404 results match your criteria: "and Liverpool Heart and Chest Hospital[Affiliation]"

Implantable Cardioverter Defibrillator and Resynchronization Therapy in Patients With Overt Chronic Kidney Disease: JACC State-of-the-Art Review.

J Am Coll Cardiol

October 2024

University of Florida, College of Medicine, Gainesville, Florida, USA; Division of Nephrology, University of Florida, Gainesville, Florida, USA. Electronic address:

Heart failure and chronic kidney disease are common and clinically important conditions that regularly coexist. Electrophysiologic changes of advanced heart failure often result in abnormal conduction, causing dyssynchronous contraction, and development of ventricular arrhythmias, which can lead to sudden cardiac arrest. In the last 2 decades, implantable cardioverter-defibrillator and cardiac resynchronization therapy devices have been developed to address these complications.

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Introduction: Current research on potentially inappropriate prescribing (PIP) in polymedicated older adults with atrial fibrillation (AF) and multimorbidity is predominantly focused on PIP of oral anticoagulants (OAC). Our study aimed to assess (i) the overall prevalence of PIP in older multimorbid adults with AF, (ii) potential associated factors of PIP, and (iii) the association of PIP with adverse health outcomes in a nationwide sample of Swedish older adults.

Methods: Swedish national registries were linked to establish a cohort with a 2-year follow-up of older adults (≥65y) who, on 1 January 2017, had a diagnosis of AF and had at least one comorbidity (n = 203,042).

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Background: Blood pressure (BP) extremes and renal (dys)function contribute to poor outcomes in patients with atrial fibrillation (AF). Using data from the prospective AF-GEN-UK study, we investigated the effect of systolic BP and interaction with renal function for prognostication.

Methods: Baseline systolic BP (SBP) values were recorded for 1580 patients (mean [SD] age 71 [11] years, 60% male) and categorized as follows: 120-129 mmHg ( n  = 289, reference group) <110 mmHg ( n  = 165), 110-119 mmHg, ( n  = 254), 130-139 mmHg ( n  = 321), 140-159 mmHg ( n  = 385) and ≥160 mmHg ( n  = 166).

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Article Synopsis
  • Atrial fibrillation (AF) is a common heart condition causing irregular heartbeats, which increases risks for strokes and heart failure, and can negatively affect quality of life.
  • The study aims to evaluate the benefits and potential drawbacks of exercise-based cardiac rehabilitation (ExCR) compared to non-exercise methods for individuals with AF or those who have received treatment for it.
  • Researchers conducted a thorough search for randomized clinical trials assessing ExCR interventions, ensuring include participants over 18 with any subtype of AF, and analyzed data to determine the effectiveness and reliability of the evidence gathered.
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Free fatty acids and mortality among adults in the United States: a report from US National Health and Nutrition Examination Survey (NHANES).

Nutr Metab (Lond)

September 2024

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.

Background: The relationship between free fatty acids (FFAs) and the risk of mortality remains unclear. There is a scarcity of prospective studies examining the associations between specific FFAs, rather than total concentrations, of their effect on long-term health outcomes.

Objective: To evaluate the correlation between different FFAs and all-cause and cardiovascular mortality in a large, diverse, nationally representative sample of adults in the US, and examine how different FFAs may mediate this association.

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Background: Patients with atrial fibrillation (AF) often have concomitant long-term conditions that negatively impact their quality of life and the clinical management they receive. The AFFIRMO study aimed to identify the needs, quality performance indicators (QPIs), and outcomes relevant to patients, caregivers and healthcare professionals (HCPs) to improve the care of patients with AF.

Methods: An on-line survey to collect the key needs, QPIs, and outcomes relevant to patients with AF, their caregivers and HCPs, was distributed between May 2022 and January 2023 in five countries (UK, Italy, Denmark, Romania and Spain).

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Renal Outcomes of Rhythm Control in Patients Recently Diagnosed With Atrial Fibrillation.

