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acute ischemic stroke in AF

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https://www.readbyqxmd.com/read/29202727/atrial-fibrillation-is-not-uncommon-among-patients-with-ischemic-stroke-and-transient-ischemic-stroke-in-china
#1
Xiaomeng Yang, Shuya Li, Xingquan Zhao, Liping Liu, Yong Jiang, Zixiao Li, Yilong Wang, Yongjun Wang
BACKGROUND: Atrial fibrillation (AF) is reported to be a less frequent cause of ischemic stroke in China than in Europe and North America, but it is not clear whether this is due to underestimation. Our aim was to define the true frequency of AF-associated stroke, to determine the yield of 6-day Holter ECG to detect AF in Chinese stroke patients, and to elucidate predictors of newly detected AF. METHODS: Patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled in a prospective, multicenter cohort study of 6-day Holter monitoring within 7 days after stroke onset at 20 sites in China between 2013 and 2015...
December 4, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29197413/timing-of-oral-anticoagulant-therapy-in-acute-ischemic-stroke-with-atrial-fibrillation-study-protocol-for-a-registry-based-randomised-controlled-trial
#2
Signild Åsberg, Ziad Hijazi, Bo Norrving, Andreas Terént, Patrik Öhagen, Jonas Oldgren
BACKGROUND: Oral anticoagulation therapy is recommended for the prevention of recurrent ischemic stroke in patients with atrial fibrillation (AF). Current guidelines do not provide evidence-based recommendations on optimal time-point to start anticoagulation therapy after an acute ischemic stroke. Non-vitamin K antagonist oral anticoagulants (NOACs) may offer advantages compared to warfarin because of faster and more predictable onset of action and potentially a lower risk of intracerebral haemorrhage also in the acute phase after an ischemic stroke...
December 2, 2017: Trials
https://www.readbyqxmd.com/read/29172199/-clinical-features-of-very-elderly-patients-aged-90-years-or-above-with-acute-ischemic-stroke-a-study-by-using-diffusion-weighted-brain-magnetic-resonance-imaging
#3
Toshiyuki Sakai, Masahide Kondo, Yosuke Kawana, Toshio Nakagawa, Hidekazu Tomimoto
We investigated the diffusion weighted magnetic resonance imaging (DWI) features of 76 very elderly patients aged 90 years or above with acute ischemic stroke. Stroke subtypes were classified into five types according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) and the Japanese Stroke Databank. The incidence rates of atherothrombotic brain infarction (ATBI), atherothrombotic brain embolism (ATBE), lacunar infarction (LI), cardiogenic brain embolism (CBE) and undetermined type of brain infarction (UTBI) were 2...
November 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29171121/insular-damage-new-onset-atrial-fibrillation-and-outcome-after-acute-intracerebral-hemorrhage
#4
L Prats-Sánchez, D Guisado-Alonso, C Painous, F Fayos, E Pascual-Goñi, R Delgado-Mederos, A Martínez-Domeño, P Camps-Renom, J Martí-Fàbregas
BACKGROUND: Cortical insular damage is associated with cardiac arrhythmias and an increased risk of death. We investigated the influence of insular damage on the outcome of patients with acute intracerebral hemorrhage (ICH) as well as the frequency and predictors of new-onset atrial fibrillation (nAF). METHODS: We studied consecutive patients with ICH from 2013 to 2016. We identified those patients who underwent continuous electrocardiographic monitoring (≥24 hours), known AF and recent ischemic stroke...
November 24, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29145634/risk-profiles-for-acute-health-events-after-incident-atrial-fibrillation-in-patients-with-end-stage-renal-disease-on-hemodialysis
#5
Medha Airy, Tara I Chang, Victoria Y Ding, Benjamin A Goldstein, Nisha Bansal, Jingbo Niu, Sankar D Navaneethan, Mintu P Turakhia, Wolfgang C Winkelmayer
Background: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). Methods: We studied older US patients who newly initiated HD for ESRD (2006-11) and who had not previously been diagnosed with AF, stroke, myocardial infarction (MI) or hip fracture. We used Cox regression with AF as a time-varying covariate, adjusted for socio-demographic characteristics and comorbidities to estimate hazard ratios [HRs (95% confidence intervals)] for the events of ischemic stroke, MI and death...
