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Exploratory Network Meta Regression Analysis of Stroke Prevention in Atrial Fibrillation Fails to Identify Any Interactions with Treatment Effect
ConclusionThis study is limited by the quantity of data available. Further investigation is warranted, and, as justifying further trials may be difficult, it would be desirable to obtain individual patient level data (IPD) to facilitate an effort to relate treatment effects to IPD covariates in order to investigate heterogeneity. Observational data could also be examined to establish if there are potential trends elsewhere. The approach and methods presented have potentially wide applications within any indication as to highlight the potential benefit of extending decision problems to include additional comparators outside...
Source: PLoS One - August 24, 2016 Category: Biomedical Science Authors: Sarah Batson Source Type: research

Real-World Evidence of Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation in the United States: the REVISIT-US Study.
CONCLUSIONS: Rivaroxaban and apixaban were associated with less ICH than warfarin and both are likely associated with reductions in the combined endpoint. Further investigation to validate the numerically higher rate of ischemic stroke with apixaban versus warfarin is required. PMID: 27633045 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - September 19, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Impact of renal function on ischemic stroke and major bleeding rates in nonvalvular atrial fibrillation patients treated with warfarin or rivaroxaban: a retrospective cohort study using real-world evidence.
CONCLUSIONS: Ischemic stroke rates were significantly lower in the overall NVAF population for rivaroxaban vs warfarin users, including patients with eCrCl below 50 mL/min. For all renal function groups, major bleeding risks were not statistically different between treatment groups. PMID: 28590785 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - June 8, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Comparison of All-Cause, Stroke, and Bleed-Specific Healthcare Resource Utilization among Patients with Non-Valvular Atrial Fibrillation (NVAF) and Newly Treated with Dabigatran or Warfarin.
CONCLUSION: Among newly diagnosed newly treated NVAF patients, dabigatran users had significantly lower all-cause, stroke- and bleed-specific HCRU, lower risk of hospitalization for stroke or bleed events, lower 30-day readmissions, and higher persistence than warfarin users. PMID: 28649894 [PubMed - as supplied by publisher]
Source: Expert Review of Pharmacoeconomics and Outcomes Research - June 28, 2017 Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research

In Potential Stroke Patients on Warfarin, the International Normalized Ratio Predicts Ischemia
Conclusions: Sub-therapeutic INR and atrial fibrillation are strongly associated with ischemia in patients on warfarin presenting with acute neurologic symptoms. Ischemia is far less likely in patients with an INR of ≥2 and rare in those with an INR ≥3.6. This study shows that the INR value of a patient on warfarin can help stratify patients’ risk for acute ischemic stroke and guide further neurologic imaging and workup.Cerebrovasc Dis Extra 2017;7:111 –119
Source: Cerebrovascular Diseases Extra - August 11, 2017 Category: Neurology Source Type: research

New Standards of Care in Ischemic Stroke
Conclusions: Endovascular therapy is now standard of care for eligible patients with anterior large vessel occlusions. Prolonged cardiac monitoring is recommended for patients with cryptogenic stroke. The novel anticoagulants are an alternative to warfarin in patients with AF.
Source: Journal of Neuro-Ophthalmology - August 17, 2017 Category: Opthalmology Tags: State-of-the-Art Review Source Type: research

Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report
Publication date: Available online 21 September 2017 Source:American Journal of Kidney Diseases Author(s): Vinod K. Bansal, Charles A. Herzog, Mark J. Sarnak, Michael J. Choi, Ravindra Mehta, Bernard G. Jaar, Michael V. Rocco, Holly Kramer Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as...
Source: American Journal of Kidney Diseases - September 21, 2017 Category: Urology & Nephrology Source Type: research

