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Cardioembolism

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https://www.readbyqxmd.com/read/29339702/efficacy-and-safety-of-oral-anticoagulation-in-elderly-patients-with-atrial-fibrillation
#1
Ilaria Cavallari, Giuseppe Patti
Elderly patients with atrial fibrillation are at a higher risk of both ischemic and bleeding events compared with younger patients; therefore, balancing risks and benefits of antithrombotic strategies in this population is crucial. Recent studies have shown that because the risk of stroke increases with age more than the risk of bleeding, the absolute benefit of oral anticoagulation is the highest in elderly patients in whom it outweighs the risk of bleeding. Direct oral anticoagulants (DOACs) have been developed as a treatment for the prevention of cardioembolic stroke to overcome some limitations of warfarin, such as the need for frequent monitoring, labile INR values requiring frequent dose adjustment, dietary and drugs interactions, and increased risk of intracranial bleeding...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29335336/periodontal-disease-regular-dental-care-use-and-incident-ischemic-stroke
#2
Souvik Sen, Lauren D Giamberardino, Kevin Moss, Thiago Morelli, Wayne D Rosamond, Rebecca F Gottesman, James Beck, Steven Offenbacher
BACKGROUND AND PURPOSE: Periodontal disease is independently associated with cardiovascular disease. Identification of periodontal disease as a risk factor for incident ischemic stroke raises the possibility that regular dental care utilization may reduce the stroke risk. METHODS: In the ARIC (Atherosclerosis Risk in Communities) study, pattern of dental visits were classified as regular or episodic dental care users. In the ancillary dental ARIC study, selected subjects from ARIC underwent fullmouth periodontal measurements collected at 6 sites per tooth and classified into 7 periodontal profile classes (PPCs)...
January 15, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29332603/previous-use-of-statins-and-atrial-electrical-remodeling-in-patients-with-cryptogenic-stroke
#3
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/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/29326535/very-rare-presentation-of-cerebrovascular-accident-in-20-year-old-man-with-familial-mediterranean-fever-case-report
#5
Miramir Aghdashi, Seyed-Mostafa Seidmardani, Sara Vossoughian, Seyed Arman Seyed Mokhtari
Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever accompanied by serosal, synovial, or cutaneous inflammation. The central nervous system (CNS) is rarely involved in FMF. The CNS involvement includes demyelinating lesions, posterior reversible encephalopathy syndrome, pseudotumor cerebri, optic neuritis, and cerebral vasculitis. Here, we present a 20-year-old man, a known case of FMF with abrupt left-sided hemiparesis. Brain magnetic resonance imaging revealed right periventricular infarction...
2018: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29324452/adjudication-of-transient-ischemic-attack-and-stroke-in-the-multi-ethnic-study-of-atherosclerosis
#6
W T Longstreth, Natalie C Gasca, Rebecca F Gottesman, John B Pearce, Ralph L Sacco
BACKGROUND: To describe adjudication of transient ischemic attack (TIA) and stroke in an observational study. METHODS: We detail the process used to adjudicate TIA and stroke in the Multi-Ethnic Study of Atherosclerosis (MESA), a large longitudinal cohort study. Two of three vascular neurologists adjudicated each event using specific protocols. We examined the initial agreement, effect of imaging on diagnosis of TIA versus ischemic stroke, and effect of strict and less strict criteria on the number of ischemic stroke subtypes classified as undetermined...
January 11, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/29321704/efficacy-and-safety-of-warfarin-experience-in-a-stroke-polyclinic-in-stroke-patients
#7
Eda Çoban, Dursun Kirbaş, Dilek Atakli, Aysun Soysal
Introduction: Cardioembolic stroke is associated with high morbidity and mortality, with an increased risk of recurrent stroke. Oral anticoagulation is highly effective in reducing the risk of stroke and mortality compared with placebo. Our study aimed to highlight the safety and efficacy of warfarin by analyzing the 20-year follow-up of patients on warfarin therapy. Methods: A retrospective observational study was performed with ischemic stroke patients receiving warfarin at our stroke polyclinic between 1992 and 2012...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29321236/midregional-proatrial-natriuretic-peptide-improves-risk-stratification-after-ischemic-stroke-association-with-mortality-and-cardioembolic-etiology
#8
Gian Marco De Marchis, Juliane Schneider, Anja Weck, Felix Fluri, Joachim Fladt, Christian Foerch, Beat Mueller, Andreas Luft, Mirjam Christ-Crain, Marcel Arnold, Mira Katan
OBJECTIVE: To validate midregional proatrial natriuretic peptide (MR-proANP) for outcome prediction and diagnosis of cardioembolic stroke etiology compared to established clinical variables. METHODS: In this prospective multicenter cohort study, we quantified MR-proANP levels in ischemic stroke patients within 24 hours of onset. Primary outcome measures were 90-day mortality, unfavorable functional outcome (modified Rankin Scale score >2), and cardioembolic stroke etiology diagnosed during hospitalization...
January 10, 2018: Neurology
https://www.readbyqxmd.com/read/29319249/stroke-prevention-in-atrial-fibrillation-which-is-the-best-balanced-in-efficacy-and-safety-as-a-thromboprophylactic
#9
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/29313142/opportunities-and-challenges-of-large-scale-screening-for-atrial-fibrillation
#10
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/29311375/clinical-reasoning-cardioembolic-stroke-in-a-23-year-old-man-with-elbow-contracture
#11
Bhaskar Roy, Elizabeth Raynor
No abstract text is available yet for this article.
January 9, 2018: Neurology
https://www.readbyqxmd.com/read/29289951/cardioembolic-stroke-in-patient-with-transcatheter-occluded-left-atrial-appendage
#12
Umberto Cucchini, Denisa Muraru, Luigi P Badano
A cerebral ischemic event in a patient managed with left atrial appendage (LAA) transcatheter obliteration is illustrated. Transesophageal echocardiography allowed identification and accurate definition of the LAA device leakage.
