Abstract:
:Background Stroke and thromboembolic events may still occur in "clinically low-risk" atrial fibrillation (AF) patients as categorized by CHA2DS2-VASc score. Our aim was to assess the proportion of "clinically low-risk" patients using a nongender CHA2DS2-VASc (ie, CHA2DS2-VA) score of 0 to 1 among patients who experienced AF-associated stroke and to identify markers associated with stroke in "clinically low-risk" patients. Methods and Results We retrospectively recruited nonvalvular AF patients who experienced embolic stroke between 2013 and 2016 from 9 institutes in Korea. AF patients with CHA2DS2-VA score of 0 to 1 at the time of stroke were analyzed and compared with "clinically low-risk" AF patients without stroke. A total of 3033 subjects with AF-associated stroke were recruited. Of these, 583 patients (19.2%) had CHA2DS2-VA score of 0 to 1. On multivariate analysis, age (≥60 years), N-terminal pro B-type natriuretic peptide (≥300 pg/mL), creatinine clearance (<50 mL/min), and left atrial dimension (≥45 mm) were independently associated with stroke. With the combined application of these 4 factors (collectively, ABCD score) to the "clinically low-risk" patients, the c-index was 0.858 (95% CI 0.838-0.877; P<0.001). Conclusions The present study suggests a new insight into how additional use of markers can further refine stroke risk differentiation among AF patients initially classified as "clinically low-risk." Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03147911.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Shin SY,Han SJ,Kim JS,Im SI,Shim J,Ahn J,Lee EM,Park YM,Kim JH,Lip GYH,Lim HEdoi
10.1161/JAHA.119.012697subject
Has Abstractpub_date
2019-11-05 00:00:00pages
e012697issue
21issn
2047-9980journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Contemporary rates of oral anticoagulant (OAC) therapy and associated outcomes among patients undergoing percutaneous coronary intervention (PCI) have been poorly described. METHODS AND RESULTS:Using data from an integrated health care system from 2009 to 2014, we identified patients on OACs within 30 days ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.116.004310
更新日期:2016-10-17 00:00:00
abstract:BACKGROUND:Pediatric syncope is common. Cardiac causes are rarely found. We describe and assess a pragmatic approach to these patients first seen by a pediatric cardiologist in the New England region, using Standardized Clinical Assessment and Management Plans (SCAMPs). METHODS AND RESULTS:Ambulatory patients aged 7 t...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.115.002931
更新日期:2016-02-19 00:00:00
abstract:BACKGROUND:Atherosclerosis is an inflammatory lipid disorder and the main underlying pathology of acute ischemic events. Despite a vast amount of data from murine atherosclerosis models, evidence of B-cell involvement in human atherosclerotic disease is limited. We therefore investigated the association of circulating ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.005747
更新日期:2017-09-07 00:00:00
abstract:BACKGROUND:People with end-stage renal disease (ESRD) are at risk for advanced heart failure, but little is known about use and outcomes of durable mechanical circulatory support in this setting. We examined use and outcomes of implantable ventricular assist devices (VADs) in a national ESRD cohort. METHODS AND RESULT...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.008664
更新日期:2018-07-06 00:00:00
abstract:BACKGROUND:Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. METHODS AND RESULTS:Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, we examined associations between healthcare resource availabilit...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.116.003813
更新日期:2017-02-03 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair is characterized by a substantial need for reintervention. Secondary open aortic procedure becomes necessary when further endoluminal options are exhausted. This synopsis and quantitative analysis of available evidence aims to overcome the limitations of institutional coho...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,meta分析,评审
doi:10.1161/JAHA.117.006618
更新日期:2017-09-13 00:00:00
abstract:BACKGROUND:The geometric organization of myocytes in the ventricular wall comprises the structural underpinnings of cardiac mechanical function. Cardiac myosin binding protein-C (MYBPC3) is a sarcomeric protein, for which phosphorylation modulates myofilament binding, sarcomere morphology, and myocyte alignment in the ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.115.002836
更新日期:2016-03-15 00:00:00
abstract:BACKGROUND:Among the growing numbers of patients with heart failure, up to one half have heart failure with preserved ejection fraction (HFpEF). The lack of effective treatments for HFpEF is a substantial and escalating unmet clinical need-and the lack of HFpEF-specific animal models represents a major preclinical barr...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.007451
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate whether the association between baseline cardiovascular health (CVH) and incident cardiovascular disease differs according to coronary heart disease (CHD) and stroke subtypes, and to assess the mediating effect of inflammatory and hemostatic blood biomarkers. METHODS...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.117.006389
更新日期:2017-10-17 00:00:00
abstract::[This corrects the article DOI: 10.1161/JAHA.117.005967.]. ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,已发布勘误
doi:10.1161/JAHA.117.004215
更新日期:2017-12-23 00:00:00
abstract::Background Systemic innate immune priming is a recognized sequela of post-ischemic neuroinflammation and contributor to delayed neurodegeneration. Given mounting evidence linking acute stroke with reactive lung inflammation, we asked whether enhanced expression of the endogenous antioxidant extracellular superoxide di...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.011801
更新日期:2019-05-07 00:00:00
abstract:BACKGROUND:Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysis within 30 minutes for those in those for whom timely transfer t...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.116.004113
更新日期:2016-10-06 00:00:00
abstract:BACKGROUND:All clinical and biological manifestations related to postcardiac arrest (CA) syndrome are attributed to ischemia-reperfusion injury in various organs including brain and heart. Molecular hydrogen (H(2)) has potential as a novel antioxidant. This study tested the hypothesis that inhalation of H(2) gas starti...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.112.003459
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Heart failure is a highly prevalent cardiovascular complication among patients receiving long-term hemodialysis, but the benefits of carvedilol, bisoprolol, and metoprolol controlled release/extended release on the outcomes of these patients remain unclear. In this study, we address the use of these 3 β-bloc...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.115.002584
