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acute ischemic stroke in AF

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https://www.readbyqxmd.com/read/28716216/1-4-times-increase-in-atrial-fibrillation-related-ischemic-stroke-and-tia-over-12years-in-a-stroke-center
#1
Qiong Yang, Leonid Churilov, Dongsheng Fan, Stephen Davis, Bernard Yan
BACKGROUND AND PURPOSE: Prevalence of atrial fibrillation (AF) has quadrupled in the past 50years in the general population. However, there is uncertainty regarding prevalence of AF over time in ischemic stroke patients given the aging population and enhanced surveillance of AF. We aimed to explore the changing prevalence of AF as well as other risk factors, stroke subtypes, investigations and pre-stroke medications among ischemic stroke and transient ischemic attack (TIA) patients. METHODS: We performed a retrospective analysis of data from a prospective database of consecutive patients with acute ischemic stroke and TIA from 2004 to 2015...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28673811/fluid-attenuated-inversion-recovery-vascular-hyperintensities-in-patients-with-transient-ischemic-attack
#2
Marcelo Marinho de Figueiredo, Edson Amaro Júnior, Maramélia Araújo de Miranda Alves, Marcela Vazzoler, Renata Carolina Acre Nunes Miranda, Gisele Sampaio Silva
BACKGROUND: Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs) are common in patients with acute ischemic stroke, possibly representing impaired hemodynamics in the ischemic territory due to intracranial steno-occlusive disease. There are few reports on FVHs in patients with transient ischemic attack (TIA). AIMS: We investigated the prevalence of FVHs and its clinical correlations in patients with TIA. METHODS: We evaluated consecutive patients admitted with TIA from February 2009 to June 2012 who had undergone magnetic resonance imaging within 30 hours of symptoms onset and intracranial and extracranial vascular imaging...
June 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28664480/usefulness-of-left-ventricular-speckle-tracking-echocardiography-and-novel-measures-of-left-atrial-structure-and-function-in-diagnosing-paroxysmal-atrial-fibrillation-in-ischemic-stroke-and-transient-ischemic-attack-patients
#3
Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Jan Skov Jensen, Tor Biering-Sørensen
Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination...
June 29, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28649948/endovascular-thrombectomy-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation-a-mr-clean-subgroup-analysis
#4
Alis Heshmatollah, Puck S S Fransen, Olvert A Berkhemer, Debbie Beumer, Aad van der Lugt, Charles B L M Majoie, Robert J Oostenbrugge, Wim H van Zwam, Peter J Koudstaal, Yvo B W E M Roos, Diederik W J Dippel
AIMS: Endovascular thrombectomy (EVT) improves outcome after acute ischemic stroke (AIS) caused by an intracranial occlusion. The aim of the present study is to determine if atrial fibrillation (AF) modifies the effect of EVT. METHODS AND RESULTS: MRCLEAN was a randomized clinical trial of EVT plus usual care vs. usual care alone for patients with an intracranial occlusion. The primary outcome was the modified Rankin scale (mRS) score at 90 days. The primary effect parameter was the adjusted common odds ratio (acOR), estimated with ordinal logistic regression and adjusted for age and stroke severity at baseline...
June 27, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28559088/additional-value-of-left-atrial-appendage-geometry-and-hemodynamics-when-considering-anticoagulation-strategy-in-patients-with-atrial-fibrillation-with-low-cha2ds2-vasc-scores
#5
Jung Myung Lee, Jin-Bae Kim, Jae-Sun Uhm, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Strokes occur in some patients with atrial fibrillation (AF), even when the CHA2DS2-VASc score is low. OBJECTIVE: We sought to determine the factors defining the residual stroke risk in patients with AF and low CHA2DS2-VASc scores, with a particular focus on the hemodynamics and geometry of the left atrial appendage (LAA). METHODS: From February 2008 to December 2012, 66 consecutive patients with nonvalvular AF and a CHA2DS2-VASc score of 0 or 1 (except a point for the female sex) were enrolled...
