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Transient ischaemic attack

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https://www.readbyqxmd.com/read/28630782/remote-assessment-of-platelet-function-in-patients-with-acute-stroke-or-transient-ischaemic-attack
#1
Philip M Bath, Jane May, Katie Flaherty, Lisa J Woodhouse, Natalia Dovlatova, Sue C Fox, Timothy J England, Kailash Krishnan, Thompson G Robinson, Nikola Sprigg, Stan Heptinstall, Tardis Investigators
BACKGROUND: The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. METHODS: Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#2
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28622955/age-specific-risks-severity-time-course-and-outcome-of-bleeding-on-long-term-antiplatelet-treatment-after-vascular-events-a-population-based-cohort-study
#3
Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting...
June 13, 2017: Lancet
https://www.readbyqxmd.com/read/28612910/percutaneous-left-atrial-appendage-occlusion-procedures-in-patients-with-heart-failure
#4
Magdalena Szymała, Witold Streb, Katarzyna Mitręga, Tomasz Podolecki, Grzegorz Mencel, Tomasz Kukulski, Zbigniew Kalarus
BACKGROUND: Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia. The percutaneous left atrial appendage occlusion (LAAO) may be considered for the stroke prophylaxis in patients with nonvalvular AF (NVAF), especially in contraindications for oral anticoagulants (OAC) or high risk of bleeding. The data about implantation, safety, efficacy and follow-up are limited. Moreover, there are no studies on patients with NVAF and heart failure with severe left ventricular systolic dysfunction (left ventricular ejection fraction - LVEF ≤ 35%)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28590505/carotid-endarterectomy-for-symptomatic-carotid-stenosis
#5
REVIEW
Saritphat Orrapin, Kittipan Rerkasem
BACKGROUND: Stroke is the third leading cause of death and the most common cause of long-term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of the Cochrane Review, originally published in 1999, and most recently updated in 2011. OBJECTIVES: To determine the balance of benefit versus risk of endarterectomy plus best medical management compared with best medical management alone, in people with a recent symptomatic carotid stenosis (i...
June 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28578318/recurrent-brain-ischaemia-and-deep-vein-thrombosis-the-clot-thickens
#6
David Turner, Marie Scully, Sheldon Stone, David J Werring
A 65-year-old man presented with two transient ischaemic attacks, and was then found to have a deep vein thrombosis. He later had recurrent ischaemic strokes. After thorough investigation, the only cause we identified was a previously undiagnosed metastatic pancreatic cancer. We describe the assessment of this presentation and discuss the causes and management of cancer-related stroke.
June 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28572220/msoar-an-effective-bedside-stroke-prognosis-tool
#7
Mark Thaller, Nicholas Mitchell
The modified-SOAR (mSOAR) score is composed of the stroke subtype, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score (mRS) and the National Institutes of Health Stroke Scale score. It has previously been shown to be a reliable predictor of mortality and length of -hospital stay. This study sought to identify whether the mSOAR can also be used to predict patient disability on discharge. A post-hoc calculation of mSOAR using Sentinel Stroke National Audit Programme (SSNAP) data and electronic discharge -summaries was performed on all stroke admissions to Bridgend Hospital over an 11-month period...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28550068/age-specific-trends-of-atrial-fibrillation-related-ischaemic-stroke-and-transient-ischaemic-attack-anticoagulant-use-and-risk-factor-profile-in-chinese-population-a-15-year-study
#8
Yannie Soo, Nathan Chan, Kam Tat Leung, Xiang-Yan Chen, Vincent Mok, Lawrence Wong, Thomas Leung
BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing globally, and the fivefold increase in stroke risk constitutes significant healthcare burden. AIMS: We aim to evaluate the trends of AF-related stroke and transient ischaemic attack (AF-stroke/TIA), prior anticoagulant use and their risk factors in different age groups in Chinese population. METHODS: Data were retrieved from the stroke registry at Prince of Wales Hospital. We compared the data at 5-year intervals over a 15-year period (years 1999, 2004, 2009 and 2014)...
May 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28538247/the-positive-predictive-value-of-an-ambulance-prealert-for-stroke-and-transient-ischaemic-attack
#9
Craig W Brown, Mary J Macleod
OBJECTIVE: Therapeutic options for ischaemic stroke, such as thrombolysis or thrombectomy, are time sensitive. Multiple innovations have been established to reduce the symptom-to-needle time. One such innovation is the prealerting of emergency department (ED) or stroke unit staff by prehospital personnel of suspected stroke patients. The diagnosis of stroke can sometimes be difficult, with stroke mimics being a recognized issue. The prealert mobilizes ED, stroke and imaging personnel, which, for a true-positive, improves door-to-needle times...
