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Total 682 results found since Jan 2013.

Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology
ConclusionsThe study reveals a high prevalence and diverse distribution of AF in patients with cardiomyopathies, inadequate anticoagulation regimen, and high risk of stroke/TIA in this population.
Source: ESC Heart Failure - September 16, 2020 Category: Cardiology Authors: Katarzyna Mizia ‐Stec, Alida L.P. Caforio, Philippe Charron, Juan R. Gimeno, Perry Elliott, Juan Pablo Kaski, Aldo P. Maggioni, Luigi Tavazzi, Angelos G. Rigopoulos, Cecile Laroche, Attila Frigy, Elisabetta Zachara, Maria Luisa Pena‐Pena, Tags: Original Research Article Source Type: research

Comparing stroke prevention therapy of direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation: a nationwide retrospective observational study
Direct oral anticoagulants (DOACs) are not only increasingly being used for the initial stroke prevention therapy but progressively also substitute vitamin K antagonist (VKA) treatment in patients with non-val...
Source: BMC Medicine - August 27, 2020 Category: Internal Medicine Authors: Lena M. Paschke, Kerstin Klimke, Attila Altiner, Dominik von Stillfried and Maike Schulz Tags: Research article Source Type: research

Non-vitamin K oral anticoagulants as first-line regimen for acute ischemic stroke with non-valvular atrial fibrillation
There are various patterns in determining the choice of the first-line antithrombotic agent for acute stroke with non-valvular atrial fibrillation. We investigated the efficacy and safety of non-vitamin K oral anticoagulants as first-line antithrombotics for patients with acute stroke and non-valvular atrial fibrillation.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Chan Wook Park, Hyo Suk Nam, Ji Hoe Heo, Hyung Jong Park, Jin Kyo Choi, Hye Sun Lee, Han Kyu Na, Young Dae Kim Source Type: research

Cost-effectiveness analysis of apixaban compared to other direct oral anticoagulants for prevention of stroke in Austrian atrial fibrillation patients.
CONCLUSION: In patients with AF and an increased risk of stroke, prophylaxis with apixaban was highly cost-effective from the perspective of the Austrian health care system. PMID: 32700584 [PubMed - as supplied by publisher]
Source: Expert Review of Pharmacoeconomics and Outcomes Research - July 24, 2020 Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research

Predicting Adverse Events beyond Stroke and Bleeding with the ABC-Stroke and ABC-Bleeding Scores in Patients with Atrial Fibrillation: The Murcia AF Project.
CONCLUSION:  In AF patients, the ABC-stroke and ABC-bleeding scores demonstrated similar predictive ability for outcomes beyond stroke and bleeding, including MI, acute HF, a composite of cardiovascular events, and all-cause deaths. This is consistent with nonspecificity of biomarkers that predict "sick" patients or poor prognosis overall. PMID: 32506417 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - June 6, 2020 Category: Hematology Authors: Camelo-Castillo A, Rivera-Caravaca JM, Marín F, Vicente V, Lip GYH, Roldán V Tags: Thromb Haemost Source Type: research

Left atrial appendage closure for stroke prevention in atrial fibrillation : An update.
Authors: Zimmermann F, Landmesser U Abstract Atrial fibrillation (AF) is one of the most frequent causes of ischemic stroke. Without treatment the annual risk of ischemic stroke is on average approximately 5-6%/year in patients with atrial fibrillation, depending on the overall cardiovascular risk profile. Oral anticoagulation with new oral anticoagulants (NOAC) or vitamin K antagonists (VKA) is recommended for patients with AF and an elevated risk for stroke (CHA2DS2-VASc score ≥1); however, severe bleeding complications are potential reasons for discontinuation of this treatment. Overall, up to 30 % of the pa...
Source: Herz - May 18, 2020 Category: Cardiology Tags: Herz Source Type: research

Incidence and consequences of resuming oral anticoagulant therapy following hematuria and risks of ischemic stroke and major bleeding in patients with atrial fibrillation
In conclusion, more and more patients who suffer a hematuria while on oral anticoagulant therapy resume NOAC. Patients resuming NOAC have similar risks of ischemic stroke/systemic embolism and major bleeding compared with those resuming VKA.
Source: Journal of Thrombosis and Thrombolysis - May 13, 2020 Category: Hematology Source Type: research

