scholarly journals Non-vitamin K antagonist oral anticoagulant discontinuation in non-valvular atrial fibrillation patients (ASPECT-NOAC)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Asilturk ◽  
M Tulmac ◽  
Ö Badak ◽  
T Onal ◽  
D Aras ◽  
...  
Keyword(s):  
State University ◽  
Private Company ◽  
Patient Request ◽  
Funding Sources ◽  
Medication Discontinuation ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Baseline Characteristics

Abstract Background and aim Data on NOAC discontinuation patterns in Turkey are lacking. We conducted a subgroup analysis in ASPECT-NOAC study to determine anticoagulant discontinuation pattern in AF patients with recently initiated NOAC therapy. Methods ASPECT-NOAC was a national, multicenter, 12-month observational study conducted in 34 outpatient cardiology clinics of state, university, private, and research hospitals covering all geographic regions of Turkey. Adult AF patients who were under NOAC therapy for less than four months were enrolled. Patients who discontinued using their NOACs were recorded at the end of 12 months. A comparative analysis of patients with discontinuation of medication was conducted. Results This study included 991 non-valvular AF patients. NOAC continuation data were available for 854 patients. During study follow-up, 74 patients (8.7%) discontinued their NOAC medication. Mean age of these patients was 67.1±11.3 years old and 38 patients (51.4%) were female. Most commonly seen comorbidities were hypertension (66.2%) and coronary heart disease (39.2%). 29 patients (39.2%) had permanent (chronic) AF, followed by 26 patients (35.1%) with paroxysmal AF. Major reason for NOAC discontinuation was stated as physician request (n=46, 62%). Following reasons were patient request (n=17, 23%), other (n=9, 12%), and bleeding (n=2, 3%). Patients with NOAC discontinuation had a shorter duration of AF (21.7±41.7 vs 26.2±53.7 months, p=0.017). There was no significant difference of educational levels between medication discontinuation subgroups (p=0.637). Other baseline characteristics and patient disease and treatment awareness levels were similar with the patients who continued their medication. Of 74 patients, two patients died during the study because of cardiac failure. Conclusion NOAC continuity rate over 12 months was found to be high. NOAC discontinuation rate were higher in the patients with shorter duration of AF. Further studies with long-term follow-up detailing discontinuation reasons are warranted. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): This study was funded by Pfizer.

Abstract 34: Cardiorespiratory Fitness Response to Short Term Supervised Exercise Training Predicts Age Related Cardiorespiratory Fitness Decline Over Long Term Follow up

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Ambarish Pandey ◽  
Cris A Slentz ◽  
Johanna L Johnson ◽  
Jarett D Berry ◽  
William E Kraus
Keyword(s):  
Exercise Training ◽  
Cardiorespiratory Fitness ◽  
Short Term ◽  
Supervised Exercise ◽  
Age Related ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Baseline Characteristics

Introduction: Substantial heterogeneity exists in the cardiorespiratory fitness (CRF) change response to short-term supervised exercise training and its long-term prognostic implication is not well understood. Here, we evaluated the association between the short-term training related changes in CRF and CRF levels 10 years later. Methods: STRRIDE trial participants that were originally randomized to exercise training for 8 months and participated in the 10-year follow up visit were included. CRF levels were measured at baseline, post-training (8 months), and 10-year follow-up as peak oxygen uptake (VO 2 , ml/kg/min) using the maximal treadmill test. Participants were stratified into low, moderate, and high CRF response (CRF-R) groups according to the training-regimen specific tertiles of CRF change from baseline to post-training. Adjusted linear regression models were used to determine the association between short-term change in CRF with training and CRF levels at 10-year follow-up. Results: The study included 80 participants (age = 52 years, 35% women). There was no significant difference in the baseline characteristics of the CRF-R groups. At 10-year follow-up, high CRF-R group had the lowest decline in CRF compared with moderate or low CRF-R groups (-0.005 vs. -2.6. vs. -3.6 ml/kg/min, p = 0.009, Figure). This was largely related to the differential age-related changes in peak oxygen pulse across the three groups (0.58 vs. -0.23 vs. -0.86 ml/beat, p = 0.02) with no difference in the peak heart rate change. In adjusted analysis, high CRF-R was significantly associated with higher CRF levels at follow-up independent of the exercise intervention and other baseline characteristics [High vs. Low (ref) CRF-R: Std β = 0.25; p = 0.004] Conclusion: CRF change in response to short-term training is a significant predictor of age-related CRF decline over long-term follow-up. Thus, training responsiveness may identify individuals at risk for exaggerated CRF decline with aging and associated incidence of cardiovascular diseases.

