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Stroke and Bleeding Risk Associated With Antithrombotic Therapy for Patients With Nonvalvular Atrial Fibrillation in Clinical Practice Health Services and Outcomes Research
Conclusions Continuation of antithrombotic therapy as well as maintaining an adequate level of TTR is beneficial to prevent strokes while minimizing bleeding events.
Source: JAHA:Journal of the American Heart Association - July 17, 2015 Category: Cardiology Authors: An, J., Niu, F., Lang, D. T., Jazdzewski, K. P., Le, P. T., Rashid, N., Meissner, B., Mendes, R., Dills, D. G., Aranda, G., Bruno, A. Tags: Health Services and Outcomes Research Source Type: research

Underutilization of warfarin for stroke prophylaxis in patients with atrial fibrillation or atrial flutter in Korea.
CONCLUSIONS: A high portion of AF/AFL patients with CHADS2 score ≥2 were undertreated with warfarin. As ischemic stroke is one of the leading causes of death in Korea, a more aggressive approach to prevent stroke in patients with AF/AFL is required. PMID: 26242197 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - August 1, 2015 Category: Cardiology Authors: Lee IH, Kim H, Je NK Tags: J Cardiol Source Type: research

Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin Versus NOACs Versus LAA Closure
ConclusionsBoth NOACs and LAAC with the Watchman device were cost-effective relative to warfarin, but LAAC was also found to be cost-effective and to offer better value relative to NOACs. The results of this analysis should be considered when formulating policy and practice guidelines for stroke prevention in AF.
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Temporal Trends in Ischemic Stroke and Anticoagulation Therapy for Nonvalvular Atrial Fibrillation: Impact of Diabetes
ConclusionsIschemic stroke declined and warfarin use increased similarly in Medicare patients with and without diabetes. Ischemic stroke rates were consistently higher in diabetes patients, validating the inclusion of diabetes in risk calculators. The population of Medicare patients with diabetes who did not receive warfarin deserves future attention. This article is protected by copyright. All rights reserved.
Source: Journal of Diabetes - February 29, 2016 Category: Endocrinology Authors: Gautam R. SHROFF, Craig A. SOLID, Zachary BLOOMGARDEN, Jonathan L. HALPERIN, Charles A. HERZOG Tags: Original Article Source Type: research

Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation
In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressur...
Source: Neuroscience Bulletin - March 7, 2016 Category: Neuroscience Source Type: research

Abstract 203: Preventing Stroke in Patients With Atrial Fibrillation: A Review of Published Interventions to Aid Patient Decision Making Session Title: Abstract Poster Session II
Conclusion: Interventions designed to aid patient decision making around stroke prevention in AF improved a selection of patient-centered outcomes. Given the availability of multiple NOACs and an implantable device for stroke prevention in AF, there is a need to develop and evaluate new patient decision support tools.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Elwyn, G., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Temporal trends in ischemic stroke and anticoagulation therapy for non‐valvular atrial fibrillation: effect of diabetes
ConclusionsIschemic stroke declined and warfarin use increased similarly in Medicare patients with and without diabetes. Ischemic stroke rates were consistently higher in diabetes patients, validating the inclusion of diabetes in risk calculators. The population of Medicare patients with diabetes who did not receive warfarin deserves future attention.
Source: Journal of Diabetes - April 12, 2016 Category: Endocrinology Authors: Gautam R. Shroff, Craig A. Solid, Zachary Bloomgarden, Jonathan L. Halperin, Charles A. Herzog Tags: Original Article Source Type: research

Temporal trends in ischemic stroke and anticoagulation therapy for non ‐valvular atrial fibrillation: effect of diabetes
ConclusionsIschemic stroke declined and warfarin use increased similarly in Medicare patients with and without diabetes. Ischemic stroke rates were consistently higher in diabetes patients, validating the inclusion of diabetes in risk calculators. The population of Medicare patients with diabetes who did not receive warfarin deserves future attention.
Source: Journal of Diabetes - April 12, 2016 Category: Endocrinology Authors: Gautam R. Shroff, Craig A. Solid, Zachary Bloomgarden, Jonathan L. Halperin, Charles A. Herzog Tags: Original Article Source Type: research

Comparison of the ATRIA, CHADS2, and CHA2DS2-VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation
Conclusion In this SAF cohort, the ATRIA score predicted ischaemic stroke risk better than CHADS2 or CHA2DS2-VASc. However, relative performance of the categorical scores varied by population stroke rates. Score cut-points may need to be optimized to better fit local population stroke rates.
Source: European Heart Journal - November 16, 2016 Category: Cardiology Authors: Aspberg, S., Chang, Y., Atterman, A., Bottai, M., Go, A. S., Singer, D. E. Tags: Prevention and epidemiology Source Type: research

Secondary prophylactic treatment and long ‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study
ConclusionsPatients with a history of TIA/stroke had a higher mortality rate versus controls, providing support for both primary and secondary prophylaxis regarding vascular risk factors for death. This study also provided support for secondary prophylactic treatment with either AC or ASA (75 mg once daily) to reduce the vascular risk of death unless there are contraindications. Long‐term prognosis after TIA and different subtypes of stroke including secondary prophylactic treatment.
Source: Brain and Behavior - October 31, 2016 Category: Neurology Authors: Sven ‐Erik Eriksson Tags: Original Research Source Type: research

Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research

Left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: a systematic review and network meta-analysis of randomized controlled trials.
CONCLUSIONS: LAA occlusion appears to preserve the benefits of oral anticoagulation therapy for stroke prevention in patients with AF, but the current evidence is of low quality. PMID: 28215062 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - February 16, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Hanif H, Belley-Cote EP, Alotaibi A, Dvirnik N, Neupane B, Beyene J, Eikelboom JW, Holmes D, Whitlock RP Tags: J Cardiovasc Surg (Torino) Source Type: research

Associations between Ischemic Stroke Follow-Up, Socioeconomic Status, and Adherence to Secondary Preventive Drugs in Southern Sweden: Observations from the Swedish Stroke Register (Riksstroke)
Conclusions: The use of secondary preventive drugs decreases over the first year after stroke and remains suboptimal. Specific reasons for nonadherence warrant further study.Neuroepidemiology 2017;48:32-38
Source: Neuroepidemiology - February 24, 2017 Category: Epidemiology Source Type: research

Abstract 160: Impact of Medication Adherence on Risk of Stroke, Major Bleeding and Other Outcomes in Atrial Fibrillation Patients Using Novel Oral Anticoagulants (Dabigatran and Rivaroxaban) Session Title: Poster Session II
Conclusion: In our sample, adherence to NOACs was associated with a reduction in stroke and DVTPE risk but did not substantially increase bleeding risk. Further studies with newer NOACs are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Deshpande, C. G., Willey Temkin, C., Laforge, R., Kogut, S. Tags: Session Title: Poster Session II Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research