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Source: The American Journal of Medicine

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Total 163 results found since Jan 2013.

Cholangiocarcinoma manifesting as non-bacterial thrombotic endocarditis in a young patient
A 41-year-old female with steroid-dependent rheumatoid arthritis and a recent (four months prior) cerebellar stroke presented with complaints of constant headache and right eye blindness of one day.  At the time of the cerebellar stroke, she had presented with persistent headaches, dizziness and gait instability. That workup, including hypercoagulability evaluation, was unremarkable apart from the radiographic abnormalities diagnosing her left medial cerebellar hemisphere infarct. She was disc harged with a plan for outpatient loop recorder placement and aspirin for secondary stroke prevention.
Source: The American Journal of Medicine - January 24, 2020 Category: General Medicine Authors: Ninad Nadkarni, Young Ju Lee, Ryan Hoefen, Richard Alweis Tags: Diagnostic Dilemma Source Type: research

To the Horizon: The Brink of an AI Revolution in Prostate Cancer?
Noorbakhsh-Sabet et al.1 published an excellent review in The American Journal of Medicine summarizing the potential of artificial intelligence (AI) in medicine. They describe wide utility (e.g. in dermatology and stroke), but do not consider surgery and urology, which embrace cutting-edge technology, including fusion-biopsy and robotics,2 and will be early AI adopters. Indeed, prostate cancer creates a huge health care burden, thus being ideal for AI transformation.
Source: The American Journal of Medicine - January 16, 2020 Category: General Medicine Authors: Joseph M. Norris, Asif Raza Tags: Letter Source Type: research

Potential role of two-phase cardiac CT in patients with embolic stroke of undetermined source
Recent trials failed to demonstrate that anticoagulation was superior to antiplatelet agents in preventing recurrent stroke after embolic stroke of undetermined source (ESUS), which may be due to the heterogeneity of etiology. We thus investigated whether the use of two-phase cardiac CT could help to evaluate the etiology in patients with ESUS.
Source: The American Journal of Medicine - December 20, 2019 Category: General Medicine Authors: Shenqiang Yan, Ying Zhou, Quan Han, Yi Chen, Min Lou Tags: Brief Observation Source Type: research

Digital Management of Hypertension Improves Systolic Blood Pressure Variability
Higher systolic blood pressure variability has been shown to be a better predictor of all-cause and cardiovascular disease mortality, stroke, and cardiac disease compared with average systolic blood pressure.
Source: The American Journal of Medicine - December 20, 2019 Category: General Medicine Authors: Richard V. Milani, Jonathan K. Wilt, Alexander R. Milani, Robert M. Bober, Eric Malamud, Jonathan Entwisle, Carl J. Lavie Tags: Clinical Research Study Source Type: research

The Anti-Platelet Anomaly: Aspirin/Dipyridamole-Induced Acute Pancreatitis
We present a case of aspirin/dipyridamole-induced pancreatitis in an elderly patient. There was no other evidence suggesting any other etiology of pancreatitis for this patient. According to the Naranjo Adverse Drug Reaction Probability Scale, the association of pancreatitis is a probable reaction due to aspirin/dipyridamole.2 Although rare, this severe complication illustrates how physicians and clinical pharmacists should be aware of the risk of pancreatitis with aspirin/dipyridamole and the consequences regarding secondary stroke prevention after it occurs.
Source: The American Journal of Medicine - November 18, 2019 Category: General Medicine Authors: Daniel J. DeSantis, Punam B. Patel, Ludmila Gerova, Derek W. Grady Tags: Diagnostic Dilemma Source Type: research

Oral anticoagulation in emergency department patients: high rates of off-label doses,no difference in bleeding rates
Patients with oral anticoagulation constitute an increasing proportion in the present medical routine.1 The approval of the first direct oral anticoagulant (DOAC) dabigatran by the U.S. food and drug administration in 2010 for the purpose of stroke prevention in patients with non-valvular atrial fibrillation revolutionized the therapy strategies of this entity since the Vitamin-K antagonists (VKA) warfarin, phenprocoumon and acenocoumarol had been the only available oral anticoagulants for decades.
Source: The American Journal of Medicine - October 24, 2019 Category: General Medicine Authors: Corinne M. Eschler, Bertram K. Woitok, Georg-Christian Funk, Philipp Walter, Volker Maier, Aristomenis K. Exadaktylos, Gregor Lindner Tags: Clinical Research Study Source Type: research

