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Oral antiplatelet and anticoagulant agents in the prevention and management of ischemic stroke.
Abstract Despite numerous advances over the last 50 years, stroke continues to be a leading cause of death and disability worldwide. The treatment and prevention of stroke has undergone extensive study, and significant advances in medical management have occurred within the past decade principally with the development of new classes of orally active anticoagulant drugs. Here we review these recent breakthroughs and the varying roles of anticoagulants and antiplatelet agents in the prevention and management of different ischemic stroke subtypes, as well as describe the benefits and ongoing challenges to incorporati...
Source: Current Pharmaceutical Design - December 20, 2016 Category: Drugs & Pharmacology Authors: Shrestha S, Coy S, Bekelis K Tags: Curr Pharm Des Source Type: research

Recent time trends in incidence, outcome and premorbid treatment of atrial fibrillation-related stroke and other embolic vascular events: a population-based study
Conclusions We found no reduction in incidence of AF-related vascular events since publication of the BAFTA trial. A third of all disabling/fatal strokes occur in non-anticoagulated patients with known prior AF.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Yiin, G. S. C., Howard, D. P. J., Paul, N. L. M., Li, L., Mehta, Z., Rothwell, P. M., on behalf of the Oxford Vascular Study Tags: JNNP Patients' choice, Open access, Stroke Cerebrovascular disease Source Type: research

Prognostic significance of delayed intraventricular haemorrhage in the INTERACT studies
Conclusions Although linked to factors determining greater ICH growth including poor SBP control, dIVH is independently associated with poor outcome in acute small to moderate-size ICH. Trial registration numbers NCT00226096 and NCT00716079.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Moullaali, T. J., Sato, S., Wang, X., Rabinstein, A. A., Arima, H., Carcel, C., Chen, G., Robinson, T., Heeley, E., Chan, E., Delcourt, C., Stapf, C., Cordonnier, C., Lindley, R. I., Chalmers, J., Anderson, C. S., for the INTERACT Investigators Tags: Stroke, Hypertension Cerebrovascular disease Source Type: research

Cost Effectiveness of Apixaban versus Warfarin or Aspirin for Stroke Prevention in Patients with Atrial Fibrillation: A Greek Perspective
ConclusionsBased on the present analysis, apixaban represents a cost-effective treatment option versus warfarin and aspirin for the prevention of stroke in patients with AF from a Greek healthcare payer perspective over a lifetime horizon.
Source: American Journal of Cardiovascular Drugs - November 22, 2016 Category: Cardiology Source Type: research

Idarucizumab: Clinical Role of a Novel Reversal Agent for Dabigatran.
Authors: Teleb M, Salire K, Wardi M, Alkhateeb H, Said S, Mukherjee D Abstract Atrial fibrillation (AF), a common cardiac arrhythmia associated with increased risk of heart failure, thromboembolic phenomena and death, is a leading cause of hospitalization of adults. A major complication of atrial fibrillation is an increased risk of ischemic stroke leading to long-term disability and in severe cases, death. Historically, coumadin has been the drug of choice for chronic anticoagulation and stroke prevention in AF patients however, given the need for constant monitoring and multiple drug interactions, newer anticoagu...
Source: Cardiovascular and Hematological Disorders Drug Targets - August 3, 2016 Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research

Detecting Nonvalvular Atrial Fibrillation and Anticoagulant Therapy in Cardioembolic Ischemic Stroke.
Authors: Min J, Farooq MU Abstract Nonvalvular Atrial fibrillation (NVAF) is the most common cardiac arrhythmia associated with an increase in risk of stroke and systemic thromboembolism. Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home. The present review will focus on the current status of detecting NVAF and stroke prevention when there is AF. The CHA2DS2-VASc risk stratification scheme is discussed for the identification of patients who are at risk for thromboembolic stroke related to NVAF. Patient with a CHA2DS2-VASc...
Source: Postgraduate Medicine - June 9, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Challenges and Treatment for Stroke Prophylaxis in Patients with Atrial Fibrillation in Mexico: A Review
Abstract Atrial fibrillation (AF) is associated with an increased risk of stroke. AF-related strokes cause greater disability and mortality than those in patients without AF, and are associated with a significant clinical and economic burden in Mexico. Antithrombotic therapy reduces stroke risk in patients with AF and is recommended for all patients except those classified as having a low stroke risk. However, its use is suboptimal all around the world; one study showed that only 4 % of Mexican patients with AF who presented with ischemic stroke were in the therapeutic range for anticoagulation. Vitamin K antagon...
Source: American Journal of Cardiovascular Drugs - February 29, 2016 Category: Cardiology Source Type: research

