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Stroke prediction atrial fibrillation

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https://www.readbyqxmd.com/read/28431475/validation-of-the-essen-stroke-risk-score-in-different-subtypes-of-ischemic-stroke
#1
Yi Liu, Yongjun Wang, William A Li, Aoshuang Yan, Yilong Wang
OBJECTIVE: Predictive scores are important tools for stratifying patients based on their risk of future vascular events and for selecting preventive therapies. The aim of this study is to validate the Essen Stroke Risk Score (ESRS) for stratifying stroke recurrence in different subtypes of non-atrial fibrillation ischemic stroke in a large Chinese cohort. METHODS: Data were derived from the Blood pressure and clinical Outcome in Stroke Survivors registry, which includes a cohort of 2204 stroke patients...
April 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28429529/impaired-left-atrial-function-predicts-inappropriate-shocks-in-primary-prevention-implantable-cardioverter-defibrillator-candidates
#2
Susumu Tao, Hiroshi Ashikaga, Luisa A Ciuffo, Kihei Yoneyama, Joao A C Lima, Terry F Frank, Robert G Weiss, Gordon F Tomaselli, Katherine C Wu
INTRODUCTION: Inappropriate implantable cardioverter-defibrillator (ICD) shocks, commonly caused by atrial fibrillation (AF), are associated with an increased mortality. Because impaired left atrial (LA) function predicts development of AF, we hypothesized that impaired LA function predicts inappropriate shocks beyond a history of AF. METHODS AND RESULTS: We prospectively analyzed the association between LA function and incident inappropriate shocks in primary prevention ICD candidates...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28428444/impact-of-atrial-fibrillation-on-the-clinical-course-of-apical-hypertrophic-cardiomyopathy
#3
Sang-Eun Lee, Jin-Kyu Park, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Apical hypertrophic cardiomyopathy (ApHCM) is considered a 'benign' form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM. METHODS: The occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years). RESULTS: AF occurred in 77 patients with ApHCM (prevalence, 25...
April 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28426886/risk-of-stroke-in-chronic-heart-failure-patients-with-preserved-ejection-fraction-but-without-atrial-fibrillation-analysis-of-the-charm-preserved-and-i-preserve-trials
#4
Azmil H Abdul-Rahim, Ana-Cristina Perez, Rachael L MacIsaac, Pardeep S Jhund, Brian L Claggett, Peter E Carson, Michel Komajda, Robert S McKelvie, Michael R Zile, Karl Swedberg, Salim Yusuf, Marc A Pfeffer, Scott D Solomon, Gregory Y H Lip, Kennedy R Lees, John J V McMurray
Aims: The incidence and predictors of stroke in patients with heart failure and preserved ejection fraction (HF-PEF), but without atrial fibrillation (AF), are unknown. We described the incidence of stroke in HF-PEF patients with and without AF and predictors of stroke in those without AF. Methods and results: We pooled data from the CHARM-Preserved and I-Preserve trials. Using Cox regression, we derived a model for stroke in patients without AF in this cohort and compared its performance with a published model in heart failure patients with reduced ejection fraction (HF-REF)-predictive variables: age, body mass index, New York Heart Association class, history of stroke, and insulin-treated diabetes...
March 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28422144/risk-and-prediction-of-sudden-cardiac-death-and-ventricular-arrhythmias-for-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#5
Tze-Fan Chao, Chia-Jen Liu, Ta-Chuan Tuan, Su-Jung Chen, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen
Sudden cardiac death (SCD) is the most devastating manifestation of ventricular arrhythmias (VAs), and is the leading cause of mortality among atrial fibrillation (AF) patients. The goal of the present study was to investigate the incidence of SCD/VAs amongst patients with and without AF. We also aimed to identify important risk factors of SCD/VAs among AF patients. Using the "National Health Insurance Research Database" in Taiwan, a total of 352,656 AF and 352,656 non-AF patients without antecedent SCD/VAs were identified...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28413184/risk-of-ischemic-stroke-in-patients-with-non-valvular-atrial-fibrillation-not-receiving-oral-anticoagulants%C3%A3-korean-nationwide-population-based-study
#6
Si-Hyuck Kang, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Myung-Jin Cha, Youngjin Cho, Il-Young Oh, Seil Oh
BACKGROUND: Atrial fibrillation, the most common cardiac arrhythmia, is associated with an elevated thromboembolic risk, including ischemic stroke. Guidelines recommend the stratification of individual stroke risk and tailored antithrombotic therapy. This study investigated the demographics, comorbidities, and prognosis of non-valvular AF (NVAF) in Korean patients.Methods and Results:We extracted data on 10,846 patients with newly diagnosed NVAF who were naïve to oral anticoagulants from the National Health Insurance Service-National Sample Cohort...
