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Source: The American Journal of Medicine

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Total 259 results found since Jan 2013.

Embolic stroke of undetermined source: Gateway to a new stroke entity?
Embolic stroke of unknown source is currently thought to represent a subpopulation of cryptogenic strokes defined by its embolic stroke pattern on imaging and if after a carefully performed diagnostic evaluation, a specific, well recognized cause of stroke has not been identified. The concept was primarily established to justify and enable the conduct of the Embolic Stroke of Unknown Source (ESUS)-trials, such as RESPECT-ESUS (Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate versus Acetylsalicylic Acid in Patients with ...
Source: The American Journal of Medicine - April 1, 2020 Category: General Medicine Authors: Wolf-R üdiger Schäbitz, Martin Köhrmann, Peter D. Schellinger, Jens Minnerup, Marc Fisher Tags: Review Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke A new kid on the block
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independent of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independently of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Tags: Review Source Type: research

Management of Acute Ischemic Stroke
The treatment of acute ischemic stroke has undergone a revolution recently with the publication of five positive thrombectomy trials in the early time window, 0-6 hours from stroke onset in 2015 and the more recent publication of two positive late window trials that included carefully selected patients up to 24 hours from stroke onset.1-3 The treatment efficacy of thrombectomy was highly robust in both time windows and the benefits can likely be expanded to less strictly selected patients. The treatment of acute ischemic stroke with thrombectomy built upon the more modest benefits observed previously with i.v.
Source: The American Journal of Medicine - October 25, 2018 Category: General Medicine Authors: Yunyun Xiong, Bharti Manwani, Marc Fisher Tags: Review Source Type: research

Cholesterol lowering and stroke: no longer room for pleiotropic effects of statins – confirmation from PCSK9 inhibitor studies
The relationship between cholesterol levels and stroke has been much less clear than between cholesterol levels and coronary heart disease. This is likely mostly due to the inadequate power of older studies and the low intensity of cholesterol-lowering interventions at that time available. Because a reduction in stroke has been, conversely, clearly observed in trials with statins, for long “pleiotropic” effects of such drugs, unrelated to cholesterol lowering, have been invoked. In a previous analysis of all randomized trials of cholesterol-lowering treatments reporting on stroke we had, however, reached the conclusion...
Source: The American Journal of Medicine - July 10, 2019 Category: General Medicine Authors: Tanya Salvatore, Riccardo Morganti, Roberto Marchioli, Raffaele De Caterina Tags: Clinical Research Study Source Type: research

Long-term cardiac monitoring after embolic stroke of undetermined source. Search longer – look harder
Ischemic stroke is a heterogeneous syndrome which may result from several causes such as atherosclerosis, small vessel disease and atrial fibrillation.1 Despite an extensive diagnostic work-up during the acute or chronic phase of the ischemic stroke, the cause of ischemic stroke remains unexplained for 20% of patients, termed cryptogenic stroke. 2 3
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Dimitrios Sagris, Stephanie L Harrison, Benjamin J.R Buckley, George Ntaios, Gregory Y.H Lip Source Type: research

Acute Stroke Imaging: What Clinicians Need to Know
Abstract: Advances in technology and software applications have contributed to new imaging modalities and strategies in the evaluation of patients with suspected acute cerebral infarction. Routine computed tomography (CT) and magnetic resonance imaging (MRI) have been the standard studies in stroke imaging, which have been complemented by CT and MR angiography, diffusion-weighted MR imaging, and cerebral perfusion studies, while conventional angiography is typically reserved for intra-arterial therapy. The purpose of this article is to review the variety of imaging studies available in the acute stroke setting, and to dis...
Source: The American Journal of Medicine - March 15, 2013 Category: Journals (General) Authors: Rihan Khan, Kambiz Nael, William Erly Tags: Reviews Source Type: research

Apparent Treatment-Resistant Hypertension among Individuals with History of Stroke or Transient Ischemic Attack
and Purpose. Blood pressure control is a paramount goal in secondary stroke prevention; however, high prevalence of uncontrolled blood pressure and use of multiple antihypertensive medication classes in stroke patients suggest this goal is not being met. We determined the prevalence and factors associated with apparent treatment-resistant hypertension in persons with/without stroke or transient ischemic attack..
Source: The American Journal of Medicine - March 11, 2015 Category: Journals (General) Authors: Virginia J. Howard, Rikki M. Tanner, Aaron Anderson, Marguerite R. Irvin, David A. Calhoun, Daniel T. Lackland, Suzanne Oparil, Paul Muntner Source Type: research