May 19, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28528780/comparative-effectiveness-and-safety-of-apixaban-and-vitamin-k-antagonist-therapy-in-patients-with-nonvalvular-atrial-fibrillation-treated-in-routine-german-practice
#10
Craig I Coleman, W Frank Peacock, Matthias Antz
BACKGROUND: Scarce data comparing real-world outcomes between apixaban and vitamin K antagonist (VKA) users with nonvalvular atrial fibrillation (NVAF) are available. We sought to assess the effectiveness and safety of newly-initiated apixaban vs. VKA in German NVAF patients. MATERIALS AND METHODS: We performed a retrospective analysis in German outpatients using IMS Disease Analyzer data. Adults newly-initiated on apixaban or a VKA from January 2013 to March 2015 with a diagnosis of NVAF on the day of the first qualifying oral anticoagulant (OAC) prescription (index date) or any time during one year prior, and at least one year of follow-up were included...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28523719/cardiovascular-events-associated-with-second-line-anti-diabetes-treatments-analysis-of-real-world-korean-data
#11
K H Ha, B Kim, H Choi, D J Kim, H C Kim
AIM: To compare the risks of cardiovascular disease (CVD) and all-cause mortality associated with sulfonylurea (SU), dipeptidyl peptidase-4 inhibitor (DPP4i) and thiazolidinedione (TZD) as add-on medications to metformin (MET) therapy in people with Type 2 diabetes. METHODS: We identified 40 263 individuals who used SU (n = 11 582), DPP4i (n = 26 623) or TZD (n = 2058) in addition to MET between January 2013 and June 2015 from the database of the Korean National Health Insurance, the single-payer healthcare system in South Korea...
May 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28505525/thrombin-generation-and-intracranial-atherosclerotic-disease-in-patients-with-a-transient-ischaemic-attack
#12
Elisabetta Favaretto, Michelangelo Sartori, Cristina Legnani, Francesca Rondelli, Michela Cini, Maria Guarino, Benilde Cosmi
BACKGROUND: Intracranial atherosclerotic disease (ICAD) is responsible for at least 10% of transient ischaemic attacks (TIA). Thrombin generation has been shown to be associated with several atherosclerotic conditions and may be relevant in the pathogenesis of TIA from ICAD. OBJECTIVE: To evaluate the association between thrombin generation and ICAD in patients with TIA. MATERIALS AND METHODS: Consecutive patients with confirmed diagnosis of TIA by vascular neurologist were enrolled...
May 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28488353/effectiveness-of-a-shared-team-approach-between-nurses-and-doctors-for-improved-risk-factor-management-in-survivors-of-stroke-a-cluster-randomized-controlled-trial
#13
M T Olaiya, J Kim, M R Nelson, V K Srikanth, C F Bladin, R P Gerraty, S M Fitzgerald, T Phan, J Frayne, D A Cadilhac, A G Thrift
BACKGROUND AND PURPOSE: Limited evidence exists on the benefits of organized care for improving risk factor control in patients with stroke or transient ischaemic attack. The effectiveness of an individualized management programme in reducing absolute cardiovascular disease risk in this high-risk population was determined. METHODS: This was a prospective, multicentre, cluster-randomized controlled trial with blinded assessment of outcomes and intention-to-treat analysis...
May 10, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28471061/impact-on-patient-management-of-the-implementation-of-a-magnetic-resonance-imaging-dedicated-to-neurological-emergencies
#14
Marie Girot, Jean-Baptiste Marc, Eric Wiel, Christian Vilhelm, Xavier Leclerc, Xavier Lenne, Hervé Hubert
RATIONALE, AIMS AND OBJECTIVES: Neurological emergencies consumed a high amount of resources in emergency department (ED). We aimed to study the effect of the implementation of a magnetic resonance imaging (MRI) dedicated to emergencies on the management of patients admitted in ED for neurological emergencies. METHODS: We enrolled consecutive patients who underwent computed tomography and/or MRI for neurological disorders categorized as the suspicion of stroke and other reasons, over 2 periods that differed according to the priority access to computed tomography in the first period versus priority access to MRI in the second one...
May 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28460651/transcatheter-closure-of-the-patent-foramen-ovale-in-children-intermediate-term-follow-up-results
#15
Kutay Sel, Hakan H Aykan, Derya Duman, Ebru Aypar, Süheyla Özkutlu, Dursun Alehan, Tevfik Karagöz
The patent foramen ovale is almost a normal anatomical hole between the atria with ~30% incidence in the general population. It has been suggested that the patent foramen ovale is the cause of some neurological events, which is explained by paradoxical embolism. Transcatheter closure of the patent foramen ovale is a common procedure in adult patients with cerebral ischaemic events, but there are limited data investigating the results in children. Between January, 2005 and February, 2014, 17 patients' patent foramen ovales were closed by the transcatheter approach in our department...
