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Specialty: Neurology
Condition: Bleeding
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Total 74 results found since Jan 2013.
Long-term stroke and major bleeding risk in patients with non-valvular atrial fibrillation: A comparative analysis between non-vitamin K antagonist oral anticoagulants and warfarin using a clinical data warehouse
ConclusionsIn this CDW based study, NOACs are more effective and safer than warfarin in patients with AF even with long-term follow-up. NOACs should be used to prevent ischemic stroke in patients with AF
Source: Frontiers in Neurology - January 26, 2023 Category: Neurology Source Type: research
Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research
Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research
A 56-Year-Old Woman with Recurrent Strokes: A Clear Case with a Therapeutic Dilemma
A 56-year-old woman with a history of cerebral amyloid angiopathy (CAA) complicated by prior intracranial hemorrhage (ICH) was evaluated for an asymptomatic ischemic stroke discovered on screening brain MRI. On echocardiogram, she was found to have a mass on her mitral valve and strongly positive antiphospholipid antibodies. She was diagnosed with nonbacterial thrombotic (Libman-Sacks) endocarditis associated with the primary antiphospholipid syndrome (APS). The treatment decision was complicated by the history of CAA with ICH within the last year with very high risk for bleeding complications if on anticoagulation. A mult...
Source: Case Reports in Neurology - February 15, 2021 Category: Neurology Source Type: research
Inactivated Four-Factor Prothrombin Complex Concentrate Dosing Practices for Reversal of Warfarin-Related Intracranial Hemorrhage
ConclusionsMost patients received single doses of I4F-PCC, with adjunctive reversal agents and rounding doses to vial size. The time difference from baseline INR to factor product administration is a potential opportunity for process improvement in the management of warfarin-related ICH.
Source: Neurocritical Care - November 20, 2020 Category: Neurology Source Type: research
Clinical Trial Based Rationale for the Successful Use of DOAC in the Treatment of Cerebral Venous Sinus Thrombosis (CVST): A Case Report
In cerebral venous sinus thrombosis (CVST), venous sinus occlusion increases venous pressure and disrupts venous return, resulting in progression to venous infarction and venous hemorrhage, with poor neurologic outcome. Therefore, early recanalization of the major venous sinus is critical.Anticoagulant therapy with continuous intravenous infusion of heparin and subsequent oral anticoagulant administration is the recommended first line of treatment for CVST. Some large clinical trials for venous thromboembolism (VTE) have shown that direct oral anticoagulant (DOAC) is non-inferior to the standard therapy with heparin or war...
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2020 Category: Neurology Authors: Toshiaki Bando, Yasushi Ueno, Daisuke Shimo, Takahiro Kuroyama, Kazuyuki Mikami, Shinya Hori, Osamu Hirai Tags: Case Report Source Type: research
Convexity Subarachnoid Hemorrhage Soon after Starting a Direct Oral Anticoagulant in 2 Patients with Acute Infarction
Convexity subarachnoid hemorrhage (cSAH) is typically due to head trauma, but various nontraumatic causes for cSAH are known also. Nontraumatic cSAH is most commonly associated with cerebral amyloid angiopathy (CAA) in the elderly or with reversible cerebral vasoconstriction syndrome in younger subjects,1 but cSAH rarely occurs subsequent to acute ischemic stroke.2 Direct oral anticoagulants (DOACs) are used to reduce the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation and have favorable bleeding profiles as compared with warfarin,3,4 but here we describe 2 cSAH patients who ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 13, 2020 Category: Neurology Authors: Yoichiro Sugita, Yoichiro Nishida, Satoru Ishibashi, Takanori Yokota Tags: Case Report Source Type: research
Critical Issues and Recent Advances in Anticoagulant Therapy: A Review
Angelika Batta, Bhupinder S Kalra, Raj KhirasariaNeurology India 2019 67(5):1200-1212
As the population is aging, clinicians are coming across more patients with atrial fibrillation and venous thromboembolism requiring anticoagulation to prevent stroke and systemic embolisms. Due to a high prevalence and unfavorable consequences, managing thromboembolic diseases have become areas of clinical concern. Traditional anticoagulants like heparin, low molecular weight heparin and warfarin have been used for the prevention and treatment of venous and arterial thromboses. But, issues of bleeding, parenteral route of administration...
Source: Neurology India - November 18, 2019 Category: Neurology Authors: Angelika Batta Bhupinder S Kalra Raj Khirasaria Source Type: research
Dabigatran and warfarin in nonvalvular atrial fibrillation or atrial flutter in outpatient clinic practice in Brazil
Conclusion: The dabigatran group had a lower frequency of minor bleeding and number of medical appointments than the warfarin group, without more embolic events or major bleeding.RESUMO Objetivos: Comparar varfarina e dabigatrana para preven ção de eventos tromboembólicos em pacientes com fibrilação atrial não valvar ou flutter (FA). Métodos: Coorte retrospectiva de pacientes com FA em uso de varfarina ou dabigatrana em serviço especializado no Brasil. Resultados: Foram avaliados 112 pacientes (média idade 65,5), com 55,3% no grupo varfarina. A mediana do tempo de seguimento foi de 1,9 anos para o grupo varfarina ...