November 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29126892/atrial-fibrillation-ablation-beyond-pulmonary-veins-the-role-of-left-atrial-appendage
#6
REVIEW
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#7
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29082335/atrial-fibrillation-trial-to-evaluate-real-world-procedures-for-their-utility-in-helping-to-lower-stroke-events-after-pulse-study-protocol-for-a-randomized-controlled-trial
#8
Tsung-Ta Hsieh, Meng Lee, Wen-Yi Huang, Sung-Chun Tang, Sheng-Feng Sung, Kuo-Husan Chang, Jiann-Der Lee, Tsong-Hai Lee, Yung-Sung Huang, Jiann-Shing Jeng, Chang-Min Chung, Yi-Ling Wu, Bruce Ovbiagele
BACKGROUND: Enhancing detection of undiagnosed atrial fibrillation (AF) in hospitalized patients with a recent ischemic stroke is important because of the treatment implications; especially since presence of paroxysmal AF may not be picked up in a single 12-lead electrocardiogram (ECG) test. While several trials have shown improved detection of AF with prolonged ECG monitoring, this strategy is associated with relatively high cost, labor intensity, and patient inconvenience, thereby making it challenging to routinely implement in all hospitals...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/28941717/the-cold-effect-of-ambient-temperature-on-ischemic-and-hemorrhagic-stroke-hospital-admissions-a-large-database-study-in-beijing-china-between-years-2013-and-2014-utilizing-a-distributed-lag-non-linear-analysis
#9
Yanxia Luo, Haibin Li, Fangfang Huang, Nicholas Van Halm-Lutterodt, Qin Xu, Anxin Wang, Jin Guo, Lixin Tao, Xia Li, Mengyang Liu, Deqiang Zheng, Sipeng Chen, Feng Zhang, Xinghua Yang, Peng Tan, Wei Wang, Xueqin Xie, Xiuhua Guo
The effects of ambient temperature on stroke death in China have been well addressed. However, few studies are focused on the attributable burden for the incident of different types of stroke due to ambient temperature, especially in Beijing, China. We purpose to assess the influence of ambient temperature on hospital stroke admissions in Beijing, China. Data on daily temperature, air pollution, and relative humidity measurements and stroke admissions in Beijing were obtained between 2013 and 2014. Distributed lag non-linear model was employed to determine the association between daily ambient temperature and stroke admissions...
September 20, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28934363/sex-related-differences-in-the-risk-factors-for-in-hospital-mortality-and-outcomes-of-ischemic-stroke-patients-in-rural-areas-of-taiwan
#10
Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
BACKGROUND AND PURPOSE: Sex-related differences in the clinical presentation and outcomes of stroke patients are issues that have attracted increased interest from the scientific community. The present study aimed to investigate sex-related differences in the risk factors for in-hospital mortality and outcome in ischemic stroke patients. METHODS: A total of 4278 acute ischemic stroke patients admitted to a stroke unit between January 1, 2007 and December 31, 2014 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28922154/atrial-fibrillation-is-independently-associated-with-cognitive-impairment-after-ischemic-stroke
#11
Russell Jude Chander, Levinia Lim, Sagarika Handa, Shaun Hiu, Angeline Choong, Xuling Lin, Rajinder Singh, Daniel Oh, Nagaendran Kandiah
BACKGROUND: While atrial fibrillation (AF) is an important risk factor for ischemic strokes and mild cognitive impairment (MCI) in Alzheimer's disease, the association between AF and post-stroke cognitive impairment (PSCI), and the factors mediating this association, is unclear. OBJECTIVE: To investigate the role of AF in PSCI, especially in relation to other markers of cerebrovascular disease. METHODS: 445 subjects with mild ischemic stroke without pre-stroke cognitive decline were assessed 3-6 months post-stroke for cognitive deficits...
