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Stroke risk from atrial fibrillation

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https://www.readbyqxmd.com/read/28219663/relation-of-stroke-and-major-bleeding-to-creatinine-clearance-in-patients-with-atrial-fibrillation-from-the-fushimi-af-registry
#1
Mitsuru Abe, Hisashi Ogawa, Mitsuru Ishii, Nobutoyo Masunaga, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Gregory Y H Lip, Masaharu Akao
Creatinine clearance (CrCl) has been widely used to adjust the dosage of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation (AF) and exclude contraindicated patients. However, there are few available real-world data on the relation between CrCl and adverse clinical outcomes in patients with AF. Therefore, we evaluated the clinical characteristics and adverse events in Japanese patients with AF stratified by CrCl. We categorized patients in the Fushimi AF Registry, a large prospective community-based Japanese cohort of patients with AF, into 3 groups as follows: (1) CrCl <30 ml/min, (2) CrCl 30 to 49 ml/min, and (3) CrCl ≥50 ml/min...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#2
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28215464/patients-with-intracranial-bleeding-and-atrial-fibrillation-treated-with-left-atrial-appendage-occlusion-results-from-the-amplatzer-cardiac-plug-registry
#3
Apostolos Tzikas, Xavier Freixa, Laura Llull, Sameer Gafoor, Samera Shakir, Heyder Omran, George Giannakoulas, Sergio Berti, Gennaro Santoro, Joelle Kefer, Adel Aminian, Steffen Gloekler, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Ignacio Cruz-Gonzalez, Prapa Kanagaratnam, Fabian Nietlispach, Reda Ibrahim, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Bernhard Meier, Haralampos Karvounis
BACKGROUND: In patients with non-valvular atrial fibrillation (NVAF), intracranial bleeding (ICB) constitutes a very challenging situation in which the rate of both ischemic and hemorrhagic events is increased. In these patients, left atrial appendage occlusion (LAAO) might represent a very valid alternative. OBJECTIVES: To investigate the procedural safety and long-term outcome of patients undergoing LAAO therapy due to previous ICB. METHODS: Data from the Amplatzer Cardiac Plug multicenter registry on 1047 consecutive patients were analyzed...
February 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#4
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#5
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#6
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#7
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28195503/pro-atrial-natriuretic-peptide-and-prediction-of-atrial-fibrillation-and-stroke-the-malm%C3%A3-preventive-project
#8
John Berntsson, J Gustav Smith, Peter M Nilsson, Bo Hedblad, Olle Melander, Gunnar Engström
Background The increasing prevalence of atrial fibrillation and novel therapeutic tools to prevent cardioembolic stroke has increased the need for risk markers. Objectives This study explored the relationship between the midregional sequence of pro-atrial natriuretic peptide (MR-proANP) levels with the risk of atrial fibrillation and stroke, and whether measurement of MR-proANP improves the prediction of these outcomes. Methods MR-proANP was measured in fasting blood samples of 5130 subjects (69% men, mean age 69...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28192452/increased-risk-of-dementia-in-patients-hospitalized-with-acute-kidney-injury-a-nationwide-population-based-cohort-study
#9
Hsin-Hsi Tsai, Ruoh-Fang Yen, Cheng-Li Lin, Chia-Hung Kao
PURPOSE: To determine whether acute kidney injury (AKI) is a risk factor for dementia. METHODS: This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Research Database for 2000-2011. The incidence and relative risk of dementia were assessed in 207788 patients hospitalized for AKI. The comparison control was selected using the propensity score based on age, sex, index year and comorbidities. RESULTS: During the 12-year follow-up, patients with AKI had a significantly higher incidence for developing dementia than did the controls (8...
