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Effect of Apixaban on All-Cause Mortality in Atrial Fibrillation: An Imputed Placebo Analysis (I2-1.001)
CONCLUSIONS: This imputed placebo analysis suggests that apixaban significantly reduces all-cause mortality by about one-third in patients with AF.Study Supported by: Bristol-Myers Squibb Company and Pfizer Inc. Editorial assistance in formatting the abstract to ensure compliance with AAN guidelines was provided by Stephanie Finucane of Caudex Medical and was funded by Bristol-Myers Squibb Company and Pfizer Inc.Disclosure: Dr. McMurray has nothing to disclose. Dr. Hart has received personal compensation for activities with Sanofi-Aventis Pharmaceuticals Inc., and Bristol-Myers Squibb Co. Dr. Flaker has received personal c...
Source: Neurology - April 9, 2014 Category: Neurology Authors: McMurray, J., Hart, R., Flaker, G., Lopes, R., Wang, J., Hanna, M., Alexander, J., Granger, C., Wallentin, L. Tags: New Antithrombotic Agents for Stroke Prevention Poster Presentations Source Type: research

Warfarin Associated Intracerebral Hemorrhage in Hong Kong Chinese (I2-1.009)
CONCLUSIONS: WICH is a serious complication of warfarin therapy with high mortality and morbidity. Initial ICH volume, presence of intraventricular hemorrhage and neurological deterioration are independent predictors of clinical outcome.Disclosure: Dr. Teo has nothing to disclose. Dr. Mahboobani has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Siu has nothing to disclose. Dr. Cheung has nothing to disclose. Dr. Ho has nothing to disclose. Dr. Lau has nothing to disclose. Dr. Chan has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Teo, K. C., Mahboobani, N. R., Lee, R., Siu, D. C., Cheung, R., Ho, S. L., Lau, G. K., Chan, K. H. Tags: New Antithrombotic Agents for Stroke Prevention Poster Presentations Source Type: research

Use of Apixaban and Warfarin in Patients Undergoing Procedures: Insights from ARISTOTLE (I2-2.003)
CONCLUSIONS: Procedures are common in patients with atrial fibrillation. The majority of procedures are non-major and non-emergent, and anticoagulation therapy is likely to be stopped peri-procedure. Overall and among emergent procedures, rates of clinical events in the first 30 days post-procedure were low and comparable between treatment groups.Study Supported by: Bristol-Myers Squibb Company and Pfizer Inc. Editorial assistance (i.e., formatting the abstract to ensure compliance with AAN guidelines) was provided by Claire Hall of Caudex Medical and was funded by Bristol-Myers Squibb Company and Pfizer Inc.Disclosure: Dr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lopes, R., Garcia, D., Wojdyla, D., Dorian, P., Alexander, J., Wallentin, L., Lanas, F., Hanna, M., Held, C., Granger, C. Tags: New Antithrombotic Agents for Stroke Prevention Data Blitz Presentations Source Type: research

Direct Thrombin Inhibitors May Have A Decreased Risk Of Intracerebral Hemorrhage Compared With Older Anticoagulants (I2-2.005)
CONCLUSIONS: We found no significant difference in risk of ICH with DTI compared to the AC group and a trend towards lower risk with DTI. Future studies with larger numbers on DTIs are needed to confirm differences in ICH risk between DTIs and other anticoagulants.Disclosure: Dr. Ravipati has nothing to disclose. Dr. Woo has received research support from the National Institutes of Health. Dr. Sekar has received research support from the National Institutes of Health. Dr. Moomaw has received research support from the National Institutes of Health. Dr. Flaherty has received personal compensation for activities with CSL Behr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ravipati, S., Woo, D., Sekar, P., Moomaw, C., Flaherty, M., Osborne, J. Tags: New Antithrombotic Agents for Stroke Prevention Data Blitz Presentations Source Type: research

