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https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#1
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27902588/short-term-hypertension-management-in-community-is-associated-with-long-term-risk-of-stroke-and-total-death-in-china-a-community-controlled-trial
#2
Zengwu Wang, Guang Hao, Xin Wang, Wen Wang, Weiwei Chen, Manlu Zhu
BACKGROUND: It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke OBJECTIVES:: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. DESIGN: Community controlled trail. PARTICIPANTS: Six community health centers (4 active, 2 control) in China, patients with hypertension. CONTROL ARM: Patients were treated with normally therapy method...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27901325/asymptomatic-carotid-artery-stenosis-who-should-be-screened-who-should-be-treated-and-how-should-we-treat-them
#3
Djurre D DE Waard, Dylan Morris, Gert J DE Borst, Richard Bulbulia, Alison Halliday
Although stopping smoking, lowering blood pressure and reducing lipid levels will reduce global stroke risk and cardiovascular mortality, these remain leading causes of death and disability especially in ageing populations. Further prevention strategies are needed and, in the first part of this review, we explore the potential benefits of appropriate screening for carotid artery disease to reduce stroke and identify those who may have related cardiac disease. Although whole-population carotid screening is an inefficient and costly means of identifying candidates with tight carotid stenosis who might warrant intervention, it can identify many people with lower levels of stenosis who may benefit from cardiovascular risk reducing medications...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27901323/safety-of-carotid-revascularization-within-48-hours-of-symptomatic-presentation
#4
Kosmas I Paraskevas, Ian M Loftus
In the last few years, there has been a gradual shift in the recommendations of carotid guidelines towards performance of carotid endarterectomy (CEA) earlier in patients with >70% carotid artery stenosis suffering an ipsilateral transient ischemic attack (TIA)/minor stroke episode. The "6-month" threshold in the early guidelines was subsequently replaced with a "14-day" target. More recently, an even earlier intervention (i.e. "within 48 hours") gains support as the optimal timing for the performance of CEA in patients with symptomatic carotid artery stenosis...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27899517/endovascular-management-of-cerebral-septic-embolism-three-recent-cases-and-review-of-the-literature
#5
Eugene L Scharf, Tia Chakraborty, Alejandro Rabinstein, Amrendra S Miranpuri
Endovascular management of acute ischemic stroke secondary to septic emboli from bacterial endocarditis is case-specific and outside established guidelines. We report three new cases of an acute ischemic stroke secondary to septic embolus from two different centers. All cases reported here were large vessel occlusions of the middle cerebral artery in anticoagulated patients. In one case the embolus was noted to be firm and aspiration thrombectomy was attempted in lieu of stent retrieval. Thrombolysis in Cerebral Ischemia (TICI) 3 recanalization was achieved and the patient experienced a good outcome with resolution of deficits...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#6
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27898406/low-incidence-of-atrial-fibrillation-in-patients-with-transient-ischemic-attack
#7
Kenneth Bruun Pedersen, Alexander Chemnitz, Charlotte Madsen, Niels C F Sandgaard, Søren Bak, Axel Brandes
BACKGROUND: Atrial fibrillation (AF) is a major cause of stroke. Therefore, all patients with ischemic stroke or transient ischemic attack (TIA) should be examined with 12-lead electrocardiogram (ECG) and continuous monitoring to detect AF. Current guidelines recommend at least 24 h continuous ECG monitoring, which is primarily based on studies investigating patients with ischemic stroke. The aim of our study was to investigate the diagnostic yield of 12-lead ECG and Holter monitoring in patients with TIA...
November 30, 2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#8
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#9
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27895004/predictors-of-vascular-cognitive-impairment-poststroke-in-a-middle-eastern-bahrain-cohort-a-proposed-case-control-comparison
#10
Claire Donnellan, Mona Al Banna, Noor Redha, Adel Al Jishi, Isa Al Sharoqi, Safa Taha, Moiz Bakhiet, Fatema Abdulla, Patrick Walsh
BACKGROUND: Poststroke dementia and cognitive impairment are associated with poor long-term outcomes after stroke. The contribution of genetic factors such as the presence of apolipoprotein (ApoE) ɛ4 allele and its association with cognitive impairment poststroke remains inconclusive, particularly in Middle Eastern regions. OBJECTIVE: The aim of this study is to examine all correlates and potential predictors of cognitive impairment including self-awareness and regulation deficits in stroke patients and compare these functions with healthy older adults from a Middle Eastern population...
November 28, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27894896/systematic-review-and-meta-analysis-of-dual-versus-single-antiplatelet-therapy-in-carotid-interventions
#11
REVIEW
M Barkat, S Hajibandeh, S Hajibandeh, F Torella, G A Antoniou
BACKGROUND: The importance of antiplatelet therapy for the management and prevention of ischaemic stroke cannot be overstated. Despite the established guidelines, there is no clear consensus on how to manage antiplatelet therapy during and after carotid interventions. OBJECTIVE: The objective was to undertake a systematic literature review and perform a meta-analysis to assess the effects of dual antiplatelet therapy in carotid endarterectomy (CEA) and stenting (CAS)...
November 26, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27894313/identifying-the-barriers-and-enablers-for-a-triage-treatment-and-transfer-clinical-intervention-to-manage-acute-stroke-patients-in-the-emergency-department-a-systematic-review-using-the-theoretical-domains-framework-tdf
#12
REVIEW
Louise E Craig, Elizabeth McInnes, Natalie Taylor, Rohan Grimley, Dominique A Cadilhac, Julie Considine, Sandy Middleton
BACKGROUND: Clinical guidelines recommend that assessment and management of patients with stroke commences early including in emergency departments (ED). To inform the development of an implementation intervention targeted in ED, we conducted a systematic review of qualitative and quantitative studies to identify relevant barriers and enablers to six key clinical behaviours in acute stroke care: appropriate triage, thrombolysis administration, monitoring and management of temperature, blood glucose levels, and of swallowing difficulties and transfer of stroke patients in ED...
