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  1. Article ; Online: Is Initiating NOACs for Atrial Arrhythmias Safe in Adults with Congenital Heart Disease?

    Yang, Hayang / Bouma, Berto J / Mulder, Barbara J M

    Cardiovascular drugs and therapy

    2017  Volume 31, Issue 4, Page(s) 413–417

    Abstract: Background: In recent years, non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have been increasingly prescribed to adults with congenital heart disease (CHD) and atrial arrhythmias without good evidence for either safety or efficacy. To ... ...

    Abstract Background: In recent years, non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have been increasingly prescribed to adults with congenital heart disease (CHD) and atrial arrhythmias without good evidence for either safety or efficacy. To address this gap, we initiated an ongoing prospective global registry (NOTE: non-vitamin K antagonist oral anticoagulants for thromboembolic prevention in patients with congenital heart disease). Using the NOTE registry data, the present study aimed to evaluate the occurrence of any adverse events during the initiation phase (first 30 days) of NOACs in adults with CHD and atrial arrhythmias.
    Methods and results: For this prospective observational study, 99 adults with CHD and atrial arrhythmias (median age 49 years [IQR 38-61], 53% male) who initiated NOACs at or after the inclusion point were analysed. Thromboembolic events, major bleeding and other minor adverse events were assessed after the first 30 days since the initiation of NOACs. In 54 patients transitioning from VKA to NOACs, 8 minor adverse events (5 minor bleeding; 3 side-effects; 1 drop-out due to minor bleeding) occurred within 30 days after the transition. No adverse events were reported in 46 VKA-naive patients within 30 days after the initiation of NOACs.
    Conclusions: Initiation of NOACs and transition from VKA to NOACs seem to be safe during the first month, without major adverse events and with only limited minor side effects in adults with CHD and atrial arrhythmias. This global ongoing prospective registry enables precise collection of important clinical information in real-world adults with CHD, managed with NOACs.
    MeSH term(s) Administration, Oral ; Adult ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Arrhythmias, Cardiac/complications ; Arrhythmias, Cardiac/drug therapy ; Female ; Heart Defects, Congenital/complications ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries ; Thromboembolism/etiology ; Thromboembolism/prevention & control
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2017-07-22
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 639068-7
    ISSN 1573-7241 ; 0920-3206
    ISSN (online) 1573-7241
    ISSN 0920-3206
    DOI 10.1007/s10557-017-6745-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 3057: Show issues Location:
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  2. Article ; Online: Platform for the interdisciplinary study of cardiovascular, metabolic and neurovascular diseases (PICMAN) protocol.

    Dalakoti, Mayank / Leow, Melvin Khee Shing / Khoo, Chin Meng / Yang, Hayang / Ling, Lieng Hsi / Muthiah, Mark / Tan, Eunice / Lee, Jonathan / Dan, Yock Young / Chew, Nicholas / Seow, Wei Qiang / Soong, Poh Loong / Gan, Louis / Gurung, Rijan / Ackers-Johnson, Matthew / Hou, Han Wei / Sachaphibulkij, Karishma / MacAry, Paul / Low, Gwen /
    Ang, Christy / Yeo, Tee Joo / Djohan, Andie Hartanto / Li, Tony / Yeung, Wesley / Soh, Rodney / Sia, Ching Hui / Panday, Vinay / Loong, Shaun S E / Tan, Benjamin Y Q / Yeo, Leonard L L / Teo, Lynette / Chow, Pierce / Foo, Roger

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 20521

    Abstract: Through extensive multisystem phenotyping, the central aim of Project PICMAN is to correlate metabolic flexibility to measures of cardiometabolic health, including myocardial diastolic dysfunction, coronary and cerebral atherosclerosis, body fat ... ...

    Abstract Through extensive multisystem phenotyping, the central aim of Project PICMAN is to correlate metabolic flexibility to measures of cardiometabolic health, including myocardial diastolic dysfunction, coronary and cerebral atherosclerosis, body fat distribution and severity of non-alcoholic fatty liver disease. This cohort will form the basis of larger interventional trials targeting metabolic inflexibility in the prevention of cardiovascular disease. Participants aged 21-72 years with no prior manifest atherosclerotic cardiovascular disease (ASCVD) are being recruited from a preventive cardiology clinic and an existing cohort of non-alcoholic fatty liver disease (NAFLD) in an academic medical centre. A total of 120 patients will be recruited in the pilot phase of this study and followed up for 5 years. Those with 10-year ASCVD risk ≥ 5% as per the QRISK3 calculator are eligible. Those with established diabetes mellitus are excluded. Participants recruited undergo a detailed assessment of health behaviours and physical measurements. Participants also undergo a series of multimodality clinical phenotyping comprising cardiac tests, vascular assessments, metabolic tests, liver and neurovascular testing. Blood samples are also being collected and banked for plasma biomarkers, 'multi-omics analyses' and for generation of induced pluripotent stem cells (iPSC). Extensive evidence points to metabolic dysregulation as an early precursor of cardiovascular disease, particularly in Asia. We hypothesise that quantifiable metabolic inflexibility may be representative of an individual in his/her silent, but high-risk progression towards insulin resistance, diabetes and cardiovascular disease. The platform for interdisciplinary cardiovascular-metabolic-neurovascular diseases (PICMAN) is a pilot, prospective, multi-ethnic cohort study.
    MeSH term(s) Humans ; Male ; Female ; Cardiovascular Diseases ; Non-alcoholic Fatty Liver Disease ; Cohort Studies ; Prospective Studies ; Cardiovascular System ; Atherosclerosis ; Risk Factors
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-47407-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Cardiac diagnostic work-up of ischaemic stroke.

