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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Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
In this study, we aim to quantify global cardiac microcalcification in patients at risk for cardiovascular disease as assessed by NaF uptake on PET/CT and correlate this uptake with CHADS2 and CHA2DS2-VASc scores. We hypothesize that global cardiac microcalcification will correlate positively with CHADS2 and CHA2DS2-VASc scores. Methods: We identified 40 patients at-risk of cardiovascular disease from the CAMONA trial (55±11.9 years, 22 females, 18 males). CHADS2 (0.75±0.19) and CHADS2-VASc (1.8±1.25) scores were calculated for each patient based on relevant clinical parameters pertaining to each scori...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Science (Poster Session) Source Type: research
Int J Angiol DOI: 10.1055/s-0040-1708477Atrial fibrillation (AF), the most prevalent arrhythmic disease, tends to foster thrombus formation due to hemodynamic disturbances, leading to severe disabling and even fatal thromboembolic diseases. Meanwhile, patients with AF may also present with acute coronary syndrome (ACS) and coronary artery disease (CAD) requiring stenting, which creates a clinical dilemma considering that majority of such patients will likely receive oral anticoagulants (OACs) for stroke prevention and require additional double antiplatelet treatment (DAPT) to reduce recurrent cardiac events and in-stent th...
Source: International Journal of Angiology - Category: Cardiology Authors: Tags: Invited Papers Source Type: research
AbstractAtrial fibrillation is the most common arrhythmia and its prevalence is expected to further increase. Patients with atrial fibrillation have an increased risk of stroke (fivefold increased risk), heart failure, and death. In patients with non-valvular atrial fibrillation, the most recent guidelines recommend the use of the CHA2DS2-VASc (congestive heart failure, arterial hypertension, age  >  75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65–74 years, sex category) scoring system to identify those who may benefit from oral anticoagulant treatmen...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Abstract BACKGROUND AND OBJECTIVES: The aim of this retrospective cohort study was to develop a new score (RA-CHADSV) (rheumatoid arthritis - congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack/thromboembolism, and vascular disease), modified from the CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years (doubled), diabetes mellitus, stroke/transient ischemic attack (doubled), vascular disease, age 65-74 years, and female), in predicting the risk of ischemic stroke in rheumatoid arthritis (RA) patients without atrial fibrillation (AF)...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
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
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