4,755 results match your criteria Stroke Anticoagulation and Prophylaxis


Aortic Thrombosis and Ischemic Stroke With Hemorrhagic Conversion in a Patient With Remote COVID-19 Infection: A Treatment Dilemma.

Cureus 2022 May 24;14(5):e25272. Epub 2022 May 24.

Internal Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, USA.

Coronavirus disease 2019 (COVID-19) is primarily known to affect the lungs; however, several studies indicate that it can be a multisystem disease. There is documentation detailing different sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients affected with this virus have been seen to develop a hypercoagulable state leading to systemic thrombosis in some cases or embolism leading to catastrophic outcomes in others. Read More

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Dronedarone for Atrial Fibrillation Prophylaxis in Patients Undergoing Open Heart Surgical Interventions: A Case Series.

J Community Hosp Intern Med Perspect 2022 12;12(2):23-29. Epub 2022 Apr 12.

GME Internal Medicine Residency, University of Central Florida College of Medicine-Ocala Campus, Ocala, FL, USA.

Atrial fibrillation (a-fib) is one of the most frequently encountered and studied arrhythmias in medicine. The presence of A-fib in the post-operative period of coronary artery bypass graft (CABG) surgery is of particular concern for clinicians as this presents risks of post-operative stroke, hospital readmission, or anticoagulation dilemmas depending on the patient's comorbidities. In this case study, we present 5 patients who were treated with dronedarone prior to undergoing open heart procedures. Read More

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Silent cerebral infarcts in patients with atrial fibrillation: Clinical implications of an imaging-adjusted CHA2DS2-VASc score.

Cardiol J 2022 Jun 15. Epub 2022 Jun 15.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.

Background: The CHA₂DS₂-VASc score does not include silent infarcts on neuroimaging in stroke risk estimation for patients with atrial fibrillation (AF). The inclusion of silent infarcts into CHA₂DS₂-VASc scoring and its impact on stroke prophylaxis recommendations in patients with AF has not been previously studied. The present study sought to quantify the prevalence of silent infarcts in patients with AF and describe potential changes in management based on magnetic resonance imaging (MRI) findings. Read More

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Efficacy and safety of vitamin-K antagonists and direct oral anticoagulants for stroke prevention in patients with heart failure and sinus rhythm: an updated systematic review and meta-analysis of randomized clinical trials.

Int J Stroke 2022 Jun 10:17474930221109149. Epub 2022 Jun 10.

Department of Internal Medicine, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.

Introduction: Heart failure is a major public health issue associated with significantly increased risk of stroke. It remains uncertain whether oral anticoagulation (OAC) in patients with heart failure and sinus rhythm (HF-SR) could improve prognosis.

Methods: We performed a systematic search of PubMed and Embase databases for randomized controlled clinical trials assessing oral anticoagulants versus antiplatelets or placebo in patients with heart failure or ventricular dysfunction/cardiomyopathy without clinical heart failure, and sinus rhythm. Read More

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Anticoagulation Control in Older Atrial Fibrillation Patients Receiving Vitamin K Antagonist Therapy for Stroke Prevention.

Int J Clin Pract 2022 31;2022:5951262. Epub 2022 Jan 31.

University of Birmingham Institute of Cardiovascular Sciences, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Introduction: Efficacy and safety of vitamin K antagonists (VKAs) among atrial fibrillation (AF) patients are enhanced when the International Normalised Ratio (INR) is 2.0-3.0. Read More

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Improvement in the Management of Oral Anticoagulation in Patients with Atrial Fibrillation in Primary Health Care.

Int J Environ Res Public Health 2022 May 31;19(11). Epub 2022 May 31.

Las Fuentes North Health Center, Aragon Health Service, 50002 Zaragoza, Spain.

