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homocysteine atrial fibrillation stroke

Yan Yao, Mei-Sheng Shang, Jian-Zeng Dong, Chang-Sheng Ma
Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with a series of adverse complications that cause so-called AF socioeconomic burden. Apart from the classical risk factors, it seems to be novel factors that increase the risk of AF and AF-related stroke. Recently, more and more evidence has well documented the close relationships between homocysteine (Hcy) and AF. As a well-known marker for pro-oxidation and pro-inflammation, Hcy plays an important role in a number of vascular diseases having strong association with AF...
October 16, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
J David Spence
In an era in which medicine personalized on the basis of genotyping is being proposed, it is timely to recognize that existing therapies could be markedly improved if they were on the basis of more effective application of principles on the basis of available phenotyping. Blood pressure control, which is poor on a worldwide basis, is a major opportunity to reduce cardiovascular risk. There are many genetic variants that have a small effect on blood pressure, but specific therapies are not available for most of them...
May 2017: Canadian Journal of Cardiology
Qiang Tan, Shuangyue Zhang, Xiaoyi Zou, Jun Zhao, Jia Hao, Qian Sun
OBJECTIVE: This study aimed to evaluate whether fluvastatin therapy could decrease the probability of atrial fibrillation (AF) progression from paroxysmal AF to permanent AF and decrease the recurrence frequency of AF. METHODS: Analyses were performed using two-tailed Student's t test or Mann-Whitney U tests. Categorical variables were compared with the χ2 statistics or Fisher's exact test. Patients with paroxysmal AF were randomized case-control, prospective into either the fluvastatin group (n=61) or control group (n=57)...
April 10, 2017: Anatolian Journal of Cardiology
Ashkan Shoamanesh, Sarah R Preis, Alexa S Beiser, Carlos S Kase, Philip A Wolf, Ramachandran S Vasan, Emelia J Benjamin, Sudha Seshadri, Jose R Romero
OBJECTIVE: We related a panel of inflammatory biomarkers to risk of incident ischemic stroke (IIS) in a community-dwelling sample. METHODS: Stroke-free Framingham offspring attending examination cycle 7 (1998-2001) had 15 circulating inflammatory biomarkers measured. Cox proportional hazard models were used to calculate the hazard ratios (HRs) of IIS per SD increment of each biomarker. Model 1 included age and sex. Model 2 additionally adjusted for systolic blood pressure, hypertension treatment, current smoking, diabetes, cardiovascular disease, and atrial fibrillation...
September 20, 2016: Neurology
J David Spence
Elevated levels of total homocysteine impair endothelial dysfunction and increase thrombosis. Homocysteine is causal in animal models, and in human studies, elevated total homocysteine is significantly associated with carotid atherosclerosis, lacunar infarction, and markedly increased risk of stroke in atrial fibrillation. Because two of the early large trials of B vitamin therapy (Vitamin Intervention for Stroke Prevention and the Norwegian Vitamin Study) did not show any reduction of stroke, and the Heart Outcomes Prevention Evaluation 2 trial was mistakenly interpreted as not showing a reduction of stroke (because the authors could not think of a biological difference between stroke and myocardial infarction), there has been widespread pessimism regarding treatment to lower total homocysteine for stroke prevention...
October 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Giuseppe Martini
Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder...
May 2016: Journal of Stroke
Hee Jung Park, Tae Uk Kim, Jung Keun Hyun, Jung Yoon Kim
OBJECTIVE: To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. METHODS: A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage...
December 2015: Annals of Rehabilitation Medicine
Souvik Sen, Katherine Dahlberg, Abigail Case, Stephanie Paolini, Joselyn Burdine, Leema R Peddareddygari, Raji P Grewal
A majority of stroke research in the United States focuses on Caucasian and African-American populations, limiting the amount of comparative stroke data available on other racial and ethnic groups. The purpose of this research was to examine differences in stroke risk factors/subtypes between minority stroke patient groups in the United States (Asian-Indian, African-American, and Hispanic), using a Caucasian reference group. All patients had a comprehensive stroke work-up to ascertain their stroke risk factors and their stroke etiology applying TOAST criteria...
