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Effect of Antiplatelet Therapy (Aspirin  + Dipyridamole Versus Clopidogrel) on Mortality Outcome in Ischemic Stroke
The optimal regimen of antiplatelet therapy for secondary prevention in noncardioembolic ischemic stroke remains controversial. We aimed to determine which regimen was associated with the greatest reduction in adverse outcomes. We analysed prospectively collected data from the Norfolk and Norwich University Hospital Stroke Register. The sample population consisted of 3,572 participants (mean age 74.96 ± 12.67) with ischemic stroke, who were consecutively admitted between 2003 and 2015. Patients were placed on one of three antiplatelet regimens at hospital discharge; aspirin monotherapy, aspirin plus dipyridamole and clopidogrel.
Source: The American Journal of Cardiology - July 2, 2018 Category: Cardiology Authors: Raphae S. Barlas, Yoon K. Loke, Mamas A. Mamas, Joao H Bettencourt-Silva, Isobel Ford, Allan B. Clark, Kristian M. Bowles, Anthony K. Metcalf, John F. Potter, Phyo K. Myint Source Type: research

Effect of Antiplatelet Therapy (Aspirin  + Dipyridamole vs Clopidogrel) on Mortality Outcome in Ischemic Stroke
The optimal regimen of antiplatelet therapy for secondary prevention in noncardioembolic ischemic stroke remains controversial. We aimed to determine which regimen was associated with the greatest reduction in adverse outcomes. We analysed prospectively collected data from the Norfolk and Norwich University Hospital Stroke Register (NNUHSR). The sample population consisted of 3,572 participants (mean age 74.96 ± 12.67) with ischemic stroke, who were consecutively admitted between 2003-2015. Patients were placed on one of three antiplatelet regimens at hospital discharge; aspirin monotherapy, aspirin plus dipyridamole and clopidogrel.
Source: The American Journal of Cardiology - July 2, 2018 Category: Cardiology Authors: Raphae S. Barlas, Yoon K. Loke, Mamas A. Mamas, Joao H Bettencourt-Silva, Isobel Ford, Allan B. Clark, Kristian M. Bowles, Anthony K. Metcalf, John F. Potter, Phyo K. Myint Source Type: research

Usefulness of the CHA2DS2-VASc and HAS-BLED Scores in Predicting the Risk of Stroke Versus Intracranial Bleeding in Patients With Atrial Fibrillation (from the FibStroke Study)
CHA2DS2-VASc and HAS-BLED scores stratify the risk of thromboembolic and bleeding events respectively in patients with atrial fibrillation. There is only little information on how they differentiate which of the 2 clinically most important complications (ischemic stroke [IS] or an intracranial bleeding [IB]) the patient is more prone to suffer. We evaluated both scores in patients with either of these major complications. The FibStroke Study collected data on all patients with atrial fibrillation with either an IS or an IB event between 2003 and 2012 in 4 Finnish hospital districts.
Source: The American Journal of Cardiology - February 12, 2018 Category: Cardiology Authors: Samuli Jaakkola, Tuomas O. Kiviniemi, Ilpo Nuotio, Juha Hartikainen, Pirjo Mustonen, Antti Palom äki, Jussi Jaakkola, Antti Ylitalo, Päivi Hartikainen, K.E. Juhani Airaksinen Source Type: research

Usefulness of the CHA2DS2-VASc and HAS-BLED Scores in Predicting the Risk of Stroke Versus Intracranial Bleeding in Patients with Atrial Fibrillation (From the FibStroke Study)
CHA2DS2-VASc and HAS-BLED scores stratify the risk of thromboembolic and bleeding events respectively in patients with atrial fibrillation (AF). There is only little information on how they differentiate which of the 2 clinically most important complications (ischemic stroke, IS or an intracranial bleeding, IB) the patient is more prone to suffer. We evaluated both scores in patients suffering either of these major complications. The FibStroke Study collected data on all patients with AF suffering either an ischemic stroke or an intracranial bleeding event between 2003-2012 in 4 Finnish hospital districts.
Source: The American Journal of Cardiology - February 12, 2018 Category: Cardiology Authors: Samuli Jaakkola, Tuomas O. Kiviniemi, Ilpo Nuotio, Juha Hartikainen, Pirjo Mustonen, Antti Palom äki, Jussi Jaakkola, Antti Ylitalo, Päivi Hartikainen, K.E. Juhani Airaksinen Source Type: research