Predictors of not initiating anticoagulation after incident venous thromboembolism: a Danish nationwide cohort study
Venous thromboembolism, com prising deep vein thrombosis and pulmonary embolism, is the third most common cause of cardiovascular death after stroke and myocardial infarction.1 Anticoagulation is the keystone in venous thromboembolism treatment and prevention of venous thromboembolism morbidity, mortality, and recurrence. International guidelines mandate anticoagulant therapy for a minimum of 3 months after proximal deep vein thrombosis and/or pulmonary embolism.2,3
Source: The American Journal of Medicine - October 10, 2019 Category: General Medicine Authors: Ida Ehlers Albertsen, Samuel Zachary Goldhaber, Gregory Piazza, Thure Filskov Overvad, Peter Br ønnum Nielsen, Torben Bjerregaard Larsen, Mette Søgaard Tags: Clinical Research Study Source Type: research

The Effect of Preexisting Anticoagulation on Cerebrovascular Events in Left-Sided Infective Endocarditis
The objective of this study was to evaluate the effect of anticoagulation on stroke occurrence and bleeding complications in patients with left-sided infective endocarditis.
Source: The American Journal of Medicine - September 5, 2019 Category: General Medicine Authors: Kyle A. Davis, Glen Huang, S. Allan Petty, Walter A. Tan, Diego Malaver, James E. Peacock Tags: Clinical Research Study Source Type: research

The effect of pre-existing anticoagulation on cerebrovascular events in left-sided infective endocarditis
The objective of this study was to evaluate the effect of anticoagulation on stroke occurrence and bleeding complications in patients with left-sided infective endocarditis.
Source: The American Journal of Medicine - September 5, 2019 Category: General Medicine Authors: Kyle A. Davis, Glen Huang, S. Allan Petty, Walter A. Tan, Diego Malaver MSA, James E. Peacock Tags: Clinical Research Study Source Type: research

Postoperative Atrial Fibrillation Following Noncardiac Surgery Increases Risk of Stroke
New-onset postoperative atrial fibrillation is well recognized to be an adverse prognostic marker in patients undergoing noncardiac surgery. Whether postoperative atrial fibrillation confers an increased risk of stroke remains unclear.
Source: The American Journal of Medicine - August 30, 2019 Category: General Medicine Authors: Anoop N. Koshy, Garry Hamilton, James Theuerle, Andrew W. Teh, Hui-Chen Han, Paul J. Gow, Han S. Lim, Vincent Thijs, Omar Farouque Tags: Clinical Research Study Source Type: research

Post-operative Atrial Fibrillation following Noncardiac Surgery Increases Risk of Stroke
New-onset post-operative atrial fibrillation is well recognized to be an adverse prognostic marker in patients undergoing noncardiac surgery. Whether post-operative atrial fibrillation confers an increased risk of stroke remains unclear.
Source: The American Journal of Medicine - August 30, 2019 Category: General Medicine Authors: Anoop N. Koshy, Garry Hamilton, James Theuerle, Andrew W Teh, Hui-Chen Han, Paul J. Gow, Han S Lim, Vincent Thijs, Omar Farouque Tags: Clinical Research Study Source Type: research

An unusual cause of stroke: Neurosarcoidosis
Source: The American Journal of Medicine - August 29, 2019 Category: General Medicine Authors: Sijie Jason Wang Tags: Diagnostic Dilemma Source Type: research

New-onset atrial fibrillation among patients with infection in the emergency department: A multicentre cohort study of one-year stroke risk
Patients with new-onset atrial fibrillation in relation to infection are frequent in emergency departments (ED) and may require antithrombotic therapy due to increased risk of stroke. Our objective was to describe the one-year risk of stroke in ED patients with infection, new-onset atrial fibrillation and no antithrombotic therapy.
Source: The American Journal of Medicine - August 9, 2019 Category: General Medicine Authors: Tobias Graversgaard Hansen, Anton Potteg ård MScPharm, Axel Brandes, Ulf Ekelund, Helene Kildegaard Jensen, Jakob Lundager Forberg, Mikkel Brabrand, Annmarie Touborg Lassen Tags: Clinical research study Source Type: research