    Yang, Hayang / Nassif, Martina / Khairy, Paul / de Groot, Joris R / Roos, Yvo B W E M / de Winter, Robbert J / Mulder, Barbara J M / Bouma, Berto J

    European heart journal

    2018  Volume 39, Issue 20, Page(s) 1851–1860

    Abstract: Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and ... ...

    Abstract Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown aetiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and embolic strokes of undetermined source.
    MeSH term(s) Aortic Diseases/complications ; Atrial Fibrillation/complications ; Brain Ischemia/etiology ; Foramen Ovale, Patent/complications ; Heart Diseases/complications ; Heart Diseases/diagnosis ; Humans ; Intracranial Embolism/etiology ; Risk Factors ; Stroke/etiology
    Language English
    Publishing date 2018-05-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehy043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1563: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 640: Show issues

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  4. Article: Non-vitamin K antagonist oral anticoagulants in adults with a Fontan circulation: are they safe.

    Yang, Hayang / Veldtman, Gruschen R / Bouma, Berto J / Budts, Werner / Niwa, Koichiro / Meijboom, Folkert / Scognamiglio, Giancarlo / Egbe, Alexander Chima / Schwerzmann, Markus / Broberg, Craig / Morissens, Marielle / Buber, Jonathan / Tsai, Shane / Polyzois, Ioannis / Post, Martijn C / Greutmann, Matthias / Van Dijk, Arie / Mulder, Barbara Jm / Aboulhosn, Jamil

    Open heart

    2019  Volume 6, Issue 1, Page(s) e000985

    Abstract: Background: In Fontan patients with atrial arrhythmias (AA), non-vitamin K antagonist oral anticoagulants(NOACs) have a class III recommendation according to the Pediatric & Congenital Electrophysiology Society (PACES)/Heart Rhythm Society (HRS) ... ...

    Abstract Background: In Fontan patients with atrial arrhythmias (AA), non-vitamin K antagonist oral anticoagulants(NOACs) have a class III recommendation according to the Pediatric & Congenital Electrophysiology Society (PACES)/Heart Rhythm Society (HRS) guideline in 2014, due to lack of data on outcomes as opposed to evidence of harm. To address this gap in data, we investigated the safety and efficacy of NOACs in adults with a Fontan circulation in a worldwide study.
    Methods: This is an international multicentre prospective cohort study, using data from the NOTE (
    Results: From April 2014 onward, 74 patients (mean age 32±10 years (range 18-68), 54% male) with a Fontan circulation using NOACs were included. During a median follow-up of 1.2 (IQR 0.8-2.0) years, three thromboembolic events (2.9 per 100 patient-years (95% CI 0.7 to 7.6)) and three major bleedings (2.9 per 100 patient-years (95% CI 0.7 to 7.6)) occurred in five atriopulmonary Fontan and one total cavopulmonary connection Fontan patients with AA. Fifteen patients experienced minor bleeding episodes (15.8 per 100 patient-years (95% CI 9.1 to 25.2)). In patients (n=37) using vitamin K antagonists (VKAs) prior to the initiation of NOAC, annual incidence of historical thromboembolic events and major bleeding were 2.4% (95% CI 0.4% to 7.4%) (n = 2) and 1.2% (95% CI 0.7% to 5.1%) (n = 1), respectively.
    Conclusions: In this review of the largest Fontan cohort using NOACs with prospective follow-up, NOACs appear to be well tolerated and their efficacy and safety during short-term follow-up seem comparable to VKAs. Longer term data are required to confirm these promising short-term results.
    Language English
    Publishing date 2019-06-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2747269-3
    ISSN 2053-3624 ; 2044-6055
    ISSN 2053-3624 ; 2044-6055
    DOI 10.1136/openhrt-2018-000985
    Database MEDical Literature Analysis and Retrieval System OnLINE

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