May 27, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28549819/rivaroxaban-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-and-active-cancer
#6
Eva S Laube, Anthony Yu, Dipti Gupta, Yimei Miao, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff, Simon Mantha
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with nonvalvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. The use of rivaroxaban in patients with cancer at the Memorial Sloan Kettering Cancer Center is monitored in the setting of a Quality Assessment Initiative...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28542605/voxelwise-distribution-of-acute-ischemic-stroke-lesions-in-patients-with-newly-diagnosed-atrial-fibrillation-trigger-of-arrhythmia-or-only-target-of-embolism
#7
Timolaos Rizos, Andreas J Bartsch, Timothy D Johnson, Felix Dittgen, Thomas E Nichols, Uwe Malzahn, Roland Veltkamp
OBJECTIVE: Atrial fibrillation (AF) is frequently detected after ischemic stroke for the first time, and brain regions involved in autonomic control have been suspected to trigger AF. We examined whether specific brain regions are associated with newly detected AF after ischemic stroke. METHODS: Patients with acute cerebral infarctions on diffusion-weighted magnetic resonance imaging were included in this lesion mapping study. Lesions were mapped and modeled voxelwise using Bayesian Spatial Generalised Linear Mixed Modeling to determine differences in infarct locations between stroke patients with new AF, without AF and with AF already known before the stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28528882/mortality-and-atrial-fibrillation-in-the-fiaca-study-evidence-of-a-differential-effect-according-to-admission-diagnosis
#8
Francisco Guillermo Clavel-Ruipérez, Luciano Consuegra-Sánchez, Francisco Javier Félix Redondo, Luis Lozano Mera, Pedro Mellado-Delgado, Juan José Martínez-Díaz, José Ramón López Mínguez, Daniel Fernández-Bergés
INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is an independent risk factor for mortality in several diseases. However, data published in acute decompensated heart failure (DHF) are contradictory. Our objective was to investigate the impact of AF on mortality in patients admitted to hospital for DHF compared with those admitted for other reasons. METHODS: This retrospective cohort study included all patients admitted to hospital within a 10-year period due to DHF, acute myocardial infarction (AMI), or ischemic stroke (IS), with a median follow-up of 6...
May 18, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28513116/worse-outcome-in-patients-with-acute-stroke-and-atrial-fibrillation-following-thrombolysis
#9
Michael Findler, Jeremy Molad, Natan M Bornstein, Eitan Auriel
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and a common cause of ischemic stroke. Stroke patients with AF have been shown to have a poorer neurological outcome than stroke patients without AF. OBJECTIVES: To determine the impact of pre-existing AF on residual degree of disability in patients treated with IV thrombolysis. METHODS: In this case-control study, data of 214 stroke patients (63 with AF and 151 without AF) were collected from the National Acute Stroke Israeli Registry, a nationwide quadrennial stroke database...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28496431/sex-differences-in-outcomes-among-stroke-survivors-with-non-valvular-atrial-fibrillation-in-china
#10
Yan Hong, Xun Yang, Wenjuan Zhao, Xianghui Zhang, Junli Zhao, Yuanju Yang, Xianjia Ning, Jinghua Wang, Zhongping An
Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden and is an established predictor of poor outcomes after stroke. However, data regarding sex differences in long-term outcomes following stroke in patients with AF are scarce. We thus aimed to assess these differences. We recruited 951 consecutive patients with acute ischemic stroke and non-valvular atrial fibrillation (NVAF) treated at three hospitals in Tianjin, China, from January 2006 to September 2014. Information regarding stroke subtype, severity, risk factors, and outcomes (mortality, dependency, and recurrence) at 3, 12, and 36 months after stroke was recorded...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28468926/atrial-fibrillation-genetic-risk-and-ischemic-stroke-mechanisms