August 2013: International Journal of Neuroscience
Graeme J Hankey, John W Eikelboom, Qilong Yi, Kennedy R Lees, Christopher Chen, Denis Xavier, Jose C Navarro, Udaya K Ranawaka, Wasim Uddin, Stefano Ricci, John Gommans, Reinhold Schmidt
BACKGROUND: Previous studies have suggested that any benefits of folic acid-based therapy to lower serum homocysteine in prevention of cardiovascular events might be offset by concomitant use of antiplatelet therapy. We aimed to establish whether there is an interaction between antiplatelet therapy and the effects of folic acid-based homocysteine-lowering therapy on major vascular events in patients with stroke or transient ischaemic attack enrolled in the vitamins to prevent stroke (VITATOPS) trial...
June 2012: Lancet Neurology
Yue Huang, Jing Jing, Xing-Quan Zhao, Chun-Xue Wang, Yi-Long Wang, Gai-Fen Liu, Chun-Juan Wang, Li-Ping Liu, Xiao-Meng Yang, Yan Jiao, Yun Jiao, Li-Shi Wang, Yong-Jun Wang, Wei-Kuan Gu
BACKGROUND AND PURPOSE: Elevated plasma C-reactive protein (CRP) has been suggested as a risk factor for ischemic stroke (IS) and coronary ischemic disease. Evidence has shown that high-sensitivity CRP (hs-CRP) is related to a worsening prognosis after IS, but hs-CRP was rare in a large-sample study in a Chinese population. We investigated the associations between hs-CRP and outcome of Chinese patients after acute IS. METHODS: Seven hundred and forty-one consecutive acute IS patients (74...
March 2012: CNS Neuroscience & Therapeutics
Ertuğrul Okuyan, Ahmet Uslu, Mehmet Akif Cakar, Irfan Sahin, Imran Onür, Asım Enhos, Halil Ibrahim Biter, Sükrü Cetin, Mustafa Hakan Dinçkal
OBJECTIVES: Increased homocysteine (HCY) levels are associated with an increased risk of cardiovascular disease. Plasma HCY is increased in chronic heart failure (CHF) patients, and previous studies suggest that hyperhomocysteinemia causes adverse cardiac remodeling and affects pump function. We aimed to evaluate the HCY levels in patients with diastolic heart failure with preserved left ventricular ejection fraction (LVEF). METHODS: We prospectively studied 68 patients (39 females and 29 males) who were hospitalized for symptomatic heart failure, as well as 40 age- and sex-matched healthy subjects who comprised the control group...
2010: Cardiology
Natalia S Rost, Rosanna Rahman, Shruti Sonni, Allison Kanakis, Christi Butler, Efi Massasa, Lisa Cloonan, Aaron Gilson, Pilar Delgado, Yuchiao Chang, Alessandro Biffi, Jordi Jimenez-Conde, Angela Besanger, Gisele Silva, Eric E Smith, Jonathan Rosand, Karen L Furie
BACKGROUND: White matter hyperintensity (WMH) is a common radiographic finding in the aging population and a potent risk factor for symptomatic cerebrovascular disease. It is unclear whether WMH represents a single or multiple biological processes. We sought to investigate the extent and determinants of WMH in patients with acute ischemic stroke (AIS). METHODS: We retrospectively analyzed a prospectively enrolled hospital-based cohort of patients with AIS. WMH volume (WMHV) was measured using a previously published method with high interrater reliability based on a semiautomated image analysis program...
May 2010: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tânia Corrêa de Toledo Ferraz Alves, Luiz Kobuti Ferreira, Mauricio Wajngarten, Geraldo F Busatto
Vascular risk factors can play an important role in determining the onset of non-genetic Alzheimer's disease (AD). Most cases of AD are sporadic and late-onset, and a complex interaction between genetic predisposition and vascular risk factors has been proposed. Vascular risk factors for AD include stroke, hypertension, diabetes, homocysteine, smoking, hypercholesterolemia, heart failure and atrial fibrillation; it is possible that these can trigger cerebrovascular dysfunction and AD pathology. Explanations for these associations include the coincidence of common disorders in the elderly where vascular and cerebrovascular disease can precipitate AD, implying that the onset of dementia disease is determined by a synergistic combination of risk factors...
