The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Vicenc Serra - One of the best experts on this subject based on the ideXlab platform.
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impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Maria Del Trigo, Antonio J Munozgarcia, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Luis Nombelafranco, Enrique Gutierrez, Asim N Cheema, Vicenc SerraAbstract:Objective To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. Methods and results This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P Conclusions The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
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Impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Mar'ia Del Trigo, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Enrique Gutierrez, Asim N Cheema, Vicenc Serra, Antonio J. Muñoz-garc'ia, Luis Nombela-franco, Ignacio J. Amat-santosAbstract:OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81\textpm7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a >=10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29\textpm18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P\textless0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P\textless0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. CONCLUSIONS: The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
Harindra C Wijeysundera - One of the best experts on this subject based on the ideXlab platform.
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impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Maria Del Trigo, Antonio J Munozgarcia, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Luis Nombelafranco, Enrique Gutierrez, Asim N Cheema, Vicenc SerraAbstract:Objective To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. Methods and results This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P Conclusions The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
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Impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Mar'ia Del Trigo, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Enrique Gutierrez, Asim N Cheema, Vicenc Serra, Antonio J. Muñoz-garc'ia, Luis Nombela-franco, Ignacio J. Amat-santosAbstract:OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81\textpm7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a >=10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29\textpm18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P\textless0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P\textless0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. CONCLUSIONS: The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
Ignacio J. Amat-santos - One of the best experts on this subject based on the ideXlab platform.
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Impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Mar'ia Del Trigo, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Enrique Gutierrez, Asim N Cheema, Vicenc Serra, Antonio J. Muñoz-garc'ia, Luis Nombela-franco, Ignacio J. Amat-santosAbstract:OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81\textpm7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a >=10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29\textpm18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P\textless0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P\textless0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. CONCLUSIONS: The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
David H. Livingston - One of the best experts on this subject based on the ideXlab platform.
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Anticoagulation Therapy in patients with traumatic brain injury: An Eastern Association for the Surgery of Trauma multicenter prospective study.
Surgery, 2020Co-Authors: Kazuhide Matsushima, Stefan W. Leichtle, Jeffrey Wild, Katelyn Young, Grace Chang, Demetrios Demetriades, Cara Diaz Lomangino, Jennifer Massetti, Nina E. Glass, David H. LivingstonAbstract:Abstract Background Trauma care providers often face a dilemma regarding Anticoagulation Therapy initiation in patients with traumatic brain injury owing to the associated risks of traumatic brain injury progression. The aims of this study were the following: (1) to describe the current practice of Anticoagulation Therapy in traumatic brain injury patients and their outcomes and (2) to identify factors associated with the progression of traumatic brain injury after Anticoagulation Therapy. Methods In this multicenter prospective observational study, we included computed tomography–proven traumatic brain injury patients who received Anticoagulation Therapy within 30 days of hospital admission. Our primary outcome was the incidence of clinically significant progression of traumatic brain injury after Anticoagulation Therapy initiation. Results A total of 168 patients were enrolled more than 22 months. Atrial fibrillation and venous thromboembolism were the most common pre-injury and postinjury Anticoagulation Therapy indications, respectively. Overall, 16 patients (9.6%) experienced clinically significant traumatic brain injury progression after Anticoagulation Therapy, out of which 9 (5.4%) patients subsequently required neurosurgical interventions. Between patients with clinical progression of traumatic brain injury and patients who showed no such progression, there were no significant differences in the baseline demographics and severity of traumatic brain injury. However, Anticoagulation Therapy was initiated significantly earlier in patients of the deterioration group than those of the no-deterioration group (4.5 days vs 11 days, P = .015). In a multiple logistic regression model, patients who received Anticoagulation Therapy later after injury had significantly lower risk of clinically significant traumatic brain injury progression (odds ratio: 0.915 for each day, 95% confidence interval: 0.841–0.995, P = .037). Conclusion Our results suggest that early Anticoagulation Therapy is associated with higher risk of traumatic brain injury progression, thus a balance between bleeding and thromboembolic risks should be carefully evaluated in each case before initiating Anticoagulation Therapy.
Asim N Cheema - One of the best experts on this subject based on the ideXlab platform.
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impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Maria Del Trigo, Antonio J Munozgarcia, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Luis Nombelafranco, Enrique Gutierrez, Asim N Cheema, Vicenc SerraAbstract:Objective To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. Methods and results This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P Conclusions The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.
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Impact of Anticoagulation Therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement
Heart, 2018Co-Authors: Mar'ia Del Trigo, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Enrique Gutierrez, Asim N Cheema, Vicenc Serra, Antonio J. Muñoz-garc'ia, Luis Nombela-franco, Ignacio J. Amat-santosAbstract:OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of Anticoagulation Therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81\textpm7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation Therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a >=10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29\textpm18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P\textless0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P\textless0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. CONCLUSIONS: The lack of Anticoagulation Therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic Anticoagulation Therapy post-TAVR would reduce the incidence of VHD.