How to Assess and Manage Stroke Risk in Atrial Fibrillation?

Drs Acharya, Friedman, and Klaas discuss when to anticoagulate patients with atrial fibrillation; additional factors that contribute to stroke risk; and treatment options for stroke prevention.
Source: Medscape Cardiology Podcast - Category: Cardiology Authors: Source Type: podcasts

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Publication date: Available online 17 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Niv Ad, Sari D. Holmes, Harold G. Roberts, J. Scott Rankin, Vinay BadhwarAbstractBackgroundSurgical treatment of symptomatic atrial fibrillation (AF) has been performed for three decades. We reviewed trends and outcomes of surgical ablation (SA) for stand-alone AF using the Society of Thoracic Surgeons Adult Cardiac Surgical Database (STS-ACSD).MethodsThe STS-ACSD was reviewed from 2011-2017 (N=7,187) for trends. Contemporary data from 2014-2017 (N=3,893) were used to compare three subgroups: off-pump (n=3,252), on-pump (n=491...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: Duzen IV, Oguz E, Cekici Y, Yavuz F, Vuruskan E, Sincer I, Poyraz F, Alıcı H, Yuksek U, Demirtas AO, Sucu M Abstract New-generation oral anticoagulants (NOACs) are now preferred as a first-line treatment in the management of atrial fibrillation for prevention of thromboembolic complications. Mean platelet volume (MPV), one of the indicators of increased platelet activity, is also associated with an increased stroke risk in atrial fibrillation patients. The aim of this study was to evaluate changes in MPV, platelet distribution width (PDW) and plateletcrit following use of NOACs. The study included 1...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
We report a case of atrial fibrillation with rheumatic heart disease (RHD) who had intracardiac thrombus and cardiogenic cerebral embolism with rivaroxaban therapy. Intracardiac thrombus disappeared after switching from rivaroxaban to warfarin. Patients of RHD have the possibility of gradual progression of valvular disease even if they are old, so we need to distinguish nonvalvular atrial fibrillation from RHD before starting direct oral anticoagulants.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Atrial fibrillation (AF) is strongly associated with stroke risk but association on its own does not necessarily imply causality. Is AF a cause (risk factor) of stroke? Would treatment that reduces AF burden also reduce the burden of stroke? Or, perhaps, AF is a risk marker associated with a vascular syndrome in which there is co-existing atrial structural and electrical remodelling that results in the clinical manifestation of AF and the risk of stroke in parallel. A number of recent studies appear to detach AF as a direct cause of stroke.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Review Source Type: research
ConclusionCardiac involvement should be effectively detected in females before considering them asymptomatic mutation carriers.
Source: Molecular Genetics & Genomic Medicine - Category: Genetics & Stem Cells Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractThere are no guideline recommendations for the use of anticoagulant therapy in atrial fibrillation (AF) patients with cancer, which creates uncertainty about the optimal antithrombotic treatment in these patients. We conducted a network meta-analysis for the first time to assess the efficacy and safety of anticoagulant drugs in patients with AF and concurrent cancer. The PubMed, EMBASE, and Cochrane databases were searched up to March 2019. A search was made for the main anticoagulant drugs (warfarin, dabigatran, apixaban, rivaroxaban, and edoxaban). Outputs were presented as odds ratios (ORs), their corresponding ...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
Conclusions The timing of AF diagnosis, use of OAC drugs, or the CHA2DS2-VASc score did not affect the distribution of ischemic strokes. Anterior territory strokes were slightly more often located within the left hemisphere.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: All Cerebrovascular disease/Stroke, Cardiac, Embolism, Infarction Research Source Type: research
Publication date: Available online 9 August 2019Source: Revista Española de Cardiología (English Edition)Author(s): Teresa López-Fernández, Ana Martín-García, Inmaculada Roldán Rabadán, Cristina Mitroi, Pilar Mazón Ramos, Pablo Díez-Villanueva, Carlos Escobar Cervantes, Concepción Alonso Martín, Gonzalo Luis Alonso Salinas, Meritxell Arenas, Vicente Ignacio Arrarte Esteban, Francisco Ayala de La Peña, Antonio Castro Fernández, Héctor García Pardo, Ramón García-Sanz, José Ramón Gonz&aac...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
ConclusionsThe Non-vitamin K antagonist oral anticoagulants constitute a new and promising category in the field of atrial fibrillation, even in the context of uncertainty, which an indirect comparison yields.
Source: Health Policy and Technology - Category: Health Management Source Type: research
Patients with atrial fibrillation (AF) are at risk of thromboembolic events. The CHA2DS2-VASc (congestive heart failure, hypertension, age 65–74, diabetes, female sex and vascular disease, which all count for 1 point, and previous transient ischemic stroke/stroke or age ≥ 75 years, which count for two points) score stratifies this risk and consequently indicates whether anticoagulation is required but leaves room for debate regarding patients with a CHA2DS2-VASc score of 1, irrespective of sex. A score of 1, irrespective of sex, is derived from varying risk factors and may represent different risks. We systematica...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
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