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Rates and Determinants of 5-Year Outcomes After Atrial Fibrillation-Related Stroke: A Population Study Clinical Sciences
Conclusions— AF-stroke is associated with considerable long-term morbidity, fatality, stroke recurrence, and nursing home requirement. Adequately resourced national AF strategies to improve AF detection and prevention are needed.
Source: Stroke - November 23, 2015 Category: Neurology Authors: Hayden, D. T., Hannon, N., Callaly, E., Ni Chroinin, D., Horgan, G., Kyne, L., Duggan, J., Dolan, E., O'Rourke, K., Williams, D., Murphy, S., Kelly, P. J. Tags: Cerebrovascular Disease/Stroke Clinical Sciences Source Type: research

High Prevalence of Atrial Fibrillation Among Patients With Ischemic Stroke Clinical Sciences
Conclusions— Access to nationwide register data shows that AF is more common among patients with ischemic stroke than those previously reported. Few patients with stroke and AF had anticoagulant treatment before the event, and few got it after the event. CHA2DS2-VASc could be a useful monitoring tool to intensify efforts to diagnose AF among patients with cryptogenic stroke.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Friberg, L., Rosenqvist, M., Lindgren, A., Terent, A., Norrving, B., Asplund, K. Tags: Coumarins, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke, Epidemiology Clinical Sciences Source Type: research

Carotid Atherosclerosis and Stroke in Atrial Fibrillation: The Atherosclerosis Risk in Communities Study Brief Reports
Conclusions— Increased cIMT and presence of carotid plaque are associated with increased risk of ischemic stroke in individuals with AF. Furthermore, they may improve risk prediction of stroke, over and above the CHA2DS2-VASc score.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Bekwelem, W., Jensen, P. N., Norby, F. L., Soliman, E. Z., Agarwal, S. K., Lip, G. Y. H., Pan, W., Folsom, A. R., Longstreth, W. T., Alonso, A., Heckbert, S. R., Chen, L. Y. Tags: Atrial Fibrillation, Risk Factors, Ischemic Stroke, Atherosclerosis Brief Reports Source Type: research

Atrial Fibrillation, Stroke Risk, and Warfarin Therapy Revisited: A Population-Based Study Clinical Sciences
Conclusions— AF is more common than present guidelines suggest. The attributable risk of AF for ischemic stroke increases with age and is close to that of hypertension in individuals aged ≥80 years. Because a majority of patients with AF with increased risk for stroke had not received anticoagulation therapy, there is a large potential for improvement.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Bjorck, S., Palaszewski, B., Friberg, L., Bergfeldt, L. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Arrhythmias, clinical electrophysiology, drugs, Epidemiology Clinical Sciences Source Type: research

Cost-Effectiveness of Oral Anticoagulants for Ischemic Stroke Prophylaxis Among Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— All the newer oral anticoagulants compared were more effective than adjusted dosed warfarin. Our model showed that apixaban was the most effective anticoagulant in a general atrial fibrillation population and has an incremental cost-effectiveness ratio <$50 000/QALY. For those with higher stroke risk (CHADS2≥3), dabigatran was the most cost-effective treatment option.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Shah, A., Shewale, A., Hayes, C. J., Martin, B. C. Tags: Anticoagulants, Cost-Effectiveness, Ischemic Stroke Clinical Sciences Source Type: research

Special MRI scan could identify stroke risk in people with atrial fibrillation
Atrial fibrillation is a heart rhythm disorder that affects millions of people. It can make you feel lousy. Even worse, it can cause potentially disabling or deadly strokes. A special MRI scan may — I stress the “may” — help identify people with atrial fibrillation who are at high risk of having a stroke. This could help many people with this condition to avoid taking warfarin or other clot-preventing medications for life. A normal heartbeat starts in a cluster of cells called the pacemaker. It sits in the heart’s upper right chamber (the right atrium). These cells generate a pulse of electricity that...
Source: New Harvard Health Information - April 28, 2015 Category: Consumer Health News Authors: Howard LeWine, M.D. Tags: Heart Health atrial fibrillation MRI prevention special MRI scan Stroke Stroke Risk Source Type: news

Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial Stroke
Conclusions High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. Clinical Trial Registration URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - December 1, 2015 Category: Cardiology Authors: Rao, M. P., Halvorsen, S., Wojdyla, D., Thomas, L., Alexander, J. H., Hylek, E. M., Hanna, M., Bahit, M. C., Lopes, R. D., De Caterina, R., Erol, C., Goto, S., Lanas, F., Lewis, B. S., Husted, S., Gersh, B. J., Wallentin, L., Granger, C. B., the Apixaban Tags: Stroke Source Type: research

Risk of ischemic stroke during periods of warfarin discontinuation for surgical procedures: A longitudinal study of 4060 patients with atrial fibrillation (P1.058)
CONCLUSIONS: The risk associated with discontinuation of warfarin for procedures must be recognized and considered in the risk benefit analysis of any procedure.Disclosure: Dr. Jahangir has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jahangir, N., Malik, A., Suri, M., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research