April 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28410424/trends-in-the-prevalence-and-management-of-pre-stroke-atrial-fibrillation-the-south-london-stroke-register-1995-2014
#7
Vageesh Jain, Iain J Marshall, Siobhan L Crichton, Christopher McKevitt, Anthony G Rudd, Charles D A Wolfe
BACKGROUND: Previous studies have found low use of anticoagulation prior to stroke, in people with atrial fibrillation (AF). This study examined data on patients with AF-related stroke from a population-based stroke register, and sought to examine changes in management of AF prior to stroke, and reasons for suboptimal treatment, in those who were known to be at a high risk of stroke. METHODS: The South London Stroke Register (SLSR) is an ongoing population-based register recording first-in-a-lifetime stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28408066/derivation-and-validation-of-a-scoring-system-for-intravenous-tissue-plasminogen-activator-use-in-asian-patients
#8
Leonard L L Yeo, Shih-Chao Chien, Jr-Rung Lin, Chia-Wei Liow, Jiann-Der Lee, Tsung-I Peng, Teoh Hock Luen, Vijay Sharma, Bernard Chan, Tsong-Hai Lee
BACKGROUND AND PURPOSE: As Chinese Asian populations have an increased risk of intracerebral hemorrhage (ICH) after intravenous tissue plasminogen activator (IV tPA), we aimed to design a rapid, clinically applicable risk scoring system to predict ICH and functional outcomes after IV tPA treatment in Asian ischemic stroke patients. METHODS: From January 2009 to December 2012, consecutive acute ischemic stroke patients treated with IV tPA recruited from the Stroke Registry in Chang Gung Healthcare System (SRICHS) in Taiwan and the National University Hospital of Singapore (NUHS) acute stroke database were used to create and validate a scoring system...
April 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28407109/cha2ds2-vasc-score-for-ischaemic-stroke-risk-stratification-in-patients-with-chronic-obstructive-pulmonary-disease-with-and-without-atrial-fibrillation-a-nationwide-cohort-study
#9
Wei-Syun Hu, Cheng-Li Lin
Aims: We conducted this nationwide cohort study to identify the performance of CHA2DS2-VASc score for ischaemic stroke risk stratification in chronic obstructive pulmonary disease (COPD) patients whether they had comorbid atrial fibrillation (AF) or not. Methods and results: Using the longitudinal health insurance database 2000, patients aged ≥20 years with newly diagnosed COPD from 2000 to 2011 with at least three claims for outpatient and/or hospitalization visits were identified...
