Abstract:
:After reviewing these published studies, I think one can conclude that in the patient population with chronic and/or paroxysmal atrial fibrillation, warfarin is beneficial and the benefits outweigh the risks. However, it is important to point out that patients at high risk for embolic disease, for example, dilated cardiomyopathy patients, were rarely included in these trials. The five trials mentioned above do not address this patient population. Current opinion is that these individuals should receive anticoagulation despite the lack of objective evidence that anticoagulation is beneficial if the risk of bleeding is not excessive. The five trials also do not address the population of patients categorized as having "lone atrial fibrillation," that is, atrial fibrillation occurring in patients with no structural heart disease. The general consensus in the low embolic risk patient, (i.e., the patient < 60 years of age who has lone atrial fibrillation) is that the risk of anticoagulation is greater than the benefit. My final thought on the subject concerns the risk of pulmonary emboli in this patient population. My guess is that this group of patients is at high risk for small pulmonary emboli, which in many instances may be subclinical--for example, clots too small to result in persistent tachypnea or tachycardia. As far as I can tell, there are no randomized trials on the prevention of pulmonary emboli in patients with chronic or paroxysmal atrial fibrillation using anticoagulation or aspirin. I guess the systemic emboli trial data are sufficient to indicate a protective effect on the lungs as well as on the brain.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Conti CRdoi
10.1002/clc.4960160703subject
Has Abstractpub_date
1993-07-01 00:00:00pages
529-30issue
7eissn
0160-9289issn
1932-8737journal_volume
16pub_type
社论abstract:BACKGROUND:Patients with phenotypic severe hypercholesterolemia (SH), low-density lipoprotein-cholesterol (LDL-c) ≥ 190 mg/dl, atherosclerotic cardiovascular disease (ASCVD) or adults 40-75 years with diabetes with risk factors or 10-year ASCVD risk ≥20% benefit from maximally tolerated statin therapy. Rural patients h...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23521
更新日期:2020-12-23 00:00:00
abstract:BACKGROUND:Recently, electrocardiogram (ECG) criteria have been proposed for the diagnosis of acute myocardial infarction (AMI) in the presence of left bundle-branch block (LBBB). However, clinical experience indicates that such ECG changes indicative of AMI are occasionally noted in clinically stable patients with LBB...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960241004
更新日期:2001-10-01 00:00:00
abstract::The hemodynamic and myocardial energetic changes due to pulsus alternans were investigated by left and right heart catheterization and by oxygen consumption measurements in three patients with dilative cardiomyopathy. In all three patients, pulsus alternans developed after intravenous administration of the phosphodies...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100506
更新日期:1987-05-01 00:00:00
abstract::A total of 1150 consecutive patients (1052 males and 98 females; age 51.2 +/- 10.1 years) with suspected coronary artery disease (Group I) were subjected to fluoroscopy for detection of coronary artery calcification (CAC) and coronary angiography. Another group (Group II) of 120 patients (95 males and 25 females; age ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960110705
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Most information concerning hypertrophic cardiomyopathy has been derived from western countries and Japan. HYPOTHESIS:Patients with hypertrophic cardiomyopathy in Taiwan may have a distinct morphology and clinical picture. METHODS:Information from 163 consecutive patients with hypertrophic cardiomyopathy a...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20057
更新日期:2007-04-01 00:00:00
abstract::Triglyceride (TG) has long been associated as a risk factor for coronary artery disease. A recent meta-analysis of various epidemiologic studies has confirmed this link. An important issue is to assess further the appropriate cutpoints to classify desirable TG because recent data indicate that levels < 200 mg/dl confe...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960221402
更新日期:1999-06-01 00:00:00
abstract::Two cases with acute myocardial infarction are presented. Both had thrombotic occlusion of the infarct-related artery. Following successful thrombolysis with streptokinase, coronary angiography was normal. These cases prove that "myocardial infarction with normal coronaries" can be associated with coronary thrombosis ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960061107
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Left ventricular ejection fraction (LVEF) has shown to predict outcomes in patients with heart failure (HF). Left ventricular recovery (LVR) has shown to improve prognosis. HYPOTHESIS:Guideline-directed medical therapy will predict LVR in patients with HF and reduced LVEF. METHODS:We studied 244 patients w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22937
更新日期:2018-06-01 00:00:00
abstract::The Randomized Endo-vein Graft Prospective (REGROUP) trial (ClinicalTrials.gov NCT01850082) is a randomized, intent-to-treat, 2-arm, parallel-design, multicenter study funded by the Cooperative Studies Program (CSP No. 588) of the US Department of Veterans Affairs. Cardiac surgeons at 16 Veterans Affairs (VA) medical ...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22267
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:We sought to determine whether lifestyle modifications are associated with high-density lipoprotein cholesterol (HDL-C) change in a cohort with long-term follow-up. HYPOTHESIS:Changes in alcohol consumption, smoking, or body mass index (BMI) are associated with within-individual changes in HDL-C. METHODS:W...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.21978
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Contraction-excitation feedback, that is, electrophysiologic changes that are caused or preceded by mechanical changes of the myocardium, has been extensively studied in the ventricles. The role of contraction-excitation feedback in the atria, and more particularly in the genesis and maintenance of atrial fi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200514
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Cardiac troponin T elevation after coronary intervention has been demonstrated to be associated with the prognosis of coronary artery disease (CAD). However, there were few studies about comprehensive risk factors analysis of troponin T elevation after elective drug-eluting stent (DES) implantation. HYPOTHE...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20973
