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Atrial fibrillation stroke

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https://www.readbyqxmd.com/read/28526929/analytical-management-of-patients-undergoing-oral-anticoagulant-therapy-could-have-a-strong-impact-on-clinical-outcomes-a-follow-up-study
#1
Vincenzo De Iuliis, Sebastiano Ursi, Gianfranco Vitullo, Irma Griffo, Antonio Marino, Marika Caruso, Francesco Cipollone, Sabrina Capodifoglio, Veronica Breda, Elena Toniato, Alfonso Pennelli, Pio Conti, Stefano Martinotti
INTRODUCTION: Oral anticoagulant therapy, such as vitamin K antagonists (VKAs), is prominent for the prevention of cerebral ischemic stroke or systemic embolism and all-cause mortality in patients with atrial fibrillation, venous thromboembolism, and mechanical or biological valve. VKA treatment requires monitoring of the international normalized ratio (INR) in order to maintain it in a therapeutic range, avoiding side effects, the main and most significant of which is bleeding. The aim of the present study was to evaluate the event rates of several clinical composite outcomes, such as bleeding, thromboembolic events, and all-cause death...
May 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28526763/self-reported-stroke-risk-stratification-reasons-for-geographic-and-racial-differences-in-stroke-study
#2
George Howard, Leslie A McClure, Claudia S Moy, Virginia J Howard, Suzanne E Judd, Ya Yuan, D Leann Long, Paul Muntner, Monika M Safford, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: The standard for stroke risk stratification is the Framingham Stroke Risk Function (FSRF), an equation requiring an examination for blood pressure assessment, venipuncture for glucose assessment, and ECG to determine atrial fibrillation and heart disease. We assess a self-reported stroke risk function (SRSRF) to stratify stroke risk in comparison to the FSRF. METHODS: Participants from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) were evaluated at baseline and followed for incident stroke...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#3
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28520924/dabigatran-vs-warfarin-in-relation-to-the-presence-of-left-ventricular-hypertrophy-in-patients-with-atrial-fibrillation-the-randomized-evaluation-of-long-term-anticoagulation-therapy-re-ly-study
#4
Paolo Verdecchia, Gianpaolo Reboldi, Fabio Angeli, Giovanni Mazzotta, Gregory Y H Lip, Martina Brueckmann, Eva Kleine, Lars Wallentin, Michael D Ezekowitz, Salim Yusuf, Stuart J Connolly, Giuseppe Di Pasquale
Aim: We tested the hypothesis that left ventricular hypertrophy (LVH) interferes with the antithrombotic effects of dabigatran and warfarin in patients with atrial fibrillation (AF). Methods and results: This is a post-hoc analysis of the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) Study. We defined LVH by electrocardiography (ECG) and included patients with AF on the ECG tracing at entry. Hazard ratios (HR) for each dabigatran dose vs. warfarin were calculated in relation to LVH...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#5
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28516318/effect-of-apixaban-on-all-cause-death-in-patients-with-atrial-fibrillation-a-meta-analysis-based-on-imputed-placebo-effect
#6
Patrícia O Guimarães, Renato D Lopes, Daniel M Wojdyla, Azmil H Abdul-Rahim, Stuart J Connolly, Greg C Flaker, Junyuan Wang, Michael Hanna, Christopher B Granger, Lars Wallentin, Kennedy R Lees, John H Alexander, John J V McMurray
PURPOSE: Vitamin K antagonists (VKAs) are the standard of care for stroke prevention in patients with atrial fibrillation (AF); therefore, there is not equipoise when comparing newer oral anticoagulants with placebo in this setting. METHODS: To explore the effect of apixaban on mortality in patients with AF, we performed a meta-analysis of apixaban versus placebo using a putative placebo analysis based on randomized controlled clinical trials that compared warfarin, aspirin, and no antithrombotic control...
