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Clinical Inquiry: What is the best imaging method for patients with a presumed acute stroke?
Abstract It depends on whether the stroke is schemic or hemorrhagic. For early detection of ischemic stroke, magnetic resonance imaging (MRI) using diffusion-weighted imaging (DWI) is highly sensitive and specific, whereas computed tomography (CT) is less sensitive but about as specific. PMID: 24475467 [PubMed - in process]
Source: The Journal of Family Practice - January 1, 2014 Category: Practice Management Authors: Sadeghi R, Neher J, St Anna L Tags: J Fam Pract Source Type: research

Help Desk Answers: Do novel oral anticoagulants safely prevent stroke in patients with nonvalvular A-fib?
Abstract Yes. Dabigatran, rivaroxaban, and apixaban are safe and effective compared with warfarin for preventing stroke in patients with nonvalvular atrial fibrillation. These novel oral anticoagulants (NOACs) are noninferior in reducing the number of strokes and systemic emboli and in lowering all-cause mortality while not increasing major bleeding complications and hemorrhagic events. PMID: 27474824 [PubMed - as supplied by publisher]
Source: The Journal of Family Practice - May 31, 2016 Category: Practice Management Authors: Siewert R, Hostetter J Tags: J Fam Pract Source Type: research

LAA occlusion studied for stroke prevention in atrial fib with prior intracerebral hemorrhage
PARIS – Transcatheter left atrial appendage occlusion shows promise in providing a far better stroke prevention strategy than does standard medical management in patients with atrial fibrillation who...
Source: Family Practice News - June 9, 2016 Category: Primary Care Source Type: news

Nonadherence to guidelines for prescribing antiplatelet/anticoagulant therapy in patients with atrial fibrillation
Conclusions. Nonadherence to guidelines was found in three out of every five patients. A greater cerebrovascular risk and a lower haemorrhagic risk were associated with this behaviour. Qualitative studies are needed to determine the causes.
Source: Family Practice - July 3, 2016 Category: Primary Care Authors: Navarro-Juan, M., Carbonell-Torregrosa, M. A., Palazon-Bru, A., Martinez-Diaz, A. M., Gil-Guillen, V. F. Tags: Health Service Research Source Type: research

Clinical Inquiries: What are the benefits and risks of daily low-dose aspirin for primary prevention of CV events?
Abstract One nonfatal myocardial infarction (MI) will be avoided for every 126 to 138 adults who take daily aspirin for 10 years (strength of recommendation [SOR]: A, systematic reviews and meta-analyses of multiple randomized controlled trials [RCTs]). Taking low-dose aspirin for primary prevention shows no clear mortality benefit. A benefit for primary prevention of stroke is less certain. Although no evidence establishes increased risk of hemorrhagic stroke from daily low-dose aspirin, one gastrointestinal hemorrhage will occur for every 72 to 357 adults who take aspirin for longer than 10 years (SOR: A, system...
Source: The Journal of Family Practice - April 1, 2018 Category: Practice Management Authors: Mutter J, Grandy R, Hulkower S, Stigleman S Tags: J Fam Pract Source Type: research

Primary Prevention of CVD with Aspirin: Benefits vs Risks
J Fam Pract. 2021 Jul;70(6S):S41-S46. doi: 10.12788/jfp.0222.ABSTRACTLow-dose aspirin (acetylsalicylic acid [ASA]; 75 to 100 mg/d) is widely used in the prevention of cardiovascular (CV) events based on the results of large-scale studies supporting a benefit. However, questions remain regarding the benefit-risk relationship in certain settings since long-term use of ASA is not devoid of risk. Incontrovertible evidence supports the benefits of ASA treatment, which exceed the risks, in patients who have had a previous CV event (myocardial infarction, stroke, unstable angina, or transient ischemic attack). Nonetheless, the qu...
Source: The Journal of Family Practice - August 25, 2021 Category: Practice Management Authors: Steven M Weisman Stephen Brunton Source Type: research

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