Filtered By:
Source: Journal of the American College of Cardiology

This page shows you your search results in order of relevance. This is page number 2.

Order by Relevance | Date

Total 269 results found since Jan 2013.

Patients With Atrial Fibrillation and a CHA 2 DS 2 -VASc Score of 1 Are They at Low or High Stroke Risk? ∗
Nonvalvular atrial fibrillation carries a risk for developing ischemic stroke that is lowered by anticoagulant therapy (1). This risk is not uniform and depends on whether a patient has either none or ≥1 of the following factors, known as the CHA2DS2-VASc stroke risk score: congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category. Both European (2) and U.S. (3) guidelines advocate estimation of a patient’s stroke risk by use of the CHA2DS2-VASc score for initial risk stratification. The European Society of Cardiol...
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Left Atrial Appendage Closure as an Alternative to Warfarin for Stroke Prevention in Atrial Fibrillation A Patient-Level Meta-Analysis
ConclusionsIn patients with NVAF at increased risk for stroke or bleeding who are candidates for chronic anticoagulation, LAAC resulted in improved rates of hemorrhagic stroke, cardiovascular/unexplained death, and nonprocedural bleeding compared to warfarin.
Source: Journal of the American College of Cardiology - June 15, 2015 Category: Cardiology Source Type: research

Mechanical Thrombectomy for Acute Ischemic Stroke A Meta-Analysis of Randomized Trials
This study systematically determined if mechanical thrombectomy after usual care would be associated with better outcomes in patients with acute ischemic stroke caused by large artery occlusion.MethodsThe authors included randomized trials that compared mechanical thrombectomy after usual care versus usual care alone for acute ischemic stroke. Random effects summary risk ratios (RR) were constructed using a DerSimonian and Laird model.ResultsNine trials with 2,410 patients were available for analysis. Compared with usual care alone, mechanical thrombectomy was associated with a higher incidence of achieving good functional...
Source: Journal of the American College of Cardiology - November 30, 2015 Category: Cardiology Source Type: research

Recent Endovascular Stroke Trials and Their Impact on Stroke Systems of Care
Five recently published randomized trials of endovascular therapy versus medical management, including intravenous thrombolysis, demonstrated strong positive data in support of intra-arterial thrombectomy procedures. The American Heart Association/American Stroke Association released a focused update of the 2013 guidelines on the early management of acute ischemic strokes to specifically incorporate the findings of the 5 “positive” trials. In this review, we examine the key results of those trials and the principal changes in the updated guidelines. We discuss the ongoing and future changes in stroke systems of care, w...
Source: Journal of the American College of Cardiology - May 30, 2016 Category: Cardiology Source Type: research

Aspirin Instead of Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Risk for Stroke
ConclusionsIn a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC. Specific patient characteristics predicted prescription of aspirin therapy over OAC.
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation: The Loire Valley Atrial Fibrillation Project
Conclusions: Renal impairment was not an independent predictor of IS/TE in patients with AF and did not significantly improve the predictive ability of the CHADS2 or CHA2DS2-VASc scores.
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Amitava Banerjee, Laurent Fauchier, Patrick Vourc'h, Christian R. Andres, Sophie Taillandier, Jean Michel Halimi, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Vorapaxar, Combination Antiplatelet Therapy, and Stroke ∗
Drugs that inhibit platelet activation and aggregation reduce vascular events, notably myocardial infarction (MI) and ischemic stroke, and are generally associated with low rates of bleeding (1). Available agents inhibit platelets via distinct mechanisms (Table 1) (2), and combining antiplatelet drugs with different mechanisms of action should enhance net antithrombotic activity. For over a decade, the standard of care in patients with acute coronary syndromes, particularly those undergoing coronary stent implantation, has been dual antiplatelet therapy with aspirin plus an adenosine diphosphate receptor antagonist. When ...
Source: Journal of the American College of Cardiology - December 1, 2014 Category: Cardiology Source Type: research

Reply Comparing the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Scores for Stroke Prediction in Atrial Fibrillation
We tested the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke), and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) stroke risk scores in the CPRD (Clinical Practice Research Datalink) cohort of incident atrial fibrillation (AF) patients not using oral anticoagulants (OAC) because these are the patients for whom physicians must make the OAC treatment decision (1). The mean patient follo...
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research