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28400900/conjugate-eye-deviation-on-ct-associated-with-worse-outcomes-despite-iv-thrombolysis
#10
Nirav H Shah, Nirav Bhatt, Anita Tipirneni, Diego Condes, Priyank Khandelwal, Jose G Romano
INTRODUCTION: Rapid stroke management has significant implications in patient outcomes. Ipsilateral computed tomography conjugate eye deviation (CT-CED) has been associated with worse outcomes but has never been evaluated as predictive of vascular occlusion. To test the hypothesis that CT-CED is a marker for vascular occlusion, we evaluated patients treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We performed a retrospective analysis of patients with acute ischemic stroke treated with IV tPA at a large tertiary care hospital over an 18-month period...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28392100/risk-prediction-for-ischemic-stroke-and-transient-ischemic-attack-in-patients-without-atrial-fibrillation-a-retrospective-cohort-study
#11
Zhong Yuan, Erica A Voss, Frank J DeFalco, Guohua Pan, Patrick B Ryan, Daniel Yannicelli, Christopher Nessel
BACKGROUND: Stroke mainly occurs in patients without atrial fibrillation (AF). This study explored risk prediction models for ischemic stroke and transient ischemic attack (TIA) in patients without AF. METHODS: Three US-based healthcare databases (Truven MarketScan Commercial Claims and Encounters [CCAE], Medicare Supplemental [MDCR], and Optum Clinformatics [Optum]) were used to establish patient cohorts without AF during the index period of 2008-2012. The performance of 2 existing models (CHADS2 and CHA2DS2-VASc) for predicting stroke and TIA was examined by fitting a logistic regression to a training dataset and evaluating predictive accuracy in a validation dataset (area under the curve, AUC) using patients with complete follow-up of 1 or 3 years, separately...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28375552/predictive-performance-of-the-cha2ds2-vasc-rule-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#12
Sander van Doorn, Thomas P A Debray, Femke Kaasenbrood, Arno W Hoes, Frans H Rutten, Karel G M Moons, Geert-Jan Geersing
BACKGROUND: The CHA2DS2-VASc decision rule is widely recommended for estimating stroke risk in patients with atrial fibrillation (AF) though validation studies show ambiguous and conflicting results. OBJECTIVES: We aimed to (1) review existing studies validating CHA2DS2-VASc in AF patients not (yet) anticoagulated, 2) meta-analyze estimates of stroke risk per score, and 3) explore sources of heterogeneity across the validation studies. METHODS: We performed a systematic literature review and random effects meta-analysis of studies externally validating CHA2DS2-VASc in AF patients not on anticoagulants...
April 4, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28373985/association-of-chads2-and-cha2ds2-vasc-scores-with-left-atrial-thrombus-with-nonvalvular-atrial-fibrillation-a-single-center-based-retrospective-study-in-a-cohort-of-2695-chinese-subjects
#13
J Huang, S L Wu, Y M Xue, H W Fei, Q W Lin, S Q Ren, H T Liao, X Z Zhan, X H Fang, L Xu
The main mechanism of the CHADS2 and CHA2DS2-VASc scores to predict stroke in nonvalvular atrial fibrillation (NVAF) is still controversial. We evaluated the association of the CHADS2 and CHA2DS2-VASc scores with left atrial thrombus (LAT) as detected by transesophageal echocardiographic (TEE) and compared the predictive ability of these risk stratification schemes with nonvalvular atrial fibrillation (NVAF). Data from 2,695 consecutive NVAF patients in whom TEE was performed for screening LAT from July 2007 to February 2014 were analyzed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28364953/comparison-of-morphologic-features-and-flow-velocity-of-the-left-atrial-appendage-among-patients-with-atrial-fibrillation-alone-transient-ischemic-attack-and-cardioembolic-stroke
#14
Yonggu Lee, Hwan-Cheol Park, Youkyung Lee, Soon-Gil Kim
The left atrial appendage (LAA) is a major source of emboli responsible for cardioembolic stroke (CES). We hypothesized that there could be differences in the morphologic and functional features of LAAs among patients with atrial fibrillation (AF) alone, patients with cardioembolic transient ischemic attack (CETIA), and patients with CES. Patients with AF and CETIA/CES were included in either a CETIA group or a CES group. Patients with AF without past histories of stroke were included in an AF/non-CVA (cerebrovascular accident) group...
March 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28360407/predictive-role-of-coagulation-fibrinolytic-and-endothelial-markers-in-patients-with-atrial-fibrillation-stroke-and-thromboembolism-a-meta-analysis-meta-regression-and-systematic-review
#15
Alexander Weymann, Anton Sabashnikov, Sadeq Ali-Hasan-Al-Saegh, Aron-Frederik Popov, Seyed Jalil Mirhosseini, William L Baker, Mohammadreza Lotfaliani, Tong Liu, Hamidreza Dehghan, Senol Yavuz, Michel Pompeu Barros de Oliveira Sá, Jae-Sik Jang, Mohamed Zeriouh, Lei Meng, Fabrizio D'Ascenzo, Abhishek J Deshmukh, Guiseppe Biondi-Zoccai, Pascal M Dohmen, Hugh Calkins, Integrated Meta-Analysis Of Cardiac Cardiac Surgery And Cardiology-Group Imcsc-Group
BACKGROUND The pathophysiological mechanism associated with the higher prothrombotic tendency in atrial fibrillation (AF) is complex and multifactorial. However, the role of prothrombotic markers in AF remains inconclusive. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating the association of coagulation activation, fibrinolytic, and endothelial function with occurrence of AF and clinical adverse events. A comprehensive subgroup analysis and meta-regression was performed to explore potential sources of heterogeneity...
