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New Watchman study reports positive data
New data from a study of Boston Scientific (NYSE:BSX)’s Watchman left atrial appendage closure device reports positive results in a study comparing it to warfarin, an anticoagulant drug treatment, in patients with nonvalvular atrial fibrillation. The 2,406-patient study, published in the Journal of the American College of Cardiology, reported a lower rate of hemorrhagic strokes, unexplained and cardiovascular death and non-procedural bleeding when compared to warfarin. “I think the fact that we now actually have some good scientific data in the field is terribly important, it has been lacking. But I think we...
Source: Mass Device - June 16, 2015 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Clinical Trials Boston Scientific Stroke Source Type: news

Risk factors and outcome of Stroke in renal transplant recipients
This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - May 23, 2016 Category: Transplant Surgery Authors: Mark D. Findlay, Peter C. Thomson, Rachael MacIsaac, Alan G. Jardine, Rajan K. Patel, Kathryn K. Stevens, Elaine Rutherford, Marc Clancy, Colin C. Geddes, Jesse Dawson, Patrick B. Mark Tags: Original Article Source Type: research

Use of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Before Stroke.
CONCLUSIONS: -While experience of using rt-PA in ischemic stroke patients on a NOAC is limited, these preliminary observations suggest that rt-PA appears to be reasonably well tolerated without prohibitive risks for adverse events among selected NOAC treated patients. Future study should evaluate the safety and efficacy of intravenous rt-PA in ischemic stroke patients taking NOACs. PMID: 28119380 [PubMed - as supplied by publisher]
Source: Circulation - January 23, 2017 Category: Cardiology Authors: Xian Y, Federspiel JJ, Hernandez AF, Laskowitz D, Schwamm LH, Bhatt DL, Smith EE, Fonarow GC, Peterson ED Tags: Circulation Source Type: research

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Two-Year Outcomes of Anticoagulation for Acute Ischemic Stroke With Nonvalvular Atrial Fibrillation 　- SAMURAI-NVAF Study.
CONCLUSIONS: Stroke/TIA patients receiving DOACs for secondary prevention were younger and had lower stroke severity and risk indices than those receiving warfarin. Estimated cumulative incidences of stroke and systemic embolism within 2 years were similar between warfarin and DOACs users, but those of death and intracranial hemorrhage were significantly lower among DOAC users. PMID: 29863095 [PubMed - as supplied by publisher]
Source: Circulation Journal - June 1, 2018 Category: Cardiology Authors: Yoshimura S, Koga M, Sato S, Todo K, Yamagami H, Kumamoto M, Itabashi R, Terasaki T, Kimura K, Yagita Y, Shiokawa Y, Kamiyama K, Okuda S, Okada Y, Takizawa S, Hasegawa Y, Kameda T, Shibuya S, Nagakane Y, Ito Y, Matsuoka H, Takamatsu K, Nishiyama K, Fujita Tags: Circ J Source Type: research

306 The Changing Face of Stroke in the DOAC Era
ConclusionThe majority of strokes occurring in anticoagulated patients are related to warfarin use. We observed an almost significant reduction in the proportion of ischaemic strokes due to under-dosing of OAC over the study period. Warfarin continues to be recommended as the first line anticoagulant for stroke prevention in atrial fibrillation by the HSE Medicines Management Programme, a decision which we would argue warrants review.
Source: Age and Ageing - September 16, 2019 Category: Geriatrics Source Type: research

Drug treatment strategies for osteoporosis in stroke patients.
Authors: Hsieh CY, Sung SF, Huang HK Abstract Introduction: Osteoporosis and subsequent fractures are well-recognized complications of stroke. However, drug treatment strategies for osteoporosis after stroke have been rarely discussed in the current guidelines for the management of stroke or osteoporosis.Areas covered: The authors review the epidemiology, characteristics, pathophysiology, and risk prediction of post-stroke osteoporosis and fractures. Then they provide an overview of existing evidence regarding drug treatment strategies for osteoporosis in stroke patients. They also review the effects on bone minera...
Source: Expert Opinion on Pharmacotherapy - March 11, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Updating the Cost Effectiveness of Oral Anticoagulants for Patients with Atrial Fibrillation Based on Varying Stroke and Bleed Risk Profiles
ConclusionsFrom a US private payer ’s perspective, dabigatran appears cost effective compared with other anticoagulants. This study indicated risk stratification especially considering both stroke and bleed risk simultaneously is important not only in clinical practice but also in health technology assessment exercises among patien ts with atrial fibrillation.
Source: PharmacoEconomics - September 13, 2020 Category: Health Management Source Type: research

