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https://www.readbyqxmd.com/read/29339434/cerebrovascular-outcomes-with-proton-pump-inhibitors-and-thienopyridines-a-systematic-review-and-meta-analysis
#1
Konark Malhotra, Aristeidis H Katsanos, Mohammad Bilal, Muhammad Fawad Ishfaq, Nitin Goyal, Georgios Tsivgoulis
BACKGROUND AND PURPOSE: Pharmacokinetic and prior studies on thienopyridine and proton pump inhibitors (PPI) coadministration provide conflicting data for cardiovascular outcomes, whereas there is no established evidence on the association of concomitant use of PPI and thienopyridines with adverse cerebrovascular outcomes. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials and cohort studies from inception to July 2017, reporting following outcomes among patients treated with thienopyridine and PPI versus thienopyridine alone (1) ischemic stroke, (2) combined ischemic or hemorrhagic stroke, (3) composite outcome of stroke, myocardial infarction (MI), and cardiovascular death, (4) MI, (5) all-cause mortality, and (6) major or minor bleeding events...
January 16, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29336253/colchicine-in-post-operative-atrial-fibrillation-a-review
#2
Dimitrios A Vrachatis, Charalampos Kossyvakis, Christos Angelidis, Vasiliki Panagopoulou, Eleni K Sarri, Sotiria Giotaki, Gerasimos Siasos, Manolis Vavuranakis, Spyridon G Deftereos
Post-operative atrial fibrillation (POAF) is a frequent entity increasing hospitalization duration, stroke and mortality. In the recent years, a few studies have sought to investigate the potential effect of colchicine in POAF prevention after cardiac surgery or catheter pulmonary vein isolation for AF. In the present review article, we intend to provide a synopsis of clinical practice guidelines, summarize and critically approach current evidence for or against colchicine as a means of POAF prevention.
January 14, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29332678/relationship-of-sleep-pattern-and-snoring-with-chronic-disease-findings-from-a-nationwide-population-based-survey
#3
Fakir Md Yunus, Safayet Khan, Dipak K Mitra, Sabuj Kanti Mistry, Kaosar Afsana, Mahfuzar Rahman
OBJECTIVES: To investigate the association of total sleep time and presence or absence of snoring with chronic disease among the Bangladeshi adult population. DESIGN: Cross-sectional survey. SETTING: Urban and rural Bangladesh. PARTICIPANTS: A total of 12,338 men and women aged ≥35 years. MEASUREMENTS: Total sleep time was considered as the total hours of sleep in 24 hours. Furthermore, sleep time was categorized into <7, 7-9, and >9 hours according to National Sleep Foundation (2015) guidelines...
February 2018: Sleep Health
https://www.readbyqxmd.com/read/29332471/fatal-exertional-heat-stroke-and-american-football-players-the-need-for-regional-heat-safety-guidelines
#4
Andrew J Grundstein, Yuri Hosokawa, Douglas J Casa
CONTEXT:   Weather-based activity modification in athletics is an important way to minimize heat illnesses. However, many commonly used heat-safety guidelines include a uniform set of heat-stress thresholds that do not account for geographic differences in acclimatization. OBJECTIVE:   To determine if heat-related fatalities among American football players occurred on days with unusually stressful weather conditions based on the local climate and to assess the need for regional heat-safety guidelines...
January 13, 2018: Journal of Athletic Training
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
#5
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/29330214/statins-have-a-dose-dependent-effect-on-amputation-and-survival-in-peripheral-artery-disease-patients
#6
Shipra Arya, Anjali Khakharia, Zachary O Binney, Randall R DeMartino, Luke P Brewster, Philip P Goodney, Peter W F Wilson
Background -Statin dose guidelines for Peripheral Artery Disease (PAD) patients are largely based on coronary artery disease and stroke data. The aim of this study is to determine the effect of statin intensity on PAD outcomes of amputation and mortality. Methods -Using an observational cohort study design and a validated algorithm we identified incident PAD patients (2003-2014) in the national Veterans Affairs data. Highest statin intensity exposure [high intensity vs low- moderate intensity vs antiplatelet therapy but no statin use (AP only)] was determined within one year of diagnosis of PAD...