Rates and Determinants for the Use of Anticoagulation Treatment before Stroke in Patients with Known Atrial Fibrillation
Conclusions: Only 21.9% of the patients hospitalized for a stroke or TIA with known AF before the event were adequately treated according to recent treatment guidelines. It is important to improve medical information about the risk of AF and the efficacy of anticoagulants in stroke prevention.Cerebrovasc Dis Extra 2020;10:44 –49
Source: Cerebrovascular Diseases Extra - May 6, 2020 Category: Neurology Source Type: research

Combination of Oral Anticoagulants and Single Antiplatelets versus Triple Therapy in Nonvalvular Atrial Fibrillation and Acute Coronary Syndrome: Stroke Prevention among Asians
Int J Angiol DOI: 10.1055/s-0040-1708477Atrial fibrillation (AF), the most prevalent arrhythmic disease, tends to foster thrombus formation due to hemodynamic disturbances, leading to severe disabling and even fatal thromboembolic diseases. Meanwhile, patients with AF may also present with acute coronary syndrome (ACS) and coronary artery disease (CAD) requiring stenting, which creates a clinical dilemma considering that majority of such patients will likely receive oral anticoagulants (OACs) for stroke prevention and require additional double antiplatelet treatment (DAPT) to reduce recurrent cardiac events and in-stent th...
Source: International Journal of Angiology - May 5, 2020 Category: Cardiology Authors: Santoso, Anwar Raharjo, Sunu B. Tags: Invited Papers Source Type: research

Anticoagulants for Stroke Prevention in Atrial Fibrillation in Elderly Patients
AbstractIschaemic stroke and systemic embolism are the major potentially preventable complications of atrial fibrillation (AF) leading to severe morbidity and mortality. Anticoagulation using vitamin K antagonists (VKA) or non-vitamin K oral anticoagulants (NOACs) is mandatory for stroke prevention in AF. Following approval of the four NOACs dabigatran, rivaroxaban, apixaban, and edoxaban, the use of VKA is declining steadily. Increasing age with thresholds of 65 and 75  years is a strong risk factor when determining annual stroke risk in AF patients. Current recommendations such as the “2016 Guidelines for the manageme...
Source: Cardiovascular Drugs and Therapy - April 28, 2020 Category: Cardiology Source Type: research

Evaluation of stroke incidence with duty ‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study
ConclusionsVICTORY AF demonstrated a 1.6% incidence of stroke in PersAF undergoing ablation with a phased RF system which did not meet statistical confidence due to poor enrollment. The secondary outcomes suggest comparable efficacy to phased RF in the tailored treatment of permanent AF trial. Rigorous clinical evaluation of the stroke risk of new AF ablation technologies as well as restriction to Vitamin K antagonist anticoagulation appears to be unachievable goals in a clinical multicenter IDE trial of AF ablation in the current era.
Source: Journal of Cardiovascular Electrophysiology - April 23, 2020 Category: Cardiology Authors: John Hummel, Atul Verma, Hugh Calkins, Lee H. Schwamm, Daryl Gress, Darryl Wells, Joseph Souza, Robert B. Hokanson, Lauren Hemingway, Kurt Stromberg, Robert Hoyt, Andrew Wickliffe, David DeLurgio, Lucas Boersma Tags: ORIGINAL ARTICLE Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants in Secondary Stroke Prevention in Atrial Fibrillation Patients: An Updated Analysis by Adding Observational Studies
ConclusionBased on current data, the use of NOACs is at least non-inferior to the use of VKAs in AF patients for secondary stroke prevention irrespective of NOAC type.
Source: Cardiovascular Drugs and Therapy - April 14, 2020 Category: Cardiology Source Type: research

