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https://www.readbyqxmd.com/read/28526929/analytical-management-of-patients-undergoing-oral-anticoagulant-therapy-could-have-a-strong-impact-on-clinical-outcomes-a-follow-up-study
#1
Vincenzo De Iuliis, Sebastiano Ursi, Gianfranco Vitullo, Irma Griffo, Antonio Marino, Marika Caruso, Francesco Cipollone, Sabrina Capodifoglio, Veronica Breda, Elena Toniato, Alfonso Pennelli, Pio Conti, Stefano Martinotti
INTRODUCTION: Oral anticoagulant therapy, such as vitamin K antagonists (VKAs), is prominent for the prevention of cerebral ischemic stroke or systemic embolism and all-cause mortality in patients with atrial fibrillation, venous thromboembolism, and mechanical or biological valve. VKA treatment requires monitoring of the international normalized ratio (INR) in order to maintain it in a therapeutic range, avoiding side effects, the main and most significant of which is bleeding. The aim of the present study was to evaluate the event rates of several clinical composite outcomes, such as bleeding, thromboembolic events, and all-cause death...
May 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28526085/papillary-fibroelastoma-unusual-cause-of-stroke-in-a-young-man-a-case-report
#2
Elisabetta Grolla, Michele Dalla Vestra, Giampaolo Zoffoli, Riccardo D'Ascoli, Adriana Critelli, Rocco Quatrale, Domenico Mangino, Fausto Rigo
BACKGROUND: Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors. CASE PRESENTATION: We describe a rare case of a 28-Year-old man that while playing football, had a sudden onset of neurological deficit: aphasia, right hemiparesis and right facial numbness. Transthoracic echocardiography (TTE) showed a 10x10 mm mass attached to the anterior mitral valve leaflet...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#3
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28515288/motor-recovery-beginning-23-years-after-ischemic-stroke
#4
Peter Sörös, Robert Teasell, Daniel F Hanley, J David Spence
It is widely believed that most stroke recovery occurs within 6 months, with little benefit of physiotherapy or other modalities beyond a year. We report a remarkable case of stroke recovery beginning 23 years after a severe stroke due to embolization from the innominate artery and subclavian artery, resulting from compression of the right subclavian artery by a cervical rib. The patient had a large right fronto-parietal infarction with severe left hemiparesis, and a totally non-functional spastic left hand...
May 17, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28512699/an-open-label-crossover-study-of-the-pharmacokinetics-of-the-60-mg-edoxaban-tablet-crushed-and-administered-either-by-a-nasogastric-tube-or-in-apple-puree-in-healthy-adults
#5
Kenneth Duchin, Anil Duggal, George J Atiee, Motonori Kidokoro, Tadanobu Takatani, Nicole Lazarus Shipitofsky, Ling He, George Zhang, Tarundeep Kakkar
BACKGROUND: Edoxaban is an orally active, direct factor Xa inhibitor indicated to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation and for the treatment of venous thromboembolism. OBJECTIVES: This study assessed the pharmacokinetics, safety, and tolerability of the edoxaban 60-mg tablet crushed and administered via a nasogastric tube in a water suspension or orally mixed in apple puree. METHODS: This phase 1, open-label, crossover study randomized 30 healthy adults to receive three edoxaban treatment regimens (oral 60-mg edoxaban tablet, or 60-mg edoxaban tablet crushed and administered via a nasogastric tube or orally in apple puree) in one of six treatment sequences...
May 17, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28509761/dabigatran-in-nonvalvular-atrial-fibrillation-from-clinical-trials-to-real-life-experience
#6
Nicola Mumoli, Daniela Mastroiacovo, Eleonora Tamborini-Permunian, Josè Vitale, Matteo Giorgi-Pierfranceschi, Marco Cei, Francesco Dentali
: Atrial fibrillation is the most common arrhythmia in over-midlife patients. In addition to systolic heart failure, cerebral thromboembolism represents the most dramatic complication of this rhythm disorder, contributing to morbidity and mortality. Traditionally, anticoagulation has been considered the main strategy in preventing stroke and systemic embolism in atrial fibrillation patients and vitamin K-dependent antagonists have been widely used in clinical practice. Recently, the development of direct oral anticoagulants has certainly improved the management of this disease, providing, for the first time, the opportunity to go beyond vitamin K-dependent antagonists limits...
