Acute post-stroke blood pressure relative to premorbid levels in intracerebral haemorrhage versus major ischaemic stroke: a population-based study

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The Lancet Neurology:  February 28, 2014 Background It is often assumed that blood pressure increases acutely after major stroke, resulting in so-called post-stroke hypertension. In view of evidence that the risks and benefits of blood pressure-lowering treatment in acute stroke might differ between patients with major ischaemic stroke and those with primary intracerebral haemorrhage, we compared […]

Genetic Loci Associated With Atrial Fibrillation: Relation to Left Atrial Structure in the Framingham Heart Study

J Am Heart Assoc.: April 2, 2014 Background Atrial fibrillation (AF) results in significant morbidity and mortality. Genome‐wide association studies (GWAS) have identified genetic variants associated with AF. Whether genetic variants associated with AF are also associated with atrial structure, an intermediate phenotype for AF, has had limited investigation. We sought to investigate associations between single nucleotide […]

Lack of Concordance between Empirical Scores and Physician Assessments of Stroke and Bleeding Risk in Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry

CIRCULATIONAHA.; March 29, 2014 Background—Physicians treating patients with atrial fibrillation (AF) must weigh the benefits of anticoagulation in preventing stroke versus the risk of bleeding. While empirical models have been developed to predict such risks, the degree to which these coincide with clinicians’ estimates is unclear. Methods and Results—We examined 10,094 AF patients enrolled in the […]

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary

Ahajournals: April 23, 2014 The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient […]

Age Dependence of Risk Factors for Stroke and Death in Young Patients With Atrial Fibrillation

STROKEAHA: March 27, 2014 Background and Purpose—The risk of stroke and death in patients with atrial fibrillation is strongly associated with age and concomitant comorbidities. The aim of this study was to examine the age dependence of risk factors for stroke and mortality in young patients with atrial fibrillation. Methods—This study is a population-based cohort study […]

Long-term survival after ischemic stroke in patients with atrial fibrillation

Neurology March 25, 2014 Objectives: While the short-term impact of atrial fibrillation–related stroke has been well studied, surprisingly little is known about its long-term effect on survival. Methods: We followed 13,559 patients with atrial fibrillation for a median of 6 years, identifying ischemic strokes through computerized databases and validating 1,025 events. Stroke severity was determined from hospital records. […]

Challenges of Decision Making Regarding Futility in a Randomized Trial

STROKEAHA: April 3, 2014 Background and Purpose—Interventional Management of Stroke (IMS) III is a randomized, parallel arm trial comparing the approach of intravenous tissue plasminogen activator followed by endovascular treatment with intravenous tissue plasminogen activator alone in patients with acute ischemic stroke presenting <3 hours of symptom onset. The trial intended to enroll 900 subjects to […]

Clopidogrel Plus Aspirin Versus Warfarin in Patients With Stroke and Aortic Arch Plaques

STROKEAHA: April 3, 2014 Background and Purpose—Severe atherosclerosis in the aortic arch is associated with a high risk of recurrent vascular events, but the optimal antithrombotic strategy is unclear. Methods—This prospective randomized controlled, open-labeled trial, with blinded end point evaluation (PROBE design) tested superiority of aspirin 75 to 150 mg/d plus clopidogrel 75 mg/d (A+C) over […]

Clinical Investigation of the Protective Effects of Palm Vitamin E Tocotrienols on Brain White Matter

STROKEAHA: April 3, 2014, Background and Purpose—Previous cell-based and animal studies showed mixed tocotrienols are neuroprotective, but the effect is yet to be proven in humans. Thus, the present study aimed to evaluate the protective activity of mixed tocotrienols in humans with white matter lesions (WMLs). WMLs are regarded as manifestations of cerebral small vessel disease, […]

Warfarin Versus Aspirin for Prevention of Cognitive Decline in Atrial Fibrillation

STROKEAHA: April 1, 2014 Background and Purpose—Atrial fibrillation is associated with decline of cognitive function. Observational evidence suggests that anticoagulation might protect against this decline. We report the first randomized controlled trial evidence on the effect of anticoagulation on cognitive function in elderly patients with atrial fibrillation. Methods—A total of 973 patients aged ≥75 years with […]

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