Patent Foramen Ovale Closure for Secondary Prevention of Cryptogenic Stroke: Updated Meta-Analysis of Randomized Clinical Trials
• In patients with recent cryptogenic stroke, percutaneous closure of patent foramen ovale reduced recurrent stroke/transient ischemic attack compared with medical therapy, but was associated with higher risk of new-onset atrial fibrillation/flutter.• Select, young patients (≤60 years) present ing with recent cryptogenic stroke may benefit from percutaneous closure of patent foramen ovale at relatively low procedural risk.
Source: The American Journal of Medicine - December 8, 2017 Category: General Medicine Authors: Muthiah Vaduganathan, Arman Qamar, Ankur Gupta, Navkaranbir Bajaj, Harsh B. Golwala, Ambarish Pandey, Deepak L. Bhatt Tags: Brief Observation Source Type: research

Twenty-Five-Year (1986-2011) Trends in the Incidence and Death Rates of Stroke Complicating Acute Myocardial Infarction
The occurrence of a stroke after an acute myocardial infarction is associated with increased morbidity and mortality rates. However, limited data are available, particularly from a population-based perspective, about recent trends in the incidence and mortality rates associated with stroke complicating an acute myocardial infarction.The purpose of this study was to examine 25-year trends (1986-2011) in the incidence and in-hospital mortality rates of initial episodes of stroke complicating acute myocardial infarction.
Source: The American Journal of Medicine - May 3, 2018 Category: General Medicine Authors: Essa Hariri, Mayra Tisminetzky, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg Tags: Clinical Research Study Source Type: research

Long-Term Cardiac Monitoring After Embolic Stroke of Undetermined Source: Search Longer, Look Harder
Embolic stroke of undetermined source (ESUS) represents a heterogeneous subgroup of patients with cryptogenic stroke, in which despite an extensive diagnostic workup the cause of stroke remains uncertain. Identifying covert atrial fibrillation among patients with ESUS remains challenging. The increasing use of cardiac implanted electronic devices (CIED), such as pacemakers, implantable defibrillators, and implantable loop recorders (ILR), has provided important information on the burden of subclinical atrial fibrillation.
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Dimitrios Sagris, Stephanie L. Harrison, Benjamin J.R. Buckley, George Ntaios, Gregory Y.H. Lip Tags: Review Source Type: research

Atrial Fibrillation and Stroke: Epidemiology
Abstract: The statistics for AFib are impressive. (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). The principal risk with AFib, stroke or thrombotic embolism, is increased 5-fold in some series; AFib accounts for ≥15% of all strokes in the United States, 36% of strokes for individuals aged>80, and up to 20% of cryptogenic strokes, which means>100,000–125,000 embolic strokes per year, of which>20% are fatal. Patients with ischemic stroke and AFib are significantly (P
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: James A. Reiffel Tags: CME multimedia activities Source Type: research

Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: A nationwide cohort study
This study revealed, that in clinical practice, vitamin K antagonist-experienced patients with a history of stroke or transient ischemic attack who switch to dabigatran therapy may have an increased rate of a recurrent stroke compared to patients persisting with vitamin K antagonist therapy.
Source: The American Journal of Medicine - September 1, 2014 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Lars Hvilsted Rasmussen, Anders Gorst-Rasmussen, Flemming Skjøth, Deirdre A. Lane, Gregory Y.H. Lip Source Type: research

The Reply
Braillon contends that we should have stressed the poor and unacceptable levels of quality of care for ischemic stroke, which was even worse for transient ischemic attack. We do not agree that the quality of care for ischemic stroke was unacceptable and poor.
Source: The American Journal of Medicine - February 22, 2015 Category: Journals (General) Authors: Sripal Bangalore, Lee Schwamm, Eric E. Smith, Inder M. Singh, Li Liang, Gregg C. Fonarow, Deepak L. Bhatt, Get With the Guidelines-Stroke Steering Committee and Investigators Tags: AJM online Source Type: research

Healthy Lifestyle and Functional Outcomes from Stroke in Women
While a healthy lifestyle has been associated with reduced risk of developing ischemic stroke, less is known about its effect on stroke severity.
Source: The American Journal of Medicine - February 17, 2016 Category: Journals (General) Authors: Pamela M. Rist, Julie E. Buring, Carlos S. Kase, Tobias Kurth Tags: Clinical Research Study Source Type: research