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Vitamin E supplementation (alone or with other antioxidants) and stroke: a meta-analysis
CONCLUSIONS: Supplementation with vitamin E alone is not associated with stroke reduction. Instead, supplementation of vitamin E with other antioxidants reduces the incidence of ischemic stroke but increases the risk of hemorrhagic stroke, cancelling any beneficial effect derived. Thus, vitamin E is not recommended in stroke prevention.SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022258259.PMID:37698992 | DOI:10.1093/nutrit/nuad114
Source: Atherosclerosis - September 12, 2023 Category: Cardiology Authors: Enrico Maggio Valeria Proietti Bocchini Roberto Carnevale Pasquale Pignatelli Francesco Violi Lorenzo Loffredo Source Type: research

Direct Oral Anticoagulants versus Vitamin K Antagonists in Cirrhotic Patients with Atrial Fibrillation: Update of Systematic Review and Meta-Analysis
ConclusionDOACs are associated with more favorable safety outcomes and may be a feasible option of oral anticoagulant for individuals with atrial fibrillation and cirrhosis. Pending validation by randomized prospective studies, the findings of this study should be interpreted with caution.
Source: American Journal of Cardiovascular Drugs - August 28, 2023 Category: Cardiology Source Type: research

Left Atrial Appendage Occlusion Devices: Are We Isolating the Right Population?
Atrial fibrillation (AF) affects more than 37 million persons worldwide contributing to significant morbidity and mortality.1 Stroke prevention with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants remains the mainstay of therapy in patients with AF because of the reduction of all-cause mortality in randomized clinical trials when compared with placebo. VKAs are necessary for those patients with valvular AF but carry a higher risk of stroke, intracranial hemorrhage, and mortality when compared with non-VKA oral anticoagulants.
Source: The American Journal of Cardiology - June 27, 2023 Category: Cardiology Authors: Navid Nafissi, Anita M. Kelsey Source Type: research

Po-04-216 patient enabled inr optimization : a multicenter prospective study
For patients using Vitamin K antagonists (VKA), maximizing time within the therapeutic range (TTR) reduces stroke, major hemorrhage, and death. Despite improvements in counselling and patient education, patients using Vitamin K antagonists have a poor TTR.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Muthiah Subramanian, Walli Mohammed, Hetan Shah, Sachin D. Yalagudri, Daljeet K. Saggu, Calambur Narasimhan Source Type: research

Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses From COMBINE AF
CONCLUSIONS: Standard-dose DOACs are safer and more effective than warfarin down to a CrCl of at least 25 mL/min. Lower-dose DOACs do not significantly lower the incidence of bleeding or ICH compared with standard-dose DOACs but are associated with a higher incidence of S/SE and death. These findings support the use of standard-dose DOACs over warfarin in patients with kidney dysfunction.PMID:37042255 | DOI:10.1161/CIRCULATIONAHA.122.062752
Source: Circulation - April 12, 2023 Category: Cardiology Authors: Josephine Harrington Anthony P Carnicelli Kaiyuan Hua Lars Wallentin Manesh R Patel Stefan H Hohnloser Robert P Giugliano Keith A A Fox Ziad Hijazi Renato D Lopes Sean D Pokorney Hwanhee Hong Christopher B Granger Source Type: research

Severe Bleeding Risk of Direct Oral Anticoagulants Versus Vitamin K Antagonists for Stroke Prevention and Treatment in Patients with Atrial Fibrillation: A Systematic Review and Network Meta-Analysis
ConclusionBased on current evidence, for stroke prevention and treatment in patients with AF, the most safe DOAC is edoxaban in terms of fatal bleeding; dabigatran in terms of major bleeding and intracranial hemorrhage and apixaban in terms of gastrointestinal bleeding. However, given the nature of indirect comparisons, more high-quality evidence from head-to-head comparisons is still needed to confirm them.
Source: Cardiovascular Drugs and Therapy - April 1, 2023 Category: Cardiology Source Type: research

GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide
ConclusionsSimilarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use.Graphical abstract
Source: Clinical Research in Cardiology - September 12, 2022 Category: Cardiology Source Type: research

Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study
CONCLUSIONS: Early initiation was noninferior to delayed start of NOAC after acute ischemic stroke in patients with atrial fibrillation. Numerically lower rates of ischemic stroke and death and the absence of symptomatic intracerebral hemorrhages implied that the early start of NOAC was safe and should be considered for acute secondary stroke prevention in patients eligible for NOAC treatment.REGISTRATION: URL: http://www.CLINICALTRIALS: gov; Unique identifier: NCT02961348.PMID:36065821 | DOI:10.1161/CIRCULATIONAHA.122.060666
Source: Circulation - September 6, 2022 Category: Cardiology Authors: Jonas Oldgren Signild Åsberg Ziad Hijazi Per Wester Maria Bertilsson Bo Norrving National TIMING Collaborators Source Type: research

The role of mitochondria-targeting miRNAs in intracerebral hemorrhage
Curr Neuropharmacol. 2022 May 6. doi: 10.2174/1570159X20666220507021445. Online ahead of print.ABSTRACTNon-traumatic intracerebral hemorrhage (ICH) is the most common type of hemorrhagic stroke, most often occurring between the ages of 45 and 60. Arterial hypertension (AH) is most often the cause of ICH, followed by atherosclerosis, blood diseases, inflammatory changes in cerebral vessels, intoxication and vitamin deficiencies. Cerebral hemorrhage can occur by diapedesis or as a result of a ruptured vessel. AH is difficult to treat; requires surgery and can lead to disability or death. One of the important directions in th...
Source: Atherosclerosis - May 7, 2022 Category: Cardiology Authors: Ilgiz Gareev Ozal Beylerli Yanchao Liang Enzhou Lu Tatiana Ilyasova Albert Sufianov Galina Sufianova Huaizhang Shi Aamir Ahmad Guang Yang Source Type: research

Real-World Comparisons of Low-Dose NOACs versus Standard-Dose NOACs or Warfarin on Efficacy and Safety in Patients with AF: A Meta-Analysis
CONCLUSIONS: Low-dose NOACs were comparable to standard-dose NOACs considering risks of ischemic stroke, major bleeding, ICH, and GH, and they were superior to warfarin. Low-dose NOACs might be prescribed effectively and safely for patients with AF. Considering limitations, further well-designed prospective studies are foreseen.PMID:35449605 | PMC:PMC9017587 | DOI:10.1155/2022/4713826
Source: Cardiology Research and Practice - April 22, 2022 Category: Cardiology Authors: Ze Li Xiaozhen Wang Dandan Li Aiping Wen Source Type: research

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