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Total 186 results found since Jan 2013.
Correspondence New oral anticoagulants in patients with atrial fibrillation
Christian Ruff and colleagues' meta-analysis reports substantial reductions in stroke and all-cause mortality by use of the new oral anticoagulants (NOACs) compared with warfarin for atrial fibrillation, justifying their increasing use, but also the unequivocal increased risk of gastrointestinal bleeding. Furthermore, the trials included patients with a presumed low risk of gastrointestinal complications and therefore the true risk might be greater outside the clinical trial setting.
Source: LANCET - July 4, 2014 Category: Journals (General) Authors: Michael J R Desborough, Vipul Jairath Tags: Correspondence Source Type: research
Correspondence Metabolic mediators of body-mass index and cardiovascular risk
The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration reported that nearly half of the excess risk of body-mass index (BMI) on coronary heart disease and three-quarters of that on stroke is mediated through blood pressure, cholesterol, and markers of glycaemia. Although these findings correctly support the idea that the adverse effects of high BMI can be substantially mitigated by targeting its metabolic mediators, the report's results underestimate by about 25% the extent to which these metabolic factors mediate the effects of BMI on cardiovascular risk.
Source: LANCET - June 13, 2014 Category: Journals (General) Authors: David Wormser, Angela M Wood, Emanuele Di Angelantonio, Simon G Thompson, John Danesh, for the Emerging Risk Factors Collaboration Tags: Correspondence Source Type: research
Articles Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775 385 individuals and 12 539 strokes
The excess risk of stroke associated with diabetes is significantly higher in women than men, independent of sex differences in other major cardiovascular risk factors. These data add to the existing evidence that men and women experience diabetes-related diseases differently and suggest the need for further work to clarify the biological, behavioural, or social mechanisms involved.
Source: LANCET - June 6, 2014 Category: Journals (General) Authors: Sanne A E Peters, Rachel R Huxley, Mark Woodward Tags: Articles Source Type: research
Comment Sex disparity in the risk of diabetes-associated stroke
In the general population, stroke is more prevalent in men than in women. Men also have a higher age-specific stroke incidence than women, except for women aged 35–44 years and those older than 85 years. Factors such as pregnancy and the use of oral contraceptives are believed to contribute to the increased risk of stroke in women in their mid-30s to mid-40s, and their relative longevity contributes to the higher risk of stroke in older women.
Source: LANCET - June 6, 2014 Category: Journals (General) Authors: Linong Ji Tags: Comment Source Type: research
Comment Focus on blood pressure as a major risk factor
The main risk factor for disease and premature death worldwide is high blood pressure. The associations between blood pressure and fatal coronary artery disease and fatal stroke have been well demonstrated. However, little evidence exists from contemporary clinical practice on the associations between blood pressure and morbidity and mortality from specific cardiovascular disease conditions in different age groups. Also missing are results concerning lifetime risk for specific cardiovascular complications associated with hypertension.
Source: LANCET - May 30, 2014 Category: Journals (General) Authors: Thomas Kahan Tags: Comment Source Type: research
Correspondence Radiotherapy for breast cancer, the TARGIT-A trial
Javant Vaidya and colleagues report an increased risk of non-breast cancer deaths with external beam radiotherapy (EBRT) compared with intraoperative radiotherapy, highlighting the difference in cardiac events in the two treatment groups. Although the log-rank statistics show a significant difference in non-breast cancer deaths in the EBRT group, these deaths included stroke, bowel ischaemia, and other events unrelated to breast irradiation. Therefore, the number of cardiac events are small, and to suggest that the risk of cardiac death differs between EBRT and intraoperative radiotherapy would be premature.
Source: LANCET - May 16, 2014 Category: Journals (General) Authors: Penny Mackenzie, Anthony Fyles, Caroline Chung Tags: Correspondence Source Type: research
Correspondence Management of brain arteriovenous malformations – Authors' reply
ARUBA is the first-ever randomised controlled trial comparing clinical outcome in patients with unruptured brain arteriovenous malformations managed either with or without preventive interventional therapy. The as-treated analysis showed a more than 5-fold increased risk of primary outcome events (ie, death or symptomatic stroke) for patients undergoing invasive therapy (hazard ratio 5·26, 95% CI 2·63–11·11), as well as a significantly increased risk of, at times, devastating neurological deficits after intervention (relative risk 2·77, 95% CI 1·20–6·25).
