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CHA2DS2-VASc Score

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https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#1
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325634/relationship-of-aging-and-incident%C3%A2-comorbidities-to-stroke-risk-in-patients%C3%A2-with-atrial-fibrillation
#2
Tze-Fan Chao, Gregory Y H Lip, Chia-Jen Liu, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Jo-Nan Liao, Fa-Po Chung, Tzeng-Ji Chen, Shih-Ann Chen
BACKGROUND: When assessing ischemic stroke risk in patients with atrial fibrillation (AF), the CHA2DS2-VASc score is calculated based on the baseline risk factors, and the outcomes are determined after a follow-up period. However, the stroke risk in patients with AF does not remain static, and with time, patients get older and accumulate more comorbidities. OBJECTIVES: This study hypothesized that the "Delta CHA2DS2-VASc score," which reflects the change in score between baseline and follow-up, would be more predictive of ischemic stroke compared with the baseline CHA2DS2-VASc score...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29321708/holter-monitorisation-results-in-early-period-of-acute-ischemic-stroke
#3
Sefer Günaydin, Birgül Baştan, Hürtan Acar, Belgin Petek Balci, Aytül Mutlu, Özlem Çokar
Introduction: Paroxysmal atrial fibrillation (PAF) has a similar risk with persistent AF for ischemic stroke. Holter monitorization (HM) and other long-term monitorization methods increased the detection of PAF and short-lasting runs of tachyarrhythmias. Their classification as PAF and roles in the etiology of ischemic stroke is controversial. In this study, we aimed to investigate the frequency of any duration of PAF and clinical characteristics of the patients with acute ischemic stroke who have undergone 24-hrs HM...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29320668/the-impact-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-on-anticoagulation-therapy-in-rural-australia
#4
Jamie W Bellinge, Jarrad J Paul, Liam S Walsh, Lokesh Garg, Gerald F Watts, Carl Schultz
OBJECTIVE: To determine the use of different anticoagulation therapies in rural Western Australia; to establish whether remoteness from health care services affects the choice of anticoagulation therapy; to gather preliminary data on anticoagulation therapy safety and efficacy. DESIGN: Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014-2015. SETTING: Four hospitals serving two-thirds of the rural population of Western Australia...
January 15, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29313819/real-world-safety-and-efficacy-of-watchman-laa-closure-at-one-year-in-patients-on-dual-antiplatelet-therapy-results-of-the-dapt-subgroup-from-the-ewolution-all-comers-study
#5
Martin W Bergmann, Hüseyin Ince, Stephan Kische, Thomas Schmitz, Felix Meincke, Boris Schmidt, David Foley, Timothy R Betts, Marek Grygier, Alexey V Protopopov, Kenneth M Stein, Lucas V A Boersma
AIMS: The study aims to confirm efficacy and safety of WATCHMAN LAA closure in AF patients unsuitable for oral anticoagulation. METHODS AND RESULTS: The EWOLUTION registry prospectively collects all clinical data on 1005 European patients implanted with a WATCHMAN device. Following the procedure, 605 patients (60.2%) received dual antiplatelet therapy according to the local standard; DAPT was discontinued in 85% of pts within 1 year. CHA2DS2-VASc and HAS-BLED scores were 4...
January 9, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29309557/management-and-prognosis-of-atrial-fibrillation-in-diabetic-patients-an-eorp-af-general-pilot-registry-report
#6
Stefano Fumagalli, Salah A Said, Cecile Laroche, Debbie Gabbai, Serena Boni, Niccolò Marchionni, Giuseppe Boriani, Aldo P Maggioni, Agata Musialik-Lydka, Adam Sokal, Jens Petersen, Harry J G M Crijns, Gregory Y H Lip
Aims: Diabetes mellitus (DM) is one of the most important cardiovascular (CV) risk factors. The aim of this study was to evaluate clinical correlates of DM, including management and outcomes, in the EURObservational Research Programme (EORP) - Atrial Fibrillation (AF) General Pilot (EORP-AF) Registry of the European Society of Cardiology. Methods and Results: We studied consecutive patients (N = 3101) enrolled in 70 centers of 9 European countries between February 2012 and March 2013, and compared diabetics with non-diabetics during a one-year follow-up...
