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Source: Current Cardiology Reports

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Total 125 results found since Jan 2013.

Update on Neurocritical Care of Stroke
AbstractPurpose of ReviewThis review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit.Recent FindingsNew studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations. More rapid automated CT perfusion and angiography may demonstrate a vascular penumbra for neuroendovascu...
Source: Current Cardiology Reports - June 23, 2017 Category: Cardiology Source Type: research

Migraine and the Risk for Stroke and Cardiovascular Disease
Abstract Numerous data have pointed to an association between migraine and cardiovascular diseases. The majority of the available data have indicated that migraine with aura can be considered a risk factor for ischemic stroke, whereas migraine without aura cannot be reliably considered as such. High frequency of attacks and a recent onset of migraine have been related to an increased ischemic stroke risk. In addition, in young subjects with ischemic stroke migraine with aura represents an independent risk factor of overall recurrent vascular events and of recurrent ischemic stroke. Also the risk of transient isch...
Source: Current Cardiology Reports - July 25, 2014 Category: Cardiology Source Type: research

Stroke: Advances in Medical Therapy and Acute Stroke Intervention
Abstract Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythm...
Source: Current Cardiology Reports - August 16, 2015 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy with Clopidogrel and Aspirin for Secondary Stroke Prevention
This article aims at providing a comprehensive review of the evidence on the use of aspirin plus clopidogrel for secondary stroke prevention, with special focus on important studies that may impact clinical practice of treating patients with stroke or transient ischemic attack.
Source: Current Cardiology Reports - August 20, 2015 Category: Cardiology Source Type: research

Genetic Risk Factors for Ischemic and Hemorrhagic Stroke
AbstractUnderstanding the genetic risk factors for stroke is an essential step to decipher the underlying mechanisms, facilitate the identification of novel therapeutic targets, and optimize the design of prevention strategies. A very small proportion of strokes are attributable to monogenic conditions, the vast majority being multifactorial, with multiple genetic and environmental risk factors of small effect size. Genome-wide association studies and large international consortia have been instrumental in finding genetic risk factors for stroke. While initial studies identified risk loci for specific stroke subtypes, more...
Source: Current Cardiology Reports - October 30, 2016 Category: Cardiology Source Type: research

Stroke Risk in Atrial Fibrillation: Beyond the CHA 2 DS 2 -VASc Score
AbstractPurpose of ReviewStroke prevention is the cornerstone of atrial fibrillation (AF) management and the anticoagulation decision is currently based on CHA2DS2-VASc risk score. We discuss several novel risk factors besides those included in CHA2DS2-VASc score and alternative models for stroke prediction.Recent FindingsSeveral clinical markers including obstructive sleep apnea and renal failure, laboratory markers like brain natriuretic peptide, imaging criteria including left atrial appendage morphology, spontaneous echo contrast, and coronary artery calcium score may predict stroke in AF patients. Addition of African ...
Source: Current Cardiology Reports - July 26, 2019 Category: Cardiology Source Type: research

Use of a Discharge Educational Strategy Versus Standard Discharge Care on Reduction of Vascular Risk in Patients with Stroke and Transient Ischemic Attack
AbstractPurpose of the ReviewThe burden of ischemic stroke is disproportionally distributed between ethnic and racial subgroups in the USA, minority populations with lower socioeconomic status being at higher risk. These discrepancies are mirrored in susceptibility, primary care, and post-discharge procedures. Post-discharge strategies are of particular importance as their primary goal is to prevent recurrent stroke, which makes up about 25% of stroke cases per year in US. As disadvantaged minorities have faster growing populations, recurrent stroke poses a significant challenge not only for caretakers but also for the hea...
Source: Current Cardiology Reports - March 18, 2020 Category: Cardiology Source Type: research

Role of Telemedicine in Prehospital Stroke Care
AbstractPurpose of ReviewTo summarize evidence for the feasibility and the efficacy of mobile stroke units (MSUs) and telemedicine in the field to reduce time delays in offering acute stroke interventions.Recent FindingsA mobile stroke unit is a modified ambulance and includes sophisticated equipment, either trained personnel on board, or connection with skilled physicians via telemedicine. Stroke assessment and treatment agreeability between the on board and remote neurologist is high in MSUs. MSUs are the promising option to reduce stroke symptom onset to treatment time; telemedicine platform has a satisfactory audiovisu...
Source: Current Cardiology Reports - May 10, 2021 Category: Cardiology Source Type: research

