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Incidence of nonvalvular atrial fibrillation and oral anticoagulant prescribing in England, 2009 to 2019: A cohort study
ConclusionsThe incidence of NVAF increased between 2009 and 2015, before plateauing. Underprescribing of OACs in NVAF is associated with a range of comorbidities, ethnicity, and socioeconomic factors, demonstrating the need for initiatives to reduce inequalities in the care for AF patients.
Source: PLoS Medicine - June 7, 2022 Category: Internal Medicine Authors: Alyaa M. Ajabnoor Source Type: research

Association of ischemic stroke onset time with presenting severity, acute progression, and long-term outcome: A cohort study
ConclusionsNight-onset strokes, compared with day-onset strokes, are associated with higher presenting neurologic severity, more frequent END, and worse 3-month functional outcome. These findings suggest that circadian time of onset is an important additional variable for inclusion in epidemiologic natural history studies and in treatment trials of neuroprotective and reperfusion agents for acute ischemic stroke.
Source: PLoS Medicine - February 4, 2022 Category: Internal Medicine Authors: Wi-Sun Ryu 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

Cardiac risk stratification in cancer patients: A longitudinal patient –patient network analysis
by Yuan Hou, Yadi Zhou, Muzna Hussain, G. Thomas Budd, Wai Hong Wilson Tang, James Abraham, Bo Xu, Chirag Shah, Rohit Moudgil, Zoran Popovic, Chris Watson, Leslie Cho, Mina Chung, Mohamed Kanj, Samir Kapadia, Brian Griffin, Lars Svensson, Patrick Collier, Feixiong Cheng BackgroundCardiovascular disease is a leading cause of death in general population and the second leading cause of mortality and morbidity in cancer survivors after recurrent malignancy in the United States. The growing awareness of cancer therapy –related cardiac dysfunction (CTRCD) has led to an emerging field of cardio-oncology; yet, there is limited k...
Source: PLoS Medicine - August 2, 2021 Category: Internal Medicine Authors: Yuan Hou Source Type: research

Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study
by Hyo-Jeong Ahn, So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Jin-Hyung Jung, Jae-Hyun Lim, Jun-Pil Yun, Soonil Kwon, Seil Oh, Gregory Y. H. Lip BackgroundThere is a paucity of information about cardiovascular outcomes related to exercise habit change after a new diagnosis of atrial fibrillation (AF). We investigated the association between exercise habits after a new AF diagnosis and ischemic stroke, heart failure (HF), and all-cause death. Methods and findingsThis is a nationwide population-based cohort study using data from the Korea National Health Insurance Service. A retrospective analysis was performed for 66,692 pa...
Source: PLoS Medicine - June 8, 2021 Category: Internal Medicine Authors: Hyo-Jeong Ahn Source Type: research

Blood pressure-lowering treatment for the prevention of cardiovascular events in patients with atrial fibrillation: An individual participant data meta-analysis
ConclusionsIn this meta-analysis, we found that BP-lowering treatment reduces the risk of major cardiovascular events similarly in individuals with and without AF. Pharmacological BP lowering for prevention of cardiovascular events should be recommended in patients with AF.
Source: PLoS Medicine - June 1, 2021 Category: Internal Medicine Authors: Ana-Catarina Pinho-Gomes Source Type: research

Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study
ConclusionsThis study demonstrates that AF screening performed by GP practice –based pharmacists was feasible, economically viable, and positively endorsed by participants. Furthermore, diagnosis of AF by the clinical pharmacist using anSLECG was more sensitive and more specific than the use of pulse palpation alone. Future research should explore the key barriers preventing the adoption of national screening programmes.
Source: PLoS Medicine - July 16, 2020 Category: Internal Medicine Authors: Vilius Savickas Source Type: research

Estimated stroke risk, yield, and number needed to screen for atrial fibrillation detected through single time screening: a multicountry patient-level meta-analysis of 141,220 screened individuals
by Nicole Lowres, Jake Olivier, Tze-Fan Chao, Shih-Ann Chen, Yi Chen, Axel Diederichsen, David A. Fitzmaurice, Juan Jose Gomez-Doblas, Joseph Harbison, Jeff S. Healey, F. D. Richard Hobbs, Femke Kaasenbrood, William Keen, Vivian W. Lee, Jes S. Lindholt, Gregory Y. H. Lip, Georges H. Mairesse, Jonathan Mant, Julie W. Martin, Enrique Mart ín-Rioboó, David D. McManus, Javier Muñiz, Thomas Münzel, Juliet Nakamya, Lis Neubeck, Jessica J. Orchard, Luis Ángel Pérula de Torres, Marco Proietti, F. Russell Quinn, Andrea K. Roalfe, Roopinder K. Sandhu, Renate B. Schnabel, Breda Smyth, Apurv Soni, Robert Tieleman, Jiguang Wang, ...
Source: PLoS Medicine - September 24, 2019 Category: Internal Medicine Authors: Nicole Lowres 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

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)
ConclusionsThe present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF. Trial registrationClinicalTrials.gov NCT02635685
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Lars O. Karlsson Source Type: research

Validation of a genetic risk score for atrial fibrillation: A prospective multicenter cohort study
ConclusionsProspective assessment of a GRS for AF identified participants with elevated risk of AF beyond established clinical criteria. Accordingly, a GRS for AF could be incorporated into overall risk assessment to better identify patients at the highest risk of developing AF, although further testing in larger populations is needed to confirm these findings. Trial registrationClinicalTrials.gov NCT01970969
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Evan D. Muse Source Type: research

Modifiable Etiological Factors and the Burden of Stroke from the Rotterdam Study: A Population-Based Cohort Study
Conclusions About half of all strokes are attributable to established causal and modifiable factors. This finding encourages not only intervention on established etiological factors, but also further study of less well established factors.Please see later in the article for the Editors' Summary
Source: PLoS Medicine - April 29, 2014 Category: Internal Medicine Authors: Michiel J. Bos et al. Source Type: research