MRI characteristics in acute ischemic stroke patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists
Despite the utility of neuroimaging in the diagnostic and therapeutic management of patients with acute ischemic stroke (AIS), imaging characteristics in patients with preceding direct oral anticoagulants (DOA...
Source: BMC Neurology - March 11, 2020 Category: Neurology Authors: Thomas Raphael Meinel, Johannes Kaesmacher, Jan Gralla, David J. Seiffge, Elias Auer, Sebasti én Frey, Marwan El-Koussy, Marcel Arnold, Urs Fischer, Martina Göldlin, Simon Jung and Arsany Hakim Tags: Research article Source Type: research

Racial Disparity in the Prescription of Anticoagulants and Risk of Stroke and Bleeding in Atrial Fibrillation Patients
Background: Oral anticoagulant (OAC) therapy is proven to be effective at reducing risk of stroke in patients with atrial fibrillation (AF). However, racial minorities with AF are less likely to be prescribed vitamin K anticoagulants (VKA). There is little information on the racial disparity in the prescription of the non-vitamin K oral anticoagulants (NOACs) and the associated risks of stroke and bleeding. Methods: We used data from the Northwestern Medicine Enterprise Data Warehouse – a joint initiative across 11 Northwestern Medicine affiliated healthcare centers within metropolitan Chicago, Illinois.
Source: Journal of Stroke and Cerebrovascular Diseases - February 27, 2020 Category: Neurology Authors: Yacob G. Tedla, Sarah M. Schwartz, Philip Silberman, Philip Greenland, Rod S. Passman Source Type: research

Factors for recurrent stroke among Asian patients with non-valvular atrial fibrillation under non-vitamin K antagonist oral anticoagulant therapy.
CONCLUSION: Atrial fibrillation patients with underlying malignancy or concurrently use of EIAED may have increased risk of treatment failure in secondary stroke prevention. PMID: 32107099 [PubMed - as supplied by publisher]
Source: J Formos Med Assoc - February 23, 2020 Category: General Medicine Authors: Lin SY, Tang SC, Tsai LK, Yeh SJ, Huang CF, Jeng JS Tags: J Formos Med Assoc Source Type: research

Uninterrupted anticoagulation during catheter ablation for atrial fibrillation: no difference in major bleeding and stroke between direct oral anticoagulants and vitamin K antagonists in an updated meta-analysis of randomised controlled trials.
Conclusion: Our meta-analysis suggests that uninterrupted DOAC is not superior to VKA in patients undergoing catheter ablation of AF with comparable rates of major bleeding and stroke. PMID: 32056498 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - February 16, 2020 Category: Cardiology Tags: Acta Cardiol Source Type: research

Acute Ischemic Stroke Outcome and Preceding Anticoagulation: Direct Oral Anticoagulants Versus Vitamin K Antagonists
Oral anticoagulation is recommended for primary and secondary prevention of cardioembolic acute ischemic stroke (AIS). In nonvalvular atrial fibrillation (AF), direct oral anticoagulants (DOAC) efficacy and safety have been largely proven and are recommended over vitamin K antagonists (VKA) by international guidelines.1-3 AIS in the setting of AF is more often disabling and leads to increased mortality compared with stroke in patients without AF.4
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2020 Category: Neurology Authors: Sofia Fel ício Tavares, Inês Ferreira, Vanessa Chaves, Luis Flores, Cristina Correia, Jorge Almeida, Luísa Fonseca, Paulo Castro Chaves Source Type: research

Abbott Wins Approval for CATALYST Trial for At-Risk Stroke Patients
This study is an extremely important step in assessing the Amplatzer Amulet as an effective non-prescription drug alternative for patients with AFib who are at an increased risk for ischemic stroke." In an email sent to MD+DI, Abbott wrote, “We already have an Amulet IDE trial underway that is intended to support our submission for approval in the U.S. for Amplatzer Amulet. The newly announced CATALYST trial will support our submission for an expanded indication for Amulet as a safe and effective alternative to NOAC drugs for patients with atrial fibrillation and at risk of stroke.” Abbo...
Source: MDDI - February 3, 2020 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Regulatory and Compliance Source Type: news

