Anticoagulant vs. antiplatelet therapy in patients with cryptogenic stroke and patent foramen ovale: an individual participant data meta-analysis

Conclusion We did not find a statistically significant difference comparing OAC with APT; our results justify randomized trials comparing different antithrombotic approaches in these patients.
Source: European Heart Journal - Category: Cardiology Authors: Tags: Thrombosis and antithrombotic therapy Source Type: research

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Publication date: Available online 13 December 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Carlos Minguito-Carazo, Tomás Benito-González, Julio Cesar Echarte-Morales, Mario Castaño-Ruiz, Felipe Fernández-VázquezAbstractA 78-year-old woman with history of transient ischemic attack was admitted for sudden aphasia. In order to assess a potential cardioembolic source an echocardiogram was performed revealing a large mass consistent with a thrombus in transit through a patent foramen ovale. Due to the high risk of systemic embolism emergent surgical thrombectomy was performed,...
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al....
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractFew data are available on age-related burden and characteristics of embolic stroke of undetermined source (ESUS) in the real world clinical practice. The aim of our study was to provide information about it. We retrospectively analyzed data of patients consecutively admitted to our Stroke Unit along 1  year (2017, November 1st–2018, October 31st). The etiology of ischemic stroke was defined at hospital discharge; ESUS was considered as a subset of cryptogenic stroke, and defined according to the 2014 international criteria. In the analyzed period, 306 patients, 52.3% females, mean age ±&thi...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Abstract BACKGROUND: Transthoracic echocardiography is routinely performed in patients with stroke or transient ischemic attack (TIA) to help plan secondary stroke management, but recent data evaluating its usefulness in this context are lacking. We sought to evaluate the value of echocardiography for identifying clinically actionable findings for secondary stroke prevention. METHODS: We conducted a multicentre cohort study of patients admitted to hospital with stroke or TIA between 2010 and 2015 at 2 academic hospitals in Toronto, Ontario, Canada. Clinically actionable echocardiographic findings for secondar...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research
Conclusion: Frequency of recent ischemic stroke in patients with symptomatic PE was higher in patients with PFO than in those without PFO. This finding supports the hypothesis that paradoxical embolism is an important mechanism of ischemic stroke in patients with PFO. Primary Funding Source: French Ministry of Health. PMID: 31060047 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
ConclusionAmong admitted ischemic stroke patients, we did not find a higher prevalence of CIED in patients with PFO compared to controls. Therefore, in the underlying source population, the presence of CIED did not increase the PFO ‐associated ischemic stroke risk.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
Conclusions: Our results suggest that inherited thrombophilias including FVL, PTM, PCD, and PSD are associated with an increased risk of arterial ischemic stroke, particularly in young patients. The association with FVL and PTM is stronger in the homozygous than in the heterozygous state, suggesting a potential dose-response relationship and causal role for inherited thrombophilias. The implications of these findings with respect to the evaluation and management of patients with ischemic stroke require further investigation.DisclosuresCrowther: Alnylam: Equity Ownership; Daiichi Sankyo: Membership on an entity's Board of D...
Source: Blood - Category: Hematology Authors: Tags: 331. Pathophysiology of Thrombosis: Poster II Source Type: research
AbstractPurpose of ReviewThis review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).Recent FindingsStroke is the third leading cause of death in industrial countries, and 15 –40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improvin...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Publication date: Available online 28 September 2018Source: The Lancet NeurologyAuthor(s): Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi MundlSummaryBackgroundPatent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce re...
Source: The Lancet Neurology - Category: Neurology Source Type: research
Use of a NobleStitch™ EL Device for PFO Closure. Surg Technol Int. 2018 Jun 01;32:219-223 Authors: de Cillis E, Acquaviva T, D'Alessandro P, Bortone AS Abstract Cryptogenic stroke is the final diagnosis in almost 40% of ischemic acute cerebrovascular events. There is currently no definitive clinical evidence that percutaneous closure of patent foramen ovale (PFO) can prevent the recurrence of stroke or transient ischemic attack (TIA). Identification of the causes of neurologic ischemic syndromes is essential for any strategy intended to prevent the catastrophic consequences of cerebral infarction. Sin...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
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