#11
Steven A Lubitz, Owen E Parsons, Christopher D Anderson, Emelia J Benjamin, Rainer Malik, Lu-Chen Weng, Martin Dichgans, Cathie L Sudlow, Peter M Rothwell, Jonathan Rosand, Patrick T Ellinor, Hugh S Markus, Matthew Traylor
BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is a leading cause of cardioembolic stroke, but the relationship between AF and noncardioembolic stroke subtypes are unclear. Because AF may be unrecognized, and because AF has a substantial genetic basis, we assessed for predisposition to AF across ischemic stroke subtypes. METHODS: We examined associations between AF genetic risk and Trial of Org 10172 in Acute Stroke Treatment stroke subtypes in 2374 ambulatory individuals with ischemic stroke and 5175 without from the Wellcome Trust Case-Control Consortium 2 using logistic regression...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#12
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
May 16, 2017: Neurology
https://www.readbyqxmd.com/read/28427162/effect-of-age-on-long-term-outcomes-after-stroke-with-atrial-fibrillation-a-hospital-based-follow-up-study-in-china
#13
Tao Wang, Bin Li, Hongfei Gu, Yongzhong Lou, Xianjia Ning, Jinghua Wang, Zhongping An
Atrial fibrillation (AF) is an established predictor of poor outcomes after stroke. We aimed to assess the effect of age on outcomes at 1 year and 3 years in stroke patients with AF.We recruited acute ischemic stroke patients with AF between January 2006 and September 2014 in Tianjin, China. Clinical features and outcomes at 1 year and 3 years after stroke were compared between younger group and elderly group. Overall, 951 consecutive stroke patients with AF were included in this study. There was a higher mortality and dependency rate in the elderly group than in the young group at both 1 and 3 years after stroke...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28400900/conjugate-eye-deviation-on-ct-associated-with-worse-outcomes-despite-iv-thrombolysis
#14
Nirav H Shah, Nirav Bhatt, Anita Tipirneni, Diego Condes, Priyank Khandelwal, Jose G Romano
INTRODUCTION: Rapid stroke management has significant implications in patient outcomes. Ipsilateral computed tomography conjugate eye deviation (CT-CED) has been associated with worse outcomes but has never been evaluated as predictive of vascular occlusion. To test the hypothesis that CT-CED is a marker for vascular occlusion, we evaluated patients treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We performed a retrospective analysis of patients with acute ischemic stroke treated with IV tPA at a large tertiary care hospital over an 18-month period...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28294063/cerebral-microbleeds-do-not-predict-hemorrhagic-transformation-in-acute-ischemic-stroke-patients-with-atrial-fibrillation-and-or-rheumatic-heart-disease
#15
Junfeng Liu, Deren Wang, Jie Li, Jing Lin, Yao Xiong, Bian Liu, Chenchen Wei, Bo Wu, Zhenxing Ma, Shihong Zhang, Ming Liu
Background and Purpose Cerebral microbleeds (CMBs) are known to be potential risk factors for intracerebral hemorrhage (ICH), but there is controversy on the relationship between CMBs and hemorrhagic transformation (HT) after ischemic stroke. Besides, the question regarding whether the relationship between CMBs and HT can be affected by antithrombotic drugs in acute stage of ischemic stroke has not yet reached a consensus. Methods 174 acute ischemic stroke patients with atrial fibrillation (AF) and/or rheumatic heart disease (RHD) were prospectively and consecutively enrolled in the study, of which 160 patients (mean 68...