Thrombophilia in Young Patients with Cerebrovascular Disease. AISYF Study (S55.005)
Conclusion: Our study showed alterations in 17/125(14%) patients with arterial CVA, excluded PAI abnormalities.With the exception of antiphospholipid antibodies the value of testing TF as part of the evaluation of patients with arterial CVA, even in patients with a cryptogenic event,is still controversial and should not lead to anticoagulation of all these patients.Study Supported by Shire HGTDisclosure: Dr. Leon Cejas has nothing to disclose. Dr. Reisin has received personal compensation for activities with Shire Pharmaceuticals Group. Dr. Reisin has received personal compensation in an editorial capacity for Neurology. D...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Leon Cejas, L., Reisin, R. Tags: Pediatric Stroke and Stroke in the Young Source Type: research

Stroke Rounds: Warfarin No Help for Dialysis Patients
(MedPage Today) -- The risk-benefit balance did not appear to be favorable for warfarin in patients with atrial fibrillation who were undergoing dialysis, a retrospective study showed.
Source: MedPage Today Neurology - March 25, 2014 Category: Neurology Source Type: news

Long-term survival after ischemic stroke in patients with atrial fibrillation
Conclusions: Ischemic stroke approximately triples the mortality rate in patients with atrial fibrillation. This effect persists well beyond the immediate period poststroke and is strongly associated with disability after stroke. Stroke prevention by anticoagulation has even greater beneficial effects on survival than usually considered when focusing solely on 30-day mortality rates.
Source: Neurology - March 24, 2014 Category: Neurology Authors: Fang, M. C., Go, A. S., Chang, Y., Borowsky, L. H., Pomernacki, N. K., Udaltsova, N., Singer, D. E. Tags: Outcome research, Stroke prevention, Cardiac, Cohort studies, Infarction ARTICLE Source Type: research

Secondary prevention of stroke in elderly people in Poland-Results of PolSenior study.
CONCLUSIONS: Secondary cardiovascular preventive therapy in Poland is used too rarely in older people after stroke, and it especially concerns anticoagulant therapy in those with a history of atrial fibrillation. Structured educational programmes should be developed in Poland to improve usage of secondary preventive therapy in the elderly. PMID: 24821632 [PubMed - in process]
Source: Neurologia i Neurochirurgia Polska - March 1, 2014 Category: Neurology Authors: Labuz-Roszak B, Skrzypek M, Pierzchała K, Machowska-Majchrzak A, Mossakowska M, Chudek J, Mańka-Gaca I, Bartman W, Więcek A Tags: Neurol Neurochir Pol Source Type: research

Summary of evidence-based guideline update: Prevention of stroke in nonvalvular atrial fibrillation: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To update the 1998 American Academy of Neurology practice parameter on stroke prevention in nonvalvular atrial fibrillation (NVAF). How often do various technologies identify previously undetected NVAF? Which therapies reduce ischemic stroke risk with the least risk of hemorrhage, including intracranial hemorrhage? The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review; modified Delphi process recommendation formulation. Major conclusions: In patients with recent cryptogenic stroke, cardiac rhythm monitoring probabl...
Source: Neurology - February 24, 2014 Category: Neurology Authors: Culebras, A., Messe, S. R., Chaturvedi, S., Kase, C. S., Gronseth, G. Tags: All Cerebrovascular disease/Stroke SPECIAL ARTICLE Source Type: research

Net Clinical Benefit of Rivaroxaban versus Warfarin in Japanese Patients with Nonvalvular Atrial Fibrillation: A Subgroup Analysis of J-ROCKET AF
Conclusion: Analysis of the NCB supports that rivaroxaban therapy provides clinical benefit for Japanese patients with AF.
Source: Journal of Stroke and Cerebrovascular Diseases - November 4, 2013 Category: Neurology Authors: Shinichiro Uchiyama, Masatsugu Hori, Masayasu Matsumoto, Norio Tanahashi, Shin-ichi Momomura, Shinya Goto, Tohru Izumi, Yukihiro Koretsune, Mariko Kajikawa, Masaharu Kato, Hitoshi Ueda, Kazuma Iekushi, Satoshi Yamanaka, Masahiro Tajiri, J-ROCKET AF Study Tags: Original Articles Source Type: research

