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First Diagnosis of Atrial Fibrillation at the Time of Stroke
Conclusions: In this contemporary cohort, nearly one in 5 AF-related strokes occurred without a pre-stroke AF diagnosis. AF was readily diagnosed using standard rhythm monitoring. The vast majority of patients with newly diagnosed AF were at high enough pre-stroke risk to merit anticoagulation. In conclusion, our findings support screening for AF before stroke. Patients with past transient AF may merit more intensive screening.Cerebrovasc Dis 2017;43:192-199
Source: Cerebrovascular Diseases - February 16, 2017 Category: Neurology Source Type: research

Higher Mortality of Ischaemic Stroke Patients Hospitalized with COVID-19 Compared to Historical Controls
Conclusions: Ischaemic stroke patients with COVID-19 had significantly higher 60-day all-cause mortality compared to propensity score-matched historical controls (ischaemic stroke patients without COVID-19).Cerebrovasc Dis
Source: Cerebrovascular Diseases - March 26, 2021 Category: Neurology Source Type: research

Exercise-Based Cardiac Rehabilitation Associates with Lower Major Adverse Cardiovascular Events in People with Stroke
Conclusion: Exercise-based cardiac rehabilitation prescribed for people following a stroke associated with significantly lower odds of major adverse cardiovascular events at 2 years, compared to usual care.Cerebrovasc Dis
Source: Cerebrovascular Diseases - December 20, 2021 Category: Neurology Source Type: research

Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood p...
Source: BMJ Open - November 11, 2014 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Global health Protocol Source Type: research

Identifying gaps in the management of atrial fibrillation with anticoagulation for stroke prevention (GIANTS): a quality improvement initiative
ConclusionsAwareness of this finding is critical to overcome therapeutic inertia in the use of DOACs for ischemic stroke patients with AF. With stroke care becoming increasingly nuanced, peripheral centers may lack the ability to guide anticoagulation in a timely and effective manner. Creation of tertiary short-term follow-up stroke clinics with cardiology follow-up may be an effective strategy to ensure standard of care. Research into systems contributors affecting the appropriate use of DOACs should be elucidated.
Source: Journal of Neurology - May 10, 2022 Category: Neurology Source Type: research

AUtomated Risk Assessment for Stroke in Atrial Fibrillation (AURAS-AF) - an automated software system to promote anticoagulation and reduce stroke risk: study protocol for a cluster randomised controlled trial
DiscussionAURAS-AF will investigate whether a simple intervention, using electronic primary care records, can improve OAC uptake in a high risk group for stroke. Given previous concerns about safety, especially surrounding inappropriate prescribing, we will also examine whether electronic reminders safely impact care in this clinical area.Trial registration: ISRCTN 55722437
Source: Trials - November 13, 2013 Category: Journals (General) Authors: Tim HoltDavid FitzmauriceTom MarshallMatthew FayNadeem QureshiAndrew DaltonF HobbsDaniel LassersonKaren KearleyJenny HislopJing Jin 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

C-reactive protein levels are associated with early cardiac complications or death in patients with acute ischemic stroke: a propensity-matched analysis of a global  federated health from the TriNetX network
AbstractThe role of inflammation in predicting early cardiac complications among stroke patients is unclear. Electronic medical records from TriNetX, a global federated health research network, were used for this retrospective analysis. Patients with ischemic stroke and C-Reactive Protein (CRP) levels measured within 24  h post-stroke were categorized into three groups: (i) <  1 mg/L, (ii)1–3 mg/L and (iii) >  3 mg/L. The primary outcome was a composite outcome of cardiac complications (heart failure (HF), ischemic heart disease, atrial fibrillation (AF), ventricular arrhythmias and Takotsubo cardiomyop...
Source: Internal and Emergency Medicine - April 29, 2023 Category: Emergency Medicine Source Type: research

Stroke prophylaxis in critically-ill patients with new-onset atrial fibrillation
AbstractDespite a high incidence of new onset atrial fibrillation (NOAF) in critically ill patients and its association with short and long-term incidence of stroke, there is limited data assessing anticoagulation on hospital discharge in these patients. We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac ICUs at our institution between January 2009 and March 2016. Patients with NOAF were identified and CHA2DS2-VASc score of ICU survivors was calculated. Prescription of oral anticoagulant therapy on hospital discharge was analyzed. A total of 640 (1.7% [38,708 patients]; 95%...
Source: Journal of Thrombosis and Thrombolysis - April 7, 2019 Category: Hematology Source Type: research

Comparison of Stroke Risk Stratification Scores for Atrial Fibrillation
Several stroke risk stratification scores have been developed to guide clinical decision making in patients with non valvular atrial fibrillation (AF). The aim of this study was to compare the performance of the CHADS2, CHA2DS2-VASc and R2CHADS2 risk scores to predict stroke.This retrospective cohort study was based on electronic medical records from Clalit Health Services (CHS), the largest payer provider healthcare organization in Israel. Data of CHS members with AF diagnosis between 2004- 2015 were extracted.
Source: The American Journal of Cardiology - March 12, 2019 Category: Cardiology Authors: Meytal Avgil Tsadok, Adi Berliner Senderey, Orna Reges, Morton Leibowitz, Maya Leventer-Roberts, Moshe Hoshen, Moti Haim Source Type: research

Thoracic aortic aneurysm and atrial fibrillation: clinical associations with the risk of stroke from a global federated health network analysis
ConclusionThis retrospective analysis reports a clinical concomitance of the two medical conditions, and shows in a PSM analysis an increased risk of ischemic events in patients affected by TAA and AF compared to AF alone.
Source: Internal and Emergency Medicine - January 14, 2023 Category: Emergency Medicine Source Type: research

Relation of Hemoglobin A1C Levels to Risk of Ischemic Stroke and Mortality in Patients With Diabetes Mellitus and Atrial Fibrillation
This study aimed to assess the incidence and risks of ischemic stroke and mortality according to baseline HbA1c levels in patients with DM and AF. We conducted a cohort study using Clalit Health Services electronic medical records. The study population included all Clalit Health Services members aged ≥25 years, with the first diagnosis of AF between January 1, 2010, and December 31, 2016, who had a diagnosis of DM.
Source: The American Journal of Cardiology - March 29, 2022 Category: Cardiology Authors: Louise Kezerle, Moti Haim, Amichay Akriv, Adi Berliner Senderey, Asaf Bachrach, Maya Leventer-Roberts, Meytal Avgil Tsadok Source Type: research

Progression of stroke risk in patients aged & lt;65 years diagnosed with atrial fibrillation: a cohort study in general practice
CONCLUSION: People aged <65 years with AF are at higher risk of developing hypertension, heart failure, and diabetes than the general population, so may warrant regular review to identify new occurrence of such risk factors.PMID:37487643 | DOI:10.3399/BJGP.2022.0568
Source: The British Journal of General Practice - July 24, 2023 Category: Primary Care Authors: Silvia C Mendon ça Duncan A Edwards Jenny Lund Catherine L Saunders Jonathan Mant Source Type: research

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