(1) Background: Evaluation and improvement of the management of patients with atrial fibrillation in treatment with oral anticoagulants from primary health care. (2) Methods: prospective quasi-experimental study, conducted on 385 patients assisted with Atrial Fibrillation (AF) at the Las Fuentes Norte Health Center, before and after the implementation of actions to improve oral anticoagulants management from October 2015 to July 2017. (3) Results: The ACO-ZAR I study revealed that the population with AF presents a global prevalence of 1. Read More

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Incidence of nonvalvular atrial fibrillation and oral anticoagulant prescribing in England, 2009 to 2019: A cohort study.

PLoS Med 2022 Jun 7;19(6):e1004003. Epub 2022 Jun 7.

Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, United Kingdom.

Background: Atrial fibrillation (AF) is an important risk factor for ischaemic stroke, and AF incidence is expected to increase. Guidelines recommend using oral anticoagulants (OACs) to prevent the development of stroke. However, studies have reported the frequent underuse of OACs in AF patients. Read More

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A case report of left ventricular thrombus formation following aggressive decongestion treatment.

Eur Heart J Case Rep 2022 Feb 14;6(2):ytac076. Epub 2022 Feb 14.

3rd Department of Cardiology, Athens Chest Hospital "Sotiria", National and Kapodistrian University of Athens, Medical School, 152 Mesogeion Avenue, Athens 11527, Greece.

Background: Intracardiac thrombi are a complication associated with cardiomyopathies. In heart failure with reduced ejection fraction, there is a hypercoagulable state that can increase the incidence of left ventricular thrombus and result in higher risk of thromboembolism, either manifested as stroke or as peripheral thromboembolic event. Haemoconcentration following decongestion treatment may enhance blood viscosity. Read More

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February 2022

Screening for untreated atrial fibrillation in the elderly population: A community-based study.

PLoS One 2022 6;17(6):e0269506. Epub 2022 Jun 6.

Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Background: Strokes are common in people with atrial fibrillation (AF), and can have devastating consequences, especially in the elderly and if AF is untreated. However, community-based studies on screening for untreated AF have not been conducted in Japan, and there has been no evaluation of the effectiveness of early screening for AF in the elderly (≥65 years).

Methods: The Kyoto Prefectural University of Medicine (KPUM) Education Initiative has conducted an AF awareness campaign consisted of screening tests using a blood pressure (BP) monitor with electrocardiogram (ECG) (the Complete, Omron Healthcare Co. Read More

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Anticoagulation management of post-cardiac surgery new-onset atrial fibrillation.

Cleve Clin J Med 2022 06 1;89(6):329-335. Epub 2022 Jun 1.

Director, Cardiac Catheterization Laboratory, Cardiac Rehabilitation and Interventional Cardiology Research, Department of Cardiovascular Medicine, Detroit Medical Center, Detroit, MI

New-onset post-cardiac surgery atrial fibrillation (PCSAF) is a frequent complication with estimated incidence of 17% to 64%, depending on type of surgery. It is associated with higher mortality, morbidity, and predisposition to stroke and systemic embolism postoperatively. Standard care involves rate or rhythm control, in addition to antithrombotic therapy in those with history of stroke, transient ischemic attack, or high risk of systemic thromboembolism. Read More

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Effect of Mailing Educational Material to Patients With Atrial Fibrillation and Their Clinicians on Use of Oral Anticoagulants: A Randomized Clinical Trial.

JAMA Netw Open 2022 May 2;5(5):e2214321. Epub 2022 May 2.

Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina.

Importance: Only about half of patients with atrial fibrillation (AF) who are at increased risk for stroke are treated with an oral anticoagulant (OAC), despite guideline recommendations for their use. Educating patients with AF about prevention of stroke with OACs may enable them as agents of change to initiate OAC treatment.

Objective: To determine whether an educational intervention directed to patients and their clinicians stimulates the use of OACs in patients with AF who are not receiving OACs. Read More

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Periprocedural Outcomes Associated With Use of a Left Atrial Appendage Occlusion Device in China.

JAMA Netw Open 2022 May 2;5(5):e2214594. Epub 2022 May 2.

Department of Cardiology, Xijing Hospital, Xi'an, China.