The efficacy and safety of Hirudin plus Aspirin versus Warfarin in the secondary prevention of Cardioembolic Stroke due to Nonvalvular Atrial Fibrillation: A multicenter prospective cohort study.
Conclusion: Significant difference in efficacy was not detected between warfarin group and hirudin plus aspirin group. Compared with warfarin, hirudin plus aspirin therapy had lower safety risk in the secondary prevention of cardioembolic stroke due to NVAF. PMID: 33526977 [PubMed - in process]
Source: International Journal of Medical Sciences - February 3, 2021 Category: Biomedical Science Tags: Int J Med Sci Source Type: research

Genetic Contributors of Incident Stroke in 10,700 African Americans With Hypertension: A Meta-Analysis From the Genetics of Hypertension Associated Treatments and Reasons for Geographic and Racial Differences in Stroke Studies
Conclusion: This study highlights biologically plausible genetic determinants for incident stroke in hypertensive AAs. Ultimately, a better understanding of genetic risk factors for stroke in AAs may give new insight into stroke burden and potential clinical tools for those among the highest at risk.
Source: Frontiers in Genetics - December 21, 2021 Category: Genetics & Stem Cells Source Type: research

Which drug should we use for stroke prevention in atrial fibrillation?
This article reviews the latest evidence and development of new oral anticoagulants for the prevention of ischaemic stroke, as well as bleeding risk assessment, mitigation and management. Recent findingsDecision-making for stroke prevention has evolved towards the initial identification of ‘low-risk’ patients who do not need any antithrombotic therapy. Subsequent to this step, patients with at least 1 stroke risk factor can be offered effective stroke prevention, which is OAC. There is increased morbidity and mortality amongst warfarin users, if time in therapeutic range is poor. New oral anticoagulants (such as dabiga...
Source: Current Opinion in Cardiology - June 6, 2014 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Harvey D. White Source Type: research

Preoperative risk factor analysis of postoperative stroke after Cox-maze procedure with mitral valve repair
Conclusions: In the group of patients who underwent the Cox-Maze procedure with mitral valve repair, having a stroke history was the only preoperative risk factor that could lead to a stroke event after surgery. Accordingly, patients with affliction of ischemic stroke, albeit sustained sinus rhythm, may require prophylactic anticoagulation.
Source: BMC Cardiovascular Disorders - September 11, 2014 Category: Cardiology Authors: Jun Seok KimSong Am LeeJae Bum ParkHyun Keun CheeJin Woo Chung 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

Clinical Benefit of American College of Chest Physicians versus European Society of Cardiology Guidelines for Stroke Prophylaxis in Atrial Fibrillation
CONCLUSIONS By expanding warfarin use to 65-–74-year-olds with a CHADS2 score of 0, rates of hemorrhages would rise without a significant reduction in stroke equivalents.
Source: Journal of General Internal Medicine - February 10, 2015 Category: Internal Medicine Source Type: research

Endovascular Treatment and the Outcomes of Atherosclerotic Intracranial Stenosis in Patients With Hyperacute Stroke
CONCLUSION: Emergent intracranial angioplasty with or without stenting is safe and feasible and yields a high rate of revascularization and favorable outcome in patients with hyperacute stroke and underlying ICAS. Patients with underlying ICAS have less severe infarctions at presentation and higher successful revascularization after multimodal endovascular therapy in the setting of hyperacute stroke compared with those with other stroke subtypes. ABBREVIATIONS: ICAS, intracranial atherosclerotic stenosis MAT, manual aspiration thrombectomy mRS, modified Rankin Scale NIHSS, National Institutes of Health Stroke Scale SAMMPRI...
Source: Neurosurgery - May 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research