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Transient ischaemic attack

Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Anthony S Kim
No abstract text is available yet for this article.
November 2016: Lancet Neurology
A John Camm, Emmanuel Simantirakis, Andreas Goette, Gregory Y H Lip, Panos Vardas, Melanie Calvert, Gregory Chlouverakis, Hans-Christoph Diener, Paulus Kirchhof
While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high-rate episodes (AHRE) recorded on a cardiac implantable electronic device, sometimes also called subclinical AF, and lasting for at least 6 min in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and transient ischaemic attack...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Levent Cerit, Hatice Kemal, Kamil Gulsen, Barcin Ozcem, Zeynep Cerit, Hamza Duygu
BACKGROUND: Vitamin D deficiency is associated with many diverse cardiovascular disorders, such as hypertension, heart failure, stroke, coronary artery disease and atrial fibrillation. The relationship between Vitamin D and the development of atrial fibrillation after coronary artery bypass surgery (CABG) has not been studied. Therefore, we assessed the relationship between Vitamin D and the development of postoperative atrial fibrillation (POAF) after CABG. METHODS: Medical records of consecutive patients who underwent CABG surgery were retrospectively reviewed for the development of atrial fibrillation in the postoperative period...
August 2, 2016: Cardiovascular Journal of Africa
Christopher W L Armstrong, Erika Bosio, Claire Neil, Simon G A Brown, Graeme J Hankey, Daniel M Fatovich
We previously reported on a 26-year-old patient who presented early during a large and eventually fatal cerebral infarct. Microarray analysis of blood samples from this patient demonstrated initially up-regulated and subsequently down-regulated Granzyme B (GzmB) expression, along with progressive up-regulation of genes for S100 calcium binding protein A12 (S100A12) and matrix metalloproteinase 9 (MMP-9). To confirm these findings, we investigated these parameters in patients with suspected stroke presenting within 6h of symptom onset to a single centre...
September 30, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
J Faulkner, Y-C Tzeng, D Lambrick, B Woolley, P D Allan, T O'Donnell, J Lanford, L Wong, L Stoner
Early exercise engagement elicits meaningful changes in peripheral blood pressure in patients diagnosed with transient ischaemic attack (TIA) or minor stroke. However, central hemodynamic markers may provide clinicians with important diagnostic and prognostic information beyond that provided by peripheral blood pressure readings. The purpose of this single-centre, randomized, parallel-group clinical trial was to determine the effect of a 12-week aerobic exercise intervention on central and peripheral hemodynamic variables in patients with TIA or minor stroke...
September 29, 2016: Journal of Human Hypertension
Céline Buffel du Vaure, Agnès Dechartres, Constance Battin, Philippe Ravaud, Isabelle Boutron
OBJECTIVES: To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions. DESIGN: Systematic review of trial registration records. DATA SOURCES: ClinicalTrials...
2016: BMJ Open
Diana Solari, Francesca Tesi, Matthias Unterhuber, Germano Gaggioli, Andrea Ungar, Marco Tomaino, Michele Brignole
OBJECTIVES: Most elderly patients affected by reflex vasodepressor syncope take one or more hypotensive drugs. The role of these drugs in causing syncope has not yet been established. We hypothesised that recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy without increasing the risk of cardiovascular and neurological events. METHODS: This randomised, parallel, prospective, trial was conducted from January 2014 to March 2016 in four general hospitals...
September 23, 2016: Heart: Official Journal of the British Cardiac Society
Rachel Wong, Rhenan Nealon, Daniel Raederstorff, Peter Howe
OBJECTIVE: Having shown that resveratrol consumption can improve flow mediated dilation of the brachial artery, we tested its effects on CVR to hypercapnia in adults with T2DM, a risk population for cerebrovascular disease and cognitive impairments. DESIGN AND METHOD: In a double-blind crossover trial, 34 adults with T2DM consumed 0, 75, 150 and 300 mg of synthetic trans-resveratrol (one dose per week in random order). Before and 1-2 hr after dosing, transcranial Doppler ultrasound was used to assess CVR to a hypercapnic stimulus (breathing Carbogen gas for 3 min) in the middle (MCA) and posterior (PCA) cerebral arteries...
