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Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

An Emergency Department Intervention to Increase Warfarin Use for Atrial Fibrillation
Conclusions: This practical stroke prevention quality improvement initiative was not associated with an increase in warfarin use among ED patients with AF.
Source: Journal of Stroke and Cerebrovascular Diseases - December 20, 2012 Category: Neurology Authors: Lesli E. Skolarus, Lewis B. Morgenstern, Phillip A. Scott, Lynda D. Lisabeth, Jillian B. Murphy, Erin M. Migda, Devin L. Brown Tags: Original Articles Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

New Data From Two Large Studies Reinforce Effectiveness of Dual Pathway Inhibition (DPI) with XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)
RARITAN, N.J., May 23, 2022 – Findings from the XARELTO® (rivaroxaban) Phase 3 COMPASS Long-Term Open Label Extension (LTOLE) study and the XARELTO® in Combination with Acetylsalicylic Acid (XATOA) registry have been published in the European Society of Cardiology’s (ESC) European Heart Journal, Cardiovascular Pharmacotherapy. Additionally, the XATOA registry was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC.22). These studies provide further evidence supporting the role of dual pathway inhibition (DPI) with the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 100 mg...
Source: Johnson and Johnson - May 23, 2022 Category: Pharmaceuticals Source Type: news

Using an Atrial Fibrillation Decision Support Tool for Thromboprophylaxis in Atrial Fibrillation: Effect of Sex and Age
ConclusionPhysicians should understand that female sex is a significant risk factor for AF‐related stroke and incorporate this into decision‐making about thromboprophylaxis. Treating older adults with aspirin instead of OAT exposes them to significant risk of bleeding with little to no reduction in AF‐related stroke risk.
Source: Journal of the American Geriatrics Society - May 24, 2016 Category: Geriatrics Authors: Mark H. Eckman, Gregory Y.H. Lip, Ruth E. Wise, Barbara Speer, Megan Sullivan, Nita Walker, Brett Kissela, Matthew L. Flaherty, Dawn Kleindorfer, Peter Baker, Robert Ireton, Dave Hoskins, Brett M. Harnett, Carlos Aguilar, Anthony Leonard, Lora Arduser, Dy Tags: Clinical Investigations Source Type: research

Prevalence and predictors of inappropriate apixaban dosing in patients with non-valvular atrial fibrillation at a large tertiary academic medical institution
ConclusionIn patients with NVAF receiving apixaban for stroke prevention in this real-world analysis,>  80% were prescribed an appropriate dosage of apixaban. Proactive procedures, such as integrating an electronic dosing algorithm, educating healthcare providers, and involving clinical pharmacists in medication review, may help ensure the use of appropriate apixaban dosages.
Source: Drugs and Therapy Perspectives - December 4, 2019 Category: Drugs & Pharmacology Source Type: research

Efficacy and Safety of Novel Oral Anticoagulants in Patients with Cervical Artery Dissections
We report on the use, safety, and efficacy of NOACs in the treatment of CAD. Methods: We retrospectively identified patients diagnosed with CAD at a single academic center between January 2010 and August 2013. Patients were categorized by their antithrombotic treatment at hospital discharge with a NOAC (dabigatran, rivaroxaban, or apixaban), traditional anticoagulant (AC: warfarin or treatment dose low-molecular weight heparin), or antiplatelet agent (AP: aspirin, clopidogrel, or aspirin/extended-release dypyridamole). Using appropriate tests, we compared the baseline medical history, presenting clinical symptoms and initi...
Source: Cerebrovascular Diseases - November 12, 2014 Category: Neurology Source Type: research

Atrial Fibrillation Decision Support Tool: Population Perspective
Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Source: American Heart Journal - August 23, 2017 Category: Cardiology Source Type: research

Oral anti-Xa anticoagulation after Trans-Aortic Valve Implantation for Aortic Stenosis: The randomized ATLANTIS trial
Conclusions ATLANTIS tests the superiority of an apixaban-based strategy versus the recommended standard of care strategy to reduce the risk of post-TAVR thromboembolic and bleeding complications in an all comer population.
Source: American Heart Journal - March 10, 2018 Category: Cardiology Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Stroke Risk Stratification in Patients With Atrial Fibrillation Comme Ci, Comme Ça, Plus Ça Change… ∗
There has been a huge increase in academic interest in atrial fibrillation (AF) and particularly its major complication: thromboembolism. This sustained flurry of activity is fueled by the development of better thromboprophylaxis with well-controlled vitamin K antagonist (VKA) anticoagulation rather than antiplatelet therapy or poorly controlled management with VKAs. The emergence of new therapies, such as non-VKA oral anticoagulant agents and left atrial appendage occlusion devices with better net clinical benefit (less strokes, fewer intracranial or life-threatening bleeds, and reduced mortality) than with warfarin or as...
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

Dual versus triple antithrombotic therapy after percutaneous coronary intervention: the prospective multicentre WOEST 2 Study
CONCLUSIONS: Dual antithrombotic therapy is associated with a substantially lower risk of clinically relevant bleeding without a statistically significant penalty in ischaemic events.PMID:35370126 | DOI:10.4244/EIJ-D-21-00703
Source: EuroIntervention - April 4, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Willem Lambertus Bor Anne Johanna Wilhelmina de Veer Renske H Olie Sem A O F Rikken Dean R P P Chan Pin Yin Jean Paul R Herrman Mathias Vrolix Martijn Meuwissen Tom Vandendriessche Carlos van Mieghem Michael Magro Naoual Bennaghmouch Rick Hermanides Tom A Source Type: research