Abbott Announces First-of-Its-Kind Trial to Assess New Therapy Option for People at Risk of Stroke
- The CATALYST trial will examine Abbott's Amplatzer ™ Amulet™ device compared to non-vitamin K oral anticoagulants, the current standard in attempting to lower stroke and bleeding risks for patients with atrial fibrillation
Source: Abbott.com - February 3, 2020 Category: Pharmaceuticals Source Type: news

Influence of oral anticoagulation on stroke severity and outcomes: A propensity score matching case-control study
Oral anticoagulants (OAC) such as vitamin K antagonists (VKA) and direct-acting OACs (DOAC) remain the mainstay for prevention of cardioembolic stroke. The influence of previous OAC treatment on stroke severity and outcomes is not well stablished. We compared patients with incident cardioembolic strokes according to pre-stroke treatment.
Source: Journal of the Neurological Sciences - January 13, 2020 Category: Neurology Authors: A. Plaza Herr áiz, L. Lobato-Pérez, M. Ramírez-Torres, I. De Lorenzo, M. Alonso de Leciñana, E. Díez-Tejedor, B. Fuentes, J. Rodríguez-Pardo Source Type: research

Cost-effectiveness of dabigatran compared with rivaroxaban for prevention of stroke and systemic embolism in patients with atrial fibrillation in China.
Abstract PURPOSE: In China, dabigatran and rivaroxaban are the only approved non-vitamin K antagonist oral anticoagulants for the treatment of atrial fibrillation (AF). The goal of this article was to assess the cost-effectiveness of dabigatran versus rivaroxaban for the prevention of stroke and systemic embolism in Chinese patients with AF from the perspective of the Chinese health care system. METHODS: A Markov model was constructed to estimate the cost-effectiveness of dabigatran versus rivaroxaban. Clinical events were modeled for a lifetime horizon, based on clinical efficacy data from indirect treatment...
Source: Clinical Therapeutics - January 9, 2020 Category: Drugs & Pharmacology Authors: Dong SJ, Wu B, Zhai SD, Zhang YJ, Chu YB, Gupta P, Li YH Tags: Clin Ther Source Type: research

Should We Judge Stroke Risk by Static or Dynamic Risk Scores? A Focus on the Dynamic Nature of Stroke and Bleeding Risks in Patients With Atrial Fibrillation
Abstract: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major risk factor for stroke. The number of patients with AF is predicted to increase in the next few decades. AF has also negative impact on quality of life as well as it significantly increases the risk of cardiovascular disease and overall mortality. Because the stroke is a pivotal outcome of AF, its prevention with the use of anticoagulation therapy constitutes an important component of AF management. The decision on oral anticoagulants' prescription should be based on appropriate risk stratification to allow for comprehensive assessmen...
Source: Journal of Cardiovascular Pharmacology - December 1, 2019 Category: Cardiology Tags: Invited Review Article Source Type: research

Idarucizumab for Intravenous Thrombolysis and Endovascular Thrombectomy in Acute Stroke: A Case Report
Non –vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, are widely used to prevent ischemic stroke in patients with nonvalvular atrial fibrillation. Nonetheless, stroke occurs in 1–2% of patients, and the use of NOACs may increase the bleeding risk for patients who are receiving a cute treatment of intravenous thrombolysis (IVT) or endovascular thrombectomy (EVT). Idarucizumab, a monoclonal antibody developed to bind dabigatran, has been proven safe and effective for patients with uncontrolled bleeding or for patients planning to receive emergent procedures.
Source: The Journal of Emergency Medicine - November 15, 2019 Category: Emergency Medicine Authors: Yu-Ting Lin, Yen-Jun Lai, Tzu-Hsien Lai Tags: Selected Topics: Neurological Emergencies Source Type: research

Four-year trends in oral anticoagulant use and declining rates of ischemic stroke among 194,030 atrial fibrillation patients drawn from a sample of 12 million people
ConclusionThere was a slight increase in the prevalence of AF between 2012 and 2015, while the overall use of antiplatelet agents decreased and that of OAC, particularly DOACs, increased. Over the same period, 1 year hospitalizations for ischemic stroke declined substantially, with a declining rate of hemorrhagic strokes.
Source: American Heart Journal - November 9, 2019 Category: Cardiology Source Type: research

