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Source: Journal of Stroke and Cerebrovascular Diseases
Drug: Warfarin
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Total 77 results found since Jan 2013.
Comparison of primary and secondary stroke prevention in patients with nonvalvular atrial fibrillation: Results from the RAFFINE registry
Atrial fibrillation (AF) is a predictor of severe stroke and early death in acute ischemic stroke patients.1 The prevalence of AF has increased as the Japanese population has aged.2 AF has been more common among patients with ischemic stroke than previously reported.3 In particular, AF patients with a history of stroke or TIA have had higher risks for stroke, hemorrhagic events, and death compared to those without.4,5 In these previous studies, most patients received warfarin for anticoagulation therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - November 7, 2022 Category: Neurology Authors: Kazuo Yamashiro, Ryota Tanaka, Sakiko Miyazaki, Katsumi Miyauchi, Hidemori Hayashi, Yuji Nishizaki, Shuko Nojiri, Satoru Suwa, Masataka Sumiyosi, Yuji Nakazato, Takao Urabe, Nobutaka Hattori, Tohru Minamino, Hiroyuki Daida Source Type: research
Another possible determinant for ischemic stroke with nonvalvular atrial fibrillation other than conventional oral anticoagulant treatment: The relationship between whole blood viscosity and stroke ☆
Prevention of ischemic stroke complication of atrial fibrillation (AF) is the crucial target in the disease. Stroke is largely prevented by warfarin and the introduction of new oral anticoagulants. While warfarin reduces stroke by 60 –70%, new oral anticoagulants provide at least equal success to this reduction with appropriate dose and treatment compliance.1,2 Nonetheless, we still encounter thromboembolic ischemic stroke in clinical practice in AF patients taking oral anticoagulants (OAC) and once experienced, stroke can hav e devastating consequences for the patients.
Source: Journal of Stroke and Cerebrovascular Diseases - August 3, 2022 Category: Neurology Authors: Sezen Baglan Uzunget, Kader Eliz Sahin Source Type: research
Risk Factors Control and Early Recurrent Cerebral Infarction in Patients with Symptomatic Intracranial Atherosclerotic Disease
Stroke caused by intracranial atherosclerotic disease (IAD) has the highest risk of early recurrence when compared to other stroke subtypes.1 Despite intensive medical management, the 1-year recurrence risk is as high as 15%.2,3 Uncontrolled risk factors may substantially influence stroke recurrence in symptomatic IAD. In the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial, uncontrolled systolic blood pressure (SBP) (>140 mmHg) and elevated cholesterol (>200 mg/dL) were associated with increased recurrent stroke during follow-up.
Source: Journal of Stroke and Cerebrovascular Diseases - June 30, 2021 Category: Neurology Authors: Victor J. Del Brutto, David S. Liebeskind, Jose G. Romano, Iszet Campo-Bustillo, George Cotsonis, Azhar Nizam, Shyam Prabhakaran, MYRIAD investigators Source Type: research
Risk of Stroke Outcomes in Atrial Fibrillation Patients Treated with Rivaroxaban and Warfarin
In a previous real-world study, rivaroxaban reduced the risk of stroke overall and severe stroke compared with warfarin in patients with nonvalvular atrial fibrillation (NVAF). The aim of this study was to assess the reproducibility in a different database of our previously observed results (Alberts M, et al. Stroke. 2020;51:549-555) on the risk of severe stroke among NVAF patients in a different population treated with rivaroxaban or warfarin.
Source: Journal of Stroke and Cerebrovascular Diseases - March 17, 2021 Category: Neurology Authors: Dejan Milentijevic, Jennifer H. Lin, Nancy Connolly, Yen-Wen Chen, Emily Kogan, Shubham Shrivastava, Erik Sjoeland, Mark J. Alberts Source Type: research
Safety of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Taking Warfarin with Subtherapeutic INR
Current guidelines allow the administration of intravenous recombinant tissue plasminogen activator (IV r-tPA) to warfarin-treated patients with acute ischemic stroke (AIS) who have an international normalized ratio (INR) of ≤1.7. However, concerns remain about the safety of using IV r-tPA in this situation due to a conceivable risk of symptomatic intracranial hemorrhage (sICH), lack of dedicated randomized controlled trials and the conflicts in the available data. We aimed to determine the risk of sICH in warfarin-tr eated patients with subtherapeutic INR who received IV r-tPA for AIS in our large volume comprehensive center.
