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https://www.readbyqxmd.com/read/29458073/establishment-and-validation-of-a-prediction-model-for-ischemic-stroke-risks-in-patients-with-type-2-diabetes
#1
Tsai-Chung Li, Hsiang-Chi Wang, Chia-Ing Li, Chiu-Shong Liu, Wen-Yuan Lin, Chih-Hsueh Lin, Sing-Yu Yang, Cheng-Chieh Lin
AIMS: A risk scoring system for predicting ischemic stroke incidence may identify type 2 diabetes patients at high risk for ischemic stroke who can benefit from preventive intervention programs. Such a risk scoring system can serve as a benchmark to test novel putative risk factors. METHODS: The study adopted a retrospective cohort, including 28,124 Chinese patients with type 2 diabetes aged 30-84 years during 2001-2004. Participants were randomly assigned to the derivation and validation sets at a 2:1 ratio...
February 16, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29457323/anticoagulation-knowledge-in-patients-with-atrial-fibrillation-an-australian-survey
#2
Kehinde O Obamiro, Leanne Chalmers, Kenneth Lee, Bonnie J Bereznicki, Luke R E Bereznicki
BACKGROUND: Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia in clinical practice, and is associated with a significant medical and economic burden. Anticoagulants reduce the risk of stroke and systemic embolism by approximately two-thirds compared with no therapy. Knowledge regarding anticoagulant therapy can influence treatment outcomes in patients with AF. OBJECTIVE: To measure the level of anticoagulation knowledge in patients with AF taking oral anticoagulants (OACs), investigate the association between patient-related factors and anticoagulation knowledge, and compare these results in patients taking warfarin and direct-acting oral anticoagulant (DOACs)...
February 19, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29452460/outcomes-after-surgical-pulmonary-embolectomy-for-acute-submassive-and-massive-pulmonary-embolism-a-single-center-experience
#3
Chetan Pasrija, Anthony Kronfli, Michael Rouse, Maxwell Raithel, Gregory J Bittle, Sheelagh Pousatis, Mehrdad Ghoreishi, James S Gammie, Bartley P Griffith, Pablo G Sanchez, Zachary N Kon
OBJECTIVES: Ideal treatment strategies for submassive and massive pulmonary embolism remain unclear. Recent reports of surgical pulmonary embolectomy have demonstrated improved outcomes, but surgical technique and postoperative outcomes continue to be refined. The aim of this study is to describe in-hospital survival and right ventricular function after surgical pulmonary embolectomy for submassive and massive pulmonary embolism with excessive predicted mortality (≥5%). METHODS: All patients undergoing surgical pulmonary embolectomy (2011-2015) were retrospectively reviewed...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29449280/prediction-of-the-multisegment-clot-sign-on-dynamic-ct-angiography-of-cardioembolic-stroke
#4
Z Chen, F Shi, M Zhang, X Gong, L Lin, M Lou
BACKGROUND AND PURPOSE: The multisegment clot sign has been observed at the site of large-artery occlusion in patients with acute ischemic stroke. This study aimed to assess its occurrence rate and relationship with stroke etiologies in patients with acute intracranial large-artery occlusion. MATERIALS AND METHODS: We included consecutive patients with acute ischemic stroke who had acute intracranial large-artery occlusion and underwent perfusion CT within 8 hours after stroke onset...