Anticoagulant Agents for Atrial Fibrillation in Cancer Patients
In a recent article in the journal, Patell et  al1 found CHADS2 (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism) and CHA2DS2VASC (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism, vascular disease, age 65-74, sex category [i.e., female]) to predict risk of ischemic stroke in cancer patients with baseline atrial fibrillation (AF). Although only 36% of patients received anticoagulant therapy, the risk of stroke generally appeared to be lower than in cancer-free individuals.
Source: The American Journal of Cardiology - February 3, 2018 Category: Cardiology Authors: Marc Sorigue, Edurne Sarrate, Mireia Franch-Sarto, Mireia Santos-Gomez, Elisa Orna Source Type: research

Prediction of Incident Atrial Fibrillation According to Gender in Patients with Ischemic Stroke From a Nationwide Cohort
The CHA2DS2-VASc score may identify patients at higher risk of atrial fibrillation (AF) following ischemic stroke (IS) among patients without known AF. We compared gender-related differences in items from CHA2DS2-VASc score and their relationship with AF occurrence after IS. This French cohort study was based on the database covering hospital care from 2009 to 2012 for the entire population. Of 336,291 patients with IS, 240,459 (71.5%) had no AF at baseline. Women were older, more frequently had hypertension, heart failure, and had a higher CHA2DS2-VASc score than men (4.63 vs 4.39, p
Source: The American Journal of Cardiology - November 30, 2017 Category: Cardiology Authors: Arnaud Bisson, Alexandre Bodin, Nicolas Clementy, Dominique Babuty, Gregory Y.H. Lip, Laurent Fauchier Source Type: research

Frequency of Inverted Electrocardiographic T Waves (Cerebral T Waves) in Patients With Acute Strokes and Their Relation to Left Ventricular Wall Motion Abnormalities
Transient, symmetric, and deep inverted electrocardiogram (ECG) T waves in the setting of stroke, commonly referred to as cerebral T waves, are rare, and the underlying mechanism is unclear. Our study aimed to test the hypothesis that cerebral T waves are associated with transient cardiac dysfunction. This retrospective study included 800 patients admitted with the primary diagnosis of hemorrhagic or ischemic stroke. ECGs were examined for cerebral T waves, defined as T-wave inversion of ≥5 mm depth in ≥4 contiguous precordial leads.
Source: The American Journal of Cardiology - November 14, 2017 Category: Cardiology Authors: Jeremy Stone, Victor Mor-Avi, Agnieszka Ardelt, Roberto M. Lang Source Type: research

Frequency of Inverted Electrocardiographic T-Waves (Cerebral T-Waves) in Patients with Acute Strokes and Their Relation to Left Ventricular Wall Motion Abnormalities
Transient, symmetric and deep inverted ECG T-waves in the setting of stroke, commonly referred to as cerebral T-waves, are rare and the underlying mechanism is unclear. Our study aimed to test the hypothesis that cerebral T-waves are associated with transient cardiac dysfunction. This retrospective study included 800 patients admitted with the primary diagnosis of hemorrhagic or ischemic stroke. Electrocardiograms were examined for cerebral T waves, defined as T-wave inversion of ≥5 mm depth in ≥4 contiguous precordial leads.
Source: The American Journal of Cardiology - November 14, 2017 Category: Cardiology Authors: Jeremy Stone, Victor Mor-Avi, Agnieszka Ardelt, Roberto M. Lang Source Type: research

