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Stroke prediction atrial fibrillation

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https://www.readbyqxmd.com/read/28104212/left-atrial-appendage-thrombus-in-transcatheter-aortic-valve-replacement-incidence-clinical-impact-and-the-role-of-cardiac%C3%A2-computed%C3%A2-tomography
#1
Sonny Palmer, Nicholas Child, Mark A de Belder, Douglas F Muir, Paul Williams
OBJECTIVES: The aim of this study was to describe the incidence and clinical impact of left atrial appendage thrombus (LAAT) in a population referred for transcatheter aortic valve replacement (TAVR) and to examine the role of cardiac computed tomography (CCT) in the diagnosis of LAAT. BACKGROUND: Atrial fibrillation is common in patients undergoing TAVR. Embolization of LAAT is a potential mechanism of periprocedural stroke. The incidence and clinical impact of LAAT in a TAVR cohort have not been reported, and the optimal method for diagnosing LAAT remains unclear...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28103324/use-of-proton-pump-inhibitors-predicts-heart-failure-and-death-in-patients-with-coronary-artery-disease
#2
Ana María Pello Lázaro, Carmen Cristóbal, Juan Antonio Franco-Peláez, Nieves Tarín, Álvaro Aceña, Rocío Carda, Ana Huelmos, María Luisa Martín-Mariscal, Jesús Fuentes-Antras, Juan Martínez-Millá, Joaquín Alonso, Óscar Lorenzo, Jesús Egido, Lorenzo López-Bescós, José Tuñón
OBJECTIVES: Proton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed the impact of PPIs on the prognosis of patients with stable CAD. METHODS: We followed 706 patients with CAD. Primary outcome was the combination of secondary outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and 2) heart failure (HF) or death...
2017: PloS One
https://www.readbyqxmd.com/read/28089151/influenza-vaccination-reduces-hemorrhagic-stroke-risk-in-patients-with-atrial-fibrillation-a-population-based-cohort-study
#3
Ju-Chi Liu, Ta-Jung Wang, Li-Chin Sung, Pai-Feng Kao, Tsung-Yeh Yang, Wen-Rui Hao, Chun-Chao Chen, Yi-Ping Hsu, Szu-Yuan Wu
PURPOSE: The risk of hemorrhagic stroke in patients with atrial fibrillation (AF) is low but the consequences of its occurrence are extremely severe. In this study, we investigated the association of influenza vaccination with the risk of hemorrhagic stroke to develop an efficient strategy for reducing this risk in patients with AF. METHODS: In this study, data were retrieved from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients who received a diagnosis of AF (n=14,454) before January 1, 2005 (index date) and were followed until December 31, 2012...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087176/carotid-plaque-detection-improves-the-predictive-value-of-cha2ds2-vasc-score-in-patients-with-non-valvular-atrial-fibrillation-the-arapacis-study
#4
Stefania Basili, Lorenzo Loffredo, Daniele Pastori, Marco Proietti, Alessio Farcomeni, Anna Rita Vestri, Pasquale Pignatelli, Giovanni Davì, William R Hiatt, Gregory Y H Lip, Gino R Corazza, Francesco Perticone, Francesco Violi
BACKGROUND AND AIMS: Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA2DS2-VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA2DS2-VASc score. METHODS: We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28075503/correlation-between-cardiac-rhythm-left-atrial-appendage-flow-velocity-and-cha2-ds2-vasc-score-study-based-on-transesophageal-echocardiography-and-2-dimensional-speckle-tracking
#5
Kun Zuo, Lanlan Sun, Xinchun Yang, Xiuzhang Lyu, Kuibao Li
BACKGROUND: The CHA2 DS2 -VASc score is a classic predictor of stroke in patients with atrial fibrillation (AF). Decreased left atrial appendage flow velocity (LAA-FV) reflects the blood stasis, and left atrial (LA) strain is a manifestation of atrial remodeling. This study aimed to explore the effects of AF rhythm and CHA2 DS2 -VASc score in the development of thrombogenesis and their potential correlation with LAA-FV and LA strain. HYPOTHESIS: AF rhythm and high CHA2 DS2 -VASc score correlate independently with decreased LAA-FV, which can be predicted by LA strain...
January 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28072697/usefulness-of-hatch-score-in-the-prediction-of-new-onset-atrial-fibrillation-for-asians
#6
Kazuyoshi Suenari, Tze-Fan Chao, Chia-Jen Liu, Yasuki Kihara, Tzeng-Ji Chen, Shih-Ann Chen
The HATCH score (hypertension <1 point>, age >75 years <1 point>, stroke or transient ischemic attack <2 points>, chronic obstructive pulmonary disease <1 point>, and heart failure <2 points>) was reported to be useful for predicting the progression of atrial fibrillation (AF) from paroxysmal to persistent or permanent AF for patients who participated in the Euro Heart Survey. The goal of the current study was to investigate whether the HATCH score was a useful scheme in predicting new-onset AF...