December 22, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29308774/a-comparison-of-dabigatran-and-warfarin-for-stroke-prevention-in-elderly-asian-population-with-nonvalvular-atrial-fibrillation-an-audit-of-current-practice-in-malaysia
#7
S H Yap, Y P Ng, A Roslan, J Kolanthaivelu, K W Koh, H S P'ng, Y L Boo, F K Hoo, L B Yap
INTRODUCTION: Atrial fibrillation (AF) is the most common cardiac arrhythmia with significant morbidity and mortality in relation to thromboembolic stroke. Our study aimed to evaluate the safety and efficacy of dabigatran in stroke prevention in elderly patient with nonvalvular AF with regard to the risk of ischemic stroke and intracranial haemorrhage (ICH) in real-world setting. METHODS: A retrospective cohort study of 200 patients on dabigatran and warfarin from January 2009 till September 2016 was carried out...
December 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29307458/prediction-of-incident-atrial-fibrillation-according-to-gender-in-patients-with-ischemic-stroke-from-a-nationwide-cohort
#8
Arnaud Bisson, Alexandre Bodin, Nicolas Clementy, Dominique Babuty, Gregory Y H Lip, Laurent Fauchier
The CHA2DS2-VASc score may identify patients at higher risk of atrial fibrillation (AF) following ischemic stroke (IS) in patients without known AF. We compared gender-related differences in items from CHA2DS2-VASc score and their relation with AF occurrence after IS. This French cohort study was based on the database covering hospital care from 2009 to 2012 for the entire population. Of 336,291 patients with IS, 240,459 (71.5%) had no AF at baseline. Women were older, more frequently had hypertension, heart failure, and had a higher CHA2DS2-VASc score than men (4...
December 2, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29306591/the-frequency-and-risk-factors-for-ischemic-stroke-in-myotonic-dystrophy-type-1-patients
#9
Kosuke Yoshida, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Takashi Kimura
INTRODUCTION: Patients with myotonic dystrophy type 1 have several cardiac abnormalities, especially myocardial conduction disorders. Few studies have investigated cerebral infarction. We investigated the frequency of both symptomatic and asymptomatic ischemic strokes in patients with myotonic dystrophy type 1. METHODS: Patients who were diagnosed with myotonic dystrophy type 1 using genetic testing or clinical examinations at Asahikawa Medical Center were included...
January 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29306476/the-cha2ds2-vasc-score-strongly-correlates-with-glomerular-filtration-rate-and-predicts-renal-function-decline-over-time-in-elderly-patients-with-atrial-fibrillation-and-chronic-kidney-disease
#10
Jan Beyer-Westendorf, Reinhold Kreutz, Florian Posch, Cihan Ay
BACKGROUND: The decline of renal function affects stroke risk in patients with atrial fibrillation (AF). Here, we aim to study the predictive value of the CHA2DS2-VASc score, a stroke-risk stratification model in AF, for renal function and renal decline in patients with AF and chronic kidney disease (CKD). METHODS: Two electronic health record cohorts with AF and CKD stage III/IV were evaluated (Cohort #1 (IMS-DA, Germany): 18,539 patients with 125,149 estimated glomerular filtration rate (eGFR) measurements; Cohort #2 (IMS-THIN, United Kingdom): 18,240 patients with 133,676 eGFR measurements)...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#11
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29301756/outcomes-of-patients-with-atrial-fibrillation-newly-recommended-for-oral-anticoagulation-under-the-2014-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guideline
#12
Matthew P Gray, Samir Saba, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: In March 2014, the American Heart Association updated their guidelines for the management of oral anticoagulation (OAC) in atrial fibrillation, recommending OAC for all patients with CHA2DS2-VASc ≥2. Previously, only patients with CHADS2 ≥2 were recommended for anticoagulation. This study compared effectiveness and safety outcomes of OAC among patients who would receive OAC using the 2014 guidelines but not the 2011 guidelines. METHODS AND RESULTS: Using claims data from a 5% sample of 2013-2014 Medicare beneficiaries, we identified patients with initially diagnosed atrial fibrillation between 2013 and 2014 and selected those who would receive OAC under the 2014 guidelines but not the 2011 guidelines (those with CHA2DS2-VASc score ≥2 or CHADS2 score <2)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29300883/left-atrial-function-to-identify-patients-with-atrial-fibrillation-at-high-risk-of-stroke-new-insights-from-a-large-registry
#13
Melissa Leung, Philippe J van Rosendael, Rachid Abou, Nina Ajmone Marsan, Dominic Y Leung, Victoria Delgado, Jeroen J Bax
Aims: Atrial fibrillation (AF) is an independent risk factor for ischaemic stroke. The CHA2DS2-VASc is the most widely used risk stratification model; however, echocardiographic refinement may be useful, particularly in low risk AF patients. The present study examined the association between advanced echocardiographic parameters and ischaemic stroke, independent of CHA2DS2-VASc score. Methods and results: One thousand, three hundred and sixty-one patients (mean age 65±12 years, 74% males) with first diagnosis of AF and baseline transthoracic echocardiogram were followed by chart review for the occurrence of stroke over a mean of 7...
