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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

Statin Adherence Is Associated With Reduced Recurrent Stroke Risk in Patients With or Without Atrial Fibrillation Clinical Sciences
Conclusions—The relationship between statin adherence and reduced recurrent stroke risk is as strong among patients with AFib as it is among patients without AFib, suggesting that AFib status should not be a reason to exclude patients from secondary stroke prevention with a statin.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Alexander C. Flint, Carol Conell, Xiushui Ren, Hooman Kamel, Sheila L. Chan, Vivek A. Rao, S. Claiborne Johnston Tags: Arrhythmias, Lipids and Cholesterol, Secondary Prevention, Ischemic Stroke Original Contributions Source Type: research

Metformin-inclusive Therapy Reduces the Risk of Stroke in Patients with Diabetes: A 4-Year Follow-up Study
Metformin is a kind of oral hypoglycemic agents commonly prescribed to patients with diabetes mellitus. Although past studies had proven its protective effect on cardiovascular risk and related mortality, the evidence of metformin on stroke prevention was still insufficient and conflicting. Our study randomly selected 14,856 patients with diabetes from the database provided by the Taiwan National Health Research Institute, and 2 cohorts were formulated according to whether metformin was in the prescription record. All cases were followed up for 4 years to track their stroke incidence. As a result, 701 (17.5%) of 3999 diabe...
Source: Journal of Stroke and Cerebrovascular Diseases - October 11, 2013 Category: Neurology Authors: Yuan-Yang Cheng, Hsin-Bang Leu, Tzeng-Ji Chen, Chen-Ling Chen, Chia-Hua Kuo, Shin-Da Lee, Chung-Lan Kao Tags: Original Articles Source Type: research

Stroke risk 'higher at start of warfarin treatment'
Conclusion This study has found that warfarin was associated with an increased risk of ischaemic stroke during the first 30 days of treatment. After 30 days of treatment, warfarin was associated with a decreased risk of stroke. However, this study has a number of limitations that should be considered: All information was from patient records, which means that it wasn't subject to recall bias, but the information may not be complete – we do not know if, for example, people took the medication they were prescribed. There may be other factors (confounders) that explain the association seen. In particular, the ba...
Source: NHS News Feed - December 19, 2013 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainstays ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Persistence of secondary prevention medication and related factors for acute ischemic stroke and transient ischemic attack in China.
CONCLUSIONS: More than half of patients with AIS and TIA reported discontinuing one or more secondary prevention medications within 3 months of hospital discharge. Several factors associated with medication persistence were identified. Here, we propose strategies that could be implemented to improve the quality of secondary prevention. PMID: 28420316 [PubMed - as supplied by publisher]
Source: Neurological Research - April 21, 2017 Category: Neurology Tags: Neurol Res Source Type: research

Data from New VOYAGER PAD Analyses at ACC.22 Reinforce Benefit of XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Peripheral Artery Disease (PAD) and Various Co-Morbid Conditions
RARITAN, N.J., April 1, 2022 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced data from new analyses from the Phase 3 VOYAGER PAD clinical trial reinforcing the benefit of the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily plus aspirin 100 mg once daily) in reducing severe vascular events in patients with PAD after lower-extremity revascularization (LER), a procedure that restores blood flow to the legs. Data from the two analyses demonstrate the role that the XARELTO® vascular dose plays in PAD patients with and without chronic kidney disease (CKD) and in PAD patients with and ...
Source: Johnson and Johnson - April 1, 2022 Category: Pharmaceuticals Tags: Innovation Source Type: news

Real world adherence to oral anticoagulant in non-valvular atrial fibrillation patients in China.
CONCLUSION: Oral anticoagulation was significantly underused in NVAF patients in China. Age, sex, concurrent drug usage and disease history were associated factors. Improving warfarin adherence was promising to reduce ischemic stroke risk of NVAF patients. PMID: 29022745 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - October 13, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Imaging the aortic arch to improve diagnostic and prognostic accuracy in transient ischemic attack patients
This study raises a final relevant question: since the prognosis of TIA patients worsens in proportion to the severity of AAA, what therapeutic options are available for these patients? The clinical guidelines recommend risk factor modification and therapy with statins (Class IIa, level of evidence C), an approach consistent with treatment of any patient affected by atherosclerosis. Treatment with coumadin or anti-platelet agents can be considered in patients with AAA >4 mm, i.e. severe AAA, but it remains very controversial because of a potential risk of thrombo-embolism (Class IIb, level of evidence C) . Finally, surgi...
Source: Atherosclerosis - November 25, 2013 Category: Cardiology Authors: Paolo Raggi Tags: Invited Commentaries Source Type: research

Effect of Addition of a Statin to Warfarin on Thromboembolic Events in Japanese Patients With Nonvalvular Atrial Fibrillation and Diabetes Mellitus
Statins have been shown to decrease stroke risk in patients with cardiovascular risk factors, but not to prevent recurrence of ischemic stroke in patients with atrial fibrillation (AF). The present subanalysis aimed to clarify the efficacy of combined use of warfarin and statins in nonvalvular AF (NVAF) patients with coronary artery disease (CAD), diabetes mellitus (DM) or hypertension. The effects of adding statins to warfarin were compared with those of warfarin alone in NVAF patients with the data set of J-RHYTHM Registry, a prospective, observational study with a 2-year follow-up.
Source: The American Journal of Cardiology - April 26, 2017 Category: Cardiology Authors: Naoko Kumagai, John A. Nusser, Hiroshi Inoue, Ken Okumura, Takeshi Yamashita, Toru Kubo, Hiroaki Kitaoka, Hideki Origasa, Hirotsugu Atarashi, J-RHYTHM Registry Investigators 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

Literature Update in Hospital Medicine
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): William Southern , Bradley A. Sharpe , Romsai Tony BoonyasaiTeaser Perioperative statins reduce perioperative myocardial infarctions, atrial fibrillation, and length of stay. Statins do not increase the risk of intracranial hemorrhage. New oral anticoagulants are superior to warfarin in preventing stroke in patients with atrial fibrillation, and may have a better safety profile. In patients who have an acute gastrointestinal bleed while on warfarin, restarting warfarin after a week may lead to fewer thromboses and lower mortality ...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research