更新日期:2016-01-06 00:00:00
abstract::Background For individuals with an out-of-hospital cardiac arrest (OHCA), survival may be influenced by the neighborhood in which the arrest occurs. Methods and Results Within the national CARES (Cardiac Arrest Registry to Enhance Survival) registry, we identified 169 502 patients with OHCA from 2013 to 2017. On the b...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.119.014178
更新日期:2020-02-18 00:00:00
abstract::Background Recent studies suggest that mavacamten (Myk461), a small myosin-binding molecule, decreases hypercontractility in myocardium expressing hypertrophic cardiomyopathy-causing missense mutations in myosin heavy chain. However, the predominant feature of most mutations in cardiac myosin binding protein-C ( cMyBP...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.009627
更新日期:2018-09-04 00:00:00
abstract:BACKGROUND:Pulse pressure (PP) is related to cardiac function, arterial stiffness, fluid status, and vascular events. This study aimed to explore the prognostic role of PP upon admission in patients with acute ischemic stroke (AIS) based on a nation-wide stroke registry. METHODS AND RESULTS:We evaluated the associatio...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.116.005113
更新日期:2017-06-22 00:00:00
abstract::Background Spontaneously hypertensive rats of the stroke-prone line (SHR-A3) develop hypertensive renal disease as a result of naturally occurring genetic variation. Our prior work identified a single-nucleotide polymorphism unique to SHR-A3 that results in truncation of the carboxy terminus of STIM1. The SHR-B2 line,...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.014142
更新日期:2020-03-03 00:00:00
abstract::Background Hyperhomocysteinemia is a risk factor for ischemic stroke; however, a targeted treatment strategy is lacking partly because of limited understanding of the causal role of homocysteine in cerebrovascular pathogenesis. Methods and Results In a genetic model of cystathionine beta synthase (CBS) deficiency, we ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.013368
更新日期:2020-02-18 00:00:00
abstract:BACKGROUND:Elevated serum phosphorus might aggravate the effect of hypertension on mortality. The objective of this study was to examine the joint effect of hypertension and serum phosphorus on the risk of mortality. METHODS AND RESULTS:A large prospective (n=15 833), population-based cohort of participants from the N...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.114.001706
更新日期:2015-05-20 00:00:00
abstract:BACKGROUND:Coronary heart disease and peripheral arterial disease (PAD) affect different vascular territories. Supplementing baseline findings with assays from stored serum, we compared their 20-year predictors. METHODS AND RESULTS:We randomly recruited 15 737 disease-free men and women aged 30 to 75 years across Scot...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.117.005967
更新日期:2017-09-18 00:00:00
abstract:BACKGROUND:Little is known about the hemodynamic response to exercise in heart failure patients at various ages before and after heart transplantation (HT). This information is important because postoperative hemodynamics may be a predictor of survival. To investigate the hemodynamic response to HT and exercise, we gro...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.115.001787
更新日期:2015-07-21 00:00:00
abstract:BACKGROUND:Novel therapies aimed at modulating the autonomic nervous system, including thoracic epidural anesthesia (TEA), have been shown in small case series to be beneficial in treating medically refractory ventricular tachycardia (VT) storm. However, it is not clear when these options should be considered. We revie...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.117.007080
更新日期:2017-10-27 00:00:00
abstract:BACKGROUND:The 4-variable risk score from University of California, Los Angeles (UCLA) demonstrated superior discrimination in advanced heart failure, compared to established risk scores. However, the model has not been externally validated, and its suitability as a selection tool for heart transplantation (HT) and lef...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.114.000998
更新日期:2014-06-06 00:00:00
abstract:BACKGROUND:Chest pain is a common reason for referral to pediatric cardiologists. Although pediatric chest pain is rarely attributable to serious cardiac pathology, extensive and costly evaluation is often performed. We have implemented a standardized approach to pediatric chest pain in our pediatric cardiology clinics...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.111.000349
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Time-limited acute stroke treatments are underused, primarily due to prehospital delay. One approach to decreasing prehospital delay is to increase stroke preparedness, the ability to recognize stroke, and the intention to immediately call emergency medical services, through community engagement with high-ri...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.116.003331
更新日期:2016-05-20 00:00:00
abstract:BACKGROUND:There are several mechanisms, including inflammation, oxidative stress and abnormal calcium homeostasis, involved in the pathogenesis of atrial fibrillation. In diabetes mellitus (DM), increased oxidative stress may be attributable to higher xanthine oxidase activity. In this study, we examined the relations...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.008807
更新日期:2018-05-02 00:00:00
abstract:BACKGROUND:Participation in cardiac rehabilitation (CR) is an essential component of care for patients with coronary artery disease. However, little is known about its benefit on cardiovascular outcomes in patients with diabetes mellitus (DM) who have undergone percutaneous coronary intervention. The aim of our study w...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.006404
更新日期:2017-10-11 00:00:00
abstract:BACKGROUND:The volume-outcome relationship associated with intensive care unit (ICU) experience with managing acute myocardial infarction (AMI) remains inadequately understood. METHODS AND RESULTS:Within a multicenter clinical ICU database, we identified patients with a primary ICU admission diagnosis of AMI between 2...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.114.001225
更新日期:2015-06-11 00:00:00
abstract::Background This study examined the association between ideal cardiovascular health ( CVH ) and the retinal microvasculature in midadulthood. Methods and Results The Cardiovascular Risk in Young Finns Study included children from 5 Finnish University cities, who were chosen randomly from the national population registe...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.118.009487
更新日期:2018-10-16 00:00:00