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Risk of ischemic stroke in asymptomatic atrial fibrillation incidentally-detected in primary care compared with other clinical presentations
CONCLUSION: Ischemic stroke risk in patients with AA-AF incidentally-detected in primary care is far from benign, and not less than incident AF presenting clinically in general practice or hospital. This provides justification for identification of previously undetected AF, e.g. by opportunistic screening, and subsequent stroke prevention with thromboprophylaxis, to reduce the approximately 10% of ischemic strokes related to unrecognized AF.PMID:34192776 | DOI:10.1055/a-1541-3885
Source: Thrombosis and Haemostasis - June 30, 2021 Category: Hematology Authors: Christopher Wallenhorst Carlos Martinez Ben Freedman Source Type: research

Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases
In this study, we used large-scale electronic health records data from multiple linked UK databases to address these evidence gaps.MethodsFor this population-based cohort study, we used linked primary care, hospital, and cancer registry data from the UK Clinical Practice Research Datalink to identify cohorts of survivors of the 20 most common cancers who were 18 years or older and alive 12 months after diagnosis and controls without history of cancer, matched for age, sex, and general practice. We compared risks for a range of cardiovascular disease outcomes using crude and adjusted Cox models. We fitted interactions to in...
Source: The Lancet - August 21, 2019 Category: General Medicine Source Type: research

The involvement of pharmacies in the screening of undiagnosed atrial fibrillation
AbstractEarly identification of atrial fibrillation (AF) is now a priority in cardiovascular prevention because AF is common although often asymptomatic, and is associated with poor outcomes that are highly preventable with appropriate medical treatment. In Italy, AF prevalence among subjects aged ≥65 years ranges from 5 to 6% in observational studies based on the diagnosis recorded by general practitioners to 10–11% in studies where ECG screening is routinely offered. It is thus evident that a large number of subjects are not detected by conventional approach, and new strategies are req uired to increase early detect...
Source: Internal and Emergency Medicine - September 19, 2017 Category: Emergency Medicine Source Type: research

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator
With over 150,000 strokes in the United Kingdom every year, and more than 1 million living survivors, stroke is the third most common cause of death and the leading cause of severe physical disability among adults. A major challenge in administering timely treatment is determining whether the stroke is due to vascular blockage (ischaemic) or haemorrhage. For patients with ischaemic stroke, thrombolysis (i.e. pharmacological ‘clot-busting’) can improve outcomes when delivered swiftly after onset, and current National Health Service Quality Improvement Scotland guidelines are for thrombolytic therapy to be provid...
Source: Health Informatics Journal - August 8, 2016 Category: Information Technology Authors: Mort, A., Eadie, L., Regan, L., Macaden, A., Heaney, D., Bouamrane, M.-M., Rushworth, G., Wilson, P. Tags: Articles Source Type: research

Combined oral contraceptives and risk of venous thromboembolism: there is higher risk in new generations compared to second generations, but paradoxically not in norgestimate-containing-pills
This study examines the VTE risk associated with COC use in two large UK databases. Methods...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Plu-Bureau, G. Tags: Smoking and tobacco, Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Family planning, Alcohol, Health education, Smoking Aetiology/Harm Source Type: research

The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study
Conclusions Each of the algorithms performed practically as well in the external independent CPRD validation cohorts as they had in the original published QResearch validation cohorts.
Source: BMJ Open - August 28, 2014 Category: Journals (General) Authors: Hippisley-Cox, J., Coupland, C., Brindle, P. Tags: Open access, Epidemiology, General practice / Family practice, Health informatics Research Source Type: research

Warfarin therapy for atrial fibrillation in general practice - is bleeding risk underestimated?
Abstract BACKGROUND Atrial fibrillation causes a five-fold increase in the risk of thromboembolic stroke. Warfarin therapy reduces the risk by 64 %, but increases the risk of serious bleeding. We aimed to investigate the quality of warfarin therapy in a general practice and determine which patients would be likely to benefit from the treatment.MATERIAL AND METHOD We carried out retrospective registration of patients with atrial fibrillation, and calculated the risk of thromboembolism (CHA2DS2-VASc score) and of bleeding (HAS-BLED score) for each patient. Two alternative methods were used for calculating the absol...
Source: Tidsskrift for den Norske Laegeforening - January 28, 2014 Category: Journals (General) Authors: Bratland B, Hornnes MB Tags: Tidsskr Nor Laegeforen Source Type: research

AUtomated Risk Assessment for Stroke in Atrial Fibrillation (AURAS-AF) - an automated software system to promote anticoagulation and reduce stroke risk: study protocol for a cluster randomised controlled trial
DiscussionAURAS-AF will investigate whether a simple intervention, using electronic primary care records, can improve OAC uptake in a high risk group for stroke. Given previous concerns about safety, especially surrounding inappropriate prescribing, we will also examine whether electronic reminders safely impact care in this clinical area.Trial registration: ISRCTN 55722437
Source: Trials - November 13, 2013 Category: Journals (General) Authors: Tim HoltDavid FitzmauriceTom MarshallMatthew FayNadeem QureshiAndrew DaltonF HobbsDaniel LassersonKaren KearleyJenny HislopJing Jin Source Type: research