February 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29447772/the-optimal-anti-coagulation-for-enhanced-risk-patients-post-catheter-ablation-for-atrial-fibrillation-ocean-trial
#5
Atul Verma, Andrew C T Ha, Paulus Kirchhof, Gerhard Hindricks, Jeff S Healey, Michael D Hill, Mukul Sharma, D George Wyse, Jean Champagne, Vidal Essebag, George Wells, Dhiraj Gupta, Hein Heidbuchel, Prashanthan Sanders, David H Birnie
BACKGROUND: The optimal long-term antithrombotic regimen for patients after successful catheter-based atrial fibrillation (AF) ablation is not well defined. Presently, practice variation exists, and the benefits of oral anticoagulation over antiplatelet therapy across the entire spectrum of stroke risk profile remain undefined in the postablation population. To date, there are no randomized trials to inform clinicians on this therapeutic question. OBJECTIVE: The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29444961/no-inferiority-of-tonbridge-thrombectomy-device-for-acute-thrombus-retrial-compared-with-solitaire-device-an-experimental-evaluation-with-a-canine-distal-external-carotid-maxillary-artery-occlusion-model
#6
Geng Zhou, Ming-Hua Li, Hai-Tao Lu, Jiang-Shan Deng, Yu-Wu Zhao, Yi Xiang J Wang, Yue-Qi Zhu
INTRODUCTION: Mechanical thrombectomy (MT) has been widely accepted as a safe and effective treatment for acute ischemic stroke (AIS). Development of stent retriever devices has been intensively developed over the past two decades. In this study, we compared the effectiveness and safety of a new thrombectomy device with Solitaire FR for the treatment of AIS models. METHODS: Mechanical performance of stent retrievers was tested in vitro. Thrombin-induced thrombus was pre-injected into the right distal external carotid-maxillary artery in 18 dogs to create an acute thrombus occlusion model, and these animals were divided into a Tonbridge group (n=9, with Tonbridge stent Tonbridge Medical Technology) and a Solitaire group as control (n=9, with Solitaire stent, ev3 Neurovascular)...
February 14, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29444357/safety-of-direct-oral-anticoagulants-versus-warfarin-in-patients-with-chronic-liver-disease-and-atrial-fibrillation
#7
Pavel Goriacko, Keith T Veltri
BACKGROUND: A complication of chronic liver disease (CLD) is the abnormality of coagulation. In clinical practice, this increased risk of bleeding has not been identified as a protective factor against stroke or systemic embolism associated with atrial fibrillation (AF). The objective of this study was to assess the safety of direct oral anticoagulant (DOAC) agents versus warfarin in CLD patients with AF. METHODS: This was a retrospective cohort study of patients with CLD and AF initiated on oral anticoagulants...
February 14, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29438571/use-of-non-vitamin-k-oral-anticoagulants-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#8
REVIEW
O Itzhaki, B Zadok, A Eisen
AIMS: To examine the efficacy and safety of non-vitamin K oral anticoagulants in people with both atrial fibrillation and diabetes mellitus. METHODS: We reviewed efficacy and safety data from the warfarin-controlled phase III non-vitamin K oral anticoagulants trials (ARISTOTLE, RE-LY, ROCKET-AF, ENGAGE and AF-TIMI 48) and their post hoc analyses with regard to diabetes status. We also reviewed the updated literature regarding this population. RESULTS: At baseline 20-40% of the participants in the phase III non-vitamin K oral anticoagulants trials had diabetes mellitus at baseline...
February 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29437728/large-vessel-stroke-as-initial-presentation-of-thrombotic-thrombocytopenic-purpura
#9
Ryan Sugarman, Andrea M Tufano, Johnson M Liu
A 67-year-old right-handed woman presented with dysarthria, left upper extremity weakness and right-sided neglect of 3 hours duration. Imaging of the brain revealed acute right middle cerebral artery stroke; however, tissue plasminogen activator could not be administered due to severe thrombocytopenia. A peripheral smear revealed schistocytes and the patient was treated empirically for thrombotic thrombocytopenic purpura (TTP) with therapeutic plasma exchange. An extensive workup revealed no embolic source or other cause for stroke, and a diagnosis of large vessel infarct secondary to TTP was made...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29434631/transcatheter-aortic-valve-replacement-and-stroke-a-comprehensive-review
#10
REVIEW
Periklis A Davlouros, Virginia C Mplani, Ioanna Koniari, Grigorios Tsigkas, George Hahalis
