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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

The Pleiotropic Effects of Statins - From Coronary Artery Disease and Stroke to Atrial Fibrillation and Ventricular Tachyarrhythmia.
Abstract Statins, 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, have been used for decades for the prevention of coronary artery disease and stroke. They act primarily by lowering serum cholesterol through the inhibition of cholesterol synthesis in the liver, which results in the upregulation of low-density lipoprotein receptors in the liver. This results in the removal of low-density lipoprotein-cholesterol. Studies have suggested that statins may demonstrate additional effects that are independent of their effects on low-density lipoprotein-cholesterol. These have been termed "pleiotropic" effects. P...
Source: Current Vascular Pharmacology - August 17, 2018 Category: Drugs & Pharmacology Authors: Liao JK, Oesterle A Tags: Curr Vasc Pharmacol Source Type: research

Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients with Acute Coronary Syndrome in IMPROVE-IT.
Conclusions -The addition of ezetimibe to simvastatin in patients stabilized after ACS reduces the frequency of ischemic stroke, with a particularly large effect seen in patients with a prior stroke. Clinical Trial Registration -URL: http://www.clinicaltrials.gov Unique Identifier: NCT00202878. PMID: 28972004 [PubMed - as supplied by publisher]
Source: Circulation - September 30, 2017 Category: Cardiology Authors: Bohula EA, Wiviott SD, Giugliano RP, Blazing MA, Park JG, Murphy SA, White JA, Mach F, Van de Werf FJ, Dalby AJ, White HD, Tershakovec AM, Cannon CP, Braunwald E Tags: Circulation Source Type: research

Stroke in Patients With Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study Clinical Sciences
Conclusions— In patients with aortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated with mortality. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Greve, A. M., Dalsgaard, M., Bang, C. N., Egstrup, K., Ray, S., Boman, K., Rossebo, A. B., Gohlke-Baerwolf, C., Devereux, R. B., Kober, L., Wachtell, K. Tags: Thrombosis risk factors, CV surgery: valvular disease, Acute Cerebral Infarction Clinical Sciences Source Type: research

Left atrial size and function as predictors of new-onset of atrial fibrillation in patients with asymptomatic aortic stenosis: The simvastatin and ezetimibe in aortic stenosis study
Abstract: Background: Left atrial (LA) size and function change with chronically increased left ventricular (LV) filling pressures. It remains unclear whether these variations in LA parameters can predict new-onset atrial fibrillation (AF) in asymptomatic patients with aortic stenosis (AS).Methods: Data were obtained in asymptomatic patients with mild-to-moderate AS (2.5≤ transaortic Doppler velocity ≤4.0m/s), preserved LV ejection fraction (EF), no previous AF, and were enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. Peak-aortic velocity, LAmax volume & LAmin volume were measured by echocardiograph...
Source: International Journal of Cardiology - February 18, 2013 Category: Cardiology Authors: Casper N. Bang, Morten Dalsgaard, Anders M. Greve, Lars Køber, Christa Gohlke-Baerwolf, Simon Ray, Anne B. Rossebø, Kenneth Egstrup, Kristian Wachtell Tags: Original Articles Source Type: research

Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study
Conclusion: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation.
Source: International Journal of Cardiology - October 13, 2011 Category: Cardiology Authors: Anders M. Greve, Eva Gerdts, Kurt Boman, Christa Gohlke-Baerwolf, Anne B. Rossebø, Christoph A. Nienaber, Simon Ray, Kenneth Egstrup, Terje R. Pedersen, Lars Køber, Ronnie Willenheimer, Kristian Wachtell Tags: Original Articles Source Type: research