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Frequency of and Determinants of Stroke After Surgical Aortic Valve Replacement in Patients With Previous Cardiac Surgery (from the Multicenter RECORD Initiative)
In conclusion, the risk of postoperative stroke after S-AVR in patients with previous cardiac surgery is high and has an impact on the immediate and late mortality. Excessive bleeding requiring blood transfusion and/or reexploration, prolonged cardiopulmonary bypass time, and use of intra-aortic balloon pump were associated with an extremely high rate of stroke.
Source: The American Journal of Cardiology - September 3, 2013 Category: Cardiology Authors: Fausto Biancari, Francesco Onorati, Giovanni Mariscalco, Marisa De Feo, Antonio Messina, Giuseppe Santarpino, Francesco Santini, Cesare Beghi, Gianantonio Nappi, Giovanni Troise, Theodor Fischlein, Giancarlo Passerone, Jouni Heikkinen, Giuseppe Faggian Tags: Valvular Heart Disease Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding, and Mortality in Patients With Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. Although randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit patients on dialysis. We thus undertook this systematic review and meta-analysis of observational studies including patients with AF on dialysis that reported associations of anticoagulation use. Twenty studies involving 529,741 subjects and 31,321 patients with AF on dialysis were identified. Anticoagulation was associated with a 45% (95% CI 13% to 88%) increased risk of any stroke, reflecting a nonsignificant 13% (95% CI −4% to 34...
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Tags: Arrhythmias and Conduction Disturbances Source Type: research

Systematic Review and Meta-Analysis of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation With Low Stroke Risk
Oral anticoagulation (OAC) in patients with atrial fibrillation (AF) has been shown to prevent thromboembolic complications, but concerns about the increased risk of major bleeding warrant judicious consideration of the risks and benefits.1 Current guidelines recommend OAC prescription for patients with AF at high risk of stroke, as measured by CHA2DS2-VASc scores of ≥2 and ≥3 in men and women respectively.2–4 Men and women with scores of 1 and 2 respectively (i.e., a single nongender-related stroke risk factor) are deemed to be at low-moderate risk of stroke and OAC prescription may be considered to reduce thromboem...
Source: The American Journal of Cardiology - August 11, 2023 Category: Cardiology Authors: Khi Yung Fong, Yiong Huak Chan, Colin Yeo, Gregory Y.H. Lip, Vern Hsen Tan Source Type: research

Stroke Risk Factors Beyond the CHADS-VASc Score: Can We Improve our Identification of ‘High Stroke Risk’ Patients with Atrial Fibrillation?
The prevention of stroke and other thromboembolic events plays a crucial role in the management of atrial fibrillation (AF) patients. Not all AF patients are equal in terms of thromboembolic risk, therefore not all will benefit from oral anticoagulation treatment. The general principle is that the expected benefit of anticoagulation in reduction of thromboembolic risk must exceed the expected harm caused by possible bleeding. Some guidelines have focused on a categorical approach to stroke prevention, with a focus on identifying high risk patients for oral anticoagulation (OAC).
Source: The American Journal of Cardiology - September 11, 2015 Category: Cardiology Authors: Filip M. Szymanski, Gregory Y.H. Lip, Krzysztof J. Filipiak, Anna E. Platek, Anna Hrynkiewicz-Szymanska, Grzegorz Opolski Source Type: research

Stroke Risk Factors Beyond the CHADS-VASc Score: Can We Improve Our Identification of “High Stroke Risk” Patients With Atrial Fibrillation?
The prevention of stroke and other thromboembolic events plays a crucial role in the management of patients with atrial fibrillation. Not all patients with atrial fibrillation are equal in terms of thromboembolic risk; therefore, not all will benefit from oral anticoagulation treatment. The general principle is that the expected benefit of anticoagulation in reduction of thromboembolic risk must exceed the expected harm caused by possible bleeding. Some guidelines have focused on a categorical approach to stroke prevention, with a focus on identifying patients at high risk for oral anticoagulation.
Source: The American Journal of Cardiology - September 11, 2015 Category: Cardiology Authors: Filip M. Szymanski, Gregory Y.H. Lip, Krzysztof J. Filipiak, Anna E. Platek, Anna Hrynkiewicz-Szymanska, Grzegorz Opolski Tags: Review Source Type: research