Validation of a Modified CHA2DS2-VASc Score for Stroke Risk Stratification in Asian Patients With Atrial Fibrillation: A Nationwide Cohort Study Clinical Sciences
Conclusions— In this Asian atrial fibrillation cohort, the mCHA2DS2-VASc score performed better than the CHA2DS2-VASc and would further identify atrial fibrillation patients who may derive a positive net clinical benefit from oral anticoagulation.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Chao, T.-F., Lip, G. Y. H., Liu, C.-J., Tuan, T.-C., Chen, S.-J., Wang, K.-L., Lin, Y.-J., Chang, S.-L., Lo, L.-W., Hu, Y.-F., Chen, T.-J., Chiang, C.-E., Chen, S.-A. Tags: Atrial Fibrillation Clinical Sciences Source Type: research

Metformin-inclusive Therapy Reduces the Risk of Stroke in Patients with Diabetes: A 4-Year Follow-up Study
Metformin is a kind of oral hypoglycemic agents commonly prescribed to patients with diabetes mellitus. Although past studies had proven its protective effect on cardiovascular risk and related mortality, the evidence of metformin on stroke prevention was still insufficient and conflicting. Our study randomly selected 14,856 patients with diabetes from the database provided by the Taiwan National Health Research Institute, and 2 cohorts were formulated according to whether metformin was in the prescription record. All cases were followed up for 4 years to track their stroke incidence. As a result, 701 (17.5%) of 3999 diabe...
Source: Journal of Stroke and Cerebrovascular Diseases - October 11, 2013 Category: Neurology Authors: Yuan-Yang Cheng, Hsin-Bang Leu, Tzeng-Ji Chen, Chen-Ling Chen, Chia-Hua Kuo, Shin-Da Lee, Chung-Lan Kao Tags: Original Articles Source Type: research

Ischemic Stroke and Intracranial Hemorrhage With Aspirin, Dabigatran, and Warfarin: Impact of Quality of Anticoagulation Control Clinical Sciences
Conclusions— In Chinese patients with atrial fibrillation, the benefits of warfarin therapy for stroke prevention and ICH risk are closely dependent on the quality of anticoagulation, as reflected by TTR. Even at the top TTR quartile, warfarin was associated with a higher stroke and ICH risk than dabigatran.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Ho, C.-W., Ho, M.-H., Chan, P.-H., Hai, J.-J., Cheung, E., Yeung, C.-Y., Lau, K.-K., Chan, K.-H., Lau, C.-P., Lip, G. Y. H., Leung, G. K.-K., Tse, H.-F., Siu, C.-W. Tags: Coumarins, Other anticoagulants, Anticoagulants Clinical Sciences Source Type: research

Rates of Ischemic Stroke During Warfarin Treatment for Atrial Fibrillation Brief Reports
Conclusions— In a large cohort of older patients with atrial fibrillation, we observed the highest rate of ischemic stroke in the first 30 days after warfarin initiation. Although causation cannot be established given the observational nature of this study, our findings highlight the need for future research in this population.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Tung, J. M., Mamdani, M. M., Juurlink, D. N., Paterson, J. M., Kapral, M. K., Gomes, T. Tags: Cardiovascular Pharmacology, Anticoagulants, Epidemiology Brief Reports Source Type: research

Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s
Commentary on: Asberg A, Erisksson M, Henriksson KM, et al.. Warfarin-associated intracerebral hemorrhage after ischemic stroke. Stroke 2014;45:2118–20. Context Since its isolation during the early half of the 20th century from the mouldy hay responsible for ‘sweet clover disease’ in cattle, warfarin has become the most widely used oral anticoagulant.1 Indications include atrial fibrillation (AF), mechanical prosthetic valves and venous thromboembolism treatment.2 Warfarin reduces stroke risk in patients with AF by nearly two-thirds; AF accounts for 20% of ischaemic strokes, which tend to be more severe t...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Ruland, S., Biller, J. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Alcohol-related disorders, Drugs misuse (including addiction), Arrhythmias, Alcohol, Health education Aetiology/Harm Source Type: research

Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research

Risks and Benefits of Anticoagulation in Atrial Fibrillation: Insights From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry Original Articles
Conclusions— In community-based outpatients with AF, use of OAC was high and driven by not only predominantly stroke but also bleeding risk. Stroke risk significantly affects OAC use among those with low bleeding risk, whereas those with high bleeding risk demonstrate consistently lower use of OAC regardless of stroke risk.
Source: Circulation: Cardiovascular Quality and Outcomes - July 16, 2013 Category: Cardiology Authors: Cullen, M. W., Kim, S., Piccini, J. P., Ansell, J. E., Fonarow, G. C., Hylek, E. M., Singer, D. E., Mahaffey, K. W., Kowey, P. R., Thomas, L., Go, A. S., Lopes, R. D., Chang, P., Peterson, E. D., Gersh, B. J., on behalf of the ORBIT-AF Investigators Tags: Coumarins, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke, Risk Factors for Stroke, Anticoagulants Original Articles Source Type: research

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