American journal of cardiovascular disease最新文献

{"title":"Acute coronary syndrome in a hospital in southern Brazil: peak of hospitalizations on Mondays and severe cases on weekends and at night.","authors":"Bruno Felix Fernandes,&nbsp;Kelser de Souza Kock","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic heart disease is the leading cause of death in Brazil and worldwide. The term acute coronary syndrome (ACS) generically represents the acute myocardial ischemic events. These events are clinically divided into three types: acute myocardial infarction (AMI) with ST-segment elevation, AMI without ST-segment elevation, and unstable angina. Although cardiovascular ischemic events occur acutely, studies describe cyclic patterns of ACS, mainly on circadian and weekly variation.</p><p><strong>Objective: </strong>The aim of this study was to analyze the circadian and weekly variation of hospitalizations for ACS in a hospital in southern Brazil in 2019.</p><p><strong>Methods: </strong>Observational, cross-sectional type study. The population was the patients hospitalized at the Nossa Senhora da Conceição Hospital (NSCH) in Tubarão (SC, Brazil) with the international classification of diseases (ICD) code referring to ACS in the year 2019, corresponding to 579 patients.</p><p><strong>Results: </strong>After applying the exclusion criteria, 512 patients hospitalized for ACS were analyzed, 55.1% were male with a median (p25-p75) age of 62.0 (56.0-69.0) years. The main ICDs of hospitalization were: I20.0 (76.2%), I21.9 (16.6%), I21.3 (3.1%) and the most prevalent comorbidities were high blood pressure (82.6%), diabetes (30.1%) and previous AMI (23.6%). The median (p25-p75) time of admission was 14 h (10-18) h and length of stay was 5 (3-9) days. Death occurred in 18 hospitalizations (3.5%) of cases.</p><p><strong>Conclusion: </strong>We conclude that in the present study there was a peak of hospitalizations for ACS on Mondays, proportionally reducing throughout the week and with a significant decrease on the weekend.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 6","pages":"307-314"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890198/pdf/ajcd0012-0307.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10663236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes following ostial left anterior descending artery intervention with or without crossover to left-main.","authors":"Osama Elkhateeb,&nbsp;Sunil Thambi,&nbsp;Hussein Beydoun,&nbsp;Helen Bishop,&nbsp;Ata Quraishi,&nbsp;Bakhtiar Kidwai,&nbsp;Lawrence Title","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ostial left anterior descending (LAD) artery lesions are a critical area for coronary stenting, given that the location subtends a large area of the myocardium and can also be more technically challenging. It remains controversial whether crossover stenting of ostial LAD back into the left-main (LM) is advantageous over stenting the ostium alone.</p><p><strong>Methods: </strong>To evaluate the long-term clinical outcomes of stenting ostial LAD lesions, we retrospectively reviewed all ostial LAD lesions cases at QEII Health Science Centre between 2008 and 2018. Specifically, we compared the outcomes in those patients that had left main stent crossover vs. ostial stenting (OS) alone.</p><p><strong>Results: </strong>The total number of patients included in the study was 175, with 25 patients (14%) having a crossover to the LM and 150 (86%) having OS. There were more patients with previous CABG (24%) in the crossover group compared to the OS group (9.2%) (P = 0.042). The one-year MACE was not significantly different between CO vs. OS (13.3% (10.5-16.1) vs. 12% (5.5-18.5)). The five-year MACE was numerically higher, although statistically not significant, in CO vs. OS (19.3 (15.9-22.7) vs. 25.9 (16.6-35.2)).</p><p><strong>Conclusion: </strong>This study shows that percutaneous intervention provides reasonable long-term outcomes and low rates of repeat revascularization for isolated ostial LAD lesions, with no noticeable difference in outcomes with crossover stenting into the LM vs. OS alone. A larger, prospective study may be required to determine the optimal strategy for treating ostial LAD lesions.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 2","pages":"73-80"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123417/pdf/ajcd0012-0073.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10254392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of physical symptoms in healthy adolescence found to be associated with female gender, obesity, tachycardia, diastolic hypertension and smoking.","authors":"Lucy Hickcox,&nbsp;Sharon Bates,&nbsp;Mohammad Reza Movahed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The goal of this study was to evaluate any association between physical symptoms and abnormal clinical history in adolescence undergoing screening echocardiography performed by Anthony Bates Foundation.