scholarly journals Transcatheter Closure of Patent Ductus Arteriosus With Severe Pulmonary Artery Hypertension Through Single Venous Approach: a Propensity Score Match Analysis From Long-term Outcomes

2021 ◽  
Author(s):  
Danqing Hu ◽  
En Chen ◽  
Wei Cai ◽  
Lianglong Chen
Keyword(s):  
Pulmonary Artery ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Pulmonary Artery Hypertension ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Baseline Characteristics

Abstract Background: Up to now, transcatheter closure of patent ductus arteriosus(PDA) without severe pulmonary artery hypertension (PAH) has been well established and accepted in clinical practice. However, in PDA patients with severe PAH, transcatheter closure still remains a challenge, regardless of the tremendous advancement in devices and techniques.Methods: We reviewed the records of PDA patients who underwent transcatheter device closure though single femoral venous approach between January 2005 and December 2018. Severe PAH was defined as systolic pulmonary artery pressure (SPAP) measured by a catheter >70mmHg, excluding irreversible severe PAH assessed by trial occlusion. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: A total of 29 patients were in severe PAH (SPAH) group after excluding 2 for failing to the trial occlusion, and 468 in non-severe PAH(non-SPAH) group. After matching, 25 patients were in SPAH group, and 39 in non-SPAH group, without any significant difference in baseline characteristics. The median follow-up periods were 57 and 44 months for groups, respectively. No significant difference was noted in the rates of cumulative adverse events in the 2 groups (p=0.208). No poor effects in left ventricular function and residual shunt evaluated by transthoracic echocardiography(TTE) in SPAH group were detected in the short- and long-term follow-up.Conclusion: In the patients with PDA associated with reversible severe PAH, compared to non-severe PAH, transcatheter closure through single venous approach has comparable adverse events rates and successful closure rate, with equivalent results of TTE examination at the short- and long-term follow-up.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

A randomized trial of levamisole versus placebo as adjuvant therapy in malignant melanoma.

1991 ◽  
Vol 9 (5) ◽  
pp. 736-740 ◽  
Author(s):  
L E Spitler
Keyword(s):  
Malignant Melanoma ◽  
Adjuvant Therapy ◽  
Randomized Trial ◽  
Control Groups ◽  
Disease Free Interval ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
And Control

We conducted a long-term follow-up (median, 10.5 years) of patients included in a randomized trial of levamisole versus placebo as surgical adjuvant therapy in 203 patients with malignant melanoma. Of the patients randomized, 104 received levamisole, and 99 received placebo. The results show that there is no difference between the treatment and control groups with regard to any of the three end points analyzed. These included disease-free interval, time to appearance of visceral metastasis, and survival. Moreover, there was no significant difference between the treatment and control groups after adjusting for age, sex, or stage of disease.