January 12, 2018: Circulation
https://www.readbyqxmd.com/read/29325349/-introduction-and-interpretation-of-guidelines-on-thromboprophylaxis-in-the-perioperative-period-of-urological-surgery
#7
X Wang, Z Y Liu
Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29317937/evaluating-the-potential-for-pharmacists-to-prescribe-oral-anticoagulants-for-atrial-fibrillation
#8
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/29316892/a-conceptual-model-of-treatment-burden-and-patient-capacity-in-stroke
#9
Katie I Gallacher, Carl R May, Peter Langhorne, Frances S Mair
BACKGROUND: Treatment burden is the workload of healthcare experienced by those with long-term conditions and the impact that this has on well-being. Treatment burden can negatively impact on quality of life and adherence to treatments. Individuals are likely to differ in their ability to manage health problems and follow treatments, defined as patient capacity. This has been under investigated in stroke. The aim of this paper is to create a conceptual model of treatment burden and patient capacity for people who have had a stroke through exploration of their experiences of healthcare...
January 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#10
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/29316375/selection-criteria-for-endovascular-therapy-for-acute-ischaemic-stroke-are-patients-missing-out
#11
Julian Maingard, Leonid Churilov, Peter Mitchell, Richard Dowling, Bernard Yan
INTRODUCTION: Endovascular clot retrieval (ECR) following intravenous thrombolysis is superior to intravenous thrombolysis alone for acute stroke with large vessel occlusion. However, trial selection criteria may exclude potentially salvageable patients. We investigated the impact of published selection criteria on the different proportions of patients excluded and clinical outcome. METHODS: We included patients with anterior circulation stroke treated with ECR from a single centre...
January 9, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29313057/regional-differences-in-thrombectomy-rates-secondary-use-of-billing-codes-in-the-miracum-medical-informatics-for-research-and-care-in-university-medicine-consortium
#12
Christian Haverkamp, Thomas Ganslandt, Petar Horki, Martin Boeker, Arnd Dörfler, Stefan Schwab, Joachim Berkefeld, Waltraud Pfeilschifter, Wolf-Dirk Niesen, Karl Egger, Manfred Kaps, Marc A Brockmann, Eva Neumaier-Probst, Kristina Szabo, Martin Skalej, Siegfried Bien, Christoph Best, Hans-Ulrich Prokosch, Horst Urbach
BACKGROUND AND PURPOSE: Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine. METHODS: Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines...
January 8, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29302990/relevance-of-the-updated-food-and-drug-administration-alteplase-label-for-acute-ischemic-stroke-the-estimated-impact-and-current-guidelines
#13
Harn J Shiue, Karen C Albright, Kara A Sands
In 2015, the Food and Drug Administration updated the contraindications for the use of alteplase in acute ischemic stroke (AIS), potentially creating a greater impact on treatment. A history of intracranial hemorrhage and recent stroke within 3 months were removed as contraindications, increasing the number of patients eligible for alteplase. The aim of this commentary is to call attention to the updates and discuss them relative to current American Heart Association/American Stroke Association guidelines. Additionally, we estimate the clinical impact of the updates by analyzing AIS admissions to a large-volume Comprehensive Stroke Center...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29301756/outcomes-of-patients-with-atrial-fibrillation-newly-recommended-for-oral-anticoagulation-under-the-2014-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guideline
#14
Matthew P Gray, Samir Saba, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: In March 2014, the American Heart Association updated their guidelines for the management of oral anticoagulation (OAC) in atrial fibrillation, recommending OAC for all patients with CHA2DS2-VASc ≥2. Previously, only patients with CHADS2 ≥2 were recommended for anticoagulation. This study compared effectiveness and safety outcomes of OAC among patients who would receive OAC using the 2014 guidelines but not the 2011 guidelines. METHODS AND RESULTS: Using claims data from a 5% sample of 2013-2014 Medicare beneficiaries, we identified patients with initially diagnosed atrial fibrillation between 2013 and 2014 and selected those who would receive OAC under the 2014 guidelines but not the 2011 guidelines (those with CHA2DS2-VASc score ≥2 or CHADS2 score <2)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29301002/should-we-eat-more-potassium-to-better-control-blood-pressure-in-hypertension
#15
Michel Burnier
Changes in lifestyle and nutrition are recommended as the first-step approach to the management of hypertension by all national and international guidelines. Today, when considering nutritional factors in hypertension, almost all the attention is focused on the reduction of salt intake to improve blood pressure (BP) control. Changes in potassium intake are only briefly evoked in guidelines. Few physicians actually think about proposing to eat more foods that are high in potassium (fruits, vegetables, nuts) to better control BP...