November 28, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27893055/assessment-of-use-vs-discontinuation-of-oral-anticoagulation-after-pulmonary-vein-isolation-in-patients-with-atrial-fibrillation
#13
Sara Själander, Fredrik Holmqvist, J Gustav Smith, Pyotr G Platonov, Milos Kesek, Peter J Svensson, Carina Blomström-Lundqvist, Fariborz Tabrizi, Jari Tapanainen, Dritan Poci, Anders Jönsson, Anders Själander
Importance: Pulmonary vein isolation (PVI) is a recommended treatment for patients with atrial fibrillation, but it is unclear whether it results in a lower risk of stroke. Objectives: To investigate the proportion of patients discontinuing anticoagulation treatment after PVI in association with the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke [doubled], vascular disease, age 65-74 years, sex category [female]) score, identify factors predicting stroke after PVI, and explore the risk of cardiovascular events after PVI in patients with and without guideline-recommended anticoagulation treatment...
November 23, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27892421/screening-for-atrial-fibrillation-during-influenza-vaccinations-by-primary-care-nurses-using-a-smartphone-electrocardiograph-iecg-a-feasibility-study
#14
Jessica Orchard, Nicole Lowres, S Ben Freedman, Laila Ladak, William Lee, Nicholas Zwar, David Peiris, Yasith Kamaladasa, Jialin Li, Lis Neubeck
BACKGROUND: People with unknown atrial fibrillation (AF), who are often asymptomatic, have a substantially increased risk of stroke. Although recommended in European guidelines, AF screening is not routinely performed. Screening at the time of influenza vaccination presents an ideal opportunity to detect AF in large numbers in a primary care medical setting, with an existing annual recall system for patients aged ≥65 years. DESIGN: Cross-sectional pilot study of handheld smartphone electrocardiogram (iECG) screening to identify unknown AF...
October 2016: European Journal of Preventive Cardiology
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
#15
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/27888051/absence-of-oral-anticoagulation-and-subsequent-outcomes-among-outpatients-with-atrial-fibrillation
#16
Paul L Hess, Sunghee Kim, Gregg C Fonarow, Laine Thomas, Daniel E Singer, James V Freeman, Bernard J Gersh, Jack Ansell, Peter R Kowey, Kenneth W Mahaffey, Paul S Chan, Benjamin A Steinberg, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Prior studies have shown a treatment gap in oral anticoagulation (OAC) use among patients with atrial fibrillation yet have incompletely characterized factors associated with failure to treat and subsequent outcomes in contemporary practice. METHODS: Using data collected between June 2010 and August 2011 from 174 ambulatory care sites in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we identified factors associated with absence of OAC via stratified logistic regression...
November 22, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27881425/relationship-between-language-preference-and-intravenous-thrombolysis-among-acute-ischemic-stroke-patients
#17
Betty Luan Erfe, Khawja Ahmeruddin Siddiqui, Lee H Schwamm, Nicte I Mejia
BACKGROUND: Approximately 20% of the US population primarily speaks a language other than English at home. Yet the effect of language preference on treatment of acute ischemic stroke (AIS) patients remains unknown. We aimed to evaluate the influence of language preference on AIS patients' receipt of intravenous (IV) thrombolysis. METHODS AND RESULTS: We analyzed data from 3894 AIS patients who participated in the American Heart Association "Get With The Guidelines(®)-Stroke" program at our hospital from January 1, 2003 to April 30, 2014...
November 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27881363/association-between-prediabetes-and-risk-of-cardiovascular-disease-and-all-cause-mortality-systematic-review-and-meta-analysis
#18
Yuli Huang, Xiaoyan Cai, Weiyi Mai, Meijun Li, Yunzhao Hu
OBJECTIVES:  To evaluate associations between different definitions of prediabetes and the risk of cardiovascular disease and all cause mortality. DESIGN:  Meta-analysis of prospective cohort studies. DATA SOURCES:  Electronic databases (PubMed, Embase, and Google Scholar). SELECTION CRITERIA:  Prospective cohort studies from general populations were included for meta-analysis if they reported adjusted relative risks with 95% confidence intervals for associations between the risk of composite cardiovascular disease, coronary heart disease, stroke, all cause mortality, and prediabetes...
November 23, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27879470/incidence-and-management-of-thrombotic-and-thromboembolic-complications-following-the-norwood-procedure-a-systematic-review
#19
Arnav Agarwal, Mohammed Firdouse, Nishaan Brar, Andy Yang, Panos Lambiris, Anthony K Chan, Tapas K Mondal
BACKGROUND: The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. METHODS: Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant...
November 21, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27875953/management-of-hypertension-in-patients-with-chronic-kidney-disease-in-asia
#20
Qi-Fang Huang, Satoshi Hoshide, Hao-Min Cheng, Sungha Park, Chang-Gyu Park, Chen-Huan Chen, Kazuomi Kario, Ji-Guang Wang
Hypertension is both a cause and consequence of chronic kidney disease (CKD). According to the Chinese national survey in 2007-2010, the prevalence of CKD was much higher in hypertensive patients (18.9%, n=16,691) than in the overall population sample (10.8%, n=47,204). CKD in hypertension confers risks to the kidneys as well as other organs. Probably because of high dietary salt intake, Asian hypertensive patients with CKD show high prevalence of non-dipping and reversed dipping blood pressure pattern, and may have even higher risks of cardiovascular disease...
November 22, 2016: Current Hypertension Reviews
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