How Well do Stroke Risk Scores Predict Hemorrhage in Patients with Atrial Fibrillation?
The decision to use anticoagulants for atrial fibrillation depends on comparing a patient’s estimated risk of stroke to their bleeding risk. Several of the risk factors in the stroke risk schemes such as overlap with hemorrhage risk. We compared how well two stroke risk scores (CHADS2 and CHA2DS2-VASc) and two hemorrhage risk scores (the ATRIA bleeding score and the HAS-BLED score) predicted major hemorrhage on and off warfarin in a cohort of 13,559 community-dwelling adults with AF. Over a cumulative 64,741 person-years of follow up, we identified a total of 777 incident major hemorrhage events.
Source: The American Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Gene R. Quinn, Daniel E. Singer, Yuchiao Chang, Alan S. Go, Leila H. Borowsky, Margaret C. Fang Source Type: research

How Well Do Stroke Risk Scores Predict Hemorrhage in Patients With Atrial Fibrillation?
The decision to use anticoagulants for atrial fibrillation depends on comparing a patient's estimated risk of stroke to their bleeding risk. Several of the risk factors in the stroke risk schemes overlap with hemorrhage risk. We compared how well 2 stroke risk scores (CHADS2 and CHA2DS2-VASc) and 2 hemorrhage risk scores (the ATRIA bleeding score and the HAS-BLED score) predicted major hemorrhage on and off warfarin in a cohort of 13,559 community-dwelling adults with AF. Over a cumulative 64,741 person-years of follow-up, we identified a total of 777 incident major hemorrhage events.
Source: The American Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Gene R. Quinn, Daniel E. Singer, Yuchiao Chang, Alan S. Go, Leila H. Borowsky, Margaret C. Fang Tags: Arrhythmias and Conduction Source Type: research

Comparison of HAS-BLED and HAS-BED versus CHADS2 and CHA2DS2VASC Stroke and Bleeding Scores in Patients with Atrial Fibrillation
Anticoagulation is recommended in Atrial Fibrillation (AF) patients for stroke prevention, and the bleeding risk associated suggests the need for a bleeding risk stratification. HAS-BLED score includes ‘labile INR’ referred to quality of anticoagulation. However, in naïve patients this item is not available. In addition, stroke and bleeding risk prediction scores shared several risk factors. Aims of our study were: 1) to evaluate if the HAS-BLED score in its refined form excluding ‘labile I NR’ (HAS-BED) is still associated with bleeding risk; and 2) to evaluate the predictive ability for bleeding of both stroke a...
Source: The American Journal of Cardiology - January 24, 2017 Category: Cardiology Authors: Daniela Poli, Emilia Antonucci, Vittorio Pengo, Sophie Testa, Gualtiero Palareti Source Type: research

Relation of Risk of Stroke in Patients With Atrial Fibrillation to Body Mass Index (From Patients Treated With Rivaroxaban and Warfarin in the ROCKET AF Trial)
We investigated stroke outcomes in normal weight (body mass index [BMI] 18.50-24.99 kg/m2), overweight (BMI 25.00-29.99 kg/m2), and obese (BMI ≥30 kg/m2) patients with AF treated with rivaroxaban and warfarin. We compared the incidence of stroke and systemic embolic events (SEE) as well as bleeding events in normal weight (n=3289), overweight (n=5535), and obese (n=5206) patients in a post-hoc analysis of the ROCKET AF trial. Stroke and SEE rates per 100 patient-years were 2.93 in the normal weight group (reference group), 2.28 in the overweight group (adjusted hazard ratio [HR] 0.81, 95% confidence interval [CI]: 0.66-0...
Source: The American Journal of Cardiology - March 28, 2017 Category: Cardiology Authors: Somasekhara R. Balla, Derek D. Cyr, Yuliya Lokhyngina, Richard C. Becker, Scott D. Berkowitz, G ünter Breithardt, Keith A.A. Fox, Werner Hacke, Jonathan L. Halperin, Graeme J. Hankey, Kenneth W. Mahaffey, Christopher C. Nessel, Jonathan P. Piccini, Danie Source Type: research

