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https://www.readbyqxmd.com/read/27910092/management-of-atrial-fibrillation-in-elderly-adults
#1
Yaanik Desai, Mikhael F El-Chami, Angel R Leon, Faisal M Merchant
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27909535/search-for-the-ideal-antithrombotic-drug-utopian-task-likely-is-implemented-already
#2
REVIEW
Petras Stirbys Md PhD
Atrial fibrillation is the most prevalent cardiac arrhythmia with a high risk of ischemic stroke. Thromboprophylaxis plays a key role in prevention of cardioembolic and non-cardioembolic events. Oral antithrombotic drugs are most often used to reduce hypercoagulable state. Patients may suffer from both under- and overtreatment compromising the outcomes. Medication peculiarities at large are well-known and widely debated. Non-adherence to antithrombotic drug regimen poses a significant risk of stroke. There is a pressing need for more detailed delineation of risk factors, namely by incorporation of the letter "N" (meaning "Non-adherence to drug therapy") into the well-known risk score alphanumeric display: CHA2DS2N-VASc...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909518/symptoms-in-atrial-fibrillation-a-contemporary-review-and-future-directions
#3
REVIEW
Steven T Heidt Bs, Anna Kratz PhD, Kayvan Najarian PhD, Afton L Hassett PsyD, Hakan Oral Md, Richard Gonzalez PhD, Brahmajee K Nallamothu Md Mph, Daniel Clauw Md, Hamid Ghanbari Md Mph
Atrial fibrillation (AF) is the most prevalent arrhythmia leading to hospital admissions in the United States. The majority of patients with AF report symptoms associated with this condition that can lead to a decrease in health related quality of life (HRQOL) and functional status. Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. Our current understanding of how AF and symptoms are linked is hampered by the dominant assessment paradigm, where symptoms thought to be associated with AF are measured at a single point in time (frequently at a clinic visit)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909151/cerebrovascular-disease-associated-risk-factors-and-antithrombotic-therapy-in-a-population-screening-cohort-insights-from-the-belgian-heart-rhythm-week-programme
#4
Marco Proietti, Georges H Mairesse, Peter Goethals, Christophe Scavee, Johan Vijgen, Ivan Blankoff, Yves Vandekerckhove, Gregory Yh Lip
BACKGROUND: Cerebrovascular disease confers a major healthcare burden worldwide and is a major cause of death and disability. Several well-established risk factors, such as atrial fibrillation (AF), are associated with cerebrovascular disease and antithrombotic therapy reduces risk. DESIGN: This study was a subgroup analysis from the Belgian Heart Rhythm Week, a nationwide AF awareness programme. METHODS: We studied subjects screened between 2012 and 2014 with available data on clinical risk factors and antithrombotic treatment...
December 1, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27908279/co-existing-intracranial-and-extracranial-carotid-artery-atherosclerotic-plaques-and-recurrent-stroke-risk-a-three-dimensional-multicontrast-cardiovascular-magnetic-resonance-study
#5
Yilan Xu, Chun Yuan, Zechen Zhou, Le He, Donghua Mi, Rui Li, Yuanyuan Cui, Yilong Wang, Yongjun Wang, Gaifen Liu, Zhuozhao Zheng, Xihai Zhao
BACKGROUND: As a systemic disease, atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously which is defined as co-existing plaques. Previous studies demonstrated that co-existing atherosclerotic diseases are significantly associated with ischemic cerebrovascular events. The aim of this study was to investigate the characteristics of co-existing intracranial and extracranial carotid atherosclerotic plaques and their relationships with recurrent stroke by using 3D multi-contrast magnetic resonance (MR) vessel wall imaging...
December 2, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27904619/modeling-of-in-hospital-mortality-determinants-in-myocardial-infarction-patients-with-and-without-stroke-a-national-study-in-iran
#6
Ali Ahmadi, Arsalan Khaledifar, Koorosh Etemad
BACKGROUND: The data and determinants of mortality due to stroke in myocardial infarction (MI) patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history. MATERIALS AND METHODS: This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904591/brain-regions-involved-in-swallowing-evidence-from-stroke-patients-in-a-cross-sectional-study
#7
Shiva Ebrahimian Dehaghani, Fariba Yadegari, Ali Asgari, Ahmad Chitsaz, Mehdi Karami
BACKGROUND: Limited data available about the mechanisms of dysphagia and areas involving swallow after brain damage; accordingly it is hard to predict which cases are more likely to develop swallowing dysfunction based on the neuroimaging. The aim of this study was to investigate the relationship between brain lesions and dysphagia in a sample of acute conscious stroke patients. MATERIALS AND METHODS: In a cross-sectional study, 113 acute conscious stroke patients (69 male mean [standard deviation (SD)] age 64...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903956/global-burden-of-all-cause-and-cause-specific-mortality-due-to-smokeless-tobacco-use-systematic-review-and-meta-analysis
#8
Dhirendra N Sinha, Rizwan A Suliankatchi, Prakash C Gupta, Thaksaphon Thamarangsi, Naveen Agarwal, Mark Parascandola, Ravi Mehrotra
OBJECTIVES: To systematically review and meta-analyse the studies investigating the association between smokeless tobacco (SLT) use and all-cause mortality and cause-specific mortality outcomes among adult users of SLT and estimate the number of attributable deaths worldwide. METHODS: Random-effects meta-analysis was used to estimate the pooled risk of death due to SLT use. Population attributable fractions were derived and used to calculate the number of attributable deaths...