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

scholarly journals Long-term follow-up of therapeutic efficacy of everolimus-eluting bioresorbable vascular scaffold in comparison to everolimus-eluting stent in treatment of chronic total occlusion guided by intracoronary imaging

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Abdallah Eltahlawi ◽  
Abdel-Aziz Fouad Abdel-Aziz ◽  
Abdel-Salam Sherif ◽  
Khalid Abdel-Azeem Shokry ◽  
Islam Elsayed Shehata
Keyword(s):  
Chronic Total Occlusion ◽  
Bioresorbable Vascular Scaffold ◽  
Total Occlusion ◽  
Intracoronary Imaging ◽  
Group I ◽  
Significant Difference ◽  
Vascular Scaffold ◽  
Long Term Follow Up

Abstract Background We hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging. Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period. Results At 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476). No differences were found at angiographic or clinical follow-up between BVS and EES. Conclusion This study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology. Trial registration ZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: [email protected]

scholarly journals Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohit Agrawal ◽  
Kanwaljeet Garg ◽  
Raghu Samala ◽  
Roopa Rajan ◽  
Vikas Naik ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Meta Analysis ◽  
Post Procedure ◽  
Standard Mean Difference ◽  
Significant Difference ◽  
Long Term Follow Up

Background: Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET.Methods: A systematic literature review was done. The post procedure changes in the Clinical Rating Scale for Tremor (CRST) score, hand score, disability and quality of life scores were analyzed.Results: We found 29 studies evaluating 617 patients. DTI based targeting was utilized in six cohorts. A significant difference was observed in the pooled standard mean difference between the pre and postoperative total CRST score (p-value < 0.001 and 0.0002), hand score (p-value 0.03 and 0.02); and the disability at 12 months (p-value 0.01). Head pain and dizziness were the most in procedure complications. The immediate pooled proportion of ataxia was 50%, while it was 20% for sensory complications, which, respectively, declined to 31 and 13% on long term follow up. A significant reduction (p = 0.03) in immediate ataxia related complications was seen with DTI targeting.Conclusion: MRgFUS for ET seems to be an effective procedure for relieving unilateral tremor. Use of DTI based targeting revealed a significant reduction in post procedure ataxia related complications as compared to traditional targeting techniques. Analysis of other complications further revealed a decreasing trend on follow up.

Abstract 16099: Predictors of Cardiovascular Implantable Electronic Device-dependence at Long-term Follow-up After Alcohol Septal Ablation in Hypertrophic Cardiomyopathy Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Weeranun D Bode ◽  
Michael F Bode ◽  
Megan Zhao ◽  
Rahul Sakhuja ◽  
Michael A Fifer ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Electronic Device ◽  
Av Block ◽  
Ventricular Pacing ◽  
Alcohol Septal Ablation ◽  
Long Term Follow Up ◽  
Baseline Characteristics ◽  
Cardiovascular Implantable Electronic Device

Introduction: The most common complication of alcohol septal ablation (ASA) is periprocedural high grade AV block (HGAVB). No long-term follow-up of cardiovascular implantable electronic device (CIED) utilization after ASA has been reported. Hypothesis: Pacemaker dependence on long-term follow up can be predicted by ECG or procedural characteristics. Methods: We analyzed all patients with hypertrophic cardiomyopathy who underwent ASA from December 1998 to December 2019 at our institution and received their first CIED within 30 days after ASA for HGAVB. All available follow-up interrogations were reviewed. CIED dependence was defined as ventricular pacing of ≥5%. CIED programming was determined by the patients’ cardiologists' discretion. Results: A total of 103 patients with hypertrophic cardiomyopathy underwent ASA. The average follow up duration was 10.1 years. Within 30 days after ASA, a total 25 patients received a CIED for HGAVB. On long term follow-up 16 patients (64%) were found to be CIED-dependent. Baseline characteristics, including pre and post-ASA ECG, were not significantly different between dependent and non-dependent patients (Table). The only predictor for CIED dependence was >1 ml of alcohol injected during ASA (OR 6.0, p<0.046). Conclusions: CIED implantation after ASA is common. Almost two thirds of patients who received CIED for postprocedural HGAVB were CIED-dependent on long term follow up. CIED dependence can be predicted by amount of injected alcohol >1 ml during ASA.

Sign in / Sign up

Export Citation Format

Share Document