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Perceptions and knowledge gaps on CHA < sub > 2 < /sub > DS < sub > 2 < /sub > -VASc score components: a joint survey of Chinese clinicians and clinical pharmacists
CONCLUSIONS: Chinese medical professionals, especially EPs and GPs, revealed a lack of knowledge and insufficient skills for CHA2DS2-VASc scores and their components. Improvements in the awareness of the CHA2DS2-VASc score and its detailed scoring criteria are urgently needed for Chinese medical professionals. Therefore, education programs concerning the introduction of stroke risk evaluation for AF patients and the development of referencing scoring tools are necessary.PMID:34694951 | DOI:10.1080/00325481.2021.1996815
Source: Postgraduate Medicine - October 25, 2021 Category: Internal Medicine Authors: Chi Zhang Long Shen Mang-Mang Pan Ying-Li Zheng Zhi-Chun Gu Hou-Wen Lin Source Type: research

Adherence to oral anticoagulation in ischemic stroke patients with atrial fibrillation
CONCLUSIONS: Adherence was poor in half of AF patients who survived an ischaemic stroke. Independent patient-related factors, rather than composite scores, were associated with poor adherence in these patients.KEY MESSAGESAdherence was poor in half of the atrial fibrillation patients who survived an ischaemic stroke.Independent patient-related factors rather than composite scores were associated with poor adherence.The findings support the importance of recognising adherence support as a crucial part of holistic patient care recommended by recent AF guideline.PMID:34498537 | DOI:10.1080/07853890.2021.1968031
Source: Annals of Medicine - September 9, 2021 Category: Internal Medicine Authors: Paula Tiili Ioannis Leventis Janne Kinnunen Ida Svedjeb äck Mika Lehto Efstathia Karagkiozi Dimitrios Sagris George Ntaios Jukka Putaala Source Type: research

Importance of attributes and willingness to pay for oral anticoagulant therapy in patients with atrial fibrillation in China: A discrete choice experiment
by Jiaxi Zhao, Hao Wang, Xue Li, Yang Hu, Vincent K. C. Yan, Carlos K. H. Wong, Yutao Guo, Marco K. H. Cheung, Gregory Y. H. Lip, Chung-Wah Siu, Hung-Fat Tse, Esther W. Chan BackgroundAdherence to oral anticoagulant therapy in patients with atrial fibrillation (AF) in China is low. Patient preference, one of the main reasons for discontinuation of oral anticoagulant therapy, is an unfamiliar concept in China. Methods and findingsA discrete choice experiment (DCE) was conducted to quantify patient preference on 7 attributes of oral anticoagulant therapy: antidote (yes/no), food –drug interaction (yes/no), frequency of blo...
Source: PLoS Medicine - August 26, 2021 Category: Internal Medicine Authors: Jiaxi Zhao Source Type: research

Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study
This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. Methods and findingsWe harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54 –105 (mean = 72.7) years and without dementia at baseline. Studies had 2–15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mas...
Source: PLoS Medicine - July 22, 2019 Category: Internal Medicine Authors: Darren M. Lipnicki Source Type: research

Protocol of a clinical trial study involving educational intervention in patients treated with warfarin
Background: Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide. Oral anticoagulation is an effective strategy for primary and secondary prevention of stroke in patients with AF. Warfarin is an oral anticoagulant widely prescribed and, despite its benefits, the achievement of the goals of drug therapy depends on patient involvement, among other factors. Educational interventions can contribute for effectiveness and safety of oral anticoagulation therapy. We sought to describe the protocol of a clinical trial designed to evaluate the effect of a patient-centered educational strategy focused on low-i...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Electronic physician notifications to improve guideline-based anticoagulation in atrial fibrillation: a randomized controlled trial
ConclusionsElectronic physician notification did not increase anticoagulation in patients with atrial fibrillation at elevated stroke risk. Primary care physicians did not prescribe anticoagulants because they perceived the bleeding risk was too high or stroke risk was too low.Trial RegistrationClinicalTrials.gov identifier NCT02950285
Source: Journal of General Internal Medicine - August 3, 2018 Category: Internal Medicine Source Type: research

Percutaneous Closure Versus Medical Treatment in Stroke Patients With Patent Foramen Ovale: A Systematic Review and Meta-analysis.
Conclusion: Compared with medical treatment, PFO closure prevents recurrent stroke and TIA but increases the incidence of AF or AFL in PFO carriers with cryptogenic stroke. Primary Funding Source: Italian Ministry of Education, University and Research (MIUR). (PROSPERO: CRD42017074686). PMID: 29310133 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - January 9, 2018 Category: Internal Medicine Authors: De Rosa S, Sievert H, Sabatino J, Polimeni A, Sorrentino S, Indolfi C Tags: Ann Intern Med Source Type: research

A Point ‐based Prediction Model for Cardiovascular Risk in Orthotopic Liver Transplantation: The CAR‐OLT Score
Conclusion: The point‐based CAR‐OLT risk score can identify patients at risk for CVD complications after OLT surgery (available at: www.carolt.us). This score may be useful for identification of candidates for further risk stratification or other management strategies to improve CVD outcomes after OLT. This article is protected by copyright. All rights reserved.
Source: Hepatology - July 1, 2017 Category: Internal Medicine Authors: Lisa B. VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T. Wilkins, Michael M. Abecassis, Daniela P. Ladner, Anton I. Skaro, Donald M. Lloyd ‐Jones Tags: Liver Failure, Cirrhosis and Portal Hypertension Source Type: research

Underuse of Anticoagulation in Patients with Atrial Fibrillation.
Authors: Vallakati A, Lewis WR Abstract Atrial fibrillation (AF) is a major risk factor for ischemic stroke. Guidelines recommend anticoagulation for patients with intermediate and high stroke risk (CHA2DS2-VASc score ≥2). Underuse of anticoagulants among eligible patients remains a persistent problem. Evidence demonstrate that the psychology of the fear of causing harm (omission bias) results in physicians' hesitancy to initiate anticoagulation and results in an inaccurate estimation of stroke risk. The American Heart Association (AHA) initiated the Get With The Guidelines-AFIB (GWTG-AFIB) module in June 2013 to...
Source: Postgraduate Medicine - December 20, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s
Commentary on: Asberg A, Erisksson M, Henriksson KM, et al.. Warfarin-associated intracerebral hemorrhage after ischemic stroke. Stroke 2014;45:2118–20. Context Since its isolation during the early half of the 20th century from the mouldy hay responsible for ‘sweet clover disease’ in cattle, warfarin has become the most widely used oral anticoagulant.1 Indications include atrial fibrillation (AF), mechanical prosthetic valves and venous thromboembolism treatment.2 Warfarin reduces stroke risk in patients with AF by nearly two-thirds; AF accounts for 20% of ischaemic strokes, which tend to be more severe t...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Ruland, S., Biller, J. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Alcohol-related disorders, Drugs misuse (including addiction), Arrhythmias, Alcohol, Health education Aetiology/Harm Source Type: research

Factors that influence awareness and treatment of atrial fibrillation in older adults
Conclusions: With projected doubling of numbers of persons over 80 in the next 30 years in the British Isles, detection and management of AF is pressing. Two-thirds of adults at high risk of stroke were inadequately treated. More regular screening for AF, application of criteria for stroke and bleeding risk and awareness of factors influencing diagnosis and treatment is recommended.
Source: QJM - April 21, 2013 Category: Internal Medicine Authors: Frewen, J., Finucane, C., Cronin, H., Rice, C., Kearney, P. M., Harbison, J., Kenny, R. A. Tags: Original papers Source Type: research