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Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events: Findings From ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Clinical Sciences
Conclusions— Patients with atrial fibrillation with previous IS/TIA are at high risk of recurrent thromboembolism and bleeding. HDER is at least as effective and is safer than warfarin, regardless of the presence or the absence of previous IS or TIA. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Rost, N. S., Giugliano, R. P., Ruff, C. T., Murphy, S. A., Crompton, A. E., Norden, A. D., Silverman, S., Singhal, A. B., Nicolau, J. C., SomaRaju, B., Mercuri, M. F., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Investigators Tags: Atrial Fibrillation, Anticoagulants, Ischemic Stroke Clinical Sciences Source Type: research

Recurrent Stroke and Bleeding Events after Acute Cardioembolic Stroke —Analysis Using Japanese Healthcare Database from Acute-Care Institutions
To understand the reality of patients who experienced a cardioembolic stroke (CES) is important because of the high incidence of recurrent stroke and the need to account for bleeding risk in relation to the need for anticoagulation treatment. We elucidated the current real-world medical care in patients who had a CES and identified the risk factors for recurrent stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - December 12, 2017 Category: Neurology Authors: Masahiro Yasaka, Yukihiro Koretsune, Takeshi Yamashita, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi Source Type: research

Real-World Use of Apixaban for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Background and Purpose—The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibril...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Marco Proietti, Imma Romanazzi, Giulio Francesco Romiti, Alessio Farcomeni, Gregory Y.H. Lip Tags: Atrial Fibrillation, Anticoagulants, Quality and Outcomes Original Contributions Source Type: research

Cerebrovascular Outcomes With Proton Pump Inhibitors and Thienopyridines Clinical Sciences
Background and Purpose—Pharmacokinetic and prior studies on thienopyridine and proton pump inhibitors (PPI) coadministration provide conflicting data for cardiovascular outcomes, whereas there is no established evidence on the association of concomitant use of PPI and thienopyridines with adverse cerebrovascular outcomes.Methods—We conducted a systematic review and meta-analysis of randomized controlled trials and cohort studies from inception to July 2017, reporting following outcomes among patients treated with thienopyridine and PPI versus thienopyridine alone (1) ischemic stroke, (2) combined ischemic or hemorrhagi...
Source: Stroke - January 22, 2018 Category: Neurology Authors: Konark Malhotra, Aristeidis H. Katsanos, Mohammad Bilal, Muhammad Fawad Ishfaq, Nitin Goyal, Georgios Tsivgoulis Tags: Meta Analysis, Ischemic Stroke Original Contributions Source Type: research

Risk of Ischemic Stroke and Major Bleeding in Patients With Atrial Fibrillation and Cancer
Background: Atrial fibrillation (AF) is an important risk factor for ischemic stroke. Cancer may increase the risk both of ischemic stroke and of bleeding. Less is known about risk of ischemic stroke and bleeding among cancer patients with AF, complicating the prevention of ischemic stroke in these patients. Methods: Register based cohort study comprising all Swedish patients hospitalized with a primary diagnosis of AF from July 1, 2005 until December 31, 2014. Patients with cancer diagnosis were compared to the rest of the cohort.
Source: Journal of Stroke and Cerebrovascular Diseases - December 26, 2019 Category: Neurology Authors: Sara Aspberg, Liyang Yu, Bruna Gigante, Karin E Smedby, Daniel E Singer Source Type: research

Factors affecting self-reported bleeding acceptance in acute ischemic stroke survivors on various types of antithrombotic therapy
Stroke causes long-term serious disability with global prevalence of 101 million people in 2019.1 Antithrombotic therapy is recommended for stroke secondary prevention depending on the acute ischemic stroke (AIS) subtype.2 One of the major causes of non-cardioembolic AIS is intracranial atherosclerosis, which requires single antiplatelet therapy (SAPT), mostly with aspirin.3,4 Dual antiplatelet therapy (DAPT) may reduce the risk of non-cardioembolic stroke by 29% in AIS attributable to severe intracranial stenosis when used for a limited period of time.
Source: Journal of Stroke and Cerebrovascular Diseases - November 16, 2022 Category: Neurology Authors: Gabriela Rusin, Jadwiga Kubica, Krzysztof Piotr Malinowski, Agnieszka S łowik, Anetta Undas Source Type: research

Survivors Of Stroke In Infancy Prone To Seizures, Epilepsy
About one-third of American infants and children who suffer bleeding into brain tissue, may later have seizures and as many as 13 percent will develop epilepsy within two years, according to new research reported at the American Stroke Association's International Stroke Conference 2013. Bleeding into brain tissue is a type of stroke called intracerebral hemorrhage (ICH). Each year, an estimated 6.4 newborns and children per every 100,000 in the United States suffer strokes. About half of the strokes are hemorrhagic, typically caused by rupturing of weakened or malformed blood vessels...
Source: Health News from Medical News Today - February 11, 2013 Category: Consumer Health News Tags: Stroke Source Type: news

