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acute ischemic stroke in AF

Patrícia O Guimarães, Pearl Zakroysky, Abhinav Goyal, Renato D Lopes, Lisa A Kaltenbach, Tracy Y Wang
To examine patterns of preadmission and discharge antithrombotic therapies in coronary artery disease (CAD) and atrial fibrillation (AF) patients admitted for acute myocardial infarction (AMI), we performed a retrospective analysis of the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG), which captures consecutive AMI patients treated at participating US hospitals. We included patients with CAD, AF, and CHA2 DS2 -VASc score ≥2 admitted for AMI (07/01/2013-09/30/2016)...
September 26, 2018: American Journal of Cardiology
Jason G Andrade, Marc W Deyell, Graham C Wong, Laurent Macle
Atrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20% to 30% of those with AF also have coronary artery disease (CAD), and 5% to 15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on ischemic outcomes (AF-related stroke and systemic embolism, as well as ischemic coronary events)...
November 2018: Canadian Journal of Cardiology
Jeong Yoon Lee, Jun Sang Sunwoo, Kyum Yil Kwon, Hakjae Roh, Moo Young Ahn, Min Ho Lee, Byoung Won Park, Min Su Hyon, Kyung Bok Lee
BACKGROUND AND OBJECTIVES: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). METHODS: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016...
December 2018: Korean Circulation Journal
Daisuke Kimura, Ikuo Fukuda, Takao Tsushima, Takehiro Sakai, Satoko Umetsu, Yukari Ogasawara, Norihito Shimamura, Hiroki Ohkuma
OBJECTIVE: We analyzed acute ischemic stroke by thromboembolism in the early period after lung cancer surgery. METHODS: A retrospective review of the clinical records of patients who underwent lung resection for primary lung cancer was performed. Patients who underwent lobectomy, bilobectomy, and pneumonectomy were included. The clinical characteristics of the patients, the incidence of atrial fibrillation (Af) after surgery, and the incidence of acute ischemic stroke were analyzed...
October 26, 2018: General Thoracic and Cardiovascular Surgery
Chien Tai Hong, Wei Ting Chiu, Nai Fang Chi, Le Yan Lai, Chaur Jong Hu, Han Hwa Hu, Lung Chan
Intravenous thrombolysis with the tissue plasminogen activator (tPA) is the gold standard for acute ischemic stroke. However, its application is limited because of the concern of the post-tPA intracranial hemorrhage (ICH). Low low-density lipoprotein (LDL) has been speculated to increase the risk of hemorrhagic transformation after ischemic stroke. However, whether LDL is associated with post-tPA ICH remains controversial. The present study obtained the medical records from Shuang Ho Hospital and retrospectively reviewed for the period between August 2009 and December 2016 to investigate the association between LDL and the risk of post-tPA ICH...
October 26, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Orsolya Székely, Kazuo Miyazawa, Gregory Yoke Hong Lip
Atrial fibrillation (AF) is associated with high morbidity and mortality rates due to thromboembolic complications, and anticoagulation is central to the management of this common arrhythmia to prevent acute thromboembolic events. The traditional anticoagulants: heparin, fondaparinux, and vitamin K antagonists (VKA, e.g. warfarin, acenocoumarol or phenprocoumin) have long served as pharmacotherapy for ischemic stroke prophylaxis. Areas covered: In this review article, the authors provide an overview on current and emerging pharmacotherapy for ischemic stroke prevention...
October 25, 2018: Expert Opinion on Pharmacotherapy
Kazuo Yamashiro, Naohide Kurita, Ryota Tanaka, Yuji Ueno, Nobukazu Miyamoto, Kenichiro Hira, Sho Nakajima, Takao Urabe, Nobutaka Hattori
BACKGROUND: The impact of adherence to direct oral anticoagulants (DOACs) is unknown. We aimed to assess the effects of preceding anticoagulation treatment on neurologic severity at admission and functional outcomes at discharge in patients with atrial fibrillation (AF) who developed acute ischemic stroke. METHODS: We retrospectively assessed consecutive patients with acute ischemic stroke and AF. Adherence to DOACs was assessed using the 4-item Morisky Medication Adherence Scale...
October 11, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
D M Akpanova, S F Berkinbayev, A T Mussagaliyeva, D A Ospanova, B S Zhussupov
BACKGROUND: Stroke takes the second place among all causes for cardiovascular death and the first place in mortality and disability among other nervous system diseases. Atrial fibrillation (AF) is presently is a commonly recognized, independent risk factor for ischemic stroke, which fivefold increases the risk of an unfavorable outcome. Prevention of stroke is a complicated medical and social challenge. AIM: To study AF prevalence among patients with stroke/transient ischemic attack (TIA) who had received an anticoagulant therapy before hospitalization...