Management of oral anticoagulation in very old patients with non valvular atrial fibrillation related acute ischemic stroke
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - October 16, 2019 Category: Hematology Source Type: research

Role of Biological Markers for Cerebral Bleeding Risk STRATification in Patients with Atrial Fibrillation on Oral Anticoagulants for Primary or Secondary Prevention of Ischemic Stroke (Strat-AF Study): Study Design and Methodology.
Conclusions: The Strat-AF study may be an essential step towards the exploration of the role of a combined clinical biomarker or multiple biomarker models in predicting stroke risk in AF, and might sustain the incorporation of such new markers in the existing stroke prediction schemes by the demonstration of a greater incremental value in predicting stroke risk and improvement in clinical outcomes in a cost-effective fashion. PMID: 31548494 [PubMed - in process]
Source: Medicina (Kaunas) - September 22, 2019 Category: Universities & Medical Training Authors: Poggesi A, Barbato C, Galmozzi F, Camilleri E, Cesari F, Chiti S, Diciotti S, Galora S, Giusti B, Gori AM, Marzi C, Melone A, Mistri D, Pescini F, Pracucci G, Rinnoci V, Sarti C, Fainardi E, Marcucci R, Salvadori E Tags: Medicina (Kaunas) Source Type: research

Effectiveness, safety and costs of stroke prevention in non-valvular auricular fibrillation. Study of cohorts matched by Propensity score.
CONCLUSIONS: Most patients initiated VKA. We found no differences between VKA and dabigatran in the risk of stroke, haemorrhages or mortality. PMID: 31551166 [PubMed - as supplied by publisher]
Source: Atencion Primaria - September 20, 2019 Category: Primary Care Authors: Giner-Soriano M, Casajuana M, Roso-Llorach A, Vedia C, Morros R Tags: Aten Primaria Source Type: research

Reducing Stroke Risk in Atrial Fibrillation: Adherence to Guidelines Has Improved, but Patient Persistence with Anticoagulant Therapy Remains Suboptimal.
Authors: Lowres N, Giskes K, Hespe C, Freedman B Abstract Atrial fibrillation (AF) is a significant risk factor for avoidable stroke. Among high-risk patients with AF, stroke risk can be mitigated using oral anticoagulants (OACs), however reduction is largely contingent on physician prescription and patient persistence with OAC therapy. Over the past decade significant advances have occurred, with revisions to clinical practice guidelines relating to management of stroke risk in AF in several countries, and the introduction of non-vitamin K antagonist OACs (NOACs). This paper summarises the evolving body of researc...
Source: Korean Circulation Journal - September 20, 2019 Category: Cardiology Tags: Korean Circ J Source Type: research

Atrial Fibrillation and Stroke. A Review on the Use of Vitamin K Antagonists and Novel Oral Anticoagulants.
Abstract Atrial fibrillation (AF) is the most common arrhythmia, ranging from 0.1% in patients <55 years to >9% in octogenarian patients. One important issue is represented by the 5-fold increased ischemic stroke risk in AF patients. Hence, the role of anticoagulation is central. Until a few years ago, vitamin K antagonists (VKAs) and low molecular weight heparin represented the only option to prevent thromboembolisms, though with risks. Novel oral anticoagulants (NOACs) have radically changed the management of AF patients, improving both life expectancy and life quality. This review aims to summarize the mo...
Source: Medicina (Kaunas) - September 19, 2019 Category: Universities & Medical Training Authors: Caturano A, Galiero R, Pafundi PC Tags: Medicina (Kaunas) Source Type: research

Concomitant Anticoagulant and Antidepressant Therapy in Atrial Fibrillation Patients and Risk of Stroke and Bleeding.
In conclusion, concomitant use of an OAC and an AD is associated with an increased bleeding risk. PMID: 31506933 [PubMed - as supplied by publisher]
Source: Clinical Pharmacology and Therapeutics - September 9, 2019 Category: Drugs & Pharmacology Authors: Komen JJ, Hjemdahl P, Mantel-Teeuwisse AK, Klungel OH, Wettermark B, Forslund T Tags: Clin Pharmacol Ther Source Type: research

