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Stroke risk from atrial fibrillation

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https://www.readbyqxmd.com/read/29453305/frequency-and-outcomes-of-reduced-dose-non-vitamin-k-antagonist-anticoagulants-results-from-orbit-af-ii-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii
#1
Benjamin A Steinberg, Peter Shrader, Karen Pieper, Laine Thomas, Larry A Allen, Jack Ansell, Paul S Chan, Michael D Ezekowitz, Gregg C Fonarow, James V Freeman, Bernard J Gersh, Peter R Kowey, Kenneth W Mahaffey, Gerald V Naccarelli, James A Reiffel, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for stroke prevention in atrial fibrillation (AF) but require lower doses in certain patients. We sought to describe the frequency, appropriateness (according to Food and Drug Administration labeling), and outcomes of patients prescribed reduced doses of NOACs in community practice. METHODS AND RESULTS: We analyzed data from the ORBIT-AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II) registry, a prospective, national, observational registry of AF patients...
February 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29447781/prediction-of-long-term-net-clinical-outcomes-using-the-timi-af-score-comparison-with-cha-2-ds-2-vasc-and-has-bled
#2
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
The TIMI-AF score was described to predict net clinical outcomes (NCOs) in atrial fibrillation (AF) patients receiving warfarin. However, this score derived from the ENGAGE AF-TIMI 48 trial, and no external validation exists in real world clinical practice. We tested the long-term predictive performance of the TIMI-AF score in comparison with CHA 2 DS 2 -VASc and HAS-BLED in a 'real-world' cohort of anticoagulated AF patients. METHODS: We included 1156 consecutive AF patients stable on vitamin K antagonist (INR 2...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447733/stroke-risk-in-patients-with-reduced-ejection-fraction-after-myocardial-infarction-without-atrial-fibrillation
#3
João Pedro Ferreira, Nicolas Girerd, John Gregson, Ichraq Latar, Abhinav Sharma, Marc A Pfeffer, John J V McMurray, Azmil H Abdul-Rahim, Bertram Pitt, Kenneth Dickstein, Patrick Rossignol, Faiez Zannad
BACKGROUND: Stroke can occur after myocardial infarction (MI) in the absence of atrial fibrillation (AF). OBJECTIVES: This study sought to identify risk factors (excluding AF) for the occurrence of stroke and to develop a calibrated and validated stroke risk score in patients with MI and heart failure (HF) and/or systolic dysfunction. METHODS: The datasets included in this pooling initiative were derived from 4 trials: CAPRICORN (Effect of Carvedilol on Outcome After Myocardial Infarction in Patients With Left Ventricular Dysfunction), OPTIMAAL (Optimal Trial in Myocardial Infarction With Angiotensin II Antagonist Losartan), VALIANT (Valsartan in Acute Myocardial Infarction Trial), and EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study); EPHESUS was used for external validation...
February 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29445431/outcome-recurrence-and-mortality-after-non-valvular-atrial-fibrillation-stroke-long-term-follow-up-study
#4
Antonio Arauz, Francisco Ruiz-Navarro, Miguel A Barboza, Angelica Ruiz, Jonathan Colin, Marisela Reyes, Humberto Silos, Carlos Cantu-Brito, Luis Murillo-Bonilla, Fernando Barinagarrementeria
Objective: Non-valvular atrial fibrillation (NVAF) is a major risk factor for ischemic stroke (IS) and a powerful predictor of mortality. This study investigates early and long-term outcome among patients with IS secondary to NVAF and identify the main factors associated with poor outcome, recurrence, and death. Methods: We analyzed the data from our consecutive NVAF acute IS database, over a period of 23 years. The endpoints were bad outcome (Modified Rankin Score ≥3), recurrence, and mortality at discharge, after 6 months, 12 months, and final follow-up...