Source: LANCET - May 9, 2014 Category: Journals (General) Authors: Christian Stapf, Michael K Parides, Alan J Moskowitz, J P Mohr Tags: Correspondence Source Type: research
Correspondence Management of brain arteriovenous malformations
The investigators of ARUBA (Feb 15, p 614) must be thoroughly applauded for conducting the first-ever randomised controlled trial of a therapeutic intervention to improve the prognosis of brain arteriovenous malformations. In view of the antagonism to the trial in some quarters, they were lucky to get even the 223 patient sample size they did, even though it was much smaller than the originally intended 800, subsequently modified to 400. However, they were not so lucky with their Data and Safety Monitoring Board who recommended halting randomisation at a mean of less than 3 years, before—possibly long before—enough fol...
Source: LANCET - May 9, 2014 Category: Journals (General) Authors: Charles Warlow Tags: Correspondence Source Type: research
Editorial Transient ischaemic attack: more than a stroke of bad luck
Transient ischaemic attack (TIA), in which clots temporarily disrupt blood supply to the brain, affects 46 000 people for the first time in the UK every year. Patients often dismiss the symptoms of TIA as a funny turn, caused by another disorder or old age. However, up to 10% of people with a TIA go on to have a stroke in the next 7 days.
Source: LANCET - May 9, 2014 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
World Report Profile: Australia's Baker IDI Heart and Diabetes Institute
Cardiovascular disease kills one Australian every 11 minutes, and 3·4 million of the country's 23 million population are affected, with rates 30% higher in Indigenous Australians. One in six Australians will have a stroke in their lifetime, and 1·5 million are estimated to have diabetes. No surprise then that Australia has one of the most well known cardiovascular disease research institutes: the Baker IDI Heart and Diabetes Institute based in Melbourne.
Source: LANCET - April 25, 2014 Category: Journals (General) Authors: Tony Kirby Tags: World Report Source Type: research
Correspondence Global burden of stroke: an underestimate – Authors' reply
We are pleased to respond to Desmond O'Neill's comments on our paper about the global burden of stroke. We fully agree that the burden of stroke goes far beyond the reported data on incidence, prevalence, mortality, and disability-adjusted life-years. Stroke also has a large physical, psychological, and financial effect on patients, their families, the health-care system, and society. Additionally, as rightly emphasised by O'Neill, stroke is just one of the many manifestations (although the most catastrophic) of cerebrovascular disease, and there are clinically silent minor strokes and occult cerebrovascular disorders that...
Source: LANCET - April 4, 2014 Category: Journals (General) Authors: Valery L Feigin, Mohammad H Forouzanfar, Rita Krishnamurthi, George A Mensah Tags: Correspondence Source Type: research
Correspondence Global burden of stroke: an underestimate
The global burden of stroke outlined by Valery Feigin and colleagues' Article (Jan 18, p 245) is likely to be a substantial underestimation in view of the consequences of stroke disease on conditions other than acute stroke, which substantially affect health and wellbeing. Overt and occult cerebrovascular disease, both large and small vessel, have been recognised to contribute to Alzheimer's disease and vascular dementia.
Source: LANCET - April 4, 2014 Category: Journals (General) Authors: Desmond O'Neill Tags: Correspondence Source Type: research
Comment NAVIGATOR: physical activity for cardiovascular health?
In The Lancet, Thomas Yates and colleagues report new findings from the NAVIGATOR trial, a multicentre, international, randomised, placebo-controlled trial that examined the effect of nateglinide, valsartan, or both, on cardiovascular events in patients with impaired glucose tolerance and either existing cardiovascular disease or at least one additional risk factor. The results of this cohort analysis of the association between daily ambulatory activity, as assessed by pedometer, and a composite of death from cardiovascular causes, non-fatal myocardial infarction, and non-fatal stroke, show a graded and independent inverse...
Source: LANCET - March 21, 2014 Category: Journals (General) Authors: Giuseppe Pugliese, Stefano Balducci Tags: Comment Source Type: research
Review The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective
On Sept 29, 2013, the Framingham Heart Study will celebrate 65 years since the examination of the first volunteer in 1948. During this period, the study has provided substantial insight into the epidemiology and risk factors of cardiovascular disease. The origins of the study are closely linked to the cardiovascular health of President Franklin D Roosevelt and his premature death from hypertensive heart disease and stroke in 1945. In this Review we describe the events leading to the foundation of the Framingham Heart Study, and provide a brief historical overview of selected contributions from the study.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Syed S Mahmood, Daniel Levy, Ramachandran S Vasan, Thomas J Wang Tags: Review Source Type: research
