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Stroke and death in elderly patients with atrial fibrillation in Japan compared with the United Kingdom
Conclusions Elderly (age ≥75 years) patients with AF in both Japan and the UK are at similarly high risk of stroke and death, with OAC still underused in both populations. Ethnicity was not independently associated with the risk of stroke, regardless of OAC use or non-use.
Source: Heart - November 10, 2016 Category: Cardiology Authors: Senoo, K., An, Y., Ogawa, H., Lane, D. A., Wolff, A., Shantsila, E., Akao, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Health care delivery, economics and global health care Source Type: research

CHADS2 and CHA2DS2-VASc score to assess risk of stroke and death in patients paced for sick sinus syndrome
Conclusions CHADS2 and CHA2DS2-VASc score are associated with increased risk of stroke and death in patients paced for SSS irrespective of the presence of AF.
Source: Heart - May 13, 2013 Category: Cardiology Authors: Svendsen, J. H., Nielsen, J. C., Darkner, S., Jensen, G. V. H., Mortensen, L. S., Andersen, H. R., on behalf of the DANPACE Investigators Tags: Open access, Drugs: cardiovascular system, Epidemiology Clinical trials Source Type: research

Stroke prevention by percutaneous closure of patent foramen ovale: a systematic review and meta-analysis
Conclusions Percutaneous closure of PFO in patients with cryptogenic stroke does not appear superior to medical therapy according to currently available randomised data. Furthermore, it is associated with an increased incidence of atrial fibrillation. However, there are signals pointing towards a potential benefit and more research should be strongly encouraged.
Source: Heart - February 10, 2014 Category: Cardiology Authors: Wolfrum, M., Froehlich, G. M., Knapp, G., Casaubon, L. K., DiNicolantonio, J. J., Lansky, A. J., Meier, P. Tags: Drugs: cardiovascular system, Epidemiology Aortic and vascular disease Source Type: research

Prediction of stroke in patients without atrial fibrillation using the CHADS2 and CHA2DS2-VASc scores: a justification for more widespread thromboprophylaxis?
The CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischaemic attack (TIA) (double)) and more recently, the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years (double score), diabetes mellitus, previous stroke/TIA (double score), vascular disease, age 65–74 years, sex category (female)) scores are validated clinical prediction tools commonly used to estimate the stroke risk in atrial fibrillation (AF) patients. More recently, the focus has been on initially identifying those patients at ‘low risk’ (ie, CHA2DS...
Source: Heart - September 9, 2014 Category: Cardiology Authors: Senoo, K., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research

Ethnicity and stroke risk in patients with atrial fibrillation
Conclusions Despite a reduced prevalence of AF among South Asian patients, their risk of stroke is higher than for white patients or black African/Caribbean patients in association with diabetes, cardiovascular disease, and hypertension. Under-prescription of anticoagulation persists in all ethnic groups, a deficit most pronounced in the elderly. Use of the CHA2DS2VASc score would enhance optimal management in primary care.
Source: Heart - July 5, 2013 Category: Cardiology Authors: Mathur, R., Pollara, E., Hull, S., Schofield, P., Ashworth, M., Robson, J. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Heart rhythm disorders Source Type: research

Stroke prevention for patients with atrial fibrillation: improving but not perfect yet
Atrial fibrillation (AF) is the most common cardiac rhythm disorder1 and one of the most important risk factors for stroke, particularly in the elderly. Stroke-related AF is associated with significant morbidity, mortality and healthcare costs.2 Although we have abundant evidence from randomised trials that anticoagulation, and to a lesser extent antiplatelet therapy, is highly efficacious in preventing stroke in patients with AF, these therapies remain underused, especially in older patients. With an ageing population and an AF prevalence that is rapidly rising,1 a better understanding of the stroke prevention practices i...
Source: Heart - July 19, 2013 Category: Cardiology Authors: Sandhu, R. K., McAlister, F. A. Tags: Health policy, Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Cognitive outcomes after acute coronary syndrome: a population based comparison with transient ischaemic attack and minor stroke
Conclusions Risk of cognitive impairment after ACS is similar to minor stroke and higher than TIA with implications for clinical practice including consent and adherence with medication. Differences in cognitive domain performance suggest a greater role for degenerative brain pathology in ACS which may be linked to vascular risk profile and cardiac factors.
Source: Heart - September 20, 2013 Category: Cardiology Authors: Volonghi, I., Pendlebury, S. T., Welch, S. J. V., Mehta, Z., Rothwell, P. M. Tags: Acute coronary syndromes, Drugs: cardiovascular system, Hypertension, Epidemiology, Tobacco use Source Type: research