Take-Home Messages From the Recently Updated AHA/ACC Guidelines for Atrial Fibrillation
Atrial fibrillation and congestive heart failure (CHF) are “growth industries” in 21st-century industrial nations. The rapid growth of the geriatric population in these countries plays an important role in the ever-increasing number of patients seen with these 2 clinical entities. Patients with atrial fibrillation are seen on a daily basis in both the c linic and the hospital. The most devastating complication resulting from atrial fibrillation is cerebral arterial embolism with resultant stroke.
Source: The American Journal of Medicine - August 8, 2019 Category: General Medicine Authors: Joseph S. Alpert Tags: Commentary Source Type: research

Varicella-zoster virus vasculopathy leading to multi-focal stroke in an immunocompromised patient
Source: The American Journal of Medicine - July 25, 2019 Category: General Medicine Authors: Sae K. Jang, Natalia E. Castillo Almeida, Randall Ambroz, Wilson Tags: Clinical Communication to the Editor Source Type: research

Central post-stroke pain with Wallenberg syndrome
Source: The American Journal of Medicine - July 24, 2019 Category: General Medicine Authors: Junki Mizumoto Tags: Clinical Communications to the Editor Source Type: research

Cholesterol lowering and stroke: no longer room for pleiotropic effects of statins – confirmation from PCSK9 inhibitor studies
The relationship between cholesterol levels and stroke has been much less clear than between cholesterol levels and coronary heart disease. This is likely mostly due to the inadequate power of older studies and the low intensity of cholesterol-lowering interventions at that time available. Because a reduction in stroke has been, conversely, clearly observed in trials with statins, for long “pleiotropic” effects of such drugs, unrelated to cholesterol lowering, have been invoked. In a previous analysis of all randomized trials of cholesterol-lowering treatments reporting on stroke we had, however, reached the conclusion...
Source: The American Journal of Medicine - July 11, 2019 Category: General Medicine Authors: Tanya Salvatore, Riccardo Morganti, Roberto Marchioli, Raffaele De Caterina Tags: Clinical Research Study Source Type: research

Cardiovascular and cerebrovascular safety of testosterone replacement therapy among aging men with low testosterone levels: a cohort study
We assessed the risk of ischemic stroke, transient ischemic attack, and myocardial infarction associated with testosterone replacement therapy (TRT) among aging men with low testosterone levels.
Source: The American Journal of Medicine - April 3, 2019 Category: General Medicine Authors: Simone Y. Loo, Laurent Azoulay, Rui Nie, Sophie Dell'Aniello, Oriana Hoi Yun Yu, Christel Renoux Tags: Clinical Research Study Source Type: research

Etiological research using observational data, and net clinical benefit. Simplicity and practicality matter
Atrial fibrillation in an elderly patient requires oral anticoagulant (OAC) treatment, and contemporary international guidelines recommend treatment for atrial fibrillation patients at 75years or older.1,2 Substantial evidence (mostly in favour) of non-vitamin K antagonist oral anticoagulants (NOACs), in comparison with warfarin, has emerged over the past decade. In particular, the benefits from a lower risk of intracranial bleeding and the non-requirement for monitoring of anticoagulant effects have driven the uptake of NOACs as the preferred choice for stroke prevention in atrial fibrillation, although some regional differences are evident.
Source: The American Journal of Medicine - March 5, 2019 Category: General Medicine Authors: Peter Br ønnum Nielsen, Iain Buchan, Gregory Y.H. Lip Tags: Editorial Source Type: research

Effectiveness and safety of off-label dose-reduced direct oral anticoagulants in atrial fibrillation
Direct oral anticoagulants (DOACs) reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation but may result in serious bleeding complications. Off-label dose-reduced use of DOAC to mitigate bleeding is common in routine clinical practice although data regarding its consequences on patient outcomes is limited. Therefore, our objective was to evaluate the effectiveness and safety of off-label dose-reduced versus per-label standard-dose DOAC treatment.
Source: The American Journal of Medicine - February 15, 2019 Category: General Medicine Authors: Ronen Arbel, Ruslan Sergienko, Ariel Hammerman, Sari Greenberg-Dotan, Erez Batat, Orly Avnery, Martin H. Ellis Source Type: research