December 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29444969/atrial-fibrillation-detected-after-stroke-is-related-to-a-low-risk-of-ischemic-stroke-recurrence
#5
Luciano A Sposato, Joshua O Cerasuolo, Lauren E Cipriano, Jiming Fang, Sebastian Fridman, Maryse Paquet, Gustavo Saposnik
OBJECTIVE: To compare the risk of 1-year ischemic stroke recurrence between atrial fibrillation (AF) diagnosed after stroke (AFDAS) and sinus rhythm (SR) and investigate whether underlying heart disease is as frequent in AFDAS as it is in AF known before stroke (KAF). METHODS: In this retrospective cohort study, we included all ischemic stroke patients admitted to institutions participating in the Ontario Stroke Registry from July 1, 2003, to March 31, 2013. Based on heart rhythm assessed during admission, we classified patients as AFDAS, KAF, or SR...
February 14, 2018: Neurology
https://www.readbyqxmd.com/read/29441984/direct-oral-anticoagulants-in-real-clinical-practice-analysis-of-patient-characteristics-and-prescribing-patterns-in-a-large-teaching-hospital
#6
B Kováčová, J Červeňová
Direct oral anticoagulants (DOACs) became rapidly accepted as an alternative to warfarin in the prevention of stroke in atrial fibrillation and prophylaxis of thromboembolic events. Their safety and efficacy have been well documented in several studies, however, as with any new drug, use in real-world population often reveals risk factors that may affect treatment outcomes. The aim of the study was to determine the prescribing patterns and analyse patient characteristics to identify incidence of selected factors (age, weight, comorbidities and interacting medication) that may affect DOAC safety and efficacy...
September 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29439352/linking-atrial-fibrillation-with-alzheimer-s-disease-epidemiological-pathological-and-mechanistic-evidence
#7
Masafumi Ihara, Kazuo Washida
Many studies have shown a relationship between atrial fibrillation (AF) and vascular dementia. AF is a major risk factor for stroke, and stroke is the greatest risk factor for vascular dementia. However, the relationship between Alzheimer's disease (AD), the leading cause of dementia, and AF remains unclear. At least four epidemiological studies have reported AF significantly raises the risk of AD 1.5- to 2.5-fold. Chronic cerebral hypoperfusion, resulting from persistent AF, could explain the link as hypoperfusion may mechanistically exacerbate amyloid-β (Aβ) neuropathology, such as senile plaques and amyloid angiopathy, by upregulating Aβ-producing enzymes and lowering Aβ clearance efficiency...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29438571/use-of-non-vitamin-k-oral-anticoagulants-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#8
REVIEW
O Itzhaki, B Zadok, A Eisen
AIMS: To examine the efficacy and safety of non-vitamin K oral anticoagulants in people with both atrial fibrillation and diabetes mellitus. METHODS: We reviewed efficacy and safety data from the warfarin-controlled phase III non-vitamin K oral anticoagulants trials (ARISTOTLE, RE-LY, ROCKET-AF, ENGAGE and AF-TIMI 48) and their post hoc analyses with regard to diabetes status. We also reviewed the updated literature regarding this population. RESULTS: At baseline 20-40% of the participants in the phase III non-vitamin K oral anticoagulants trials had diabetes mellitus at baseline...
February 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29436121/antiplatelet-therapy-combined-with-acenocoumarol-in-relation-to-major-bleeding-ischaemic-stroke-and-mortality
#9
José Miguel Rivera-Caravaca, Francisco Marín, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Vanessa Roldán, Gregory Y H Lip
BACKGROUND: Vascular disease is a frequent comorbidity in atrial fibrillation (AF) patients, resulting in concomitant use of antiplatelet therapy. In the present study, we investigated the incidence and risk of major bleeding, ischaemic stroke, and mortality in a cohort of AF patients taking acenocoumarol plus antiplatelet therapy, in comparison with AF patients taking only acenocoumarol monotherapy. METHODS: We consecutively included 1361 "real-world" AF patients stable for at least the previous 6 months on acenocoumarol (INR 2...