Clot lysis time predicts stroke during anticoagulant therapy in patients with atrial fibrillation
ConclusionsImpaired fibrinolysis may predict thromboembolic events in AF patients receiving VKA.
Source: Canadian Journal of Cardiology - August 8, 2019 Category: Cardiology Source Type: research

Atrial high-rate episodes: prevalence, stroke risk, implications for management, and clinical gaps in evidence
AbstractSelf-terminating atrial arrhythmias are commonly detected on continuous rhythm monitoring, e.g. by pacemakers or defibrillators. It is unclear whether the presence of these arrhythmias has therapeutic consequences. We sought to summarize evidence on the prevalence of atrial high-rate episodes (AHREs) and their impact on risk of stroke. We performed a comprehensive, tabulated review of published literature on the prevalence of AHRE. In patients with AHRE, but without atrial fibrillation (AF), we reviewed the stroke risk and the potential risk/benefit of oral anticoagulation. Atrial high-rate episodes are found in 10...
Source: Europace - August 3, 2019 Category: Cardiology Source Type: research

A Narrative Review of Nonvitamin K Antagonist Oral Anticoagulant Use in Secondary Stroke Prevention
The prevalence of atrial fibrillation (AF), the most common cardiac arrhythmia, increases with age, predisposing elderly patients to an increased risk of embolic stroke. With an increasingly aged population the number of people who experience a stroke every year, overall global burden of stroke, and numbers of stroke survivors and related deaths continue to increase. Anticoagulation with vitamin K antagonists (VKAs) reduces the risk of ischemic stroke in patients with AF; however, increased bleeding risk is well documented, particularly in the elderly.
Source: Journal of Stroke and Cerebrovascular Diseases - July 4, 2019 Category: Neurology Authors: Valeria Caso, Florian Masuhr Tags: Review Article Source Type: research

Treatment Approaches to Lacunar Stroke
Lacunar strokes are appropriately named for their ability to cavitate and form ponds or “little lakes” (Latin: lacune -ae meaning pond or pit is a diminutive form of lacus meaning lake). They account for a substantial proportion of both symptomatic and asymptomatic ischemic strokes. In recent years, there have been several advances in the management of large vessel occlusions. New therapies such as non-vitamin K antagonist oral anticoagulants and left atrial appendage closure have recently been developed to improve stroke prevention in atrial fibrillation; however, the treatment of small vessel disease-related strokes ...
Source: Journal of Stroke and Cerebrovascular Diseases - May 27, 2019 Category: Neurology Authors: Alvin S. Das, Robert W. Regenhardt, Steven K. Feske, Mahmut Edip Gurol Tags: Review Article Source Type: research

Safety of Recanalization Therapy in Patients with Acute Ischemic Stroke Under Anticoagulation: A Systematic Review and Meta-Analysis
Intravenous thrombolysis treatment (IVT) and endovascular therapy (EVT) have been proved as fist-line beneficial option for eligible patients who have acute ischemic stroke (AIS) with major safety concern of symptomatic intracranial hemorrhage (sICH). Unfortunately, the emergency management of patients with AIS taking vitamin K antagonists and with international normalized ratio  higher than 1.7 or taking new oral anticoagulants (NOACs) represents a great challenge. We aim to comprehensively determine the safety of EVT in patients under prior-stroke anticoagulants and IVT in patients under NOAC use.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2018 Category: Neurology Authors: Mingsu Liu, Yang Zheng, Guangqin Li Tags: Review Article Source Type: research

