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AF Stroke

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https://www.readbyqxmd.com/read/29332603/previous-use-of-statins-and-atrial-electrical-remodeling-in-patients-with-cryptogenic-stroke
#1
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Andrea Lo Monaco, Giuseppe Martini
BACKGROUND: In the general population the leading cause of cardioembolic stroke is atrial fibrillation (AF). A silent AF is also the possible cause of many cryptogenic strokes. P wave dispersion (PWD), a predictor of AF, has been proposed as a marker of silent AF occurrence in these strokes. PWD correlates with high-sensitive C-reactive protein levels reflecting the role of inflammation in promoting a slowed and inhomogeneous atrial conduction. Statins have a multitude of additional effects beyond lipid lowering, in particular anti-inflammatory effects that may influence atrial conduction...
January 10, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29332054/dementia-and-atrial-fibrillation-a-dangerous-combination-for-ischemic-stroke-and-mortality
#2
Daniele Pastori, Kazuo Miyazawa, Gregory Y H Lip
The risk of developing dementia is increased in patients with atrial fibrillation (AF), with the incidence of both conditions increasing with aging. Patients with dementia frequently do not receiving adequate thrombo-prophylaxis, because of the inability to monitor INR and/or to achieve and maintain good compliance with anticoagulant treatment. Under-treatment is therefore an important contributor to the increased risk of ischemic stroke and mortality in this subgroup of AF patients. In newly-diagnosed patients with AF starting oral anticoagulation, the presence of cognitive impairment should be considered in addition to the calculation of the SAMe-TT2R2 score, as part of an integrated decision management pathway to choose the most appropriate oral anticoagulant [i...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#3
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29330651/3d-computed-tomography-to-compare-the-dimensions-of-the-left-atrial-appendage-in-patients-with-normal-sinus-rhythm-and-those-with-paroxysmal-atrial-fibrillation
#4
Maiko Hozawa, Yoshihiro Morino, Yuki Matsumoto, Ryoichi Tanaka, Kyohei Nagata, Akiko Kumagai, Atsushi Tashiro, Akio Doi, Kunihiro Yoshioka
Although paroxysmal atrial fibrillation (PAF) is an important cause of cardioembolic stroke, in contrast to chronic AF patients, the anatomical features of the left atrial appendage (LAA) in PAF patients remain unknown. Here, we investigated differences in LAA structures in patients with PAF and those with normal sinus rhythms (NSR) using 3D-computed tomography (3D-CT), which allows us to visualize complicated LAA structures at high spatial resolution. Study subjects were 30 consecutive PAF and 30 NSR patients with complete enhanced cardiac 3D-CT images available...
January 12, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29327638/hybrid-and-surgical-procedures-for-the-treatment-of-persistent-and-longstanding-persistent-atrial-fibrillation
#5
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
January 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29326831/management-of-complications-in-anticoagulated-patients-with-atrial-fibrillation
#6
George D Katritsis, Demosthenes G Katritsis
Oral anticoagulation is mandatory for patients at high risk of thromboembolism, but the risk of bleeding should also be taken into account. Direct oral anticoagulants are now recommended for non-valvular AF as a potential alternative to warfarin. In this article we discuss methods to assess the anticoagulant effect of these agents, specific and general antidotes, and management of complications such as embolic and haemorrhagic stroke, and significant bleeding.
