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Rationale and Design of the Hamburg City Health Study
AbstractThe Hamburg City Health Study  (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinatio...
Source: European Journal of Epidemiology - November 7, 2019 Category: Epidemiology Source Type: research

Ischaemic stroke cases set to rise 4% every year over next decade
Total of 3.7 million new cases in US, France, Germany, Italy, Spain, UK, Japan and China by 2027, trends analysis suggests Related items fromOnMedica NHS Health Check makes ‘modest’ but successful start Know your heart health risk stats as well as your PIN number, public urged Atrial fibrillation poses greater risk for women than men Diabetes, stroke and heart attack cut life expectancy England could have lowest disease burden in the world
Source: OnMedica Latest News - June 16, 2019 Category: UK Health Source Type: news

Left atrial appendage closure in non-valvular atrial fibrillation.
Authors: Häusler KG, Landmesser U Abstract Atrial fibrillation is the most frequent cardiac arrhythmia worldwide, causing approximately 20% of all ischemic strokes. Therefore, oral anticoagulation is recommended in patients with atrial fibrillation with at least a moderate risk of stroke; however, there is a significant proportion of patients who cannot undergo long-term oral anticoagulation. As the left atrial appendage is of major relevance for atrial fibrillation-induced thrombus formation, catheter-based or surgical closure of the left atrial appendage appears to be a promising therapeutic option. Large regi...
Source: Herz - May 12, 2019 Category: Cardiology Tags: Herz Source Type: research

Comparative effectiveness of rivaroxaban versus a vitamin K antagonist in patients with renal impairment treated for non-valvular atrial fibrillation in Germany — A retrospective cohort study
ConclusionThe prescription of rivaroxaban in patients with NVAF and renal impairment was associated with a lower incidence of ischaemic stroke and intracranial haemorrhage versus phenprocoumon in patients without evidence of cancer.
Source: IJC Heart and Vasculature - May 9, 2019 Category: Cardiology Source Type: research

Correlation Between Intracranial Arterial Calcification and Imaging of Cerebral Small Vessel Disease
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

29.04.19: Not intended for U.S. and UK Media
Study reaffirms safety and efficacy profile of Xarelto™ for the prevention of stroke in patients with atrial fibrillationFirst results from RELOADED, an observational study in the EU, indicate that non-vitamin-K oral anticoagulants (NOACs) like Xarelto provide a benefit in renal preservation over time when compared to the vitamin-K antagonist (VKA) phenprocoumon / The data from the comparative effectiveness study in Germany confirm an improved safety outcome and comparable effectiveness for Xarelto compared with phenprocoumon in patients with non-valvular atrial fibrillation (NVAF), including those with renal insufficiency(1)mehr ...
Source: Bayer IR Newsfeed: Events - April 28, 2019 Category: Pharmaceuticals Source Type: news

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Propensity Score-Matched Analysis of Lesion Patterns in Stroke Patients With Patent Foramen Ovale and Patients With Spontaneous Intracranial Artery Dissection
Conclusion: The present study suggests that lesion patterns observed from DWI of patients with PFO and SIAD might provide clues to the etiology of infarcts. Single lesions (cortical or subcortical) might be a typical feature of PFO associated strokes, while multiple lesions in one vascular territory might be a specific feature of SIAD associated strokes. Introduction Both patent foramen ovale (PFO) and spontaneous intracranial artery dissection (SIAD) are important stroke risk factors, especially in young and middle-aged adults (1–3). About 25% of patients with ischemic stroke are cryptogenic (4), and PFO is ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Ischemic stroke risk estimation in patients without oral anticoagulation: an observational cohort study based on secondary data from Germany
Oral anticoagulants can cause potentially serious adverse events. Therefore, before prescribing oral anticoagulants for ischemic stroke prevention in patients with atrial fibrillation (AF), stroke risk assessm...
Source: BMC Cardiovascular Disorders - April 23, 2019 Category: Cardiology Authors: Felix S. Wicke, Martin A. Schaller, Kateryna Karymova, Martin Beyer and Beate S. M üller Tags: Research article Source Type: research

Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), t...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Digitalis therapy is associated with higher comorbidities and poorer prognosis in patients undergoing ablation of atrial arrhythmias: data from the German Ablation Registry
ConclusionIn the present study of patients undergoing catheter ablation of supraventricular arrhythmias, an association of digitalis therapy with increased mortality and an increased rate of other severe adverse events were observed. The results from this ‘real-life’ registry are consistent with previously published studies. However, whether digitalis therapy promotes a poorer prognosis or may just serve as a marker for this aspect cannot be thoroughly interpreted.
Source: Clinical Research in Cardiology - February 23, 2019 Category: Cardiology Source Type: research

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