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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

Warfarin Use in Patients With Atrial Fibrillation Undergoing Hemodialysis Clinical Sciences
Conclusions—Our findings suggest that warfarin should be used carefully in hemodialysis patients, given the higher risk of hemorrhagic events and the lack of ability to prevent thromboembolic complications.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Chang-Yun Yoon, Juhwan Noh, Jong Hyun Jhee, Tae Ik Chang, Ea Wha Kang, Youn Kyung Kee, Hyoungnae Kim, Seohyun Park, Hae-Ryong Yun, Su-Young Jung, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Changsoo Kim, Tae-Hyun Yoo Tags: Arrhythmias, Clinical Studies, Nephrology and Kidney, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Real-World Use of Apixaban for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Background and Purpose—The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibril...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Marco Proietti, Imma Romanazzi, Giulio Francesco Romiti, Alessio Farcomeni, Gregory Y.H. Lip Tags: Atrial Fibrillation, Anticoagulants, Quality and Outcomes Original Contributions Source Type: research

Risk of Stroke Outcomes in Atrial Fibrillation Patients Treated with Rivaroxaban and Warfarin
In a previous real-world study, rivaroxaban reduced the risk of stroke overall and severe stroke compared with warfarin in patients with nonvalvular atrial fibrillation (NVAF). The aim of this study was to assess the reproducibility in a different database of our previously observed results (Alberts M, et al. Stroke. 2020;51:549-555) on the risk of severe stroke among NVAF patients in a different population treated with rivaroxaban or warfarin.
Source: Journal of Stroke and Cerebrovascular Diseases - March 17, 2021 Category: Neurology Authors: Dejan Milentijevic, Jennifer H. Lin, Nancy Connolly, Yen-Wen Chen, Emily Kogan, Shubham Shrivastava, Erik Sjoeland, Mark J. Alberts Source Type: research

Left Ventricular Systolic Dysfunction, Heart Failure, and the Risk of Stroke and Systemic Embolism in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial Original Articles
Conclusions— Patients with LVSD (with/without HF) had a higher risk of SSE or death (but similar rate of SSE) compared with patients with HF but preserved LV systolic function; both had a greater risk than patients without either HF or LVSD. Apixaban reduced the risk of both outcomes more than warfarin in all 3 patient groups. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: McMurray, J. J. V., Ezekowitz, J. A., Lewis, B. S., Gersh, B. J., van Diepen, S., Amerena, J., Bartunek, J., Commerford, P., Oh, B.-H., Harjola, V.-P., Al-Khatib, S. M., Hanna, M., Alexander, J. H., Lopes, R. D., Wojdyla, D. M., Wallentin, L., Granger, C. Tags: Congestive, Cerebrovascular disease/stroke, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke Original Articles Source Type: research

Rate of Antithrombotic Drug use and Clinical Outcomes According to CHADS2 Scores in Patients With an Initial Cardioembolic Stroke who had Nonvalvular Atrial Fibrillation
This study investigated the relationship between CHADS2 scores and the rate of antithrombotic drug use and clinical outcomes in patients with an initial cardioembolic stroke who had nonvalvular atrial fibrillation (NVAF).Methods: In 234 patients (135 men and 99 women; mean age [±SD] 76 ± 11 years) with initial cardiogenic cerebral embolism with NVAF who were admitted to our hospital between April 2007 and March 2011, the CHADS2 score, use of warfarin, and clinical outcomes were retrospectively investigated.Results: CHADS2 scores were as follows: 0 points, n = 21 (9%); 1 point, n = 72 (31%); 2 points, n = 92 (39%); 3 poin...
Source: Journal of Stroke and Cerebrovascular Diseases - July 23, 2012 Category: Neurology Authors: Ichiro Deguchi, Hiroshi Ogawa, Yasuko Ohe, Manabu Nemoto, Norio Tanahashi Tags: Original Articles Source Type: research

Repeated Episodes of Ischemic Stroke over a Short Period in a Patient with Essential Thrombocythemia on Anticoagulant Therapy
A 69-year-old man who had essential thrombocythemia, for which he was taking no medications, suddenly developed aphasia and right hemiplegia and was admitted to the hospital. He was thought to have had an embolic stroke and was initially treated with warfarin. Although the international normalized ratio was in the therapeutic range, he had 3 additional ischemic stroke episodes with the same symptoms after the index stroke. Magnetic resonance angiographic examinations revealed serial changes in middle cerebral artery stenosis. After administration of an antiplatelet agent and hydroxyurea, he had no additional strokes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 14, 2012 Category: Neurology Authors: Masaki Naganuma, Kazuya Isoda, Shinsuke Nishi, Kiyotaka Ito, Teruyuki Hirano Tags: Case Reports Source Type: research

