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Multicentre collection of uniform data on patients hospitalised for transient ischaemic attack or stroke in the Philippines: the Philippine Neurological Association One Database-Stroke (PNA1DB-Stroke) protocol
Introduction For scientific advances to translate into improved patient outcomes, systems of care must be in place to facilitate delivery of care. There is scarce information on quality of care and clinical outcome in our stroke patients. We aim to collect uniform data from patients with first or recurrent transient ischaemic attack (TIA) or ischaemic or haemorrhagic stroke to determine in-patient caseload, patient profile, types of diagnostic and therapeutic procedures, outcomes and overall quality of care among patients hospitalised for acute stroke in the Philippines. Methods and analysis This multicentre observational...
Source: BMJ Open - May 24, 2022 Category: General Medicine Authors: Philippine Neurological Association One Database - Stroke, Disease Study Management Group, Gan, Alvarez, Canete, Co, Collantes, Escabillas, Hiyadan, Juangco, Lokin, Macrohon-Valdez, Punsalan, Sarapuddin, Picar, Pascual V Tags: Open access, Neurology Source Type: research

Stroke prevention of thoracoscopic left atrial appendage clipping in patients with non-valvular atrial fibrillation at high risk of stroke and bleeding: study protocol for a non-randomised controlled clinical trial
Introduction Non-valvular atrial fibrillation (NVAF) is a high-risk factor for ischaemic stroke. The 2016 European Society of Cardiology Atrial Fibrillation Management guidelines recommend oral anticoagulants (OACs) to prevent stroke in men with CHA2DS2-VASc scores ≥2 and women ≥3. However, in patients with a high risk of stroke and a high risk of bleeding (HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years), Drugs/alcohol concomitantly) score≥3), OAC had a higher risk of bleeding. Left atrial appendage cl...
Source: BMJ Open - October 28, 2022 Category: General Medicine Authors: Ye, C., Han, X., Chen, Y., Liu, F., Ma, H., Yang, Y., Liu, Y., Hu, Q., Yao, Q., Xie, W., Xu, D. Tags: Open access, Surgery Source Type: research

Understanding clinicians' decisions to offer intravenous thrombolytic treatment to patients with acute ischaemic stroke: a protocol for a discrete choice experiment
Background Intravenous thrombolysis is an effective emergency treatment for acute ischaemic stroke for patients meeting specific criteria. Approximately 12% of eligible patients in England, Wales and Northern Ireland received thrombolysis in the first quarter of 2013, yet as many as 15% are eligible to receive treatment. Suboptimal use of thrombolysis may have been largely attributable to structural factors; however, with the widespread implementation of 24/7 hyper acute stroke services, continuing variation is likely to reflect differences in clinical decision-making, in particular the influence of ambiguous areas within ...
Source: BMJ Open - July 9, 2014 Category: Journals (General) Authors: De Brun,, A., Flynn, D., Joyce, K., Ternent, L., Price, C., Rodgers, H., Ford, G. A., Lancsar, E., Rudd, M., Thomson, R. G. Tags: Open access, Health services research Protocol Source Type: research

Prevalence of left atrial appendage thrombus in patients with acute ischaemic stroke and sinus rhythm: a cross-sectional study
Conclusions In patients with AIS and sinus rhythm on 12-lead ECG, our study revealed that the prevalence of LAA thrombus was 6.7% with the most prevalent aetiology being paroxysmal AF. The presence of SEC can be a predictor of LAA thrombus in these patients.
Source: BMJ Open - December 17, 2021 Category: General Medicine Authors: Nguyen, H. T., Nguyen, H. V. B., Nguyen, H. Q., Le, H. Q. Tags: Open access, Cardiovascular medicine Source Type: research

Background incidence rates of hospitalisations and emergency department visits for thromboembolic and coagulation disorders in Ontario, Canada for COVID-19 vaccine safety assessment: a population-based retrospective observational study
Conclusions Our estimated background rates help contextualise observed events of these potential adverse events of special interest and to detect potential safety signals related to COVID-19 vaccines.
Source: BMJ Open - December 17, 2021 Category: General Medicine Authors: Nasreen, S., Calzavara, A. J., Sundaram, M. E., MacDonald, S. E., Righolt, C. H., Pai, M., Field, T. S., Zhou, L. W., Wilson, S. E., Kwong, J. C. Tags: Open access, Public health, COVID-19 Source Type: research

Associations between stress disorders and cardiovascular disease events in the Danish population
Conclusions By expanding beyond PTSD and examining a second stress disorder—adjustment disorder—this study provides evidence that stress-related psychopathology is associated with CVD events. Further, limited evidence of gender differences in associations for either of the stress disorders and CVD was found.
Source: BMJ Open - December 14, 2015 Category: Journals (General) Authors: Gradus, J. L., Farkas, D. K., Svensson, E., Ehrenstein, V., Lash, T. L., Milstein, A., Adler, N., Sorensen, H. T. Tags: Open access, Cardiovascular medicine, Epidemiology, Mental health, Public health Research Source Type: research

Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER): protocol for a prospective observational nationwide study
Introduction Atrial fibrillation (AF) is a prevalent disease considerably contributing to the worldwide cardiovascular burden. For patients at high thromboembolic risk (CHA2DS2-VASc ≥3) and not suitable for chronic oral anticoagulation, owing to history of major bleeding or other contraindications, left atrial appendage occlusion (LAAO) is indicated for stroke prevention, as it lowers patient’s ischaemic burden without augmentation in their anticoagulation profile. Methods and analysis Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (S...
Source: BMJ Open - September 21, 2022 Category: General Medicine Authors: Kowalewski, M., Wanha, W., Litwinowicz, R., Kołodziejczak, M., Pasierski, M., Januszek, R., Kuzma, Łukasz, Grygier, M., Lesiak, M., Kapłon-Cieslicka, A., Reczuch, K., Gil, R., Pawłowski, T., Bartus, K., Dobrzycki, S., Lorusso, Tags: Open access, Cardiovascular medicine Source Type: research

The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study
Conclusions Each of the algorithms performed practically as well in the external independent CPRD validation cohorts as they had in the original published QResearch validation cohorts.
Source: BMJ Open - August 28, 2014 Category: Journals (General) Authors: Hippisley-Cox, J., Coupland, C., Brindle, P. Tags: Open access, Epidemiology, General practice / Family practice, Health informatics Research Source Type: research

Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol
In this study, the effect of the implementation of a multidisciplinary antithrombotic team is compared with usual care using a pre-post study design. The study is performed at the Erasmus University Medical Center Rotterdam and the Reinier de Graaf Hospital Delft. Patients who are or will be treated with antithrombotics are included in the study. We aim to include 1900 patients, 950 in each hospital. Primary outcome is the proportion of patients with a composite end point consisting of ≥1 bleeding or ≥1 thrombotic event from the beginning of antithrombotic therapy (or hospitalisation) until 3 months after hospit...
Source: BMJ Open - December 19, 2016 Category: Journals (General) Authors: Dreijer, A. R., Kruip, M. J. H. A., Diepstraten, J., Polinder, S., Brouwer, R., Leebeek, F. W. G., Vulto, A. G., van den Bemt, P. M. L. A. Tags: Open access, Epidemiology, Haematology (incl blood transfusion), Health economics Protocol Source Type: research

Optimal duration of dual antiplatelet therapy following percutaneous coronary intervention: protocol for an umbrella review
Introduction Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT. Methods and analysis We will perform a comprehensive search of the published and grey literature for systematic reviews involving ra...
Source: BMJ Open - April 4, 2017 Category: Journals (General) Authors: Elliott, J., Kelly, S. E., Bai, Z., Liu, W., Skidmore, B., Boucher, M., So, D. Y. F., Wells, G. A. Tags: Open access, Cardiovascular medicine, Evidence based practice Protocol Source Type: research

Randomised controlled trial to investigate optimal antithrombotic therapy in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention: a study protocol of the OPTIMA-AF trial
This study received approval from the Certified Review Board of Osaka University (a certified research ethics committee by the Japanese Clinical Research Act). The findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration number Japan Registry of Clinical Trials: jRCTs051190053; Pre-results.
Source: BMJ Open - December 14, 2021 Category: General Medicine Authors: Sotomi, Y., Kozuma, K., Kashiwabara, K., Higuchi, Y., Ando, K., Morino, Y., Ako, J., Tanabe, K., Muramatsu, T., Nakazawa, G., Hikoso, S., Sakata, Y., on behalf of the OPTIMA-AF Investigators Tags: Open access, Cardiovascular medicine Source Type: research

Continuation versus discontinuation of aspirin-based antiplatelet therapy for perioperative bleeding and ischaemic events in adults undergoing neurosurgery: protocol for a systematic review and meta-analysis
Introduction Antiplatelet therapy is commonly used in primary or secondary prevention of atherosclerotic and thrombotic diseases, such as coronary artery disease, transient ischaemic attack or stroke. Recent studies noted that antiplatelet therapy should be continued perioperatively in patients at high risk of thrombosis and low bleeding risk in orthopaedic, spinal or urological surgery. However, evidence in neurosurgery is lacking. Thus, we aim to conduct a systematic review and meta-analysis to assess whether the continuous use of antiplatelet drugs in neurosurgery increases the risk of perioperative bleeding. Methods a...
Source: BMJ Open - September 30, 2021 Category: General Medicine Authors: Wang, X., Wang, X., Yu, Y., Han, R. Tags: Open access, Anaesthesia Source Type: research

In-hospital gastrointestinal bleeding in patients with acute myocardial infarction: incidence, outcomes and risk factors analysis from China Acute Myocardial Infarction Registry
Conclusions GIB is associated with both in-hospital and follow-up MACCEs. Gastrointestinal prophylactic treatment should be administered to patients with AMI who receive primary PCI, thrombolytic therapy or GPIIb/IIIa receptor inhibitor. Trial registration number NCT01874691.
Source: BMJ Open - September 7, 2021 Category: General Medicine Authors: Shi, W., Fan, X., Yang, J., Ni, L., Su, S., Yu, M., Yang, H., Yu, M., Yang, Y., On behalf of China Acute Myocardial Infarction(CAMI) Registry Study Group Tags: Open access, Cardiovascular medicine Source Type: research

Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis
This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management. Methods and analysis After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TT...
Source: BMJ Open - August 10, 2021 Category: General Medicine Authors: Lin, J., Wu, B., Lin, L., Ding, Y., Zhong, B., Huang, Z., Lin, M., Xu, D.-P. Tags: Open access, Cardiovascular medicine Source Type: research

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