2017: PloS One
https://www.readbyqxmd.com/read/28185970/risk-factors-for-hemorrhagic-transformation-following-intravenous-thrombolysis-in-acute-cerebral-infarction-a-retrospective-single-center-study
#10
Xiahong Xu, Changsong Li, Ting Wan, Xiaobo Gu, Wenxia Zhu, Junjie Hao, Huan Bao, Lian Zuo, Hui Hu, Gang Li
OBJECTIVE: To investigate the risk factors for the hemorrhagic transformation (HT) following intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute cerebral infarction. METHODS: Acute cerebral infarction patients receiving r-tPA thrombolysis in Shanghai Eastern Hospital were retrospectively studied. Based upon the cranial CT or MRI examination, after the intravenous thrombolysis, the patients were divided into two groups: HT group and non-HT group...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28183856/prediction-of-early-recurrent-thromboembolic-event-and-major-bleeding-in-patients-with-acute-stroke-and-atrial-fibrillation-by-a-risk-stratification-schema-the-alessa-score-study
#11
Maurizio Paciaroni, Giancarlo Agnelli, Valeria Caso, Georgios Tsivgoulis, Karen L Furie, Prasanna Tadi, Cecilia Becattini, Nicola Falocci, Marialuisa Zedde, Azmil H Abdul-Rahim, Kennedy R Lees, Andrea Alberti, Michele Venti, Monica Acciarresi, Cataldo D'Amore, Maria Giulia Mosconi, Ludovica Anna Cimini, Antonio Procopio, Paolo Bovi, Monica Carletti, Alberto Rigatelli, Manuel Cappellari, Jukka Putaala, Liisa Tomppo, Turgut Tatlisumak, Fabio Bandini, Simona Marcheselli, Alessandro Pezzini, Loris Poli, Alessandro Padovani, Luca Masotti, Vieri Vannucchi, Sung-Il Sohn, Gianni Lorenzini, Rossana Tassi, Francesca Guideri, Maurizio Acampa, Giuseppe Martini, George Ntaios, Efstathia Karagkiozi, George Athanasakis, Kostantinos Makaritsis, Kostantinos Vadikolias, Chrysoula Liantinioti, Maria Chondrogianni, Nicola Mumoli, Domenico Consoli, Franco Galati, Simona Sacco, Antonio Carolei, Cindy Tiseo, Francesco Corea, Walter Ageno, Marta Bellesini, Giovanna Colombo, Giorgio Silvestrelli, Alfonso Ciccone, Umberto Scoditti, Licia Denti, Michelangelo Mancuso, Miriam Maccarrone, Giovanni Orlandi, Nicola Giannini, Gino Gialdini, Tiziana Tassinari, Maria Luisa De Lodovici, Giorgio Bono, Christina Rueckert, Antonio Baldi, Sebastiano D'Anna, Danilo Toni, Federica Letteri, Martina Giuntini, Enrico Maria Lotti, Yuriy Flomin, Alessio Pieroni, Odysseas Kargiotis, Theodore Karapanayiotides, Serena Monaco, Mario Maimone Baronello, Laszló Csiba, Lilla Szabó, Alberto Chiti, Elisa Giorli, Massimo Del Sette, Davide Imberti, Dorjan Zabzuni, Boris Doronin, Vera Volodina, Patrik Michel, Peter Vanacker, Kristian Barlinn, Lars-Peder Pallesen, Jessica Kepplinger, Ulf Bodechtel, Johannes Gerber, Dirk Deleu, Gayane Melikyan, Faisal Ibrahim, Naveed Akhtar, Vanessa Gourbali, Shadi Yaghi
BACKGROUND AND PURPOSES: This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. METHODS: The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2...
February 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#12
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28182159/incidence-type-of-atrial-fibrillation-and-risk-factors-for-stroke-a-population-based-cohort-study
#13
Cecilia Johansson, Erik Dahlqvist, Jonas Andersson, Jan-Håkan Jansson, Lars Johansson
PURPOSE: The aims of this study were to estimate the incidence of atrial fibrillation and atrial flutter (AF), to assess the presence of provoking factors and risk factors for stroke and systemic embolism, and to determine the type of AF in patients with first-diagnosed AF. PATIENTS AND METHODS: This cohort study was performed in northern Sweden between January 1, 2011 and December 31, 2012. Diagnosis registries were searched for the International Classification of Diseases-10 code for AF (I48) to identify cases of incident AF...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28178370/barriers-and-enablers-to-adherence-to-anticoagulation-in-heart-failure-with-atrial-fibrillation-patient-and-provider-perspectives
#14
Caleb Ferguson, Sally C Inglis, Phillip J Newton, Sandy Middleton, Peter S Macdonald, Patricia M Davidson
AIMS & OBJECTIVES: The purpose of this study was to elucidate the barriers and enablers to adherence to anticoagulation in individuals with chronic heart failure (CHF) with concomitant atrial fibrillation (AF) from the perspective of patients and providers. BACKGROUND: CHF and AF commonly coexist and are associated with increased stroke risk and mortality. Oral anticoagulation significantly reduces stroke risk and improves outcomes. Yet, in approximately 30% of cases anticoagulation is not commenced for a variety of reasons...