March 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28291892/association-of-preceding-antithrombotic-treatment-with-acute-ischemic-stroke-severity-and-in-hospital-outcomes-among-patients-with-atrial-fibrillation
#16
MULTICENTER STUDY
Ying Xian, Emily C O'Brien, Li Liang, Haolin Xu, Lee H Schwamm, Gregg C Fonarow, Deepak L Bhatt, Eric E Smith, DaiWai M Olson, Lesley Maisch, Deidre Hannah, Brianna Lindholm, Barbara L Lytle, Michael J Pencina, Adrian F Hernandez, Eric D Peterson
Importance: Antithrombotic therapies are known to prevent stroke for patients with atrial fibrillation (AF) but are often underused in community practice. Objectives: To examine the prevalence of patients with acute ischemic stroke with known history of AF who were not receiving guideline-recommended antithrombotic treatment before stroke and to determine the association of preceding antithrombotic therapy with stroke severity and in-hospital outcomes. Design, Setting, and Participants: Retrospective observational study of 94 474 patients with acute ischemic stroke and known history of AF admitted from October 2012 through March 2015 to 1622 hospitals participating in the Get With the Guidelines-Stroke program...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28284577/chronic-kidney-disease-is-independently-associated-with-acute-recurrent-cerebral-infarct-in-patients-with-atrial-fibrillation
#17
Kenichi Sakuta, Yasuyuki Iguchi, Takeo Sato, Kenichiro Sakai, Yuka Terasawa, Hidetaka Mitsumura
BACKGROUND AND PURPOSE: The present study aimed to determine the frequency and time of recurrent cerebral infarct (RCI) in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF), and to clarify associated factors. METHODS: We retrospectively assessed and compared the clinical features of 79 consecutive patients (male, n=56; median age, 75y; median baseline NIHSS, 4) who were hospitalized due to AIS accompanied by AF, and who did or did not develop RCI between January 2012 and March 2015...
March 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28242246/the-value-of-the-score-for-the-targeting-of-atrial-fibrillation-staf-screening-in-acute-stroke-patients
#18
Xiao-Yan Liu, Yong-Xin Li, Yao-Gao Fu, Ye-Yan Cai, Yu-Sheng Zhang, Jiang-Yong Min, An-Ding Xu
BACKGROUND AND PURPOSE: Recently, the score for the targeting of atrial fibrillation (STAF) was introduced to identify the risk of atrial fibrillation (AF) in stroke patients. In this study, we aim to evaluate the usefulness of the STAF score for AF screening in acute stroke patients. METHODS: Patients with acute ischemic stroke who were admitted to our stroke unit were prospectively enrolled from March 2011 to March 2013. Baseline National Institutes of Health Stroke Scale (NIHSS), left atrial dilatation, and vascular etiology were assessed to calculate the STAF score...
February 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28236595/prestroke-cha2ds2-vasc-score-and-severity-of-acute-stroke-in-patients-with-atrial-fibrillation-findings-from-raf-study
#19
Monica Acciarresi, Maurizio Paciaroni, Giancarlo Agnelli, Nicola Falocci, Valeria Caso, Cecilia Becattini, Simona Marcheselli, Christina Rueckert, Alessandro Pezzini, Andrea Morotti, Paolo Costa, Alessandro Padovani, Laszló Csiba, Lilla Szabó, Sung-Il Sohn, Tiziana Tassinari, Azmil H Abdul-Rahim, Patrik Michel, Maria Cordier, Peter Vanacker, Suzette Remillard, Andrea Alberti, Michele Venti, Cataldo D'Amore, Umberto Scoditti, Licia Denti, Giovanni Orlandi, Alberto Chiti, Gino Gialdini, Paolo Bovi, Monica Carletti, Alberto Rigatelli, Jukka Putaala, Turgut Tatlisumak, Luca Masotti, Gianni Lorenzini, Rossana Tassi, Francesca Guideri, Giuseppe Martini, Georgios Tsivgoulis, Kostantinos Vadikolias, Chrissoula Liantinioti, Francesco Corea, Massimo Del Sette, Walter Ageno, Maria Luisa De Lodovici, Giorgio Bono, Antonio Baldi, Sebastiano D'Anna, Simona Sacco, Antonio Carolei, Cindy Tiseo, Davide Imberti, Dorjan Zabzuni, Boris Doronin, Vera Volodina, Domenico Consoli, Franco Galati, Alessio Pieroni, Danilo Toni, Serena Monaco, Mario Maimone Baronello, Kristian Barlinn, Lars-Peder Pallesen, Jessica Kepplinger, Ulf Bodechtel, Johannes Gerber, Dirk Deleu, Gayane Melikyan, Faisal Ibrahim, Naveed Akhtar, Maria Giulia Mosconi, Kennedy R Lees
BACKGROUND AND PURPOSE: The aim of this study was to investigate for a possible association between both prestroke CHA2DS2-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). METHODS: This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS ≥10)...
February 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#20
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
2017: Cerebrovascular Diseases
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