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Atrial fibrillation stroke

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https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#1
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28937581/thrombosis-on-a-left-atrial-appendage-occluder-device-the-double-edged-sword-of-stroke-prevention-strategies-in-atrial-fibrillation
#2
Giuseppe Ciconte, Manuel Conti, Mario Baldi, Massimo Saviano, Gabriele Vicedomini, Carlo Pappone
: A huge thrombus, developing after percutaneous left atrial appendage occlusion, has been successfully treated with dabigatran and aspirin as combination therapy.Although novel oral anticoagulants alone may be effective in thrombus dissolution, the association of an antiplatelet drug may safely enhance this process.
September 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28936235/health-literacy-and-atrial-fibrillation-relevance-and-future-directions-for-patient-centred-care
#3
Konstantinos N Aronis, Brittany Edgar, Wendy Lin, Maria Auxiliadora Parreiras Martins, Michael K Paasche-Orlow, Jared W Magnani
Atrial fibrillation (AF) is a common cardiac arrhythmia with significant clinical outcomes, and is associated with high medical and social costs. AF is complicated for patients because of its specialised terminology, long-term adherence, symptom monitoring, referral to specialty care, array of potential interventions and potential for adversity. Health literacy is a frequently under-recognised, yet fundamental, component towards successful care in AF. Health literacy is defined as the capacity to obtain, process and understand health information, and has had markedly limited study in AF...
2017: European Cardiology
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#4
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935464/effectiveness-and-safety-of-oral-anticoagulation-with-non-vitamin-k-antagonists-compared-to-well-managed-vitamin-k-antagonists-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-propensity-score-matched-cohort-study
#5
Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Mario Saugo, Giacomo Zoppellaro, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo
BACKGROUND: The global real-life impact of non-vitamin K antagonist oral anticoagulants (NOACs) introduction in the healthcare system in a setting of well-managed vitamin K antagonist (VKA) therapy has not been specifically addressed. METHODS: We did a population-based retrospective cohort study in naïve patients initiating oral anticoagulants for stroke prevention in atrial fibrillation in a region with a well-managed VKA therapy. NOAC and VKA cohorts were identified using Anatomical Therapeutic Chemical (ATC) codes, while excluding other indications for anticoagulation therapy using ICD-9CM codes...
September 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28935034/persistence-with-dabigatran-therapy-at-2%C3%A2-years-in-patients-with-atrial-fibrillation
#6
Miney Paquette, Lionel Riou França, Christine Teutsch, Hans-Christoph Diener, Shihai Lu, Sergio J Dubner, Chang Sheng Ma, Kenneth J Rothman, Kristina Zint, Jonathan L Halperin, Menno V Huisman, Gregory Y H Lip, Robby Nieuwlaat
BACKGROUND: Guidelines recommend long-term oral anticoagulation therapy for stroke prevention in patients with atrial fibrillation (AF). Treatment discontinuation rates in vitamin K antagonist (VKA)-treated patients are high but may be lower with non-VKA oral anticoagulant agents. OBJECTIVES: The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up. METHODS: Consecutive patients newly diagnosed with AF and ≥1 stroke risk factor were followed up for 2 years...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28934363/sex-related-differences-in-the-risk-factors-for-in-hospital-mortality-and-outcomes-of-ischemic-stroke-patients-in-rural-areas-of-taiwan
#7
Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
BACKGROUND AND PURPOSE: Sex-related differences in the clinical presentation and outcomes of stroke patients are issues that have attracted increased interest from the scientific community. The present study aimed to investigate sex-related differences in the risk factors for in-hospital mortality and outcome in ischemic stroke patients. METHODS: A total of 4278 acute ischemic stroke patients admitted to a stroke unit between January 1, 2007 and December 31, 2014 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28934312/clinical-characteristics-and-12-month-outcomes-of-patients-with-valvular-and-non-valvular-atrial-fibrillation-in-kenya
#8
Tecla M Temu, Kathleen A Lane, Changyu Shen, Loise Ng'ang'a, Constantine O Akwanalo, Peng-Sheng Chen, Wilfred Emonyi, Susan R Heckbert, Myra M Koech, Imran Manji, Matteo Vatta, Eric J Velazquez, Jennifer Wessel, Sylvester Kimaiyo, Thomas S Inui, Gerald S Bloomfield
BACKGROUND: Atrial fibrillation (AF) is a major contributor to the global cardiovascular disease burden. The clinical profile and outcomes of AF patients with valvular heart diseases in sub-Saharan Africa (SSA) have not been adequately described. We assessed clinical features and 12-month outcomes of patients with valvular AF (vAF) in comparison to AF patients without valvular heart disease (nvAF) in western Kenya. METHODS: We performed a cohort study with retrospective data gathering to characterize risk factors and prospective data collection to characterize their hospitalization, stroke and mortality rates...