January 2017: Medicine (Baltimore)
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/28064291/anticoagulation-use-and-predictors-of-stroke-bleeding-and-mortality-in-multi-ethnic-asian-patients-with-atrial-fibrillation-a-single-centre-experience
#8
P L Chia, X Teoh, C M Hua, M E Ching, D Foo
INTRODUCTION: Atrial fibrillation (AF) is the most common cardiac arrhythmia in singapore. We describe a cohort of multi-ethnic Asian patients with AF, with the aim to evaluate anticoagulation use and to identify factors predictive of stroke, bleeding and all-cause mortality. MATERIALS AND METHODS: this was a single centre, retrospective cohort study. All patients with an admission diagnosis of AF between 1 January 2000 and 31 December 2010 were identified. Of these patients, those who had follow-up data up to 31 December 2012 were included in the study...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28064150/a-novel-risk-prediction-score-in-atrial-fibrillation-for-a-net-clinical-outcome-from-the-engage-af-timi-48-randomized-clinical-trial
#9
Christina L Fanola, Robert P Giugliano, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
AIMS: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. METHODS AND RESULTS: ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#10
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28053220/application-of-static-modeling-in-the-prediction-of-in-vivo-drug-drug-interactions-between-rivaroxaban-and-anti-arrhythmic-agents-based-on-in-vitro-inhibition-studies
#11
Eleanor Jing Yi Cheong, Janice Jia Ni Goh, Yanjun Hong, Gopalakrishnan Venkatesan, Yuanjie Liu, Gigi Ngar Chee Chiu, Pipin Kojodjojo, Eric Chun Yong Chan
Rivaroxaban, a direct Factor Xa inhibitor, is indicated for stroke prevention in non-valvular atrial fibrillation (AF). Studies have revealed that the clearance of rivaroxaban is largely attributed to CYP3A4, CYP2J2 metabolism and P-gp efflux pathways. Amiodarone and dronedarone are anti-arrhythmic agents employed in AF management. Amiodarone, dronedarone and their major metabolites, N-desethylamiodarone (NDEA) and N-desbutyldronedarone (NDBD) demonstrate inhibitory effects on CYP3A4 and CYP2J2 with FDA recommended probe substrates...
January 4, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28033129/new-oral-anticoagulants-and-prevention-of-thromboembolic-events-in-patients-with-hypertension-and-atrial-fibrillation-an-appraisal
#12
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
https://www.readbyqxmd.com/read/28029361/comparison-of-outcomes-of-atrial-fibrillation-in-patients-with-reduced-versus-preserved-left-ventricular-ejection-fraction
#13
Mina M Benjamin, Ashish Chaddha, Emmanuel Sampene, Michael E Field, Peter S Rahko
Patients with newly diagnosed atrial fibrillation (AF) and a rapid ventricular response may present with a reduced left ventricular ejection fraction (LVEF). We compared long-term outcomes of these patients with those with preserved LVEF. This retrospective cohort study included 385 consecutive adults with newly diagnosed AF with rapid ventricular response, presenting to a single medical center from January 2006 to August 2014. Patients with a history of coronary artery disease or known cardiomyopathy were excluded...
October 11, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28027833/usefulness-of-a-healthcare-database-for-epidemiological-research-in-atrial-fibrillation
#14
Yukihiro Koretsune, Takeshi Yamashita, Masahiro Yasaka, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: Big data are gaining attention as a valuable resource for providing insights into a range of issues and questions in healthcare. We evaluated the capacity of a Japanese healthcare database to conduct epidemiological research in non-valvular atrial fibrillation (NVAF). METHODS AND RESULTS: We examined data collected between April 2008 and September 2013 in a Japanese healthcare database. Prior to the risk factor analysis, we validated the criteria for defining the occurrence of a stroke, systemic embolic event (SEE), and intracranial bleeding event during the study period...
