Prevalence and Prevention of Thromboembolic Events Flashcards
What is Noncompaction Cardiomyopathy (NCCM)?
A rare cardiomyopathy with unknown origin, frequently associated with specific genetic abnormalities
Which part of the heart is primarily affected by NCCM?
Left ventricle (LV)
What is the hypothesized cause of NCCM?
Arrest of the normal compaction process of the myocardium during fetal development
What are the key characteristics of NCCM?
Prominent myocardial trabeculations and deep intertrabecular recesses in the LV cavity
What are typical complications associated with NCCM?
- Heart failure
- Arrhythmias
- Thromboembolic events
What is the gold-standard imaging technology for diagnosing NCCM?
Echocardiography
Who developed some of the most known echocardiographic criteria for NCCM diagnosis?
- Chin
- Jenni
- Stöllberger
- Belanger
What did Diwadkar et al. find regarding echocardiography and NCCM diagnosis?
Echocardiography fails to detect NCCM morphology/hypertrabeculation in a significant number of patients
What is the estimated prevalence of NCCM based on recent studies?
0.24% in a cohort from echocardiograms performed
What percentage of patients with dilated cardiomyopathy showed NCCM with EF <50%?
6.8%
What is the prevalence of NCCM in an otherwise healthy population with normal ejection fraction?
0.05%
What is a significant risk factor for thromboembolic events in NCCM?
Reduced systolic function
What percentage of NCCM patients experience stroke and embolism?
At least 15%
What is the recommendation for anticoagulant therapy in NCCM patients with atrial fibrillation?
Anticoagulants such as VKA and NOAC should be considered
Fill in the blank: Oral anticoagulant therapy (OAC) prevents the majority of ischaemic strokes in patients with _______.
atrial fibrillation
What are the recommended anticoagulant options for patients with atrial fibrillation?
- Vitamin K antagonists (VKA)
- Non-vitamin K type oral anticoagulants (NOACs)
What should be considered when prescribing anticoagulants based on CHA2DS2-VASc scores?
Men with score ≥2 and women with score ≥3 should benefit from OAC
What is the recommendation for anticoagulation in NCCM patients with systolic dysfunction and sinus rhythm?
No significant overall difference demonstrated between VKA and high dose acetylsalicylic acid
What did a case study of a 50-year-old female patient with NCCM reveal about her heart function?
Reduced LV systolic function with ejection fraction of approximately 30–35%
What is the overall thromboembolic annualized event rate in NCCM patients compared to heart failure patients?
Not different
What is the clinical significance of deep intertrabecular recesses in NCCM?
They are theorized to lead to thrombus formation and increased risk of thromboembolic events
What should be empirically prescribed for NCCM patients with significant LV dysfunction?
Oral anticoagulation therapy
True or False: There is strong evidence for anticoagulant therapy in NCCM patients without a history of thromboembolism.
False
What is the need for further research regarding NCCM?
Evidence-based guidelines for preventing thromboembolic events are highly needed