July 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28506581/-sudden-death-in-versailles-a-review-of-a-cardiovascular-treatrise-by-dionis-1710
#7
P Charlier
In 1710, the surgeon Pierre Dionis publishes a Dissertation on sudden death. Echoing and expanding the work of his Roman colleague Jean Marie Lancisi, he describes and analyzes dozens of cases of sudden death observed by him. A large number of cases was followed by autopsies allowing clinicopathological confrontation. Are proposed causes of death (pulmonary embolism, myocardial infarction, hemorrhagic stroke, arterial rupture, etc.), pathophysiological mechanisms based on the ancient theory of humors, and preventive actions to avoid these unexpected deaths...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28502818/renal-function-considerations-for-stroke-prevention-in-atrial-fibrillation
#8
REVIEW
John Fanikos, Allison E Burnett, Charles E Mahan, Paul P Dobesh
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in nonvalvular atrial fibrillation patients with mild or moderate renal impairment...
May 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28501899/is-there-a-july-effect-in-pediatric-neurosurgery
#9
Yimo Lin, Rory R Mayer, Terence Verla, Jeffrey S Raskin, Sandi Lam
PURPOSE: The belief that July, when resident physicians' training year begins, may be associated with increased risk of patient morbidity and mortality is known as the "July effect." This study aimed to compare complication rates after pediatric neurosurgical procedures in the first versus last academic quarters in two national datasets. METHODS: Data were extracted from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) database for year 2012 for 30-day complication events and the Kids' Inpatient Database (KID) for year 2012 for in-hospital complication events after pediatric neurosurgical procedures...
May 13, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#10
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28499672/association-of-elevated-pulmonary-artery-systolic-pressure-with-stroke-and-systemic-embolic-events-in-patients-with-hypertrophic-cardiomyopathy
#11
Keigo Kanbayashi, Yuichiro Minami, Shintaro Haruki, Ryozo Maeda, Ryosuke Itani, Kyomi Ashihara, Nobuhisa Hagiwara
BACKGROUND: Echocardiographically estimated pulmonary artery systolic pressure (PASP) is a non-invasive widely available method that is used to estimate pulmonary arterial pressure. Although elevated PASP predicts mortality in patients with hypertrophic cardiomyopathy (HCM), the relationship between PASP and embolic events is unclear. This study aimed to determine whether elevated PASP is associated with stroke and systemic embolic events in a tertiary referral HCM cohort. METHODS: This study included 374 clinically diagnosed patients with HCM...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28496927/e-ea-for-the-prediction-of-left-atrial-appendage-thrombi-in-patients-with-atrial-fibrillation-and-severe-mitral-stenosis
#12
Atoosheh Rohani, Hoorak Poorzand, Mohammad R Arefifar
Atrial fibrillation (AF), left atrial appendage thrombi (LAAT) and subsequent embolic stroke are the most frequent complications of mitral stenosis .E/Ea is used traditionally for the assessment of left atrium pressure, and besides AF and dilated LA size which promotes stasis of blood in LA, high LA pressure also play a role to clot formation in LA .The receiver operator characteristics (ROC) curve point-coordinates identified an E:e' value of ≥ 36.5to have 57.14% sensitivity and 90.91% specificity for LAAT;We find this ratio relatively specific for prediction of LAAT, independent of MVA and LA volume, however it needs to be externally validated...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28495674/noncentral-nervous-system-systemic-embolism-in-patients-with-atrial-fibrillation-results-from-rocket-af-rivaroxaban-once-daily-oral-direct-factor-xa-inhibition-compared-with-vitamin-k-antagonism-for-prevention-of-stroke-and-embolism-trial-in-atrial-fibrillation
#13
Ryan Orgel, Daniel Wojdyla, David Huberman, Jonathan L Halperin, Günter Breithardt, Daniel E Singer, Keith A A Fox, Graeme J Hankey, Kenneth W Mahaffey, W Schuyler Jones, Manesh R Patel
No abstract text is available yet for this article.
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#14
Julia Seeger, Ralf Birkemeyer, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. METHODS AND RESULTS: Twelve consecutive non-valvular atrial fibrillation patients (age 76.6±7.8years) at high risk for stroke (CHA2DS2-VASc-Score 5.5±0.9) and bleeding (HAS-BLED-Score 3.8±0.9), received LAA closure with the Watchman FLX...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28493056/non-vitamin-k-oral-anticoagulants-for-stroke-prevention-in-special-populations-with-atrial-fibrillation
#15
REVIEW
Arnaud Bisson, Denis Angoulvant, Raphael Philippart, Nicolas Clementy, Dominique Babuty, Laurent Fauchier
Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke or systemic embolism compared with normal sinus rhythm. These strokes may efficiently be prevented in patients with risk factors using oral anticoagulant therapy, with either vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) (i.e., direct thrombin inhibitors or direct factor Xa inhibitors). Owing to their specific risk profiles, some AF populations may have increased risks of both thromboembolic and bleeding events...
