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Recurrent Acute Ischemic Stroke after Infective Endocarditis Caused by Streptococcus Constellatus: First Case Report and Analysis of the Case Series
Acute ischemic stroke (AIS) is highly prevalent in patients with infective endocarditis (IE) and associated with high rates of death and disability. IE presenting as an acute ischemic stroke, especially recurrent concurrence of acute anterior and posterior circulation infarct, has rarely been reported. Herein, we report a case study of a 60-year-old man with a history of aortic valve replacement and was under warfarin, presented with recurrent acute ischemic stroke which was found to have no vegetation secondary to infective endocarditis caused by Streptococcus constellatus as the embolic source.
Source: Journal of Stroke and Cerebrovascular Diseases - April 26, 2018 Category: Neurology Authors: Yumin Wang, Weili Zhao, Jun Lu, Guoli Li, Bin Peng, Hongquan Wang Tags: Case Studies Source Type: research

The Left Atrial Appendage: Target for Stroke Reduction in Atrial Fibrillation.
Abstract A patient with atrial fibrillation (AF) has a greater than 5% annual risk of major stroke, a 5-fold increase compared to the general population. While anticoagulation remains the standard stroke prevention strategy, the nature of lifelong anticoagulation inevitably carries an increased risk of bleeding, increased stroke during periods of interruption, increased cost, and significant lifestyle modification. Many patients with atrial fibrillation have had their left atrial appendage (LAA) ligated or excised by surgeons during cardiac surgery, a decision based largely on intuition and with no clear evidence ...
Source: Methodist DeBakey Cardiovascular Journal - April 1, 2015 Category: Cardiology Authors: Ramlawi B, Abu Saleh WK, Edgerton J Tags: Methodist Debakey Cardiovasc J Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Anticoagulation Resumption in a Patient With Mechanical Heart Valves, Antithrombin Deficiency, and Hemorrhagic Transformation Following Thrombectomy After Ischemic Stroke
This study is the first report of administering argatroban and titrating to its appropriate dose in the patient with valve thrombosis, antithrombin deficiency, and HT after mechanical thrombectomy for acute ischemic stroke. Notably, the fluctuations argatroban brings to the coagulation test results might not be interpreted as increased bleeding risk. This case also suggested that the reported timing (day 6 to day 14 after hemorrhage) of anticoagulant resumption in primary intracerebral hemorrhage with mechanical valves might be late for some patients with HT.
Source: Frontiers in Pharmacology - December 16, 2020 Category: Drugs & Pharmacology Source Type: research

Cardiac Valve Strands in Ischemic Stroke: Strand Effects and Outcomes of Medical or Surgical Intervention (P4.233)
CONCLUSIONS:At present, there is no consensus regarding appropriate therapy for prevention of recurrent strokes in the setting of valve strands. Based on this case series, four patients continued to have ischemic events on aspirin alone, while patients who started warfarin or later underwent surgery did not have any recurrent strokes at one to two year follow-up. As demonstrated, valve strands can also recur despite removal. The long-term therapeutic intervention remains to be determined. Disclosure: Dr. Chu has nothing to disclose. Dr. Fabian has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chu, J., Fabian, R. Tags: Cerebrovascular Disease and Interventional Neurology: Cardiac Source Type: research

Cor Triatriatum and Stroke: A Case Report and Review of Literature (P3.294)
Conclusions:This is the largest review of CTS cases with associated stroke. The review showed neuroimaging results consistent with a cardioembolic mechanism. All but two of the cases made use of anticoagulation. Three cases underwent surgery. This case has the longest follow-up and the first to demonstrate failure of anti-platelet therapy and anticoagulation. The need for further investigations regarding optimal stroke prevention in this subset of patients is emphasized.Disclosure: Dr. Diestro has nothing to disclose. Dr. Espiritu has nothing to disclose. Dr. Dorotan has nothing to disclose. Dr. Regalado has nothing to dis...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Diestro, J. D., Espiritu, A., Dorotan, M. K., Regalado, J., Pascual, J. L. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Mitral valve repair and bioprosthetic replacement without postoperative anticoagulation does not increase the risk of stroke or mortality ADULT CARDIAC
CONCLUSIONS Despite current guidelines recommending postoperative anticoagulation following MVRR or bioprosthetic replacement, the avoidance of warfarin does not increase perioperative complications and has no impact on intermediate survival. Accordingly, a prospective randomized study to adjudicate the role of extended warfarin thromboprophylaxis in mitral valve surgery is warranted.
Source: European Journal of Cardio-Thoracic Surgery - June 13, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Schwann, T. A., Engoren, M., Bonnell, M., Clancy, C., Khouri, S., Kabour, A., Jamil, T., Habib, R. H. Tags: ADULT CARDIAC Source Type: research

Novel anticoagulants in patients with mechanical heart valves
Commentary on: Eikelboom JW, Connolly SJ, Brueckmann M, et al.. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 2013;369:1206. Context Novel anticoagulants (including the direct thrombin inhibitor dabigatran etixilate) and oral factor Xa inhibitors have similar or superior efficacy and safety to warfarin for reducing thromboembolic stroke in patients with atrial fibrillation, and for prevention of deep venous thrombosis. Eikelboom and colleagues set out to examine whether these novel anticoagulants could be used as an alternative to warfarin in patients with mechanical heart valves. Method...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Stewart, R. A. H. Tags: Drugs: cardiovascular system, Stroke, Venous thromboembolism Therapeutics Source Type: research

Intra-Arterial Thrombectomy for Acute Ischemic Stroke Related to the Procoagulant Effect of Warfarin in A Patient with Atrial Fibrillation and Bioprosthetic Valve Replacement
CONCLUSION: This report describes the roles of endovascular therapy and NOAC in patients with similar highly complex conditions and has clinical relevance for therapeutic plans in the clinical setting.PMID:37674421
Source: Acta Neurologica Taiwanica - September 7, 2023 Category: Neurology Authors: Hsu-Tung Huang Yi-Ting Huang David Yen-Ting Chen Lung Chan Chien-Tai Hong Chen-Chih Chung Source Type: research

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