Left Ventricular Systolic Dysfunction, Heart Failure, and the Risk of Stroke and Systemic Embolism in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial Original Articles
Conclusions— Patients with LVSD (with/without HF) had a higher risk of SSE or death (but similar rate of SSE) compared with patients with HF but preserved LV systolic function; both had a greater risk than patients without either HF or LVSD. Apixaban reduced the risk of both outcomes more than warfarin in all 3 patient groups. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: McMurray, J. J. V., Ezekowitz, J. A., Lewis, B. S., Gersh, B. J., van Diepen, S., Amerena, J., Bartunek, J., Commerford, P., Oh, B.-H., Harjola, V.-P., Al-Khatib, S. M., Hanna, M., Alexander, J. H., Lopes, R. D., Wojdyla, D. M., Wallentin, L., Granger, C. Tags: Congestive, Cerebrovascular disease/stroke, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke Original Articles Source Type: research

CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk
In contrast, a CHA2DS2-VASc score of 0 identifies a subgroup of patients with very low stroke risk unlikely to benefit from anticoagulation treatment. Professor Nabauer said: "AF is the most frequent cardiac arrhythmia requiring hospitalisation and has a 1-2% prevalence in the general population. AF is associated with a significant risk of stroke with frequently disabling consequences. While oral anticoagulation is very effective in preventing ischaemic strokes in AF, it increases bleeding risk...
Source: Health News from Medical News Today - September 3, 2013 Category: Consumer Health News Tags: Stroke Source Type: news

Intra-arterial Thrombectomy versus Standard Intravenous Thrombolysis in Patients with Anterior Circulation Stroke Caused by Intracranial Arterial Occlusions: A Single-center Experience
Background: Severely impaired patients with persisting intracranial occlusion despite standard treatment with intravenous (IV) administration of recombinant tissue plasminogen activator (rtPA) or presenting beyond the therapeutic window for IV rtPA may be candidates for interventional neurothrombectomy (NT). The safety and efficacy of NT by the Penumbra System (PS) were compared with standard IV rtPA treatment in patients with severe acute ischemic stroke (AIS) caused by large intracranial vessel occlusion in the anterior circulation.Methods: Consecutive AIS patients underwent a predefined treatment algorithm based on arri...
Source: Journal of Stroke and Cerebrovascular Diseases - February 4, 2013 Category: Neurology Authors: Fabrizio Sallustio, Giacomo Koch, Silvia Di Legge, Costanza Rossi, Barbara Rizzato, Simone Napolitano, Domenico Samà, Natale Arnò, Angela Giordano, Domenicantonio Tropepi, Giulia Misaggi, Marina Diomedi, Costantino Del Giudice, Alessio Spinelli, Sebasti Tags: Original Articles Source Type: research

Why Ischemic Stroke Patients Do Not Receive Thrombolytic Treatment? (P7.122)
CONCLUSIONS:This retrospective analysis suggests that less than half of the patients presenting within 4 hours of symptom onset receive rt-PA. The most common reason was minor or rapidly improving symptoms. A significant proportion of patients did not receive rt-PA because patient or family refused. Minority of patients had absolute contraindication. More patient and family education is needed to allay fears of rt-PA use.Disclosure: Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lahoti, S., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Aortic Transgraft Hemorrhage after Intravenous Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke
Conclusions: Our analysis provides reassurance regarding the risk of IV tPA therapy in patients undergoing aortic graft replacement.
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2014 Category: Neurology Authors: Tomohiro Kawano, Katsufumi Kajimoto, Masahiro Higashi, Kenji Minatoya, Kazunori Toyoda, Kazuyuki Nagatsuka Tags: Original Articles Source Type: research

Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open‐label, parallel‐group trial
DiscussionThe CSPS.com is expected to provide evidence indicating whether secondary IS prevention in high‐risk patients can be improved by using DAPT involving cilostazol.
Source: International Journal of Stroke - December 8, 2014 Category: Neurology Authors: Kazunori Toyoda, Shinichiro Uchiyama, Haruhiko Hoshino, Kazumi Kimura, Hideki Origasa, Hiroaki Naritomi, Kazuo Minematsu, Takenori Yamaguchi, Tags: Protocols Source Type: research

Patients with known atrial fibrilation and first ischemic stroke. Assessing of anticoagulation status. (P1.055)
Conclusions: This preliminary observation suggests that despite the extended evidence of the indication of primary prevention with OA in AF patients, there is still an important number of patients without treatment, being older age one of the main causes for not indicating OA although this is not a formal contraindication. Another observation though not significant, is that patients with no OA tend to have more severe strokes as it is reported in the literature.Disclosure: Dr. Parisi has nothing to disclose. Dr. Rattagan has nothing to disclose. Dr. Persi has nothing to disclose. Dr. Gatto has received personal compensatio...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Parisi, V., Rattagan, M. L., Persi, G., Gatto, E. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research