Subclinical device-detected atrial fibrillation and stroke risk: a systematic review and meta-analysis
AbstractAimsTo determine stroke risk in subclinical atrial fibrillation (AF) and temporal association between subclinical AF and stroke.Methods and resultsPubmed/Embase was searched for studies reporting stroke in subclinical AF in patients with cardiac implantable electronic devices (CIEDs). After exclusions, 11 studies were analysed. Of these seven studies reported prevalence of subclinical AF, two studies reported association between subclinical and clinical AF, seven studies reported stroke risk in subclinical AF, and five studies reported temporal relationship between subclinical AF and stroke. Subclinical AF was noted after CIEDs implant in 35% [interquartile range (IQR) 34 –42] of unselected patients with pacing indication over 1–2.5 years. The definition and cut-off duration (for stroke risk) of subclinical AF varied across studies. Subclinical AF was strongly associated with clinical AF (OR 5.7, 95% CI 4.0–8.0,P defined cut-off duration was 1.89/100 person-year (95% CI 1.02–3.52) with 2.4-fold (95% CI 1.8–3.3,P
We examined the association between LDL-C levels and incident stroke in patients with atrial fibrillation treated with direct oral anticoagulants (DOACs).
ConclusionsConsidering the high risk of both thromboembolic and hemorrhagic events of patients undergoing LAAO, establishment of an appropriate antithrombotic therapy in terms of efficacy and safety after LAAO is of vital importance.Trial registrationEudraCT number: 2018-001013-32
AbstractPurposeOptimal stroke prevention strategies for patients with atrial fibrillation (AF) who experience a major bleed are poorly defined. We sought to estimate the effectiveness and safety of oral anticoagulation (OAC) represcription after an OAC contraindication.MethodsTREAT-AF is a retrospective cohort study of patients with newly diagnosed AF (2004 –2012), treated in the Veterans Health Administration. From this cohort, we identified patients with a contraindication to OAC after AF diagnoses, defined as incident intracranial bleeding, non-intracranial bleeding requiring hospitalization, or unrepaired cerebra...
ConclusionOntario taxpayers spend significant financial resources on surgical ablation of AF, a procedure lacking high ‐quality evidence demonstrating benefit in reducing mortality or stroke. Further large prospective studies examining clinically important outcomes are needed to justify its routine use in patient care and to guide allocation of healthcare funds.
ConclusionIn NVAF patients of all ages initiating either apixaban or warfarin for stroke prevention in the Sentinel System, apixaban was associated with a decreased risk of GI bleeding, ICH, and ischemic stroke compared with warfarin. Among patients less than 65 years of age, apixaban use was associated with a decreased risk of GI bleeding and ischemic stroke.
ConclusionsPostoperative implantation of a permanent RV pacemaker does not alter the long ‐term risks of HF and mortality following mitral valve surgery.
Authors: Su Y, Ma M, Zhang H, Pan X, Zhang X, Zhang F, Lv Y, Yan C Abstract Hyponatremia is a risk factor associated with poor prognosis in patients with heart failure (HF) with reduced ejection fraction. However, whether hyponatremia has a similar role in patients with HF with preserved ejection fraction (HFpEF) has remained controversial. Therefore, the present study aimed to investigate the clinical characteristics and 24-month prognostic profile of a cohort of patients with HFpEF in China. From a registered observational cohort study on 1,027 subjects with HF, 496 patients with HFpEF were included. The associat...
ConclusionsA high NLR on admission could be a useful marker for predicting poor short ‐term outcome in patients with mild AIS following IVT.
Publication date: Available online 24 September 2020Source: Canadian Journal of CardiologyAuthor(s): Michelle Samuel, James M. Brophy, Laura D’Aronco, Jean-Claude Tardif, Paul Khairy
Assessing atrial fibrillation (AF) risk may be useful in primary prevention (PP; people with risk factors) and secondary prevention (SP; eg. embolic stroke of unknown source). We sought whether disease stage influenced the prediction of AF by echocardiography.