Contribution of routine cardiac biological markers to the etiological workup of ischemic stroke

Optimization of the detection of atrial fibrillation following stroke is mandatory. Unfortunately, access to long-term cardiac monitoring is limited in many centers. The aim of this study was to assess the potential usefulness of three routine biological markers, troponin, D-dimers and BNP, measured in acute stroke phase in the selection of patients at risk of cardio-embolic stroke.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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Premature atrial complexes (PACs) meet increased attention as a potential intermediary between sinus rhythm and atrial fibrillation (AF). Patients with even high numbers of PACs do not fulfill current guidelines for oral anticoagulation treatment though an associated stroke risk is suspected. Objective: We aimed to determine whether a high number of PACs or runs of AF less than 30 seconds in 2-day continuous electrocardiogram (ECG) recording was associated with risk of recurrent ischemic stroke/transient ischemic attack (TIA) or death in a large cohort of patients with acute ischemic stroke or TIA and no prior AF.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
AbstractPatients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) should be triaged to an endovascular-capable hospital by the emergency medical service (EMS). We designed a prehospital LVO prediction scale based on EMS assessments. In the derivation cohort, 1157 patients transferred to our hospital by the EMS because of suspected stroke within 24 h of onset were retrospectively examined. Factors associated with AIS due to LVO were identified based on the EMS assessment, and a prehospital scale identifying LVO was developed. The accuracy of this scale was validated in 502 consecutive patients who were t...
Source: Translational Stroke Research - Category: Neurology Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
ConclusionsIn AF patients who survived an ICH, restarting OAC was not associated with a greater risk of recurrent ICH. Evidence from randomized controlled studies is needed to further clarify the clinical benefit of restarting OAC in this high-risk population. Further evaluation of which individuals benefit from restarting OAC is also needed to provide more clinical guidance.
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
CONCLUSIONS: Compared to warfarin, NOACs were associated with a significantly lower risk of adverse events, with heterogeneity in treatment effects among different age strata. Overall, the clear safety signal in favor of NOACs over warfarin was evident irrespective of age strata, being most marked in the most elderly. PMID: 31809694 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
AbstractThe best strategy in atrial fibrillation (AF) after  >  12 months after an acute coronary syndrome or in patients with chronic coronary syndrome without an indication for interventional revascularization remains unclear. European guidelines generally recommend therapy with oral anticoagulation (OAC) alone, whereas North American guidelines advise com bination therapy consisting of OAC plus antiplatelet therapy in some patients. We performed a meta-analysis of available trials comparing these treatment strategies. The primary endpoint was major adverse cardiac events (MACE), secondary endp...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al....
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractSeveral studies have explored the use of NOACs compared with vitamin K antagonists (VKAs) in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF); and therefore, we aimed to compare the efficacy and safety outcomes of NOACs with VKAs in this population. We systematically searched the PubMed and Embase databases until August 5, 2019 for studies that compared the effect of NOACs with VKAs in patients with HCM and AF. The risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. A total of four observational studies were included in this meta-analysis. Over...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
This study identified 17,371 HCM patients without AF and utilized propensity-score-matching to identify one-to-one matched control of general population with AF receiving oral anti-coagulants (OACs). During a median follow-up of 7.3 years, 847 (4.9%) subjects experienced IS with the incidence of 0.589/100 person-years. The corresponding matched controls experienced 788 (4.5%) events with the incidence of 0.494/100 person-years. Compared with control, HCM patients had similar risk of IS (Hazard ratios [HRs] 0.965, 95% confidence interval [CI] 0.854-1.091). HCM patients with age above 65 years had a significantly increased r...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
CONCLUSION:  In AF patients with malignancy, NOACs appear at least as effective as VKAs in preventing thrombotic events and reduce intracranial bleeding. NOACs may represent a valid and more practical alternative to VKAs in this setting of high-risk patients. PMID: 31785599 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
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