2018: Kardiologiia
Satoru Kashima, Takahiro Shimizu, Hisanao Akiyama, Yasuhiro Hasegawa
BACKGROUND AND PURPOSE: This study aimed to investigate factors associated with stroke recurrence and new-onset atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). METHODS: Between January 2005 and March 2012, a total of 1514 consecutive patients were admitted to our hospital with a diagnosis of acute ischemic stroke within 7 days after onset. Of these, 236 patients met the diagnostic criteria for ESUS. A retrospective analysis was performed of the following characteristics of these ESUS patients: medical history, comorbidities, and magnetic resonance imaging (MRI) findings including the deep and subcortical white matter hyperintensity (DSWMH) grade, drugs used for preventing recurrence, and clinical information such as NIH Stroke Scale scores on admission and outcomes evaluated by modified Rankin scale...
September 21, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Wei-Syun Hu, Cheng-Li Lin
OBJECTIVE: This investigation aimed at assessing the issue of incident atrial fibrillation (AF) associated with acute critical illness. METHODS: The study came from Taiwan and used that nation's Longitudinal Health Insurance Database 2000. Using propensity score matching, multivariable adjustment and competing risk methods, the correlations between the new-onset AF and critical illness (septicemia/septic shock, acute myocardial infarction【AMI】, hemorrhagic stroke and ischemic stroke) were investigated...
September 19, 2018: European Journal of Internal Medicine
Ravi R Pradhan, Ashish Jha, Gaurav Nepal, Manju Sharma
Valvular heart disease is one of the more common diseases in low- and middle-income countries, when associated with atrial fibrillation (AF), carries a risk of multisystemic embolizations. We report a case of 37-year-old man with multiple systemic emboli consisting of acute ischemic stroke, acute myocardial infarction, and acute limb ischemia. This is a rare occurrence in a single subject. The patient had a background of rheumatic heart disease (RHD) involving severe mitral stenosis (MS) with AF, who was not compliant with his medications...
July 11, 2018: Curēus
Elyar Sadeghi-Hokmabadi, Mohammad Yazdchi, Mehdi Farhoudi, Homayoun Sadeghi, Aliakbar Taheraghdam, Reza Rikhtegar, Hannaneh Aliyar, Sahar Mohammadi-Fallah, Rogayyeh Asadi, Elham Mehdizadeh-Far, Neda Ghaemian
Background: Tissue plasminogen activator (tPA) has been long approved as an efficacious treatment in patients with acute ischemic stroke (AIS); however, due to some serious complications, particularly intracranial hemorrhage (ICH), many physicians are still reluctant to use it liberally. This study sought to find potential prognostic factors in patients with AIS treated with tPA. Methods: A retrospective, hospital-bases observational study was conducted. Consecutively, a total of 132 patients with AIS treated with intravenous tPA, form June 2011 to July 2015 were enrolled...
January 5, 2018: Iranian Journal of Neurology
Nobuo Kutsuna, Kotaro Makita, Kosei Goto, Koki Hirayama, Goro Kido, Yukihide Kagawa
Cerebral infarction (CI) caused by middle cerebral artery occlusion exhibits a very high mortality rate. To reduce this rate, a decompressive hemicraniectomy (DHC) is performed clinically based on several randomized trials. In ischemic stroke, a state of malnutrition leads to poor outcomes. However, little evidence is available on nutrition state in the acute phase after DHC. This preliminary study focuses on serum markers, especially dynamic or static nutrition-associated markers including prealbumin, transferrin, retinol binding protein (RBP) and serum albumin under tube feeding with Peptamen®AF (Nestlé Health Science Japan)...
2018: Advances in Experimental Medicine and Biology
Chih-Chung Shiao, Wei-Chih Kan, Jian-Jhong Wang, Yu-Feng Lin, Likwang Chen, Eric Chueh, Ya-Ting Huang, Wen-Po Chiang, Li-Jung Tseng, Chih-Hsien Wang, Vin-Cent Wu
The influence of acute kidney injury (AKI) on subsequent incident atrial fibrillation (AF) has not yet been fully addressed. This retrospective nationwide cohort study was conducted using Taiwan's National Health Insurance Research Database from 1 January 2000 to 31 December 2010. A total of 41,463 patients without a previous AF, mitral valve disease, and hyperthyroidism who developed de novo dialysis-requiring AKI (AKI-D) during their index hospitalization were enrolled. After propensity score matching, "non-recovery group" ( n = 2895), "AKI-recovery group" ( n = 2895) and "non-AKI group" (control group, n = 5790) were categorized...