December 24, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28017937/catheter-ablation-of-atrial-fibrillation-in-very-young-adults-a-5-year-follow-up-study
#15
Ardan M Saguner, Tilman Maurer, Erik Wissner, Francesco Santoro, Christine Lemes, Shibu Mathew, Christian Sohns, Christian H Heeger, Bruno Reißmann, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Peter Wohlmuth, Karl-Heinz Kuck, Feifan Ouyang, Andreas Metzner
AIMS: Catheter ablation is an established therapy for symptomatic atrial fibrillation (AF). However, outcome data on catheter ablation for AF in young adults is scarce. METHODS AND RESULTS: From 2005-2014, 85 consecutive young adults (mean age 31 ± 4 years; 69% men) with symptomatic paroxysmal AF (PAF, n = 52) and persistent (Pers) AF (n = 33) underwent pulmonary vein isolation (PVI) [±ablation of complex fractionated atrial electrograms/linear lesions in PVI non-responders] at our centre...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27999513/choosing-non-vitamin-k-antagonist-oral-anticoagulants-practical-considerations-we-need-to-know
#16
REVIEW
Alpesh Amin
BACKGROUND: Warfarin is a well-established agent for use in the prevention of stroke or systemic embolic event (SEE) in patients with nonvalvular atrial fibrillation (NVAF) and for the treatment of venous thromboembolism (VTE). However, management of patients requiring oral anticoagulation with warfarin can be complicated by the need for frequent monitoring, drug-drug and drug-food interactions, and a variable response based on genetic polymorphisms. The non-vitamin K antagonist oral anticoagulants (NOACs) were developed as alternatives to warfarin; they do not require routine monitoring and have predictable pharmacokinetics, fewer drug-drug interactions, and limited drug-food interactions...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27982112/usefulness-of-cha2ds2-vasc-scoring-systems-for-predicting-risk-of-perioperative-embolism-in-patients-of-cardiac-myxomas-underwent-surgical-treatment
#17
Liang Yin, Jing Wang, Wei Li, Xinyu Ling, Qian Xue, Yufeng Zhang, Zhinong Wang
Cardiac myxomas are rare but manifested with risk of embolism and often cause unexpected symptoms or sudden death. We retrospectively collected the medical records of patients diagnosed of cardiac myxomas at the cardiac center of our university. Overall 465 patients were included in this study, patients in the embolism group had significantly higher CHA2DS2-VASc scores (P = 0.005). In embolic group, stroke was recorded in 110 (77.14%) patients, while embolic events in the limbs were observed in 10 (2.15%) and 9(1...
December 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27973336/transcatheter-left-atrial-appendage-occlusion-in-patients-with-atrial-fibrillation-and-a-high-bleeding-risk-using-aspirin-alone-for-post-implant-antithrombotic-therapy
#18
Kasper Korsholm, Kirsten Melgaard Nielsen, Jesper Møller Jensen, Henrik Kjærulf Jensen, Grethe Andersen, Jens Erik Nielsen-Kudsk
AIMS: To evaluate safety and efficacy of left atrial appendage occlusion (LAAO) with the Amplatzer Cardiac Plug (ACP) or Amulet using Aspirin (ASA) alone as post-implant antithrombotic treatment. METHODS AND RESULTS: Single-center, prospective, non-randomized study on LAAO with the ACP or Amulet in a consecutive cohort (n=110) treated by ASA alone post-implantation. Primary outcome was device-related thrombosis, while secondary outcomes were ischemic stroke or major bleeding...
December 15, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27929577/a-practical-approach-to-the-new-oral-anticoagulants-used-for-stroke-prevention-in-patients-with-atrial-fibrillation
#19
S Bashir, A Al-Mohammed, S Gupta
This review evaluates the research undertaken in the last six years on the use of new oral anticoagulants for stroke prevention in atrial fibrillation and provides evidence-based answers to common clinical questions. Two types of new oral anticoagulants - direct thrombin (IIa) inhibitors, and Xa inhibitors - are currently available. These drugs have similar pharmacokinetics and pharmacodynamics. They are more predictable than, though in many respects comparable to, warfarin. They do not require frequent laboratory tests, nor do they have a narrow therapeutic window...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27928866/semi-automatic-software-based-detection-of-atrial-fibrillation-in-acute-ischaemic-stroke-and-transient-ischaemic-attack
#20
M N Nickelsen, A Snoer, A M Ali, T Wienecke
BACKGROUND AND PURPOSE: Paroxysmal atrial fibrillation (PAF) is often asymptomatic and increases the risk of ischaemic stroke. Detection of PAF is challenging but crucial because a change of treatment decreases the risk of ischaemic stroke. Post-stroke investigations recommend at least 24-h continuous cardiac rhythm monitoring. Extended monitoring detects more PAF but is limited by costs due to manual analysis. Interpretive software might be a reasonable screening tool. The aim was to validate the performance and utility of Pathfinder SL software compared to manual analysis...
February 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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