</p><p><strong>Method: </strong>The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001. We performed uni- and multivariate analysis to evaluate any association between physical symptoms with gender, smoking, obesity, heart rate, and hypertension.</p><p><strong>Results: </strong>We found a strong association between symptoms and the female gender (33% vs. 17.5% of males, P < 0.001). Furthermore, obesity (46.5% vs. 22.5%, P < 0.001), smoking (46.2% vs. 22.5%, P = 0.04), heart rate > 90 (34.8 vs. 22.8%, P = 0.001), and diastolic blood pressure > 90 (34.9% vs. 23.4%, P = 0.03) were all associated with symptoms. Increased systolic pressure was not associated with physical symptoms (24.3% vs. 21.9%, P = 0.4). Using multivariate analysis, female gender, diastolic blood pressure and obesity remained independently associated with physical symptoms. (Female gender: OR: 2.2, CI: 1.7-2.9, P < 0.001, obesity: OR: 2.5, CI 1.2-5.05, P = 0.009, and high diastolic blood pressure: OR: 2.08, CI 1.1-3.7, P = 0.01).</p><p><strong>Conclusion: </strong>Physical symptoms are associated with smoking, female gender, obesity, tachycardia, and high diastolic blood pressure but not systolic pressure in adolescence undergoing routine screening echocardiography.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 6","pages":"315-319"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890197/pdf/ajcd0012-0315.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10653608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma proteomic analysis of association between atrial fibrillation, coronary microvascular disease and heart failure.","authors":"Gunjan Dixit,&nbsp;John Blair,&nbsp;Cevher Ozcan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The clinical association between atrial fibrillation (AF), coronary microvascular disease (CMD) and heart failure with preserved ejection fraction (HFpEF) is highly prevalent, however the mechanism behind this association is not known. We hypothesized that plasma proteomic analysis can identify novel biomarkers and the mechanistic pathways in concomitant AF, CMD and HFpEF. To discover circulating biomarkers for the association between AF, CMD and HFpEF, an unbiased label-free quantitative proteomics approach was used in plasma derived from patients who underwent coronary physiology studies (n=18). Circulating proteins were analyzed by liquid chromatography-mass spectrometry and screened to determine candidate biomarkers of the concomitant AF, CMD and HFpEF. We identified 130 dysregulated proteins across the groups with the independent patient replicates. Among those, 35 proteins were candidate biomarkers of the association between AF, CMD and HFpEF. We found significantly elevated SAA1, LRG1 and APOC3 proteins in the coexistence of AF, CMD and HFpEF, whereas LCP1, PON1 and C1S were markedly downregulated in their associations. AF was associated with reduced LCP1, KLKB1 and C4A in these patients. Combined downregulation of PON1 and C1S was a marker of concurrent HFpEF and CMD. PON1 was associated with HFpEF while C1S was a marker of CMD. These proteins are related to inflammation, extra cellular remodeling, oxidative stress, and coagulation. In conclusion, plasma proteomic profile provides biomarkers and mechanistic insight into the association of AF, CMD and HFpEF. SAA1, LRG1, APOC3, LCP1, PON1 and C1S are candidate markers for the risk stratification of their associations and potential underlying mechanistic pathways.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 2","pages":"81-91"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123414/pdf/ajcd0012-0081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of the ceRNA network in the progression of acute myocardial infarction.","authors":"Hui Liu,&nbsp;Shuai Qin,&nbsp;Yuanyuan Zhao,&nbsp;Lei Gao,&nbsp;Chao Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) is a common disease that induced by sudden occlusion of a coronary artery and myocardial necrosis, which causes a great medical burden worldwide. Noncoding RNAs, such as circRNA, lncRNA and miRNA, play crucial roles in the progression of cardiovascular diseases. However, the circRNA-miRNA-mRNA network in the occurrence and development of AMI needs further investigation. In this study, we downloaded three AMI datasets, including circRNA (GSE160717), miRNA (GSE24591), and mRNA (GSE66360) from GEO database. The differentially expressed candidates, and GO and KEGG functions were analyzed by RStudio, and subsequently import to PPI and Cytoscape to obtain the hub genes. By using the starbase target prediction database, we further screen the ceRNA network of circRNA-miRNA-mRNA based on the selected differentially expressed candidates. We found 46 differential expressed mRNAs, 65 miRNAs, and five circRNAs. GO functions and KEGG enrichment of the 46 mRNAs focused on immune response and functions, involving IL-17 signaling pathway, Toll-like receptor signaling pathway, cytokine-cytokine receptor interaction, TNF signaling pathway, chemokine signaling