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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

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

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asian Patients With Atrial Fibrillation Clinical Sciences
Conclusions—In real-world practice among a high-risk Asian atrial fibrillation population, all 3 NOACs demonstrated similar risk of ischemic stroke and lower risk of ICH compared with warfarin. All-cause mortality was significantly lower only with dabigatran and apixaban.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Myung-Jin Cha, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Seil Oh, Gregory Y.H. Lip Tags: Atrial Fibrillation Original Contributions Source Type: research

Hemorrhagic Transformation After Large Cerebral Infarction in Rats Pretreated With Dabigatran or Warfarin Basic Sciences
Background and Purpose—It is uncertain whether hemorrhagic transformation (HT) after large cerebral infarction is less frequent in dabigatran users than warfarin users. We compared the occurrence of HT after large cerebral infarction among rats pretreated with dabigatran, warfarin, or placebo.Methods—This was a triple-blind, randomized, and placebo-controlled experiment. After treatment with warfarin (0.2 mg/kg), dabigatran (20 mg/kg), or saline for 7 days, Wistar rats were subjected to transient middle cerebral artery occlusion. As the primary outcome, HT was determined by gradient-recalled echo imaging. For the secon...
Source: Stroke - September 25, 2017 Category: Neurology Authors: Il Kwon, Sunho An, Jayoung Kim, Seung-Hee Yang, Joonsang Yoo, Jang-Hyun Baek, Hyo Suk Nam, Young Dae Kim, Hye Sun Lee, Hyun-Jung Choi, Ji Hoe Heo Tags: Magnetic Resonance Imaging (MRI), Anticoagulants, Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Warfarin Use in Patients With Atrial Fibrillation Undergoing Hemodialysis Clinical Sciences
Conclusions—Our findings suggest that warfarin should be used carefully in hemodialysis patients, given the higher risk of hemorrhagic events and the lack of ability to prevent thromboembolic complications.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Chang-Yun Yoon, Juhwan Noh, Jong Hyun Jhee, Tae Ik Chang, Ea Wha Kang, Youn Kyung Kee, Hyoungnae Kim, Seohyun Park, Hae-Ryong Yun, Su-Young Jung, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Changsoo Kim, Tae-Hyun Yoo Tags: Arrhythmias, Clinical Studies, Nephrology and Kidney, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban Versus Warfarin in Patients With Nonvalvular Atrial Fibrillation and Previous Stroke or Transient Ischemic Attack Clinical Sciences
Conclusions—Results from our study of the 3 NOACs versus warfarin in nonvalvular atrial fibrillation patients with a previous history of stroke/transient ischemic attack are relatively consistent with their respective phase III trials and previous stroke/transient ischemic attack subgroup analyses. All NOACs seemed no worse than warfarin in respect to ischemic stroke, ICH, or major bleeding risk.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Craig I. Coleman, W. Frank Peacock, Thomas J. Bunz, Mark J. Alberts Tags: Arrhythmias, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Cerebral Microbleeds in Murine Amyloid Angiopathy Basic Sciences
Conclusions—Anticoagulation with warfarin or dabigatran for 3 to 4 months does not promote the formation of CMBs in aged APP23 mice. Nevertheless, warfarin but not dabigatran is associated with a higher risk of extensive intracerebral hemorrhage, suggesting that this model may allow preclinical safety evaluation of antithrombotic therapies.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Marilena Marinescu, Li Sun, Marc Fatar, Andreas Neubauer, Lothar Schad, Joanne van Ryn, Lorenz Lehmann, Roland Veltkamp Tags: Animal Models of Human Disease, Basic Science Research, Translational Studies Original Contributions Source Type: research

Rivaroxaban Versus Dabigatran or Warfarin in Real-World Studies of Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—In this systematic review and meta-analysis, rivaroxaban was as effective as dabigatran, but was more effective than warfarin for the prevention of stroke/thromboembolism in atrial fibrillation patients. Major bleeding risk was significantly higher with rivaroxaban than with dabigatran, as was all-cause mortality and gastrointestinal bleeding. Rivaroxaban was comparable to warfarin for major bleeding, with an increased risk in gastrointestinal bleeding and decreased risk of intracranial hemorrhage.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Ying Bai, Hai Deng, Alena Shantsila, Gregory Y.H. Lip Tags: Meta Analysis, Quality and Outcomes Original Contributions Source Type: research

