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https://www.readbyqxmd.com/read/28888264/availability-of-patient-decision-aids-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#1
REVIEW
Elizabeth S O'Neill, Stuart W Grande, Ariel Sherman, Glyn Elwyn, Megan Coylewright
BACKGROUND: Atrial fibrillation is a common irregular heart rhythm that increases patients' risk of stroke. Aspirin, warfarin, direct oral anticoagulants, and an implantable device can reduce this risk. Given the availability of multiple comparable options, this decision depends on patient preferences and is appropriate for the use of decision aids and other efforts to promote shared decision making. The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28865942/left-atrial-appendage-closure-in-patients-with-intracranial-haemorrhage-and-atrial-fibrillation
#2
F Fayos-Vidal, D Arzamendi-Aizpurua, X Millán-Álvarez, D Guisado-Alonso, P Camps-Renom, L Prats-Sánchez, A Martínez-Domeño, R Delgado-Mederos, J Martí-Fàbregas
INTRODUCTION: The use of oral anticoagulants in patients with a history of atrial fibrillation (AF) and intracranial haemorrhage (ICH) is controversial on account of the risk of haemorrhagic stroke recurrence. This study presents our experience regarding the safety and efficacy of percutaneous left atrial appendage closure (LAAC), an alternative to anticoagulation in these patients. METHODS: We conducted a retrospective, single-centre, observational study. LAAC was performed in patients with a history of ICH and non-valvular AF...
August 30, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28862960/selection-of-stent-type-in-patients-with-atrial-fibrillation-presenting-with-acute-myocardial-infarction-an-analysis-from-the-action-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#3
Amit N Vora, Tracy Y Wang, Shuang Li, Karen Chiswell, Connie Hess, Renato D Lopes, Sunil V Rao, Eric D Peterson
BACKGROUND: Patients receiving oral anticoagulation in addition to dual-antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug-eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI). METHODS AND RESULTS: From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28859022/embolic-stroke-of-undetermined-source-in-latin-america-a-review
#4
Carlos Cantú-Brito, Gisele Sampaio Silva, Sebastián F Ameriso
BACKGROUND: Stroke is a major health concern throughout Latin America. As elsewhere, no precise cause can be determined for a substantial portion of strokes. In 6 studies since 2010 in the region, 16% to 43% of ischemic strokes were identified as cryptogenic. The term embolic stroke of undetermined source (ESUS) has been proposed as more clinically useful and positively defined than the vague term cryptogenic. The epidemiology of ESUS in Latin America is largely unknown. REVIEW SUMMARY: This article aims to provide a description of the epidemiology of ESUS in Latin America and practical information regarding available diagnostic procedures and current guidelines...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28818318/sex-and-gender-differences-in-thromboprophylactic-treatment-of-patients-with-atrial-fibrillation-after-the-introduction-of-non-vitamin-k-oral-anticoagulants
#5
Desirée Loikas, Tomas Forslund, Björn Wettermark, Karin Schenck-Gustafsson, Paul Hjemdahl, Mia von Euler
To examine sex differences in thromboprophylaxis in patients with atrial fibrillation before and after the introduction of non-vitamin K oral anticoagulants, we performed a cross-sectional registry study based on anonymized individual-level patient data of all individuals with a diagnosis of nonvalvular atrial fibrillation (International Classification of Diseases, Tenth Revision code I48) in the region of Stockholm, Sweden (2.2 million inhabitants), in 2011 and 2015, respectively. Thromboprophylaxis improved considerably during the period...
July 21, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28807511/prevalence-and-predictors-of-inappropriate-anticoagulation-in-patients-with-a-cha2ds2-vasc-score-of-0-and-atrial-fibrillation
#6
Sepehr Saberian, Auroa Badin, Vince Siebert, Ashish Roy, Sandeep Banga, Harshavardhan R Ghadiam, Rebecca R Wigant, Ashim Aggarwal, Timir S Baman
BACKGROUND: Previous studies have shown underutilization of anticoagulation therapy in patients with atrial fibrillation and a CHA2DS2-VASc score ≥2; however there exists little data regarding the inappropriate use of anticoagulation in patients with a CHA2DS2-VASc score of 0. We aimed to determine the true prevalence and predictors of inappropriate anticoagulation therapy in patients with atrial fibrillation and a CHA2DS2-VASc score of 0. METHODS: A retrospective chart review was performed on all patients with atrial fibrillation and a CHA2DS2-VASc score of 0 in our institution from January 2009 to January 2016...
