Abstract:
BACKGROUND:The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHODS:Patients on warfarin for atrial fibrillation or venous thromboembolism were consecutively enrolled from January 2007 to December 2010. Baseline kidney function was assessed, and patients were followed to their first decline of kidney function to creatinine clearance<30 mL/min. Multivariate regression assessed independent risk factors for the primary outcome. Severe renal impairment based on baseline kidney function was assessed by Kaplan-Meier analyses. RESULTS:Of 787 patients identified, 34 were excluded for baseline CrCl <30 mL/min. The mean age was 71 years, and 74% and 31% had hypertension and diabetes mellitus, respectively. At baseline, 23% (n=174) had moderate chronic kidney disease (CKD) (CrCl 30-59mL/min), whereas 31% had mild CKD (CrCl 60-89mL/min). Severe renal impairment occurred in 92 patients (12%), 25% of which was seen within 5.3 months. Of those with baseline stage 3 CKD, 37% developed severe renal impairment. Stage 3 CKD conferred a 14-fold increased risk in the development of severe renal dysfunction (odds ratio 14.5, 95% CI 6.7-31.3, P<.001). Coronary artery disease was also associated with severe renal impairment (odds ratio 2.2, 95% CI 1.3-3.8, P=.004). CONCLUSIONS:Acute and chronic renal dysfunction is common among individuals requiring long-term anticoagulant therapy. Patients with moderate chronic kidney disease and coronary artery disease are at the highest short-term risk of developing severe renal impairment. More frequent monitoring of these patients is warranted.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Fanola CL,Mooney D,Cowan AJ,Ko D,Sisson EK,Henault LE,Tripodis Y,Hylek EMdoi
10.1016/j.ahj.2016.08.017subject
Has Abstractpub_date
2017-02-01 00:00:00pages
150-155eissn
0002-8703issn
1097-6744pii
S0002-8703(16)30255-1journal_volume
184pub_type
杂志文章abstract:BACKGROUND:Vesnarinone has yielded controversial results on morbidity in patients with congestive heart failure. We tested the hypothesis that vesnarinone may have a beneficial effect on cardiac remodeling and function. METHODS:Thirty-four patients with left ventricular ejection fraction (LVEF) <30% (17 treated with v...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(98)70120-6
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Endothelin 1 is a potent endogenous vasoconstrictor neurohormone, and endothelin 1 plasma concentrations predict adverse outcomes in patients with acute heart failure (AHF). Tezosentan, an intravenous endothelin receptor antagonist, improved hemodynamics in patients with AHF; however, its effects on morbidit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.04.035
更新日期:2005-07-01 00:00:00
abstract::Twenty-six patients with Ebstein's anomaly were classified into three types according to their clinical features, heart catheterization data, angiocardiographic and anatomical findings which were obtained on surgery or autopsy. The hemodynamics in each type were discussed. 1. Tricuspid Stenosis Dominant Type. Eight pa...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90458-1
更新日期:1978-02-01 00:00:00
abstract::Ventricular tachyarrhythmias are the cause of sudden cardiac death in ischemic heart disease. Reliable animal models are necessary to study techniques for identifying individuals at risk and to develop effective modes of therapy. The purpose of the present study was to evaluate the inducibility of ventricular tachyarr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90191-7
更新日期:1985-11-01 00:00:00
abstract::Three cases of apical left ventricular hypertrophy demonstrating a sequestered small left ventricular apical cavity with complete systolic and partial diastolic intraventricular obstruction are described. Doppler studies revealed that flow from the apical chamber is aborted during early systole with further emptying d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90730-2
更新日期:1988-12-01 00:00:00
abstract::Resting measurements of left ventricular systolic function do not reliably predict exercise capacity in patients with cardiac disease. Therefore left ventricular filling shortly after a myocardial infarction was prospectively studied to determine whether it could predict subsequent exercise time. Consecutive patients ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80086-9
更新日期:1990-01-01 00:00:00
abstract::In this editorial, the problem of restenosis after coronary balloon angioplasty and other transluminal interventions is reviewed from the perspective of quantitative coronary angiography. The review is largely based on the experience of the Thoraxcentre in the application of quantitative angiography to the study of re...
journal_title:American heart journal
pub_type: 社论
doi:10.1016/0002-8703(93)90689-7
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Protease-activated receptor 1 antagonism with vorapaxar represents a novel strategy for platelet inhibition. In TRACER, vorapaxar was compared with placebo plus standard of care among 12,944 patients with non-ST-segment elevation acute coronary syndromes. We anticipated that most patients would have received...