November 30, 2016: Tobacco Control
https://www.readbyqxmd.com/read/27903562/validity-of-self-reported-myocardial-infarction-and-stroke-in-regions-with-sami-and-norwegian-populations-the-saminor-1-survey-and-the-cvdnor-project
#9
Bent-Martin Eliassen, Marita Melhus, Grethe S Tell, Kristin Benjaminsen Borch, Tonje Braaten, Ann Ragnhild Broderstad, Sidsel Graff-Iversen
OBJECTIVE: Updated knowledge on the validity of self-reported myocardial infarction (SMI) and self-reported stroke (SRS) is needed in Norway. Our objective was to compare questionnaire data and hospital discharge data from regions with Sami and Norwegian populations to assess the validity of these outcomes by ethnicity, sex, age and education. DESIGN: Validation study using cross-sectional questionnaire data and hospital discharge data from all Norwegian somatic hospitals...
November 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27899753/temporal-evolution-of-poststroke-cognitive-impairment-using-the-montreal-cognitive-assessment
#10
Britta Nijsse, Johanna M A Visser-Meily, Maria L van Mierlo, Marcel W M Post, Paul L M de Kort, Caroline M van Heugten
BACKGROUND AND PURPOSE: The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal pattern of overall and domain-specific cognition at 2 and 6 months after stroke using the MoCA and to identify patient groups at risk for cognitive impairment at 6 months after stroke. METHODS: Prospective cohort study in which 324 patients were administered the MoCA at 2 and 6 months post stroke...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27899752/patent-foramen-ovale-and-cryptogenic-strokes-in-the-stroke-in-young-fabry-patients-study
#11
Roman Huber, Ulrike Grittner, Frank Weidemann, Vincent Thijs, Christian Tanislav, Christian Enzinger, Franz Fazekas, Markus Wolf, Michael G Hennerici, Dominick J H McCabe, Jukaa Putaala, Turgut Tatlisumak, Christoph Kessler, Bettina von Sarnowski, Peter Martus, Edwin Kolodny, Bo Norrving, Arndt Rolfs
BACKGROUND AND PURPOSE: A patent foramen ovale (PFO) is disproportionately prevalent in patients with cryptogenic stroke. Without alternative explanations, it is frequently considered to be causative. A detailed stratification of these patients may improve the identification of incidental PFO. METHODS: We investigated the PFO prevalence in 3497 transient ischemic attack and ischemic stroke patients aged 18 to 55 years in the prospective multicenter SIFAP1 study (Stroke in Young Fabry Patients 1) using the ASCO classification...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27898167/nsaids-prescription-prevalence-after-a-cardiovascular-event-related-hospitalization-in-medicaid-beneficiaries-from-puerto-rico
#12
Suzette M Vélez, José J Hernández, Sasha M Davis, María G Almodóvar, José R Mercado
OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation. NSAIDs are associated with serious adverse effects and cardiovascular (CV) risks that include myocardial infarction, stroke and heart failure. In the period of time immediately after a CV event, modification to the drug therapy regimen and lifestyle habits should be instituted to decrease morbidity and mortality. The objective of this study is to measure the prevalence of NSAIDs prescribing in the immediate 90 days after a CV-related hospitalization in Medicaid beneficiaries in Puerto Rico...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27897386/cardiovascular-and-stroke-risk-in-japanese-hemodialysis-patients-with-atrial-fibrillation
#13
Jumpei Hasegawa, Brian Bieber, Maria Larkina, Bruce M Robinson, Sachiko Wakai, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Takashi Akiba
Atrial fibrillation is one of the most common arrhythmias in hemodialysis patients. We evaluated its clinical outcomes among hemodialysis patients with atrial fibrillation in Japan. Using data derived from the Japanese Dialysis Outcomes and Practice Patterns Study, we analyzed backgrounds and outcomes among hemodialysis patients with and without atrial fibrillation in Japan. Among 7002 hemodialysis patients, the prevalence of atrial fibrillation was 5.7% and the incidence was 0.2 per 100 patient-years. Atrial fibrillation was independently associated with all-cause mortality (hazard ratio, 1...