August 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28756016/pharmacological-stroke-prevention-in-the-elderly-with-atrial-fibrillation-in-poland-results-of-polsenior-study
#7
Beata Łabuz-Roszak, Michał Skrzypek, Agnieszka Machowska-Majchrzak, Małgorzata Mossakowska, Jerzy Chudek, Andrzej Więcek, Krystyna Pierzchała, Beata Łącka-Gaździk, Tomasz Grodzicki
INTRODUCTION: Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland. OBJECTIVES: The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors...
July 11, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28707135/secondary-stroke-prevention-in-cryptogenic-stroke-and-embolic-stroke-of-undetermined-source-esus
#8
REVIEW
Hans-Christoph Diener, Richard Bernstein, Robert Hart
PURPOSE OF THE REVIEW: The purpose of the study was to review the literature on cryptogenic stroke and embolic stroke of undetermined stroke (ESUS). Cryptogenic stroke according to TOAST criteria is a stroke which is not due to cardiogenic embolism, small vessel disease with lacunes or large vessel disease of brain supplying arteries. In the context of secondary stroke prevention studies, cryptogenic stroke is not operationally defined. RECENT FINDINGS: The new concept of "embolic stroke of undetermined source" (ESUS) provides an operational definition...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28681581/risk-analysis-of-new-oral-anticoagulants-for-gastrointestinal-bleeding-and-intracranial-hemorrhage-in-atrial-fibrillation-patients-a-systematic-review-and-network-meta-analysis
#9
Wei-Wei Xu, Shen-Jiang Hu, Tao Wu
BACKGROUND: Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic review and network meta-analysis using Bayesian inference to analyze the risks of GIB and ICH in AF patients taking NOACs. METHODS: We analyzed data from 20 randomized controlled trials of 91 671 AF patients receiving anticoagulants, antiplatelet drugs, or placebo...
July 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28664360/factors-associated-with-antithrombotic-treatment-decisions-for-stroke-prevention-in-atrial-fibrillation-in-the-stockholm-region-after-the-introduction-of-noacs
#10
Joris Komen, Tomas Forslund, Paul Hjemdahl, Björn Wettermark
PURPOSE: The purpose of this study was to investigate the influence of patient characteristics such as age and stroke and bleeding risks on decisions for antithrombotic treatment in patients with atrial fibrillation (AF). METHODS: This was a retrospective, population-based study including AF patients initiated with either warfarin, dabigatran, rivaroxaban, apixaban, or low-dose aspirin (ASA) between March 2015 and February 2016. Multivariate models were used to calculate adjusted odds ratios (aOR) for factors associated with treatment decisions...
June 29, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28648031/-impact-of-different-antithrombotic-therapy-strategy-on-prognosis-in-coronary-heart-disease-patients-combining-with-atrial-fibrillation-a-meta-analysis
#11
C Yuan, L Zhong, R C Huang
Objective: To evaluate the impact of various anticoagulation antiplatelet therapy strategies on the prognosis of patients with coronary heart disease combining with atrial fibrillation. Methods: Present meta analysis was performed according to search results on English EMBASE database by computer retrieval, Pubmed, the Cochrane Central Register of Controlled Trials, Medline, Chinese CBM database, CNKI database, Wan Fang database, China science and technology papers online electronic databases, manual retrieval for important international conference proceedings up to April 30 2016...