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326830/optimum-risk-assessment-for-stroke-in-atrial-fibrillation-should-we-hold-the-status-quo-or-consider-magnitude-synergism-and-left-atrial-appendage-anatomy
#7
James A Reiffel
Thromboembolic stroke and systemic embolism are generally agreed to be the major morbidity/mortality concerns for patients with AF. However, the risk of thromboembolism is not the same for all AF patients. Both AF and comorbidities must interact synergistically to create the risk for thromboembolism. But, is the synergism dichotomous - AF present or absent, comorbid disorder present or absent - or does synergism have magnitude, depending on the number and severity of the associated disorders and the amount of time one is in AF? This review discusses the current risk-score contributors and options for assessing risk of thromboembolism in AF patients, and what their combined roles might be...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326112/epidemiology-of-new-onset-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery
#8
Giovanni Filardo, Ralph J Damiano, Gorav Ailawadi, Vinod H Thourani, Benjamin D Pollock, Danielle M Sass, Teresa K Phan, Hoa Nguyen, Briget da Graca
OBJECTIVES: Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap. METHODS: From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS)...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29325634/relationship-of-aging-and-incident%C3%A2-comorbidities-to-stroke-risk-in-patients%C3%A2-with-atrial-fibrillation
#9
Tze-Fan Chao, Gregory Y H Lip, Chia-Jen Liu, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Jo-Nan Liao, Fa-Po Chung, Tzeng-Ji Chen, Shih-Ann Chen
BACKGROUND: When assessing ischemic stroke risk in patients with atrial fibrillation (AF), the CHA2DS2-VASc score is calculated based on the baseline risk factors, and the outcomes are determined after a follow-up period. However, the stroke risk in patients with AF does not remain static, and with time, patients get older and accumulate more comorbidities. OBJECTIVES: This study hypothesized that the "Delta CHA2DS2-VASc score," which reflects the change in score between baseline and follow-up, would be more predictive of ischemic stroke compared with the baseline CHA2DS2-VASc score...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29324261/platelet-toll-like-receptor-and-its-ligand-hmgb-1-expression-is-increased-in-the-left-atrium-of-atrial-fibrillation-patients
#10
Kadri Murat Gurses, Duygu Kocyigit, Muhammed Ulvi Yalcin, Hande Canpinar, Banu Evranos, Ugur Canpolat, Hikmet Yorgun, Levent Sahiner, Dicle Guc, Kudret Aytemir
BACKGROUND: Atrial fibrillation(AF) is the most common sustained arrhythmia. Its most feared sequelae are stroke and peripheral thromboembolism due to atrial thrombi formation. Mechanisms underlying the relationship between platelet activation and left atrial thrombi have not been clearly elucidated yet. We aimed to investigate whether immune-mediated platelet activation occurred in AF patients in this cross-sectional study. METHODS: Persistent and paroxysmal AF patients who underwent cryoballoon-based AF ablation between March 2015 and July 2016 were included as the patient group...
January 8, 2018: Cytokine
https://www.readbyqxmd.com/read/29321708/holter-monitorisation-results-in-early-period-of-acute-ischemic-stroke
#11
Sefer Günaydin, Birgül Baştan, Hürtan Acar, Belgin Petek Balci, Aytül Mutlu, Özlem Çokar
Introduction: Paroxysmal atrial fibrillation (PAF) has a similar risk with persistent AF for ischemic stroke. Holter monitorization (HM) and other long-term monitorization methods increased the detection of PAF and short-lasting runs of tachyarrhythmias. Their classification as PAF and roles in the etiology of ischemic stroke is controversial. In this study, we aimed to investigate the frequency of any duration of PAF and clinical characteristics of the patients with acute ischemic stroke who have undergone 24-hrs HM...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#12
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29320668/the-impact-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-on-anticoagulation-therapy-in-rural-australia
#13
Jamie W Bellinge, Jarrad J Paul, Liam S Walsh, Lokesh Garg, Gerald F Watts, Carl Schultz
OBJECTIVE: To determine the use of different anticoagulation therapies in rural Western Australia; to establish whether remoteness from health care services affects the choice of anticoagulation therapy; to gather preliminary data on anticoagulation therapy safety and efficacy. DESIGN: Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014-2015. SETTING: Four hospitals serving two-thirds of the rural population of Western Australia...
