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Atrial fibrilation, stroke

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https://www.readbyqxmd.com/read/28550068/age-specific-trends-of-atrial-fibrillation-related-ischaemic-stroke-and-transient-ischaemic-attack-anticoagulant-use-and-risk-factor-profile-in-chinese-population-a-15-year-study
#1
Yannie Soo, Nathan Chan, Kam Tat Leung, Xiang-Yan Chen, Vincent Mok, Lawrence Wong, Thomas Leung
BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing globally, and the fivefold increase in stroke risk constitutes significant healthcare burden. AIMS: We aim to evaluate the trends of AF-related stroke and transient ischaemic attack (AF-stroke/TIA), prior anticoagulant use and their risk factors in different age groups in Chinese population. METHODS: Data were retrieved from the stroke registry at Prince of Wales Hospital. We compared the data at 5-year intervals over a 15-year period (years 1999, 2004, 2009 and 2014)...
May 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28549819/rivaroxaban-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-and-active-cancer
#2
Eva S Laube, Anthony Yu, Dipti Gupta, Yimei Miao, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff, Simon Mantha
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with nonvalvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. The use of rivaroxaban in patients with cancer at the Memorial Sloan Kettering Cancer Center is monitored in the setting of a Quality Assessment Initiative...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28549027/a-minimally-invasive-stand-alone-cox-maze-procedure-is-as-effective-as-median-sternotomy-approach
#3
Matthew R Schill, Laurie A Sinn, Jason W Greenberg, Matthew C Henn, Timothy S Lancaster, Richard B Schuessler, Hersh S Maniar, Ralph J Damiano
OBJECTIVE: The Cox-Maze IV procedure has been shown to be an effective treatment for atrial fibrillation when performed concomitantly with other operations either via median sternotomy or right minithoracotomy. Few studies have compared these approaches in patients with lone atrial fibrillation. This study examined outcomes with sternotomy versus minithoracotomy in stand-alone Cox-Maze IV procedures at our institution. METHODS: Between 2002 and 2015, 195 patients underwent stand-alone biatrial Cox-Maze IV...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#4
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develops atrial fibrillation after CTI ablation. No uniform recommendations are available to guide anticoagulation regimes or ECG monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: Ablation strategy, oral anticoagulation (OAC) management and ECG monitoring after successful cavotricuspid isthmus (CTI) ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28546325/reciprocal-interaction-of-24-hour-blood-pressure-variability-and-systolic-blood-pressure-on-outcome-in-stroke-thrombolysis
#5
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
May 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28545622/warfarin-and-the-risk-of-stroke-and-bleeding-in-patients-with-atrial-fibrillation-receiving-dialysis-a-systematic-review-and-meta-analysis
#6
REVIEW
Ziv Harel, Glenn M Chertow, Prakesh S Shah, Shai Harel, Paul Dorian, Andrew T Yan, Gustavo Saposnik, Manish M Sood, Amber O Molnar, Jeffrey Perl, Rachel M Wald, Sam Silver, Ron Wald
BACKGROUND: Patients with atrial fibrillation who receive dialysis are at a high risk of ischemic stroke. The role of warfarin in mitigating this risk in patients with atrial fibrillation who receive dialysis is uncertain. Our objective was to examine the safety and efficacy of warfarin in patients who have atrial fibrillation and receive dialysis. METHODS: We used MedLine, Embase, and the Cochrane Library to conduct a systematic review and meta-analysis of published and unpublished observational and interventional studies related to the use of warfarin in patients with atrial fibrillation who receive dialysis, and provided data on the risk of stroke and/or bleeding outcomes relative to placebo or no anticoagulation therapy...
June 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28545542/recognition-and-treatment-of-sleep-disordered-breathing-an-important-component-of-chronic-disease-management
#7
REVIEW
Peter C Farrell, Glenn Richards
Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status...
May 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28545407/cryoballoon-vs-open-irrigated-radiofrequency-ablation-for-paroxysmal-atrial-fibrillation-long-term-freezeaf-outcomes
#8
Armin Luik, Kevin Kunzmann, Patrick Hörmann, Kerstin Schmidt, Andrea Radzewitz, Peter Bramlage, Thomas Schenk, Gerhard Schymik, Matthias Merkel, Meinhard Kieser, Claus Schmitt
BACKGROUND: Effective treatment of paroxysmal atrial fibrillation (AF) is essential for reducing the risk of stroke and heart failure. Cryoballoon (CB) ablation has been developed as an alternative to the use of radiofrequency (RF) energy for electrical isolation of the pulmonary veins. Herein, we provide long-term data regarding the efficacy of CB ablation in comparison to RF. METHODS: FreezeAF was a randomised non-inferiority study comparing CB ablation with RF ablation for the treatment of patients with drug-refractory paroxysmal AF...