May 10, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28490653/prospective-association-between-%C3%AE-2-microglobulin-levels-and-ischemic-stroke-risk-among-women
#16
Pamela M Rist, Monik C Jiménez, Kathryn M Rexrode
OBJECTIVE: To determine whether elevated β2-microglobulin (B2M) levels were associated with an increased risk of incident ischemic stroke events among women. METHODS: We performed a nested case-control study among women enrolled in the Nurses' Health Study who provided blood samples between 1989 and 1990 and were free of prior stroke and cancer. We measured B2M levels in 473 ischemic strokes cases confirmed by medical record review and in 473 controls matched 1:1 to the cases on age, race, date of blood collection, menopausal status, postmenopausal hormone use, and smoking status...
May 10, 2017: Neurology
https://www.readbyqxmd.com/read/28488811/resolution-of-occlusive-carotid-artery-thrombus-treated-with-anticoagulation-as-demonstrated-on-duplex-ultrasonography
#17
Laura Stein, John W Liang, Jesse Weinberger
BACKGROUND AND PURPOSE: While the majority of cerebral ischemic events due to carotid occlusive disease result from atherosclerotic plaque rupture, intraluminal carotid artery thrombus occasionally occurs in patients without preexisting carotid atherosclerosis. Identification of nonatherosclerotic thrombus as the cause of the carotid occlusive disease can obviate the need for an interventional procedure, and resolution of thrombus can be monitored with B-mode duplex ultrasonography. METHODS: We reviewed 3 patients treated on The Mount Sinai Hospital Stroke Unit with anticoagulation for nonatherosclerotic carotid thrombi and followed with serial Doppler ultrasonogrpahy for resolution of thrombus...
May 10, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#18
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485278/30-day-results-from-prospective-multi-specialty-evaluation-of-carotid-artery-stenting-using-the-cguard-micronet-covered-embolic-prevention-stent-system-in-real-world-multicenter-clinical-practice-the-iron-guard-study
#19
Francesco Speziale, Laura Capoccia, Pasqualino Sirignano, Wassim Mansour, Chiara Pranteda, Renato Casana, Carlo Setacci
AIMS: The aim of the present study was to evaluate peri-procedural and 30-day outcomes in a prospective series of patients treated with the CGuard embolic prevention stent system (EPS). METHODS AND RESULTS: From April 2015 to June 2016 a physician-initiated prospective multicenter study was performed in 200 consecutive patients admitted to protected carotid artery stenting (CAS) and treated using CGuard EPS in twelve Vascular Centers. Outcome measures were: technical success, periprocedural (0-24 hours) and post- procedural (24hours-30 days) major and minor strokes, death, acute myocardial infarction (AMI), transient ischemic attack (TIA), and external carotid occlusion...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28483832/screening-for-atrial-fibrillation-a-report-of-the-af-screen-international-collaboration
#20
REVIEW
Ben Freedman, John Camm, Hugh Calkins, Jeffrey S Healey, Mårten Rosenqvist, Jiguang Wang, Christine M Albert, Craig S Anderson, Sotiris Antoniou, Emelia J Benjamin, Giuseppe Boriani, Johannes Brachmann, Axel Brandes, Tze-Fan Chao, David Conen, Johan Engdahl, Laurent Fauchier, David A Fitzmaurice, Leif Friberg, Bernard J Gersh, David J Gladstone, Taya V Glotzer, Kylie Gwynne, Graeme J Hankey, Joseph Harbison, Graham S Hillis, Mellanie T Hills, Hooman Kamel, Paulus Kirchhof, Peter R Kowey, Derk Krieger, Vivian W Y Lee, Lars-Åke Levin, Gregory Y H Lip, Trudie Lobban, Nicole Lowres, Georges H Mairesse, Carlos Martinez, Lis Neubeck, Jessica Orchard, Jonathan P Piccini, Katrina Poppe, Tatjana S Potpara, Helmut Puererfellner, Michiel Rienstra, Roopinder K Sandhu, Renate B Schnabel, Chung-Wah Siu, Steven Steinhubl, Jesper H Svendsen, Emma Svennberg, Sakis Themistoclakis, Robert G Tieleman, Mintu P Turakhia, Arnljot Tveit, Steven B Uittenbogaart, Isabelle C Van Gelder, Atul Verma, Rolf Wachter, Bryan P Yan
Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document...
May 9, 2017: Circulation
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