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Left ventricular hypertrophy and left atrial size are associated with ischemic strokes among non-vitamin K antagonist oral anticoagulant users
ConclusionsPrior cerebrovascular events, diabetes, left ventricular hypertrophy, and increased left atrial size are risk factors for developing an IS among NOAC users.
Source: Journal of Neurology - August 7, 2023 Category: Neurology Source Type: research

Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke: results from the NOR-FIB Study
ConclusionClinical risk scores may guide a personalized evaluation approach in CS patients. Increasing awareness of the usage of available AF-predicting scores may optimize the arrhythmia detection pathway in stroke units.
Source: Journal of Neurology - May 10, 2023 Category: Neurology Source Type: research

Impacts of medication non-adherence to major modifiable stroke-related diseases on stroke prevention and mortality: a meta-analysis
ConclusionsNon-adherence to medications for the four stroke-related diseases contributes to the development of stroke and/or mortality in primary stroke prevention. More efforts are needed to improve patients ’ medication adherence.
Source: Journal of Neurology - February 27, 2023 Category: Neurology Source Type: research

The optimum anticoagulation time after endovascular thrombectomy for atrial fibrillation-related large vessel occlusion stroke: a real-world study
ConclusionsIn AF-related AIS, the time of EVT to anticoagulation is an independent factor of the functional outcome and hemorrhage events after anticoagulation. The optimal initiate time of anticoagulant after EVT is 4.5  days.ClinicalTrialRegisterNCT03754738.
Source: Journal of Neurology - January 3, 2023 Category: Neurology Source Type: research

Identifying gaps in the management of atrial fibrillation with anticoagulation for stroke prevention (GIANTS): a quality improvement initiative
ConclusionsAwareness of this finding is critical to overcome therapeutic inertia in the use of DOACs for ischemic stroke patients with AF. With stroke care becoming increasingly nuanced, peripheral centers may lack the ability to guide anticoagulation in a timely and effective manner. Creation of tertiary short-term follow-up stroke clinics with cardiology follow-up may be an effective strategy to ensure standard of care. Research into systems contributors affecting the appropriate use of DOACs should be elucidated.
Source: Journal of Neurology - May 10, 2022 Category: Neurology Source Type: research

Time trends in stroke severity in the years 2005 to 2020: results from the Austrian Stroke Unit Registry
ConclusionDespite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.
Source: Journal of Neurology - March 21, 2022 Category: Neurology Source Type: research

Early anticoagulation in atrial fibrillation-related acute ischaemic stroke: efficacy and safety profile
ConclusionsEarly anticoagulation was associated with lower ischaemic recurrence and better functional outcome at 3 months. Additional studies are needed to better clarify its haemorrhagic risk.
Source: Journal of Neurology - September 9, 2021 Category: Neurology Source Type: research

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study
ConclusionOur data suggest that a major disruption of social life (i.e., the imposed COVID-19 lockdown) is unlikely to relevantly affect the medication intake behaviour of patients with high pre-established adherence, but might have an impact in patients with previously suboptimal adherence.Trial registration numberMAAESTRO: electronic Monitoring and improvement of Adherence to direct oral Anticoagulant treatment —a randomized crossover study of an Educational and reminder-based intervention in ischaemic STROke patients under polypharmacy, NCT03344146.
Source: Journal of Neurology - June 3, 2021 Category: Neurology Source Type: research

Sex-specific differences in presentations and determinants of outcomes after endovascular thrombectomy for large vessel occlusion stroke
ConclusionIn a real-world analysis of ELVO stroke patients treated with EVT, we found that despite advanced age and more pre-stroke disability, women have comparable reperfusion rates and functional outcomes compared to men. Sex-specific determinants of reperfusion and functional outcome were identified that require further study.
Source: Journal of Neurology - May 29, 2021 Category: Neurology Source Type: research

SARS-CoV-2 infection and acute ischemic stroke in Lombardy, Italy
ConclusionsIschemic strokes in COVID-19 patients have distinctive risk factor profile and etiology, increased clinical severity and higher in-hospital mortality rate compared to non-COVID-19 patients. A simple model based on clinical and routine laboratory parameters may be useful in identifying ischemic stroke patients with SARS-CoV-2 infection who are unlikely to survive the acute phase.
Source: Journal of Neurology - May 24, 2021 Category: Neurology Source Type: research

Early apixaban therapy after ischemic stroke in patients with atrial fibrillation
ConclusionsSymptomatic HT rates are likely to be low in randomized trials of DOAC initiation post-stroke. Recurrent ischemic stroke may be the major clinical outcome. These data may be used as expected event rates when calculating sample size requirements for future safety/efficacy trials of early versus late DOAC initiation after AF-related stroke.
Source: Journal of Neurology - January 3, 2021 Category: Neurology Source Type: research

CHA 2 DS 2 -VASc score as predictor of stroke and all-cause death in stable ischaemic heart disease patients without atrial fibrillation
ConclusionsHigher CHA2DS2-VASc score values were associated with higher risk of stroke and all-cause mortality during long-term follow-up in this real-world sample of patients with sIHD in sinus rhythm.
Source: Journal of Neurology - June 10, 2020 Category: Neurology Source Type: research

Prevalence and risk factors of silent brain infarcts in patients with AF detected by 3T-MRI
ConclusionsLA enlargement on echocardiogram was associated with SBI in patients with AF and low or moderate embolic risk according to CHADS2 and in the low-risk population according to CHA2DS2VASc. Although further studies are needed, a neuroimaging screening might be justified in these patients to guide medical therapies to improve stroke prevention.
Source: Journal of Neurology - May 13, 2020 Category: Neurology Source Type: research

MR-imaging pattern is not a predictor of occult atrial fibrillation in patients with cryptogenic stroke
ConclusionsIn this MRI-based analysis of patients with cryptogenic stroke who had received ICM implantation, the detection rate of AF in patients with ICM was not related to the imaging pattern. In addition, the lacunar infarct pattern should not be an exclusion criterion for ICM insertion in patients with cryptogenic stroke. ICM insertion in patients with cryptogenic stroke should not be evaluated solely on the basis of reference to infarct patterns.
Source: Journal of Neurology - September 10, 2019 Category: Neurology Source Type: research

Stroke severity in patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists
AbstractBackgroundAlthough direct oral anticoagulants (DOAC) have proven at least equally effective in the prevention of acute ischemic stroke (AIS) in patients with atrial fibrillation as compared to the vitamin K antagonists (VKA), no reliable data on the severity of AIS of DOAC patients as compared to VKA is available.MethodsUsing a prospectively collected cohort of AIS patients, we performed univariate and multivariate (displayed as adjusted Odds Ratios, OR and 95% confidence intervals, 95% CI) analyses regarding the severity of AIS in patients with preceding DOAC (N = 210) versus VKA (N = 173) therapy. Additio...
Source: Journal of Neurology - June 3, 2019 Category: Neurology Source Type: research

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