Atrial Fibrillation, Stroke Risk, and Warfarin Therapy Revisited: A Population-Based Study Clinical Sciences
Conclusions— AF is more common than present guidelines suggest. The attributable risk of AF for ischemic stroke increases with age and is close to that of hypertension in individuals aged ≥80 years. Because a majority of patients with AF with increased risk for stroke had not received anticoagulation therapy, there is a large potential for improvement.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Bjorck, S., Palaszewski, B., Friberg, L., Bergfeldt, L. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Arrhythmias, clinical electrophysiology, drugs, Epidemiology Clinical Sciences Source Type: research

Metformin-inclusive Therapy Reduces the Risk of Stroke in Patients with Diabetes: A 4-Year Follow-up Study
Metformin is a kind of oral hypoglycemic agents commonly prescribed to patients with diabetes mellitus. Although past studies had proven its protective effect on cardiovascular risk and related mortality, the evidence of metformin on stroke prevention was still insufficient and conflicting. Our study randomly selected 14,856 patients with diabetes from the database provided by the Taiwan National Health Research Institute, and 2 cohorts were formulated according to whether metformin was in the prescription record. All cases were followed up for 4 years to track their stroke incidence. As a result, 701 (17.5%) of 3999 diabe...
Source: Journal of Stroke and Cerebrovascular Diseases - October 11, 2013 Category: Neurology Authors: Yuan-Yang Cheng, Hsin-Bang Leu, Tzeng-Ji Chen, Chen-Ling Chen, Chia-Hua Kuo, Shin-Da Lee, Chung-Lan Kao Tags: Original Articles Source Type: research

Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Imaging of Contrast Medium Extravasation in Anticoagulation-Associated Intracerebral Hemorrhage With Dual-Energy Computed Tomography Basic Sciences
Conclusions— Dual-energy computed tomography allows quantifying CE, as a marker of ongoing bleeding, in a model of anticoagulation-associated ICH. Dabigatran induces less CE in ICH than warfarin and consequently reduces risks of hematoma expansion. This constitutes a potential safety advantage of dabigatran over warfarin. Nevertheless, in case of warfarin anticoagulation, prothrombin complex concentrates reduce this side effect.
Source: Stroke - September 23, 2013 Category: Neurology Authors: Won, S.-Y., Schlunk, F., Dinkel, J., Karatas, H., Leung, W., Hayakawa, K., Lauer, A., Steinmetz, H., Lo, E. H., Foerch, C., Gupta, R. Tags: Coumarins, Other anticoagulants, Other Treatment, Acute Cerebral Hemorrhage, Intracerebral Hemorrhage Basic Sciences Source Type: research

Safety of intravenous thrombolysis for ischemic stroke in patients treated with warfarin
ObjectiveControversy surrounds the safety of intravenous (IV) tissue plasminogen activator (tPA) in ischemic stroke patients treated with warfarin. The European tPA license precludes its use in anticoagulated patients altogether. American guidelines accept IV tPA use with an international normalized ratio (INR) ≤ 1.7. The influence of warfarin on symptomatic intracerebral hemorrhage (SICH), arterial recanalization, and long‐term functional outcome in stroke thrombolysis remains unclear. MethodsWe analyzed data from 45,074 patients treated with IV tPA enrolled in the Safe Implementation of Thrombolysis in Stroke (SITS) ...
Source: Annals of Neurology - September 4, 2013 Category: Neurology Authors: Michael V. Mazya, Kennedy R. Lees, Romesh Markus, Risto O. Roine, Raymond C. S. Seet, Nils Wahlgren, Niaz Ahmed, Tags: Original Article Source Type: research

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