Continuation or Discontinuation of Anticoagulation in the Early Phase After Acute Ischemic Stroke Brief Report
Background and Purpose—There is no consensus on whether anticoagulation should be continued or temporarily stopped in patients suffering acute ischemic stroke while using anticoagulation. We assessed treatment variations and outcomes in these patients.Methods—Post hoc analysis of PASS (Preventive Antibiotics in Stroke Study). We included patients with acute ischemic stroke who used anticoagulation at admission. We compared clinical outcomes, thrombotic, and major bleeding events at 3 months.Results—Nine percent (192/2101) of the patients with acute ischemic stroke used anticoagulation at admission (186 vitamin K anta...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Adrien E. Groot, Jan-Dirk M. Vermeij, Willeke F. Westendorp, Paul J. Nederkoorn, Diederik van de Beek, Jonathan M. Coutinho Tags: Secondary Prevention, Anticoagulants, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Outcome of Secondary Stroke Prevention in Patients Taking Non –Vitamin K Antagonist Oral Anticoagulants
In this study, to determine whether or not there is a difference in outcome in secondary stroke prevention between warfarin and NOACs, patients w ith embolic stroke with newly prescribed anticoagulants were prospectively analyzed.
Source: Journal of Stroke and Cerebrovascular Diseases - December 21, 2017 Category: Neurology Authors: Taizen Nakase, Junta Moroi, Tatsuya Ishikawa Source Type: research

Analysis of Recurrent Stroke Volume and Prognosis between Warfarin and Four Non –Vitamin K Antagonist Oral Anticoagulants' Administration for Secondary Prevention of Stroke
We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non –vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - October 21, 2017 Category: Neurology Authors: Yukie Kanai, Hiroaki Oguro, Nao Tahara, Hanako Matsuda, Hiroyuki Takayoshi, Shingo Mitaki, Keiichi Onoda, Shuhei Yamaguchi Source Type: research

Fibrin Clot Permeability as a Predictor of Stroke and Bleeding in Anticoagulated Patients With Atrial Fibrillation Clinical Sciences
Background and Purpose—Formation of denser fiber networks has been reported in atrial fibrillation and ischemic stroke. In this longitudinal cohort study, we evaluated whether fibrin clot density may predict thromboembolic and bleeding risk in patients with atrial fibrillation on vitamin K antagonists.Methods—In 236 patients with atrial fibrillation receiving vitamin K antagonists treatment, we measured ex vivo plasma clot permeability (Ks), a measure of the pore size in fibrin networks.Results—During a median follow-up of 4.3 (interquartile range, 3.7–4.8) years, annual rates of ischemic stroke or transient ischem...
Source: Stroke - September 25, 2017 Category: Neurology Authors: Leszek Drabik, Paweł Wołkow, Anetta Undas Tags: Atrial Fibrillation, Ischemic Stroke, Thrombosis Original Contributions Source Type: research

Real-World Setting Comparison of Nonvitamin-K Antagonist Oral Anticoagulants Versus Vitamin-K Antagonists for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—This meta-analysis confirms the main findings of the randomized controlled trials of dabigatran, rivaroxaban, and apixaban in the real-world setting and, hence, strengthens their validity.
Source: Stroke - August 28, 2017 Category: Neurology Authors: George Ntaios, Vasileios Papavasileiou, Konstantinos Makaritsis, Konstantinos Vemmos, Patrik Michel, Gregory Y.H. Lip Tags: Arrhythmias, Secondary Prevention, Meta Analysis, Mortality/Survival, Ischemic Stroke Original Contributions Source Type: research

Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban Versus Warfarin in Patients With Nonvalvular Atrial Fibrillation and Previous Stroke or Transient Ischemic Attack Clinical Sciences
Conclusions—Results from our study of the 3 NOACs versus warfarin in nonvalvular atrial fibrillation patients with a previous history of stroke/transient ischemic attack are relatively consistent with their respective phase III trials and previous stroke/transient ischemic attack subgroup analyses. All NOACs seemed no worse than warfarin in respect to ischemic stroke, ICH, or major bleeding risk.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Craig I. Coleman, W. Frank Peacock, Thomas J. Bunz, Mark J. Alberts Tags: Arrhythmias, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Safety of Endovascular Thrombectomy in Patients Receiving Non-Vitamin K Antagonist Oral Anticoagulants Brief Reports
Conclusions— Thrombectomy in non–vitamin K antagonist oral anticoagulant patients seems safe although a comparatively high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts is necessary. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01850797.
Source: Stroke - March 27, 2016 Category: Neurology Authors: Purrucker, J. C., Wolf, M., Haas, K., Rizos, T., Khan, S., Dziewas, R., Kleinschnitz, C., Binder, A., Groschel, K., Hennerici, M. G., Lobotesis, K., Poli, S., Seidel, G., Neumann-Haefelin, T., Ringleb, P. A., Heuschmann, P. U., Veltkamp, R. Tags: Angiography, Anticoagulants, Ischemic Stroke Brief Reports Source Type: research

