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Ischemic Stroke in Nonvalvular Atrial Fibrillation at Warfarin Initiation Clinical Sciences
Conclusions—Warfarin effect was qualitatively different in the first 30 days after initiation than subsequently. This is consistent with a modest increase in stroke risk occurring briefly after starting warfarin.
Source: Stroke - May 22, 2017 Category: Neurology Authors: Ping G. Tepper, Xianchen Liu, Melissa Hamilton, Jack Mardekian, William Petkun, Wilson Tan, Daniel E. Singer Tags: Epidemiology Original Contributions Source Type: research

Comparison of primary and secondary stroke prevention in patients with nonvalvular atrial fibrillation: Results from the RAFFINE registry
Atrial fibrillation (AF) is a predictor of severe stroke and early death in acute ischemic stroke patients.1 The prevalence of AF has increased as the Japanese population has aged.2 AF has been more common among patients with ischemic stroke than previously reported.3 In particular, AF patients with a history of stroke or TIA have had higher risks for stroke, hemorrhagic events, and death compared to those without.4,5 In these previous studies, most patients received warfarin for anticoagulation therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - November 7, 2022 Category: Neurology Authors: Kazuo Yamashiro, Ryota Tanaka, Sakiko Miyazaki, Katsumi Miyauchi, Hidemori Hayashi, Yuji Nishizaki, Shuko Nojiri, Satoru Suwa, Masataka Sumiyosi, Yuji Nakazato, Takao Urabe, Nobutaka Hattori, Tohru Minamino, Hiroyuki Daida Source Type: research

Dabigatran Versus Warfarin: Effects on Ischemic and Hemorrhagic Strokes and Bleeding in Asians and Non-Asians With Atrial Fibrillation Clinical Sciences
Conclusions— Hemorrhagic stroke rates were higher on warfarin in Asians versus non-Asians, despite similar blood pressure, younger age, and lower international normalized ratio values. Hemorrhagic strokes were significantly reduced by DE in both Asians and non-Asians. DE benefits were consistent across Asian and non-Asian subgroups. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00262600.
Source: Stroke - June 24, 2013 Category: Neurology Authors: Hori, M., Connolly, S. J., Zhu, J., Liu, L. S., Lau, C.-P., Pais, P., Xavier, D., Kim, S. S., Omar, R., Dans, A. L., Tan, R. S., Chen, J.-H., Tanomsup, S., Watanabe, M., Koyanagi, M., Ezekowitz, M. D., Reilly, P. A., Wallentin, L., Yusuf, S., the RE-LY In Tags: Other anticoagulants, Embolic stroke Clinical Sciences Source Type: research

Warfarin versus Aspirin for Prevention of Stroke in Heart Failure: A Meta-analysis of Randomized Controlled Clinical Trials
Conclusions: Compared with aspirin, warfarin reduced the risk of stroke while conferring an increased risk of major hemorrhage. Warfarin does not increase mortality or confer an increased risk of ICH compared with aspirin.
Source: Journal of Stroke and Cerebrovascular Diseases - November 21, 2012 Category: Neurology Authors: Gyanendra Kumar, Munish Kumar Goyal Tags: Original Articles Source Type: research

Vitreous Hemorrhage as a Complication of IV-tPA Therapy in a Patient with Acute Stroke (P4.227)
CONCLUSIONS: To our knowledge, this is the first case report of vitreous hemorrhage following acute stroke therapy with IV-tPA. This underscores the risk of intraocular hemorrhage in patients with retinal neovascularization that could occur with other retinal vascular disorders such as diabetic retinopathy. The decision to proceed with IV-tPA in the presence of retinal neovascularization should be made on a case-by-case basis and further discussion with the patient.Disclosure: Dr. Shah has nothing to disclose. Dr. Verstraeten has nothing to disclose. Dr. Wright has nothing to disclose. Dr. Rana has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Shah, L., Verstraeten, T., Wright, D., Rana, S. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Thrombolysis Source Type: research

Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

The quest to prevent stroke in atrial fibrillation: Fighting the fluttering heart in Singapore
There has been resurgence in the attention placed on pharmacotherapy in atrial fibrillation (AF) recently as specialists in international conferences discuss the utility of novel anticoagulants with caution owing to limited knowledge of the side effect profile in this nascent stage. AF is a well-known risk factor for stroke and has been for more than 20 years, since warfarin was demonstrated to reduce the risk of stroke, with aspirin doing so to a lesser degree.1 Today, there is international variation in the use of warfarin to prevent stroke despite well-established data.2 Singapore finds itself in a peculiar geographical...
Source: Neurology - June 2, 2014 Category: Neurology Authors: Goh, O., Lai, G., Tu, T. M., Lee, K. E. Tags: Cost effectiveness/economic, Stroke prevention, All Cerebrovascular disease/Stroke, Health care reform, Risk factors in epidemiology GLOBAL PERSPECTIVES Source Type: research