March 31, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28356180/nocturnal-desaturation-is-associated-with-atrial-fibrillation-in-patients-with-ischemic-stroke-and-obstructive-sleep-apnea
#16
Chung-Yao Chen, Chien-Hui Ho, Chia-Ling Chen, Chung-Chieh Yu
STUDY OBJECTIVES: Both atrial fibrillation (AF) and obstructive sleep apnea (OSA) are risk factors for ischemic stroke. Previous studies suggested that OSA is associated with AF in individuals who have not had a stroke. For better secondary prevention of stroke, this study determined the association between OSA and AF among patients with ischemic stroke. METHODS: This cross-sectional study recruited consecutive patients with subacute ischemic stroke admitted for neurorehabilitation...
March 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28355753/-effect-of-obstructive-sleep-apnea-on-sleep-architecture-of-acute-ischemic-stroke-patients
#17
Y N Xu, J Li, J Y Huang, C Zhu, C J Mao, Y Shen, C F Liu
Objective: To investigate the effect of obstructive sleep apnea (OSA) on sleep architecture in acute ischemic stroke (AIS) patients. Methods: Seventy AIS patients with polysomnography examination from June 2014 to April 2016 were included in the Second Affiliated Hospital of Soochow University. Twenty-seven healthy controls during the same period were chosen as control group. According to apnea-hypopnea index (AHI), AIS patients were divided into AIS group (AHI<5/h) and AIS+ OSA group (AHI≥5/h). Their general conditions, Neurological function defect (national institutes of health stroke scale, NIHSS) on admission and at discharge and self-care ability (modified Rankin Scale, mRS) at discharge and 3 months later (mRS score <2 reflected good prognosis, and mRS score≥2 reflected unfavorable prognosis) were collected...
March 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28355459/laboratory-monitoring-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-review
#18
John W Eikelboom, Daniel J Quinlan, Jack Hirsh, Stuart J Connolly, Jeffrey I Weitz
Importance: The non-vitamin K antagonist oral anticoagulants (NOACs) apixaban, dabigatran, edoxaban, and rivaroxaban are administered in fixed doses without anticoagulant monitoring. Randomized trials show that unmonitored NOAC therapy is at least as effective as and safer than dose-adjusted warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Subgroup analyses indicate that plasma drug levels or anticoagulant activity of the NOACs predict stroke and bleeding...
March 29, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28345395/evaluation-of-the-predictive-value-of-cha2ds2-vasc-score-for-in-stent-restenosis
#19
Samet Yilmaz, Mehmet Kadri Akboga, Dursun Aras, Serkan Topaloglu
The CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age 65-74 years, female gender) score is used to estimate thromboembolic risk in atrial fibrillation (AF). Its usefulness in predicting in-stent restenosis (ISR) is unknown. We evaluated the predictive value of the CHA2DS2-VASc score in AF-free patients who have undergone stent implantation. A total of 1350 patients who underwent coronary angiography and successful bare-metal stent implantation were analyzed...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28340049/cardiac-troponin-i-as-a-predictor-of-mortality-in-patients-with-first-episode-acute-atrial-fibrillation
#20
Mohammad E Naffaa, Roni Nasser, Elias Manassa, Maha Younis, Zaher S Azzam, Doron Aronson
Background: Recent-onset atrial fibrillation (AF) is a frequent cause for presentation to the emergency department. Recent studies proposed that the addition of biomarker information might improve the prediction of clinical outcomes by enabling identification of patients at high risk. Aim: We aimed to examine the role of cardiac troponin I as a predictor of clinical outcome in patients with first episode acute atrial fibrillation. Design: : Patients, 18 years or older, presenting to our hospital with a primary diagnosis of first episode acute atrial fibrillation were included in this retrospective study...
March 11, 2017: QJM: Monthly Journal of the Association of Physicians
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