Keeping Faith With Patients After Stroke or Transient Ischemic Attack

I recently recommended statin therapy to a 68-year-old patient, explaining that it would reduce his risk of a major coronary event or stroke in the next 10 years from 18% to 15%. He asked, “But how will we know if it works?” I confessed we never would because success would be an uneventful walk through good health. He was not sold.
Source: JAMA Neurology - Category: Neurology Source Type: research

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AbstractStatins, drugs known for lipid lowering capabilities and reduction of cardiovascular disease, have demonstrated neuroprotective effects following ischemic stroke in retrospective clinical and animal studies. However, dosing (methods, time, type of statin, and quantity) varies across studies, limiting the clinical applicability of these findings. Furthermore, a comprehensive review of statins in edema and blood-brain barrier (BBB) breakdown is needed to provide insight on diverse, less explored neuroprotective effects. In the present study, we conduct a meta-analysis of publications evaluating statin administration ...
Source: Translational Stroke Research - Category: Neurology Source Type: research
Authors: Chen Z, Jiang C, Qu H, Liang S, Yang J, Wu H, He C, Wang X Abstract Introduction: The aim of the current study was to evaluate the association between lipoprotein(a) [Lp(a)] and major adverse cardiovascular events (MACEs) in patients with percutaneous coronary intervention (PCI) treatment. Material and methods: This was a retrospective study. The demographics, prior medical histories, comorbidities and laboratory parameters were collected from the electronic health record. All participants were followed up for 1 year after the indexed PCI. Studied end points were a composite of MACEs including all-caus...
Source: Archives of Medical Science - Category: General Medicine Tags: Arch Med Sci Source Type: research
AbstractPurpose of ReviewTo review randomized interventional clinical and imaging trials that support lower targeted atherogenic lipoprotein cholesterol goals in “extreme” and “very high” atherosclerotic cardiovascular disease (ASCVD) risk settings. Major atherosclerotic cardiovascular event (MACE) prevention among the highest risk patients with ASCVD requires aggressive management of global risks, including lowering of the fundamental atherogenic ap olipoprotein B-associated lipoprotein cholesterol particles [i.e., triglyceride-rich lipoprotein remnant cholesterol, low-density lipoprotein cholester...
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research
ConclusionBoth neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
ConclusionsAMI patients in Taiwan with HIS had similar clinical outcomes to those with non-HIS. Using HIS for effective reduction of low-density lipoprotein cholesterol is safe in Taiwan.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Atrial fibrillation (AF) is a common cause of cerebral infarction, which could lead to endothelial dysfunction, increased reactive oxygen species (ROS) and oxidized low density lipoprotein (Ox-LDL).AF is assoc...
Source: BMC Neurology - Category: Neurology Authors: Tags: Research article Source Type: research
Background and aims: Atrial fibrillation (AF) is a major cause of ischemic stroke; however, detailed clinical data and prognostic factors for stroke patients with AF are lacking in Korea. We aimed to investigate clinical information and factors associated with functional outcomes of stroke patients with AF from the Korean nationwide ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION) database.Methods: From January 2013 to December 2015, consecutive clinical information from acute stroke patients with AF or history of AF was collected from 11 centers in Korea. Collected data included demographi...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Publication date: Available online 11 October 2019Source: Life SciencesAuthor(s): Jenq-Lin Yang, Yun-Ru Yang, Shang-Der ChenAbstractStroke is the major cause of adult disability and the second or third leading cause of death in developed countries. The treatment options for stroke (thrombolysis or thrombectomy) are restricted to a small subset of patients with acute ischemic stroke because of the limited time for an efficacious response and the strict criteria applied to minimize the risk of cerebral hemorrhage. Attempts to develop new treatments, such as neuroprotectants, for acute ischemic stroke have been costly and tim...
Source: Life Sciences - Category: Biology Source Type: research
ConclusionThe prognostic value of Fibrinogen after stroke or TIA remains unclear. Standardised methods and fully-adjusted multivariable analysis are needed in future prognostic studies.
Source: Age and Ageing - Category: Geriatrics Source Type: research
ConclusionFirstly, this study highlights the incidence of inappropriate prescribing of statins for primary prevention in frail older patients in long term care. It also raises the question surrounding the indication of statin therapy in secondary prevention where cholesterol level are within target range highlighting the need for further studies examining the benefit of statins in frail older patients in LTC.
Source: Age and Ageing - Category: Geriatrics Source Type: research
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