Chronic Myocardial Injury and Risk for Stroke
This study aimed to investigate the association between chronic myocardial injury and stroke.
Source: The American Journal of Medicine - February 1, 2019 Category: General Medicine Authors: Linda Ryd én, Andreas Roos, Martin J Holzmann Tags: Clinical Research Study Source Type: research

Comparative stroke, bleeding, and mortality risks in older Medicare patients treated with oral anticoagulants for nonvalvular atrial fibrillation
Non-vitamin K antagonist oral anticoagulants (NOACs) are alternatives to warfarin in patients with nonvalvular atrial fibrillation. Randomized trials compared NOACs to warfarin, but none have compared individual NOACs against each other for safety and effectiveness.
Source: The American Journal of Medicine - January 9, 2019 Category: General Medicine Authors: David J. Graham, Elande Baro, Rongmei Zhang, Jiemin Liao, Michael Wernecke, Marsha E. Reichman, Mao Hu, Onyekachukwu Illoh, Yuqin Wei, Margie R. Goulding, Yoganand Chillarige, Mary Ross Southworth, Thomas E. MaCurdy, Jeffrey A. Kelman Tags: Clinical Research Study Source Type: research

The Reply
When preparing our review of patent foramen ovale closures,1 we were not aware of the 2013 report by Kent et al.,2 cited by Wani and colleagues in their comments. We would certainly agree that a cryptogenic stroke in a young patient without risk factors for cerebrovascular disease is more likely to be due to paradoxical embolism than a cryptogenic stroke in an elderly patient with risk factors for cerebrovascular disease.
Source: The American Journal of Medicine - October 27, 2018 Category: General Medicine Authors: James E Dalen Tags: Letter Source Type: research

RoPES, Strokes and Closures
We read with great interest the review article by Dalen and Alpert regarding “Which Patent Foramen Ovales Need Closure to Prevent Cryptogenic Strokes?”1 The authors have provided a succinct contemporary review and have also distinctively tabulated the results of the path-defining trials in this somewhat contentious field. The main message provided by the authors is that in patients with cryptogenic stroke, a patent foramen ovale associated with an atrial septal aneurysm should be closed and that closure is not indicated when an atrial septal aneurysm is absent.
Source: The American Journal of Medicine - October 27, 2018 Category: General Medicine Authors: Adil S. Wani, Suhail Q. Allaqaband, M. Fuad Jan Tags: Letter Source Type: research

Management of Acute Ischemic Stroke
The treatment of acute ischemic stroke has undergone a revolution recently with the publication of five positive thrombectomy trials in the early time window, 0-6 hours from stroke onset in 2015 and the more recent publication of two positive late window trials that included carefully selected patients up to 24 hours from stroke onset.1-3 The treatment efficacy of thrombectomy was highly robust in both time windows and the benefits can likely be expanded to less strictly selected patients. The treatment of acute ischemic stroke with thrombectomy built upon the more modest benefits observed previously with i.v.
Source: The American Journal of Medicine - October 25, 2018 Category: General Medicine Authors: Yunyun Xiong, Bharti Manwani, Marc Fisher Tags: Review Source Type: research

Concomitant use of direct oral anticoagulants with antiplatelet agents and the risk of major bleeding in patients with non-valvular atrial fibrillation
Direct oral anticoagulants (DOACs) are increasingly being used for ischemic stroke prevention among patients with non-valvular atrial fibrillation,1,2 partly because of their favorable efficacy and safety compared with vitamin K antagonists (VKAs).3 However, the safety of DOACs in patients with non-valvular atrial fibrillation requiring additional use of antiplatelet agents remains uncertain. This is important, as up to 30% of patients with non-valvular atrial fibrillation may receive concomitant treatments of oral anticoagulants with antiplatelets due to comorbid cardiovascular conditions.
Source: The American Journal of Medicine - October 25, 2018 Category: General Medicine Authors: Antonios Douros, Christel Renoux, Hui Yin, Kristian B. Filion, Samy Suissa, Laurent Azoulay Tags: Clinical Research Study Source Type: research

Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications
Atrial fibrillation is the most common arrhythmia in the United States and affects between 2.7 million and 6.1 million adults in the United States, with a lifetime risk of up to 1 in 4 adults over age 40 and a prevalence that is projected to double over the next 25 years.1,2 Though warfarin has long been the cornerstone of therapy to reduce the risk of stroke, several new direct oral anticoagulants (DOACs) have recently become available, beginning with FDA approval of dabigatran in October 2010, and followed by rivaroxaban in 2011, apixaban in 2014, and most recently edoxaban in 2015.
Source: The American Journal of Medicine - October 3, 2018 Category: General Medicine Authors: Benjamin A. Rodwin, Joseph A. Salami, Erica S. Spatz, Javier Valero-Elizondo, Salim S. Virani, Ron Blankstein, Michael J. Blaha, Khurram Nasir, Nihar R. Desai Tags: Clinical Research Study Source Type: research

Of Cardiac Holes and Crew Leaders
I enjoyed reading, and learned a lot from, Drs. Dalen and Alpert's article1 on closure of a foramen ovale to prevent cryptogenic stroke. It is a timely review that organizes evidence that, until now, had been somewhat confusing. In the article, the word foramen (from the Latin forare, meaning to pierce or bore a hole) was meant to appear 61 times. Unfortunately, it was mistakenly replaced by the word foremen (from the Dutch voormen, meaning the leaders of work crews, usually men, or the spokesmen for juries) on 27 of the 61 occasions.
Source: The American Journal of Medicine - October 1, 2018 Category: General Medicine Authors: Fernando Elijovich Tags: Letter Source Type: research

Improved Outcomes by Integrated Care of Anticoagulated Patients with Atrial Fibrillation Using the Simple ABC (Atrial Fibrillation Better Care) Pathway
Integrated care for the clinical management of atrial fibrillation patients is advocated as a holistic way to improve outcomes; the simple Atrial fibrillation Better Care (ABC) pathway has been proposed. The ABC pathway streamlines care as follows: ‘A’ Avoid stroke; ‘B’ Better symptom management; ‘C’ Cardiovascular and Comorbidity optimization.
Source: The American Journal of Medicine - August 25, 2018 Category: General Medicine Authors: Marco Proietti, Giulio Francesco Romiti, Brian Olshansky, Deirdre A. Lane, Gregory Y.H. Lip Tags: Clinical Research Study Source Type: research

Periprocedural Bridging Anticoagulation: Measuring the Impact of a Clinical Trial on Care Delivery
Warfarin remains the most commonly prescribed oral anticoagulant in North America for patients with atrial fibrillation.1 –3 Historically, when patients underwent surgical procedures, many clinicians chose to give shorter acting “bridging” anticoagulants to help reduce the risk of stroke while the effect of warfarin was wearing off before surgery or building back up after surgery. In response to observational stu dies, the BRIDGE trial was conducted to test the safety and efficacy of short acting low-molecular-weight heparin (LMWH) as a bridge before and after surgery in patients with atrial fibrillation treated with warfarin.
Source: The American Journal of Medicine - August 1, 2018 Category: General Medicine Authors: Geoffrey D Barnes, Yun Li, Xiaokui Gu, Brian Haymart, Eva Kline-Rogers, Steven Almany, Jay Kozlowski, Gregory Krol, Michael McNamara, James B Froehlich, Scott Kaatz Tags: Clinical Research Study Source Type: research

Dementia and Atrial Fibrillation: Pathophysiological Mechanisms and Therapeutic Implications
Dementia and atrial fibrillation have several epidemiologic characteristics in common, including high overall prevalence, increasing incidence with aging, and an expected rise in incidence.1,2 Atrial fibrillation has been associated more closely with dementia3-18 than other potentially comorbid age-related conditions.19,20 However, while atrial fibrillation increases the risk of stroke by a factor of 4- to 5-fold,21 it is uncertain whether cognitive impairment in the context of atrial fibrillation is mediated by an increased risk of stroke or whether other factors are responsible.
Source: The American Journal of Medicine - August 1, 2018 Category: General Medicine Authors: Romain Chopard, Gregory Piazza, Seth Alan Gale, Umberto Campia, Ida Ehlers Albertsen, Jisoo Kim, Samuel Z. Goldhaber Tags: Review The American Journal of Medicine Source Type: research