Importance: Left atrial appendage occlusion (LAAO) has emerged as an alternative to anticoagulation for patients with atrial fibrillation. However, the performance of LAAO among East Asian patients is unknown.

Objective: To document the procedural success rate and configurations, major adverse event rates, and antithrombotic medication regimens during and after LAAO procedures among patients in China. Read More

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Evolving concepts in the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation.

Eur J Intern Med 2022 Jul 25;101:14-20. Epub 2022 May 25.

Cardiothoracovascular Department, University of Trieste, Trieste, Italy. Electronic address:

Thromboembolic and bleeding complications negatively impact recovery and survival after transcatheter aortic valve implantation (TAVI). Particularly, there is a considerable risk of ischaemic stroke and vascular access related bleeding, as well as spontaneous gastro-intestinal bleeding. Therefore, benefit and harm of antithrombotic therapy should be carefully balanced. Read More

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The use of non-vitamin K oral anticoagulants in dialysis patients-A systematic review.

Semin Dial 2022 May 27. Epub 2022 May 27.

Department of Renal Medicine, Aarhus University Hospital, Aarhus.

Non-vitamin K oral anticoagulants (NOACs) are used for prevention of thromboembolic events, but their use in dialysis patients is debatable. This study investigated the available evidence for the use of NOACs in dialysis patients. Online databases were systematically searched for eligible studies including pharmacokinetic (PK) studies, cohort studies, and randomized control trials (RCTs) comparing NOAC with vitamin K antagonist (VKA) or no anticoagulant treatment. Read More

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Effectiveness and safety of edoxaban therapy in daily-care patients with atrial fibrillation. Results from the DRESDEN NOAC REGISTRY.

Thromb Res 2022 Jul 23;215:37-40. Epub 2022 May 23.

Universitätsklinikum "Carl Gustav Carus", Department of Medicine I, Dresden, Germany. Electronic address:

Background: Edoxaban is a non-vitamin K dependent oral anticoagulant (NOAC) licensed for stroke prevention in atrial fibrillation (SPAF). Outcome data on clinical effectiveness and safety in routine care are increasing.

Patients And Methods: In the prospective, non-interventional DRESDEN NOAC REGISTRY a network of 230 physicians enrolled >5000 NOAC patients who received prospective central follow. Read More

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Frequency of cardioversions as an additional risk factor for stroke in atrial fibrillation - the FinCV-4 study.

Ann Med 2022 12;54(1):1452-1458

Heart Center, Turku University Hospital and University of Turku, Turku, Finland.

Background: Patients with atrial fibrillation (AF) are selected for oral anticoagulation based on individual patient characteristics. There is little information on how clinical AF burden associates with the risk of ischaemic stroke or systemic embolism (SSE). The aim of this study was to explore the association of the frequency of cardioversions (CV) as a measure of clinical AF burden on the long-term SSE risk, with a focus on patients at intermediate stroke risk based on CHADS-VASc score. Read More

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December 2022

Evaluation of Apixaban in Patients With Antiphospholipid Syndrome: A Case Series and Review of Literature.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221099893

Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.

Several guidelines endorsed the indefinite use warfarin or heparin-containing products for acute venous thromboembolism (VTE) treatment and secondary prevention and discouraged the use of direct oral anticoagulants (DOAC) for patients diagnosed with antiphospholipid syndrome (APS). However, adequate anticoagulation despite warfarin therapy remains a challenge in APS patients. Using DOACs in APS patients is seen in clinical practice, despite the lack of evidence to support their use in this population. Read More

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Stroke Risk Stratification in Patients With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting.

J Am Heart Assoc 2022 May 16;11(10):e024703. Epub 2022 May 16.

Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Sweden.

Background The CHADS-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke or TIA [transient ischemic attack], vascular disease, age 65 to 74 years, sex category female; 2 indicates 2 points, otherwise 1 point) scoring system is recommended to guide decisions on oral anticoagulation therapy for stroke prevention in patients with nonsurgery atrial fibrillation. A score ≥1 in men and ≥2 in women, corresponding to an annual stroke risk exceeding 1%, warrants long-term oral anticoagulation provided the bleeding risk is acceptable. However, in patients with new-onset postoperative atrial fibrillation, the optimal risk stratification method is unknown. Read More

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Prognosis of elderly non-valvular atrial fibrillation patients stratified by B-type natriuretic peptide: ELDERCARE-AF subanalysis.