Source: Arquivos de Neuro-Psiquiatria - February 21, 2019 Category: Neurology Source Type: research
Prolonged Blood-Brain Barrier Injury Occurs After Experimental Intracerebral Hemorrhage and Is Not Acutely Associated with Additional Bleeding
AbstractIntracerebral hemorrhage (ICH) causes blood-brain barrier (BBB) damage along with altered element levels in the brain. BBB permeability was quantified at 3, 7, and 14 days with Evans Blue dye after collagenase-induced ICH in rat. At peak permeability (day 3), a gadolinium (Gd)-based contrast agent was injected to further characterize BBB disruption, and X-ray fluorescence imaging (XFI) was used to map Gd, Fe, Cl, and other elements. XFI revealed that Ca, Cl, Gd , and Fe concentrations were significantly elevated, whereas K was significantly decreased. Therefore, using Gd-XFI, we co-determined BBB dysfunction with...
Source: Translational Stroke Research - June 14, 2018 Category: Neurology Source Type: research
Cost-Effectiveness of Left Atrial Appendage Closure With the WATCHMAN Device Compared With Warfarin or Non-Vitamin K Antagonist Oral Anticoagulants for Secondary Prevention in Nonvalvular Atrial Fibrillation Clinical Sciences
Conclusions—Upfront procedure costs initially make LAAC higher cost than warfarin and the non–vitamin K antagonist oral anticoagulants, but within 10 years, LAAC delivers more quality-adjusted life years and has lower total costs, making LAAC the most cost-effective treatment strategy for secondary prevention of stroke in atrial fibrillation.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Vivek Y. Reddy, Ronald L. Akehurst, Stacey L. Amorosi, Meghan B. Gavaghan, Deanna S. Hertz, David R. Holmes Jr Tags: Atrial Fibrillation, Cost-Effectiveness Original Contributions Source Type: research
Direct Oral Anticoagulant Agents: Pharmacologic Profile, Indications, Coagulation Monitoring, and Reversal Agents
Vitamin K antagonists (VKAs), such as warfarin, have been used for thromboprophylaxis and for the treatment of thromboembolic events in patients with nonvalvular atrial fibrillation for over 60 years. The increasing use of direct oral anticoagulants (DOACs) in recent years has shown greater advantages and safer use over VKA, including reduced bleeding, fewer drug interactions, no food interactions, a quick onset and offset of activity, and predictable dose-response properties. Despite their advantages, there are a couple of major limitations that raise concerns among clinicians, including the need for more coagulation assa...
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2018 Category: Neurology Authors: Deborah K. Rose, Barak Bar Tags: Review Article Source Type: research
Anticoagulation in patients with cardiac manifestations of Chagas disease and cardioembolic ischemic stroke
Conclusion Patients with Chagas disease an d previous CIS had better control of INR with a higher frequency of minor bleeding.RESUMO Objetivos descrever as caracter ísticas da anticoagulação em pacientes com manifestações cardíacas da doença de Chagas (MCDC) e comparar os participantes com sem acidente vascular cerebral isquêmico cardioembólico (AVCIC). Resultados 42 pacientes com MCDC em anticoagulação foram estudados (62,9 ± 12,4 anos), 59,5% do sexo feminino e 47,6% com AVCIC prévio, 78,6% portadores de fibrilação atrial não valvar e 69,7% com cardiomiopatia dilatada. Varfarina foi utilizada em 78,6% dos...
Source: Arquivos de Neuro-Psiquiatria - January 22, 2018 Category: Neurology Source Type: research
Real-World Use of Apixaban for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Background and Purpose—The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibril...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Marco Proietti, Imma Romanazzi, Giulio Francesco Romiti, Alessio Farcomeni, Gregory Y.H. Lip Tags: Atrial Fibrillation, Anticoagulants, Quality and Outcomes Original Contributions Source Type: research
Echocardiographic Risk Factors for Stroke and Outcomes in Patients With Atrial Fibrillation Anticoagulated With Apixaban or Warfarin Clinical Sciences
Conclusions—In anticoagulated patients with atrial fibrillation and risk factors for stroke, echocardiographic findings do not seem to add to the risk of thromboembolic events.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: Stroke - November 27, 2017 Category: Neurology Authors: Dragos Vinereanu, Renato D. Lopes, Hillary Mulder, Bernard J. Gersh, Michael Hanna, Pedro G.M. de Barros e Silva, Dan Atar, Lars Wallentin, Christopher B. Granger, John H. Alexander Tags: Arrhythmias, Echocardiography, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
