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Specialty: Internal Medicine
Condition: Atrial Fibrillation

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Total 509 results found since Jan 2013.

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Seven days of non-invasive cardiac monitoring early postischaemic stroke or TIA increases atrial fibrillation detection rate compared with current guideline-based practice
Commentary on: Higgins P, Macfarlane PW, Dawson J, et al.. Non-invasive cardiac event monitoring to detect atrial fibrillation after ischemic stroke: a randomized, controlled trial. Stroke 2013;44:2525–31. Context Atrial fibrillation (AF) is an established risk factor for stroke, and anticoagulation treatment is effective in reducing recurrent stroke risk. Guidelines recommend the use of clinical prediction tools to select patients with AF for anticoagulation therapy. It has long been recognised that paroxysmal AF (PAF) may pose a similar stroke risk to persistent AF, but the association between the duration of PAF a...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Coutts, S. B., Choi, P. M. C. Tags: EBM Diagnosis, Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Screening (public health) Source Type: research

Prolonged cardiac monitoring after cryptogenic stroke superior to 24 h ECG in detection of occult paroxysmal atrial fibrillation
Commentary on: Gladstone DJ, Spring M, Dorian P, et al.. Atrial fibrillation in patients with cryptogenic stroke. N Eng J Med 2014;370:2467–77. Context Stroke remains a prevalent and devastating condition for many people across the world, it is a leading cause of disability and is associated with significant monetary and social losses, yet is considered to be a largely preventable disease. One-third of all strokes are considered cryptogenic after initial diagnostic evaluations. Cryptogenic stroke has been identified, only recently, as an important area of additional investigation. Part of the EMBRACE trial, Gladstone...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Miller, D. J. Tags: EBM Diagnosis, Drugs: cardiovascular system, Stroke, Arrhythmias 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

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Atrial fibrillation is associated with an increased risk of cognitive impairment and dementia with or without a history of clinical stroke
Commentary on: Kalantarian S, Stern TA, Mansour M, et al.. Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med 2013;158(5 Pt 1):338–46. Context Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. The estimated US prevalence of 2.7–6.1 million is expected to increase to 5.6–12.1 million by the middle of the current century. In addition, AF prevalence dramatically increases with age: <1% in individuals aged 50–59 years are affected, whereas about 10% of those aged 80–84 years and 11–18% of those ≥85 ...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Forti, P. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Dementia, Drugs: CNS (not psychiatric), Stroke, Memory disorders (psychiatry), Psychiatry of old age, Arrhythmias Source Type: research

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

Rate and rhythm control have comparable effects on mortality and stroke in atrial fibrillation but better data are needed
Commentary on: Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al.. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med 2014;160:760–73. Context Atrial fibrillation (AF) represents a large and growing burden on cardiovascular healthcare and leads to a substantial impact on quality-of-life, increased cardiovascular events and a doubling of hospitalisation and death rates.1 Unlike many other cardiac conditions, the evidence base for treatment in AF remains patchy with clear gaps relating to a number of clinically important management strategies. Current practic...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Kotecha, D., Kirchhof, P. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Radiology, Clinical diagnostic tests, Arrhythmias Therapeutics Source Type: research

CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores in stroke with atrial fibrillation: A nationwide multicenter registry study
The performance of scoring systems for risk stratification in patients with atrial fibrillation (AF) was not validated well in patients with stroke. The purpose of this study was to evaluate whether the risk scoring systems predict vascular outcomes in stroke patients with AF. Data were obtained from a nationwide multicenter registry for acute stroke with AF from January 1, 2013, to December 31, 2015. We investigated the predictive power of the CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke scores in stroke patients with AF. The subjects were further stratified into groups according to treatment with or without oral anti...
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Delayed diagnosis of atrial fibrillation after first ‐ever stroke increases recurrent stroke risk: A 5‐year nationwide follow‐up study
ConclusionDelayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.
Source: Internal Medicine Journal - November 29, 2017 Category: Internal Medicine Authors: Ping ‐Song Chou, Bo‐Lin Ho, Yi‐Hsin Chan, Min‐Hsien Wu, Han‐Hwa Hu, A‐Ching Chao Tags: Original Article 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

Gender differences in stroke prevention in atrial fibrillation in general practice: using the GRASP‐AF audit tool
ConclusionWomen with AF are at higher risk of stroke than men without OAC. The gender‐related differences in risk of stroke disappear if OAC is used. Despite this, women are more likely not to receive OAC.
Source: International Journal of Clinical Practice - March 1, 2015 Category: Internal Medicine Authors: E. Shantsila, A. Wolff, G. Y. H. Lip, D. A. Lane Tags: Original Paper Source Type: research

Left Atrial Mechanical Dysfunction and the Risk for Ischemic Stroke in People Without Prevalent Atrial Fibrillation or Stroke : A Prospective Cohort Study
CONCLUSION: In people without prior AF or stroke, when added to CHA2DS2-VASc variables, left atrial reservoir strain improves stroke prediction and yields a predicted net benefit, as shown by decision curve analysis.PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute of the National Institutes of Health.PMID:36534978 | DOI:10.7326/M22-1638
Source: Annals of Internal Medicine - December 19, 2022 Category: Internal Medicine Authors: Ankit Maheshwari Faye L Norby Riccardo M Inciardi Wendy Wang Michael J Zhang Elsayed Z Soliman Alvaro Alonso Michelle C Johansen Rebecca F Gottesman Scott D Solomon Amil M Shah Lin Yee Chen Source Type: research