Meta-Analysis Comparing Patent Foramen Ovale Closure Versus Medical Therapy to Prevent Recurrent Stroke
It is unknown if closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials (RCT) that compared PFO closure plus MT to MT alone in patients with cryptogenic stroke. The efficacy endpoints were recurrent stroke, transient ischemia attack (TIA), and death. The safety endpoints were major bleeding and newly-detected atrial fibrillation (AF).
Source: The American Journal of Cardiology - December 11, 2017 Category: Cardiology Authors: Tomo Ando, Anthony A. Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L. Grines, Sripal Bangalore Source Type: research

Meta-Analysis Comparing Patent Foramen Ovale Closure Versus Medical Therapy to Prevent Recurrent Cryptogenic Stroke
New evidence suggests that closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials that compared PFO closure plus MT with MT alone in patients with cryptogenic stroke. The efficacy end points were recurrent stroke, transient ischemia attack, and death. The safety end points were major bleeding and newly detected atrial fibrillation.
Source: The American Journal of Cardiology - December 11, 2017 Category: Cardiology Authors: Tomo Ando, Anthony A. Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L. Grines, Sripal Bangalore Source Type: research

Meta-analysis of Stroke and Bleeding Risk in Patients with Various Atrial Fibrillation Patterns Receiving Oral Anticoagulants
Oral anticoagulation therapy (OAT) is a mainstay for stroke prevention in atrial fibrillation (AF) patients. However, whether the risks of stroke/systemic embolic events (SEE) and bleeding events are affected by the type, duration, and frequency of AF in patients receiving OAT has been previously debated. We aimed to determine the risk of stroke/SEE and bleeding events associated with paroxysmal AF compared to persistent or permanent AF among patients who received OAT. Comprehensive literature searches of the Cochrane Library, PubMed/MEDLINE, and EMBASE databases were conducted from inception to July 2018.
Source: The American Journal of Cardiology - December 19, 2018 Category: Cardiology Authors: Weifang Zhang, Youwen Xiong, Lingling Yu, Aizhen Xiong, Huihui Bao, Xiaoshu Cheng Source Type: research

Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy After Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment
The patient's profile drawing the greatest benefit from dual antiplatelet therapy (DAPT) after a non-cardioembolic, ischemic cerebrovascular event is not well characterized. Aim of this meta-regression analysis was to compare DAPT versus single antiplatelet therapy (SAPT) in patients with stroke or transient ischemic attack (TIA). We searched randomized trials evaluating clinical outcome with aspirin plus a P2Y12 inhibitor versus SAPT in patients with non-cardioembolic stroke or TIA. Primary endpoint was the incidence of recurrent stroke; safety outcome measure was major bleeding.
Source: The American Journal of Cardiology - May 24, 2019 Category: Cardiology Authors: Giuseppe Patti, Alessandro Sticchi, Antonio Bisignani, Francesco Pelliccia, Vincenzo Pasceri, Giulio Speciale, Maria Penco Source Type: research

Meta-Analysis of Risk of Stroke or Transient Ischemic Attack With Dabigatran for Atrial Fibrillation Ablation
In conclusion, periprocedural use of dabigatran for AF ablation was related to a higher risk of thromboembolic complications including stroke and transient ischemic attack.
Source: The American Journal of Cardiology - January 16, 2014 Category: Cardiology Authors: Partha Sardar, Ramez Nairooz, Saurav Chatterjee, Jørn Wetterslev, Joydeep Ghosh, Wilbert S. Aronow Tags: Arrhythmias and Conduction Disturbances Source Type: research

Meta-analysis of Net Long-term Benefit of Different Therapeutic Strategies in Patients with Cryptogenic Stroke and Patent Foramen Ovale
We pooled available data on follow-up events in patients with patent foramen ovale and cryptogenic stroke to evaluate the net clinical benefit of different therapeutic strategies (percutaneous closure vs antiplatelet vs anticoagulant therapy). MEDLINE/Pubmed and Cochrane databases and reviewed cited references to identify relevant studies were used; 3,311 patients from 21 clinical studies, both observational and randomized, with follow-up ≥12 months were overall included. Net clinical benefit was evaluated considering the cumulative incidence of both stroke/transient ischemic attack and major bleeding events.
Source: The American Journal of Cardiology - January 5, 2015 Category: Cardiology Authors: Giuseppe Patti, Francesco Pelliccia, Carlo Gaudio, Cesare Greco Source Type: research

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