Response to the letter by Drs. Lattanzi and Silvestrini Re: Prevalence of Nonstenotic Carotid Plaque in Stroke Due to Atrial Fibrillation Compared to Embolic Stroke of Undetermined Source

We appreciate the thoughtful feedback regarding our manuscript by Drs. Lattanzi and Silvestrini. We agree that serologic and physiologic biomarkers of other occult stroke mechanisms would add to our understanding and management of these patients. In regard to occult cardiac sources of embolism, elevations in the brain natriuretic peptide,1 and larger P-wave terminal force (PWTF)2 or left atrial diameter3 are increasingly thought to be markers of a prothrombotic cardiopathy. As previously shown by Dr.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research

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CONCLUSIONS: The GGT level was significantly associated with cardioembolic stroke via AF. The results obtained in the present study may explain why GGT is associated with stroke. PMID: 31942759 [PubMed]
Source: Journal of Clinical Neurology - Category: Neurology Tags: J Clin Neurol Source Type: research
Purpose of review Recent data have changed the landscape of patent foramen ovale (PFO) closure for secondary stroke prevention. This review synthesizes the data and provides a framework for optimal management of stroke patients with PFO. Recent findings The cumulative evidence indicates that PFO closure reduces the risk of recurrent stroke in carefully selected young cryptogenic stroke patients, with an annualized risk reduction of ∼0.6%. The benefit of PFO closure is particularly evident in patients with embolic appearing strokes, large right-to-left shunt, or an associated atrial septal aneurysm. There may be li...
Source: Current Opinion in Neurology - Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research
Purpose of review The association between atrial fibrillation and stroke is firmly established, and anticoagulation reduces stroke risk in patients with atrial fibrillation. However, the role of anticoagulation in very brief durations of atrial fibrillation (subclinical atrial fibrillation) is an area of controversy. Recent findings Stroke risk increases alongside burden of atrial fibrillation. Ongoing trials will clarify if 24 h or less of atrial fibrillation on extended monitoring necessitates lifelong anticoagulation. Trials examining empiric anticoagulation for individuals with ESUS did not demonstrate benefit o...
Source: Current Opinion in Neurology - Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research
Publication date: Available online 14 January 2020Source: Journal of Pharmaceutical and Biomedical AnalysisAuthor(s): Filipa Gouveia, Joana Bicker, Joana Santos, Marília Rocha, Gilberto Alves, Amílcar Falcão, Ana FortunaAbstractDirect oral anticoagulants (DOACs) have been commonly used for the treatment of venous thromboembolism and for the prevention of stroke in patients with atrial fibrillation. Despite not being initially recommended, monitoring DOACs plasma concentrations is now recognized as essential in emergency situations and in special populations. Moreover, the inter-individual variability f...
Source: Journal of Pharmaceutical and Biomedical Analysis - Category: Drugs & Pharmacology Source Type: research
In this study, we evaluated the correlation between LAA morphology and cardiac function by transthoracic echocardiography in patients with sinus rhythm.Methods and ResultsWe studied 55 patients (36 men, 70  ± 11 years) who underwent cardiac computed tomography and transthoracic echocardiography. The following 4 different morphologies were used to categorize LAA by computed tomography: chicken wing (CW), windsock, cactus, and cauliflower. These morphologies were also classified into CW and non-CW (nonCW) types. There were no significant differences in the left ventricular ejection fraction (63% vs ...
Source: Journal of Echocardiography - Category: Cardiology Source Type: research
CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners. PMID: 31932552 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
CONCLUSION:  Moderate quality evidence suggests lower INR targets reduce bleeding but increase thromboembolism in AF. The data are dominated by East-Asian studies, limiting generalizability to Western populations. Until higher quality data demonstrate otherwise, an INR range of 2 to 3 should remain standard for thromboembolic prophylaxis in AF. PMID: 31940677 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
Background: The diagnosis of covert atrial fibrillation (AF) remains a major challenge to guide secondary prevention of patients with embolic stroke of undetermined source (ESUS). Aims: We analyzed consecutive ESUS patients from 3 prospective stroke registries to assess whether the presence of supraventricular extrasystoles (SVE) on standard 12-lead electrocardiogram (ECG) is associated with the detection of AF (primary outcome), stroke recurrence and death (secondary outcomes) during follow-up.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Source: BMJ News - Category: General Medicine Source Type: research
Conclusion Nonagenarians and centenarians in the Cilento region had a healthy metabolic profile and a low prevalence of clinical cardiovascular disease. Even among nonagenarians and centenarians with structural heart abnormalities, report of symptoms is low. Larger studies in the Cilento population may help elucidate the mechanisms underlying cardiovascular health in the oldest old.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Epidemiology Source Type: research
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