January 15, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29319249/stroke-prevention-in-atrial-fibrillation-which-is-the-best-balanced-in-efficacy-and-safety-as-a-thromboprophylactic
#14
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29317937/evaluating-the-potential-for-pharmacists-to-prescribe-oral-anticoagulants-for-atrial-fibrillation
#15
Roopinder K Sandhu, Lisa M Guirguis, Tammy J Bungard, Erik Youngson, Lisa Dolovich, Jamie C Brehaut, Jeff S Healey, Finlay A McAlister
Background: Oral anticoagulant therapy (OAC) to prevent atrial fibrillation (AF)-related strokes remains poorly used. Alternate strategies, such as community pharmacist prescribing of OAC, should be explored. Methods: Approximately 400 pharmacists, half with additional prescribing authority (APA), randomly selected from the Alberta College of Pharmacists, were invited to participate in an online survey over a 6-week period. The survey consisted of demographics, case scenarios assessing appropriateness of OAC (based on the 2014 Canadian Cardiovascular Society AF guidelines) and perceived barriers to prescribing...
January 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#16
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29316055/dedicated-warfarin-care-programme-results-in-superior-warfarin-control-in-queensland-australia
#17
Nijole Bernaitis, Tony Badrick, Shailendra Anoopkumar-Dukie
BACKGROUND: Warfarin is used to prevent stroke in patients with atrial fibrillation (AF). Ongoing monitoring of International normalised ratio (INR) and time in therapeutic range (TTR) commonly used to assess the quality of warfarin management are required. Anticoagulant clinics have demonstrated improved TTRs, particularly in countries with poorer control in primary care settings. Reported TTR in Australia has been relatively high; so, it is unknown if benefit would be seen from dedicated warfarin clinics in Australia...
January 9, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29313819/real-world-safety-and-efficacy-of-watchman-laa-closure-at-one-year-in-patients-on-dual-antiplatelet-therapy-results-of-the-dapt-subgroup-from-the-ewolution-all-comers-study
#18
Martin W Bergmann, Hüseyin Ince, Stephan Kische, Thomas Schmitz, Felix Meincke, Boris Schmidt, David Foley, Timothy R Betts, Marek Grygier, Alexey V Protopopov, Kenneth M Stein, Lucas V A Boersma
AIMS: The study aims to confirm efficacy and safety of WATCHMAN LAA closure in AF patients unsuitable for oral anticoagulation. METHODS AND RESULTS: The EWOLUTION registry prospectively collects all clinical data on 1005 European patients implanted with a WATCHMAN device. Following the procedure, 605 patients (60.2%) received dual antiplatelet therapy according to the local standard; DAPT was discontinued in 85% of pts within 1 year. CHA2DS2-VASc and HAS-BLED scores were 4...
January 9, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29313142/opportunities-and-challenges-of-large-scale-screening-for-atrial-fibrillation
#19
REVIEW
Matthias Daniel Zink, Nikolaus Marx, Harry J G M Crijns, Ulrich Schotten
Atrial fibrillation (AF) is a common arrhythmia and is highly associated with stroke and cardiovascular morbidity. As many AF episodes remain subclinical (SCAF), large-scale AF screening is considered a desirable approach for the treatment and prevention of cardioembolic stroke. Newly available single-lead ECG devices have provided promising results in the diagnosis of SCAF and treatment by nonvitamin K antagonist drugs appears to be safe and effective. Nevertheless, a further gain in knowledge is needed to clarify the different types of AF...
January 8, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29310958/increased-left-ventricular-filling-pressure-and-arterial-occlusion-in-stroke-related-to-atrial-fibrillation
#20
Wi-Sun Ryu, Eun-Kee Bae, Soo-Hyun Park, Sang-Wuk Jeong, Dawid Schellingerhout, Matthias Nahrendorf, Dong-Eog Kim
BACKGROUND: We investigated whether left ventricular filling pressure is associated with arterial occlusion in patients with ischemic stroke related to atrial fibrillation (AF). METHODS: Ninety-nine patients with AF-related stroke were included. Left ventricular filling pressure was assessed by E (early mitral inflow velocity)/e' (early diastolic velocity of the mitral valve annulus velocity) ratio based on tissue Doppler echocardiography. Arterial occlusion was evaluated by computed tomography or magnetic resonance angiography...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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