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Total 186 results found since Jan 2013.
Articles Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants
Interventions that reduce high blood pressure, cholesterol, and glucose might address about half of excess risk of coronary heart disease and three-quarters of excess risk of stroke associated with high BMI. Maintenance of optimum bodyweight is needed for the full benefits.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects) Tags: Articles Source Type: research
Seminar Intracranial atherosclerosis
Atherosclerotic disease often involves the intracranial arteries including those encased by cranial bones and dura, and those located in the subarachnoid space. Age, hypertension, and diabetes mellitus are independent risk factors for intracranial atherosclerosis. Intracranial atherosclerosis can result in thromboembolism with or without hypoperfusion leading to transient or permanent cerebral ischaemic events. High rates of recurrent ischaemic stroke and other cardiovascular events mandate early diagnosis and treatment.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Adnan I Qureshi, Louis R Caplan Tags: Seminar Source Type: research
Articles Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials
This meta-analysis is the first to include data for all four new oral anticoagulants studied in the pivotal phase 3 clinical trials for stroke prevention or systemic embolic events in patients with atrial fibrillation. New oral anticoagulants had a favourable risk–benefit profile, with significant reductions in stroke, intracranial haemorrhage, and mortality, and with similar major bleeding as for warfarin, but increased gastrointestinal bleeding. The relative efficacy and safety of new oral anticoagulants was consistent across a wide range of patients.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Christian T Ruff, Robert P Giugliano, Eugene Braunwald, Elaine B Hoffman, Naveen Deenadayalu, Michael D Ezekowitz, A John Camm, Jeffrey I Weitz, Basil S Lewis, Alexander Parkhomenko, Takeshi Yamashita, Elliott M Antman Tags: Articles Source Type: research
Comment Warfarin or novel oral anticoagulants for atrial fibrillation?
Stroke prevention is central to the management of atrial fibrillation and, until recently, the focus was to identify high-risk patients who would be given a so-called inconvenient drug, warfarin. Nowadays, the landscape for stroke prevention has changed with the availability of novel oral anticoagulants, and an increased appreciation that vitamin K antagonists (eg, warfarin) work best with high-quality anticoagulation control (shown by the average individual time in therapeutic range at an international normalised ratio of 2·0–3·0).
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Gregory Y H Lip Tags: Comment Source Type: research
Department of Error Department of Error
Giroud M, Jacquin A, Béjot Y. The worldwide landscape of stroke in the 21st century. Lancet 2013; published online Oct 24. http://dx.doi.org/10.1016/S0140-6736(13)62077-2—In this Comment, in the fifth paragraph, the second sentence should have read “…had increased significantly since 1990 (increases of 68%, 84%, 26%, and 12%, respectively)”. This correction has been made to the online version as of Oct 25, and will be made to the printed Comment.
Source: LANCET - February 21, 2014 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: research
Editorial Statins for millions more?
Last week, the National Institute for Health and Care Excellence (NICE) in the UK unveiled draft guidance on cardiovascular risk assessment and, in particular, on lipid modification for the primary and secondary prevention of cardiovascular disease. In an update to the existing guideline, the new proposal is that the threshold be halved for prescribing statins to prevent cardiovascular disease, which includes coronary heart disease and stroke.
Source: LANCET - February 21, 2014 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Correspondence Refining the American guidelines for prevention of cardiovascular disease
The recent American Heart Association (AHA) and American College of Cardiology (ACC) guidelines recommend that more people are offered treatment to prevent heart attacks and strokes; they do this by lowering the risk cutoff from a 20% 10-year risk to 7·5% (the approximate risk of a person aged 60 years). Paul Ridker and Nancy Cook state that the risk calculator in the guidelines overestimates risk about two-fold. This variation, however, has little effect on discriminating between who will and will not have a heart attack or stroke (ie, on screening performance).
Source: LANCET - February 15, 2014 Category: Journals (General) Authors: Nicholas Wald, Joan Morris Tags: Correspondence Source Type: research
Articles Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial
The ARUBA trial showed that medical management alone is superior to medical management with interventional therapy for the prevention of death or stroke in patients with unruptured brain arteriovenous malformations followed up for 33 months. The trial is continuing its observational phase to establish whether the disparities will persist over an additional 5 years of follow-up.