September 2016: Journal of Hypertension
Antti Palomäki, Tuomas Kiviniemi, Pirjo Mustonen, Casey Odei, Juha E K Hartikainen, Ilpo Nuotio, Antti Ylitalo, Päivi Hartikainen, Fausto Biancari, K E Juhani Airaksinen
BACKGROUND: Recent studies have reported that patients with paroxysmal atrial fibrillation (AF) have lower risk of thromboembolism and better prognosis than patients with chronic AF. We sought to address the differences in ischaemic events in patients with paroxysmal AF and chronic AF. METHODS: The FibStroke study is a cross-sectional observational multicenter registry that included AF patients with an ischaemic stroke, TIA (transient ischaemic attack) or intracranial bleed during 2003-2012 identified from discharge registries of four Finnish hospitals...
June 23, 2016: International Journal of Cardiology
Anoop Dinesh Shah, Spiros Denaxas, Owen Nicholas, Aroon D Hingorani, Harry Hemingway
BACKGROUND: Eosinophil and lymphocyte counts are commonly performed in clinical practice. Previous studies provide conflicting evidence of association with cardiovascular diseases. METHODS: We used linked primary care, hospitalisation, disease registry and mortality data in England (the CALIBER (CArdiovascular disease research using LInked Bespoke studies and Electronic health Records) programme). We included people aged 30 or older without cardiovascular disease at baseline, and used Cox models to estimate cause-specific HRs for the association of eosinophil or lymphocyte counts with the first occurrence of cardiovascular disease...
2016: Open Heart
Vincent Amoah, Benjamin Wrigley, Eric Holroyd, Andrew Smallwood, Angel L Armesilla, Alan Nevill, James Cotton
INTRODUCTION: We evaluated the association between two single nucleotide polymorphisms of the vascular endothelial growth factor gene and one of the hypoxia-inducible factor-1α gene and the degree of coronary collateral formation in patients with a coronary chronic total occlusion. METHODS: Totally, 98 patients with symptomatic coronary artery disease and a chronic total occlusion observed during coronary angiography were recruited. Genotyping of two vascular endothelial growth factor promoter single nucleotide polymorphisms (-152G>A and -165C>T) and the C1772T single nucleotide polymorphism of hypoxia-inducible factor-1α were performed using polymerase chain reaction and restriction fragment length polymorphism analysis...
2016: SAGE Open Medicine
Kerri A Nottage, Russell E Ware, Banu Aygun, Matthew Smeltzer, Guolian Kang, Joseph Moen, Winfred C Wang, Jane S Hankins, Kathleen J Helton
Silent cerebral infarction (SCI) is the most common neurological abnormality among children with sickle cell anaemia (SCA). The effect of hydroxycarbamide (also termed hydroxyurea) on the development and progression of SCI is unclear. We evaluated brain magnetic resonance imaging/angiography (MRI/MRA) in children with SCA receiving long-term hydroxycarbamide therapy. Fifty participants (median 9·4 years, range 1·1-17·3) enrolled in the Hydroxyurea Study of Long-Term Effects (HUSTLE; NCT00305175) underwent brain MRI/MRA and laboratory evaluations before hydroxycarbamide initiation and after 3 and 6 years of treatment to maximum tolerated dose...
October 2016: British Journal of Haematology
Nazem Akoum
Atrial fibrillation (AF) is directly implicated in embolic stroke and suspected in a large proportion of cryptogenic stroke. The current stroke-prevention strategy in embolic and cryptogenic stroke starts with arrhythmia detection, followed by risk stratification and treatment for those deemed to be at increased risk. This approach is practical and widespread; however, more recent findings have questioned its validity. Arrhythmia detection is dependent on the length and fidelity of monitoring. Long-term monitoring using implanted recorders improves arrhythmia detection in patients with cryptogenic stroke...