Patent Foramen Ovale Science: Keeping the Horse in Front of the Cart∗
Compared with a prevalence of 25% in the general population, the higher prevalence of patent foramen ovale (PFO) in cryptogenic stroke (CS) patients has led to the intuitive conclusion that PFO is a risk factor for CS . However, distinguishing truly culpable PFOs from the innocent bystanders has been difficult. Some have advocated closure for just about any PFO , an approach which subjects people (many are not yet “patients” with any PFO-related neurological or other clinical syndrome) to procedural and device-related risks. This clearly puts the cart before the horse. PFO closure for secondary stroke prevention contin...
Source: Journal of the American College of Cardiology - May 3, 2013 Category: Cardiology Authors: Deeb N. Salem, David E. Thaler Tags: Patent Foramen Ovale and Stroke: Editorial Comment Source Type: research

The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)
Objectives: The goal of this study was to analyze the impact of dabigatran plasma concentrations, patient demographics, and aspirin (ASA) use on frequencies of ischemic strokes/systemic emboli and major bleeds in atrial fibrillation patients.Background: The efficacy and safety of dabigatran etexilate were demonstrated in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, but a therapeutic concentration range has not been defined.Methods: In a pre-specified analysis of RE-LY, plasma concentrations of dabigatran were determined in patients treated with dabigatran etexilate 110 mg twice daily (bid) ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: Paul A. Reilly, Thorsten Lehr, Sebastian Haertter, Stuart J. Connolly, Salim Yusuf, John W. Eikelboom, Michael D. Ezekowitz, Gerhard Nehmiz, Susan Wang, Lars Wallentin, RE-LY Investigators Tags: Antithrombotic Therapy Source Type: research

Effect of Diabetes and Glycemic Control on Ischemic Stroke Risk in AF Patients ATRIA Study
BackgroundDiagnosed diabetes mellitus (DM) is a consistently documented risk factor for ischemic stroke in patients with atrial fibrillation (AF).ObjectivesThe purpose of this study was to assess the association between duration of diabetes and elevated hemoglobin A1c (HbA1c) with risk of stroke among diabetic patients with AF.MethodsWe assessed this association in the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) California community-based cohort of AF patients (study years 1996 to 2003) where all events were clinician adjudicated. We used Cox proportional hazards regression to estimate the rate of isc...
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research

Predicting Stroke in Patients With Atrial Fibrillation An Incomplete Picture Without Considering Quality of Anticoagulation
Van den Ham et al. (1) nicely compare the new stroke risk stratification tool anticoagulation and risk factors in atrial fibrillation (ATRIA) with CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism, Vascular disease, Age 65–74 years, Sex category [female]) in patients with atrial fibrillation.
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research

Comparing the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Scores for Stroke Prediction in Atrial Fibrillation
Van den Ham et al. (1) recently compared the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack), and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) stroke risk scores in a primary care community cohort of patients with first-diagnosed atrial fibrillation (AF) not using oral anticoagulation (OAC) for undefined reasons. They concluded that improved risk ...
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research

Acute Ischemic Stroke Intervention
Acute ischemic stroke (AIS) is the leading cause of disability worldwide and among the leading causes of mortality. Although intravenous tissue plasminogen activator (IV-rtPA) was approved nearly 2 decades ago for treatment of AIS, only a minority of patients receive it due to a narrow time window for administration and several contraindications to its use. Endovascular approaches to recanalization in AIS developed in the 1980s, and recently, 5 major randomized trials showed an overwhelming superior benefit of combining endovascular mechanical thrombectomy with IV-rtPA over IV-rtPA alone. In this paper, we discuss the evol...
Source: Journal of the American College of Cardiology - May 30, 2016 Category: Cardiology Source Type: research

Lack of Stroke Subtype Information May Hinder Indirect Comparison Between the ROCKET-AF and Other Trials of New Oral Anticoagulants
Although we agree with Lip et al. () on the limitation of their study, we argue that lack of stroke subtype information may hinder scientific conclusion by including the ROCKET-AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) in any indirect comparison of new oral anticoagulants (NOA).
Source: Journal of the American College of Cardiology - January 30, 2013 Category: Cardiology Authors: Hai-feng Li, Ren-liang Zhao Tags: Letters to the Editor Source Type: research