Objective: Chronic Chagas Cardiomyopathy (CCC) carries a high risk of embolic events due to structural changes in the left ventricle and frequent conduction disorders. However, there is limited data on anticoagulant prescription patterns and factors influencing the use of direct oral anticoagulants (DOACs) in these patients. This study aims to characterize CCC patients based on the anticoagulant therapy received and identify factors associated with DOACs use.
Materials And Methods: A cross-sectional study was conducted at a tertiary-level hospital in Colombia between 2019-2022. Multivariate logistic regression models were used to assess factors associated with anticoagulant therapy and DOACs use.
Results: Among 224 CCC patients, 65.7% (n=153) were on anticoagulants, with DOACs being the most prescribed (53%). Notably, 35% of patients at high risk of stroke (CHA2DS2-VASc) were not receiving anticoagulants. Atrial fibrillation (OR 256.08; 95% CI 61.94-1058.72), ventricular aneurysms (OR 4.82; 95% CI 1.54-15.09), and reduced interventricular septal thickness (OR 0.75; 95% CI 0.60-0.92) were associated with anticoagulant use. DOACs were mainly prescribed for patients with atrial fibrillation (OR 13.29; 95% CI 2.47-71.56) and high bleeding risk (HAS-BLED ≥3, OR 11.36; 95% CI 1.15-112.11).
Conclusions: A significant proportion of CCC patients were not receiving anticoagulants despite their high risk of stroke and embolic events. The use of anticoagulation was significantly associated with atrial fibrillation, the presence of ventricular aneurysms and reduced interventricular septal thickness. It is crucial to raise awareness among healthcare professionals in endemic areas to improve treatment.
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http://dx.doi.org/10.47487/apcyccv.v5i4.433. | DOI Listing |
Circ Genom Precis Med
January 2025
Mary and Steve Wen Cardiovascular Division, Department of Medicine, University of California, Los Angeles. (W.F., N.D.W.).
Background: Lp(a; Lipoprotein[a]) is a predictor of atherosclerotic cardiovascular disease (ASCVD); however, there are few algorithms incorporating Lp(a), especially from real-world settings. We developed an electronic health record (EHR)-based risk prediction algorithm including Lp(a).
Methods: Utilizing a large EHR database, we categorized Lp(a) cut points at 25, 50, and 75 mg/dL and constructed 10-year ASCVD risk prediction models incorporating Lp(a), with external validation in a pooled cohort of 4 US prospective studies.
Arch Ital Urol Androl
January 2025
Urology Department, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang.
Introduction: Excision and primary anastomosis (EPA) urethroplasty is the standard treatment for traumatic urethral strictures, but managing them remains challenging for urologists. Identifying factors leading to EPA urethroplasty failure benefits both patients and surgeons. This study aims to analyze risk factors for urethral stricture recurrence after one-year follow-up of EPA urethroplasty.
View Article and Find Full Text PDFCirc Genom Precis Med
January 2025
Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston. (S.M.U., K.P., B.T., A.C.F., P.N.).
Background: Earlier identification of high coronary artery disease (CAD) risk individuals may enable more effective prevention strategies. However, existing 10-year risk frameworks are ineffective at earlier identification. We sought to understand how the variable importance of genomic and clinical factors across life stages may significantly improve lifelong CAD event prediction.
View Article and Find Full Text PDFAdolescence is characterized by heightened emotion dysregulation, impulsivity, and engagement in high-risk behaviors, such as substance use, violence, and unprotected sexual activity. Dialectical Behavioral Therapy for Adolescents (DBT-A) is an evidence-based intervention that targets emotion regulation and impulsivity among adolescents, proven effective at decreasing high-risk behaviors. However, limited research exists on adolescents' perceptions of DBT-A, particularly in schools.
View Article and Find Full Text PDFStroke
January 2025
Department of Neurology, University of Pennsylvania, PA. (L.I., S.E.Z., S.E.K., B.L.C.).
Background: A modified computed tomography angiography (CTA)-based Carotid Plaque Reporting and Data System (Plaque-RADS) classification was applied to a cohort of patients with embolic stroke of undetermined source to test whether high-risk Plaque-RADS subtypes are more prevalent on the ipsilateral side of stroke. With the widespread use of CTA for stroke evaluation, a CTA-based Plaque-RADS would be valuable for generalizability.
Methods: A retrospective observational cross-sectional study was conducted at a single integrated health system comprised of 3 hospitals with a comprehensive stroke center between October 1, 2015, and April 1, 2017.
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