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Intracerebral hemorrhage under antithrombotic medication in a recent year
Antithrombotic medication will be a risk of hemorrhagic complication. Meanwhile, direct oral anticoagulants (DOACs), which are recently introduced in the clinical use, are reported to show lower risk of intracerebral hemorrhage (ICH) compared with warfarin. However, the severity at onset and the outcome of ICH patients with DOACs are still controversial. Therefore, this study aimed to reveal the clinical features of recent ICH patients with antithrombotic medication including DOACs.
Source: Journal of Stroke and Cerebrovascular Diseases - March 18, 2017 Category: Neurology Authors: Taizen Nakase, Tatsuya Ishikawa, Akifumi Suzuki Source Type: research

Evaluation of the Efficacy and Safety of Direct Oral Anticoagulants in Japanese Patients —Analysis of Pharmaceuticals and Medical Devices Agency Data
Two forms of direct oral anticoagulant (DOAC) have recently been introduced: direct thrombin inhibitors (DTI; e.g., dabigatran) and factor Xa inhibitors (FXa; e.g., rivaroxaban and apixaban). Despite the advantages of DOACs over warfarin with regard to cerebrovascular complications, those associated with DOACs have been reported with the increasing use of DOACs. Nevertheless, little is known about real-world comparative efficacy and safety of DOACs.
Source: Journal of Stroke and Cerebrovascular Diseases - February 3, 2017 Category: Neurology Authors: Yasuo Terayama Source Type: research

The Sex, Age, Medical History, Treatment, Tobacco Use, Race Risk (SAMe TT2R2) Score Predicts Warfarin Control in a Singaporean Population
Warfarin reduces stroke risk in atrial fibrillation (AF) patients but requires ongoing monitoring. Time in therapeutic range (TTR) is used as a measure of warfarin control, with a TTR less than 60% associated with adverse patient outcomes. The Sex, Age, Medical history, Treatment, Tobacco use, Race (SAMe-TT2R2) score has been identified as a model able to predict warfarin control, but this has been tested in mainly Caucasian populations. Therefore, the aim of this study was to determine the ability of the SAMe-TT2R2 score to predict warfarin control in a Singaporean population consisting of Chinese, Malay, and Indian race.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2016 Category: Neurology Authors: Nijole Bernaitis, Chi Keong Ching, Liping Chen, Jin Shing Hon, Siew Chong Teo, Andrew K. Davey, Shailendra Anoopkumar-Dukie Source Type: research

Warfarin-Resistant Deep Vein Thrombosis during the Treatment of Acute Ischemic Stroke in Lung Adenocarcinoma
A 66-year-old man with acute ischemic stroke in the setting of lung adenocarcinoma developed acute-onset deep vein thrombosis (DVT) of the lower limbs after changing to warfarin from a heparin combination. The diagnosis of warfarin-resistant DVT was established based on the laboratory data and clinical evaluation. Heparin administration resulted in good control of thrombin regulation. Cancer patients are at high risk of venous thromboembolism, and the combination of these 2 conditions is known as Trousseau's syndrome.
Source: Journal of Stroke and Cerebrovascular Diseases - June 21, 2016 Category: Neurology Authors: Hiroyuki Naito, Shiro Aoki, Naoko Sumi, Kazuhide Ochi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research

Perioperative Heparin Bridging in Atrial Fibrillation Patients Requiring Temporary Interruption of Anticoagulation: Evidence from Meta-analysis
Patients with atrial fibrillation (AF) often require temporary interruption of warfarin for an elective operation or invasive procedure. However, the safety and efficacy of periprocedural bridging anticoagulation with unfractionated heparin (UH) or low–molecular-weight heparin (LMWH) are still unclear. We evaluated the safety of periprocedural heparin bridging in AF patients requiring temporary interruption of oral anticoagulation.
Source: Journal of Stroke and Cerebrovascular Diseases - June 7, 2016 Category: Neurology Authors: Karam Ayoub, Ramez Nairooz, Ahmed Almomani, Meera Marji, Hakan Paydak, Waddah Maskoun Source Type: research