December 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#14
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29289494/quantifying-time-in-atrial-fibrillation-and-the-need-for-anticoagulation
#15
REVIEW
Kazuo Miyazawa, Daniele Pastori, Gregory Y H Lip
Atrial fibrillation (AF) is one of the major cardiovascular diseases, and the number of patients with AF is predicted to increase markedly in the coming years. Despite recent advance in management of patients with AF, AF remains one of the main causes of stroke or systemic embolism. Application of simple stroke risk-stratification schemes, such as the CHA2DS2-VASc score has been introduced to identify patients who mostly benefit from oral anticoagulants (OACs) for stroke prevention. Current medical devices allow the detection of short and asymptomatic episodes of AF, termed atrial high rate episodes (AHREs), which are also associated with an increased risk of thromboembolism...
December 28, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29284990/the-impact-of-risk-factors-and-comorbidities-on-the-incidence-of-atrial-fibrillation
#16
Nabil Naser, Mirza Dilic, Azra Durak, Mehmed Kulic, Esad Pepic, Elnur Smajic, Zumreta Kusljugic
Introduction: Atrial fibrillation (AF) is the most common form of cardiac arrhythmia in clinical practice and its prevalence increases with age. Patients who develop AF also have cardiovascular risk factors, structural heart disease, and comorbidities, all of which can increase mortality. AF causes a significant economic burden with the increasing trend in AF prevalence and hospitalizations. Research Objectives: The objective of our study is to evaluate the impact of the most common known risk factors on the incidence of atrial fibrillation as an important precursor of cardiac and cerebrovascular morbidity and mortality among our patients in Bosnia and Herzegovina during median follow up period (September 2006 - September 2016)...
December 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/29275886/the-extent-of-left-atrial-low-voltage-areas-included-in-pulmonary-vein-isolation-is-associated-with-freedom-from-recurrent-atrial-arrhythmia
#17
Dong Huang, Jing-Bo Li, Tarek Zghaib, Esra Gucuk Ipek, Muhammad Balouch, David D Spragg, Hiroshi Ashikaga, Harikrishna Tandri, Sunil K Sinha, Joseph E Marine, Ronald D Berger, Hugh Calkins, Saman Nazarian
BACKGROUND: The extent of left atrial (LA) baseline low-voltage areas (LVA-B), which may be a surrogate for fibrosis, is associated with recurrent atrial fibrillation (AF) after ablation. This study aimed to assess the relationship between the extent of LVA-B isolated by ablation (LVA-I) and AF recurrence. METHODS: The study cohort included 159 consecutive patients with drug-refractory AF who underwent an initial AF ablation with LA voltage mapping during sinus rhythm...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29274754/the-has-bled-atria-and-orbit-bleeding-scores-in-atrial-fibrillation-patients-using-non-vitamin-k-antagonist-oral-anticoagulants
#18
Gregory Y H Lip, Flemming Skjøth, Peter Brønnum Nielsen, Jette Nordstrøm Kjældgaard, Torben Bjerregaard Larsen
BACKGROUND: Various bleeding risk scores have been proposed to assess the risk of bleeding in patients with atrial fibrillation (AF) taking oral anticoagulants (OAC). Limited data are available with these scores, in users of non-Vitamin K antagonist OACs (NOACs). METHODS: Using the Danish registries we evaluated and compared the risk classification properties of the HAS-BLED, ATRIA and ORBIT scores for predicting major bleeding in 57,930 atrial fibrillation patients (44...
December 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29273652/improved-risk-stratification-of-patients-with-atrial-fibrillation-an-integrated-garfield-af-tool-for-the-prediction-of-mortality-stroke-and-bleed-in-patients-with-and-without-anticoagulation
#19
Keith A A Fox, Joseph E Lucas, Karen S Pieper, Jean-Pierre Bassand, A John Camm, David A Fitzmaurice, Samuel Z Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Gloria Kayani, Ali Oto, Lorenzo G Mantovani, Frank Misselwitz, Jonathan P Piccini, Alexander G G Turpie, Freek W A Verheugt, Ajay K Kakkar
OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF)...
December 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#20
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
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