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https://www.readbyqxmd.com/read/28091833/the-gap-between-indicated-and-prescribed-stroke-prevention-therapies-in-a-high-risk-geriatric-population
#1
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28089253/progressive-bilateral-vertebral-artery-dissection-in-a-case-of-osteogenesis-imperfecta
#2
Yuji Kato, Harumitsu Nagoya, Tetsuya Abe, Takeshi Hayashi, Masanori Yasuda, Akira Uchino, Norio Tanahashi, Masaki Takao
A 32-year-old woman with osteogenesis imperfecta (OI) was admitted to the hospital because of a right-sided occipital headache and facial paresthesia. She was diagnosed with lateral medullary syndrome due to right vertebral artery (VA) dissection. She was treated conservatively without antithrombotic therapy. She developed subarachnoid hemorrhage because of contralateral VA dissection 18 days later. This clinical course may reflect the underlying weakness of the vessel wall in OI. In patients with OI, occlusion of a unilateral VA could cause dissection and subsequent rupture of the contralateral VA...
January 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#3
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28087823/prognosis-of-carotid-dissecting-aneurysms-results-from-cadiss-and-a-systematic-review
#4
Susanna C Larsson, Alice King, Jeremy Madigan, Christopher Levi, John W Norris, Hugh S Markus
OBJECTIVE: To determine the natural history of dissecting aneurysm (DA) and whether DA is associated with an increased recurrent stroke risk and whether type of antithrombotic drugs (antiplatelets vs anticoagulants) modifies the persistence or development of DA. METHODS: We included 264 patients with extracranial cervical artery dissection (CAD) from the Cervical Artery Dissection in Stroke Study (CADISS), a multicenter prospective study that compared antiplatelet with anticoagulation therapy...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28086795/atherosclerotic-and-thrombotic-genetic-and-environmental-determinants-in-egyptian-coronary-artery-disease-patients-a-pilot-study
#5
Manal S Fawzy, Eman A Toraih, Nagwa M Aly, Abeer Fakhr-Eldeen, Dahlia I Badran, Mohammad H Hussein
BACKGROUND: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Multiple genetic variants in combination with various environmental risk factors have been implicated. This study aimed to investigate the association of twelve thrombotic and atherosclerotic gene variants in combination with other environmental risk factors with CAD risk in a preliminary sample of Egyptian CAD patients. METHODS: Twenty three consecutive CAD patients undergoing diagnostic coronary angiography and 34 unrelated controls, have been enrolled in the study...
January 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28077455/symptomatic-carotid-occlusion-is-frequently-associated-with-microembolization
#6
Ava L Liberman, Ali Zandieh, Caitlin Loomis, Jonathan M Raser-Schramm, Christina A Wilson, Jose Torres, Koto Ishida, Swaroop Pawar, Rebecca Davis, Michael T Mullen, Steven R Messé, Scott E Kasner, Brett L Cucchiara
BACKGROUND AND PURPOSE: Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored. METHODS: We conducted a prospective observational cohort study of patients hospitalized within 7 days of ischemic stroke or transient ischemic attack because of ≥50% carotid artery stenosis or occlusion. Transcranial Doppler emboli detection was performed in the middle cerebral artery ipsilateral to the symptomatic carotid...
January 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28070883/pilot-of-a-computerised-antithrombotic-risk-assessment-tool-version-2-caratv2-0-for-stroke-prevention-in-atrial-fibrillation
#7
Yishen Wang, Beata Bajorek
BACKGROUND: The decision-making process for stroke prevention in atrial fibrillation (AF) requires a comprehensive assessment of risk vs. benefit and an appropriate selection of antithrombotic agents (e.g., warfarin, non-vitamin K antagonist oral anticoagulants [NOACs]). The aim of this pilot-test was to examine the impact of a customised decision support tool - the Computerised Antithrombotic Risk Assessment Tool (CARATV2.0) using antithrombotic therapy on a cohort of patients with AF...