更新日期:2011-12-01 00:00:00
abstract::Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that has widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate res...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230804
更新日期:2000-08-01 00:00:00
abstract::Mitral anulus calcification (MAC) and mitral valve prolapse (MVP) are frequently diagnosed conditions. We studied two patients with mild or moderate mitral regurgitation who demonstrated both MAC and MVP on angiography and echocardiography. M-mode echocardiography is probably the definitive test for confirming the pre...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960020309
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:It is known that exercise-induced ST-segment elevation in lead V1 (V1-E) detects left anterior descending (LAD) stenosis. It was also postulated that ST elevation in aVR and simultaneous ST depression in V5 (aVR-E + V5-D) is a marker of ischemia due to significant stenosis of the LAD in patients with single-...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260506
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The reproducibility of left ventricular (LV) mass measurement by two-dimensional (2-D) echocardiography is inadequate for individual assessments. HYPOTHESIS:This study was undertaken to evaluate the potential of LV mass determination with a new three-dimensional (3-D) echocardiographic method compared with ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201111
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to d...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22297
更新日期:2014-09-01 00:00:00
abstract::Heart transplantation is the only curative therapy for chronic heart failure, and it plays an important role in the treatment of chronic heart failure with a survival rate of approximately 50% of all patients after 10 years. This has to be kept in mind when alternative therapies enter into our daily routine in treatin...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22124
更新日期:2013-07-01 00:00:00
abstract::Women's health and well-being are shaped by a combination of healthcare policies that impact the type of health insurance coverage they benefit from, as well as access to preventive, screening, and treatment services. Furthermore, more distal policies, such as those that pertain to housing, education, and employment, ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22896
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:There are no studies in the literature related to the effect of beta blockers (BB) on changes in C-reactive protein (CRP) levels after percutaneous coronary intervention (PCI). HYPOTHESIS:We designed a prospective randomized study to investigate the impact of BB therapy on CRP in patients who underwent elec...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960280509
更新日期:2005-05-01 00:00:00
abstract::Lipoprotein (a) [Lp(a)] concentrations were determined in 365 patients undergoing coronary angiography for stable angina (n = 159), unstable angina (n = 99), recent myocardial infarction (n = 45), and nonischemic heart disease (cardiomyopathy or valvular disease, n = 62, non-IHD). Mean +/- SD and median Lp(a) concentr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180909
更新日期:1995-09-01 00:00:00
abstract::Flecainide is reported to be effective in patients with paroxysmal tachycardias, but its effect on rapid ventricular response over accessory atrioventricular pathway during atrial fibrillation is not known. The influence of flecainide on various electrophysiological properties of the accessory pathway with special emp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080603
更新日期:1985-06-01 00:00:00
abstract::This report describes the development of a quality assurance-oriented integrated software system designed for an anesthesiology-based intraoperative transesophageal echocardiography service. Entry data include patient and operation demographics, two-dimensional echocardiographic, saline-contrast, and color flow/pulsed...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960161012
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Epicardial placement of the left ventricular (LV) lead via a video-assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique. HYPOTHESIS:Long-term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23300
更新日期:2020-03-01 00:00:00
abstract::Many invasive and noninvasive methods have been used to study the cardiac atria; however, few allow quantitative measurement of atrial function. To determine the interaction between left ventricular (LV) contraction and left atrial (LA) filling, gated radionuclide angiography was conducted in 30 normal subjects (24 me...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170508
更新日期:1994-05-01 00:00:00
abstract::The purpose of this study was to investigate the efficacy of the patient-based coronary heart disease (CHD) risk management strategy in general practice by analyzing patients who were sent to a specialized center as refractory to conventional treatment. Of the 452 patients studied, 152 were excluded because of seconda...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170305
更新日期:1994-03-01 00:00:00
abstract::Surgical ablation procedure can restore sinus rhythm (SR) in patients with atrial fibrillation (AF) undergoing cardiac surgery. However, it is not known whether it has any impact on clinical outcomes. There is a need for a randomized trial with long-term follow-up to study the outcome of surgical ablation in patients ...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22085
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality, which is not fully explained by traditional risk factors; hence, the interest in nontraditional risk factors such as inflammation and insulin resistance (IR). Though IR is shown in nondiabetic CKD, its association wi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20901
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the influence of atrial fibrillation (AF) on the immediate and long-term outcome of patients undergoing balloon mitral valvotomy (BMV). HYPOTHESIS:Patients with atrial fibrillation fair poorly after balloon mitral valvotomy. METHODS:There were a total of 818 consecu...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22068
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Contrast-induced nephropathy (CIN) is the third cause of acute deterioration of renal function in hospitalized patients. HYPOTHESIS:The purpose of the study was to compare the efficacy of saline infusion, saline infusion plus N-acetylcysteine (NAC), and sodium bicarbonate (SB) infusion to prevent CIN in pat...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.20576
更新日期:2010-03-01 00:00:00