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Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Higher Risk of Ischemic Events in Secondary Prevention for Patients With Persistent Than Those With Paroxysmal Atrial Fibrillation Clinical Sciences
Conclusions— Among patients with previous ischemic stroke or transient ischemic attack, those with sustained AF had a higher risk of stroke or systemic embolism compared with those with paroxysmal AF. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01581502.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Koga, M., Yoshimura, S., Hasegawa, Y., Shibuya, S., Ito, Y., Matsuoka, H., Takamatsu, K., Nishiyama, K., Todo, K., Kimura, K., Furui, E., Terasaki, T., Shiokawa, Y., Kamiyama, K., Takizawa, S., Okuda, S., Okada, Y., Kameda, T., Nagakane, Y., Yagita, Y., K Tags: Atrial Fibrillation, Secondary Prevention, Quality and Outcomes Clinical Sciences Source Type: research

Intracerebral Hemorrhage: The 'Other' Stroke
J Mocco, MD, MS Professor and Vice Chair for Education Director, Cerebrovascular Center Residency Program Director Department of Neurological Surgery Mount Sinai Health System Intracerebral Hemorrhage: The 'Other' Stroke A recent patient of mine, 48-year-old "Joe" (not his real name), was eating with his family at an Italian restaurant. Suddenly, he stood up, cursed, and collapsed. They brought him to the hospital, and he could not talk, move, or do anything we asked him to do. It turned out that Joe had suffered the second-most common, but deadliest, form of stroke: intracerebral hemorrhage. When people hear "stroke,...
Source: Healthy Living - The Huffington Post - November 7, 2016 Category: Consumer Health News Source Type: news

Different impact of aspirin on renal progression in patients with predialysis advanced chronic kidney disease with or without previous stroke.
CONCLUSIONS: There was no significant benefit in preventing ischemic stroke in the patients with advanced CKD who received aspirin therapy. Furthermore, the use of aspirin was associated with the risk of renal failure in the patients with advanced CKD without previous stroke. PMID: 27884500 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - November 20, 2016 Category: Internal Medicine Authors: Hsiao KC, Huang JY, Lee CT, Hung TW, Liaw YP, Chang HR Tags: Eur J Intern Med 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

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

Abbott ’s Amplatzer Stroke Reduction Data Is Strong at EuroPCR
Abbott Laboratories’ Amplatzer Amulet left atrial appendage (LAA) occlusion device has been shown at one year to reduce stroke by 57% as compared to the predicted stroke risk. The data also showed it was able to make this reduction without the need for lifetime blood thinners.  The Abbott Park IL-based company released the data at EuroPCR, the annual meeting of the European Association of Percutaneous Cardiovascular Interventions in Paris, and simultaneously published in EuroIntervention. More than 1,078 patients suffering from atrial fibrillation (Afib) were in the study with one-year-follow up. “The Amulet is a devi...
Source: MDDI - May 24, 2018 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Source Type: news

Patent foramen ovale closure reduces recurrent stroke risk in cryptogenic stroke: A systematic review and meta-analysis of randomized controlled trials.
CONCLUSION: PFO device closure in appropriately selected patients with moderate to severe right-to-left shunt and/or atrial septal aneurysm shows benefit with respect to recurrent strokes, particularly in younger patients. Further studies are essential to evaluate the impact of higher incidence of atrial fibrillation seen with the PFO closure device on long-term mortality and stroke rates. PMID: 29983901 [PubMed]
Source: World Journal of Cardiology - June 26, 2018 Category: Cardiology Authors: Anantha-Narayanan M, Anugula D, Das G Tags: World J Cardiol Source Type: research