June 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28642210/rationale-and-design-for-a-randomized-comparison-of-efficacy-and-safety-between-aspirin-and-clopidogrel-in-atrial-fibrillation-patients-with-low-stroke-risk-cesac-af-trial
#12
Sang Min Park, Haemin Jeong, Mi-Hyang Jung, Kyung Soon Hong, Myeong-Ki Hong, Chang Seok Bang, Christopher Y Kim
BACKGROUND: Atrial fibrillation (AF) increases the risk of thromboembolic stroke. An oral anticoagulant should be administrated to prevent stroke in patients with moderate stroke risk (ie, CHA2DS2-VASc score>2). If the stroke risk is low (i.e. the score=1), however, antiplatelet agent such as aspirin is widely used. Aspirin can cause peptic ulcer disease (PUD) while its alternative, clopidogrel, theoretically does not. OBJECTIVE: To elucidate the efficacy and safety between aspirin and clopidogrel, a multicenter randomized controlled trial was designed in AF patients with low stroke risk...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28623609/administration-of-direct-oral-anticoagulants-in-patients-with-myeloproliferative-neoplasms
#13
Jean-Christophe Ianotto, Marie-Anne Couturier, Hubert Galinat, Dominique Mottier, Christian Berthou, Gaëlle Guillerm, Eric Lippert, Aurélien Delluc
Direct oral anticoagulants (DOACs) have been approved to treat and prevent thrombotic events. However, they are not yet labeled for use in patients with active cancers. Myeloproliferative neoplasms (MPNs) are clonal chronic disorders with a high incidence of thrombotic events, for which low-dose aspirin (LDA) is the standard drug treatment. We analyzed efficacy and safety of DOACs prescription in patients treated for MPNs. An MPN database, the OBENE registry, was established at our institution. We collected biological and clinical data from diagnosis to last follow-up for every patient included in this study...
June 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#14
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28606562/the-efficacy-and-safety-of-3-types-of-interventions-for-stroke-prevention-in-patients-with-cardiovascular-and-cerebrovascular-diseases-a-network-meta-analysis
#15
Qian Sun, Shumei Chang, Songtao Lu, Yajing Zhang, Yajun Chang
PURPOSE: The goal of this study was to compare the relative efficacy and safety of different types of interventions for stroke prevention in patients with cardiovascular and cerebrovascular diseases. METHODS: This network meta-analysis (NMA) was conducted with a random effects model of Bayesian framework using Stata version 12.0. Odds ratios (ORs) and their credible intervals (CrIs) were applied for the efficacy and safety evaluation of various medical interventions, including aspirin, dipyridamole, ticlopidine, warfarin, and apixaban...
July 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28584203/current-use-of-oral-anticoagulants-and-prognostic-analysis-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#16
Heng-Bo Zhai, Jun Liu, Zhi-Chao Dong, Dong-Xia Wang, Bo Zhang
BACKGROUND: It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28567361/unexpected-evolution-of-a-non-stenotic-lesion-in-the-left-main-coronary-artery-of-a-patient-with-non-st-segment-elevation-myocardial-infarction
#17
Alexandru Florin Ispas, Lionel Mangin, Alexandru Paziuc, Loic Belle
A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28558081/stroke-prevention-in-atrial-fibrillation-focus-on-latin-america
#18
REVIEW
Ayrton R Massaro, Gregory Y H Lip
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28543401/oral-anticoagulation-management-in-patients-with-atrial-fibrillation-undergoing-cardiac-implantable-electronic-device-implantation
#19
Eric Black-Maier, Sunghee Kim, Benjamin A Steinberg, Gregg C Fonarow, James V Freeman, Peter R Kowey, Jack Ansell, Bernard J Gersh, Kenneth W Mahaffey, Gerald Naccarelli, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Oral anticoagulation (OAC) therapy is associated with increased periprocedural risks after cardiac implantable electronic device (CIED) implantation. Patterns of anticoagulation management involving non-vitamin K antagonist oral anticoagulants (NOACs) have not been characterized. HYPOTHESIS: Anticoagulation strategies and outcomes differ by anticoagulant type in patients undergoing CIED implantation. METHODS: Using the nationwide Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we assessed how atrial fibrillation (AF) patients undergoing CIED implantation were cared for and their subsequent outcomes...
May 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28527773/prevalence-management-and-long-term-6-year-outcomes-of-atrial%C3%A2-fibrillation-among-patients-receiving-drug-eluting-coronary-stents
#20
Hyo-In Choi, Jung-Min Ahn, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to investigate the incidence, management, and clinical relevance of atrial fibrillation (AF) during and after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and evaluate outcomes of different antithrombotic strategies. BACKGROUND: Uncertainty exists regarding the optimal antithrombotic strategy in patients with AF who are undergoing PCI with DES. METHODS: Using a consecutive series of 10,027 patients who underwent DES implantation between 2003 and 2011, we evaluated the overall prevalence and clinical impact of AF...
June 12, 2017: JACC. Cardiovascular Interventions
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