JACC Clin Electrophysiol

November 2024

Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:

Article Synopsis
  • Atrial fibrillation (AF) is linked to kidney problems, and this study aimed to see if rhythm control (using medications or procedures to restore normal heart rhythm) is better for kidney function compared to rate control (slowing the heart rate).
  • Researchers analyzed data from 20,886 AF patients to compare rates of major kidney issues between those receiving rhythm control and those receiving rate control over several years.
  • Results showed that rhythm control significantly reduced the risk of kidney-related problems in patients with chronic kidney disease (CKD), while there was no difference in outcomes for patients without significant CKD.
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The use of hematopoietic cell transplantation (HCT) has expanded in the last 4 decades to include an older and more comorbid population. These patients face an increased risk of cardiovascular disease after HCT. The risk varies depending on several factors, including the type of transplant (autologous or allogeneic).

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Background: There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia).

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Atrial Fibrillation and Stable Coronary Artery Disease.

N Engl J Med

December 2024

From the Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital - all in Liverpool, United Kingdom.

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Asundexian versus Apixaban in Patients with Atrial Fibrillation.

N Engl J Med

January 2025

From Duke Clinical Research Institute, Duke University School of Medicine (J.P.P., M.R.P., R.D.L., W.S.J., J. Harrington, S.J.E., F.W.R., J.H.A.), and Duke University Medical Center (J.P.P., M.R.P., R.D.L., W.S.J., J. Harrington, F.W.R., J.H.A.) - both in Durham, NC; Hirslanden Clinic Zurich, Zurich, Switzerland (J.S.); the School of Medicine, Tulane University, New Orleans (K.F.); the University Medical Center, University of Groningen, Groningen (I.C.V.G., M.R.), Radboud University Medical Center, Nijmegen (M.H.), Rijnstate Hospital, Arnhem (M.H.), and the Dutch Network for Cardiovascular Research, Utrecht (M.H.) - all in the Netherlands; Cooper Medical School of Rowan University, Camden (A.M.R.), and Bayer U.S., Whippany (R.C.) - both in New Jersey; the Cardiology Center of Beijing, Anzhen Hospital No. 2, Beijing (C.-S.M.); the Canadian VIGOUR Centre, University of Alberta, Edmonton, and St. Michael's Hospital, Unity Health Toronto, and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto - all in Canada (S.G.G.); the Uppsala Clinical Research Center and the Department of Medical Sciences, Uppsala University, Uppsala, Sweden (J.O.); the Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (C.H.); the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (M.A.); the School of Cardiology, University of Pisa, and the Cardiology Division, Pisa University Hospital, Pisa (R.D.C.), and Santa Maria della Misericordia Hospital, University of Perugia, Perugia (V.C.) - all in Italy; the Department of Cardiology, University Heart and Vascular Center Hamburg, and the German Center for Cardiovascular Research, Hamburg (P.K.), and Bayer, Wuppertal (C.N., T.V., H.M.) - all in Germany; the Institute of Cardiovascular Sciences, University of Birmingham, Birmingham (P.K.), the Faculty of Medicine, National Heart and Lung Institute, Imperial College, London (D.A.G.), the Centre for Health Services and Clinical Research, Faculty of Life and Medical Sciences, University of Hertfordshire, Hatfield (D.A.G.), and the Liverpool Centre for Cardiovascular Science at University of Liverpool and John Moores University and Liverpool Heart and Chest Hospital, Liverpool (G.Y.H.L.) - all in the United Kingdom; the Department of Clinical Medicine, Danish Center for Health Services Research, Aalborg University, Aalborg, Denmark (G.Y.H.L.); and Bayer, São Paulo (J. Hung).

Background: Stroke prevention with direct-acting oral anticoagulant agents in patients with atrial fibrillation confers a risk of bleeding and limits their use. Asundexian, an activated factor XI (XIa) inhibitor, is an oral anticoagulant that may prevent strokes with less bleeding.

