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Patients with a history of myocardial infarction and coronary artery disease (CAD) have a higher risk of developing AF. Conversely, patients with atrial fibrillation (AF) have a higher risk of developing myocardial infarction, suggesting a link in underlying pathophysiology. The aim of this study was to assess whether coronary angiographic parameters are associated with a substrate for AF in patients without a history of AF.
During cardiac surgery in 62 patients (coronary artery bypass grafting (CABG;n=47), aortic valve replacement (AVR;n=9) or CABG+AVR (n=6)) without a history of clinical AF (age 65.4±8.5years, 26.2% female), AF was induced by burst pacing. The preoperative coronary angiogram (CAG) was assessed for the severity of CAD, and the adequacy of atrial coronary blood supply as quantified by a novel scoring system including the location and severity of right coronary artery disease in relation to the right atrial branches. Epicardial mapping of the right atrium (256 unipolar electrodes) was used to assess the complexity of induced AF.
There was no association between the adequacy of right atrial coronary blood supply on preoperative CAG and AF complexity parameters. Multivariable analysis revealed that only increasing age (B0.232 (0.030;0.433),p=0.03) and the presence of 3VD (B3.602 (0.187;7.018),p=0.04) were independently associated with an increased maximal activation time difference.
The adequacy of epicardial right atrial blood supply is not associated with increased complexity of induced atrial fibrillation in patients without a history of clinical AF, while age and the extent of ventricular coronary artery disease are.
The adequacy of epicardial right atrial blood supply is not associated with increased complexity of induced atrial fibrillation in patients without a history of clinical AF, while age and the extent of ventricular coronary artery disease are.
Evidence is sparse on the association between alcohol intakes in the lower range and risk of atrial fibrillation (AF). We aimed to investigate self-reported low and moderate alcohol intakes and subsequent risk of incident AF among current drinkers.
Norwegian population-based health examination surveys assessing self-reported daily alcohol intake (mean grams per day) were linked to health and population registers. Hazard ratios (HR) (95% confidence interval) for time to incident (first) hospitalization with AF by alcohol intake level were assessed by Cox regression, with adjustment for educational level and cardiovascular risk factors except blood pressure.
The study population included 234,392 participants (49% men). Incident hospitalization with AF was identified in 5043 (2.2%) persons during a mean follow-up of 9years. Compared to a very low alcohol intake of <1 unit weekly, a moderate consumption in the range of 1 to <2 units daily increased the risk of incident AF by 18% (HR 1.18 [1.06-1.32]). The average risk of incident AF increased by 9% per daily alcohol unit of 12g (HR 1.09 [1.03, 1.14]). In sex-stratified analyses significant associations were found in men only.
We found that less than two alcohol units/day significantly increased the risk of incident AF, however, in men only. this website Reduction of even a moderate alcohol intake may thus reduce the risk of AF at the population level.
We found that less than two alcohol units/day significantly increased the risk of incident AF, however, in men only. Reduction of even a moderate alcohol intake may thus reduce the risk of AF at the population level.Atrial fibrillation (AF) is the most common sustained heart arrhythmia and significantly increases risk of stroke. Opportunistic AF testing in high-risk patients typically requires frequent electrocardiogram tests to capture the arrhythmia. Risk-prediction algorithms may help to more accurately identify people with undiagnosed AF and machine learning (ML) may aid in the diagnosis of AF. Here, we applied an AF-risk prediction algorithm to secondary care data linked to primary care data in the DISCOVER database in order to evaluate changes in model performance, and identify patients not previously detected in primary care. We identified an additional 5,444 patients who had an AF diagnosis only in secondary care during the data extraction period. 2,696 (49.5%) were accepted by the algorithm and the algorithm correctly assigned 2,637 (97.8%) patients to the AF cohort. Using a risk threshold of 7.4% in patients aged ≥ 30 years, algorithm sensitivity and specificity was 38% and 95%, respectively. Approximately 15% of AF patients assigned to the AF cohort by the algorithm had a secondary care diagnosis with no record of AF in primary care. These additional patients did not substantially alter algorithm performance. The additional detection of previously undiagnosed AF patients in secondary care highlights unexpected potential utility of this ML algorithm.[This corrects the article DOI 10.1002/trc2.12089.].
Despite the increase in Alzheimer's disease (AD) cases in the United States, no new treatments have been approved in the United States since 2003. The costs associated with drug development programs are high and serve as a significant deterrent to AD therapeutic investigations. In this study, we analyze the sponsorship data for AD clinical trials conducted since 2016 to assess the fiscal support for AD clinical trials.
We analyzed the funding sources of all AD trials over the past 5 years as reported on ClinicalTrials.gov.
There were 136 trials being conducted for treatments in the US AD therapeutic pipeline on the index date of this study. Among non-prevention trials, disease-modifying therapies (DMT) in Phase 3 were almost entirely sponsored by the biopharmaceutical industry; Phase 2 DMT trials were split between the biopharmaceutical industry and funding from the National Institutes of Health (NIH) to academic medical centers (AMCs). The majority of prevention trials received sponsorship from public-private partnerships (PPP). Trials of symptomatic agents are equally likely to have biopharmaceutical or NIH/AMC sponsorship. Most trials with repurposed agents had NIH/AMC funding (89%). Since 2016, there has been consistent growth in the number of trials sponsored both in part and fully by NIH/AMC sources and in PPP, and there has been a reduction in biopharmaceutical company-sponsored trials.
The number of trials supported by the biopharmaceutical industry has decreased over the past 5 years; trials supported from federal sources and PPP have increased. Repurposed compounds are mostly in Phase 2 trials and provide critical mechanistic information.
The number of trials supported by the biopharmaceutical industry has decreased over the past 5 years; trials supported from federal sources and PPP have increased. Repurposed compounds are mostly in Phase 2 trials and provide critical mechanistic information.
Homepage: https://www.selleckchem.com/products/bromelain.html
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