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Stroke prediction atrial fibrillation

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https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#1
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29340587/subclinical-device-detected-atrial-fibrillation-and-stroke-risk-a-systematic-review-and-meta-analysis
#2
Rajiv Mahajan, Tharani Perera, Adrian D Elliott, Darragh J Twomey, Sharath Kumar, Dian A Munwar, Kashif B Khokhar, Anand Thiyagarajah, Melissa E Middeldorp, Chrishan J Nalliah, Jeroen M L Hendriks, Jonathan M Kalman, Dennis H Lau, Prashanthan Sanders
Aims: To determine stroke risk in subclinical atrial fibrillation (AF) and temporal association between subclinical AF and stroke. Methods and results: Pubmed/Embase was searched for studies reporting stroke in subclinical AF in patients with cardiac implantable electronic devices (CIEDs). After exclusions, 11 studies were analysed. Of these seven studies reported prevalence of subclinical AF, two studies reported association between subclinical and clinical AF, seven studies reported stroke risk in subclinical AF, and five studies reported temporal relationship between subclinical AF and stroke...
January 10, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29325635/stroke-prediction-rules-in-atrial%C3%A2-fibrillation
#3
EDITORIAL
Brian F Gage
No abstract text is available yet for this article.
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29325634/relationship-of-aging-and-incident%C3%A2-comorbidities-to-stroke-risk-in-patients%C3%A2-with-atrial-fibrillation
#4
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
#5
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/29321236/midregional-proatrial-natriuretic-peptide-improves-risk-stratification-after-ischemic-stroke-association-with-mortality-and-cardioembolic-etiology
#6
Gian Marco De Marchis, Juliane Schneider, Anja Weck, Felix Fluri, Joachim Fladt, Christian Foerch, Beat Mueller, Andreas Luft, Mirjam Christ-Crain, Marcel Arnold, Mira Katan
OBJECTIVE: To validate midregional proatrial natriuretic peptide (MR-proANP) for outcome prediction and diagnosis of cardioembolic stroke etiology compared to established clinical variables. METHODS: In this prospective multicenter cohort study, we quantified MR-proANP levels in ischemic stroke patients within 24 hours of onset. Primary outcome measures were 90-day mortality, unfavorable functional outcome (modified Rankin Scale score >2), and cardioembolic stroke etiology diagnosed during hospitalization...
January 10, 2018: Neurology
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#7
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29310958/increased-left-ventricular-filling-pressure-and-arterial-occlusion-in-stroke-related-to-atrial-fibrillation
#8
Wi-Sun Ryu, Eun-Kee Bae, Soo-Hyun Park, Sang-Wuk Jeong, Dawid Schellingerhout, Matthias Nahrendorf, Dong-Eog Kim
BACKGROUND: We investigated whether left ventricular filling pressure is associated with arterial occlusion in patients with ischemic stroke related to atrial fibrillation (AF). METHODS: Ninety-nine patients with AF-related stroke were included. Left ventricular filling pressure was assessed by E (early mitral inflow velocity)/e' (early diastolic velocity of the mitral valve annulus velocity) ratio based on tissue Doppler echocardiography. Arterial occlusion was evaluated by computed tomography or magnetic resonance angiography...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29307458/prediction-of-incident-atrial-fibrillation-according-to-gender-in-patients-with-ischemic-stroke-from-a-nationwide-cohort
#9
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/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/29306469/value-of-dapt-score-to-predict-adverse-outcome-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-a-post-hoc-analysis-from-the-afcas-registry
#11
Wail Nammas, Tuomas Kiviniemi, Axel Schlitt, Andrea Rubboli, Josè Valencia, Gregory Y H Lip, Pasi P Karjalainen, Fausto Biancari, K E Juhani Airaksinen
BACKGROUND: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI. METHODS AND RESULTS: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29302461/warfarin-anticoagulation-in-acute-type-a-aortic-dissection-survivors-watas
#12
Yskert von Kodolitsch, Oliver Wilson, Helke Schüler, Axel Larena-Avellaneda, Tilo Kölbel, Sabine Wipper, Fiona Rohlffs, Christian Behrendt, E Sebastian Debus, Jens Brickwedel, Evaldas Girdauskas, Christian Detter, Alexander M Bernhardt, Jürgen Berger, Stefan Blankenberg, Hermann Reichenspurner, Tamer Ghazy, Klaus Matschke, Ralf-Thorsten Hoffmann, Norbert Weiss, Adrian Mahlmann
Background: Early survivors of acute type A aortic dissection (AAAD) remain at risk for late death and late aortic events. However, the frequency and long-term effects of warfarin anticoagulation on long-term outcome in post-surgical AAAD survivors have not been elucidated. Methods: Two tertiary care centers performed a retrospective observational cohort study of warfarin anticoagulation in AAAD in 243 persons with early survival of surgical repair (WATAS). Serial postoperative tomographic imaging was available in 106 persons...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29289494/quantifying-time-in-atrial-fibrillation-and-the-need-for-anticoagulation
#13
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/29288496/cha2-ds2-vasc-scores-for-outcomes-prediction-in-acute-ischemic-stroke
#14
Chun-Hung Su, Teng-Fu Tsao, An-Chih Chen, Kai-Wei Chang, Yi-Sun Yang, Kwo-Chang Ueng, Chin-Feng Tsai
BACKGROUND: The CHADS2 and CHA2 DS2 -VASc scores are clinical risk stratification instruments that are used clinically to assess the risk of stroke in patients with atrial fibrillation (AF). The aim of this study was to evaluate whether the pre-stroke CHADS2 and CHA2 DS2 -VASc scores could be useful for predicting infarction severity and long-term outcomes in patients of acute ischemic stroke. MATERIALS AND METHODS: This prospective study included all 1494 patients who had acute ischemic stroke without hemorrhagic transformation which were evidenced with magnetic resonance (MR) imaging during hospitalization...