February 12, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#10
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29433933/five-year-case-fatality-following-first-ever-stroke-in-the-mashhad-stroke-incidence-study-a-population-based-study-of-stroke-in-the-middle-east
#11
Mohammad Taghi Farzadfard, Amanda G Thrift, Amin Amiri, Moira K Kapral, Peyman Hashemi, Luciano A Sposato, Maryam Salehi, Ali Shoeibi, Alireza Hoseini, Naghmeh Mokhber, Mahmoud Reza Azarpazhooh
BACKGROUND AND PURPOSE: Despite recent declines in stroke mortality in high-income countries, the incidence and mortality of stroke have increased in many low- and middle-income countries. Population-based information on stroke in such countries is a research priority to address this rising trend. This study was designed to evaluate 5-year stroke mortality and its associated factors. METHODS: During a 12-month period beginning from November 2006, 624 patients with first-ever stroke (FES) living in Mashhad, Iran, were recruited and followed longitudinally...
February 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29431527/role-of-cardiac-electronic-implantable-device-in-the-stratification-and-management-of-embolic-risk-of-silent-atrial-fibrillation-are-all-atrial-fibrillations-created-equal
#12
Andrea Di Cori, Alessio Lilli, Giulio Zucchelli, Valerio Zaca
Ischemic strokes may be associated with atrial fibrillation (AF). AF detection is critical in ischemic stroke survivors, often recommending a switch from antiplatelet therapy to oral anticoagulants for secondary prevention. Areas covered: Cardiac implantable electronic devices (CIED) with their long-term recording capability allows to document AF and to quantify the arrhythmia burden. Recent series in pacemaker and implantable cardioverter-defibrillator (ICD) recipients with no prior stroke showed that short episodes of AF increased stroke risk compared with those without AF recorded...
February 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29429886/sex-differences-in-stroke-attack-incidence-and-mortality-rates-in-northern-france
#13
Aline Meirhaeghe, Dominique Cottel, Béatrice Cousin, Marie-Pierre Dumont, Nadine Marécaux, Philippe Amouyel, Jean Dallongeville
BACKGROUND: Age and sex have a major impact on stroke onset. AIMS: We aimed to compare the attack, incidence, and 28-day mortality rate for stroke as well as risk factors in men and women aged 35 and over. METHODS: Data were obtained between 2008 and 2015 from the stroke population-based registry covering the city of Lille (northern France). RESULTS: A total of 2426 strokes (1917 incident strokes) were recorded. The number of strokes was lower in women than in men when considering individuals under the age of 75 but was twice as high when considering individuals aged 75 or over...
February 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29428132/implantable-loop-recorders-for-cryptogenic-stroke-plus-real-world-atrial-fibrillation-detection-rate-with-implantable-loop-recorders
#14
REVIEW
Dan L Musat, Nicolle Milstein, Suneet Mittal
Cryptogenic stroke (CS) represents 10%-40% of ischemic strokes and is associated with significant morbidity and mortality and high risk of recurrence. Undetected atrial fibrillation is an important consideration in these patients. Tools for electrocardiographic monitoring range from 12-lead electrocardiogram to implantable loop recorders (ILRs). ILRs have become an important tool for long-term electrocardiogram monitoring in CS patients. Advancements in ILR technology are needed to ensure more robust connectivity and to help triage incoming data...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29426978/impact-of-intracranial-artery-calcification-on-cerebral-hemodynamic-changes
#15
Xiaohong Wu, Li Wang, Jingxin Zhong, Jacky Ko, Lin Shi, Yannie Soo, Thomas Leung, Ka Sing Wong, Jill Abrigo, Xiangyan Chen
PURPOSE: Intracranial artery calcification (IAC) has been demonstrated to be correlated with ischemic stroke, cognitive decline, and other vascular events by accumulating evidences from both Western and Asian populations. The proposed study aimed to investigate its potential mechanisms by evaluating the blood flow velocity and pulsatility index (PI) of cerebral arteries. METHODS: Consecutive ischemic stroke patients admitted to the Prince of Wales Hospital were recruited after excluding those with atrial fibrillation or poor temporal window...
