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Meta-Analysis of Cilostazol Versus Aspirin for the Secondary Prevention of Stroke
In conclusion, compared with aspirin, cilostazol is associated with significantly less hemorrhagic stroke, the combined end point of stroke, myocardial infarction, and vascular death, and total hemorrhagic events, with numerically fewer gastrointestinal bleeds when used for the secondary prevention of stroke.
Source: The American Journal of Cardiology - July 8, 2013 Category: Cardiology Authors: James J. DiNicolantonio, Carl J. Lavie, Hassan Fares, Arthur R. Menezes, James H. O'Keefe, Sripal Bangalore, Franz H. Messerli Tags: Miscellaneous Source Type: research

Age-Related Disparity Trends in Stroke-Related Mortality in the United States, 1999 to 2019
Stroke hospitalizations and mortality have declined in older subjects in the United States; however, acute ischemic stroke hospitalizations have increased in subjects 25 to 64  years of age.1,2 Regardless of increasing acute ischemic stroke hospitalization trends in young patients, population-based estimates and trends of stroke (including hemorrhagic and ischemic stroke) related mortality stratified by age groups are currently scarce. Therefore, in this study, we assess ed trends in stroke mortality rates in varying age groups over 2 decades in the United States.
Source: The American Journal of Cardiology - February 28, 2022 Category: Cardiology Authors: Rochell Issa, Abdul Mannan Khan Minhas, Robert W. Ariss, Salik Nazir, Hiba Rehman, Waleed Tallat Kayani, Salim S. Virani Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding, and Mortality in Patients With Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. Although randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit patients on dialysis. We thus undertook this systematic review and meta-analysis of observational studies including patients with AF on dialysis that reported associations of anticoagulation use. Twenty studies involving 529,741 subjects and 31,321 patients with AF on dialysis were identified. Anticoagulation was associated with a 45% (95% CI 13% to 88%) increased risk of any stroke, reflecting a nonsignificant 13% (95% CI −4% to 34...
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Tags: Arrhythmias and Conduction Disturbances Source Type: research

How Well do Stroke Risk Scores Predict Hemorrhage in Patients with Atrial Fibrillation?
The decision to use anticoagulants for atrial fibrillation depends on comparing a patient’s estimated risk of stroke to their bleeding risk. Several of the risk factors in the stroke risk schemes such as overlap with hemorrhage risk. We compared how well two stroke risk scores (CHADS2 and CHA2DS2-VASc) and two hemorrhage risk scores (the ATRIA bleeding score and the HAS-BLED score) predicted major hemorrhage on and off warfarin in a cohort of 13,559 community-dwelling adults with AF. Over a cumulative 64,741 person-years of follow up, we identified a total of 777 incident major hemorrhage events.
Source: The American Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Gene R. Quinn, Daniel E. Singer, Yuchiao Chang, Alan S. Go, Leila H. Borowsky, Margaret C. Fang Source Type: research

How Well Do Stroke Risk Scores Predict Hemorrhage in Patients With Atrial Fibrillation?
The decision to use anticoagulants for atrial fibrillation depends on comparing a patient's estimated risk of stroke to their bleeding risk. Several of the risk factors in the stroke risk schemes overlap with hemorrhage risk. We compared how well 2 stroke risk scores (CHADS2 and CHA2DS2-VASc) and 2 hemorrhage risk scores (the ATRIA bleeding score and the HAS-BLED score) predicted major hemorrhage on and off warfarin in a cohort of 13,559 community-dwelling adults with AF. Over a cumulative 64,741 person-years of follow-up, we identified a total of 777 incident major hemorrhage events.
Source: The American Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Gene R. Quinn, Daniel E. Singer, Yuchiao Chang, Alan S. Go, Leila H. Borowsky, Margaret C. Fang Tags: Arrhythmias and Conduction Source Type: research

Relation of CHA2DS2VASC Score with Hemorrhagic Stroke and Mortality in Patients Undergoing Fibrinolytic Therapy for ST Elevation Myocardial Infarction
Hemorrhagic stroke (HS) is a feared complication of Fibrinolytic therapy (FT). Risk assessment scores may help in risk stratification to reduce this complication. Patients (admissions) ≥18 years with a primary diagnosis of STEMI who received systemic thrombolysis were extracted from Nationwide Inpatient Sample database and stratified and compared based on CHA2DS2VASC score 0-3, 4-6 and 7-9 as low, intermediate and high risk respectively. The primary outcomes of interest were hem orrhagic stroke (HS) and mortality.
Source: The American Journal of Cardiology - October 18, 2018 Category: Cardiology Authors: Gbolahan O. Ogunbayo, Robert Pecha, Naoki Misumida, Dustin Hillerson, Ayman Elbadawi, Ahmed Abdel-latif, Claude S. Elayi, Adrian W. Messerli, Susan S. Smyth Source Type: research