May 18, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28514242/risks-of-cardiovascular-adverse-events-and-death-in-patients-with-previous-stroke-undergoing-emergency-noncardiac-nonintracranial-surgery-the-importance-of-operative-timing
#7
Mia N Christiansen, Charlotte Andersson, Gunnar H Gislason, Christian Torp-Pedersen, Robert D Sanders, Per Føge Jensen, Mads E Jørgensen
BACKGROUND: The outcomes of emergent noncardiac, nonintracranial surgery in patients with previous stroke remain unknown. METHODS: All emergency surgeries performed in Denmark (2005 to 2011) were analyzed according to time elapsed between previous ischemic stroke and surgery. The risks of 30-day mortality and major adverse cardiovascular events were estimated as odds ratios (ORs) and 95% CIs using adjusted logistic regression models in a priori defined groups (reference was no previous stroke)...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28513116/worse-outcome-in-patients-with-acute-stroke-and-atrial-fibrillation-following-thrombolysis
#8
Michael Findler, Jeremy Molad, Natan M Bornstein, Eitan Auriel
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and a common cause of ischemic stroke. Stroke patients with AF have been shown to have a poorer neurological outcome than stroke patients without AF. OBJECTIVES: To determine the impact of pre-existing AF on residual degree of disability in patients treated with IV thrombolysis. METHODS: In this case-control study, data of 214 stroke patients (63 with AF and 151 without AF) were collected from the National Acute Stroke Israeli Registry, a nationwide quadrennial stroke database...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28512699/an-open-label-crossover-study-of-the-pharmacokinetics-of-the-60-mg-edoxaban-tablet-crushed-and-administered-either-by-a-nasogastric-tube-or-in-apple-puree-in-healthy-adults
#9
Kenneth Duchin, Anil Duggal, George J Atiee, Motonori Kidokoro, Tadanobu Takatani, Nicole Lazarus Shipitofsky, Ling He, George Zhang, Tarundeep Kakkar
BACKGROUND: Edoxaban is an orally active, direct factor Xa inhibitor indicated to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation and for the treatment of venous thromboembolism. OBJECTIVES: This study assessed the pharmacokinetics, safety, and tolerability of the edoxaban 60-mg tablet crushed and administered via a nasogastric tube in a water suspension or orally mixed in apple puree. METHODS: This phase 1, open-label, crossover study randomized 30 healthy adults to receive three edoxaban treatment regimens (oral 60-mg edoxaban tablet, or 60-mg edoxaban tablet crushed and administered via a nasogastric tube or orally in apple puree) in one of six treatment sequences...
May 17, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28512109/resumption-of-anticoagulation-after-major-bleeding-decreases-the-risk-of-stroke-in-patients-with-atrial-fibrillation
#10
Marcelle D Smit, Isabelle C Van Gelder
No abstract text is available yet for this article.
May 16, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28511557/impact-of-a-perioperative-prophylaxis-guideline-on-post-cardiothoracic-surgery-atrial-fibrillation
#11
Rosanna Li, C Michael White, Jola Mehmeti, Spencer T Martin, Laura C Hobbs
BACKGROUND: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). OBJECTIVE: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. METHODS: Data were retrospectively collected on 400 adults (200 patients pre-guideline implementation and 200 patients post-guideline implementation) with a CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28511486/a-review-on-detection-and-treatment-methods-of-sleep-apnea
#12
REVIEW
Rajeswari Jayaraj, Jagannath Mohan, Adalarasu Kanagasabai
This paper presents a review on detection and treatment methods of sleep apnea. Sleep apnea is the most common type of breathing-related sleep disorder. It manifests in a variety of behaviours from teeth grinding to night terrors as involuntary night-time events. The most common sleep disorders are narcolepsy, hypersomnia, sleep talking, sleep walking, and bedwetting. Sleep apnea (somnipathy) is a serious sleep disorder that pauses breathing while sleeping. Breathing pauses occur 30 times or more during sleep and it lasts for few seconds to minutes, when normal breathing starts after this pause...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28510678/trends-and-patterns-of-geographic-variation-in-cardiovascular-mortality-among-us-counties-1980-2014
#13
Gregory A Roth, Laura Dwyer-Lindgren, Amelia Bertozzi-Villa, Rebecca W Stubbs, Chloe Morozoff, Mohsen Naghavi, Ali H Mokdad, Christopher J L Murray
Importance: In the United States, regional variation in cardiovascular mortality is well-known but county-level estimates for all major cardiovascular conditions have not been produced. Objective: To estimate age-standardized mortality rates from cardiovascular diseases by county. Design and Setting: Deidentified death records from the National Center for Health Statistics and population counts from the US Census Bureau, the National Center for Health Statistics, and the Human Mortality Database from 1980 through 2014 were used...
