis is controversial, both clinically and pathologically. To increase diagnostic accuracy and provide prognostic information, we prospectively tested the routine application of immunofluorescence and electron microscopy in endomyocardial biopsy eval...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90180-3
更新日期:1987-11-01 00:00:00
abstract::Currently available internal cardiac defibrillators use a uniphasic, truncated exponential waveform morphology of about 6 msec in duration at an energy level of 23 to 33 joules. To determine if improved defibrillation could be achieved with a different waveform morphology, we implanted 4.5 cm2 titanium patches to the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90187-7
更新日期:1989-08-01 00:00:00
abstract::Antiplatelet therapy is the current criterion standard for the treatment of patients undergoing percutaneous coronary intervention and patients who have acute coronary syndromes. Clopidogrel in combination with aspirin is the current standard of care for reducing cardiovascular events in these patients. However, patie...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.06.003
更新日期:2008-08-01 00:00:00
abstract::The efficacy and safety of once-daily administration of the new angiotensin-converting enzyme inhibitor quinapril or quinapril plus hydrochlorothiazide (HCTZ) were assessed in 64 older (greater than 65 years) patients with mild to moderate hypertension in an uncontrolled, open-label study. Treatment was initiated with...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)91065-9
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The purpose of the current study was to determine whether survival after revascularization (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty) is influenced by the extent of electrocardiographic (ECG) evidence of previous myocardial infarction (MI) in patients with ischemic ca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.119996
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The study aimed to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux and enoxaparin, for non-ST-elevation acute coronary syndrome in the United States. METHODS:It was based on a large randomized trial of 20,078 patients Fifth Organization to Assess Strategies i...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2009.02.017
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The purpose of this investigation was to quantify the amount of intralesional calcium detected by intravascular ultrasound (IVUS) compared with undecalcified histology in human arteries. This method preserves intralesional calcium and reduces sectioning artifacts, thereby providing an accurate measure of cal...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70496-5
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The transmission of 12-lead electrocardiograms from remote locations to hand-held computers of cardiologists is now possible with the development of wireless technology and computer software. This investigation determined whether the cardiologist's decisions regarding reperfusion therapy for patients with sy...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.110288
更新日期:2000-11-01 00:00:00
abstract::In 30 years of follow-up in the Framingham study, routine biennial ECG examinations revealed 315 subjects with ECG-LVH and 164 with unrecognized ECG-MI without previous cardiac explanation. Among subjects initially free of clinically evident coronary heart disease and both ECG abnormalities, the incidence of ECG-LVH w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90156-0
更新日期:1986-02-01 00:00:00
abstract::To clarify the difference between alcoholic cardiomyopathy and dilated cardiomyopathy and to investigate the characteristics of alcoholic cardiomyopathy, right ventricular endomyocardial biopsy was performed, and the two diseases were compared clinically and histologically. Changes in the cardiothoracic ratio, cardiac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90175-9
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Recently revised American College of Cardiology/American Heart Association guidelines for exercise electrocardiography (ExECG) have suggested that ExECG scores be used to assist in management decisions in patients with suspected coronary artery disease (CAD). METHODS:We used 442 women who underwent both ExE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125835
更新日期:2002-11-01 00:00:00
abstract::We studied 56 right ventricular papillary muscles isolated from cats to determine whether the direct mechanical effects of contrast media are due to their pharmacologic action or to the hyperosmolality caused by them. A 10% solution of Renografin-76 abruptly decreased force 22% below control, then slowly increased it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90550-7
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:To examine sex differences in pain and associated symptoms in patients with exercise-related ischemia, as well as the independence of these findings from other clinical factors. METHODS:Prospective study of 482 women and 425 men (mean age 58 years) undergoing exercise stress testing with myocardial perfusio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.06.028
更新日期:2006-04-01 00:00:00
abstract::To identify a method for characterizing the dynamic behavior of ventricular arrhythmias at different heart rates, 201 consecutive patients with frequent premature ventricular contractions (PVCs) underwent two 24-hour electrocardiographic monitoring periods. The percentage of PVCs for each cycle length was calculated a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70203-5
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Coronary artery disease (CAD) is the most common cause of left ventricular systolic dysfunction (LVSD). Patients with ischemia as the cause of LVSD may warrant revascularization. Angiography is the most accurate method of CAD diagnosis but is invasive, expensive, and associated with some risk. Noninvasive im...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2010.03.026
更新日期:2010-06-01 00:00:00
abstract::Two patients with isolated T wave alternans are reported, with their vectocardiograms, their response to carotid sinus stimulation, and the response to calcium infusion in one of them with documented severe hypocalcemia. Eleven cases of the literature are briefly reviewed. The alternans of the T wave appears with seve...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90369-1
更新日期:1978-03-01 00:00:00
abstract:BACKGROUND:Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher refusal rates in black individuals. Decision support can assist with...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2019.10.011
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:The objective was to report recent trends in the incidence, adoption of evidence-based treatment, and clinical outcomes for first-time hospitalization for acute myocardial infarction. METHODS:This is a large retrospective population-based cohort study using medical administrative data (International Classif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.08.026
更新日期:2013-11-01 00:00:00
abstract::While sudden death after acute myocardial infarction or ischemia most commonly occurs in the first few minutes, usually from tachyarrhythmias, little is known of associated hemodynamics. We monitored hemodynamics for 15 minutes following coronary embolization with mercury in 31 awake dogs. In 17 nonsurvivors, mean art...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90131-9
更新日期:1981-04-01 00:00:00
abstract::The isovolumic relaxation time (IVRT) is an important noninvasive index of left ventricular diastolic function. Despite its widespread use, however, the IVRT has not been related analytically to invasive parameters of ventricular function. Establishing such a relationship would make the IVRT more useful by itself and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90416-s
更新日期:1992-11-01 00:00:00
abstract::Transthoracic echocardiography has played a useful role in the screening of cardiac transplant donors. However, transthoracic echocardiograms may be suboptimal in many patients on ventilators. The role of transesophageal echocardiography in cardiac donor screening is unknown. Therefore we compared the potential benefi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90758-2
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Recent data indicate that cardiac antibodies play an active role in the pathogenesis of dilated cardiomyopathy (DCM) and may contribute to cardiac dysfunction in patients with DCM. The present study investigated the influence of immunoadsorption with subsequent immunoglobulin G substitution (IA/IgG) on cardi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.01.012
更新日期:2010-05-01 00:00:00
abstract::Antiarrhythmic drugs are often more effective in suppressing ventricular tachycardias than are background premature extrasystoles. The mechanism of action of these agents was examined by studies on the effects of lidocaine and quinidine on post-repolarization refractoriness of both basic and premature action potential...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90222-6
更新日期:1989-11-01 00:00:00
abstract::Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90603-9
更新日期:1985-02-01 00:00:00
abstract::The development of ECG Minnesota Q-QS codes and their subsequent evolution were studied in the first 692 subjects to enter the POSCH program who had had one MI. The mean interval from MI to entry into the study was 2.2 years. Sixty-three percent of the subjects developed the most significant code with the infarction. ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90169-3
更新日期:1985-08-01 00:00:00