pathway, and NF-kappaB signaling pathway, which may aggravate the pathologies of AMI. PPI and Cytoscape analysis showed 10 hub genes, including TLR2, IL1B, CCL4, CCL3, CCR5, TREM1, CXCL2, NLRP3, CSF3, and CCL20. By using starbase and circinteractome databases, ceRNA network construction showed that circRNA_023461 and circRNA_400027 regulate several miRNA-mRNA axes in AMI. In summary, this study uncovered the circRNA-miRNA-mRNA network based on three AMI datasets. The differentially expressed genes, including CCL20, CCL4, CSF3, and IL1B, focus on immune functions and pathways. Furthermore, circRNA_023461 and circRNA_400027 regulate several miRNA-mRNA axes, exerting important roles in AMI progression. Our founding provides new insights into AMI and improve the therapeutic strategies for AMI.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 6","pages":"283-297"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890199/pdf/ajcd0012-0283.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10653610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of four established risk scores for prediction of in-hospital mortality in patients undergoing primary percutaneous coronary intervention.","authors":"Rajesh Kumar,&nbsp;Iftikhar Ahmed,&nbsp;Lajpat Rai,&nbsp;Sanam Khowaja,&nbsp;Muhammad Hashim,&nbsp;Zille Huma,&nbsp;Jawaid Akbar Sial,&nbsp;Tahir Saghir,&nbsp;Nadeem Qamar,&nbsp;Musa Karim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to compare the predictive power of Shock Index (SI), TIMI Risk Index (TRI), LASH Score, and ACEF Score for the prediction of in-hospital mortality in a contemporary cohort of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) at a tertiary care cardiac center of a developing country.</p><p><strong>Methods: </strong>Consecutive patients diagnosed with STEMI and undergoing primary PCI were included in this study. SI, TRI, LASH, and ACEF were computed and their predictive power was assessed as the area under the curve (AUC) on the receiver operating characteristics (ROC) curve analysis for in-hospital mortality.</p><p><strong>Results: </strong>We included 977 patients, 780 (79.8%) of which were male, and the mean age was 55.6 ± 11.5 years. The in-hospital mortality rate was 4.3% (42). AUC for TRI was 0.669 (optimal cutoff: ≥17.5, sensitivity: 76.2%, specificity: 45.6%). AUC for SI was 0.595 (optimal cutoff: ≥0.9, sensitivity: 21.4%, specificity: 89.8%). AUC for LASH score was 0.745 (optimal cutoff: ≥0, sensitivity: 76.2%, specificity: 66.9%). AUC for the ACEF score was 0.786 (optimal cutoff: ≥1.66, sensitivity: 71.4%, specificity: 73.5%).</p><p><strong>Conclusion: </strong>In conclusion, ACEF showed sufficiently high predictive power with good sensitivity and specificity compared to other three scores. These simplified indices based on readily available hemodynamic parameters can be reliable alternatives to the computational complex scoring systems for the risk stratification of STEMI patients.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"12 6","pages":"298-306"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890196/pdf/ajcd0012-0298.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10653612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the CREST score for predicting circulatory-aetiology death in out-of-hospital cardiac arrest without STEMI.","authors":"Timothy N Jones,&nbsp;Matthew Kelham,&nbsp;Krishnaraj S Rathod,&nbsp;Charles J Knight,&nbsp;Alastair Proudfoot,&nbsp;Ajay K Jain,&nbsp;Andrew Wragg,&nbsp;Muhiddin Ozkor,&nbsp;Paul Rees,&nbsp;Oliver Guttmann,&nbsp;Andreas Baumbach,&nbsp;Anthony Mathur,&nbsp;Daniel A Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>The CREST tool was recently developed to stratify the risk of circulatory-aetiology death (CED) in out-of-hospital cardiac arrest (OHCA) patients without ST-elevation myocardial infarction (STEMI). We aimed to validate the CREST score using an external cohort and determine whether it could be improved by the addition of serum lactate on admission.</p><p><strong>Methods: </strong>The study involved the retrospective analysis of consecutive patients admitted to a single tertiary centre with OHCA of presumed cardiac origin over a 51-month period. The CREST score was calculated by attributing points to the following variables: Coronary artery disease (CAD), non-shockable Rhythm, Ejection fraction <30%, cardiogenic Shock at presentation and ischaemic Time ≥25 minutes. The primary endpoint was CED vs neurological aetiology death (NED) or survival.</p><p><strong>Results: </strong>Of 500 patients admitted with OHCA, 211 did not meet criteria for STEMI and were included. 115 patients died in hospital (71 NED, 44 CED). When analysed individually, CED was associated with all CREST variables other than a previous diagnosis of CAD. The CREST score accurately predicted CED with excellent discrimination (C-statistic 0.880, 95% CI 0.813-0.946) and calibration (Hosmer and Lemeshow P=0.948). Although an admission lactate ≥7 mmol/L also predicted CED, its addition to the CREST score (the C-AREST score) did not significantly improve the predictive ability (CS 0.885, 0.815-0.954, HS P=0.942, X² difference in -2 log likelihood =0.326, P=0.850).