January 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28068791/the-utilization-of-antithrombotic-therapy-in-older-patients-in-aged-care-facilities-with-atrial-fibrillation
#8
Bridget Frain, Ronald Castelino, Luke R Bereznicki
Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28065908/ticagrelor-but-not-clopidogrel-active-metabolite-displays-antithrombotic-properties-in-the-left-atrial-endocardium
#9
Martin F Reiner, Alexander Breitenstein, Erik W Holy, Martina Glanzmann, Heidi Amstalden, Simon F Stämpfli, Nicole R Bonetti, Volkmar Falk, Stephan Keller, Gianluigi Savarese, Stefano Benussi, Francesco Maisano, Thomas F Lüscher, Jürg H Beer, Jan Steffel, Giovanni G Camici
AIMS: Oral anticoagulation is considered standard therapy for stroke prevention in atrial fibrillation (AF). Endocardial activation triggers expression of pro-thrombotic mediators including tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1), and contributes to thrombus formation in the left atrial appendage (LAA) of AF patients. Recently, pleiotropic effects of specific P2Y12 receptor antagonists were demonstrated; however, whether these drugs possess antithrombotic effects on LAA endocardial cells currently remains unknown...
January 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#10
REVIEW
Csaba András Dézsi, Balázs Bence Dézsi, Döme András Dézsi
: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28065447/percutaneous-left-atrial-appendage-closure-followed-by-single-antiplatelet-therapy-short-and-mid-term-outcomes
#11
Zakaria Jalal, Marie-Lou Dinet, Nicolas Combes, Xavier Pillois, Pauline Renou, Igor Sibon, Xavier Iriart, Jean-Benoît Thambo
BACKGROUND: After left atrial appendage closure (LAAC), various antithrombotic protocols have been suggested, but the optimal post-procedural antithrombotic strategy is still under debate. AIMS: To investigate the efficacy and safety of LAAC with an AMPLATZER™ Cardiac Plug (ACP) device (St. Jude Medical, Minneapolis, MN, USA) followed by single antiplatelet therapy. METHODS: Consecutive patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulants who underwent LAAC with an ACP device between 2012 and 2014 in two French centres were included...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28063671/meta-analysis-of-major-bleeding-events-on-aspirin-versus-vitamin-k-antagonists-in-randomized-trials
#12
P Ambrosi, A Daumas, P Villani, R Giorgi
BACKGROUND AND OBJECTIVES: The relative bleeding risk of aspirin versus vitamin K antagonists (VKA) is unclear. Most of previous meta-analyses included trials with target INR for VKA therapy far beyond usually recommended range (2-3). The aim of this study was to compare the bleeding risk of aspirin and VKA, as indicated by the aggregate body of clinical evidence including data from the recently published WARCEF trial. METHODS: In this meta-analysis we included randomized controlled trials that compared aspirin to VKA (1...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28062617/growth-differentiation-factor-15-as-a-biomarker-in-cardiovascular-disease
#13
REVIEW
Kai C Wollert, Tibor Kempf, Lars Wallentin
BACKGROUND: Growth differentiation factor 15 (GDF-15) is expressed and secreted in response to inflammation, oxidative stress, hypoxia, telomere erosion, and oncogene activation. Cardiovascular (CV) disease is a major driver of GDF-15 production. GDF-15 has favorable preanalytic characteristics and can be measured in serum and plasma by immunoassay. CONTENT: In community-dwelling individuals higher concentrations of GDF-15 are associated with increased risks of developing CV disease, chronic kidney disease, and cancer, independent of traditional CV risk factors, renal function, and other biomarkers (C-reactive protein, B-type natriuretic peptide, cardiac troponin)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28054113/-chronic-subdural-hematoma-in-the-elderly
#14
T A Juratli, J Klein, G Schackert
Chronic subdural hematoma (cSDH) is a common condition, the frequency of which further increases due to an aging population and more frequent use of antithrombotic drugs. It leads to unspecific symptoms and neurological deficits and is usually treated surgically. Burr hole trepanation and twist drill craniostomy have become the therapeutic standards with craniotomy being rarely used for recurrent cases. Although recurrences are relatively common, in most cases a good outcome can be achieved even in the elderly; however, as cSDH is associated with other comorbidities, it is indicative of an increased morbidity and mortality...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28052755/atrial-fibrillation-in-patients-hospitalized-with-acute-myocardial-infarction-analysis-of-the-china-acute-myocardial-infarction-cami-registry
#15
Yan Dai, Jingang Yang, Zhan Gao, Haiyan Xu, Yi Sun, Yuan Wu, Xiaojin Gao, Wei Li, Yang Wang, Runlin Gao, Yuejin Yang
BACKGROUND: The incidence, clinical outcomes and antithrombotic treatment spectrum of atrial fibrillation (AF) in patients hospitalized with acute myocardial infarction (AMI) have not been well studied in Chinese population. METHODS: Twenty-six thousand five hundred ninety-two consecutive patients diagnosed with AMI were enrolled in CAMI registry from January 2013 to September 2014. After excluding 343 patients with uncertain AF status and 1,591 patients transferred out during hospitalization, 24,658 patients were finally included in this study and involved in analysis...