In Potential Stroke Patients on Warfarin, the International Normalized Ratio Predicts Ischemia
Conclusions: Sub-therapeutic INR and atrial fibrillation are strongly associated with ischemia in patients on warfarin presenting with acute neurologic symptoms. Ischemia is far less likely in patients with an INR of ≥2 and rare in those with an INR ≥3.6. This study shows that the INR value of a patient on warfarin can help stratify patients’ risk for acute ischemic stroke and guide further neurologic imaging and workup.Cerebrovasc Dis Extra 2017;7:111 –119
Source: Cerebrovascular Diseases Extra - October 25, 2017 Category: Neurology Source Type: research

Heart Failure and Stroke
AbstractPurposeIschemic stroke significantly contributes to morbidity and mortality in heart failure (HF). The risk of stroke increases significantly, with coexisting atrial fibrillation (AF). An aggravating factor could be asymptomatic paroxysms of AF (so-called silent AF), and therefore, the risk stratification in these patients remains difficult. This review provides an overview of stroke risk in HF, its risk stratification, and stroke prevention in these patients.Recent FindingsStroke risk stratification in HF patients remains an important issue. Recently, the CHA2DS2-VASc score, originally developed to predict stroke ...
Source: Current Heart Failure Reports - July 30, 2018 Category: Cardiology Source Type: research

Direct oral anticoagulants for stroke prevention in atrial fibrillation: treatment outcomes and dosing in special populations.
CONCLUSIONS: Overall, results of secondary analyses indicate that the recommended dosing strategy for each of the DOACs produces a consistent anticoagulant effect across a diverse patient population, including those at increased risk of stroke or bleeding. PMID: 30081727 [PubMed - in process]
Source: Adv Data - August 9, 2018 Category: Epidemiology Authors: Stacy ZA, Richter SK Tags: Ther Adv Cardiovasc Dis Source Type: research

Heart Failure and Stroke
AbstractPurposeIschemic stroke significantly contributes to morbidity and mortality in heart failure (HF). The risk of stroke increases significantly, with coexisting atrial fibrillation (AF). An aggravating factor could be asymptomatic paroxysms of AF (so-called silent AF), and therefore, the risk stratification in these patients remains difficult. This review provides an overview of stroke risk in HF, its risk stratification, and stroke prevention in these patients.Recent FindingsStroke risk stratification in HF patients remains an important issue. Recently, the CHA2DS2-VASc score, originally developed to predict stroke ...
Source: Current Heart Failure Reports - October 1, 2018 Category: Cardiology Source Type: research

Changes in survival and characteristics among older stroke unit patients —1994 versus 2012
ConclusionsThree ‐year survival in older Norwegian stroke patients treated on an SU remained stable despite improved treatment in the last decades. Differences in background characteristics may explain this lack of difference; patients in 2012 were older, more often living in supported care, and had higher prestro ke comorbidity; however, their strokes were milder and risk factors more often treated.
Source: Brain and Behavior - November 25, 2018 Category: Neurology Authors: Angela Susan Labberton, Ole Morten R ønning, Bente Thommessen, Mathias Barra Tags: ORIGINAL RESEARCH Source Type: research

Comparison of hospital length of stay of acute ischemic stroke patients with non-valvular atrial fibrillation started on rivaroxaban or warfarin treatment during hospitalization.
Conclusions: The rivaroxaban users had a 3-day shorter LOS-OAC after IPTW-adjustment. Using rivaroxaban was associated with a 4 to 5 days shorter LOS-OAC than using warfarin in patients with mild or moderate stroke, though treatment selection did not have a large impact in patients with severe stroke. PMID: 32936057 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - September 18, 2020 Category: Health Management Tags: J Med Econ Source Type: research

Impact of atrial fibrillation on the risk of ischemic stroke in patients on hemodialysis: BOREAS-HD3 Study
ConclusionPresent analyses using comprehensive adjustment for multiple confounders, including prior history of ischemic stroke, indicated that AF independently increases the risk of new-onset of ischemic stroke by more than twofold in Japanese HD patients.
Source: Clinical and Experimental Nephrology - November 18, 2020 Category: Urology & Nephrology Source Type: research