</p><p><strong>Conclusion: </strong>Our study is the first to independently validate the CREST score for predicting CED in patients presenting with OHCA without STEMI. Addition of lactate on admission did not improve its predictive ability.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":" ","pages":"723-733"},"PeriodicalIF":1.3,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784677/pdf/ajcd0011-0723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left bundle branch pacing in hypertrophic cardiomyopathy-a novel approach.","authors":"Soumya Patra,&nbsp;Ashesh Halder,&nbsp;Rabin Chakraborty,&nbsp;Arindam Pande,&nbsp;Dilip Kumar,&nbsp;Somnath Dey,&nbsp;Sanjeev S Mukherjee,&nbsp;Rana Rathor Roy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Symptomatic bradycardia attributed by sick sinus syndrome in hypertrophic cardiomyopathy (HCM) is not commonly seen. Dual chamber pacing with right ventricular apical lead placement is conventional strategy in such scenario. Now physiological pacing which includes left bundle branch (LBB) pacing emerging as new technology for pacemaker implantation. Use of this technique is difficult in HCM due to septal hypertrophy. There is no such case reported so far in the literature where LBB pacing was performed in adult HCM for sick sinus syndrome. Here we present a novel approach of treating irreversible, symptomatic sinus node dysfunction in non-obstructive HCM with implementation of left bundle pacing strategy. Pacing parameters remain stable after 3 months of follow-up.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":" ","pages":"710-713"},"PeriodicalIF":1.3,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784675/pdf/ajcd0011-0710.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Diastolic function in patients with heart failure with preserved ejection fraction and atrial fibrillation: impact of diabetes.","authors":"Ruxandra-Nicoleta Horodinschi,&nbsp;Camelia Cristina Diaconu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>[This corrects the article on p. 564 in vol. 11, PMID: 34849288.].</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":" ","pages":"743-744"},"PeriodicalIF":1.3,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784672/pdf/ajcd0011-0743.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The WATCHMAN device and post-implantation anticoagulation management. A review of key studies and the risk of device-related thrombosis.","authors":"Mohamed Magdi,&nbsp;Sarath Lal Mannumbeth Renjithal,&nbsp;Mahmood Mubasher,&nbsp;Mostafa Reda Mostafa,&nbsp;Yashdeep Lathwal,&nbsp;Pradeeksha Mukuntharaj,&nbsp;Sarah Mohamed,&nbsp;Richard Alweis,&nbsp;Bryan E-Xin Tan,&nbsp;Bipul Baibhav","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke is a devastating complication of atrial fibrillation (Afib). Anticoagulation is the gold standard to prevent stroke and systemic embolization. However, many patients have a contraindication to oral anticoagulation. The WATCHMAN device, which closes the left atrial appendage, is non-inferior to warfarin to prevent embolic events in clinical trials. Post-procedural anticoagulation is needed to avoid device-related thrombosis. The use of anticoagulants after WATCHMAN implantation in patients with high bleeding risks has been a source of debate.</p><p><strong>Objective: </strong>This article summarizes the current evidence on anticoagulation following the implantation of the WATCHMAN device, focusing on patients who have an absolute contraindication to oral anticoagulation.</p><p><strong>Observation: </strong>The WATCHMAN device is efficacious and safe in preventing stroke and systemic embolization. Warfarin and aspirin are given for 45 days after implantation. If TEE at 45 days shows minimal residual peri-device flow (≤ 5mm) and no device-related thrombus, warfarin is stopped. This is followed by aspirin and clopidogrel for six months, then aspirin indefinitely. Antithrombotic therapy with aspirin and clopidogrel for six months followed by daily aspirin indefinitely may be feasible for patients with an absolute contraindication to OAC. DOACs are more convenient to use than warfarin, and limited evidence suggests that they are not inferior following implantation of the device.</p><p><strong>Conclusion: </strong>Following the WATCHMAN implantation, the most often utilized regimen is warfarin followed by antiplatelet treatment. In cases where there is a high risk of bleeding, antiplatelets alone may be sufficient. More research is needed to tailor the existing antithrombotic regimen to the needs of patients.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":" ","pages":"714-722"},"PeriodicalIF":1.3,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784674/pdf/ajcd0011-0714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}