February 9, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29424795/evaluation-of-vasopressin-for-vasoplegic-shock-in-patients-with-preoperative-left-ventricular-dysfunction-after-cardiac-surgery-a-propensity-score-analysis
#16
Yongqing Cheng, Tuo Pan, Min Ge, Tao Chen, Jiaxin Ye, Lichong Lu, Cheng Chen, Qiuyan Zong, Yi Ding, Dongjin Wang
PURPOSE: Postoperative vasoplegic shock after cardiac surgery seems to be a frequent complication with poor outcomes. We hypothesized that vasopressin may increase the risk of poor outcomes in patients with preoperative Left Ventricular Dysfunction (pLVD) rather than norepinephrine. The aim of this study was to assess whether vasopressin is superior to norepinephrine to improve outcomes in patients with pLVD after cardiac surgery. METHODS: This retrospective cohort study included 1,156 patients with postoperative vasoplegic shock (mean arterial pressure <65 mmHg resistant to fluid challenge and cardiac index >2...
February 7, 2018: Shock
https://www.readbyqxmd.com/read/29424437/simulation-for-predicting-effectiveness-and-safety-of-new-cardiovascular-drugs-in-routine-care-populations
#17
Mehdi Najafzadeh, Sebastian S Schneeweiss, Niteesh K Choudhry, Shirley V Wang, Joshua J Gagne
In the presence of heterogeneity of treatment effect (HTE), the average treatment effect from a randomized controlled trial (RCT) may not be applicable to different patients, such as those in observational settings. Our objective was to develop a novel approach that uses individual-level simulation to expand RCT results to target patient populations in the presence of HTE. For this purpose, we compared the results of the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial, and two observational studies that compared benefits and risks of dabigatran to warfarin in patients with atrial fibrillation...
February 9, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29419390/dyslipidemia-and-risk-of-cardiovascular-events-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-therapy-insights-from-the-aristotle-apixaban-for-reduction-in-stroke-and-other-thromboembolic-events-in-atrial-fibrillation-trial
#18
Tymon Pol, Claes Held, Johan Westerbergh, Johan Lindbäck, John H Alexander, Marco Alings, Cetin Erol, Shinya Goto, Sigrun Halvorsen, Kurt Huber, Michael Hanna, Renato D Lopes, Witold Ruzyllo, Christopher B Granger, Ziad Hijazi
BACKGROUND: Dyslipidemia is a major risk factor for cardiovascular events. The prognostic importance of lipoproteins in patients with atrial fibrillation is not well understood. We aimed to explore the association between apolipoprotein A1 (ApoA1) and B (ApoB) and cardiovascular events in patients with atrial fibrillation receiving oral anticoagulation. METHODS AND RESULTS: Using data from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial, ApoA1 and ApoB plasma levels were measured at baseline in 14 884 atrial fibrillation patients...
February 1, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29412241/oral-anticoagulation-in-atrial-fibrillation-development-and-evaluation-of-a-mobile-health-application-to-support-shared-decision-making
#19
Laura Siga Stephan, Eduardo Dytz Almeida, Raphael Boesche Guimarães, Antonio Gaudie Ley, Rodrigo Gonçalves Mathias, Maria Valéria Assis, Tiago Luiz Luz Leiria
BACKGROUND: Atrial fibrillation is responsible for one in four strokes, which may be prevented by oral anticoagulation, an underused therapy around the world. Considering the challenges imposed by this sort of treatment, mobile health support for shared decision-making may improve patients' knowledge and optimize the decisional process. OBJECTIVE: To develop and evaluate a mobile application to support shared decision about thromboembolic prophylaxis in atrial fibrillation...
February 1, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29408019/impact-of-atrial-fibrillation-on-cognitive-function-psychological-distress-quality-of-life-and-impulsiveness
#20
Rokas Serpytis, Aurelija Navickaite, Emilija Serpytiene, Jurate Barysiene, Germanas Marinskis, Dalius Jatuzis, Zaneta Petrulioniene, Aleksandras Laucevicius, Pranas Serpytis
OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia and a known risk factor for cerebrovascular stroke. Atrial fibrillation and long standing hypertension may produce ischemic lesions leading to progressive cognitive impairment. The impact of atrial fibrillation alone on cognitive impairment has not been evaluated. Our objective was to compare cognitive function, quality of life, psychological distress and impulsiveness in people with atrial fibrillation and a matched control group...
January 30, 2018: American Journal of Medicine
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