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Atrial fibrilation stroke

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https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#1
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29784865/opportunistic-pulse-checks-in-primary-care-to-improve-recognition-of-atrial-fibrillation-a-retrospective-analysis-of-electronic-patient-records
#2
James Cole, Payam Torabi, Isabel Dostal, Kate Homer, John Robson
BACKGROUND: Atrial fibrillation (AF) is an important and modifiable risk factor for stroke. Earlier identification may reduce stroke-related morbidity and mortality. Trial evidence shows that opportunistic pulse regularity checks in individuals aged ≥65 years increases detection of AF. However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs). AIM: To evaluate the impact of a systematic programme to promote pulse regularity checks, the programme's uptake in general practice, and the prevalence of AF...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29782263/-nonvalvular-atrial-fibrillation-and-diabetic-nephropathy-epidemiology-prognosis-and-choice-of-anticoagulant-therapy
#3
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29780241/patient-and-physician-preferences-for-attributes-of-coronary-revascularization
#4
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the "right choice" depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29780228/risk-factors-of-acute-ischemic-stroke-in-patients-presented-to-beni-suef-university-hospital-prevalence-and-relation-to-stroke-severity-at-presentation
#5
Rasha H Soliman, Mohammed I Oraby, Mohammed Fathy, Alaa M Essam
Background: Acute ischemic stroke is one of the major causes of disability and death worldwide. Effective prevention remains the best approach for reducing the burden of stroke. The aim of this work was to study the prevalence of stroke risk factors and the possible relation between such risk factors and the disease severity at presentation in a sample of stroke patients presented to Beni-Suef University Hospital, north Upper Egypt. Methods: A sample of 167 patients of acute ischemic stroke recruited from Beni-Suef University Hospital was included in this cross-sectional descriptive study...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29779883/gender-gap-and-risk-factors-for-poor-stroke-outcomes-a-single-hospital-based-prospective-cohort-study
#6
Kuo-Hua Hung, Jerry Cheng-Yen Lai, Kuang-Nan Hsu, Chihmin Hu, Hung-Chang Chang, Cheng-Neng Chen, He-Shu Ku, Ming-Shiang Yang, Pei-Hao Chen
BACKGROUND: This study intended to investigate whether etiological stroke subtypes and their corresponding major risk factors have differential effects on outcomes between genders. PATIENTS AND METHODS: We enrolled 403 consecutive patients with first-ever acute ischemic stroke (170 women, 233 men), from a referral hospital in Taiwan over a 2-year period. Gender differences in demographics, vascular risk factors, access to health care, etiological stroke subtypes, stroke severity, and outcomes were examined...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#7
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#8
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#9
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29772946/safety-and-effectiveness-of-apixaban-in-comparison-to-warfarin-in-patients-with-nonvalvular-atrial-fibrillation-a-propensity-matched-analysis-from-japanese-administrative-claims-data
#10
Shun Kohsaka, Jun Katada, Kumiko Saito, Yasuo Terayama
OBJECTIVE: To investigate the risk of bleeding events and stroke/systemic embolism (SE) among Japanese patients with nonvalvular atrial fibrillation (NVAF), focusing on the initial dosage of apixaban and patient age. METHODS: This retrospective cohort study used de-identified electronic health records-based claims data from 314 acute-care hospitals in Japan. NVAF patients newly initiated on warfarin or apixaban, with no prescription during the 180-day blanking period, were eligible...
May 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29772576/wake-up-stroke-versus-stroke-with-known-onset-time-clinical-and-multimodality-ct-imaging-characteristics
#11
Jan W Dankbaar, Henri P Bienfait, Coen van den Berg, Edwin Bennink, Alexander D Horsch, Tom van Seeters, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
BACKGROUND: Current guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time. METHODS: All patients were selected from a large prospective cohort study (Dutch acute stroke study)...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29772570/undertreatment-of-vascular-risk-factors-in-patients-with-monocular-ischaemic-visual-loss
#12
Angeliki Zarkali, Suk Fun Cheng, Agnes Dados, Robert Simister, Arvind Chandratheva
BACKGROUND AND PURPOSE: Ischaemic visual loss is often considered a lower risk factor than other transient ischaemic attacks (TIA). We aimed to determine the recurrence risk, prevalence and management of vascular risk factors in these patients. METHODS: The study took place in the University College Hospital London daily TIA clinic, main referral centre for North-Central London and Moorfields Eye Hospital. Consecutive records for patients with transient (< 24 h) or permanent (> 24 h) ischaemic visual loss were reviewed during the period January 2014-October 2016...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#13
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768394/stroke-risk-reduction-after-laa-occlusion-in-elderly-patients-with-atrial-fibrillation-long-term-results
#14
Radosław Litwinowicz, Magdalena Bartus, Piotr Ceranowicz, Bogusław Kapelak, Dhanunjaya Lakkireddy, Krzysztof Bartus
No abstract text is available yet for this article.