Comparison of prasugrel and clopidogrel in patients with non-cardioembolic ischaemic stroke: a phase 3, randomised, non-inferiority trial (PRASTRO-I)
Publication date: March 2019Source: The Lancet Neurology, Volume 18, Issue 3Author(s): Akira Ogawa, Kazunori Toyoda, Kazuo Kitagawa, Takanari Kitazono, Takehiko Nagao, Hiroshi Yamagami, Shinichiro Uchiyama, Norio Tanahashi, Masayasu Matsumoto, Kazuo Minematsu, Izumi Nagata, Masakatsu Nishikawa, Shinsuke Nanto, Kenji Abe, Yasuo Ikeda, PRASTRO-I Study GroupSummaryBackgroundThe effect of prasugrel in terms of the prevention of recurrence of ischaemic stroke is unknown. We investigated the non-inferiority of prasugrel to clopidogrel for prevention of ischaemic stroke, myocardial infarction, and death from other vascular causes...
Source: The Lancet Neurology - February 14, 2019 Category: Neurology Source Type: research

Cortical stimulation in aphasia following ischemic stroke: toward model-guided electrical neuromodulation.
Abstract The aim of this paper is to integrate different bodies of research including brain traveling waves, brain neuromodulation, neural field modeling and post-stroke language disorders in order to explore the opportunity of implementing model-guided, cortical neuromodulation for the treatment of post-stroke aphasia. Worldwide according to WHO, strokes are the second leading cause of death and the third leading cause of disability. In ischemic stroke, there is not enough blood supply to provide enough oxygen and nutrients to parts of the brain, while in hemorrhagic stroke, there is bleeding within the enclosed ...
Source: Biological Cybernetics - February 3, 2020 Category: Science Authors: Beuter A, Balossier A, Vassal F, Hemm S, Volpert V Tags: Biol Cybern Source Type: research

Factors for recurrent stroke among Asian patients with non-valvular atrial fibrillation under non-vitamin K antagonist oral anticoagulant therapy.
CONCLUSION: Atrial fibrillation patients with underlying malignancy or concurrently use of EIAED may have increased risk of treatment failure in secondary stroke prevention. PMID: 32107099 [PubMed - as supplied by publisher]
Source: J Formos Med Assoc - February 23, 2020 Category: General Medicine Authors: Lin SY, Tang SC, Tsai LK, Yeh SJ, Huang CF, Jeng JS Tags: J Formos Med Assoc Source Type: research

Female Sex as a Risk Modifier for Stroke Risk in Atrial Fibrillation: Using CHA2DS2-VASc versus CHA2DS2-VA for Stroke Risk Stratification in Atrial Fibrillation: A Note of Caution.
Abstract Stroke prevention is a key clinical concern in the management of patients with atrial fibrillation. Oral anticoagulation treatment reduces the risk of disabling stroke, but the treatment increases the risk of bleeding. For decades, the decision to initiate oral anticoagulation has been guided by clinical risk scoring systems such as the CHADS2 and CHA2DS2-VASc scores. In this narrative review, we focus on the recent discussion of the "Sc" (Sex Category) criterion in the CHA2DS2-VASc score. Epidemiological considerations when assessing stroke rates in cohorts are discussed, and the implications of differen...
Source: Thrombosis and Haemostasis - April 20, 2020 Category: Hematology Authors: Nielsen PB, Overvad TF Tags: Thromb Haemost Source Type: research

Surgical vs. drug therapy in patients with patent foramen ovale and cryptogenic stroke.
CONCLUSION: Compared with drug therapy, PFO closure reduced the risk of recurrent stroke among patients with a risk score of ≥2 and reduced the incidence of serious bleeding without increasing the risk of new-onset atrial fibrillation or atrial flutter. PMID: 32394019 [PubMed - as supplied by publisher]
Source: Herz - May 14, 2020 Category: Cardiology Tags: Herz Source Type: research

Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research

Safety and efficacy of intravenous thrombolytic treatment in wake ‐up stroke: Experiences from a single center
ConclusionsOur study demonstrated that in patients who awaken with stroke symptoms, intravenous thrombolytic treatment is a safe procedure that may lead to favorable outcomes. Further studies should be performed to increase the size of the group of patients with wake ‐up strokes who can be treated with reperfusion therapy.
Source: Brain and Behavior - May 3, 2021 Category: Neurology Authors: Adam Wi śniewski Tags: ORIGINAL RESEARCH Source Type: research