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Temporal Trends and Patient Characteristics Associated With Drug Utilisation After First-Ever Stroke: Insights From Chronic Disease Registry Data in Singapore.
CONCLUSION: This study reveals changes in prescription behaviour over time in a multiethnic Asian population with first-ever stroke. Patient characteristics including younger age, Malay ethnicity and certain comorbidities (i.e. hyperlipidaemia, atrial fibrillation) were associated with the combined use of all 3 guideline medications among ischaemic stroke patients. PMID: 32301477 [PubMed - in process]
Source: Ann Acad Med Singapo... - February 29, 2020 Category: General Medicine Authors: Yeo SH, Toh MPH, Lee SH, Seet RC, Wong LY, Yau WP Tags: Ann Acad Med Singapore Source Type: research

Discrepancy between guidelines for stroke prevention in atrial fibrillation and practice patterns in primary care. The nationwide French AFIGP survey.
CONCLUSIONS: In this large French study, approximately 45% of thromboembolic high-risk patients were either not treated or inadequately treated. Better compliance with evidence-based guidelines is needed to reduce the burden of stroke in the AF population. PMID: 26113478 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - June 22, 2015 Category: Cardiology Authors: Sabouret P, Bricard M, Hermann MA, Cotté FE, Deret-Bixio L, Rushton-Smith S Tags: Arch Cardiovasc Dis Source Type: research

Spotlight on unmet needs in stroke prevention: The PIONEER AF-PCI, NAVIGATE ESUS and GALILEO trials.
This article focuses on three randomised controlled trials (RCTs) that are investigating the utility of rivaroxaban, a direct, oral, factor Xa inhibitor, in additional areas of stroke prevention where data for anticoagulants are lacking: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment (PIONEER AF-PCI); New Approach riVaroxoban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE ESUS); and Global study comparing a rivAroxaban-based antithrombo...
Source: Thrombosis and Haemostasis - September 13, 2016 Category: Hematology Authors: Hemmrich M, Peterson ED, Thomitzek K, Weitz JI Tags: Thromb Haemost Source Type: research

Evaluation of Antithrombotic Bridging Methods in Acute Ischemic Stroke Patients with Atrial Fibrillation (P6.281)
Conclusions:Preliminary data supports against bridging with parenteral anticoagulation in acute ischemic stroke and AF, with a higher incidence of complications observed overall. Higher incidence of extracranial complications observed with bridging anticoagulation and higher incidence of intracranial complications observed from bridging antiplatelet therapy. This finding may be related to the limited number of patients included. A future goal for this project will be to expand the number of charts reviewed to strengthen the validity of these results.Disclosure: Dr. Swafford has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Swafford, K., Lee, J. Tags: Prevention of Cerebrovascular Disease Source Type: research

Ischemic Stroke Management: Posthospitalization and Transition of Care
Am Fam Physician. 2023 Jul;108(1):70-77.ABSTRACTIschemic stroke is a major cause of morbidity and mortality worldwide. Ischemic stroke and transient ischemic attack exist on a continuum of the same disease process. Ischemic stroke is common, and more than 85% of stroke risk is attributed to modifiable risk factors. The initial management of acute stroke is usually performed in the emergency department and hospital settings. Family physicians have a key role in follow-up, ensuring that a complete diagnostic evaluation has been performed, addressing modifiable risk factors, facilitating rehabilitation, and managing chronic s...
Source: American Family Physician - July 13, 2023 Category: Primary Care Authors: Scott T Larson Brigit E Ray Jason Wilbur Source Type: research

Stroke risk and suboptimal thromboprophylaxis in Chinese patients with atrial fibrillation: Would the novel oral anticoagulants have an impact?
Abstract: Background: The risk of stroke associated with atrial fibrillation (AF) is higher in Far Eastern population than in Western population, and warfarin use suboptimal. There is uncertainty whether the novel oral anticoagulants (NOACs) would have a major impact on stroke prevention in Far Eastern populations with AF.Objectives: We investigated current antithrombotic therapy use on stroke and bleeding risk, determinants of warfarin use and performed a modeling analysis of the net clinical benefit of the NOACs (apixaban, dabigatran) in a large cohort of Chinese patients with AF.Methods: We studied 1034 Chinese patients...
Source: International Journal of Cardiology - October 24, 2012 Category: Cardiology Authors: Yutao Guo, Ron Pisters, Stavros Apostolakis, Andrew D. Blann, Haijun Wang, Xiaoning Zhao, Yu Zhang, Dexian Zhang, Jingling Ma, Yutang Wang, Gregory Y.H. Lip Tags: Original Articles Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy.
Abstract OPINION STATEMENT: For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major bleeding as warfarin that offsets reductions in stroke risk. Dual antiplatelet therapy is recommended for end...
Source: Atherosclerosis - February 27, 2016 Category: Cardiology Authors: Yuan K, Kim AS Tags: Curr Treat Options Cardiovasc Med Source Type: research

Primary Prevention of Stroke in Chronic Kidney Disease Patients: A Scientific Update
Background: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking.Summary: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population. The use of oral anticoagulation in AF appears safe...
Source: Cerebrovascular Diseases - January 9, 2018 Category: Neurology Source Type: research

Temporary oral anticoagulation after MitraClip - a strategy to lower the incidence of post-procedural stroke?
CONCLUSIONS: Temporary oral anticoagulation might be a strategy to reduce the incidence of stroke within the first 30 days after the MitraClip procedure. Bleeding events were not significantly altered due to temporary oral anticoagulation. PMID: 30650019 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - January 18, 2019 Category: Cardiology Tags: Acta Cardiol Source Type: research

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