Am Heart J 2022 08 11;250:66-75. Epub 2022 May 11.

Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.

Background: B-type natriuretic peptide (BNP) is a risk factor for stroke and cardiac death in patients with atrial fibrillation. We hypothesized the prognostic outcomes of very elderly non-valvular atrial fibrillation patients ineligible for standard anticoagulation treatment would vary according to BNP stratification.

Methods: In this subanalysis of the ELDERCARE-AF trial, patients were stratified by BNP levels at enrollment, and clinical outcomes compared among BNP subgroups. Read More

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Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation.

Am J Cardiol 2022 Jul 9;175:58-64. Epub 2022 May 9.

Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address:

Warfarin is the standard anticoagulation therapy for valvular atrial fibrillation (AF); however, new oral anticoagulants have emerged as an alternative. We compared the efficacy and safety of dabigatran with conventional treatment in AF associated with left-sided valvular heart disease (VHD), including mitral stenosis (MS). Patients with AF and left-sided VHD were randomly assigned to receive dabigatran or conventional treatment. Read More

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[Safety and effectiveness of oral anticoagulation in patients with atrial fibrillation and renal insufficiency - a real-world perspective].

Dtsch Med Wochenschr 2022 Apr 11;147(10):617-624. Epub 2022 May 11.

Medizinische Klinik I, Nephrologie; Universitätsklinikum Würzburg.

Non-vitamin-K dependent oral anti-coagulants (NOAC) are the current therapeutic standard for preventing strokes in patients with atrial fibrillation (AF) and should be preferred over vitamin K antagonists (VKA) in this indication. This recommendation applies also to patients with VHF and concomitant chronic kidney disease (CKD). Real World Evidence (RWE), i. Read More

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COMPARE LAAO: Rationale and design of the randomized controlled trial "COMPARing Effectiveness and safety of Left Atrial Appendage Occlusion to standard of care for atrial fibrillation patients at high stroke risk and ineligible to use oral anticoagulation therapy".

Am Heart J 2022 08 7;250:45-56. Epub 2022 May 7.

Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands; Amsterdam University Medical Center, location AMC, Cardiology Department, Amsterdam, The Netherlands.

Background: Left atrial appendage occlusion (LAAO) provides an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). In patients with a long-term or permanent contraindication for OAC randomized controlled trial (RCT) data is lacking.

Study Objectives: To assess the efficacy and safety of LAAO in AF patients who are ineligible to use OAC. Read More

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Left atrial appendage occlusion in hereditary haemorrhagic telangiectasia patients (Rendu Osler Syndrome) with non-valvular atrial fibrillation: Prevention of cardioembolic events while avoiding the long-term risks of oral anticoagulation.

Cardiovasc Revasc Med 2022 Apr 30. Epub 2022 Apr 30.

Cardiology Department, Cardiovascular Institute (ICCV), Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.. Electronic address:

Background/purpose: Hereditary haemorrhagic telangiectasia (HHT) (Osler-Weber-Rendu Syndrome) is an inherited vascular disorder, associated with arteriovenous malformations and bleeding events. Despite potential benefits, data regarding the use of left atrial appendage occlusion (LAAO) in HHT patients with non-valvular atrial fibrillation (NVAF) is scarce. The aim of the present paper was to assess the outcomes of HHT patients undergoing LAAO. Read More

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Antithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation.

J Am Coll Cardiol 2022 05;79(18):1785-1798

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut, USA.

Background: Pivotal trials of percutaneous left atrial appendage occlusion (LAAO) used specific postprocedure treatment protocols.

Objectives: This study sought to evaluate patterns of postprocedure care after LAAO with the Watchman device in clinical practice and compare the risk of adverse events for different discharge antithrombotic strategies.