May 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28509761/dabigatran-in-nonvalvular-atrial-fibrillation-from-clinical-trials-to-real-life-experience
#14
Nicola Mumoli, Daniela Mastroiacovo, Eleonora Tamborini-Permunian, Josè Vitale, Matteo Giorgi-Pierfranceschi, Marco Cei, Francesco Dentali
: Atrial fibrillation is the most common arrhythmia in over-midlife patients. In addition to systolic heart failure, cerebral thromboembolism represents the most dramatic complication of this rhythm disorder, contributing to morbidity and mortality. Traditionally, anticoagulation has been considered the main strategy in preventing stroke and systemic embolism in atrial fibrillation patients and vitamin K-dependent antagonists have been widely used in clinical practice. Recently, the development of direct oral anticoagulants has certainly improved the management of this disease, providing, for the first time, the opportunity to go beyond vitamin K-dependent antagonists limits...
July 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28507907/effectiveness-of-enzyme-replacement-therapy-in-fabry-disease-long-term-experience-in-argentina
#15
Gustavo Cabrera, Juan Politei, Norberto Antongiovani, Hernán Amartino
Evidence regarding long term effectiveness of enzyme replacement therapy (ERT) in Fabry disease (FD) is needed. The aim of this study was to analyze in a cohort of FD patients in Argentina, the long term effectiveness of ERT on renal, cardiac and cerebrovascular parameters. METHODS: Patients with genetically proven FD were included from GADYTEF (Argentinean group for the treatment of FD) between 2001 and 2014. Renal, cardiac, and cerebral outcomes were prospectively studied in patients treated with ERT...
June 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28506983/riskier-business-atrial-fibrillation-stroke-prevention-in-the-cha2ds2-vasc-era
#16
EDITORIAL
Thomas A Dewland, Eric C Stecker
No abstract text is available yet for this article.
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506981/contemporary-trends-in-oral-anticoagulant-prescription-in-atrial-fibrillation-patients-at-low-to-moderate-risk-of-stroke-after-guideline-recommended-change-in-use-of-the-chads2-to-the-cha2ds2-vasc-score-for-thromboembolic-risk-assessment-analysis-from-the-national
#17
David F Katz, Thomas M Maddox, Mintu Turakhia, Anil Gehi, Emily C O'Brien, Steven A Lubitz, Alexander Turchin, Gheorghe Doros, Lanyu Lei, Paul Varosy, Lucas Marzec, Jonathan C Hsu
BACKGROUND: Use of the CHA2DS2-VASc score instead of the CHADS2 score for thromboembolic risk stratification and initiation of oral anticoagulation (OAC) was recommended in the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines. We sought to define the proportion of patients with AF qualifying for and receiving OAC in contemporary practice by applying the CHA2DS2-VASc score to patients with a low CHADS2 score. METHODS AND RESULTS: Among patients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's outpatient Practice Innovation and Clinical Excellence registry (2008-2014) CHADS2 score of 0 or 1, we calculated the impact of adoption of the CHA2DS2-VASc score on the proportion of patients with an indication for OAC...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506913/predicting-determinants-of-atrial-fibrillation-or-flutter-for-therapy-elucidation-in-patients-at-risk-for-thromboembolic-events-predate-af-study
#18
Javed M Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater
BACKGROUND: Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown. OBJECTIVES: In this study, we prospectively evaluated the use of the CHA2DS2-VASc score for the prediction of new-onset AF using insertable cardiac monitors (ICMs) and examined whether this screening led to the initiation of OAC therapy...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#19
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28504982/characteristics-in-hospital-management-and-outcome-of-late-acute-st-elevation-myocardial-infarction-presenters
#20
Enrico Cerrato, Davide Forno, Silvia Ferro, Alessandra Chinaglia
BACKGROUND: Patients with delayed presentation of acute myocardial infarction with ST-segment elevation (STEMI) frequently have a poor prognosis but literature about acute complications in intensive cardiac care unit (ICCU) and in-hospital outcome are still limited. METHODS: All STEMI patients admitted to our institution between June 2007 and December 2013 were divided into patients presenting more than 12 h after symptom onset (lateSTEMI) and within 12 h (STEMI)...
May 12, 2017: Journal of Cardiovascular Medicine
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