Transcatheter aortic valve implantation (TAVR) has emerged as an alternative, rapidly evolving treatment option for patients with severe aortic stenosis and high surgical risk. Stroke is a devastating complication being confined mainly in the periprocedural and 30-day period following TAVR, with a lower and relatively constant frequency thereafter. Early stroke is mainly due to debris embolization during the procedure, whereas later events are associated with patient specific factors. Despite the fact that the rate of clinical stroke has been constantly decreasing compared to initial TAVR experience, modern neuro-imaging with MRI suggests that new ischemic lesions post-TAVR are almost universal...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29433151/anticoagulants-resumption-after-warfarin-related-intracerebral-haemorrhage-the-multicenter-study-on-cerebral-hemorrhage-in-italy-much-italy
#11
Loris Poli, Mario Grassi, Marialuisa Zedde, Simona Marcheselli, Giorgio Silvestrelli, Maria Sessa, Andrea Zini, Maurizio Paciaroni, Cristiano Azzini, Massimo Gamba, Antonella Toriello, Rossana Tassi, Elisa Giorli, Rocco Salvatore Calabrò, Marco Ritelli, Alessandro De Vito, Nicola Pugliese, Giuseppe Martini, Alessia Lanari, Corrado Lodigiani, Marina Padroni, Valeria De Giuli, Filomena Caria, Andrea Morotti, Paolo Costa, Davide Strambo, Manuel Corato, Rosario Pascarella, Massimo Del Sette, Giovanni Malferrari, Marina Colombi, Alessandro Padovani, Alessandro Pezzini
Whether to resume antithrombotic treatment after oral anticoagulant-related intracerebral haemorrhage (OAC-ICH) is debatable. In this study, we aimed at investigating long-term outcome associated with OAC resumption after warfarin-related ICH, in comparison with secondary prevention strategies with platelet inhibitors or antithrombotic discontinuation. Participants were patients who sustained an incident ICH during warfarin treatment (2002-2014) included in the Multicenter Study on Cerebral Hemorrhage in Italy...
February 12, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29432362/left-axillary-artery-cannulation-facilitates-reoperative-total-aortic-arch-replacement
#12
Jonathan M Hemli, Bo Gu, S Jacob Scheinerman, Derek R Brinster
Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft...
February 9, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29431856/cerebral-embolization-silent-cerebral-infarction-and-neurocognitive-decline-after-thoracic-endovascular-aortic-repair
#13
A H Perera, N Rudarakanchana, L Monzon, C D Bicknell, B Modarai, O Kirmi, T Athanasiou, M Hamady, R G Gibbs
BACKGROUND: Silent cerebral infarction is brain injury detected incidentally on imaging; it can be associated with cognitive decline and future stroke. This study investigated cerebral embolization, silent cerebral infarction and neurocognitive decline following thoracic endovascular aortic repair (TEVAR). METHODS: Patients undergoing elective or emergency TEVAR at Imperial College Healthcare NHS Trust and Guy's and St Thomas' NHS Foundation Trust between January 2012 and April 2015 were recruited...
February 12, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29431527/role-of-cardiac-electronic-implantable-device-in-the-stratification-and-management-of-embolic-risk-of-silent-atrial-fibrillation-are-all-atrial-fibrillations-created-equal
#14
Andrea Di Cori, Alessio Lilli, Giulio Zucchelli, Valerio Zaca
Ischemic strokes may be associated with atrial fibrillation (AF). AF detection is critical in ischemic stroke survivors, often recommending a switch from antiplatelet therapy to oral anticoagulants for secondary prevention. Areas covered: Cardiac implantable electronic devices (CIED) with their long-term recording capability allows to document AF and to quantify the arrhythmia burden. Recent series in pacemaker and implantable cardioverter-defibrillator (ICD) recipients with no prior stroke showed that short episodes of AF increased stroke risk compared with those without AF recorded...
February 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29429636/the-expand-study-efficacy-and-safety-of-rivaroxaban-in-japanese-patients-with-non-valvular-atrial-fibrillation
#15
Hiroaki Shimokawa, Takeshi Yamashita, Shinichiro Uchiyama, Takanari Kitazono, Wataru Shimizu, Takanori Ikeda, Masahiro Kamouchi, Koichi Kaikita, Koji Fukuda, Hideki Origasa, Ichiro Sakuma, Keijiro Saku, Yasuo Okumura, Yuichiro Nakamura, Hideo Morimoto, Naoki Matsumoto, Akihito Tsuchida, Junya Ako, Nobuyoshi Sugishita, Shogo Shimizu, Hirotsugu Atarashi, Hiroshi Inoue
AIMS: The EXPAND study examined the real-world efficacy and safety of rivaroxaban for the prevention of stroke and systemic embolism (SE) in Japanese patients with non-valvular atrial fibrillation (NVAF). METHODS AND RESULTS: This multicenter, prospective, non-interventional, observational, cohort study was conducted at 684 medical centers in Japan. A total of 7141 NVAF patients ≥20 years of age (mean, 71.6 ± 9.4 years) who were being or about to be treated with rivaroxaban (10 mg/day, 43...
