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Source: The American Journal of Cardiology
Condition: Ischemic Stroke
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Total 182 results found since Jan 2013.
Real-World Direct Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Medicare Beneficiaries with Atrial Fibrillation
It remains unknown whether the comparative effectiveness of direct oral anticoagulants (DOACs) and warfarin differs between atrial fibrillation (AF) patients with and without a history of stroke or transient ischemic attack (TIA). Using 2012-2014 Medicare claims data, we identified patients newly diagnosed with AF in 2013-2014 who initiated apixaban, dabigatran, rivaroxaban or warfarin. We categorized patients based on a history of stroke or TIA. We constructed Cox proportional hazard models that included indicator variables for treatment groups, a history of stroke or TIA, and the interaction between them, and controlled ...
Source: The American Journal of Cardiology - April 9, 2020 Category: Cardiology Authors: Lanting Yang, Maria M. Brooks, Nancy W. Glynn, Yuting Zhang, Samir Saba, Inmaculada Hernandez Source Type: research
Relation of Advanced Interatrial Block to Risk of Atrial Fibrillation and Stroke
Advanced interatrial block (A-IAB) has been associated to atrial fibrillation (AF) and ischemic stroke, raising the question as to whether such patients, even when still in sinus rhythm without documented AF, could benefit from oral anticoagulation. AF and A-IAB are both markers of stroke. The anatomical substrate in both is fibrotic atrial cardiomyopathy, resulting in atrial electromechanical dyssynchrony, dysfunction, and left atrial remodelling, that favour blood stasis and hypercoagulation. Under these conditions thrombogenic cascade may be triggered, resulting in systemic embolization.
Source: The American Journal of Cardiology - March 16, 2020 Category: Cardiology Authors: Antoni Bay és-de-Luna, Manuel Martínez-Sellés, Roberto Elosua, Antoni Bayés-Genís, Guiomar Mendieta, Adrian Baranchuk, Günter Breithardt Source Type: research
Observed versus Expected Ischemic and Bleeding Events Following Left Atrial Appendage Occlusion
Data on the efficacy of left atrial appendage occlusion (LAAO) in clinical practice are limited. We performed a systematic review and meta-analysis of observational studies that reported observed vs. expected rates of ischemic strokes and/or major bleeding following LAAO. Our primary end points were the pooled relative risk reduction (RRR) in ischemic stroke and major bleeding with corresponding 95% confidence intervals (CI) compared with what was expected by the CHA2DS2-VASc and HASBLED scores, respectively.
Source: The American Journal of Cardiology - March 13, 2020 Category: Cardiology Authors: Tatiana Busu, Safi U Khan, Muhammad Alhajji, Fahad Alqahtani, David R Holmes, Mohamad Alkhouli Source Type: research
Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research
Validation of Acute Ischemic Stroke Codes Using the International Classification of Diseases Tenth Revision
Administrative databases have increasingly become a platform for clinical investigations aiming to address trends in the prevalence, patterns of care, and outcomes of major cardiovascular diseases including strokes1-4. Identification of acute ischemic stroke (AIS) events in these databases is dependent on billing codes. Hence, accurate querying of administrative databases for research purposes require proper validation of those billing codes. Several studies have previously validated the use of certain International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) codes to discern hospitalizations for AIS.
Source: The American Journal of Cardiology - January 7, 2020 Category: Cardiology Authors: Mohamed Alhajji, Akram Kawsara, Mohamad Alkhouli Source Type: research
Incidence and Outcomes of Acute Ischemic Stroke Following Percutaneous Coronary Interventions in Men Versus Women
Comparative data on the incidence and outcomes of stroke after percutaneous coronary interventions (PCI) between men and women are limited. We identified hospitalizations for PCI in the National-Inpatient-Sample between January 1st 2003 and December 31st 2016. We compared the incidence of post-PCI stroke and in-hospital complications, mortality, and cost of post-PCI strokes between men and women. Among 8,753,574 weighted hospitalizations for PCI, 49,097 (0.56%) were complicated with ischemic stroke.
Source: The American Journal of Cardiology - November 6, 2019 Category: Cardiology Authors: Mohamad Alkhouli, Fahad Alqahtani, Mohamed Farouk Elsisy, Akram Kawsara, Mirvat Alasnag Source Type: research
Safety and Efficacy of Direct Oral Anticoagulants Versus Warfarin in Patients with Chronic Kidney Disease and Atrial Fibrillation
This study evaluated and compared the safety outcomes of DOACs versus warfarin in patients with non-valvular AF and concomitant CKD. Patients in our health system with AF prescribed oral anticoagulants during 2010 to 2017 were identified. All-cause mortality, bleeding, and hemorrhagic and ischemic stroke were evaluated based on degree of renal impairment and method of anticoagulation.
Source: The American Journal of Cardiology - October 30, 2019 Category: Cardiology Authors: Amber Makani, Samir Saba, Sandeep K. Jain, Aditya Bhonsale, Michael S. Sharbaugh, Floyd Thoma, Yisi Wang, Oscar C. Marroquin, Joon S. Lee, N.A. Mark Estes, Suresh R. Mulukutla Source Type: research
Relation of Preprocedural Hemoglobin Level to Outcomes After Percutaneous Coronary Intervention
This study assessed the impact of elevated Hb on major adverse cardiac and cerebrovascular event (MACCE) at 12 months, a composite of all-cause mortality, nonfatal myocardial infarction, and ischemic stroke after PCI. We pooled patient-level data from four Korean multicenter drug-eluting stent registries from 2010 to 2016.