January 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28052124/prevalence-of-atrial-fibrillation-and-antithrombotic-therapy-in-hemodialysis-patients-cross-sectional-results-of-the-vienna-investigation-of-atrial-fibrillation-and-thromboembolism-in-patients-on-hemodialysis-vivaldi
#16
Oliver Königsbrügge, Florian Posch, Marlies Antlanger, Josef Kovarik, Renate Klauser-Braun, Josef Kletzmayr, Sabine Schmaldienst, Martin Auinger, Günther Zuntner, Matthias Lorenz, Ella Grilz, Gerald Stampfel, Stefan Steiner, Ingrid Pabinger, Marcus Säemann, Cihan Ay
BACKGROUND: Atrial fibrillation (AF) adds significant risk of stroke and thromboembolism in patients on hemodialysis (HD). The aim of this study was to investigate the prevalence of AF in a population-based cohort of HD patients and practice patterns of antithrombotic therapy for stroke prevention in AF. METHODS: The Vienna InVestigation of AtriaL fibrillation and thromboembolism in patients on hemodialysis (VIVALDI), an ongoing prospective observational cohort study, investigates the prevalence of AF and the risk of thromboembolic events in HD patients in Vienna, Austria...
2017: PloS One
https://www.readbyqxmd.com/read/28042389/clinical-problems-with-antithrombotic-therapy-for-endoscopic-submucosal-dissection-for-gastric-neoplasms
#17
REVIEW
Toshiyuki Yoshio, Tsutomu Nishida, Yoshito Hayashi, Hideki Iijima, Masahiko Tsujii, Junko Fujisaki, Tetsuo Takehara
Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation. With appropriate cessation, antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients. However, high thrombosis-risk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy (HBT) in the perioperative period...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28042233/gastrointestinal-endoscopy-in-patients-on-anticoagulant-therapy-and-antiplatelet-agents
#18
REVIEW
Angelo Zullo, Cesare Hassan, Franco Radaelli
Periprocedural management of antithrombotics for gastrointestinal endoscopy is a common clinical issue, given the widespread use of these drugs for primary and secondary cardiovascular prevention. For diagnostic procedures, with or without biopsy, no adjustments in antithrombotics are usually needed. For operative procedures, balancing the risk of periprocedural hemorrhage with the continuation of antithrombotics against the chance of recurrent thromboembolic events with their discontinuation may be challenging...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28035750/bleeding-risk-of-terminally-ill-patients-hospitalized-in-palliative-care-units-the-rheso-study
#19
Bernard Tardy, Stéphane Picard, Frédéric Guirimand, Céline Chapelle, Marie Delerue Danel, Thomas Celarier, Jean-François Ciais, Pascale Vassal, Sébastien Salas, Marilène Filbet, Jean-Marie Gomas, Aline Guillot, Jean-Baptiste Gaultier, Adel Merah, Anne Richard, Silvy Laporte, Laurent Bertoletti
BACKGROUND: The value of primary thromboprophylaxis in patients admitted to palliative care units is debated. Moreover, the bleeding risk of these patients is unknown. OBJECTIVES: Our primary aim was to assess the bleeding risk of patients in a real-world practice setting of hospital palliative care. Our secondary aim was to determine the incidence of symptomatic deep-vein thrombosis and to identify risk factors for bleeding. PATIENTS/METHODS: In this prospective, observational study in 22 French palliative care units, 1199 patients (median age: 71 years, male: 45...
December 30, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28033129/new-oral-anticoagulants-and-prevention-of-thromboembolic-events-in-patients-with-hypertension-and-atrial-fibrillation-an-appraisal
#20
Claudio Borghi, Stefania Paolillo, Arrigo F G Cicero, Paola Gargiulo, Bruno Trimarco, Pasquale Perrone Filardi
Arterial hypertension (HTN) and atrial fibrillation often coexist and the combination of these two conditions carries an increased risk of stroke. HTN is one of the most important risk factors included in the scores for stoke prediction in atrial fibrillation used to assess the need of anticoagulation, and HTN has also been strictly related to bleeding complications of antithrombotic therapy. Antithrombotic drugs options include vitamin K antagonists, or new oral anticoagulants, recently approved for stroke prevention in nonvalvular atrial fibrillation...
December 28, 2016: Journal of Hypertension
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