May 2, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28431835/variability-in-the-use-of-neuroimaging-techniques-for-diagnosis-and-follow-up-of-stroke-patients
#16
C Valcárcel-Nazco, D Alonso-Modino, F Montón-Álvarez, R Sabatel-Hernández, M S Pastor-Santoveña, P Mesa-Blanco, J C López-Fernández, P Serrano-Aguilar
INTRODUCTION AND OBJECTIVE: Imaging diagnosis is essential for treatment planning in stroke patients. However, use of these techniques varies due to uncertainty about their effectiveness. Our purpose was to describe the use of CT and MRI in stroke and transient ischaemic attack (TIA) over 5years in hospitals belonging to the Canary Islands Health Service and analyse interhospital variability based on routinely collected administrative data. PATIENTS AND METHOD: We gathered the minimum basic dataset (MBDS) from patients diagnosed with stroke or TIA between 2005 and 2010 in 4hospitals...
April 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28416587/cardiovascular-outcomes-with-an-inhaled-beta2-agonist-corticosteroid-in-patients-with-copd-at-high-cardiovascular-risk
#17
Robert D Brook, Julie A Anderson, Peter Ma Calverley, Bartolome R Celli, Courtney Crim, Martin A Denvir, Sheldon Magder, Fernando J Martinez, Sanjay Rajagopalan, Jørgen Vestbo, Julie Yates, David E Newby
OBJECTIVES: Cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) often coexist. We assessed the effect of inhaled COPD treatments on CVD outcomes and safety in patients with COPD and at heightened CVD risk. METHODS: The SUMMIT (Study to Understand Mortality and MorbidITy) was a multicentre, randomised, double-blind, placebo-controlled, event-driven trial in 16 485 patients with moderate COPD who had or were at high risk of CVD. Here, we assessed the prespecified secondary endpoint of time to first on-treatment composite CVD event (CVD death, myocardial infarction, stroke, unstable angina or transient ischaemic attack (TIA)) by Cox regression and by clinician-reported CVD adverse events across the four groups: once-daily inhaled placebo (n=4111), long-acting beta2-agonist (vilanterol (VI) 25 µg; n=4118), corticosteroid (fluticasone furoate (FF) 100 µg; n=4135) and combination therapy (FF/VI; n=4121)...
April 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28416195/pitavastatin-versus-pravastatin-in-adults-with-hiv-1-infection-and-dyslipidaemia-intrepid-12-week-and-52-week-results-of-a-phase-4-multicentre-randomised-double-blind-superiority-trial
#18
Judith A Aberg, Craig A Sponseller, Douglas J Ward, Vladimir A Kryzhanovski, Stuart E Campbell, Melanie A Thompson
BACKGROUND: People living with HIV-1 infection are at greater risk for cardiovascular disease than seronegative adults. Treatment of dyslipidaemia with statins has been challenging in people with HIV because of an increased potential for drug interactions due to competing cytochrome P450 metabolism between statins and commonly used antiretroviral agents. Neither pitavastatin nor pravastatin depend on cytochrome P450 for primary metabolism. We aimed to assess the safety and efficacy of pitavastatin versus pravastatin in adults with HIV and dyslipidaemia...
April 13, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#19
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28403155/fruit-consumption-and-physical-activity-in-relation-to-all-cause-and-cardiovascular-mortality-among-70-000-chinese-adults-with-pre-existing-vascular-disease
#20
Xiaocao Tian, Huaidong Du, Liming Li, Derrick Bennett, Ruqin Gao, Shanpeng Li, Shaojie Wang, Yu Guo, Zheng Bian, Ling Yang, Yiping Chen, Junshi Chen, Yan Gao, Min Weng, Zengchang Pang, Baofa Jiang, Zhengming Chen
OBJECTIVES: To assess the associations of fresh fruit consumption and total physical activity with all-cause and cardiovascular mortality among Chinese adults who have been diagnosed with cardiovascular disease (CVD) or hypertension. METHODS: During 2004-08, the China Kadoorie Biobank study recruited 70,047 adults, aged 30-79 years, with physician-diagnosed stroke or transient ischaemic attack, ischemic heart disease, or hypertension. Information on diet and physical activity was collected using an interviewer-administered electronic questionnaire...
2017: PloS One
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