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Source: Medicine
Condition: Atrial Fibrillation
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Total 92 results found since Jan 2013.
A meta-analysis for efficacy and safety evaluation of transcatheter left atrial appendage occlusion in patients with nonvalvular atrial fibrillation
Objectives: This meta-analysis was conducted to evaluate the efficacy and safety of transcatheter left atrial appendage (LAA) occlusion in patients with nonvalvular atrial fibrillation.
Methods: The randomized controlled trials (RCT) or observational studies with any transcatheter LAA occlusion devices were searched in PubMed, Embase, and Cochrane library from inception to November 2015. The incidence rates from individual studies were combined to evaluate the procedural efficacy and safety, including all-cause death, cardiac/neurological death, stroke, transient ischemic attack (TIA), thrombosis, hemorrhagic complication...
Source: Medicine - August 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
Presence of diabetic microvascular complications does not incrementally increase risk of ischemic stroke in diabetic patients with atrial fibrillation: A nationwide cohort study
Abstract: Conventional stroke risk prediction tools used in atrial fibrillation (AF) incorporate the presence of diabetes mellitus (DM) as a risk factor. However, it is unknown whether this risk is homogenous or dependent on the presence of diabetic microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy. The present study examined the risk of ischemic stroke in diabetic patients with and without microvascular complications. The present study used the National Health Insurance Research Database in Taiwan with detailed healthcare data on all-comers to the Taiwanese medical system from January ...
Source: Medicine - July 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Intravenous thrombolysis is more safe and effective for posterior circulation stroke: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
Abstract: We aimed to compare the safety and efficacy of intravenous thrombolysis (IVT) with alteplase for anterior circulation stroke (ACS) and posterior circulation stroke (PCS). From a large multicenter prospective registry—the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database—all patients who received IVT within 4.5 hours after stroke onset was reviewed. According to the clinical presentations and imaging findings, the eligible patients were divided into ACS and PCS groups. The safety and efficacy outcome measures included post-IVT symptomatic intracranial hemorrhage (sICH), paren...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
A cohort study of relationship between serum calcium levels and cerebral microbleeds (CMBs) in ischemic stroke patients with AF and/or RHD
Abstract: Calcium is an essential element for life and has cerebroprotective property in stroke patients. Low serum calcium levels were found to be related to large hematoma volumes in intracerebral hemorrhagic patients and hemorrhagic transformation in ischemic stroke patients after thrombolysis. However, their impact on hemorrhage-prone small vessel disease represented by cerebral microbleeds (CMBs) is uncertain. We aim to investigate whether low serum calcium levels are associated with presence and location of CMBs.
Ischemic stroke patients with atrial fibrillation (AF) and/or rheumatic heart disease admitted to our ho...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Effect of RAAS blockers on adverse clinical outcomes in high CVD risk subjects with atrial fibrillation: A meta-analysis and systematic review of randomized controlled trials
This study suggests that RAAS blockade offers protection against heart failure and cardiovascular events in high cardiovascular disease risk subjects with atrial fibrillation.
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
The Abundance of Epicardial Adipose Tissue Surrounding Left Atrium Is Associated With the Occurrence of Stroke in Patients With Atrial Fibrillation
Abstract: Epicardial adipose tissue (EAT) is positively associated with risk factors for cardiovascular disease, but the role of EAT in the development of atrial fibrillation (AF)-related stroke and its association with the anatomical and functional remodeling of the left atrium (LA) have not been elucidated.
This was a comparative cross-sectional study. Twenty-seven patients with paroxysmal or persistent AF and cardioembolic stroke were selected and compared with 68 age- and sex-matched AF patients without stroke. In addition, 20 controls without a history of AF or stroke were included. The periatrial EAT and the structu...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Atrial Fibrillation Increases the Risk of Peripheral Arterial Disease With Relative Complications and Mortality: A Population-Based Cohort Study
Abstract: Atrial fibrillation (AF), an increasing prevalent cardiac arrhythmia due to aging general population, has many common risk factors with peripheral arterial disease (PAD). However, it is unclear whether AF is associated with a risk of PAD. We investigated the prevalence of AF and PAD in the general population and the risk of PAD among the AF population.
This longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database recorded during 2000 to 2011. In total, 3814 and 15,364 patients were included in the AF and non-AF cohorts, respectiv...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Digoxin Use and Adverse Outcomes in Patients With Atrial Fibrillation
Abstract: Digoxin has long been used for rate control in atrial fibrillation (AF); its safety remains controversial.