Diastolic hypotension may attenuate benefits from intensive systolic targets: secondary analysis of a randomized controlled trial
The potential for harm due to excessive lowering of diastolic blood pressure as a result of antihypertensive treatment has been discussed for several decades.1 Numerous observational studies and secondary analyses of randomized data have suggested that treating diastolic blood pressure below a certain threshold may lead to adverse outcomes, including a higher incidence of coronary events, stroke, heart failure, and all-cause mortality.1 –6 Proposed mechanisms include reduced endocardial perfusion leading to coronary events,7 or flow limiting coronary stenosis.
Source: The American Journal of Medicine - June 12, 2018 Category: General Medicine Authors: Todd C. Lee, Rodrigo B. Cavalcanti, Emily G. McDonald, Louise Pilote, James M. Brophy Tags: A Clinical Research Study Source Type: research

To Reduce Stroke with PFO Closure, Respect the Shunt
We read with interest the very timely updated meta-analysis regarding closure of patent foramen ovale for cryptogenic stroke by Vaduganathan et  al.1 They suggest a marked benefit in stroke prevention with an increase in the incidence of atrial fibrillation. However, we would like to draw your attention to a few caveats that are important for clinicians dealing with this situation and expand on the pooled analysis using the same 5 trials i ncluded in the current paper.2-6
Source: The American Journal of Medicine - May 19, 2018 Category: General Medicine Authors: Arka Chatterjee, Mark A. Law Tags: Letter Source Type: research

Patent Foramen Ovale Closure Versus Medical Therapy After Cryptogenic Stroke
We read with great interest the recent updated meta-analysis by Vaduganathan et  al evaluating patent foramen ovale closure for prevention of cryptogenic stroke.1 Although we congratulate and applaud their excellent work, we would like to comment on several important issues in the study.
Source: The American Journal of Medicine - May 19, 2018 Category: General Medicine Authors: Hong-Tao Tie, Rui Shi Tags: Letter Source Type: research

Twenty-Five-Year (1986-2011) Trends in the Incidence and Death Rates of Stroke Complicating Acute Myocardial Infarction
The occurrence of a stroke after an acute myocardial infarction is associated with increased morbidity and mortality rates. However, limited data are available, particularly from a population-based perspective, about recent trends in the incidence and mortality rates associated with stroke complicating an acute myocardial infarction.The purpose of this study was to examine 25-year trends (1986-2011) in the incidence and in-hospital mortality rates of initial episodes of stroke complicating acute myocardial infarction.
Source: The American Journal of Medicine - May 3, 2018 Category: General Medicine Authors: Essa Hariri, Mayra Tisminetzky, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg Tags: Clinical Research Study Source Type: research

Twenty-five year (1986-2011) trends in the incidence and death rates of stroke complicating acute myocardial infarction
: The occurrence of a stroke after an acute myocardial infarction is associated with increased morbidity and mortality. However, limited data are available, particularly from a population-based perspective, about recent trends in the incidence and death rates associated with stroke complicating an acute myocardial infarction.
Source: The American Journal of Medicine - May 3, 2018 Category: General Medicine Authors: Essa Hariri, Mayra Tisminetzky, Darleen Lassard, Jorge Yarzebski, Joel Gore, Robert Goldberg Source Type: research

Comparative Trends in Heart Disease, Stroke, and All-Cause Mortality in the United States and a Large Integrated Healthcare Delivery System
We examined whether differences in recent trends in heart disease, stroke, and total mortality exist in the United States and Kaiser Permanente Northern California (KPNC), a large integrated healthcare delivery system.
Source: The American Journal of Medicine - April 2, 2018 Category: General Medicine Authors: Stephen Sidney, Michael E. Sorel, Charles P. Quesenberry, Marc G. Jaffe, Matthew D. Solomon, Mai N. Nguyen-Huynh, Alan S. Go, Jamal S. Rana Tags: Clinical Research Study Source Type: research

Patent Foramen Ovale Closure for Secondary Prevention of Cryptogenic Stroke: Updated Meta-Analysis of Randomized Clinical Trials
• In patients with recent cryptogenic stroke, percutaneous closure of patent foramen ovale reduced recurrent stroke/transient ischemic attack compared with medical therapy, but was associated with higher risk of new-onset atrial fibrillation/flutter.• Select, young patients (≤60 years) present ing with recent cryptogenic stroke may benefit from percutaneous closure of patent foramen ovale at relatively low procedural risk.
Source: The American Journal of Medicine - December 8, 2017 Category: General Medicine Authors: Muthiah Vaduganathan, Arman Qamar, Ankur Gupta, Navkaranbir Bajaj, Harsh B. Golwala, Ambarish Pandey, Deepak L. Bhatt Tags: Brief Observation Source Type: research