May 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28544422/assessment-of-clinically-relevant-bleeding-as-a-surrogate-outcome-for-major-bleeding-validation-by-meta-analysis-of-randomized-controlled-trials
#9
S Laporte, C Chapelle, L Bertoletti, E Ollier, P Zufferey, J-C Lega, A Merah, H Décousus, S Schulman, G Meyer, M Cucherat, P Mismetti
BACKGROUND: Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials, but its validity for estimating compromise between thrombotic and bleeding events has never been assessed. METHODS: We systematically reviewed randomized phase III trials comparing new anticoagulants with standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates...
May 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#10
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28543401/oral-anticoagulation-management-in-patients-with-atrial-fibrillation-undergoing-cardiac-implantable-electronic-device-implantation
#11
Eric Black-Maier, Sunghee Kim, Benjamin A Steinberg, Gregg C Fonarow, James V Freeman, Peter R Kowey, Jack Ansell, Bernard J Gersh, Kenneth W Mahaffey, Gerald Naccarelli, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Oral anticoagulation (OAC) therapy is associated with increased periprocedural risks after cardiac implantable electronic device (CIED) implantation. Patterns of anticoagulation management involving non-vitamin K antagonist oral anticoagulants (NOACs) have not been characterized. HYPOTHESIS: Anticoagulation strategies and outcomes differ by anticoagulant type in patients undergoing CIED implantation. METHODS: Using the nationwide Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we assessed how atrial fibrillation (AF) patients undergoing CIED implantation were cared for and their subsequent outcomes...
May 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28542605/voxelwise-distribution-of-acute-ischemic-stroke-lesions-in-patients-with-newly-diagnosed-atrial-fibrillation-trigger-of-arrhythmia-or-only-target-of-embolism
#12
Timolaos Rizos, Andreas J Bartsch, Timothy D Johnson, Felix Dittgen, Thomas E Nichols, Uwe Malzahn, Roland Veltkamp
OBJECTIVE: Atrial fibrillation (AF) is frequently detected after ischemic stroke for the first time, and brain regions involved in autonomic control have been suspected to trigger AF. We examined whether specific brain regions are associated with newly detected AF after ischemic stroke. METHODS: Patients with acute cerebral infarctions on diffusion-weighted magnetic resonance imaging were included in this lesion mapping study. Lesions were mapped and modeled voxelwise using Bayesian Spatial Generalised Linear Mixed Modeling to determine differences in infarct locations between stroke patients with new AF, without AF and with AF already known before the stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28541499/hypertension-and-cardiac-arrhythmias-executive-summary-of-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-esc-council-on-hypertension-endorsed-by-the-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-and-sociedad-latinoamericana
#13
Gregory Y H Lip, Antonio Coca, Thomas Kahan, Giuseppe Boriani, Antonis S Manolis, Michael Hecht Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel, Francisco Marín, Márcio Jansen de Oliveira Figueiredo, Giovanni de Simone, Wendy S Tzou, Chern En Chiang, Bryan Williams
Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD or HF. In addition, high doses of thiazide diuretics commonly used to treat hypertension, may result in electrolyte abnormalities (eg...
May 25, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28539562/sex-related-differences-in-the-clinical-events-of-patients-with-atrial-fibrillation%C3%A3-the-fushimi-af-registry
#14
Hisashi Ogawa, Yasuhiro Hamatani, Kosuke Doi, Yuji Tezuka, Yoshimori An, Mitsuru Ishii, Moritake Iguchi, Nobutoyo Masunaga, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Mitsuru Abe, Gregory Yh Lip, Masaharu Akao
BACKGROUND: Female sex is considered a risk factor for thromboembolism in patients with atrial fibrillation (AF), and is included in the risk stratification scheme, CHA2DS2-VASc score. The purpose of the present study was to investigate the clinical outcomes of female Japanese AF patients.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of the AF patients in Fushimi-ku, Kyoto. Follow-up data were available for 3,878 patients. Female AF patients (n=1,551, 40...