Comparison of Stroke and Bleeding Risk Profile in Patients With Atrial Fibrillation and Chronic Kidney Disease
This study explores the impact of glomerular filtration rate (GFR) in the embolic-hemorrhagic balance among a large cohort of patients with AF. The study cohort included 15,457 patients diagnosed with AF between January 2014 and April 2020. The risk of ischemic stroke and major bleeding was determined by competing risk regression.
Source: The American Journal of Cardiology - April 12, 2023 Category: Cardiology Authors: Jos é Antonio Parada Barcia, Sergio Raposeiras Roubin, Emad Abu-Assi, Pablo Domínguez Erquicia, Andrea Lizancos Castro, Lucía Rioboo Lestón, Juan Ocampo Míguez, Inmaculada González Bermúdez, Andrés Íñiguez-Romo Source Type: research

Effects of Oral Anticoagulant Therapy in Medical Inpatients ≥65 Years With Atrial Fibrillation
In this retrospective cohort observational study, we investigated mortality, ischemic, and hemorrhagic events in patients ≥65 years with atrial fibrillation consecutively discharged from an Acute Geriatric Ward in the period 2010 to 2013. Stroke and bleeding risk were evaluated using CHA2DS2-VASC (congestive heart failure/left ventricular dysfunction, hypertension, aged ≥75 years, diabetes mellitus, stroke/transient ischemic attack/systemic embolism, vascular disease, aged 65 to 74 years, gender category) and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile in...
Source: The American Journal of Cardiology - December 1, 2015 Category: Cardiology Authors: Mario Bo, Irene Sciarrillo, Federica Li Puma, Marco Badinella Martini, Yolanda Falcone, Marina Iacovino, Enrica Grisoglio, Elena Menditto, Gianfranco Fonte, Enrico Brunetti, Guido Maggiani, Giovanni Carlo Isaia, Fiorenzo Gaita Tags: Arrhythmias and Conduction Disturbances Source Type: research

Drug-coated balloon for in-stent restenosis in high risk patients: Another brick in the wall of the challenging settings for interventionists
Recently Miglionico et al. published in this Journal an interesting prospective observational study regarding 82 high-risk patients with in-stent restenosis of bare metal stent (BMS), n=48 (59%) or drug-eluting stent (DES), n=34 (41%) .1 All patients had at least one of the following high-risk features: history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or non-cardiac surgery or recent surgery, chronic inflammatory disease or neoplasm.
Source: The American Journal of Cardiology - March 21, 2016 Category: Cardiology Authors: Dario Buccheri, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Source Type: research

Drug-Coated Balloon for Instent Restenosis in Patients at High Risk: Another Brick in the Wall of the Challenging Settings for Interventionists
Recently, Miglionico et al1 published in this journal an interesting prospective observational study regarding 82 patients at high-risk with instent restenosis of bare-metal stent, n = 48 (59%) or drug-eluting stent (DES), n = 34 (41%). All patients had at least one of the following high-risk features: a history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or noncardiac surgery or recent surgery, chronic inflammatory disease, or neoplasm.
Source: The American Journal of Cardiology - March 20, 2016 Category: Cardiology Authors: Dario Bucchei, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Tags: Readers' Comments 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

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

Association of Frailty Status on the Causes and Outcomes of Patients Admitted With Cardiovascular Disease
Data are limited about the contemporary association between frailty and the causes and outcomes of patients admitted with cardiovascular diseases (CVD). Using the US National Inpatient Sample, CVD admissions of interest (acute myocardial infarction, ischemic stroke, atrial fibrillation (AF), heart failure, pulmonary embolism, cardiac arrest, and hemorrhagic stroke) were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of in-hospital mortality among different groups with frailty.
Source: The American Journal of Cardiology - January 24, 2023 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Muhammad Rashid, Jo Protheroe, Richard Partington, Christian Mallen, Mamas A. Mamas Source Type: research

Left Atrial Appendage Occlusion Devices: Are We Isolating the Right Population?
Atrial fibrillation (AF) affects more than 37 million persons worldwide contributing to significant morbidity and mortality.1 Stroke prevention with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants remains the mainstay of therapy in patients with AF because of the reduction of all-cause mortality in randomized clinical trials when compared with placebo. VKAs are necessary for those patients with valvular AF but carry a higher risk of stroke, intracranial hemorrhage, and mortality when compared with non-VKA oral anticoagulants.
Source: The American Journal of Cardiology - June 27, 2023 Category: Cardiology Authors: Navid Nafissi, Anita M. Kelsey Source Type: research

Necropsy Findings Early After Transcatheter Aortic Valve Implantation for Aortic Stenosis
Although transcatheter aortic valve implantation has been available for 10 years, reports of cardiovascular morphologic studies after the procedure are virtually nonexistent. The investigators describe such findings in 2 patients, both 86 years of age, who died early (hours or several days) after transcatheter aortic valve implantation. Although the prosthesis in each was seated well, and each of the 3 calcified cusps of the native aortic valves was well compressed to the wall of the aorta, thus providing a good bioprosthetic orifice, the ostium of the dominant right coronary artery in each was obliterated by the native ri...
Source: The American Journal of Cardiology - November 26, 2012 Category: Cardiology Authors: William C. Roberts, Robert C. Stoler, Paul A. Grayburn, Robert F. Hebeler, Jong M. Ko, David L. Brown, William T. Brinkman, Michael J. Mack, Joseph M. Guileyardo Tags: Case Reports Source Type: research

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