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Atrial fibrillation and stroke

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https://www.readbyqxmd.com/read/28087552/screening-for-atrial-fibrillation-using-economical-and-accurate-technology-safety-a-pilot-study
#1
Mark Lown, Arthur Yue, George Lewith, Paul Little, Mike Moore
INTRODUCTION: Atrial fibrillation (AF) is a cause of stroke and a marker of atherosclerosis and of all patients with stroke, around 17% have AF. The screening and treatment of AF could prevent about 12% of all strokes. Several relatively low-cost devices with good accuracy now exist which can detect AF including WatchBP and AliveCor. However, they can only measure the ECG or pulse over short time periods. Inexpensive devices such as heart rate monitors, which are widely available, can measure heart rate for prolonged periods and may have potential in screening for AF...
January 13, 2017: BMJ Open
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
#2
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/28086887/patients-and-physicians-perceptions-and-attitudes-about-oral-anticoagulation-and-atrial-fibrillation-a-qualitative-systematic-review
#3
Gemma Mas Dalmau, Elisenda Sant Arderiu, María Belén Enfedaque Montes, Ivan Solà, Sandra Pequeño Saco, Pablo Alonso Coello
BACKGROUND: Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians' perceptions and attitudes towards the benefits and downsides of this treatment. The purpose of this systematic review was to evaluate and synthesize patients' and physicians' perceptions and attitudes towards the benefits and downsides of vitamin K antagonist, in order to explore potential factors related with its underuse...
January 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28077508/not-all-types-of-atrial-fibrillation-carry-the-same-stroke-risk-but-most-benefit-from-oral-anticoagulation
#4
EDITORIAL
Stefan H Hohnloser, Mate Vamos
No abstract text is available yet for this article.
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28077507/stroke-and-mortality-risk-in-patients-with-various-patterns-of-atrial-fibrillation-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction-48
#5
Mark S Link, Robert P Giugliano, Christian T Ruff, Benjamin M Scirica, Heikke Huikuri, Ali Oto, Andrea E Crompton, Sabina A Murphy, Hans Lanz, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
BACKGROUND: Whether the pattern of atrial fibrillation (AF) modifies the risk/benefit of anticoagulation is controversial. In ENGAGE AF-TIMI 48 trial (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48), the factor Xa inhibitor edoxaban was noninferior to warfarin in preventing stroke or systemic embolic events and significantly reduced bleeding and cardiovascular mortality. However, detailed analyses by AF pattern have not been reported...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28076988/ischemic-stroke-risk-in-east-asian-patients-with-cha2ds2-vasc-score-of-1-systematic-review-and-meta-analysis
#6
Ying Bai, Alena Shantsila, Gregory Y H Lip
Background The use of anticoagulation for stroke prevention in patients with atrial fibrillation (AF) and CHA2DS2-VASc score of 1 has been debated, partially due to limited data on ischemic stroke risk and specific clinical trials in these patients. East Asian patients have a different stroke risk profile compared to non-East Asians. We performed a systematic review and meta-analysis of ischemic stroke risk in AF patients with a CHA2DS2-VASc score of 1 in East Asian countries. Methods A comprehensive literature search for studies evaluating ischemic stroke risk related with AF with CHA2DS2-VASc score of 1 was conducted by two reviewers...
January 11, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28076963/long-term-consequences-of-atrial-fibrillation-after-aortic-valve-replacement
#7
Hiroki Kohno, Hideki Ueda, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
Background Atrial fibrillation is a common complication after cardiac surgery, but the risk factors and long-term outcome after primary isolated aortic valve replacement remains to be clarified. Methods A single-center retrospective study was conducted on 157 patients who underwent first-time isolated aortic valve replacement between April 1999 and February 2015. Fifty-eight patients developed new-onset atrial fibrillation within 6 months postoperatively, and they were compared with patients who remained in sinus rhythm...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28076631/targeting-stroke-risk-and-improving-outcomes-in-patients-with-atrial-fibrillation-in-latin-america
#8
Bruce Stambler, Fernando Scazzuso
CONTEXT AND OBJECTIVE: To examine stroke risk factors, including atrial fibrillation, management and prevention, and stroke outcomes across Latin America. DESIGN AND SETTING: Narrative review conducted at Piedmont Heart Institute, United States. METHODS: The PubMed, Embase and Cochrane databases were searched for stroke AND "Latin America" AND epidemiology (between January 2009 and March 2015). Further studies in the SciELO, World Health Organization and Pan-American Health Organization databases were used to address specific points...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
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
#9
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/28074998/-prognostic-factors-of-functional-recovery-from-a-stroke-at-one-year
#10
J A Moreno-Palacios, I Moreno-Martinez, A Bartolome-Nogues, E Lopez-Blanco, R Juarez-Fernandez, I Garcia-Delgado
INTRODUCTION: Recovery of the ability to walk and independence is fundamental for any patient who suffers a stroke, and it can be influenced by a number of factors. AIM: To determine what variables are more important to achieve a good functional recovery at one year after the stroke. PATIENTS AND METHODS: An observational, longitudinal prospective study was conducted with 231 patients diagnosed with a stroke in the year 2013. An analysis was performed of the clinical characteristics, socio-demographic data, neurological situation at the time of hospitalisation -National Institute of Health Stroke Scale (NIHSS)-, functional situation (Rankin Scale and Barthel Index) and ability to walk, both on hospitalisation and on discharge from rehabilitation and at one year...