May 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28536667/association-between-embolic-stroke-patterns-esus-etiology-and-new-diagnosis-of-atrial-fibrillation-a-secondary-data-analysis-of-the-find-af-trial
#15
Ilko L Maier, Katharina Schregel, André Karch, Mark Weber-Krueger, Rafael T Mikolajczyk, Raoul Stahrenberg, Klaus Gröschel, Mathias Bähr, Michael Knauth, Marios-Nikos Psychogios, Rolf Wachter, Jan Liman
Background. Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. Methods. Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28536104/development-and-validation-of-qrisk3-risk-prediction-algorithms-to-estimate-future-risk-of-cardiovascular-disease-prospective-cohort-study
#16
Julia Hippisley-Cox, Carol Coupland, Peter Brindle
Objectives To develop and validate updated QRISK3 prediction algorithms to estimate the 10 year risk of cardiovascular disease in women and men accounting for potential new risk factors.Design Prospective open cohort study.Setting General practices in England providing data for the QResearch database.Participants 1309 QResearch general practices in England: 981 practices were used to develop the scores and a separate set of 328 practices were used to validate the scores. 7.89 million patients aged 25-84 years were in the derivation cohort and 2...
May 23, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28535119/comparison-of-effectiveness-and-safety-of-treatment-with-apixaban-vs-other-oral-anticoagulants-among-elderly-nonvalvular-atrial-fibrillation-patients
#17
Steven Deitelzweig, Xuemei Luo, Kiran Gupta, Jeffrey Trocio, Jack Mardekian, Tammy Curtice, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
OBJECTIVE: To compare the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) of elderly (≥65 years of age) nonvalvular atrial fibrillation (NVAF) patients initiating apixaban vs. rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients with Medicare Advantage coverage in the US initiating oral anticoagulants (OACs, index event) were identified from the Humana database (1/1/2013-9/30/2015) and grouped into cohorts depending on OAC initiated. Propensity score matching (PSM), 1:1, was conducted among patients treated with apixaban vs...
May 23, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28532776/effect-of-addition-of-a-statin-to-warfarin-on-thromboembolic-events-in-japanese-patients-with-nonvalvular-atrial-fibrillation-and-diabetes-mellitus
#18
Naoko Kumagai, John A Nusser, Hiroshi Inoue, Ken Okumura, Takeshi Yamashita, Toru Kubo, Hiroaki Kitaoka, Hideki Origasa, Hirotsugu Atarashi
Statins have been shown to decrease stroke risk in patients with cardiovascular risk factors but not to prevent recurrence of ischemic stroke in patients with atrial fibrillation (AF). The present subanalysis aimed to clarify the efficacy of combined use of warfarin and statins in patients with nonvalvular AF (NVAF) with coronary artery disease, diabetes mellitus (DM), or hypertension. The effects of adding statins to warfarin were compared with those of warfarin alone in patients with NVAF with the data set of J-RHYTHM Registry, a prospective, observational study with a 2-year follow-up...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532651/suboptimal-anticoagulant-management-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-warfarin-for-stroke-prevention
#19
Teruyuki Hirano, Hirokazu Kaneko, Sari Mishina, Feng Wang, Satoshi Morita
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with increasing prevalence in Japan. Although prothrombin time-international normalized ratio (PT-INR) targets for monitoring warfarin therapy in patients with nonvalvular AF (NVAF) are well defined, real-world patient characteristics and PT-INR levels remain unknown among Japanese patients with NVAF who initiate and continue warfarin (warfarin maintainers) versus those who switch from warfarin to direct oral anticoagulants (DOACs; warfarin switchers)...
May 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28532180/premature-atrial-complexes-in-an-ischemic-stroke-population-and-risk-of-recurrent-stroke-a-systematic-review
#20
Michala Herskind Sejr, Sam Riahi, Torben Bjerregaard Larsen, Jens Cosedis Nielsen, Peter Brønnum Nielsen
Premature atrial complexes (PACs) have been proposed as a possible mediator between normal sinus rhythm and atrial fibrillation (AF). The aim of this study was to summarize the available knowledge of association between PACs and recurrent stroke or transient ischemic attack (TIA) in ischemic stroke patients. Areas covered: In this systematic review, we investigated the risk of recurrent events in patients who experienced ischemic stroke or TIA. Occurrence of PACs in electrocardiographic monitoring after index stroke/TIA was required...
May 22, 2017: Expert Review of Cardiovascular Therapy
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