September 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#12
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28918086/confidence-in-the-use-of-direct-oral-anticoagulants-in-the-acute-phase-of-nonvalvular-atrial-fibrillation-related-ischemic-stroke-over-the-years-a-real-world-single-center-study
#13
Federico Moroni, Luca Masotti, Vieri Vannucchi, Raffaella Chiarelli, Cristiana Seravalle, Alessandra Pesci, Francesca Pallini, Silvia Puliti, Barbara Cimolato, Lamberto Fattorini, Cornelia Scerra, Francesca Ristori, Maria Letizia Imbalzano, Stefano Spolveri, Giancarlo Landini, Elisa Grifoni, Maurizio Paciaroni
BACKGROUD AND AIM: The use of direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) is controversial. The aims of our study were to analyze physicians' confidence in prescribing DOACs in NVAF-related AIS, the characteristics of patients receiving DOACs, and their 90-day prognosis. MATERIAL AND METHODS: Clinical records of consecutive patients admitted to our wards for NVAF-related AIS over the years 2014-2016 were reviewed...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28892526/rivaroxaban-vs-warfarin-sodium-in-the-ultra-early-period-after-atrial-fibrillation-related-mild-ischemic-stroke-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Keun-Sik Hong, Sun U Kwon, Sang Hun Lee, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu
Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation...
October 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28882227/left-atrial-fibrosis-and-risk-of-cerebrovascular-and-cardiovascular-events-in-patients-with%C3%A2-atrial-fibrillation
#15
MULTICENTER STUDY
Jordan B King, Peyman N Azadani, Promporn Suksaranjit, Adam P Bress, Daniel M Witt, Frederick T Han, Mihail G Chelu, Michelle A Silver, Joseph Biskupiak, Brent D Wilson, Alan K Morris, Eugene G Kholmovski, Nassir Marrouche
BACKGROUND: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF. OBJECTIVES: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28881842/effect-of-age-on-long-term-outcomes-after-stroke-with-atrial-fibrillation-a-hospital-based-follow-up-study-in-china
#16
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...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28862284/detection-of-atrial-fibrillation-in-patients-with-embolic-stroke-of-undetermined-source-by-prolonged-monitoring-with-implantable-loop-recorders
#17
Carsten Israel, Alkisti Kitsiou, Malik Kalyani, Sameera Deelawar, Lucy Ekosso Ejangue, Andreas Rogalewski, Christoph Hagemeister, Jens Minnerup, Wolf-Rüdiger Schäbitz
Recently, the clinical entity embolic stroke of undetermined source (ESUS) has been defined for patients with ischemic strokes, where neither a cardioembolic nor a non-cardiac source can be detected. These patients may suffer from asymptomatic atrial fibrillation (AF), terminating spontaneously and thus eluding detection. Implantable loop recorders (ILR) with automatic AF detection algorithms can detect short-lasting, subclinical AF. The aim of this study was to prospectively assess and predict AF detection in patients with ESUS using ILR with daily remote interrogation...
October 5, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28837206/neutrophil-extracellular-traps-are-increased-in-patients-with-acute-ischemic-stroke-prognostic-significance
#18
Juana Vallés, Aída Lago, María Teresa Santos, Ana María Latorre, José I Tembl, Juan B Salom, Candela Nieves, Antonio Moscardó
Neutrophil extracellular traps (NETs) are networks of DNA, histones, and proteolytic enzymes produced by activated neutrophils through different mechanisms. NET formation is promoted by activated platelets and can in turn activate platelets, thus favoring thrombotic processes. NETs have been detected in venous and arterial thrombosis, but data in stroke are scarce. The aim of this study was to evaluate NETs in the plasma of patients with acute ischemic stroke and their potential association with baseline clinical characteristics, stroke severity, and one-year clinical outcomes...
October 5, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28815120/integrating-temporal-pattern-mining-in-ischemic-stroke-prediction-and-treatment-pathway-discovery-for-atrial-fibrillation
#19
Shijing Guo, Xiang Li, Haifeng Liu, Ping Zhang, Xin Du, Guotong Xie, Fei Wang
Atrial fibrillation (AF) is associated with an increased risk of acute ischemic stroke (AIS). Accurately predicting AIS and planning effective treatment pathways for AIS prevention are crucial for AF patients. Because of the temporality of patients' disease progressions, sequential disease and treatment patterns have the potential to improve risk prediction performance and contribute to effective treatment pathways. This paper integrates temporal pattern mining into the AF study of AIS prediction and treatment pathway discovery...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischaemic-stroke-and-non-valvular-atrial-fibrillation
#20
Y Sakamoto, S Okubo, C Nito, S Suda, N Matsumoto, A Abe, J Aoki, T Shimoyama, Y Takayama, K Suzuki, M Mishina, K Kimura
BACKGROUND AND PURPOSE: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischaemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has the potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aim of the present study was to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF...
November 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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