January 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28073987/neutrophil-lymphocyte-ratio-and-risk-of-atrial-fibrillation-after-thoracic-surgery
#11
Kevin J Walsh, Kay See Tan, Hao Zhang, David Amar
OBJECTIVES: Postoperative atrial fibrillation (POAF) occurs frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke. Recent studies have shown conflicting results on the role of neutrophil-lymphocyte ratio (NLR) and its association with the development of POAF after cardiac surgery. Our goal was to determine whether an association exists between NLR and the incidence of POAF after non-cardiac thoracic surgery. METHODS: Using a database of 259 consecutive patients age 60 or older who had anatomic lung resection or oesophagectomy for oncologic resection, we compared preoperative, postanaesthesia care unit and postoperative day 1 NLR between patients who did and did not develop POAF during their hospitalization using Fisher's exact test or logistic regression...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073863/revisiting-sex-differences-in-outcomes-in-non-valvular-atrial-fibrillation-a-population-based-cohort-study
#12
Christel Renoux, Janie Coulombe, Samy Suissa
AIMS: In patients with non-valvular atrial fibrillation (NVAF), it is uncertain whether the higher risk of ischaemic stroke in women reported in some studies is due to residual confounding. We assessed this association using standard time-fixed and more accurate time-dependent adjustment for confounders. METHODS AND RESULTS: Using the computerized databases of the Régie de l'assurance maladie du Québec (RAMQ), we identified a cohort of patients with NVAF during 2000-2009 and RAMQ medication coverage...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28072697/usefulness-of-hatch-score-in-the-prediction-of-new-onset-atrial-fibrillation-for-asians
#13
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/28071818/safety-profile-of-the-direct-oral-anticoagulants-an-analysis-of-the-who-database-of-adverse-drug-reactions
#14
Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28070883/pilot-of-a-computerised-antithrombotic-risk-assessment-tool-version-2-caratv2-0-for-stroke-prevention-in-atrial-fibrillation
#15
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/28070049/-common-factors-for-ischemic-cerebral-stroke-in-coronary-artery-bypass-grafting-in-patients-with-concomitant-carotid-and-coronary-artery-severe-stenosis
#16
Lei Huang, Feng Kuang, Zhonggui Shan, Yiquan Lai, Hongwei Guo
To analyze two common factors for perioperative ischemic stroke in patients with concomitant carotid and coronary artery severe stenosis and to improve the therapeutic effect.
 Methods: A total of 44 patients with multi-vessel coronary artery disease combined with carotid stenosis, who admitted to the Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University from 2008 to 2014, were enrolled in this study. Among them, 32 cases were male, 12 cases was female. All patients received coronary artery bypass grafting after treatment of neck diseases...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28068791/the-utilization-of-antithrombotic-therapy-in-older-patients-in-aged-care-facilities-with-atrial-fibrillation
#17
Bridget Frain, Ronald Castelino, Luke R Bereznicki
Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28067195/combined-erythropoietin-and-iron-therapy-for-anemic-patients-undergoing-transcatheter-aortic-valve-replacement-the-epicure-randomized-clinical-trial
#18
Marina Urena, Maria Del Trigo, Omar Abdul-Jawad Altisent, Francisco Campelo-Prada, Ander Regueiro, Robert DeLarochellière, Daniel Doyle, Siamak Mohammadi, Jean-Michel Paradis, François Dagenais, Eric Dumont, Rishi Puri, Vincent Laroche, Josep Rodés-Cabau
AIMS: The aim of this study was to evaluate, in anemic patients, the efficacy of erythropoietin (EPO) in reducing red-cell (RC) transfusion rates post-TAVI. METHODS AND RESULTS: This was a randomized double-blind trial. Patients with severe symptomatic aortic stenosis and concomitant anemia with an indication for TAVI were randomized (1:1) to receive 2 weight-based doses of EPO (darbepoetin alfa) + iron or placebo at days 10 (±4 days) and 1 (±1 day) pre- TAVI...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28066862/impact-of-race-on-outcome-of-patients-undergoing-rhythm-control-of-atrial-fibrillation
#19
Asad F Durrani, Siva Soma, Andrew D Althouse, George Leef, Dingxin Qin, Samir Saba
Racial disparities between African American (AA) and White patients have been documented in cardiovascular disease. We investigated whether these disparities exist in patients undergoing rhythm control for atrial fibrillation (AF). 5873 AF patients (241 AA) were followed to the endpoint of death, stroke, or AF recurrence. Invasive procedures for AF rhythm control were examined in both racial groups. Over a mean follow-up time of 40 months, AA patients had a higher adjusted risk of death [HR 1.39, 95% CI 1...
January 9, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28065908/ticagrelor-but-not-clopidogrel-active-metabolite-displays-antithrombotic-properties-in-the-left-atrial-endocardium
#20
Martin F Reiner, Alexander Breitenstein, Erik W Holy, Martina Glanzmann, Heidi Amstalden, Simon F Stämpfli, Nicole R Bonetti, Volkmar Falk, Stephan Keller, Gianluigi Savarese, Stefano Benussi, Francesco Maisano, Thomas F Lüscher, Jürg H Beer, Jan Steffel, Giovanni G Camici
AIMS: Oral anticoagulation is considered standard therapy for stroke prevention in atrial fibrillation (AF). Endocardial activation triggers expression of pro-thrombotic mediators including tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1), and contributes to thrombus formation in the left atrial appendage (LAA) of AF patients. Recently, pleiotropic effects of specific P2Y12 receptor antagonists were demonstrated; however, whether these drugs possess antithrombotic effects on LAA endocardial cells currently remains unknown...
January 8, 2017: European Heart Journal
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