2010: Journal of Alzheimer's Disease: JAD
Bruce Ovbiagele, David S Liebeskind, Sandra Pineda, Jeffrey L Saver
OBJECTIVE: To assess the association of proteinuria with the frequency and number of cerebral microbleeds (CMB), a harbinger of future hemorrhagic stroke. DESIGN: Cross-sectional analysis. Patients Patients with consecutive ischemic stroke and transient ischemic attack admitted to a university hospital during a 22-month period. INTERVENTIONS: Presence and number of CMB were evaluated using gradient-echo T2*-weighted magnetic resonance imaging...
January 2010: Archives of Neurology
Claire L Allen, Ulvi Bayraktutan
Stroke is a leading cause of morbidity and mortality in western populations, with up to 40% of survivors not expected to recover independence from severe disabilities. This equates to an immense financial burden on health systems worldwide. Hence further education is required to inform individuals of the risks to promote secondary prevention strategies in future generations. Stroke is a heterogeneous, multifactorial disease regulated by modifiable and nonmodifiable risk factors. Modifiable factors include a history of high blood pressure, diabetes mellitus and coronary heart disease...
May 2008: International Journal of Stroke: Official Journal of the International Stroke Society
Christianna Purnell, Sujuan Gao, Christopher M Callahan, Hugh C Hendrie
OBJECTIVE: The purpose of this study was to conduct a systematic review of the literature of cardiovascular factors pertaining to incident Alzheimer disease (AD). METHODS: A systematic literature review was conducted of all studies of cardiovascular risk factors for incident AD listed in PubMed in English from 2000 to 2007. Risk factors included hypertension, diabetes, exercise, alcohol intake, smoking, B complex vitamins, homocysteine, stroke, atrial fibrillation, apolipoprotein E (APOE), lipids, and diet...
January 2009: Alzheimer Disease and Associated Disorders
Zaldy S Tan, Alexa Beiser, Ramachandran S Vasan, Rhoda Au, Sanford Auerbach, Douglas P Kiel, Philip A Wolf, Sudha Seshadri
BACKGROUND: Clinical hypothyroidism and hyperthyroidism are recognized causes of reversible dementia, but previous studies relating thyrotropin levels to cognitive performance in clinically euthyroid persons have yielded inconsistent results. METHODS: We related serum thyrotropin concentrations measured at baseline (March 1977-November 1979) to the risk of Alzheimer disease (AD) in 1864 cognitively intact, clinically euthyroid Framingham original cohort participants (mean age, 71 years; 59% women)...
July 28, 2008: Archives of Internal Medicine
Amytis Towfighi, Jeffrey L Saver, Rita Engelhardt, Bruce Ovbiagele
BACKGROUND: Data on recent stroke prevalence rates among middle-aged men in the United States indicate that men aged 55 to 64 years are 3 times more likely than men aged 45 to 54 years to have experienced a stroke. We aimed to determine potential risk factors that may contribute to this steep increase in late midlife stroke occurrence. METHODS: We analyzed the National Health and Nutrition Examination Survey 1999 to 2004 data sets, assessing stroke prevalence, predictors of stroke occurrence, and vascular risk factors in men across their midlife years...
July 2008: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Rohit R Das, Sudha Seshadri, Alexa S Beiser, Margaret Kelly-Hayes, Rhoda Au, Jayandra J Himali, Carlos S Kase, Emelia J Benjamin, Joseph F Polak, Christopher J O'Donnell, Mitsuhiro Yoshita, Ralph B D'Agostino, Charles DeCarli, Philip A Wolf
BACKGROUND AND PURPOSE: Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8% and 17.7% depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS: Our study sample comprised 2040 Framingham Offspring (53% female; mean age, 62+/-9 years) who attended the sixth examination (1996-1998), underwent volumetric brain MRI (1999-2005,) and were free of clinical stroke at MRI...
November 2008: Stroke; a Journal of Cerebral Circulation
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