August 29, 2018: Journal of Clinical Medicine
Gustavo Zapata-Wainberg, Jaime Masjuan, Sonia Quintas, Álvaro Ximénez-Carrillo, Andrés García Pastor, Maite Martínez Zabaleta, Pere Cardona, María Del Mar Freijo Guerrero, Laura Llull, Lorena Benavente Fernández, Mar Castellanos Rodrigo, José Egido, Joaquín Serena, José Vivancos
BACKGROUND/PURPOSE: To describe the clinical and epidemiological characteristics of acute ischemic stroke (AIS) in patients with atrial fibrillation (AF) previously treated with oral anticoagulants (OACs) according to the type of OAC prescribed. To analyze the outcomes of the patients and the therapeutic approach adopted by the neurologist in the acute phase and for secondary prevention. METHODS: We performed a multicenter, observational study based on prospective registries...
August 28, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Ahmet Guner, Alev Kılıcgedik, Macit Kalçık, Mehmet Ozkan
Coronary embolism (CE) is the underlying cause of 3% of acute coronary syndromes but is frequently overlooked in the differential diagnoses of acute coronary syndromes. The CE may be direct (left sided from the native or prosthetic heart valve, the left atrium, left atrial appendage or pulmonary venous bed), paradoxical (from the venous circulation through a patent foramen ovale, atrial septal defect, ventricular septal defects, cyanotic congenital heart defects or pulmonary arteriovenous malformations), or iatrogenic (following cardiac interventions...
August 13, 2018: Echocardiography
Michael J Quon, Hassan Behlouli, Louise Pilote
OBJECTIVES: The purpose of this study was to determine if anticoagulation of patients with new onset secondary atrial fibrillation (AF) occurring with acute coronary syndromes (ACS), acute pulmonary disease, or sepsis is associated with a reduction in ischemic stroke or an increase in bleeding risk. BACKGROUND: Studies evaluating the benefits and risks of anticoagulation in secondary AF are infrequent, and the optimal management of these patients is not well understood...
March 2018: JACC. Clinical Electrophysiology
E O Vershinina, A N Repin
OBJECTIVE: to analyze long-term outcomes and to develop a model for determining the risk of long-term adverse сardiovascular events after elective percutaneous coronary interventions (PCI). MATERIALS AND METHODS: We included in this study 148 patients, sent from 2009 to 2011 for routine endovascular intervention for chronic ischemic heart disease on the background of stenotic coronary artery atherosclerosis. Outcomes of interventions were assessed over 6 years after the index PCI by analyzing medical records and telephone interviews...
July 2018: Kardiologiia
Mariana Alves, Marco Ribeiro Narciso, João Cruz, Marina Rocha, Teresa Fonseca
INTRODUCTION: The detection of paroxysmal atrial fibrillation (PAF) is crucial in the etiological study of an acute ischemic stroke (AIS), although this type of arrhythmia is often under-diagnosed. This prospective study aims to (1) evaluate the new-onset PAF detection rate among elderly patients with AIS in an acute setting, and (2) to assess the applicability of the STAF score (Score for the Targeting of Atrial Fibrillation) for such patients. METHODOLOGY: An observational and prospective study was performed over a period of 11 months...
July 27, 2018: Aging Clinical and Experimental Research
Shinji Ito, Koichi Kikuchi, Akihiro Ueda, Ryunosuke Nagao, Toshiki Maeda, Kenichiro Murate, Sayuri Shima, Yasuaki Mizutani, Yoshiki Niimi, Tatsuro Mutoh
Background: The development of acute multiple embolic infarctions (AMEI) resulting from cancer is known as Trousseau's syndrome (TS). At present, however, there is no good marker for predicting the prognosis of TS patients. In the present study, we evaluated the use of serial D-dimer levels as a prognostic marker for TS. Methods: This retrospective cohort study included 1,409 consecutive acute ischemic stroke patients. We selected a group of patients with TS showing AMEI ( n = 38; TS group) and a group of patients with atrial fibrillation (Af) and AMEI ( n = 35; Af group) as controls...
2018: Frontiers in Neurology
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