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Systemic Inflammation Exacerbates Stroke in Patients with Left Ventricular Assist Device (P4.235)
CONCLUSIONS:In LVAD patients, total prevention of cerebrovascular complications cannot be accomplished only by adjusting warfarin dosage to meet the therapeutic range. However, recognition of increased CRP and appropriate management of inflammation prior to the stroke onset may enable us to avoid its aggravation and secure patient’s opportunity for heart transplantation.Disclosure: Dr. Ohtomo has nothing to disclose. Dr. Iwata has received personal compensation for activities with Janssen Pharmaceuticals, Eisai Inc., Daiichi Pharmaceutical Corp., Ono Pharmaceutical, and Takeda Pharmaceutical Co. Ltd. Dr. Iwata has re...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ohtomo, R., Iwata, A., Kinoshita, O., Shimizu, J., Ono, M., Tsuji, S. Tags: Cerebrovascular Disease and Interventional Neurology: Cardiac Source Type: research

Recurrent Stroke in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial
In this study, we explore IIS rates in WARCEF patients with and without baseline stroke to look for risk factors for IIS and determine if a subgroup with an IIS rate high enough to give a clinically relevant stroke risk reduction can be identified. Methods: We compared potential stroke risk factors between patients with baseline stroke and those without using the exact conditional score test for Poisson variables. We looked for risk factors for IIS, by comparing IIS rates between different risk factors. For EF we tried cut-off points of 10, 15 and 20%. The cut-off point 15% was used as it was the highest EF that was associ...
Source: Cerebrovascular Diseases - November 7, 2014 Category: Neurology Source Type: research

The first prognostic model for stroke and death in patients with systolic heart failure.
CONCLUSIONS: This novel prognostic model predicts the overall risk of ischemic stroke or death for HF patients. This model compares favorably for death with the Seattle model and has the added utility of including stroke as an endpoint. Use of this model will help identify those patients in need of more intensive monitoring and therapy and may help identify appropriate populations for trials of new therapies. CLINICAL TRIAL REGISTRATION: http://www.Clinicatrials.govNCT00041938. PMID: 26549533 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - November 5, 2015 Category: Cardiology Authors: Freudenberger RS, Cheng B, Mann DL, Thompson JL, Sacco RL, Buchsbaum R, Sanford A, Pullicino PM, Levin B, Teerlink JR, Graham S, Mohr JP, Labovitz AJ, Di Tullio MR, Lip GY, Estol CJ, Lok DJ, Ponikowski P, Anker SD, Homma S, WARCEF Investigators Tags: J Cardiol Source Type: research

Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation.
Conclusion: Variation in published AF stroke rates for patients not receiving anticoagulant therapy results in multifold variation in the net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty in current thresholds of stroke risk score for recommending anticoagulation. Primary Funding Source: None. PMID: 30264130 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - September 25, 2018 Category: Internal Medicine Authors: Shah SJ, Eckman MH, Aspberg S, Go AS, Singer DE Tags: Ann Intern Med Source Type: research

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research

Underutilization of warfarin for stroke prophylaxis in patients with atrial fibrillation or atrial flutter in Korea.
CONCLUSIONS: A high portion of AF/AFL patients with CHADS2 score ≥2 were undertreated with warfarin. As ischemic stroke is one of the leading causes of death in Korea, a more aggressive approach to prevent stroke in patients with AF/AFL is required. PMID: 26242197 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - August 1, 2015 Category: Cardiology Authors: Lee IH, Kim H, Je NK Tags: J Cardiol Source Type: research

Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation
In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressur...
Source: Neuroscience Bulletin - March 7, 2016 Category: Neuroscience Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation
ConclusionsPatients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545)
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - April 22, 2013 Category: Cardiology Source Type: research

A New Risk Scheme to Predict Ischemic Stroke and Other Thromboembolism in Atrial Fibrillation: The ATRIA Study Stroke Risk Score Arrhythmia and Electrophysiology
Conclusions The ATRIA stroke risk score performed better than existing risk scores, was validated successfully, and showed improvement in predicting severe events, which is of greatest concern. The ATRIA score should improve the antithrombotic decision for patients with AF and should provide a secure foundation for the addition of biomarkers in future prognostic models.
Source: JAHA:Journal of the American Heart Association - June 19, 2013 Category: Cardiology Authors: Singer, D. E., Chang, Y., Borowsky, L. H., Fang, M. C., Pomernacki, N. K., Udaltsova, N., Reynolds, K., Go, A. S. Tags: Arrhythmia and Electrophysiology Source Type: research

Stroke prevention with rivaroxaban in higher‐risk populations with atrial fibrillation
ConclusionsThese subgroup analyses demonstrate that the treatment effect for rivaroxaban vs. warfarin is broadly consistent across a wide range of patient groups, with respect to both efficacy and safety.
Source: International Journal of Clinical Practice - April 9, 2015 Category: Internal Medicine Authors: H.‐C. Diener, J. L. Halperin, K. Fox, G. J. Hankey Tags: Review Article Source Type: research

Effect of Warfarin on Ischemic Stroke, Bleeding, and Mortality in Patients with Atrial Fibrillation Receiving Peritoneal Dialysis
ConclusionThere is no significant association between warfarin treatment with risks of mortality, ischemic stroke or bleeding in patients with atrial fibrillation receiving peritoneal dialysis.
Source: American Journal of Cardiovascular Drugs - April 22, 2019 Category: Cardiology Source Type: research

Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients with Atrial Fibrillation: 2.3 Year Follow-Up of the PROTECT AF Trial.
CONCLUSIONS: The "local" strategy of LAA closure is noninferior to "systemic" anticoagulation with Warfarin. PROTECT AF has, for the first time, implicated the LAA in the pathogenesis of stroke in AF. CLINICAL TRIAL REGISTRATION INFORMATION: Clinicaltrials.gov; Unique Identifier: NCT00129545. PMID: 23325525 [PubMed - as supplied by publisher]
Source: Circulation - January 16, 2013 Category: Cardiology Authors: Reddy VY, Doshi SK, Siever H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D Tags: Circulation Source Type: research

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