January 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29276498/role-of-hyperintense-acute-reperfusion-marker-for-classifying-the-stroke-etiology
#13
Hee Young Choi, Kyung Mi Lee, Hyug-Gi Kim, Eui Jong Kim, Woo Suk Choi, Bum Joon Kim, Sung Hyuk Heo, Dae-Il Chang
Purpose: The hyperintense acute reperfusion marker (HARM) is a delayed enhancement of the subarachnoid or subpial space observed on post-contrast fluid-attenuated inversion recovery (FLAIR) images and is associated with permeability changes to the blood-brain barrier in acute stroke. We investigated the relationship between HARM and stroke etiology based on the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. In addition, we evaluated the relationship between HARM and stroke locations with respect to vascular territories and anatomic compartments...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29273598/correction-to-early-elevated-troponin-levels-after-ischemic-stroke-suggests-a-cardioembolic-source
#14
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29273521/the-pathology-and-pathophysiology-of-vascular-dementia
#15
REVIEW
Raj N Kalaria
Vascular dementia (VaD) is widely recognised as the second most common type of dementia. Consensus and accurate diagnosis of clinically suspected VaD relies on wide-ranging clinical, neuropsychological and neuroimaging measures in life but more importantly pathological confirmation. Factors defining subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes as well as time after the initial vascular event...
December 19, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29250272/percutaneous-left-atrial-appendage-closure-is-there-a-role-in-valvular-atrial-fibrillation
#16
REVIEW
Chetan Huded, Amar Krishnaswamy, Samir Kapadia
Atrial fibrillation, a chronic and highly morbid cardiovascular condition which affects over 33 million people worldwide, can be broadly categorized as valvular vs non-valvular in etiology. However, definitions of valvular atrial fibrillation have varied widely in the literature, and there is no clear consensus definition to date. Historically, patients with atrial fibrillation in the setting of rheumatic mitral valve disease have constituted a particularly high risk group for cardioembolic stroke, and for this reason many contemporary trials of pharmaceutical and device therapies for atrial fibrillation have systematically excluded patients with valvular heart disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250236/post-ictal-transient-atrial-fibrillation-as-a-rare-manifestation-of-grand-mal-seizure
#17
Gulshan Man Singh Dangol, David A Hoffman
Atrial fibrillation (AF) most frequently occurs as a consequence of multiple etiologies including valvular disease, coronary artery disease, hyperthyroidism, alcohol ingestion, and pulmonary embolism. However, on rare occasion transient AF may be a result of generalized tonic-clonic seizures (GTCS). A 33-year-old-man presented to the emergency department following GTCS in AF with rapid ventricular response. He had no previous documented history. Diagnostic evaluation including electrolytes, thyroid function, cardiac enzymes, serum and urine drug screen, and two-dimensional echocardiogram were unremarkable...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29246963/associations-of-lipoprotein-a-levels-with-incident-atrial-fibrillation-and-ischemic-stroke-the-aric-atherosclerosis-risk-in-communities-study
#18
Konstantinos N Aronis, Di Zhao, Ron C Hoogeveen, Alvaro Alonso, Christie M Ballantyne, Eliseo Guallar, Steven R Jones, Seth S Martin, Saman Nazarian, Brian T Steffen, Salim S Virani, Erin D Michos
BACKGROUND: Lipoprotein(a) (Lp[a]) is proatherosclerotic and prothrombotic, causally related to coronary disease, and associated with other cardiovascular diseases. The association of Lp(a) with incident atrial fibrillation (AF) and with ischemic stroke among individuals with AF remains to be elucidated. METHODS AND RESULTS: In the community-based ARIC (Atherosclerosis Risk in Communities) study cohort, Lp(a) levels were measured by a Denka Seiken assay at visit 4 (1996-1998)...
December 15, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29246672/recurrent-stroke-and-bleeding-events-after-acute-cardioembolic-stroke-analysis-using-japanese-healthcare-database-from-acute-care-institutions
#19
Masahiro Yasaka, Yukihiro Koretsune, Takeshi Yamashita, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: To understand the reality of patients who experienced a cardioembolic stroke (CES) is important because of the high incidence of recurrent stroke and the need to account for bleeding risk in relation to the need for anticoagulation treatment. We elucidated the current real-world medical care in patients who had a CES and identified the risk factors for recurrent stroke. METHODS AND RESULTS: The study comprised 9804 patients who were diagnosed with CES between April 2008 and September 2013 as identified in a healthcare database used by acute-care institutions in Japan...
December 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29235504/the-%C3%AE-fibrinogen-gene-455g-a-polymorphism-associated-with-cardioembolic-stroke-in-atrial-fibrillation-with-low-cha2ds2-vasc-score
#20
Xiaofeng Hu, Junjun Wang, Yaguo Li, Jiong Wu, Song Qiao, Shanhu Xu, Jun Huang, Linhui Chen
Previous work has suggested that ischemic stroke (IS) may be more likely to occur in individuals with a genetic predisposition. In this study, we investigated the potential association of IS-relevant genetic risk factors with cardioembolic stroke (CES) in atrial fibrillation (AF) patients with low CHA2DS2-VaSc score. Genotyping was performed using the GenomeLab SNPstream genotyping platform for five IS-relevant SNPs (MMP-9 C1562T, ALOX5AP SG13S114A/T, MTHFR 677 C/T, FGB 455 G/A, and eNOS G298A) in 479 AF patients with CES and 580 age and sex-matched AF patients without CES...
December 13, 2017: Scientific Reports
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