Point-of-Care Testing of Coagulation in Patients Treated With Non-Vitamin K Antagonist Oral Anticoagulants Clinical Sciences
Conclusions— If anti-Xa test is not available, we propose the use of the CoaguChek POCT to guide thrombolysis decisions after individual risk assessment in rivaroxaban-treated patients having acute ischemic stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT02371044.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Ebner, M., Peter, A., Spencer, C., Hartig, F., Birschmann, I., Kuhn, J., Wolf, M., Winter, N., Russo, F., Zuern, C. S., Blumenstock, G., Ziemann, U., Poli, S. Tags: Coagulation, Other anticoagulants, Other diagnostic testing, Emergency treatment of Stroke, Anticoagulants, Thrombolysis, Coagulation and fibronolysis Clinical Sciences Source Type: research

Potential new uses of non-vitamin K antagonist oral anticoagulants to treat and prevent stroke
Conclusion: There may be a role for NOACs in stroke prevention and treatment beyond atrial fibrillation. Randomized controlled trials are needed to compare NOACs to current stroke prevention and treatment strategies in certain subgroups of patients with cerebrovascular disease.
Source: Neurology - September 21, 2015 Category: Neurology Authors: Yaghi, S., Kamel, H., Elkind, M. S. V. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Infarction, Cerebral venous thrombosis VIEWS & amp;amp; REVIEWS Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Asian Patients With Nonvalvular Atrial Fibrillation: Meta-Analysis Clinical Sciences
Conclusions— Our findings suggest that standard-dose NOACs were more effective and safer in Asians than in non-Asians, whereas low-dose NOACs performed similarly in both populations.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Wang, K.-L., Lip, G. Y. H., Lin, S.-J., Chiang, C.-E. Tags: Other anticoagulants, Anticoagulants Clinical Sciences Source Type: research

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Severity and Functional Outcome of Patients with Cardioembolic Stroke Occurring during Non-vitamin K Antagonist Oral Anticoagulant Treatment
Severity and functional outcome of patients with cardioembolic stroke (CE) occurring during non-vitamin K antagonist oral anticoagulant (NOAC) treatment remain uncertain.
Source: Journal of Stroke and Cerebrovascular Diseases - April 2, 2015 Category: Neurology Authors: Hirofumi Tomita, Joji Hagii, Norifumi Metoki, Shin Saito, Hiroshi Shiroto, Hiroyasu Hitomi, Takaatsu Kamada, Satoshi Seino, Koki Takahashi, Satoko Sasaki, Minoru Yasujima, Ken Okumura Source Type: research

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

Intracranial Hemorrhage Among Patients With Atrial Fibrillation Anticoagulated With Warfarin or Rivaroxaban: The Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation Clinical Sciences
Conclusions— Among patients with atrial fibrillation treated with anticoagulation, the risk of ICH was higher among Asians, blacks, the elderly, and in those with previous stroke or transient ischemic attack, increased diastolic blood pressure, and reduced platelet count or serum albumin at baseline. The risk of ICH was significantly lower in patients with heart failure and in those who were randomized to rivaroxaban instead of warfarin. The external validity of these findings requires testing in other atrial fibrillation populations.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Hankey, G. J., Stevens, S. R., Piccini, J. P., Lokhnygina, Y., Mahaffey, K. W., Halperin, J. L., Patel, M. R., Breithardt, G., Singer, D. E., Becker, R. C., Berkowitz, S. D., Paolini, J. F., Nessel, C. C., Hacke, W., Fox, K. A. A., Califf, R. M., on behal Tags: Acute Cerebral Hemorrhage, Anticoagulants Clinical Sciences Source Type: research