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.2014.09.002
更新日期:2014-12-01 00:00:00
abstract::We evaluated the usefulness of peripherally injected sonicated albumin microbubbles in transesophageal echo-Doppler cardiographic assessment of the left atrial appendage in 19 patients (age 61 +/- 19 [range 21 to 86] years; 12 [63%] women). Multiplane transesophageal echocardiography was performed before and after int...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70180-7
更新日期:1997-04-01 00:00:00
abstract::Our hypothesis was that the postoperative abnormalities in septal motion observed by M-mode echocardiography (MME) are due to changes of either ventricular shape or of total cardiac motion within the thorax. We obtained preoperative and early and late postoperative MME and two-dimensional echocardiograms on 25 patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90202-2
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Quality improvement programs have shown increased use of beta-blockers post-myocardial infarction (MI), but there are no data on whether appropriate doses are administered. METHODS:In a prospective registry that enrolled consecutive patients with MI, we evaluated beta-blocker dosing at discharge after MI an...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.06.023
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The pulmonary venous flow signal measured by transesophageal echocardiography is generally recorded from the left upper pulmonary vein in the left lateral decubitus position, whereas that by transthoracic echocardiography is from the right upper pulmonary vein in the left semi-lateral decubitus position. The...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70486-2
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS:We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of postoperative rhythm versus rate control and anticoagulation for...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.09.003
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. METHODS:In this open-label, m...
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.2019.06.010
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The 6-minute walk test is a submaximal exercise test that is widely used as an outcomes measure in clinical trials and cardiopulmonary rehabilitation. An initial learning effect with repeated administration is well documented, but it is unknown whether this learning effect persists with time. METHODS:This s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00119-4
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Patients with recurrent forms of atrial fibrillation may receive dual-chamber pacemakers after atrioventricular junction ablation for refractory symptoms. These patients are at risk for chronic atrial fibrillation, which would negate the benefits of dual-chamber pacing. The purpose of this study was to exami...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-8703(99)70223-1
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Technetium Tc 99m gated single photon emission computed tomography (SPECT) has become the cornerstone of noninvasive risk stratification in patients with ischemic heart disease, but its role in patients with heart failure is not as well established. STUDY DESIGN:This study is a substudy of the Heart Failure...
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.2007.03.045
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Evidence from numerous studies of coronary angiography show differences between observers' assessments of 15% to 45%. The implication of this variation is serious: If readings are erroneous, some patients will undergo revascularization procedures unnecessarily and others will be denied an essential treatment...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-8703(00)90316-8
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Little is known about the role of diet in the development of venous thromboembolism (VTE). We explored the prospective relation of dietary patterns, food groups, and nutrients to incident VTE in older women. METHODS:In 1986, Iowa women aged 55 to 69 years completed a mailed survey, including a 127-item food...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.04.003
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:There is interest in measuring and comparing outcomes of percutaneous transluminal coronary angioplasty (PTCA) other than death, but there are no accepted methods for adjusting these outcomes for preprocedure differences in populations. We sought to identify independent predictors of functional outcome after...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70142-0
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.002
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Inflammation is an important feature of atherosclerotic lesions, and the vulnerability of coronary lesions in acute myocardial infarction (AMI) at the time of onset may be related to blood levels of C-reactive protein (CRP) on admission, before CRP levels are affected by myocardial damage. METHODS:A total o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.108244
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:CSL112 (apolipoprotein A-I [human]) is a plasma-derived apolipoprotein A-I developed for early reduction of cardiovascular risk following an acute myocardial infarction (AMI). The safety of CSL112 among AMI subjects with moderate, stage 3 chronic kidney disease (CKD) is unknown. METHODS:CSL112_2001, a multi...
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.2018.11.008
更新日期:2019-02-01 00:00:00
abstract::High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90834-5
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.09.010
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:We sought to determine the relationship of adverse diastolic remodeling (ie, worsening diastolic or persistent restrictive filling) with infarct scar characteristics, and to evaluate its prognostic value after ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Severe diastolic dysfunction (restr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.05.020
更新日期:2016-10-01 00:00:00
abstract::Sudden cardiac death syndrome remains a major health problem responsible for approximately 400,000 deaths annually in the US. Effective therapies exist but are costly and are associated with potential complications. Currently used strategies for selection of the best candidates for implantable cardioverter defibrillat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2007.01.024
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Renal function significantly impacts morbidity and mortality after a percutaneous coronary intervention. Platelet glycoprotein (GP) IIb/IIIa inhibitors reduce ischemic complications during percutaneous coronary intervention; little is known of whether their safety and efficacy are influenced by renal functio...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.12.002
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Surgical ventricular restoration (SVR) is an operation that demonstrates promise to improve outcomes for patients with left ventricular dysfunction. Current use and operative outcomes of SVR have come from centers of expertise, and operative risks of SVR in community practice are unknown. We sought to charac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.01.016
更新日期:2006-09-01 00:00:00
abstract::Endocarditis is a rare manifestation of disseminated Histoplasma capsulatum infection. A 22-year-old man presented with a seven month history of fever, weight loss, and progressive aortic insufficiency. The diagnosis of H. capsulatum was suggested by a diagnostic rise in complement fixation titers and positive echocar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90630-4
更新日期:1980-06-01 00:00:00