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Recurrent Ischemic Stroke: Strategies for Prevention.
Abstract Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, ...
Source: American Family Physician - October 1, 2017 Category: Primary Care Authors: Oza R, Rundell K, Garcellano M Tags: Am Fam Physician Source Type: research

Family Physician Prescribing Practices and Perspectives on Shared Decision-Making Regarding the Use of Oral Anticoagulants for Stroke Prevention in Patients 75  Years or Older With Atrial Fibrillation
CONCLUSION: Family physicians strongly consider patient risks and utilize risk-assessment tools when initiating OAC in older adults with AF. Despite all physicians reporting the use of shared decision-making and that their patients were educated on the indications for OAC, confidence in initiating treatment was variable. Further exploration into factors impacting physician confidence is needed.PMID:36960556 | DOI:10.1177/21501319231164060
Source: Primary Care - March 24, 2023 Category: Primary Care Authors: Jahaan Ali Reza Abbasi-Dezfouly Sheny Khera Paul Kivi Peter George Jaminal Tian Source Type: research

Diagnosis and Treatment of Atrial Fibrillation.
Abstract Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atrial fibrillation should be confirmed with 12-lead electrocardiography. Because normal electrocardiographic findings do not rule out atrial fibrillation, home monitoring is recommended if there is clinical suspicion of arrhythmia despite normal test results. Treatment is based on decisions made ...
Source: American Family Physician - September 14, 2016 Category: Primary Care Authors: Gutierrez C, Blanchard DG Tags: Am Fam Physician Source Type: research

Two-year outcomes of UK patients newly diagnosed with atrial fibrillation: findings from the prospective observational cohort study GARFIELD-AF
CONCLUSION: The data support a benefit of anticoagulation in reducing stroke and death, without an increased risk of a major bleed in patients with new-onset AF. Anticoagulation treatment in patients at high risk of stroke who are not receiving anticoagulation may further improve outcomes.PMID:35577587 | DOI:10.3399/BJGP.2021.0548
Source: The British Journal of General Practice - May 16, 2022 Category: Primary Care Authors: Patricia N Apenteng Saverio Virdone Fd Richard Hobbs A John Camm Keith Aa Fox Karen S Pieper Gloria Kayani David Fitzmaurice GARFIELD UK investigators* Source Type: research

Approach to the new oral anticoagulants in family practice: Part 1: comparing the options.
CONCLUSION: The NOACs represent important alternatives in the management of patients with AF and VTE, especially for patients who have difficulty accessing regular coagulation monitoring. The companion to this article addresses common "what if" questions that arise in the long-term clinical follow-up and management of patients receiving NOACs. PMID: 25392438 [PubMed - as supplied by publisher]
Source: Canadian Family Physician Medecin de Famille Canadien - November 1, 2014 Category: Primary Care Authors: Douketis J, Bell AD, Eikelboom J, Liew A Tags: Can Fam Physician Source Type: research

Novel Anticoagulants in Atrial Fibrillation: A Primer for the Primary Physician
This article provides a review of recent published trials of the use of NOACs in atrial fibrillation. Practical points on indications, contraindications, mechanism of action, interactions, and perioperative management tips are discussed with a view toward the safe and effective use of these new medications. When patients are transitioned between different anticoagulant medications, the risks of thrombosis and bleeding need to be considered. When switching from warfarin to a NOAC, the NOAC can be started once the international normalized ratio is ≤2.0.
Source: Journal of the American Board of Family Medicine - July 7, 2015 Category: Primary Care Authors: Mookadam, M., Shamoun, F. E., Mookadam, F. Tags: Clinical Reviews Source Type: research

New oral anticoagulants for nonvalvular atrial fibrillation in the elderly: Limited applicability in primary care.
CONCLUSION: There is uncertainty about effectiveness and safety of NOACs in unselected elderly patients with AF in primary care. Therefore, the balance between benefit and harm is still unclear. For this reason, routine use of NOACs is not recommended in elderly patients in primary care. PMID: 25495417 [PubMed - in process]
Source: European Journal of General Practice - December 4, 2015 Category: Primary Care Tags: Eur J Gen Pract Source Type: research

Anticoagulation: Updated Guidelines for Outpatient Management.
Abstract Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism and preventing stroke in those with nonvalvular atrial fibrillation. Vitamin K antagonists are recommended for patients with mechanical valves and valvular atrial fibrillation. Vitamin K antagonists inhibit the production of vitamin K-related factors and require a minimum of five days overlap with parenteral anticoagulants, ...
Source: American Family Physician - September 30, 2019 Category: Primary Care Authors: Wigle P, Hein B, Bernheisel CR Tags: Am Fam Physician Source Type: research

The use and adherence of oral anticoagulants in Primary Health Care in Catalunya, Spain: A real-world data cohort study.
CONCLUSIONS: Acenocoumarol was the most frequently prescribed OAC as first therapy in NVAF patients. Non-naive to DOAC showed better persistence than naive. Rivaroxaban showed higher proportion of adherent patients during the implementation phase than apixaban and dabigatran the lowest. PMID: 32788057 [PubMed - as supplied by publisher]
Source: Atencion Primaria - August 8, 2020 Category: Primary Care Authors: Giner-Soriano M, Cortes J, Gomez-Lumbreras A, Prat-Vallverdú O, Quijada-Manuitt MA, Morros R Tags: Aten Primaria Source Type: research

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