February 3, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29428159/cerebral-protection-devices-during-transcatheter-aortic-valve-implantation
#16
REVIEW
Wieneke Vlastra, Jeroen Vendrik, Karel T Koch, Jan Baan, Jan J Piek, Ronak Delewi
Transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis is associated with an improvement of clinical outcomes, quality of life, and self-sufficiency. The most feared TAVI-related complication is the occurrence of stroke. In order to reduce peri-procedural cerebral embolizations, diverse cerebral protection devices have been developed. These devices work though deflection or filtering of emboli, and are in different stages of testing. Silent cerebral infarctions identified by diffusion-weighted magnetic resonance imaging (DW-MRI) are used as surrogate primary outcomes, but the clinical significance is still unclear...
February 2, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29427478/from-ruling-out-to-ruling-in-putting-pocus-in-focus
#17
Arjun K Venkatesh, Charles D Scales, Marta E Heilbrun
Over the past twenty years, the Emergency Department (ED) has transformed from a location that managed patients with acute life-threatening illness or injury to an acute diagnostic center. The advent of rapid and accurate imaging, novel biomarkers, and other innovations concurrent with effects from financial and social forces has supported the development of an acute care system focused on "ruling out" low-frequency, high-mortality events such as acute myocardial infarction, stroke, pulmonary embolism, and aortic dissection...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29426964/incidental-pulmonary-embolism-in-suspected-stroke-patients-undergoing-carotid-ct-angiography
#18
Guang-Liang Chen, Dong-Hui Shen, Jin Wei, Hua Wang, Yuan-Fen Liu, Qing Duan
PURPOSE: The purpose of this study was to investigate the prevalence of incidental pulmonary embolism (IPE) in suspected stroke patients receiving carotid computed tomography angiography (CTA) and its characteristics. MATERIALS AND METHODS: A total of 4873 cases receiving carotid CTA between January 2013 and December 2016 were retrospectively reassessed by one radiologist. Patients with previous or suspected PE were excluded. The remaining prior contrast-enhanced carotid CTA studies were regarded as a "potentially incidental" IPE when a filling defect was found in one or more pulmonary arteries and subjected to the other two thoracic radiologists independently for reviewing and assessing for characteristics of the IPE and the image quality of the PE...
February 9, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29426678/low-yield-of-extensive-workup-for-embolic-sources-in-lacunar-stroke-patients
#19
Yan Wang, Yoon Choi, Joshuae Gallardo, Ifeoma Nwaneri, James R Brorson
OBJECTIVE: We aimed to evaluate the yield of extensive etiologic workup in lacunar stroke patients. BACKGROUND: As lacunar strokes are infrequently caused by thromboembolism, the clinical relevance of extensive workup for thromboembolic sources is questioned. METHODS: Among consecutive stroke admissions to a single center over 3 years, the 100 cases initially classified as lacunar stroke and a sample of 100 cases classified as non-lacunar ischemic strokes were studied...
February 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29425382/the-beneficial-effect-of-weight-reduction-on-adverse-cardiovascular-outcomes-following-bariatric-surgery-is-attenuated-in-patients-with-obstructive-sleep-apnea
#20
Ahmed Dalmar, Maharaj Singh, Bennet Pandey, Christopher Stoming, Zoe Heis, Khawaja Afzal Ammar, M Fuad Jan, Indrajit Choudhuri, Thomas Y Chua, Jasbir Sra, A Jamil Tajik, Arshad Jahangir
Weight loss after bariatric surgery is associated with reduction in adverse cardiovascular outcomes; however, the impact of obstructive sleep apnea (OSA) on reduction of cardiovascular outcomes after bariatric surgery in morbidly obese patients is not known. We retrospectively assessed differences in cardiovascular events after laparoscopic adjustable gastric banding (LAGB)-induced weight loss in patients with and without OSA before and after propensity score matching for age, sex, body mass index (BMI), and major comorbidities between the two groups and determined predictors of poor outcomes...
February 7, 2018: Sleep
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