Prognostic Impact of Mild Hypokalemia in Terms of Death and Stroke in the General Population —A Prospective Population Study
Potassium supplementation reduces the risk of cardiovascular mortality and stroke in population studies; however, the prognostic impact of mild hypokalemia in the general population has not been thoroughly investigated. We aimed to investigate associations between mild hypokalemia and endpoints in the general population.
Source: The American Journal of Medicine - October 9, 2017 Category: General Medicine Authors: Nick Mattsson, Olav Wendelboe Nielsen, Linda Johnson, Eva Prescott, Peter Schnohr, Gorm Boje Jensen, Lars K øber, Ahmad Sajadieh Tags: Clinical Research Study Source Type: research

Renal function considerations for stroke prevention in atrial fibrillation
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in n...
Source: The American Journal of Medicine - May 11, 2017 Category: General Medicine Authors: John Fanikos, Allison E. Burnett, Charles E. Mahan, Paul P. Dobesh Tags: Review Source Type: research

Prevalence and Significance of Unrecognized Renal Dysfunction in Patients with Stroke
Unrecognized renal dysfunction, defined as an estimated glomerular filtration rate
Source: The American Journal of Medicine - May 20, 2016 Category: Journals (General) Authors: David Pereg, Zach Rozenbaum, Dina Vorobeichik, Nir Shlomo, Ronit Gilad, Sivan Bloch, Morris Mosseri, David Tanne Tags: Clinical research study Source Type: research

Healthy Lifestyle and Functional Outcomes from Stroke in Women
While a healthy lifestyle has been associated with reduced risk of developing ischemic stroke, less is known about its effect on stroke severity.
Source: The American Journal of Medicine - February 17, 2016 Category: Journals (General) Authors: Pamela M. Rist, Julie E. Buring, Carlos S. Kase, Tobias Kurth Tags: Clinical Research Study Source Type: research

Apparent Treatment-Resistant Hypertension among Individuals with History of Stroke or Transient Ischemic Attack
and Purpose. Blood pressure control is a paramount goal in secondary stroke prevention; however, high prevalence of uncontrolled blood pressure and use of multiple antihypertensive medication classes in stroke patients suggest this goal is not being met. We determined the prevalence and factors associated with apparent treatment-resistant hypertension in persons with/without stroke or transient ischemic attack..
Source: The American Journal of Medicine - March 11, 2015 Category: Journals (General) Authors: Virginia J. Howard, Rikki M. Tanner, Aaron Anderson, Marguerite R. Irvin, David A. Calhoun, Daniel T. Lackland, Suzanne Oparil, Paul Muntner Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independently of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Tags: Review Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke A new kid on the block
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independent of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Source Type: research

The Reply
Braillon contends that we should have stressed the poor and unacceptable levels of quality of care for ischemic stroke, which was even worse for transient ischemic attack. We do not agree that the quality of care for ischemic stroke was unacceptable and poor.
Source: The American Journal of Medicine - February 22, 2015 Category: Journals (General) Authors: Sripal Bangalore, Lee Schwamm, Eric E. Smith, Inder M. Singh, Li Liang, Gregg C. Fonarow, Deepak L. Bhatt, Get With the Guidelines-Stroke Steering Committee and Investigators Tags: AJM online Source Type: research

The Association between Red Cell Distribution Width and Stroke in Patients with Atrial Fibrillation
Red cell distribution width is associated with increased risk of cardiovascular morbidity and mortality. We aimed to assess its association with stroke in patients with atrial fibrillation.
Source: The American Journal of Medicine - October 14, 2014 Category: Journals (General) Authors: Walid Saliba, Ofra Barnett-Griness, Mazen Elias, Gad Rennert Source Type: research

Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: A nationwide cohort study
This study revealed, that in clinical practice, vitamin K antagonist-experienced patients with a history of stroke or transient ischemic attack who switch to dabigatran therapy may have an increased rate of a recurrent stroke compared to patients persisting with vitamin K antagonist therapy.
Source: The American Journal of Medicine - September 1, 2014 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Lars Hvilsted Rasmussen, Anders Gorst-Rasmussen, Flemming Skjøth, Deirdre A. Lane, Gregory Y.H. Lip Source Type: research