February 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28177198/the-tasmanian-atrial-fibrillation-study-transition-to-direct-oral-anticoagulants-2011-2015
#15
Endalkachew Admassie Alamneh, Leanne Chalmers, Luke R Bereznicki
INTRODUCTION: Contemporary Australian data regarding antithrombotic prescribing patterns following approval of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) are limited. AIM: The aim of the present study was to assess antithrombotic prescribing patterns before, during and after the clinical introduction of DOACs. METHODS: Using digital medical records, this retrospective cohort study included all patients with AF as a primary or secondary diagnosis who were admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
February 8, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28174323/mild-hypokalemia-and-supraventricular-ectopy-increases-the-risk-of-stroke-in-community-dwelling-subjects
#16
Nick Mattsson, Preman Kumarathurai, Bjørn Strøier Larsen, Olav Wendelboe Nielsen, Ahmad Sajadieh
BACKGROUND AND PURPOSE: Stroke is independently associated with the common conditions of hypokalemia and supraventricular ectopy, and we hypothesize that the combination of excessive supraventricular ectopic activity and hypokalemia has a synergistic impact on the prognosis in terms of stroke in the general population. METHODS: Subjects (55-75 years old) from the Copenhagen Holter Study cohort (N=671) with no history of atrial fibrillation or stroke were studied-including baseline values of potassium and ambulatory 48-hour Holter monitoring...
February 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28169020/description-of-stroke-mimics-after-complete-neurovascular-assessment
#17
C Avellaneda-Gómez, A Rodríguez Campello, E Giralt Steinhauer, A Gómez González, M Serra Martínez, P de Ceballos Cerrajería, A Zabalza de Torres, E Cuadrado-Godia, A Ois Santiago, J Jiménez-Conde, J Roquer
INTRODUCTION: A considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with small samples. OBJECTIVE: The purpose of our study is to identify conditions that may present as SM, define their epidemiological and clinical characteristics, and determine the percentage of cases of SM treated with intravenous fibrinolysis...
February 4, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28167634/management-of-patients-on-non-vitamin-k-antagonist-oral-anticoagulants-in-the-acute-care-and-periprocedural-setting-a-scientific-statement-from-the-american-heart-association
#18
Amish N Raval, Joaquin E Cigarroa, Mina K Chung, Larry J Diaz-Sandoval, Deborah Diercks, Jonathan P Piccini, Hee Soo Jung, Jeffrey B Washam, Babu G Welch, Allyson R Zazulia, Sean P Collins
Non-vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States...
February 6, 2017: Circulation
https://www.readbyqxmd.com/read/28164742/modified-rankin-scale-as-a-determinant-of-direct-medical-costs-after-stroke
#19
Sarah Dewilde, Lieven Annemans, Andre Peeters, Dimitri Hemelsoet, Yves Vandermeeren, Philippe Desfontaines, Raf Brouns, Geert Vanhooren, Patrick Cras, Boudewijn Michielsens, Patricia Redondo, Vincent Thijs
Background Resource use in the acute and subacute phases after stroke depends on the degree of disability. Aims To determine if direct costs after stroke also vary by level of disability as measured using the modified Rankin scale at the chronic stage after stroke. Methods In a multicentre study, we collected acute and chronic in- and outpatient resource use in survivors of ischemic stroke stratified by levels of disability according to the modified Rankin Scale. Statistical inference on costs at each level of the modified Rankin Scale was estimated using a general linear model for the first three months, the first year, and any subsequent year after ischemic stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28159822/beta-blocker-use-is-associated-with-impaired-left-atrial-function-in-hypertension
#20
Mayank Sardana, Amer Ahmed Syed, Zeba Hashmath, Timothy S Phan, Maheswara R Koppula, Uzma Kewan, Zoubair Ahmed, Ravikantha Chandamuri, Swapna Varakantam, Ejaz Shah, Ryan Gorz, Scott R Akers, Julio A Chirinos
BACKGROUND: Impaired left atrial (LA) mechanical function is present in hypertension and likely contributes to various complications, including atrial arrhythmias, stroke, and heart failure. Various antihypertensive drug classes exert differential effects on central hemodynamics and left ventricular function. However, little is known about their effects on LA function. METHODS AND RESULTS: We studied 212 subjects with hypertension and without heart failure or atrial fibrillation...
February 3, 2017: Journal of the American Heart Association
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