Methods: In a phase 3, international, double-blind trial, we randomly assigned high-risk patients with atrial fibrillation in a 1:1 ratio to receive asundexian at a dose of 50 mg once daily or standard-dose apixaban.

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Background And Aims: INTERASPIRE is an international study of coronary heart disease (CHD) patients, designed to measure if guideline standards for secondary prevention and cardiac rehabilitation are being achieved in a timely manner.

Methods: Between 2020 and 2023, adults hospitalized in the preceding 6-24 months with incident or recurrent CHD were sampled in 14 countries from all 6 World Health Organization regions and invited for a standardized interview and examination. Direct age and sex standardization was used for country-level prevalence estimation.

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Clinical phenotypes and outcomes of patients with left ventricular thrombus: an unsupervised cluster analysis.

Hellenic J Cardiol

August 2024

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore. Electronic address:

Article Synopsis
  • Researchers studied 472 patients with left ventricular thrombus (LVT) to identify unique clinical profiles using cluster analysis.
  • They found two distinct groups: one made up of younger patients with fewer risk factors linked primarily to recent heart attacks, and another older group with more comorbidities related to ischemic cardiomyopathy.
  • The study revealed that the second group had a lower chance of LVT resolution and a higher risk of mortality, highlighting the importance of tailored treatment approaches for different patient profiles.
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Metabolic syndrome and psoriatic arthritis: the role of weight loss as a disease-modifying therapy.

Ther Adv Musculoskelet Dis

August 2024

Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, The University of Manchester, Manchester, UK.

Psoriatic arthritis (PsA) is an inflammatory joint and entheseal disease associated with significant personal and public health burden. PsA has a prevalence of up to 1%, affecting ~20% of people suffering with psoriasis. PsA is frequently accompanied by metabolic syndrome (MetS), and both conditions are characterised by a chronic pro-inflammatory state, with several key cytokines in PsA (interleukin (IL)-17 and IL-23) also elevated in those with MetS.

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Background: There is ongoing debate around rate versus rhythm control strategies for managing atrial fibrillation (AF), however, much of the data comes from Western cohorts. Kerala-AF represents the largest prospective AF cohort study from the Indian subcontinent.

Objectives: To compare 12-month outcomes between rate and rhythm control strategies.

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Anticoagulation Adherence: Bridging the Gap between Acute Stroke Treatment and Long-Term Secondary Prevention.

Cerebrovasc Dis Extra

August 2024

Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool, UK.

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Article Synopsis
  • Cardiac autonomic neuropathy (CAN) is a serious complication in diabetes that can lead to cardiovascular events, but it's not commonly diagnosed due to time constraints.
  • A study explored using AI and deep learning to analyze retinal images from diabetic patients for diagnosing CAN, successfully applying techniques like ResNet 18 and Multiple Instance Learning.
  • The results showed high accuracy, with the AI model identifying 93% of CAN cases and 89% of non-CAN cases, particularly excelling in distinguishing severe CAN stages, indicating a promising diagnostic tool for clinical practice.
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Background: The impact of chronic oral anticoagulant (OACs) use on long-term post-discharge outcomes after coronavirus disease 2019 (COVID-19) hospitalisation remains unclear. Herein, we compared clinical outcomes up to 2-years after COVID-19 hospitalisation between patients on vitamin K antagonists (VKAs), direct-acting OACs (DOACs) and no OAC therapy.

Methods: Data from TriNetX, a global federated health research network, were used.

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Delaying Oral Anticoagulants: A False Economy?

Pharmacoeconomics

November 2024

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK.

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Navigating the bleeding risk dilemma in patients with atrial fibrillation on therapy with direct-acting oral anticoagulants: Comparing the HAS-BLED vs. DOAC Score.

Eur J Intern Med

October 2024

Faculty of Nursing, University of Murcia, Murcia, Spain; Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain; Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. Electronic address:

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