2017: PloS One
https://www.readbyqxmd.com/read/28932397/undiagnosed-and-diagnosed-diabetes-mellitus-among-hospitalised-acute-heart-failure-patients-in-botswana
#9
Julius Chacha Mwita, Mgaywa Gilbert Mjungu Damas Magafu, Bernard Omech, Billy Tsima, Matthew J Dewhurst, Monkgogi Goepamang, Yohana Mashalla
OBJECTIVE: The objective of this study was to determine the burden of diagnosed and undiagnosed type 2 diabetes mellitus among patients hospitalised with acute heart failure in Botswana. METHODS: The study enrolled 193 consecutive patients admitted with acute heart failure to the medical wards at Princess Marina Hospital in Gaborone. Patients were classified as previously known diabetics, undiagnosed diabetics (glycated haemoglobin ≥ 6.5%) or as non-diabetics (glycated haemoglobin < 6...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#10
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28929326/the-involvement-of-pharmacies-in-the-screening-of-undiagnosed-atrial-fibrillation
#11
Pietro Amedeo Modesti, Gianni Donigaglia, Plinio Fabiani, Nicola Mumoli, Andrea Colella, Maria Boddi
Early identification of atrial fibrillation (AF) is now a priority in cardiovascular prevention because AF is common although often asymptomatic, and is associated with poor outcomes that are highly preventable with appropriate medical treatment. In Italy, AF prevalence among subjects aged ≥65 years ranges from 5 to 6% in observational studies based on the diagnosis recorded by general practitioners to 10-11% in studies where ECG screening is routinely offered. It is thus evident that a large number of subjects are not detected by conventional approach, and new strategies are required to increase early detection of AF...
September 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28929012/current-practice-in-the-management-of-new-onset-atrial-fibrillation-in-critically-ill-patients-a-uk-wide-survey
#12
Chung Shen Chean, Daniel McAuley, Anthony Gordon, Ingeborg Dorothea Welters
BACKGROUND: New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. METHODS: We designed a short user-friendly online questionnaire...
2017: PeerJ
https://www.readbyqxmd.com/read/28928995/acute-unilateral-renal-infarction-in-the-setting-of-an-inherited-thrombophilia-and-atrial-septal-defect
#13
Siavash Piran, Sam Schulman
We present a case of renal infarction in a 43-year-old female with history of stroke at age 14. She was found to be heterozygous for the prothrombin G20210A gene mutation. Loop monitoring revealed no atrial fibrillation. Transthoracic and transesophageal echocardiograms showed no thrombus. However, there was a small shunt due to an atrial septal defect (ASD). She was treated with warfarin and had device closure of her ASD. This was a suspected case of paradoxical embolism through an ASD leading to renal infarction...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#14
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28924104/validation-of-the-r2chads2-and-chads2-scores-for-predicting-post-stroke-cognitive-impairment
#15
Kazuo Washida, Hisatomo Kowa, Hirotoshi Hamaguchi, Fumio Kanda, Tatsushi Toda
Objective Post-stroke cognitive impairment often afflicts stroke survivors and is a major obstacle both for cognitive and physical rehabilitation. Stroke risk scores ["Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Stroke" (CHADS2) and "CHADS2 + creatinine clearance <60 mL/min" (R2CHADS2)] are used to assess the future risk of cardioembolic stroke in patients with atrial fibrillation (AF). However, congestive heart failure, hypertension, aging, diabetes mellitus, stroke, and renal dysfunction are also risk factors for cognitive impairment...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28923492/rationale-and-design-of-the-atrial-fibrillation-health-literacy-information-technology-trial-af-litt
#16
Emily N Guhl, Courtney L Schlusser, Lori E Henault, Timothy W Bickmore, Everlyne Kimani, Michael K Paasche-Orlow, Jared W Magnani
BACKGROUND: Atrial Fibrillation (AF) is a common cardiac arrhythmia that is challenging for patients and adversely impacts health-related quality of life (HRQoL). Long-term management of AF requires that patients adhere to complex therapies, understand difficult terminology, navigate subspecialty care, and have continued symptom monitoring with the goal of preventing adverse outcomes. Continued interventions to ameliorate the patient experience of AF are essential. DESIGN: The Atrial Fibrillation health Literacy Information Technology Trial (AF-LITT; NCT03093558) is an investigator-initiated, 2-arm randomized clinical trial (RCT)...
September 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28922154/atrial-fibrillation-is-independently-associated-with-cognitive-impairment-after-ischemic-stroke
#17
Russell Jude Chander, Levinia Lim, Sagarika Handa, Shaun Hiu, Angeline Choong, Xuling Lin, Rajinder Singh, Daniel Oh, Nagaendran Kandiah
BACKGROUND: While atrial fibrillation (AF) is an important risk factor for ischemic strokes and mild cognitive impairment (MCI) in Alzheimer's disease, the association between AF and post-stroke cognitive impairment (PSCI), and the factors mediating this association, is unclear. OBJECTIVE: To investigate the role of AF in PSCI, especially in relation to other markers of cerebrovascular disease. METHODS: 445 subjects with mild ischemic stroke without pre-stroke cognitive decline were assessed 3-6 months post-stroke for cognitive deficits...
September 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#18
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28919876/peptide-composition-of-stroke-causing-emboli-correlate-with-serum-markers-of-atherosclerosis-and-inflammation
#19
Neal M Rao, Joseph Capri, Whitaker Cohn, Maram Abdaljaleel, Lucas Restrepo, Jeffrey A Gornbein, William H Yong, David S Liebeskind, Julian P Whitelegge
INTRODUCTION: The specific protein composition of stroke-causing emboli is unknown. Because ischemic stroke has a varied etiology, it is possible that the composition of the thrombus from which an embolus originated will have distinctive molecular characteristics reflective of the underlying pathophysiology. We used mass spectrometry to evaluate the protein composition of retrieved emboli from patients with differing stroke etiologies and correlated the protein levels to serum predictors of atherosclerosis...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#20
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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