Usefulness of CHADS2 and CHA2DS2-VASc Scores for Stroke Prediction in Patients With Cancer and Atrial Fibrillation
Stroke prediction scores have not been validated in patients with cancer and Atrial Fibrillation (AF). We aimed to identify unique risk factors and evaluate validity of CHADS2 and CHA2DS2-VASc scores to predict risk of stroke and mortality. A retrospective review of all cancer patients with pre-existing AF presenting from 2008 to 2014 was performed. Outcomes included ischemic stroke and mortality. Prognostic factors were identified with Fine& Gray regression for stroke and Cox proportional hazards analysis for survival.
Source: The American Journal of Cardiology - September 19, 2017 Category: Cardiology Authors: Rushad Patell, Alejandra Gutierrez, Lisa Rybicki, Alok A. Khorana Source Type: research

Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban and Warfarin in Newly Diagnosed Atrial Fibrillation
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran and rivaroxaban in atrial fibrillation (AF). Using 2013-2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with AF who initiated apixaban, dabigatran, rivaroxaban, warfarin or no oral anticoagulation therapy in 2013-2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence.
Source: The American Journal of Cardiology - August 8, 2017 Category: Cardiology Authors: Inmaculada Hernandez, Yuting Zhang, Samir Saba Source Type: research

Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Newly Diagnosed Atrial Fibrillation
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence.
Source: The American Journal of Cardiology - August 8, 2017 Category: Cardiology Authors: Inmaculada Hernandez, Yuting Zhang, Samir Saba Source Type: research

Effect of Addition of a Statin to Warfarin on Thromboembolic Events in Japanese Patients With Nonvalvular Atrial Fibrillation and Diabetes Mellitus
Statins have been shown to decrease stroke risk in patients with cardiovascular risk factors, but not to prevent recurrence of ischemic stroke in patients with atrial fibrillation (AF). The present subanalysis aimed to clarify the efficacy of combined use of warfarin and statins in nonvalvular AF (NVAF) patients with coronary artery disease (CAD), diabetes mellitus (DM) or hypertension. The effects of adding statins to warfarin were compared with those of warfarin alone in NVAF patients with the data set of J-RHYTHM Registry, a prospective, observational study with a 2-year follow-up.
Source: The American Journal of Cardiology - April 26, 2017 Category: Cardiology Authors: Naoko Kumagai, John A. Nusser, Hiroshi Inoue, Ken Okumura, Takeshi Yamashita, Toru Kubo, Hiroaki Kitaoka, Hideki Origasa, Hirotsugu Atarashi, J-RHYTHM Registry Investigators Source Type: research

Comparison of Morphologic Features and Flow Velocity of the Left Atrial Appendage Among Patients With Atrial Fibrillation Alone, Transient Ischemic Attack, and Cardioembolic Stroke
The left atrial appendage (LAA) is a major source of emboli responsible for cardioembolic stroke (CES). We hypothesized that there could be differences in the morphologic and functional features of LAAs among patients with atrial fibrillation (AF) alone, patients with cardioembolic transient ischemic attack (CETIA), and patients with CES. Patients with AF and CETIA/CES were included in either a CETIA group or a CES group. Patients with AF without past histories of stroke were included in an AF/non-CVA (cerebrovascular accident) group.
Source: The American Journal of Cardiology - February 28, 2017 Category: Cardiology Authors: Yonggu Lee, Hwan-Cheol Park, Youkyung Lee, Soon-Gil Kim Tags: Arrhythmias and Conduction Disturbances Source Type: research

Changing Trends of Atherosclerotic Risk Factors Among Patients with Acute Myocardial Infarction and Acute Ischemic Stroke
We aimed to evaluate the secular trends in demographics, risk factors as well as clinical characteristics of patients presenting with acute myocardial infarction (AMI) or acute ischemic stroke (AIS), using a large nationally representative dataset of in-hospital admissions. We used the 2003-2013 Nationwide Inpatient Sample. All admissions with primary diagnosis of AMI or AIS were included. Across 2003-2013, a total of 1,360,660 patients with AMI and 937,425 patients with AIS were included in the study.
Source: The American Journal of Cardiology - February 27, 2017 Category: Cardiology Authors: Shikhar Agarwal, Karan Sud, Badal Thakkar, Venu Menon, Wael A. Jaber, Samir R. Kapadia Source Type: research

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