12/15-Lipoxygenase Inhibition or Knockout Reduces Warfarin-Associated Hemorrhagic Transformation After Experimental Stroke Basic Sciences
Conclusions—In addition to its benefits in infarct size reduction, 12/15-LOX inhibition also may independently reduce HT in warfarin-treated mice. ML351 should be further evaluated as stroke treatment in anticoagulated patients suffering a stroke, either alone or in conjunction with tissue-type plasminogen activator.
Source: Stroke - January 22, 2017 Category: Neurology Authors: Yu Liu, Yi Zheng, Hulya Karatas, Xiaoying Wang, Christian Foerch, Eng H. Lo, Klaus van Leyen Tags: Blood-Brain Barrier, Ischemic Stroke, Neuroprotectants Original Contributions Source Type: research

Anticoagulation Use and Clinical Outcomes After Major Bleeding on Dabigatran or Warfarin in Atrial Fibrillation Clinical Sciences
Conclusions—Dabigatran was associated with a superior benefit/risk ratio than warfarin and anticoagulation discontinuation in the treatment of atrial fibrillation patients who have survived a major bleed.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Inmaculada Hernandez, Yuting Zhang, Maria M. Brooks, Paul K.L. Chin, Samir Saba Tags: Atrial Fibrillation, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions 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

Noncontrast Computed Tomography Hypodensities Predict Poor Outcome in Intracerebral Hemorrhage Patients Clinical Sciences
Conclusions— The presence of noncontract CT hypodensities at baseline independently predicts poor outcome and comes as a useful and widely available addition to our ability to predict ICH patients’ clinical evolution.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Boulouis, G., Morotti, A., Brouwers, H. B., Charidimou, A., Jessel, M. J., Auriel, E., Pontes-Neto, O., Ayres, A., Vashkevich, A., Schwab, K. M., Rosand, J., Viswanathan, A., Gurol, M. E., Greenberg, S. M., Goldstein, J. N. Tags: Computerized Tomography (CT), Prognosis, Mortality/Survival, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage Clinical Sciences Source Type: research

Left Ventricular Ejection Fraction and Risk of Stroke and Cardiac Events in Heart Failure: Data From the Warfarin Versus Aspirin in Reduced Ejection Fraction Trial Clinical Sciences
Conclusions— In patients with systolic HF and sinus rhythm, LVEF is inversely associated with death and its components, whereas an association with stroke exists for very low LVEF values. An interaction with warfarin treatment on stroke risk may exist. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00041938.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Di Tullio, M. R., Qian, M., Thompson, J. L. P., Labovitz, A. J., Mann, D. L., Sacco, R. L., Pullicino, P. M., Freudenberger, R. S., Teerlink, J. R., Graham, S., Lip, G. Y. H., Levin, B., Mohr, J. P., Buchsbaum, R., Estol, C. J., Lok, D. J., Ponikowski, P. Tags: Heart Failure, Echocardiography, Anticoagulants, Ischemic Stroke Clinical Sciences Source Type: research

Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events: Findings From ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Clinical Sciences
Conclusions— Patients with atrial fibrillation with previous IS/TIA are at high risk of recurrent thromboembolism and bleeding. HDER is at least as effective and is safer than warfarin, regardless of the presence or the absence of previous IS or TIA. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Rost, N. S., Giugliano, R. P., Ruff, C. T., Murphy, S. A., Crompton, A. E., Norden, A. D., Silverman, S., Singhal, A. B., Nicolau, J. C., SomaRaju, B., Mercuri, M. F., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Investigators Tags: Atrial Fibrillation, Anticoagulants, Ischemic Stroke Clinical Sciences Source Type: research

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