Stroke Prevention in Cervical Artery Dissection
AbstractPurpose of ReviewCervical artery dissection (CAD) is rare, yet it is a common cause of stroke in young and middle-aged adults. Historically, some senior clinicians favored anticoagulation in the prevention of stroke due to CAD. Choosing the optimal antithrombotic treatment with either antiplatelet (AP) or anticoagulant (AC) medications remains a challenge. This paper will review the clinical features and imaging of CAD, and the acute treatment and prevention of stroke due to CAD.Recent FindingsUntil 2015, there were no prospective randomized trials in the optimal antithrombotic management of CAD. The Cervical Arter...
Source: Current Cardiology Reports - October 23, 2021 Category: Cardiology Source Type: research

Use of Prolonged Cardiac Rhythm Monitoring to Identify Atrial Fibrillation After Cryptogenic Stroke
AbstractPurpose of ReviewProlonged cardiac monitoring (PCM) improves detection of atrial fibrillation (AF) after cryptogenic stroke. We summarize current research supporting the use of PCM as part of the cryptogenic stroke evaluation, while highlighting areas that require more investigation.Recent FindingsDespite increased AF detection with longer durations of PCM, more definitive research is needed to demonstrate how PCM improves clinical outcomes. The optimal type, timing, and length of cardiac monitoring after cryptogenic stoke remains unknown. Clinical calculators will be important to risk stratify which cryptogenic st...
Source: Current Cardiology Reports - February 16, 2022 Category: Cardiology Source Type: research

Rationale and Current Evidence for Testing Iron Chelators for Treating Stroke
AbstractPurpose of ReviewTo discuss the mechanisms of iron regulation in the brain and the pathophysiological role of deregulation of iron homeostasis following a stroke, and to review existing evidence supporting the potential role of iron chelators in the treatment of ischemic and hemorrhagic stroke.Recent FindingsIn recent years, accumulating evidence has highlighted the role of neuroinflammation in neurological injury after ischemic and hemorrhagic stroke, and that free iron is central to this process. Via the Fenton reaction, free iron catalyzes the conversion of superoxide ion and hydrogen peroxide into hydroxyl radi...
Source: Current Cardiology Reports - March 3, 2019 Category: Cardiology Source Type: research

Ethics and Bias in Clinical Trial Enrollment in Stroke
AbstractPurpose of ReviewTo familiarize the reader with ethical concerns and potential scientific bias in management and conduction of clinical stroke trials.Recent FindingsThe goal of clinical trials in stroke is to find effective interventions for stroke prevention, acute treatment, and rehabilitation and recovery. Acute trials must be designed in the context of the time-sensitivity of revascularization therapies. Standard ethical constraints apply. However, informed consent is hindered by tight time windows for reperfusion therapy and frequent cognitive impairment in patients. These might be mitigated by using visual de...
Source: Current Cardiology Reports - April 21, 2019 Category: Cardiology Source Type: research

A Clinical Update on Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke
AbstractPurpose of ReviewAntiplatelet therapy remains the standard of care in secondary stroke prevention for non-cardioembolic ischemic stroke and transient ischemic attack. We aim to examine the use of antiplatelet agents in secondary prevention through highlighting relevant clinical trials and meta-analyses as well as providing commentary regarding our practice.Recent FindingsIn the POINT and CHANCE trials, dual antiplatelet therapy reduced recurrent stroke compared to aspirin monotherapy. Sub-analyses of these trials suggest that genetic polymorphisms could play a role in diminishing the effectiveness of clopidogrel. S...
Source: Current Cardiology Reports - August 19, 2021 Category: Cardiology Source Type: research

Stroke and Noninfective Native Valvular Disease
AbstractPurpose of ReviewEmbolic stroke of undetermined source is a challenging clinical entity. While less common than atrial fibrillation and endocarditis, many noninfective heart valve lesions have been associated with stroke and may be considered as culprits for cerebral infarcts when other more common causes are excluded. This review discusses the epidemiology, pathophysiology, and management of noninfective valvular diseases that are commonly associated with stroke.Recent FindingsCalcific debris from degenerating aortic and mitral valves may embolize to the cerebral vasculature causing small- or large-vessel ischemia...
Source: Current Cardiology Reports - March 27, 2023 Category: Cardiology Source Type: research