Self-Advocacy
On August 18, 2008 I went up to the office to do a load of xeroxing, throwing my bag in the back seat of the car. When I got to school, however, something was wrong. Though early in the am, it was like I was drunk, with walking wobbly and difficult. Being a compulsive, I idiotically worked for half an hour, holding on to the copying machine to steady myself. Then I drove home (second stupid act), called the health help line, where they told me to get to the ER. And don't drive! Once there, they figured I had had a stroke and put me on coumadin, a powerful blood thinner. Three days later, in the evening, a nurse wrote on my...
Source: Healthy Living - The Huffington Post - November 16, 2015 Category: Consumer Health News Source Type: news

Antithrombotic therapy for ischaemic stroke patients with AF/RHD in West China daily practice.
CONCLUSION: Our study suggests that overall real-world use of warfarin in IS patients with AF and/or RHD is low before and after admission in West China. Implementation study on this respect should be conducted in this area to improve the daily practice. PMID: 26178783 [PubMed - as supplied by publisher]
Source: Neurological Research - July 17, 2015 Category: Neurology Tags: Neurol Res Source Type: research

Cost effectiveness of left atrial appendage closure versus Warfarin for stroke risk reduction in non-valvular Atrial Fibrillation in CMS patients
Stroke is the most severe and debilitating consequence of atrial fibrillation (AF), with many patients ranking the resultant disability as worse than death. Warfarin, the established first-line therapy, is effective at reducing ischemic stroke, but is associated with increased bleeding risk and lower quality of life (QoL). Left atrial appendage closure (LAAC) with the Watchman Device has been found to be superior to warfarin at reducing risk of stroke in AF patients. This analysis sought to assess the cost effectiveness of LAAC versus warfarin for stroke prevention in non-valvular AF from the perspective of the US Centers ...
Source: Value in Health - May 1, 2015 Category: Global & Universal Authors: V. Reddy, R. Akehurst, S.L. Amorosi, S. Armstrong, S. Beard, C. Knight, C. Taggart, D. Holmes Source Type: research

Outcome of men and women after atrial fibrillation and stroke
ConclusionsThere were no gender differences in long‐term mortality after stroke related to AF. Men were significantly more often prescribed anticoagulants before stroke, a finding that indicates the need for further studies.
Source: Acta Neurologica Scandinavica - February 1, 2015 Category: Neurology Authors: A.‐C. Jönsson, J. Ek, C. Kremer Tags: Original Article Source Type: research

Utility of a Dedicated Pediatric Cardiac Anticoagulation Program: The Boston Children’s Hospital Experience
Abstract Congenital heart disease is the leading cause of stroke in children. Warfarin therapy can be difficult to manage safely in this population because of its narrow therapeutic index, multiple drug and dietary interactions, small patient size, high-risk cardiac indications, and lack of data to support anticoagulation recommendations. We sought to describe our institution’s effort to develop a dedicated cardiac anticoagulation service to address the special needs of this population and to review the literature. In 2009, in response to Joint Commission National Patient Safety Goals for Anticoagulation, Boston...
Source: Mammalian Genome - January 8, 2015 Category: Genetics & Stem Cells Source Type: research

Left Atrial Appendage Closure With the Watchman™ Device
Conclusions Left atrial appendage closure with the WatchmanTM device is feasible and may be a good alternative therapy for stroke prevention in patients with atrial fibrillation and restrictions for anticoagulation.
Source: Revista Brasileira de Cardiologia Invasiva - November 26, 2014 Category: Cardiology Source Type: research

Stroke and Bleeding Risks in Patients with Atrial Fibrillation
Publication date: April 2014 Source:Interventional Cardiology Clinics, Volume 3, Issue 2 Author(s): Abhishek Maan , Jeremy N. Ruskin , E. Kevin HeistTeaser Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a substantial risk of stroke and mortality. Strokes in patients with AF are associated with a greater disability and poorer outcomes than strokes in patients in sinus rhythm. Patients with AF are at increased risk of bleeding, especially if they use anticoagulant therapy. Recent research in the field of anticoagulation has led to development of new anticoagulants for stroke preventio...
Source: Interventional Cardiology Clinics - November 3, 2014 Category: Cardiology Source Type: research

Preferences for Oral Anticoagulants in Atrial Fibrillation: a Best–Best Discrete Choice Experiment
Conclusions Based on the study sample and the modelled attributes, the overall profiles of the new oral anticoagulants were preferred to warfarin as their cost decreased. Public subsidisation and the development of antidotes (such as vitamin K for warfarin) for the new oral anticoagulants may have a positive effect on the under-treatment of AF.
Source: PharmacoEconomics - October 26, 2014 Category: Health Management Source Type: research

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