Source: Journal of Stroke and Cerebrovascular Diseases - February 25, 2021 Category: Neurology Authors: Ashkan Mowla, Aurangzeb Memon, Seyed-Mostafa Razavi, Navdeep S. Lail, Caila B. Vaughn, Pegah Mohammadi, Robert N. Sawyer, Peyman Shirani Source Type: research
Time to Stable Therapeutic Range on Initiation of Warfarin as an Indicator of Control
Warfarin remains widely used with a time in therapeutic range (TiTR) above 65% recommended for best outcomes. Patients not achieving or maintaining this warfarin control may be better suited to alternate anticoagulants. Despite this, there is limited data defining a suitable trial time in patients initiating warfarin therapy, therefore the aim of this study was to determine the mean time to stable therapeutic range (TtSTR).
Source: Journal of Stroke and Cerebrovascular Diseases - January 22, 2021 Category: Neurology Authors: Narong Puttasung, Andrew K Davey, Tony Badrick, Shailendra Anoopkumar-Dukie, Nijole Bernaitis Source Type: research
Current Advances in Endovascular Treatment of Intracranial Atherosclerotic Disease and Future Prospective
Intracranial atherosclerotic disease (ICAD) is an important cause of large vessel disease leading to acute ischemic stroke (AIS). Currently, medical management such as risk factor control, antiplatelet therapy, and lifestyle changes are considered the first-line of treatment to prevent transient ischemic attack (TIA) or AIS.1 The results of the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial2 demonstrated that symptomatic ICAD is a high-risk cause of recurrent stroke and highlighted the need for better treatment strategies, leading to consideration for both better medical management and the possibility of a...
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2020 Category: Neurology Authors: Mostafa Jafari, Thanh N. Nguyen, Santiago Ortega-Gutierrez, Muhammad Shazam Hussain, Ameer E. Hassan, Asad Ikram, Javed Khader Eliyas, Gustavo J. Rodriguez, Afshin A. Divani Tags: Review Article Source Type: research
Clinical Trial Based Rationale for the Successful Use of DOAC in the Treatment of Cerebral Venous Sinus Thrombosis (CVST): A Case Report
In cerebral venous sinus thrombosis (CVST), venous sinus occlusion increases venous pressure and disrupts venous return, resulting in progression to venous infarction and venous hemorrhage, with poor neurologic outcome. Therefore, early recanalization of the major venous sinus is critical.Anticoagulant therapy with continuous intravenous infusion of heparin and subsequent oral anticoagulant administration is the recommended first line of treatment for CVST. Some large clinical trials for venous thromboembolism (VTE) have shown that direct oral anticoagulant (DOAC) is non-inferior to the standard therapy with heparin or war...
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2020 Category: Neurology Authors: Toshiaki Bando, Yasushi Ueno, Daisuke Shimo, Takahiro Kuroyama, Kazuyuki Mikami, Shinya Hori, Osamu Hirai Tags: Case Report Source Type: research
Convexity Subarachnoid Hemorrhage Soon after Starting a Direct Oral Anticoagulant in 2 Patients with Acute Infarction
Convexity subarachnoid hemorrhage (cSAH) is typically due to head trauma, but various nontraumatic causes for cSAH are known also. Nontraumatic cSAH is most commonly associated with cerebral amyloid angiopathy (CAA) in the elderly or with reversible cerebral vasoconstriction syndrome in younger subjects,1 but cSAH rarely occurs subsequent to acute ischemic stroke.2 Direct oral anticoagulants (DOACs) are used to reduce the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation and have favorable bleeding profiles as compared with warfarin,3,4 but here we describe 2 cSAH patients who ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 13, 2020 Category: Neurology Authors: Yoichiro Sugita, Yoichiro Nishida, Satoru Ishibashi, Takanori Yokota Tags: Case Report Source Type: research
Reversal strategies and outcomes in patients with atrial fibrillation and warfarin-associated intracranial hemorrhage
While anticoagulants are highly effective in preventing thromboembolism in atrial fibrillation (AF), they raise the risk of hemorrhage, which can be life-threatening especially in cases of intracranial hemorrhage (ICH). Warfarin-associated intraparenchymal hemorrhage (IPH) leads to death within 30 days in as many as 60% of cases while the other major category of ICH on warfarin, subdural hemorrhage (SDH), leads to death in approximately a quarter of cases.1 Managing these potentially devastating bleeds is an important consideration in treating patients on oral anticoagulant therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Daniel E. Singer, Leila H. Borowsky, Susan Regan, Jong Woo Lee, Kristina Zint, Lionel Riou Franca, Joshua N. Goldstein Source Type: research
Multicenter prospective analysis of stroke patients taking oral anticoagulants: The PASTA registry - Study design and characteristics
The management of atrial fibrillation and deep venous thrombosis has evolved with the development of direct oral anticoagulants (DOAC), and oral anticoagulant (OAC) might influence the development or clinical course in both ischemic and hemorrhagic stroke. However, detailed data on the differences between the effects of the prior prescription of warfarin and DOAC on the clinical characteristics, neuroradiologic findings, and outcome of stroke are limited.
