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Use of Warfarin at Discharge Among Acute Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation in China Clinical Sciences
Conclusions— The rate of warfarin use remains low among patients with ischemic stroke and known nonvalvular atrial fibrillation in China. Hospital size and academic status together with patient age, heart failure, heavy alcohol drinking, international normalized ratio in hospital, and stroke severity on admission were each independently associated with the use of warfarin at discharge. There is much room for improvement for secondary stroke prevention in nonvalvular atrial fibrillation patients in China.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Yang, X., Li, Z., Zhao, X., Wang, C., Liu, L., Wang, C., Pan, Y., Li, H., Wang, D., Hart, R. G., Wang, Y., Wang, Y., on behalf of the China National Stroke Registry II Investigators Tags: Anticoagulants, Treatment, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Rates and Determinants of 5-Year Outcomes After Atrial Fibrillation-Related Stroke: A Population Study Clinical Sciences
Conclusions— AF-stroke is associated with considerable long-term morbidity, fatality, stroke recurrence, and nursing home requirement. Adequately resourced national AF strategies to improve AF detection and prevention are needed.
Source: Stroke - November 23, 2015 Category: Neurology Authors: Hayden, D. T., Hannon, N., Callaly, E., Ni Chroinin, D., Horgan, G., Kyne, L., Duggan, J., Dolan, E., O'Rourke, K., Williams, D., Murphy, S., Kelly, P. J. Tags: Cerebrovascular Disease/Stroke Clinical Sciences Source Type: research

High Prevalence of Atrial Fibrillation Among Patients With Ischemic Stroke Clinical Sciences
Conclusions— Access to nationwide register data shows that AF is more common among patients with ischemic stroke than those previously reported. Few patients with stroke and AF had anticoagulant treatment before the event, and few got it after the event. CHA2DS2-VASc could be a useful monitoring tool to intensify efforts to diagnose AF among patients with cryptogenic stroke.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Friberg, L., Rosenqvist, M., Lindgren, A., Terent, A., Norrving, B., Asplund, K. Tags: Coumarins, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke, Epidemiology Clinical Sciences Source Type: research

Carotid Atherosclerosis and Stroke in Atrial Fibrillation: The Atherosclerosis Risk in Communities Study Brief Reports
Conclusions— Increased cIMT and presence of carotid plaque are associated with increased risk of ischemic stroke in individuals with AF. Furthermore, they may improve risk prediction of stroke, over and above the CHA2DS2-VASc score.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Bekwelem, W., Jensen, P. N., Norby, F. L., Soliman, E. Z., Agarwal, S. K., Lip, G. Y. H., Pan, W., Folsom, A. R., Longstreth, W. T., Alonso, A., Heckbert, S. R., Chen, L. Y. Tags: Atrial Fibrillation, Risk Factors, Ischemic Stroke, Atherosclerosis Brief Reports Source Type: research

Amino Terminal Pro-B-Type Natriuretic Peptide, Secondary Stroke Prevention, and Choice of Antithrombotic Therapy Clinical Sciences
Conclusions— For secondary stroke prevention, elevated NT-proBNP concentrations may identify a subgroup of ischemic stroke patients without known atrial fibrillation, about 5% based on the current study, who may benefit more from anticoagulants than antiplatelet agents. Clinical Trial Registration— This trial was not registered because enrollment began before 2005.
Source: Stroke - February 25, 2013 Category: Neurology Authors: Longstreth, W. T., Kronmal, R. A., Thompson, J. L. P., Christenson, R. H., Levine, S. R., Gross, R., Brey, R. L., Buchsbaum, R., Elkind, M. S. V., Tirschwell, D. L., Seliger, S. L., Mohr, J. P., deFilippi, C. R. Tags: Primary and Secondary Stroke Prevention Clinical Sciences Source Type: research

Cost-Effectiveness of Oral Anticoagulants for Ischemic Stroke Prophylaxis Among Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— All the newer oral anticoagulants compared were more effective than adjusted dosed warfarin. Our model showed that apixaban was the most effective anticoagulant in a general atrial fibrillation population and has an incremental cost-effectiveness ratio <$50 000/QALY. For those with higher stroke risk (CHADS2≥3), dabigatran was the most cost-effective treatment option.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Shah, A., Shewale, A., Hayes, C. J., Martin, B. C. Tags: Anticoagulants, Cost-Effectiveness, Ischemic Stroke Clinical Sciences Source Type: research

Identifying a High Stroke Risk Subgroup in Individuals with Heart Failure
Conclusions: The combination of previous stroke/TIA and DM increases the incidence of stroke in participants with HF without AF. No analyzed subgroup had a stroke rate high enough to make it likely that the benefits of warfarin would outweigh the risks.
Source: Journal of Stroke and Cerebrovascular Diseases - December 6, 2011 Category: Neurology Authors: Patrick M. Pullicino, Leslie A. McClure, Virginia J. Howard, Virginia G. Wadley, Monika M. Safford, James F. Meschia, Aaron Anderson, George Howard, Elsayed Z. Soliman Tags: Original Articles Source Type: research