August 24, 2016: Heart: Official Journal of the British Cardiac Society
Allan Davies, Avedis Ekmejian, Nicholas Collins, Rohan Bhagwandeen
BACKGROUND: Percutaneous patent foramen ovale (PFO) closure is a therapeutic option to prevent recurrent cerebral ischaemia in patients with cryptogenic stroke and transient cerebral ischaemia (TIA). The apparent lack of benefit seen in previous randomised trials has, in part, reflected inclusion of patients with alternate mechanisms of stroke. The role of formal neurology involvement in accurately delineating the likely aetiology of stroke or TIA is crucial in appropriate identification of patients for device closure...
August 5, 2016: Heart, Lung & Circulation
Scott Munro, Sally Rodbard, Khalid Ali, Claire Horsfield, Wendy Knibb, Janet Holah, Ottilia Speirs, Tom Quinn
BACKGROUND: Suspected transient ischaemic attack (TIA) is a common presentation to emergency medical services (EMS) in the United Kingdom (UK). Several EMS systems have adopted the ABCD2 score to aid pre-hospital risk stratification and decision-making on patient disposition, such as direct referral to an Emergency Department or specialist TIA clinic. However, the ABCD2 score, developed for hospital use, has not been validated for use in the pre-hospital context of EMS care. METHODS: We conducted a pilot study to assess eligibility criteria, recruitment rates, protocol compliance, consent and follow-up procedures to inform the development of a definitive study to validate the ABCD2 tool in pre-hospital evaluation of patients with suspected TIA...
2016: Experimental & Translational Stroke Medicine
A Silva-Pinto, A Costa, R Serrão, A Sarmento, P Abreu
OBJECTIVES: The aim of the study was to provide insights into the contributions of HIV infection stage, antiretroviral therapy (ART) and vascular risk factors to the occurrence of ischaemic stroke in HIV-infected patients. METHODS: We performed a case-control study of HIV-infected patients followed in our clinic. We compared patients hospitalized between January 2006 and June 2014 with an ischaemic stroke or transient ischaemic attack to age- and gender-matched controls without stroke...
August 18, 2016: HIV Medicine
K Hurst, R Lee, E Sideso, M Giles, A Handa
BACKGROUND: The UK National Institute for Health and Care Excellence (NICE) guidelines state that carotid endarterectomy should be scheduled within 2 weeks of symptoms. The recent National Stroke Strategy has reduced the time interval to 48 h. This study aimed to review the possible delays. METHODS: This study analysed patients with confirmed transient ischaemic attack (TIA) or minor stroke, referred to a single tertiary centre clinic and followed up 1 month after the event...
October 2016: British Journal of Surgery
C H Nolte, H Erdur, U Grittner, A Schneider, S K Piper, J F Scheitz, I Wellwood, P M W Bath, H-C Diener, K R Lees, M Endres
BACKGROUND AND PURPOSE: Elevated heart rate (HR) is associated with worse outcomes in patients with cardiovascular disease. Its predictive value in acute stroke patients is less well established. We investigated the effects of HR on admission in acute ischaemic stroke patients. METHODS: Using the Virtual International Stroke Trials Archive (VISTA) database, the association between HR in acute stroke patients without atrial fibrillation and the pre-defined composite end-point of (recurrent) ischaemic stroke, transient ischaemic attack (TIA), myocardial infarction (MI) and vascular death within 90 days was analysed...
August 12, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Anne Oikarinen, Janne Engblom, Maria Kääriäinen, Helvi Kyngäs
INTRODUCTION: Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. AIMS AND OBJECTIVES: To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. DESIGN: A quasi-experimental, nonequivalent control group pretest-post-test design...
August 8, 2016: Scandinavian Journal of Caring Sciences
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