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Specialty: Cardiology
Drug: Coumadin

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Total 1360 results found since Jan 2013.

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

Comparative Performance of ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation Results From a National Primary Care Database
ConclusionsThe ATRIA score performed better in the U.K. Clinical Practice Research Datalink AF cohort. It more accurately identified low-risk patients than the CHA2DS2-VASc score, which assigned these patients to higher-risk categories. Such reclassification of stroke risk could prevent overuse of anticoagulants in very low stroke risk patients with AF.
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

The first prognostic model for stroke and death in patients with systolic heart failure.
CONCLUSIONS: This novel prognostic model predicts the overall risk of ischemic stroke or death for HF patients. This model compares favorably for death with the Seattle model and has the added utility of including stroke as an endpoint. Use of this model will help identify those patients in need of more intensive monitoring and therapy and may help identify appropriate populations for trials of new therapies. CLINICAL TRIAL REGISTRATION: http://www.Clinicatrials.govNCT00041938. PMID: 26549533 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - November 5, 2015 Category: Cardiology Authors: Freudenberger RS, Cheng B, Mann DL, Thompson JL, Sacco RL, Buchsbaum R, Sanford A, Pullicino PM, Levin B, Teerlink JR, Graham S, Mohr JP, Labovitz AJ, Di Tullio MR, Lip GY, Estol CJ, Lok DJ, Ponikowski P, Anker SD, Homma S, WARCEF Investigators Tags: J Cardiol Source Type: research

Ischaemic stroke in patients with atrial fibrillation with chronic kidney disease undergoing peritoneal dialysis
Conclusion In CKD patients on PD with AF, who had similar ischaemic stroke risk as non-CKD counterparts, warfarin therapy is associated with reduction in risk of ischaemic stroke without a higher risk of ICH.
Source: Europace - May 24, 2016 Category: Cardiology Authors: Chan, P.-H., Huang, D., Yip, P.-S., Hai, J., Tse, H.-F., Chan, T.-M., Lip, G. Y. H., Lo, W.-K., Siu, C.-W. Tags: Atrial fibrillation Source Type: research

Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation.
Conclusions Warfarin is effective in preventing stroke in AF patients in primary health care. PMID: 27460750 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - July 28, 2016 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Timing of Treatment Initiation With Oral Anticoagulants for Acute Ischemic Stroke in Patients With Nonvalvular Atrial Fibrillation.
CONCLUSIONS: Our study revealed that neurologists began OACs earlier in patients with mild acute cerebral infarction. Even in patients with severe stroke, OACs were started earlier than expected. PMID: 27980235 [PubMed - as supplied by publisher]
Source: Circulation Journal - December 12, 2016 Category: Cardiology Authors: Deguchi I, Tanahashi N, Takao M Tags: Circ J Source Type: research

Stroke Prevention in Atrial Fibrillation: Looking Forward.
Abstract Ischemic strokes related to atrial fibrillation are highly prevalent, presenting with severe neurologic syndromes and associated with high risk of recurrence. Although advances have been made in both primary and secondary stroke prevention for patients with atrial fibrillation, the long-term risks for stroke recurrence and bleeding complications from antithrombotic treatment remain substantial. We summarize the major advances in stroke prevention for patients with atrial fibrillation during the past 30 years and focus on novel diagnostic and treatment approaches currently under investigation in ongoing cl...
Source: Circulation - December 15, 2020 Category: Cardiology Authors: Katsanos AH, Kamel H, Healey JS, Hart RG Tags: Circulation Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Percutaneous Left Atrial Appendage Occlusion with a Watchman Device Following Recurrent Stroke on Warfarin and Rivaroxaban in Patient with Paroxysmal Atrial Fibrillation
We present the case of a 66 year-old male with paroxysmal atrial fibrillation who experienced recurrent stroke despite treatment with warfarin initially, and rivaroxaban subsequently. After excluding non-cardioembolic causes of recurrent stroke, we proceeded with percutaneous occlusion of the LAA with a Watchman device. Nine months post-procedure he has not experienced recurrence of neurological symptoms. Our case provides anectodal evidence that catheter-based LAA occlusion can be beneficial in secondary stroke prevention where oral anticoagulation has been problematic.
Source: Heart, Lung and Circulation - September 30, 2013 Category: Cardiology Authors: Roberto Spina, Rajesh Subbiah, Romesh Markus, Brendan Gunalingam Tags: Brief Communications Source Type: research

Abstract 271: Anti-coagulation and Ischemic Stroke Risk in Patients with Chronic Kidney Disease and Atrial Fibrillation: Insights from the Kaiser Permanente Colorado Atrial Fibrillation Registry Session Title: Poster Session II
Conclusion: 1 in 3 patients with atrial fibrillation have CKD. There were similar reductions in the risk of stroke associated with warfarin use for CKD and non-CKD patients. These findings reinforce current clinical practice guidelines, which recommend warfarin use based on thromboembolic risk without consideration for CKD status.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Schneider, P. M., Tavel, H. M., Witt, D. M., Kauffman, Y. S., Shetterly, S. M., Go, A. S., Ho, P. M., Magid, D. J. Tags: Session Title: Poster Session II Source Type: research

Medical Costs of Oral Anticoagulants vs Warfarin for Atrial Fibrillation Patients with Different Stroke Risks
Conclusions Medical cost differences associated with OACs vs. warfarin vary according to stroke risk. Of the three OACs, apixaban demonstrated consistent medical cost reductions vs. warfarin for NVAF patients with moderate and high stroke risks.
Source: Cardiology and Therapy - December 1, 2013 Category: Cardiology Source Type: research

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

The Risk Stratification and Stroke Prevention Therapy Care Gap in Canadian Atrial Fibrillation Patients
Conclusions In a large Canadian AF population, primary care physicians did not provide a stroke or bleeding risk in a substantial proportion of their AF patients. When estimates were provided, they were on the basis of a predictive stroke and bleeding risk index in less than half of the patients. Furthermore, there was under- and overestimation of stroke and bleeding risk in a substantial proportion of patients. As many as 1 in 3 patients receiving warfarin have their TTR < 60%. These findings suggest an opportunity to enhance knowledge translation to primary care physicians.
Source: Canadian Journal of Cardiology - October 23, 2015 Category: Cardiology Source Type: research

Abstract 201: Are Patients With Atrial Fibrillation Willing to Consider New Strategies to Prevent Stroke? A Qualitative Analysis of Community-Based Focus Groups Session Title: Abstract Poster Session II
Conclusion: Focus group participants expressed a fear of debilitating stroke, with varying levels of acceptance of inconveniences and potential bleeding associated with blood thinners. Among a subset of participants, there was willingness to consider new stroke prevention therapies; however, this was preferred with a known, trusted physician. Subspecialized clinicians offering new therapies may be challenged to establish perceived mutual respect with patients, traditionally built over time, and this may be required for patients to consider new therapies. Future research is needed to determine best practices for both establ...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Heart Failure and Stroke
AbstractPurposeIschemic stroke significantly contributes to morbidity and mortality in heart failure (HF). The risk of stroke increases significantly, with coexisting atrial fibrillation (AF). An aggravating factor could be asymptomatic paroxysms of AF (so-called silent AF), and therefore, the risk stratification in these patients remains difficult. This review provides an overview of stroke risk in HF, its risk stratification, and stroke prevention in these patients.Recent FindingsStroke risk stratification in HF patients remains an important issue. Recently, the CHA2DS2-VASc score, originally developed to predict stroke ...
Source: Current Heart Failure Reports - July 30, 2018 Category: Cardiology Source Type: research