Reduced Smoke-like Echo and Resolved Thrombus in the Left Atrium with Rivaroxaban Therapy in an Acute Cardioembolic Stroke Patient
We report a case of a nonvalvular atrial fibrillation (NVAF) patient with acute cardioembolic stroke in whom rivaroxaban, an oral direct factor Xa inhibitor, reduced a smoke-like echo in the left atrium and resolved a thrombus in the left atrial appendage. A 71-year-old man was admitted because of the sudden onset of right hemiplegia and aphasia and was diagnosed with acute cardioembolic stroke associated with NVAF. The patient had not been treated with warfarin before admission, and rivaroxaban therapy (15 mg once daily) was initiated. Transesophageal echocardiography was performed on day 8 and a mobile thrombus was foun...
Source: Journal of Stroke and Cerebrovascular Diseases - April 11, 2014 Category: Neurology Authors: Shin Saito, Hirofumi Tomita, Yoshihiro Kimura, Hiroshi Shiroto, Joji Hagii, Norifumi Metoki, Hiroyasu Hitomi, Takaatsu Kamada, Tomohiro Osanai, Ken Okumura, Minoru Yasujima Tags: Case Reports Source Type: research

Warfarin-Associated Intracerebral Hemorrhage After Ischemic Stroke Brief Reports
Conclusions— In this nationwide study, the risk of warfarin-associated ICH among ischemic stroke patients was low and did not change during the 2000s.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Asberg, S., Eriksson, M., Henriksson, K. M., Terent, A. Tags: Intracerebral Hemorrhage, Anticoagulants, Epidemiology Brief Reports Source Type: research

Ischemic Stroke in Patients with Elevated Body Mass Index while on Novel Anticoagulants: A case series report (P1.059)
CONCLUSIONS:We report and characterize the largest published case series of patients with non-valvular atrial fibrillation who had ischemic stroke while on novel oral anticoagulants. Elevated body mass index was noted among those who developed embolic strokes while on these agents.Disclosure: Dr. Kamal has nothing to disclose. Dr. Smith has nothing to disclose. Dr. Mowla has nothing to disclose. Dr. Shirani has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Fanous has nothing to disclose. Dr. Ching has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kamal, H., Smith, K., Mowla, A., Shirani, P., Sawyer Jr., R., Fanous, A., Ching, M. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research

Left Atrial Appendage Occlusion Device and Novel Oral Anticoagulants Versus Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation: Systematic Review and Meta-Analysis of Randomized Controlled Trials Original Articles
Conclusions— Novel oral anticoagulants is superior to warfarin for stroke prevention in nonvalvular atrial fibrillation. This benefit was also observed in the elderly population. DEVICE is a reasonable noninferior alternative to warfarin for stroke prevention, but cautious use is essential given safety concerns.
Source: Circulation: Arrhythmia and Electrophysiology - October 20, 2015 Category: Cardiology Authors: Briceno, D. F., Villablanca, P., Cyrille, N., Massera, D., Bader, E., Manheimer, E., Aagaard, P., Ferrick, K., Gross, J., Kim, S. G., Krumerman, A., Palma, E., Guttenplan, N., Romero, J., Fisher, J., Garcia, M., Natale, A., Di Biase, L. Tags: Coumarins, Other anticoagulants, Other Stroke Treatment - Medical Original Articles Source Type: research

Boston Scientific dips on Medicare reimbursement hit for Watchman anti-stroke device
Boston Scientific (NYSE:BSX) shares took a hit yesterday after a Centers for Medicare & Medicaid Services proposal that would limit coverage for the Watchman anti-stroke device. Investors also likely reacted to a pair of Class II recalls from the FDA, sending BSX shares down -4.2% to $18.01 apiece yesterday. Watchman, a transcatheter implant designed to seal off the left atrial appendage to prevent the formation of blood clots that could cause stroke, was approved by the FDA in March and asked for a CMS coverage decision in May. The federal health insurer proposed to limit coverage for Watchman to patients in approv...
Source: Mass Device - November 12, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiac Implants Cardiovascular Recalls Boston Scientific Cardiac Rhythm Management Stroke Source Type: news

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

D-Dimer versus International Normalized Ratio of Prothrombin Time in Ischemic Stroke Patients Treated with Sufficient Warfarin
In patients receiving chronic warfarin therapy, the international normalized ratio of prothrombin time (PT-INR) reportedly correlates with the incidence, size, severity, and outcome of ischemic stroke, and thus there are guidelines for the optimal PT-INR range that is to be maintained during secondary or primary prevention of ischemic stroke. However, the details of ischemic stroke in patients in whom an optimal PT-INR is maintained by warfarin therapy have not been thoroughly investigated. We conducted a retrospective study to determine the predictors of the size, severity, and outcome of ischemic stroke occurring in pati...
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2016 Category: Neurology Authors: Ryoo Yamamoto, Yoshiharu Nakae, Fumiaki Tanaka, Ken Johkura Source Type: research

Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events: Findings From ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Clinical Sciences
Conclusions— Patients with atrial fibrillation with previous IS/TIA are at high risk of recurrent thromboembolism and bleeding. HDER is at least as effective and is safer than warfarin, regardless of the presence or the absence of previous IS or TIA. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Rost, N. S., Giugliano, R. P., Ruff, C. T., Murphy, S. A., Crompton, A. E., Norden, A. D., Silverman, S., Singhal, A. B., Nicolau, J. C., SomaRaju, B., Mercuri, M. F., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Investigators Tags: Atrial Fibrillation, Anticoagulants, Ischemic Stroke Clinical Sciences Source Type: research