December 29, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29276556/atrial-fibrillation-predictors-on-mobile-cardiac-telemetry-in-cryptogenic-ischemic-stroke
#15
Omar Kass-Hout, Tareq Kass-Hout, Ankit Parikh, Michael Hoskins, Stephen D Clements, Srikant Rangaraju, Ali Reza Noorian, Lauren Ayala, Debra Blanke, Laura Bamford, Aaron Anderson, Samir Belagaje, Manuel Yepes, Michael Frankel, Fadi Nahab
Background and Purpose: The objective of our study was to evaluate magnetic resonance imaging (MRI) and echocardiographic characteristics that would identify patients with cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) who subsequently developed paroxysmal atrial fibrillation (PAF) on mobile cardiac outpatient telemetry (MCOT). Methods: All patients with cryptogenic IS or TIA seen at the Emory University Hospital and Emory University Hospital Midtown from January 1, 2009, to June 30, 2013, who underwent MCOT were included in this analysis...
January 2018: Neurohospitalist
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
#16
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/29260030/pre-stroke-glycemic-control-is-associated-with-early-neurologic-deterioration-in-acute-atrial-fibrillation-related-ischemic-stroke
#17
J-S Kim, R-Y Kim, J-K Cha, H W Rha, M-J Kang, D-H Kim, H-S Park, J-H Choi, J-T Huh, I-K Lee
Background: It has been suggested that AF-related ischemic stroke (IS) that is accompanied by atherosclerotic burden have poorer outcomes. The aim of this study was to investigate the importance of pre-stroke glycemic control (PSGC) on the early neurologic deterioration (END) of patients with acute AF-related IS. Methods: We retrospectively recruited 121 patients with AF-related IS who also had Diabetes mellitus (DM). The HbA1C level was measured in all subjects...
September 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29249057/stroke-associated-infection-independently-predicts-3-month-poor-functional-outcome-and-mortality
#18
Satoshi Suda, Junya Aoki, Takashi Shimoyama, Kentaro Suzuki, Yuki Sakamoto, Takehiro Katano, Seiji Okubo, Chikako Nito, Yasuhiro Nishiyama, Masahiro Mishina, Kazumi Kimura
Stroke-associated infection (SAI) is a common and serious complication of stroke. This study aimed to assess the effects of SAI on patient mortality and functional outcome at 3 months after stroke onset. We retrospectively analyzed 809 consecutive patients with acute stroke (517 men and 292 women; median age, 72 years) who were admitted to our department between September 2014 and June 2016. SAI was defined as an infection diagnosed during the hospitalization period. Poor outcome was defined as a modified Rankin Scale (mRS) score of 3-5 or death (mRS score of 6)...
December 16, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29229726/prognostic-significance-of-blood-pressure-variability-on-beat-to-beat-monitoring-after-transient-ischemic-attack-and-stroke
#19
Alastair J S Webb, Sara Mazzucco, Linxin Li, Peter M Rothwell
BACKGROUND AND PURPOSE: Visit-to-visit and day-to-day blood pressure (BP) variability (BPV) predict an increased risk of cardiovascular events but only reflect 1 form of BPV. Beat-to-beat BPV can be rapidly assessed and might also be predictive. METHODS: In consecutive patients within 6 weeks of transient ischemic attack or nondisabling stroke (Oxford Vascular Study), BPV (coefficient of variation) was measured beat-to-beat for 5 minutes (Finometer), day-to-day for 1 week on home monitoring (3 readings, 3× daily), and on awake ambulatory BP monitoring...
December 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29229215/atrial-fibrillation-neurogenic-or-myogenic
#20
REVIEW
Alina Scridon, Răzvan Constantin Şerban, Philippe Chevalier
A 55-year-old hypertensive patient presents atrial fibrillation after vasovagal syncope. Non-invasive cardiac workup is normal. Without antiarrhythmic therapy, the patient has no recurrence for the next 3years, then presents with a stroke. Echocardiography eventually reveals left atrial dilation. This sequence of events illustrates the well-known links between age, arterial hypertension, atrial fibrillation, atrial neuromyopathy and stroke. A frequently neglected common denominator in this equation is impaired sympathovagal balance...
December 8, 2017: Archives of Cardiovascular Diseases
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