November 29, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#14
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27895487/combination-therapy-with-lercanidipine-and-enalapril-in-the-management-of-the-hypertensive-patient-an-update-of-the-evidence
#15
REVIEW
Christina Antza, Stella Stabouli, Vasilios Kotsis
Hypertension is an important risk factor for premature death as it increases the probability of stroke, myocardial infarction, and heart failure. Antihypertensive drugs can decrease cardiovascular (CV) morbidity and mortality. The majority of hypertensive patients need more than one antihypertensive agent to attain blood pressure (BP) targets. Monotherapy can effectively reduce BP only in 20%-40% of patients. Multiple mechanisms including increased peripheral vascular resistance, increased cardiac work, and hypervolemia are involved in the pathogenesis of hypertension...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#16
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27891376/smokeless-tobacco-and-stroke-a-clinico-epidemiological-follow-up-study-in-a-tertiary-care-hospital
#17
Subhransu Sekhar Jena, Shobhitendu Kabi, Baikuntha Nath Panda, B C Kameswari, Payal, Ishwar Chandra Behera, Subrat Kumar Tripathy, Seemanchana Mahanta
INTRODUCTION: Among the modifiable risk factors for stroke, tobacco smoking is well recognized. In some studies the use of Smokeless Tobacco (ST) has also been contributed as a risk factor for ischemic stroke. Use of ST is very common in South-East Asia. The form of ST varies according to the geographical and cultural variation. AIM: To study the various clinical symptoms and radiological findings of stroke due to different types of ST. MATERIALS AND METHODS: This was a prospective hospital based study carried out over a period of 2 years...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890386/2016-guidelines-of-the-taiwan-heart-rhythm-society-and-the-taiwan-society-of-cardiology-for-the-management-of-atrial-fibrillation
#18
Chern-En Chiang, Tsu-Juey Wu, Kwo-Chang Ueng, Tze-Fan Chao, Kuan-Cheng Chang, Chun-Chieh Wang, Yenn-Jiang Lin, Wei-Hsian Yin, Jen-Yuan Kuo, Wei-Shiang Lin, Chia-Ti Tsai, Yen-Bin Liu, Kun-Tai Lee, Li-Jen Lin, Lian-Yu Lin, Kang-Ling Wang, Yi-Jen Chen, Mien-Cheng Chen, Chen-Chuan Cheng, Ming-Shien Wen, Wen-Jone Chen, Jyh-Hong Chen, Wen-Ter Lai, Chuen-Wang Chiou, Jiunn-Lee Lin, San-Jou Yeh, Shih-Ann Chen
Atrial fibrillation (AF) is the most common sustained arrhythmia. Both the incidence and prevalence of AF are increasing, and the burden of AF is becoming huge. Many innovative advances have emerged in the past decade for the diagnosis and management of AF, including a new scoring system for the prediction of stroke and bleeding events, the introduction of non-vitamin K antagonist oral anticoagulants and their special benefits in Asians, new rhythm- and rate-control concepts, optimal endpoints of rate control, upstream therapy, life-style modification to prevent AF recurrence, and new ablation techniques...
November 24, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27889950/retinopathy-a-sign-of-cerebral-small-vessel-disease-in-diabetes
#19
Toshitaka Umemura, Takahiko Kawamura
Cardio-cerebrovascular disease greatly influences the prognosis of diabetic patients. Silent lacunar infarcts, white matter lesions (WMLs), and cerebral microbleeds are magnetic resonance imaging (MRI) markers of cerebral small vessel disease (SVD) and as they are associated with stroke and dementia, prevention of their incidence and progression is important in clinical practice. The findings of previous autopsy and clinical studies suggest that lacunar infarcts are more prevalent in diabetic patients. On the other hand, the findings of studies on an association between diabetes and WMLs have been inconsistent...
November 27, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27889047/sex-differences-in-the-association-between-stroke-and-bone-mineral-density-in-elderly-koreans-the-korean-national-health-and-nutrition-examination-survey-2008-2010
#20
Ji Eun Lee, Hye-Rim Jeon, Jung Keun Park, Kyung-Do Han, Ji-Hyun Kim, Jinnie Yoon, Seok-Won Park, Yang-Hyun Kim, Kyung-Hwan Cho
OBJECTIVES: The aim of this study was to investigate whether osteoporosis is more prevalent in elderly Korean people who have had a stroke and whether the association differs by sex. STUDY DESIGN: A total of 3806 elderly subjects (1951 men and 1855 women) from the Korea National Health and Nutrition Examination Survey were included in this study. Stroke history was determined by self-administered questionnaire. Bone mineral density (BMD) was measured at the lumbar spine, total hip, and neck of the femur using dual-energy X-ray absorptiometry...
January 2017: Maturitas
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