Source: The American Journal of Cardiology - August 8, 2019 Category: Cardiology Authors: Byung Gyu Kim, Hyoeun Kim, Sung-Jin Hong, Chul-Min Ahn, Dong-Ho Shin, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Byeong-Keuk Kim, Byoung Kwon Lee Source Type: research
The Interaction Among Atrial Thromboembolism, Atrial Fibrillation, and Atrial Cardiomyopathy
I read with interest the timely paper titled “Thromboembolism in the Absence of Atrial Fibrillation” by Smietana et al1 that discusses several highly important but underappreciated contributors to ischemic stroke in patients with and without atrial fibrillation (AF). Several are worthy of further emphasis and/or expansion for your readers, both investigators and clinicians. First is the recognition of the concept of atrial cardiomyopathy.2 Atrial cardiomyopathy may be a cause and/or consequence of AF; can vary with the etiology, duration, number, and severity of associated comorbidities as well as the amount of AF pres...
Source: The American Journal of Cardiology - August 1, 2019 Category: Cardiology Authors: James A. Reiffel Source Type: research
Meta-Analysis Evaluating Outcomes of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery
Surgical left atrial appendage occlusion (S-LAAO) has become a common procedure performed in patients undergoing cardiac surgery; however, evidence to support this procedure remains inconclusive. This meta-analysis aims to assess the efficacy of S-LAAO in terms of ischemic stroke, postoperative atrial fibrillation (AF), and all-cause mortality. A thorough literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We identified ten relevant studies for our meta-analysis.
Source: The American Journal of Cardiology - July 31, 2019 Category: Cardiology Authors: Abdisamad M Ibrahim, Nitin Tandan, Cameron Koester, Mohammad Al-Akchar, Bishal Bhandari, Albert Botchway, Jumana Abdelkarim, Ruby Maini, Mohamed Labedi Source Type: research
Atrial Septal Defect and the Risk of Ischemic Stroke in the Perioperative Period of Noncardiac Surgery
Stroke is a serious complication of non-cardiac surgery. Congenital defects of the interatrial septum may be a potent risk factor for perioperative stroke. The aim of the present study was to determine the association between atrial septal defect (ASD) or patent foramen ovale (PFO) and in-hospital perioperative ischemic stroke after non-cardiac surgery in a large nationwide cohort of patients hospitalized in the United States. Patients undergoing noncardiac surgery between 2004 and 2014 were identified using the Healthcare Cost and Utilization Project's National Inpatient Sample.
Source: The American Journal of Cardiology - July 14, 2019 Category: Cardiology Authors: Nathaniel R. Smilowitz, Varun Subashchandran, Jeffrey S. Berger Source Type: research
Lipid-Lowering Prescription Patterns in Patients with Diabetes Mellitus or Cardiovascular Disease
The purpose of this study is to describe lipid-lowering therapy (LLT) prescriptions and low-density lipoprotein cholesterol (LDL-C) monitoring in patients with diabetes mellitus (DM) with or without concomitant cardiovascular disease (CVD). Olmsted County, MN residents with a first-ever diagnosis of DM or CVD (ischemic stroke/transient ischemic attack, myocardial infarction, unstable angina pectoris, or revascularization procedure) between 2005 and 2012 were classified as having DM only, CVD only, or CVD + DM.
Source: The American Journal of Cardiology - July 14, 2019 Category: Cardiology Authors: Alanna M. Chamberlain, Sarah S. Cohen, Jill M. Killian, Keri L. Monda, Susan A. Weston, Ted Okerson Source Type: research
Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy After Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment
The patient's profile drawing the greatest benefit from dual antiplatelet therapy (DAPT) after a non-cardioembolic, ischemic cerebrovascular event is not well characterized. Aim of this meta-regression analysis was to compare DAPT versus single antiplatelet therapy (SAPT) in patients with stroke or transient ischemic attack (TIA). We searched randomized trials evaluating clinical outcome with aspirin plus a P2Y12 inhibitor versus SAPT in patients with non-cardioembolic stroke or TIA. Primary endpoint was the incidence of recurrent stroke; safety outcome measure was major bleeding.
Source: The American Journal of Cardiology - May 24, 2019 Category: Cardiology Authors: Giuseppe Patti, Alessandro Sticchi, Antonio Bisignani, Francesco Pelliccia, Vincenzo Pasceri, Giulio Speciale, Maria Penco Source Type: research
Thromboembolism In The Absence Of Atrial Fibrillation
Atrial fibrillation (AF) is associated with thrombus formation in the left atrial appendage (LAA) and systemic embolic events including ischemic stroke. Cardiogenic thromboembolism can also occur in the absence of clinical AF as a result of various pathological conditions affecting the endocardium. The inconsistent temporal relation between AF and ischemic events has stimulated exploration for factors other than clinical AF that contribute to thromboembolism. These include sub-clinical AF, a thrombogenic atrial cardiomyopathy, LAA dysfunction and embolism from other sources.
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Jeffrey Smietana, Anna Plitt, Jonathan L. Halperin Source Type: research
PFO-mediated Stroke: Exposing the Misnomer of ‘Cryptogenic’ Stroke
We read with interest the recent article by Wintzer-Wehekind et al1. In an observational study of 453 consecutive patients who underwent PFO closure due to an ischemic event of no other apparent cause, the authors evaluated the safety of discontinuing antithrombotic therapy following PFO closure. At a median follow-up of 8 years, antithrombotic therapy was associated with a 6% incidence of bleeding, and the subset of patients who discontinued their blood thinners did not have more recurrent ischemic events on long-term follow-up.
Source: The American Journal of Cardiology - March 15, 2019 Category: Cardiology Authors: Muhammad O. Zaman, Sanaullah Mojaddedi, Fabian Nietlispach, Bernhard Meier, Mohammad K. Mojadidi Source Type: research