Source: Journal of Stroke and Cerebrovascular Diseases - October 28, 2019 Category: Neurology Authors: Satoshi Suda, Yasuyuki Iguchi, Shigeru Fujimoto, Yoshiki Yagita, Yu Kono, Masayuki Ueda, Kenichi Todo, Tomoyuki Kono, Takayuki Mizunari, Mineo Yamazaki, Takao Kanzawa, Seiji Okubo, Kimito Kondo, Nobuhito Nakajima, Takeshi Inoue, Takeshi Iwanaga, Makoto Na Source Type: research
Intracardiac Thrombus Following Rivaroxaban Treatment in a Patient with Atrial Fibrillation Associated with Rheumatic Heart Disease
We report a case of atrial fibrillation with rheumatic heart disease (RHD) who had intracardiac thrombus and cardiogenic cerebral embolism with rivaroxaban therapy. Intracardiac thrombus disappeared after switching from rivaroxaban to warfarin. Patients of RHD have the possibility of gradual progression of valvular disease even if they are old, so we need to distinguish nonvalvular atrial fibrillation from RHD before starting direct oral anticoagulants.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2019 Category: Neurology Authors: Hiroaki Ohara, Shiro Yamamoto, Keiko Nagano, Kazuo Hashikawa Tags: Case Report Source Type: research
A Therapeutic International Normalized Ratio Results in Smaller Infarcts and Better Outcomes for Patients with Ischemic Stroke
Background: Prior studies have shown that warfarin is effective for both primary and secondary stroke prevention in individuals with atrial fibrillation. It is also known that those on warfarin with atrial fibrillation often have poorer long-term poststroke outcomes, possibly because cardioembolic strokes tend to be larger and more severe. Less is known regarding the direct effect of the international normalized ratio (INR) value at the time of stroke on severity or long-term functional status. Methods: We prospectively followed a consecutive series of 112 patients presenting to our institution with acute ischemic stroke b...
Source: Journal of Stroke and Cerebrovascular Diseases - July 16, 2019 Category: Neurology Authors: Dawn Merbach, Erin Lawrence, Dania Mallick, Elisabeth B. Marsh Source Type: research
Effectiveness of Nonvitamin K Antagonist Oral Anticoagulants and Warfarin for Preventing Further Cerebral Microbleeds in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation and At Least One Microbleed: CMB-NOW Multisite Pilot Trial
Nonvitamin K antagonist oral anticoagulants (NOACs) are considered superior, or at least noninferior, to warfarin in preventing stroke or systemic embolism in patients with nonvalvular atrial fibrillation. Here, we recruited acute ischemic stroke patients with nonvalvular atrial fibrillation and at least one cerebral microbleed (CMB), and evaluated the proportion of patients who had an increased number of CMBs (%) after receiving anticoagulant therapy with NOACs or with warfarin for 12 months.
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2019 Category: Neurology Authors: Mutsumi Yokoyama, Atsushi Mizuma, Tohru Terao, Fumiaki Tanaka, Kazutoshi Nishiyama, Yasuhiro Hasegawa, Eiichiro Nagata, Shigeru Nogawa, Hiroyuki Kobayashi, Noriharu Yanagimachi, Takashi Okazaki, Kazuo Kitagawa, Shunya Takizawa, for the CMB-NOW Study Inves Source Type: research
Secular Trends in the Background of Intracerebral Hemorrhage from 2010 to 2015
Direct oral anticoagulants (DOACs) were recently introduced for the clinical use in stroke prevention, and they are reported to show a lower risk of intracerebral hemorrhage (ICH) compared to warfarin. We were interested to know whether there is any change in clinical backgrounds of ICH patients to date.
Source: Journal of Stroke and Cerebrovascular Diseases - October 6, 2018 Category: Neurology Authors: Taizen Nakase, Junta Moroi, Tatsuya Ishikawa Source Type: research
