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Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage. Patient concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU). Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma. Interventions: The patient was treated with Idarucizumab ...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Is intravenous thrombolysis safe for acute ischemic stroke patients taking warfarin with INR 1.9?: A case report
Conclusion: The clinical guidelines are still the main reference for guiding clinical practice, and the main thrombolytic standards and contraindications for treatment still need to be conformed. On this basis, for individualized patients, clinicians must accurately judge the cause of acute stroke, to make optimal choice, reduce disability and mortality, and improve quality of life of patients.
Source: Medicine - March 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous thrombolysis: A meta-analysis
Conclusion: The systematic review showed that male, age, diabetes, NIHSS, OTT, atrial fibrillation, post stroke, infarct size, and ischemic signs of CT were significantly correlated with hemorrhagic transformation (HT). PROSPERO Registration number: CRD42019127499.
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Statins reduce new-onset atrial fibrillation after acute myocardial infarction: A nationwide study
The objective of this study was to investigate whether statins confer a beneficial effect on AF after AMI. Data available in the Taiwan National Health Insurance Research Database on 32886 AMI patients between 2008 and 2011 were retrospectively analyzed. Total 27553 (83.8%) had complete 1-yr follow-up data. Cardiovascular outcomes were analyzed based on the baseline characteristics and AF type (existing, new-onset, or non-AF). AF groups had significantly higher incidence of heart failure (HF), stroke, all-cause death, and major adverse cardiac and cerebrovascular event (MACCE) after index AMI (all P 
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Long-term efficacy after closure of patent foramen ovale for ischemic neurological events in young adults: A systematic review and meta-analysis
Background: The efficacy of patent foramen ovale (PFO) closure remains controversial, and it is unclear which patient groups are best benefited. We performed this meta-analysis to clarify the efficacy of PFO closure of younger patients for prevention of recurrent ischemic neurological events. Methods: We systematically searched for studies of PFO closure for younger patients under the age of 55, and pooled available data on PFO closure of younger vs older patients and on PFO closure of younger patients vs medical therapy. The primary endpoints were the composite outcome of recurrent ischemic neurological events [strok...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Similar thrombolysis outcomes in acute stroke patients with and without atrial fibrillation if pre-stroke CHA2DS2-VASc score is low: A retrospective study
The prognosis of acute ischemic stroke patients treated with intravenous (IV) recombinant tissue plasminogen activator (rtPA) is poorer in patients with atrial fibrillation (AF) than patients without AF, which might be related to the greater stroke severity in AF patients. Higher pre-stroke CHA2DS2-VASc scores are associated with greater stroke severity and poorer outcomes. AF Patients tend to have higher CHA2DS2-VASc scores than the non-AF patients. We thus hypothesized that pre-stroke CHA2DS2-VASc scores can be used to improve outcome stratification of IV thrombolysis therapy in acute stroke patients with and without AF....
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Global research productions pertaining to atrial fibrillation from 2004 to 2018: A bibliometric analysis
Conclusion: Bibliometric analysis of the literature shows that research on AF continues to be a hot spot, and the clinical treatment of AF is an important research frontier. However, further research and collaboration are needed worldwide. Our findings aim to provide valuable information for the editors of journals that publish research on arrhythmia, and to help researchers identify new perspectives for future researches.
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

The impact of renal function on efficacy and safety of new oral anticoagulant in atrial fibrillation patients: A systemic review and meta-analysis
Background and objectives This meta-analysis was to investigate the efficacy and safety of new oral anticoagulant (NOAC) in atrial fibrillation (AF) patients with renal function insufficiency, and to explore whether renal decline occurs in AF patients with NOAC and its impact on outcomes. Methods and results In AF patients with mild renal insufficiency, the NOAC was associated with significantly lower rates of stroke (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.67–0.91; P 
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Effect of anticoagulation therapy in older patients with chronic kidney disease and atrial fibrillation: A meta-analysis
Conclusion: Compared with nonanticoagulation, anticoagulation therapy is associated with a reduced risk of death in older AF patients with nondialysis, but an increased risk of bleeding in older patients with dialysis.
Source: Medicine - October 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Predictive value of CHA2DS2-VASc scores regarding the risk of stroke and all-cause mortality in patients with atrial fibrillation (CONSORT compliant)
Background: Patients with atrial fibrillation (AF) have a higher risk of fatal complications (e.g., stroke). This investigation was performed as an observational retrospective cohort study includes 137 patients (age 61 ± 15; 34.3% women) with a primary diagnosis of AF (paroxysmal, persistent, and permanent). Methods: We collected information about the drug therapy, comorbidities and survival of AF patients and determined their congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA2DS2-VASc) scores. Statistical analysis ident...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Net clinical benefit analysis of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and chronic kidney disease: Protocol for a systematic review and meta-analysis
Conclusions: This study will provide new evidence for clinical profile of NOACs on SSE, major bleeding, all-cause death, and NCB in CKD patients. PROSPERO registration number: CRD42019116940.
Source: Medicine - June 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review 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

Impact of inflammation-mediated myocardial fibrosis on the risk of recurrence after successful ablation of atrial fibrillation – the FIBRO-RISK study: Protocol for a non-randomized clinical trial
In conclusion, FIBRO-RISK will be the first CMR-based study that will investigate the impact of inflammation-mediated myocardial fibrosis and ventricular remodeling on the risk of recurrence after successful ablation of AF, aiming to validate inflammatory biomarkers and myocardial fibrosis as predictors for AF recurrence.
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Risk factors analysis of nosocomial pneumonia in elderly patients with acute cerebral infraction
In this study, 324 aged 70 years and over patients with ACI who were admitted to the inpatient department of TianJin First Hospital (China) from January 2012 to February 2018 were retrospectively analyzed. The patients were divided into NP group (80 patients) and non-NP group (244 patients) according to whether NP was occurred 48 hours after hospitalization. Baseline profiles and biochemical analyses were compared between 2 groups. Information regarding risk factors for NP in elderly patients with ACI was collected from all patients. Associations with NP and outcome were evaluated. Among the total patients, NP occurred ...
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of inflammation-mediated myocardial fibrosis on the risk of recurrence after successful ablation of atrial fibrillation – the FIBRO-RISK study: Protocol for a non-randomized clinical trial
In conclusion, FIBRO-RISK will be the first CMR-based study that will investigate the impact of inflammation-mediated myocardial fibrosis and ventricular remodeling on the risk of recurrence after successful ablation of AF, aiming to validate inflammatory biomarkers and myocardial fibrosis as predictors for AF recurrence.
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

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