Increased Stroke Risk Caused by Warfarin?

An increase in stroke risk supports the theory of a transient hypercoagulable state at the start of warfarin treatment in patients with atrial fibrillation.
Source: Medscape Neurology Podcast - Category: Neurology Authors: Source Type: podcasts

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The most common form of sustained cardiac arrhythmia, which is characterized by irregular heartbeats, is atrial fibrillation (AF). The maintenance of AF is mediated by changes in the atrial structural and electrical properties.1 AF is a major risk factor for ischemic stroke and heart failure,2,3 which are associated with enhanced morbidity, mortality, and socioeconomic burden.4 The prevalence of AF is estimated to markedly increase as the population ages. Therefore, it is important to elucidate the molecular mechanisms underlying AF.
Source: Heart and Lung - Category: Intensive Care Authors: Source Type: research
This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Baseline characteristics and data on diagnostic studies, as well as treatments received during hospitalization and at discharge, were collected and analyzed. Two hundred and three strokes/transient ischemic attacks (TIAs) were recorded but only 173 patients (85%) with ischemic events were included in the study. The pati...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
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Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: CASE REPORT Source Type: research
ConclusionsIn Japanese NVAF patients undergoing CA, NOACs have similar effects to warfarin in the prevention of stroke and systemic embolism. Moreover, NOACs were associated with a lower incidence of bleeding complications.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
ConclusionsGPs and patients are waiting for the other to mention issues surrounding AF treatment such as switching, use of thrombosis service, and number of pills to take first. The perceptions and experiences of patients with AF regarding their disease and treatment highly influence the decisions GPs make, together with these patients, as well as considerations that patients have regarding their treatment; GPs need to be aware of their AF patients ’ perceptions and experiences with their condition and medication’ in order to facilitate discussions with patients and improve clinical outcomes.
Source: Cardiology and Therapy - Category: Cardiology Source Type: research
CONCLUSIONS: A significantly higher proportion of Thai patients receiving the Japan-specific dose of rivaroxaban had anti-FXa activity at peak concentrations within the expected range. PMID: 32461505 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
AbstractPurpose of reviewIn this review article, we aim to describe the pathophysiology of concomitant atrial fibrillation and both left and right heart failure, as well as pronounce the prognosis of having these two conditions simultaneously. This review also summarizes the current management of atrial fibrillation including stroke and thromboembolism prevention in the presence of systolic and diastolic heart failure.Recent findingsWhile rhythm control strategy is not superior to rate control strategy in atrial fibrillation patients without heart failure, catheter ablation for atrial fibrillation has shown to improve outc...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
ConclusionsA high trough apixaban level in patients indicated for standard dose was not associated with adverse events, while a high apixaban level in patients indicated for a reduced dose was associated with bleeding requiring hospitalization.
Source: European Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractAtrial fibrillation (AF) is the most common cardiac arrhythmia. Pharmacologic and non-pharmacologic rhythm control strategies impact on AF-related symptoms, while leaving largely unaffected the risk of stroke. Moreover, up to 20% of AF patients are asymptomatic during paroxysmal relapses of arrhythmia, thus underlying the need for early markers to identify at-risk patients and prevent cerebrovascular accidents. Indeed, non-invasive assessment of pre-clinical substrate changes that predispose to AF could provide early identification of at-risk patients and allow for tailored care paths. ECG-derived P wave analysis i...
Source: High Blood Pressure and Cardiovascular Prevention - Category: Cardiology Source Type: research
AbstractStroke after catheter ablation (CA) of atrial fibrillation (AF) is a potential complication with long term consequences. Aim of this study was to determine incidence and potential predictors of stroke and left atrial appendage (LAA) thrombi after AF ablation with cryo-energy. Two hundred nine consecutive patients with symptomatic drug refractory AF (65% male; 61  ± 11 yo, 69% paroxysmal AF, mean CHA2DS2-VASc score 2  ± 1.4) were enrolled between October 2012 until December 2015. Long term follow-up was performed with outpatient clinic visits at 6-month intervals. Incidence ...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
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