May 16, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#15
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29764706/atrial-fibrillation-and-ischemic-events-with-rivaroxaban-in-patients-with-stable-coronary-artery-disease-afire-protocol-for-a-multicenter-prospective-randomized-open-label-parallel-group-study
#16
Satoshi Yasuda, Koichi Kaikita, Hisao Ogawa, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui
BACKGROUND: In atrial fibrillation (AF) patients with coronary artery disease (CAD), anticoagulants are commonly used in combination with antiplatelet drugs. However, dual therapy can increase the risk of bleeding, and the potential therapeutic benefits must be weighed against this. Therefore, it is recommended that dual therapy is only used for a limited time, and that monotherapy with anticoagulants should start from 1 year after percutaneous coronary intervention (PCI). However, there is a lack of evidence on the use of monotherapy, in particular with direct oral anticoagulants, in this group of patients...
May 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29764671/stroke-type-and-severity-in-patients-with-subclinical-atrial-fibrillation-an-analysis-from-the-asymptomatic-atrial-fibrillation-and-stroke-evaluation-in-pacemaker-patients-and-the-atrial-fibrillation-reduction-atrial-pacing-trial-assert
#17
Kanjana S Perera, Mukul Sharma, Stuart J Connolly, Jia Wang, Michael R Gold, Stefan H Hohnloser, Chu Pak Lau, Isabelle C Van Gelder, Carlos Morillo, Alessandro Capucci, Carsten W Israel, Gluca Botto, Jeffery S Healey
BACKGROUND: The Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial (ASSERT) demonstrated that subclinical atrial fibrillation (SCAF) was associated with a 2.5-fold increased risk of stroke. However, the absolute stroke rate was only 1.7% per year and fewer than 20% patients with stroke had SCAF in the preceding 30 days. This raises the possibility that SCAF is merely a risk marker for stroke rather than the cause...
April 18, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29763917/relevance-of-dementia-in-atrial-fibrillation-patients-within-a-specific-european-health-care-area
#18
Moisés Rodríguez-Mañero, Estrella López-Pardo, Alberto Cordero, Omar Kreidieh, José Novo Platas, Luis Valdés, Adrian Cid-Menendez, Javier García-Seara, María Pereira-Vázquez, Jose-Luis Martínez-Sande, Alberto Ruano, Carlos Peña-Gil, Pilar Mazón, Jose María García-Acuña, José Ramón González-Juanatey
INTRODUCTION: Atrial fibrillation might increase the risk of dementia. We aim to test the hypothesis that dementia could reclassify the actual risk of stroke and death predicted by the CHA2DS2-VASc in patients with atrial fibrillation (AF). METHODS: A prospective study performed in a specific health care area. RESULTS: From our health care area (n = 348,985), throughout 2013, AF was codified in 7,990 (2.08%). Mean age was 76.83 ± 10.5, mean CHA2DS2-VASc = 3...
May 15, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/29762085/association-between-comorbid-cancer-and-outcomes-among-admissions-for-acute-ischemic-stroke-receiving-systemic-thrombolysis
#19
Erin R Weeda, Nicole Bohm
Background The impact of cancer on outcomes was not assessed in major trials of systemic thrombolysis in acute ischemic stroke. Aims To evaluate the association between comorbid cancer and hospital outcomes among patients receiving systemic thrombolysis for the treatment of acute ischemic stroke. Methods The 2013 and 2014 United States National Inpatient Sample was used to identify adult patients hospitalized for acute ischemic stroke who received systemic thrombolysis. Identified admissions were stratified into two cohorts based on the presence or absence of comorbid cancer...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29760204/model-based-meta-analysis-to-evaluate-optimal-doses-of-direct-oral-factor-xa-inhibitors-in-atrial-fibrillation-patients
#20
Hideki Yoshioka, Hiromi Sato, Hiroto Hatakeyama, Akihiro Hisaka
The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrial fibrillation were demonstrated compared with warfarin by several large clinical trials; however, subsequent meta-analyses reported a higher risk of major bleeding with rivaroxaban than with the other FXa inhibitors. In the present study, we first estimated the changes of prothrombin time (PT) in 5 randomized trials based on reported population pharmacokinetic and pharmacodynamic models and then carried out a model-based meta-analysis to obtain models describing the relationship between PT changes and the event rates of ischemic stroke/systemic embolism (SE) and of major bleeding...
May 22, 2018: Blood Advances
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