Prediction of stroke or TIA in patients without atrial fibrillation using CHADS2 and CHA2DS2-VASc scores
Conclusions In patients with ACS but no AF, the CHADS2 and CHA2DS2-VASc scores predict ischaemic stroke/TIA events with similar accuracy to that observed in historical populations with non-valvular AF, but with lower absolute event rates. Further study of the utility of the CHADS2 and CHA2DS2-VASc scores for the assessment of thromboembolic risk and selection of antithrombotic therapy in patients without AF is warranted.
Source: Heart - September 9, 2014 Category: Cardiology Authors: Mitchell, L. B., Southern, D. A., Galbraith, D., Ghali, W. A., Knudtson, M., Wilton, S. B., for the APPROACH investigators Tags: Drugs: cardiovascular system, Epidemiology Coronary artery disease Source Type: research

Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure
Conclusions Patients with ASD had a higher risk of first-time AF after closure than the comparison cohort. There was no effect of closure on the use of AF-related medicine in patients with prevalent AF.
Source: Heart - April 9, 2015 Category: Cardiology Authors: Nyboe, C., Olsen, M. S., Nielsen-Kudsk, J. E., Hjortdal, V. E. Tags: Congenital heart disease in adult patients, Congenital heart disease, Drugs: cardiovascular system, Epidemiology Source Type: research

Atrial appendage occlusion for stroke prevention in patients with atrial fibrillation
In the developed countries, stroke is an important cause of mortality and disability. Cardioembolism is the most frequent cause of ischaemic stroke, in the presence of atrial fibrillation (AF).1 AF is the most common cardiac arrhythmia in the general population and its prevalence increases with age; the lifetime risk of AF development is 25% in people over 40 years old.2 Anticoagulation has been established as an effective treatment strategy for stroke prevention in patients with AF and risk factors for stroke.3 The new oral anticoagulants (NOACs) seem to be similarly efficacious compared with vitamin K antagonists (V...
Source: Heart - November 24, 2016 Category: Cardiology Authors: Swaans, M. J., Boersma, L. V. A. Tags: Drugs: cardiovascular system, Echocardiography, Hypertension, Interventional cardiology, Clinical diagnostic tests, Epidemiology Editorials Source Type: research

Associations with anticoagulation: a cross-sectional registry-based analysis of stroke survivors with atrial fibrillation
Conclusions Anticoagulation was underused in this high-risk population, and those at highest risk were less likely to be treated. Strategies need to be developed to improve prescription of anticoagulation treatment.
Source: Heart - March 5, 2014 Category: Cardiology Authors: Abdul-Rahim, A. H., Wong, J., McAlpine, C., Young, C., Quinn, T. J. Tags: Drugs: cardiovascular system Cardiac risk factors and prevention Source Type: research

Risk of left atrial appendage thrombus and stroke in patients with atrial fibrillation and mitral regurgitation
Conclusions Among patients with NVAF, the presence or severity of MR was not associated with a decreased risk of LAAT or stroke.
Source: Heart - December 10, 2021 Category: Cardiology Authors: Melduni, R., Nkomo, V. T., Wysokinski, W., Gersh, B. J., Deshmukh, A., Padang, R., Greene, E. L., Oh, J. K., Lee, H.-C. Tags: Arrhythmias and sudden death Source Type: research

Rivaroxaban and other novel anticoagulants for stroke prevention in atrial fibrillation: time to embrace the future
Atrial fibrillation (AF) is now said to be at epidemic proportions.1 Although symptoms and heart failure are two of the main reasons that patients with AF suffer from reduced quality of life, thromboembolic complications, particularly stroke, remain the major determinant of significant morbidity and mortality.2 Importantly, the risk of thromboembolism (TE) is completely irrespective of symptoms, and hence the sad fact that people continue to present with catastrophic stroke in AF with no prior history of its detection.3 Appropriate anticoagulation is imperative to reduce the TE/stroke risk. Numerous large scale studies hav...
Source: Heart - February 18, 2013 Category: Cardiology Authors: Rajappan, K. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

To occlude or not? Left atrial appendage occlusion for stroke prevention in atrial fibrillation
The cornerstone of atrial fibrillation (AF) management is effective stroke prevention, which by now remains the only proven method of improved survival in patients with AF. Oral anticoagulation with the use of vitamin K antagonists (eg, warfarin) or non-vitamin K antagonist oral anticoagulants (NOACs) has been shown to substantially reduce the risk of AF-related strokes and thus is presently the standard of care for stroke prevention in non-valvular AF. Approximately 90% of thrombi being formed in AF are localised in left atrial appendage (LAA).1 Thus, LAA exclusion seems a tempting method of prophylaxis against stroke, pa...
Source: Heart - January 4, 2017 Category: Cardiology Authors: Mazurek, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Net clinical benefit of warfarin in individuals with atrial fibrillation across stroke risk and across primary and secondary care
Conclusions CHA2DS2-VASc accurately stratifies IS risk in individuals with AF across both primary and secondary care. However, the incidence rate of ischaemic stroke at CHA2DS2-VASc=1 are lower than previously reported, which may change the decision to start anticoagulation with warfarin in these individuals.
Source: Heart - January 12, 2017 Category: Cardiology Authors: Allan, V., Banerjee, A., Shah, A. D., Patel, R., Denaxas, S., Casas, J.-P., Hemingway, H. Tags: Open access, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research

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