Effects of Pretreatment with Warfarin or Rivaroxaban on Neurovascular Unit Dissociation after Tissue Plasminogen Activator Thrombolysis in Ischemic Rat Brain
In this study, we assessed the risks and benefits of pre-treatment with warfarin or rivaroxaban after tissue-type plasminogen activator (tPA) thrombolysis in ischemic rat brain.
Source: Journal of Stroke and Cerebrovascular Diseases - May 23, 2016 Category: Neurology Authors: Jingwei Shang, Toru Yamashita, Syoichiro Kono, Ryuta Morihara, Yumiko Nakano, Yusuke Fukui, Xianghong Li, Nozomi Hishikawa, Yasuyuki Ohta, Koji Abe Source Type: research

D-Dimer versus International Normalized Ratio of Prothrombin Time in Ischemic Stroke Patients Treated with Sufficient Warfarin
In patients receiving chronic warfarin therapy, the international normalized ratio of prothrombin time (PT-INR) reportedly correlates with the incidence, size, severity, and outcome of ischemic stroke, and thus there are guidelines for the optimal PT-INR range that is to be maintained during secondary or primary prevention of ischemic stroke. However, the details of ischemic stroke in patients in whom an optimal PT-INR is maintained by warfarin therapy have not been thoroughly investigated. We conducted a retrospective study to determine the predictors of the size, severity, and outcome of ischemic stroke occurring in pati...
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2016 Category: Neurology Authors: Ryoo Yamamoto, Yoshiharu Nakae, Fumiaki Tanaka, Ken Johkura Source Type: research

Design and Rationale of the RELAXED (Recurrent Embolism Lessened by rivaroxaban, an Anti-Xa agent, of Early Dosing for acute ischemic stroke and transient ischemic attack with atrial fibrillation) Study
In the acute phase of cardioembolic stroke in patients with nonvalvular atrial fibrillation (NVAF), the recurrence rate is high. Nonvitamin K antagonist oral anticoagulants may be appropriate for prevention of early recurrence because they have a much lower risk of hemorrhagic stroke than warfarin.
Source: Journal of Stroke and Cerebrovascular Diseases - March 14, 2016 Category: Neurology Authors: Masahiro Yasaka, Kazuo Minematsu, Kazunori Toyoda, Hiroshi Yamagami, Shinichi Yoshimura, Takehiko Nagao, Etsuro Mori, Teruyuki Hirano, Toshimitsu Hamasaki, Takenori Yamaguchi Source Type: research

Secondary Prevention of Stroke with Warfarin in Patients with Nonvalvular Atrial Fibrillation: Subanalysis of the J-RHYTHM Registry
Prior ischemic stroke or transient ischemic attack (TIA) is a high risk for thromboembolism in patients with nonvalvular atrial fibrillation (NVAF). To clarify rates of thromboembolic and hemorrhagic events, and target intensities of warfarin for secondary prevention, a subanalysis was performed using data from the J-RHYTHM Registry.
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2015 Category: Neurology Authors: Eitaro Kodani, Hirotsugu Atarashi, Hiroshi Inoue, Ken Okumura, Takeshi Yamashita, Hideki Origasa, J-RHYTHM Registry Investigators Source Type: research

Puerperal Extracranial Vertebral Artery Dissection and Nonaneurysmal Subarachnoid Hemorrhage
Previously reported only a few times before, we present a case of extracranial vertebral dissection and spontaneous frontoparietal subarachnoid hemorrhage (SAH) in the puerperium, discussing possible mechanisms and difficulties in management. A 35-year-old woman presented 10 days postcaesarean section with neck pain and vertigo with normal initial investigations. Following recurrent vertigo, headache, and ataxia, imaging revealed a frontoparietal SAH and vertebral artery dissection. The patient was consequently treated with aspirin, and then following a return of symptoms 3 weeks later, warfarin therapy was continued for 6 months.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2015 Category: Neurology Authors: James W. Garrard, Renata F. Simm, Edson Bor-Seng-Shu, Ricardo C. Nogueira Tags: Case Studies Source Type: research

Efficacy and Safety of Edoxaban in Nonvalvular Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials
This study compared the efficacy and safety of edoxaban and warfarin in nonvalvular atrial fibrillation, and the effects of different edoxaban dosages. Methods: A systematic search for randomized controlled trials comparing edoxaban with warfarin in nonvalvular atrial fibrillation was conducted using PubMed, EMBASE, and the Cochrane Library databases.
Source: Journal of Stroke and Cerebrovascular Diseases - August 28, 2015 Category: Neurology Authors: Junyu Chen, Xiaodong Zhuang, Ming Long, Chen Su, Lichun Wang Source Type: research

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