Intracranial Hemorrhage Among Patients With Atrial Fibrillation Anticoagulated With Warfarin or Rivaroxaban: The Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation Clinical Sciences
Conclusions— Among patients with atrial fibrillation treated with anticoagulation, the risk of ICH was higher among Asians, blacks, the elderly, and in those with previous stroke or transient ischemic attack, increased diastolic blood pressure, and reduced platelet count or serum albumin at baseline. The risk of ICH was significantly lower in patients with heart failure and in those who were randomized to rivaroxaban instead of warfarin. The external validity of these findings requires testing in other atrial fibrillation populations.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Hankey, G. J., Stevens, S. R., Piccini, J. P., Lokhnygina, Y., Mahaffey, K. W., Halperin, J. L., Patel, M. R., Breithardt, G., Singer, D. E., Becker, R. C., Berkowitz, S. D., Paolini, J. F., Nessel, C. C., Hacke, W., Fox, K. A. A., Califf, R. M., on behal Tags: Acute Cerebral Hemorrhage, Anticoagulants Clinical Sciences Source Type: research

Significant Underuse of Warfarin in Patients with Nonvalvular Atrial Fibrillation: Results from the China National Stroke Registry
Conclusions: We found that warfarin was significantly underused in patients with known NVAF in China. Age and CHD and prestroke antiplatelet therapy were related factors.
Source: Journal of Stroke and Cerebrovascular Diseases - December 2, 2013 Category: Neurology Authors: Chunjuan Wang, Zhonghua Yang, Chunxue Wang, Yilong Wang, Xingquan Zhao, Liping Liu, David Z. Wang, Hao Li, Yongjun Wang Tags: Original Articles Source Type: research

Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s
Commentary on: Asberg A, Erisksson M, Henriksson KM, et al.. Warfarin-associated intracerebral hemorrhage after ischemic stroke. Stroke 2014;45:2118–20. Context Since its isolation during the early half of the 20th century from the mouldy hay responsible for ‘sweet clover disease’ in cattle, warfarin has become the most widely used oral anticoagulant.1 Indications include atrial fibrillation (AF), mechanical prosthetic valves and venous thromboembolism treatment.2 Warfarin reduces stroke risk in patients with AF by nearly two-thirds; AF accounts for 20% of ischaemic strokes, which tend to be more severe t...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Ruland, S., Biller, J. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Alcohol-related disorders, Drugs misuse (including addiction), Arrhythmias, Alcohol, Health education Aetiology/Harm Source Type: research

Residual Risk of Stroke and Death in Anticoagulated Patients According to the Type of Atrial Fibrillation: AMADEUS Trial Clinical Sciences
Conclusions— The risk of cardiovascular death, stroke, or systemic embolism is higher in anticoagulated patients with permanent AF than in those with nonpermanent AF, regardless of preexisting heart failure.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Senoo, K., Lip, G. Y. H., Lane, D. A., Buller, H. R., Kotecha, D. Tags: Thrombosis risk factors Clinical Sciences Source Type: research

Analysts: Worst case unlikely in Medicare call on Boston Scientific’s Watchman anti-stroke device
The worst-case Medicare reimbursement scenario for Boston Scientific‘s (NYSE:BSX) Watchman anti-stroke device is unlikely to play out, according to a pair of analysts. Boston Scientific shares took a hit earlier this month after the Centers for Medicare & Medicaid Services proposed to limit coverage for the Watchman device, a transcatheter implant designed to seal off the left atrial appendage to prevent the formation of blood clots that could cause stroke. The FDA approved Watchman in March. The federal health insurer proposed to limit coverage for Watchman to patients in approved clinical trials who can&#...
Source: Mass Device - November 23, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiac Implants Wall Street Beat Boston Scientific Centers for Medicare and Medicaid Services (CMS) Reimbursement Stroke Source Type: news

Renal Function and the Risk of Stroke and Bleeding in Patients With Atrial Fibrillation Clinical Sciences
Background and Purpose—We sought to determine the risk of stroke/thromboembolism and bleeding associated with reduced renal function in patients with atrial fibrillation and the risk of stroke and bleeding associated with warfarin treatment in specific estimated glomerular filtration rate (eGFR) groups.Methods—We conducted a register-based cohort study and included patients discharged with nonvalvular atrial fibrillation from 1997 to 2011 with available eGFR.Results—A total of 17 349 patients were identified with eGFR available at baseline. All levels of lower eGFR were associated with higher risk of stroke/thrombo...
Source: Stroke - October 23, 2016 Category: Neurology Authors: Bonde, A. N., Lip, G. Y. H., Kamper, A.–L., Fosbol, E. L., Staerk, L., Carlson, N., Torp–Pedersen, C., Gislason, G., Olesen, J. B. Tags: Atrial Fibrillation Original Contributions Source Type: research

Anticoagulation Use and Clinical Outcomes After Major Bleeding on Dabigatran or Warfarin in Atrial Fibrillation Clinical Sciences
Conclusions—Dabigatran was associated with a superior benefit/risk ratio than warfarin and anticoagulation discontinuation in the treatment of atrial fibrillation patients who have survived a major bleed.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Inmaculada Hernandez, Yuting Zhang, Maria M. Brooks, Paul K.L. Chin, Samir Saba Tags: Atrial Fibrillation, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Analysis of Recurrent Stroke Volume and Prognosis between Warfarin and Four Non –Vitamin K Antagonist Oral Anticoagulants' Administration for Secondary Prevention of Stroke
We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non –vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - October 21, 2017 Category: Neurology Authors: Yukie Kanai, Hiroaki Oguro, Nao Tahara, Hanako Matsuda, Hiroyuki Takayoshi, Shingo Mitaki, Keiichi Onoda, Shuhei Yamaguchi Source Type: research