Source: LANCET - February 15, 2014 Category: Journals (General) Authors: J P Mohr, Michael K Parides, Christian Stapf, Ellen Moquete, Claudia S Moy, Jessica R Overbey, Rustam Al-Shahi Salman, Eric Vicaut, William L Young, Emmanuel Houdart, Charlotte Cordonnier, Marco A Stefani, Andreas Hartmann, Rüdiger von Kummer, Alessandra Tags: Articles Source Type: research
Correspondence Premature mortality in patients with epilepsy
We commend Seena Fazel and colleagues on their study highlighting the risk of premature death in people with epilepsy and the role of psychiatric comorbidity in increasing this mortality. Although the observed odds ratio for premature mortality was similar to that in a previous study using similar methods, we wonder to what extent the mortality estimates were inflated by inclusion of status epilepticus in the epilepsy cohort. In most cases, status epilepticus is a symptom of an acute brain insult (ie, stroke, anoxia) and does not fulfil criteria for epilepsy.
Source: LANCET - February 8, 2014 Category: Journals (General) Authors: Torbjörn Tomson, Dale C Hesdorffer Tags: Correspondence Source Type: research
Correspondence Lessons from the SPS3 trial
We read with interest the results of the SPS3 trial (Aug 10, p 507). The SPS3 Study Group concluded that the use of a systolic-blood-pressure (SBP) target of less than 130 mm Hg is likely to be beneficial for patients with recent lacunar stroke. However, several comments should be made before we encourage clinicians to achieve more intensive blood pressure reduction.
Source: LANCET - February 8, 2014 Category: Journals (General) Authors: Luis Castilla-Guerra, María del Carmen Fernandez-Moreno Tags: Correspondence Source Type: research
Comment Improved medical treatment in secondary prevention of stroke
Atherosclerotic intracranial arterial stenosis is a cause of transient ischaemic attack and ischaemic stroke, and is associated with a high risk of recurrence. Patients with recently symptomatic severe (70–99%) stenosis are at particularly high risk. In the SAMMPRIS trial, investigators compared two alternative treatment strategies in patients with a recent (<30 days) transient ischaemic attack or non-disabling stroke attributed to angiographically verified 70–99% intracranial stenosis: aggressive medical treatment (combination antiplatelet therapy and intensive management of risk factors) versus aggressive medical ...
Source: LANCET - January 24, 2014 Category: Journals (General) Authors: Peter M Rothwell, Hugh S Markus Tags: Comment Source Type: research
Articles Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010
Although age-standardised rates of stroke mortality have decreased worldwide in the past two decades, the absolute number of people who have a stroke every year, stroke survivors, related deaths, and the overall global burden of stroke (DALYs lost) are great and increasing. Further study is needed to improve understanding of stroke determinants and burden worldwide, and to establish causes of disparities and changes in trends in stroke burden between countries of different income levels.
Source: LANCET - January 17, 2014 Category: Journals (General) Authors: Valery L Feigin, Mohammad H Forouzanfar, Rita Krishnamurthi, George A Mensah, Myles Connor, Derrick A Bennett, Andrew E Moran, Ralph L Sacco, Laurie Anderson, Thomas Truelsen, Martin O'Donnell, Narayanaswamy Venketasubramanian, Suzanne Barker-Collo, Carle Tags: Articles Source Type: research
Department of Error Department of Error
Feigin VL, Forouzanfar MH, Krishnamurthi R, et al, on behalf of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 2013; published online Oct 24. http://dx.doi.org/10.1016/S0140-6736(13)61953-4—In this Article, on line 7 of the Findings section of the Summary, the sentence should have read “…had significantly increased since 1990 (68%, 84%, 26%, and 12% increase, respectively)”.
Source: LANCET - January 17, 2014 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: research
Comment The worldwide landscape of stroke in the 21st century
Assessment of the epidemiology of stroke is a difficult but exciting challenge that is justified by the objectives of identifying vascular risk factors, establishment of needs for the implementation of dedicated services, and guiding and assessment of future preventive and therapeutic priorities. Prospective population-based stroke registries are ideal methods to provide reliable and optimum information about stroke epidemiology, provided they comply with established quality criteria.
Source: LANCET - January 17, 2014 Category: Journals (General) Authors: Maurice Giroud, Agnès Jacquin, Yannick Béjot Tags: Comment Source Type: research
Articles A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis
In a large scale, robust evaluation, results from this study have shown no differences between the LSCTC and usual care on any of the assessed outcomes. The immediate period after stroke might not be the ideal time to deliver structured caregiver training.
Source: LANCET - December 20, 2013 Category: Journals (General) Authors: Anne Forster, Josie Dickerson, John Young, Anita Patel, Lalit Kalra, Jane Nixon, David Smithard, Martin Knapp, Ivana Holloway, Shamaila Anwar, Amanda Farrin, on behalf of the TRACS Trial Collaboration Tags: Articles Source Type: research