Cerebrovascular Accidents During Mechanical Circulatory Support Clinical Sciences
Conclusions—Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialysis may increase the risk of hemorrhagic stroke. Although any stroke increases mortality, post-LVAD hemorrhagic stroke was associated with higher mortality compared with ischemic stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Saef Izzy, Daniel B. Rubin, Firas S. Ahmed, Feras Akbik, Simone Renault, Katelyn W. Sylvester, Henrikas Vaitkevicius, Jennifer A. Smallwood, Michael M. Givertz, Steven K. Feske Tags: Heart Failure, Complications, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Risk of ischemic stroke during periods of warfarin discontinuation for surgical procedures: A longitudinal study of 4060 patients with atrial fibrillation (P1.058)
CONCLUSIONS: The risk associated with discontinuation of warfarin for procedures must be recognized and considered in the risk benefit analysis of any procedure.Disclosure: Dr. Jahangir has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jahangir, N., Malik, A., Suri, M., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research

Validation of a Modified CHA2DS2-VASc Score for Stroke Risk Stratification in Asian Patients With Atrial Fibrillation: A Nationwide Cohort Study Clinical Sciences
Conclusions— In this Asian atrial fibrillation cohort, the mCHA2DS2-VASc score performed better than the CHA2DS2-VASc and would further identify atrial fibrillation patients who may derive a positive net clinical benefit from oral anticoagulation.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Chao, T.-F., Lip, G. Y. H., Liu, C.-J., Tuan, T.-C., Chen, S.-J., Wang, K.-L., Lin, Y.-J., Chang, S.-L., Lo, L.-W., Hu, Y.-F., Chen, T.-J., Chiang, C.-E., Chen, S.-A. Tags: Atrial Fibrillation Clinical Sciences Source Type: research

Rates of Ischemic Stroke During Warfarin Treatment for Atrial Fibrillation Brief Reports
Conclusions— In a large cohort of older patients with atrial fibrillation, we observed the highest rate of ischemic stroke in the first 30 days after warfarin initiation. Although causation cannot be established given the observational nature of this study, our findings highlight the need for future research in this population.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Tung, J. M., Mamdani, M. M., Juurlink, D. N., Paterson, J. M., Kapral, M. K., Gomes, T. Tags: Cardiovascular Pharmacology, Anticoagulants, Epidemiology Brief Reports Source Type: research

Warfarin versus Aspirin for Prevention of Stroke in Heart Failure: A Meta-analysis of Randomized Controlled Clinical Trials
Conclusions: Compared with aspirin, warfarin reduced the risk of stroke while conferring an increased risk of major hemorrhage. Warfarin does not increase mortality or confer an increased risk of ICH compared with aspirin.
Source: Journal of Stroke and Cerebrovascular Diseases - November 21, 2012 Category: Neurology Authors: Gyanendra Kumar, Munish Kumar Goyal Tags: Original Articles Source Type: research

Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Systemic Inflammation Exacerbates Stroke in Patients with Left Ventricular Assist Device (P4.235)
CONCLUSIONS:In LVAD patients, total prevention of cerebrovascular complications cannot be accomplished only by adjusting warfarin dosage to meet the therapeutic range. However, recognition of increased CRP and appropriate management of inflammation prior to the stroke onset may enable us to avoid its aggravation and secure patient’s opportunity for heart transplantation.Disclosure: Dr. Ohtomo has nothing to disclose. Dr. Iwata has received personal compensation for activities with Janssen Pharmaceuticals, Eisai Inc., Daiichi Pharmaceutical Corp., Ono Pharmaceutical, and Takeda Pharmaceutical Co. Ltd. Dr. Iwata has re...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ohtomo, R., Iwata, A., Kinoshita, O., Shimizu, J., Ono, M., Tsuji, S. Tags: Cerebrovascular Disease and Interventional Neurology: Cardiac Source Type: research

Recurrent Stroke in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial
In this study, we explore IIS rates in WARCEF patients with and without baseline stroke to look for risk factors for IIS and determine if a subgroup with an IIS rate high enough to give a clinically relevant stroke risk reduction can be identified. Methods: We compared potential stroke risk factors between patients with baseline stroke and those without using the exact conditional score test for Poisson variables. We looked for risk factors for IIS, by comparing IIS rates between different risk factors. For EF we tried cut-off points of 10, 15 and 20%. The cut-off point 15% was used as it was the highest EF that was associ...
Source: Cerebrovascular Diseases - November 7, 2014 Category: Neurology Source Type: research

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