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Source: Journal of the American College of Cardiology

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Total 269 results found since Jan 2013.

Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort
Conclusions: In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease.
Source: Journal of the American College of Cardiology - May 3, 2013 Category: Cardiology Authors: Marco R. Di Tullio, Zhezhen Jin, Cesare Russo, Mitchell S.V. Elkind, Tatjana Rundek, Mitsuhiro Yoshita, Charles DeCarli, Clinton B. Wright, Shunichi Homma, Ralph L. Sacco Tags: Patent Foramen Ovale and Stroke Source Type: research

New Ischemic Stroke and Outcomes With Vorapaxar Versus Placebo Results From the TRA 2°P-TIMI 50 Trial
BackgroundVorapaxar, a novel antiplatelet therapy, reduces thrombotic events in patients with a history of myocardial infarction (MI) or peripheral artery disease (PAD); however, because of an increased risk of intracranial hemorrhage, it is contraindicated in patients with a history of stroke.ObjectivesThe aim of this study was to investigate the incidence of new ischemic stroke and subsequent death or intracerebral hemorrhage in patients with MI or PAD and no cerebrovascular disease (CVD) treated with vorapaxar.MethodsThe TRA 2°P-TIMI 50 (Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in ...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Comparative Performance of ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation Results From a National Primary Care Database
ConclusionsThe ATRIA score performed better in the U.K. Clinical Practice Research Datalink AF cohort. It more accurately identified low-risk patients than the CHA2DS2-VASc score, which assigned these patients to higher-risk categories. Such reclassification of stroke risk could prevent overuse of anticoagulants in very low stroke risk patients with AF.
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

Device Closure of Patent Foramen Ovale After Stroke Pooled Analysis of Completed Randomized Trials
ConclusionsAmong patients with PFO and cryptogenic stroke, closure reduced recurrent stroke and had a statistically significant effect on the composite of stroke, transient ischemic attack, and death in adjusted but not unadjusted analyses.
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research

Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke
ConclusionsIndividuals with hypercholesterolemia and hypertension who fail to take their prescribed statin and antihypertensive medication experience a substantially increased risk of fatal stroke. The risk is lower if the patient is adherent to either one of these therapies.
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research

Refining Stroke Prediction in Atrial  Fibrillation Patients by Addition of African-American Ethnicity to CHA 2 DS 2 -VASc Score
Conclusions In patients> 65 years of age with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score  significantly improved stroke prediction.
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Carotid Stiffness Is Associated With Incident Stroke A Systematic Review and Individual Participant Data Meta-Analysis
ConclusionsCarotid stiffness is associated with incident stroke independently of CV factors and aortic stiffness. In addition, carotid stiffness improves stroke risk prediction beyond Framingham and aortic stiffness.
Source: Journal of the American College of Cardiology - November 2, 2015 Category: Cardiology Source Type: research

N-Terminal Pro–B-Type Natriuretic Peptide for Risk Assessment in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation)
This study sought to assess the prognostic value of N-terminal pro–B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF) enrolled in the ARISTOTLE (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation) trial, and the treatment effect of apixaban according to NT-proBNP levels.Background: Natriuretic peptides are associated with mortality and cardiovascular events in several cardiac diseases.Methods: In the ARISTOTLE trial, 18,201 patients with AF were randomized to apixaban or warfarin. Plasma samples at randomization were available from 14,892 patients. The association bet...
Source: Journal of the American College of Cardiology - April 5, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, Christina Christersson, Justin Ezekowitz, Bernard J. Gersh, Michael Hanna, Stefan Hohnloser, John Horowitz, Kurt Huber, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Gr Tags: Atrial Fibrillation Source Type: research

Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin Versus NOACs Versus LAA Closure
ConclusionsBoth NOACs and LAAC with the Watchman device were cost-effective relative to warfarin, but LAAC was also found to be cost-effective and to offer better value relative to NOACs. The results of this analysis should be considered when formulating policy and practice guidelines for stroke prevention in AF.
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation
Conclusions: Patients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545)
Source: Journal of the American College of Cardiology - April 24, 2013 Category: Cardiology Authors: Oluseun Alli, Shepal Doshi, Saibal Kar, Vivek Reddy, Horst Sievert, Chris Mullin, Vijay Swarup, Brian Whisenant, David Holmes Tags: Heart Rhythm Disorders Source Type: research

Age Threshold for Increased Stroke Risk Among Patients With Atrial Fibrillation A Nationwide Cohort Study From Taiwan
This study hypothesized that the age threshold (65 years) used in the CHA2DS2-VASc system for initiating oral anticoagulants (OACs) might be lower in Taiwanese AF patients than in non-Asians.MethodsWe used the National Health Insurance Research Database in Taiwan to study 186,570 nonanticoagulated AF patients. There were 9,416 males with a CHA2DS2-VASc score of 0 and 6,390 females with a CHA2DS2-VASc score of 1. Their risk of ischemic stroke was analyzed with stratification on the basis of age.ResultsThe annual risks of ischemic stroke for males (score 0) and females (score 1) were 1.15% and 1.12%, respectively, and contin...
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research

Standards and Barriers in Acute Stroke Therapy A Leap Forward in the Evolution of Endovascular Interventions for Stroke ∗
Whether interventional approaches to stroke neurology have lagged behind those aimed at heart attack—for reasons biological or practical—are topics for another day. However, the balance has changed. Tissue plasminogen activator (tPA) was first approved in the United States for intravenous administration to patients with acute stroke in 1996 (1), and a study for catheter-directed intra-arterial infusion of a thrombolytic agent for this indication was first published in 1998 (2). The first positive randomized controlled study using mechanical thrombectomy devices for stroke came from the Netherlands just last year (3), ...
Source: Journal of the American College of Cardiology - November 30, 2015 Category: Cardiology Source Type: research

Stroke Prediction in Atrial Fibrillation Is it Black and White? ∗
Atrial fibrillation (AF) is a common arrhythmia that predisposes patients to risk of stroke (1) that can be prevented with anticoagulation (2) . However, a minority of patients with AF and risk of stroke are treated with anticoagulants (3) , with undertreatment being due to a variety of factors. Optimizing treatment depends, in part, on the ability to understand risks, benefits, and personal preferences of individual patients. The CHADS 2 (congestive heart failure, hypertension, age  ≥75 years, diabetes, and 2 points for prior stroke or transient ischemic attack) scoring system has been useful for stratifying risk of ...
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research