We performed a literature search using MEDLINE (source PubMed, January 1, 1966, to July 31, 2015) and EMBASE (January 1, 1980, to July 31, 2015) with no restrictions. Studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. Pooled effect estimates were obtained by using random-effects meta-analysis.
Twenty-two studies involving 586,594 patients were identified. Patients taking digoxin, as compared with those who took no digoxin, ...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
Atrial Fibrillation is Associated With Poor Outcomes in Thrombolyzed Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Abstract: The influence of atrial fibrillation (AF) on the clinical outcomes of patients with ischemic stroke (IS) has not been completely determined. We aimed to perform a systematic review and meta-analysis to assess the relationship between AF and adverse events in patients with acute IS treated with thrombolysis.
PubMed, EMBASE, and the Cochrane Library were searched for relevant studies regarding the association between AF and the outcomes of patients with IS treated with thrombolysis. Random and fixed effect models were used for pooling data.
Twelve cohort studies involving 14,801 patients with acute IS were includ...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research
Association of Increased Epicardial Adipose Tissue Thickness With Adverse Cardiovascular Outcomes in Patients With Atrial Fibrillation
This study was conducted to analyze the ability of EAT thickness in predicting adverse cardiovascular (CV) events in AF.
In 190 persistent AF patients, we performed a comprehensive transthoracic echocardiographic examination with assessment of EAT thickness. The definition of CV events included CV mortality, hospitalization for heart failure, myocardial infarction, and stroke.
There were 69 CV events including 19 CV deaths, 32 hospitalizations for heart failure, 3 myocardial infarctions, and 15 strokes during a mean follow-up of 29 (25th–75th percentile: 17–36) months. The multivariable analysis demonstrates that chr...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Warfarin Use and Risk of Stroke in Patients With Atrial Fibrillation Undergoing Hemodialysis: A Meta-Analysis
Abstract: In spite of the substantial burden of atrial fibrillation and associated elevated ischemic stroke risk in patients undergoing hemodialysis, the role of warfarin in these high-risk patients remains uncertain. Our objective was to clarify the association between warfarin use and risk of stroke for patients with atrial fibrillation undergoing dialysis.
PubMed and Embase from January 1966 to January 2015 were searched to identify relevant studies. Inclusion criteria were cohort studies, patients with atrial fibrillation undergoing hemodialysis, and reported quantitative estimates of the multivariate adjusted relativ...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research
Predicting Hemorrhagic Transformation of Acute Ischemic Stroke: Prospective Validation of the HeRS Score
Abstract: Hemorrhagic transformation (HT) increases the morbidity and mortality of ischemic stroke. Anticoagulation is often indicated in patients with atrial fibrillation, low ejection fraction, or mechanical valves who are hospitalized with acute stroke, but increases the risk of HT. Risk quantification would be useful. Prior studies have investigated risk of systemic hemorrhage in anticoagulated patients, but none looked specifically at HT. In our previously published work, age, infarct volume, and estimated glomerular filtration rate (eGFR) significantly predicted HT. We created the hemorrhage risk stratification (HeRS...
Source: Medicine - January 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Effectiveness and Safety of Warfarin in Dialysis Patients With Atrial Fibrillation: A Meta-Analysis of Observational Studies
The objective of this study was to assess the effectiveness and safety of warfarin use in patients with AF undergoing dialysis.
Three databases PubMed, EMBASE, and OVID were searched from their inception to August 2015.
Observational studies which assessed the ischemic stroke or bleeding risk of warfarin use in dialysis patients with AF were included. Two reviewers independently extracted data and assessed methodological quality based on the Newcastle–Ottawa Scale score. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model and heterogeneity was assessed based...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research
Do NOACs Improve Antithrombotic Therapy in Secondary Stroke Prevention in Nonvalvular Atrial Fibrillation?
Abstract: Guidelines recommended oral anticoagulant (OAC) for ischemic stroke patients related to atrial fibrillation (AF). But, underprescription or underdose of warfarin was observed worldwide. We aimed to explore if the use of antithrombotic therapy in nonvalvular AF (NVAF) ischemic stroke patients improved after novel oral anticoagulants (NOACs) became available.
Between January 2011 to December 2013, 360 acute ischemic stroke patients related to NVAF were recruited. Patients were categorized into 2 groups based on the date (July 2012) of NOACs’ availability. There were 184 patients recruited before July 2012, and wh...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
“Sudden Drop” in Blood Pressure is Associated With Recanalization After Thrombolysis
Abstract: We aim to investigate whether the phenomenon of “sudden drop” in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.
We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT). BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.
We observed the phenomenon of “sudden drop” in systolic BP (≥20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54...
Source: Medicine - July 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