January 2, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29299952/the-utility-of-coagulation-activity-for-prediction-of-risk-of-mortality-and-cardiovascular-events-in-guideline-treated-myocardial-infarction-patients
#16
Christina Christersson, Bertil Lindahl, Lars Berglund, Agneta Siegbahn, Jonas Oldgren
BACKGROUND: Despite improved treatment of myocardial infarction (MI), real-world patients still suffer substantial risk for subsequent cardiovascular events. Little is known about coagulation activity shortly after MI and whether coagulation activity markers may identify patients at increased risk despite contemporary treatment. OBJECTIVE: To evaluate D-dimer concentration and thrombin generation potential shortly after discharge after MI and evaluate if these markers could predict the risk of future cardiovascular and bleeding events...
January 4, 2018: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/29298854/racial-disparities-in-refusal-of-stroke-thrombolysis-in-chicago
#17
Scott J Mendelson, Neelum T Aggarwal, Christopher Richards, Kathleen O'Neill, Jane L Holl, Shyam Prabhakaran
OBJECTIVE: To evaluate race differences in tissue plasminogen activator (tPA) refusal among eligible patients with acute ischemic stroke (AIS) in Chicago. METHODS: Using the Get With The Guidelines-Stroke registry data from 15 primary stroke centers between January 2013 and June 2015, we performed a retrospective analysis of patients with AIS presenting to the emergency department within 4.5 hours from symptom onset. Patient or proxy refusal was captured as a reason for nonadministration of tPA to eligible patients in the registry...
January 3, 2018: Neurology
https://www.readbyqxmd.com/read/29297187/the-evaluation-of-the-recommended-prevention-of-thrombosis-in-hospitalized-patients-with-atrial-fibrillation-and-high-thromboembolism-risk
#18
Iwona Gorczyca-Michta, Beata Wożakowska-Kapłon, Katarzyna Starzyk, Anna Szpotowicz, Anna Stec
BackgroundAccording to the applicable guidelines for stroke prevention patients with a high risk of thromboembolic complications should receive oral anticoagulants. The objective of the present study is to evaluate the prevention of thrombosis in patients with diagnosed atrial fibrillation on discharge and a high risk of stroke.Methods and materialsThe present study is a retrospective single-centre registry. The analysis was carried out on the basis of the data on 4099 patients with non-valvular atrial fibrillation who were discharged from the cardiology department in years 2004-2012...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29296820/cumulative-incidence-risk-factors-and-management-of-atrial-fibrillation-in-patients-receiving-ibrutinib
#19
Tracy E Wiczer, Lauren B Levine, Jessica Brumbaugh, Jessica Coggins, Qiuhong Zhao, Amy S Ruppert, Kerry Rogers, Anli McCoy, Luay Mousa, Avirup Guha, Nyla A Heerema, Kami Maddocks, Beth Christian, Leslie A Andritsos, Samantha Jaglowski, Steven Devine, Robert Baiocchi, Jennifer Woyach, Jeffrey Jones, Michael Grever, Kristie A Blum, John C Byrd, Farrukh T Awan
Atrial fibrillation (AF) has been reported in up to 16% of patients taking ibrutinib. Data regarding the management of AF in this patient population are limited, and stroke prevention poses a challenge because of increased risk of bleeding with ibrutinib treatment. Our study sought to describe the incidence of AF in adult patients treated with ibrutinib for a hematologic malignancy, assess management strategies, evaluate stroke and bleeding outcomes, and identify risk factors for occurrence. Of 582 patients treated with ibrutinib, 76 developed AF...
September 12, 2017: Blood Advances
https://www.readbyqxmd.com/read/29289402/blood-pressure-lowering-targets-in-patients-with-diabetes-mellitus
#20
REVIEW
Alexander A Leung, Raj S Padwal
Diabetes is a highly prevalent medical condition that commonly coexists with hypertension. The presence of diabetes and hypertension significantly increases the risk of adverse cardiovascular events. Although compelling evidence exists from randomized controlled trials demonstrating that blood pressure (BP) reduction effectively prevents cardiovascular complications, optimal BP targets remain uncertain and continue to be the subject of ongoing controversy. Until recently, most major clinical practice guidelines recommended a BP target of < 130/80 mm Hg, but some expert panels have raised their recommended treatment targets in recent years...
November 3, 2017: Canadian Journal of Cardiology
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