Long-Term Risk of Ischemic Stroke After the Cox-Maze III Procedure for Atrial Fibrillation

Conclusions This multicenter study showed a low incidence of perioperative and long-term postoperative ischemic stroke/TIA after CM-III. Although general risk of ischemic stroke/TIA was reduced, patients with CHA2DS2-VASc score 2 or greater had a higher risk compared with score 0 or 1. Complete left atrial appendage excision may be an important reason for the low ischemic stroke rate.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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CONCLUSION: The results of the study show that the VVI-derived LAA strain rate is a significant predictor of documented ischemic stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. Its predictive power is similar to the predictive power of the CHA2DS2-VASc score. PMID: 30824998 [PubMed - as supplied by publisher]
Source: Wiener Klinische Wochenschrift - Category: General Medicine Authors: Tags: Wien Klin Wochenschr Source Type: research
AbstractPurposePatients with atrial fibrillation (AF) undergoing cardiac surgery are at substantially increased risk for stroke. Increasing evidence has suggested that surgical left atrial appendage occlusion (S-LAAO) may have the potential to substantially mitigate this stroke risk; however, S-LAAO is performed in a minority of patients with AF undergoing cardiac surgery. We sought to identify factors associated with usage of S-LAAO.MethodsIn a nationally-representative, contemporary cohort (07/2011 –06/2012) of older patients undergoing cardiac surgery with preoperative AF (n = 11,404) from the Medica...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
This study investigated the CHA2DS2-VASc score to stratify patients with cardiovascular diseases receiving a fourth-generation synchronous telehealth program. Methods: This was a retrospective cohort study. We recruited patients with cardiovascular disease who received the fourth-generation synchronous telehealth program at the National Taiwan University Hospital between October 2012 and June 2015. We enrolled 431 patients who had joined a telehealth program and compared them to 1549 control patients. Risk of cardiovascular hospitalization was estimated with Kaplan-Meier curves. The CHA2DS2-VASc score was used as the compo...
Source: Journal of Medical Internet Research - Category: General Medicine Authors: Source Type: research
The CHA2DS2-VASc score estimates the risk of stroke in patients with atrial fibrillation.1,2 The CHA2DS2-VASc score accounts for congestive heart failure; hypertension; age of at least 75  years (doubled); diabetes mellitus; previous stroke, transient ischemic attack or thromboembolism (doubled); vascular disease; age 65 to 74 years; and sex category (female). Should the CHA2DS2-VASc score be considered as a categorical or a continuous factor, if the patients have an incremental in crease in risk of death, stroke, or bleeding?
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Editorial Commentary Source Type: research
In a recent article in the journal, Patell et  al1 found CHADS2 (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism) and CHA2DS2VASC (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism, vascular disease, age 65-74, sex category [i.e., female]) to predict risk of ischemic stroke in cancer patients with baseline atrial fibrillation (AF). Although only 36% of patients received anticoagulant therapy, the risk of stroke generally appeared to be lower than in cancer-free individuals.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0037-1615261This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age>75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascul...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Original Article Source Type: research
Authors: Manaktala R, Kluger J Abstract Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to ...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
BackgroundCHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2DS2‐VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF). HypothesisTo determine the association of antithrombin III (AT‐III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF. MethodsAT‐III and MPV we...
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: CLINICAL INVESTIGATIONS Source Type: research
Background and Purpose—The CHA2DS2-VASc stroke score (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65–74, female) is used in most guidelines for risk stratification in atrial fibrillation (AF), but most data for this score have been derived in Western populations. Ethnic differences in stroke risk may be present. Our objective was to investigate risk factors for stroke in AF and application of the CHA2DS2-VASc score in an Asian AF population from Korea.Methods—A total of 5855 oral anticoagulant&n...
Source: Stroke - Category: Neurology Authors: Tags: Arrhythmias, Risk Factors, Ischemic Stroke Original Contributions Source Type: research
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - Category: Cardiology Source Type: research
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