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Condition: Hemorrhagic Stroke
Nutrition: Vitamin K

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Total 372 results found since Jan 2013.

Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
ConclusionsIn AF-stroke patients treated with OAC, the presence of CMBs was associated with an unfavorable composite outcome for both VKAs and DOACs, with a higher risk for recurrent IS than for ICH. Strokes were numerically higher under VKAs and increased in the presence of CMBs.Clinical trial registrationhttp://www.clinicaltrials.gov, Unique identifier: NCT03826927.
Source: Frontiers in Neurology - September 20, 2022 Category: Neurology Source Type: research

Efficacy and Safety of Anticoagulants in Patients with Atrial Fibrillation and History of Falls or Risk of Falls: A Systematic Review and Multilevel Meta-Analysis
ConclusionNOACs were associated with less intracranial hemorrhages and ischemic strokes/systemic embolisms than VKAs in AF patients at risk of falls. These findings suggesting preferred use of NOACs over VKAs have clinical implications for physicians, patients and policy makers.
Source: Drug Safety - September 19, 2022 Category: Drugs & Pharmacology Source Type: research

GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide
ConclusionsSimilarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use.Graphical abstract
Source: Clinical Research in Cardiology - September 12, 2022 Category: Cardiology Source Type: research

Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study
CONCLUSIONS: Early initiation was noninferior to delayed start of NOAC after acute ischemic stroke in patients with atrial fibrillation. Numerically lower rates of ischemic stroke and death and the absence of symptomatic intracerebral hemorrhages implied that the early start of NOAC was safe and should be considered for acute secondary stroke prevention in patients eligible for NOAC treatment.REGISTRATION: URL: http://www.CLINICALTRIALS: gov; Unique identifier: NCT02961348.PMID:36065821 | DOI:10.1161/CIRCULATIONAHA.122.060666
Source: Circulation - September 6, 2022 Category: Cardiology Authors: Jonas Oldgren Signild Åsberg Ziad Hijazi Per Wester Maria Bertilsson Bo Norrving National TIMING Collaborators Source Type: research

Risk of bleeding complications per different perioperative antithrombotic regimes during carotid endarterectomy: a national registry analysis
CONCLUSION: The effectiveness and safety of DAPT did not differ from single antiplatelet therapy (SAPT) in patients undergoing CEA and needs further evaluation in prospective studies. Considering additional data from the literature and guideline recommendations DAPT should be started immediately after stroke until 30 days after CEA followed by SAPT, due to possible reduction in the risk of recurrency.PMID:36031046 | DOI:10.1016/j.ejvs.2022.08.020
Source: PubMed: Eur J Vasc Endovasc ... - August 28, 2022 Category: Surgery Authors: Simone Ja Donners Joost M Mekke Eline S van Hattum Raechel J Toorop Gert J de Borst Dutch Audit for Carotid Interventions (DACI) Collaborators Source Type: research

Bridging intravenous thrombolysis in patients with atrial fibrillation
ConclusionBridging IVT appears to be a reasonable clinical option in selected patients with AF. Given the increased sICH risk in patients with VKA, subgroup analysis of the randomized controlled trials should analyze whether patients with VKA might benefit from withholding bridging IVT.Registrationclinicaltrials.gov; Unique identifier: NCT03496064.
Source: Frontiers in Neurology - August 3, 2022 Category: Neurology Source Type: research

Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation
ConclusionsASDs were significantly associated with all-cause mortality in patients with NVAF taking OACs.
Source: Drugs in R&D - July 19, 2022 Category: Drugs & Pharmacology Source Type: research

Use of Oral Anticoagulants and Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke
To the Editor A recent article suggested that the use of non –vitamin K antagonist oral anticoagulants (NOACs) within 7 days of intravenous alteplase was not associated with an increased risk of intracranial hemorrhage. However, we are concerned that some readers may interpret these results as an endorsement of the use of alteplase in patients with acute st roke who were taking NOACs, irrespective of the time frame of last use. Based on dose-finding studies, the drug half-life is 12 hours for apixaban, 11 to 13 hours for rivaroxaban, 10 to 14 hours for edoxaban, and 12 to 17 hours for dabigatran in patients with normal k...
Source: JAMA - June 21, 2022 Category: General Medicine Source Type: research

Aetiology, secondary prevention strategies and outcomes of ischaemic stroke despite oral anticoagulant therapy in patients with atrial fibrillation
Conclusions Stroke despite anticoagulation comprises heterogeneous aetiologies and cardioembolism despite sufficient anticoagulation is most common. While DOAC were associated with better outcomes than VKA, adding antiplatelets was linked to worse outcomes in these high-risk patients. Our findings indicate that individualised and novel preventive strategies beyond the currently available anticoagulants are needed. Trial registration number ISRCTN48292829.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Polymeris, A. A., Meinel, T. R., Oehler, H., Hölscher, K., Zietz, A., Scheitz, J. F., Nolte, C. H., Stretz, C., Yaghi, S., Stoll, S., Wang, R., Häusler, K. G., Hellwig, S., Klammer, M. G., Litmeier, S., Leon Guerrero, C. R., Moeini-Naghani Tags: Open access Cerebrovascular disease Source Type: research

Pharmacological Difference Between Platelet Aggregations in Cardioembolic Stroke Patients with Direct Oral Anticoagulants: A Pilot Study
Major hemorrhagic complication incidence in patients with arterial fibrillation (AF), and treated with direct oral anticoagulants (DOACs), is lower than in vitamin K antagonist-treated patients.1 –5 Additionally, among DOACs, the direct oral thrombin inhibitor (dabigatran) and direct oral factor Xa (FXa) inhibitors (apixaban and rivaroxaban) seem to affect the coagulation system differently, which could provide distinct clinical outcomes.6,7 The results from the US6 and Denmark8 cohort stu dies suggest there is a minute, but notable difference in major bleeding complication incidence between dabigatran and FXa inhibitors.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2022 Category: Neurology Authors: Masahito Nakazaki, Shinichi Oka, Hirotoshi Magota, Ryo Kiyose, Rie Onodera, Ryo Ukai, Yuko Kataoka-Sasaki, Masanori Sasaki, Osamu Honmou Source Type: research

Direct oral anticoagulation in atrial fibrillation and heart valve surgery-a meta-analysis and systematic review
CONCLUSION: Cumulative data analysis reveals that DOAC may provide an effective and safe alternative to VKA in patients with AF after surgically implanted bioprosthetic heart valves or repair with AF. Within a relatively heterogeneous study population, this meta-analysis shows a risk reduction of major bleedings and thromboembolic stroke or systemic embolisms for DOAC.PMID:35481366 | DOI:10.1177/17539447221093963
Source: Adv Data - April 28, 2022 Category: Epidemiology Authors: Stephen Gerfer Ilija Djordjevic Kaveh Eghbalzadeh Navid Mader Thorsten Wahlers Elmar Kuhn Source Type: research