Methods: We evaluated patients in the LAAO Registry of the National Cardiovascular Data Registry who underwent LAAO with the Watchman device between 2016 and 2018. Read More

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True Efficacy of LAA Closure: Patient Outcomes on Long-term Single-Antiplatelet or No Therapy: Insights From the EWOLUTION Registry.

J Invasive Cardiol 2022 05;34(5):E348-E355

Interventional Cardiology, Cardiologicum Hamburg, Schloßgarten 3-7, 22401 Hamburg, Germany.

Background: Left atrial appendage occlusion (LAAO) is recommended for patients with atrial fibrillation at increased stroke risk, where effective long-term oral anticoagulation (OAC) is not feasible. In order to assess long-term safety of LAAO with aspirin monotherapy or no therapy, we aimed to report on patients with the Watchman LAAO device (Boston Scientific) once postimplantation intensified antiplatelet or anticoagulation therapy is discontinued.

Methods: A total of 1025 patients scheduled for elective LAAO therapy prospectively consented for participation in the EWOLUTION registry; 1005 patients received a successful implant and were followed for 2 years. Read More

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Coagulation factors XI and XII as possible targets for anticoagulant therapy.

Thromb Res 2022 Jun 25;214:53-62. Epub 2022 Apr 25.

Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Norway; University of Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Norway.

In this review, we give an overview over observational and experimental studies supporting factors XI and XII as targets for anticoagulant therapy. The majority of observational studies on FXI report low concentrations of FXI to be protective against ischemic stroke and venous thrombosis. There is also extensive evidence from experimental and animal studies supporting FXI inhibition as a target for anticoagulant therapy, alone or in combination with other antithrombotic treatments. Read More

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Direct oral anticoagulation in atrial fibrillation and heart valve surgery-a meta-analysis and systematic review.

Ther Adv Cardiovasc Dis 2022 Jan-Dec;16:17539447221093963

Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany.

Aims: Oral anticoagulation with direct oral anticoagulants (DOAC) could provide an alternative to vitamin K antagonists (VKA) for patients with atrial fibrillation (AF) undergoing bioprosthetic heart valve replacement or valve repair.

Methods And Results: The aim of this meta-analysis was to review the safety and efficacy of DOAC in patients with surgical implanted bioprosthetic heart valves or valve repairs and AF including data from six clinical trials with a total of 1,857 patients. The efficacy and safety data of DOAC and VKA were pooled to perform random-effects meta-analyses using the Mantel-Haenszel method with pooled risk ratios (RR) and 95% confidence interval (CI). Read More

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[Atrial fibrillation, oral anticoagulation and nephroprotection: caution or bravery?]

G Ital Nefrol 2022 Apr 21;39(2). Epub 2022 Apr 21.

UOC Nefrologia Dialisi e Trapianto, Ospedale San Bortolo, Vicenza, Italy.

Atrial fibrillation (AF) and chronic kidney disease (CKD) are strictly related and share several risk factors (i.e. hypertension, diabetes mellitus, congestive heart failure). Read More

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Antiplatelets and Anticoagulants in Ischemic Stroke,Transient Ischaemic Attack: A Practice Survey Among Singapore Neurologists.

Acta Neurol Taiwan 2022 Dec;31(4):154-160

Raffles Neuroscience Centre,Raffles Hospital,Singapore.

Purpose: Evidence-based stroke clinical practice guidelines provide guidance as how to best manage patients with cerebrovascular disease. Where there are grey zones, the clinician decides what she/he feels is the most appropriate in that circumstance. This study was performed to determine how adult neurologists in Singapore would use antiplatelets(AP) and anticoagulants(AC) for their ischemic stroke patients in various settings where the evidence is uncertain. Read More

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December 2022

Atrial Fibrillation in Heart Failure: Focus on Antithrombotic Management.

Cardiol Clin 2022 May;40(2):245-258

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address:

Heart failure (HF) and atrial fibrillation (AF), increasingly common in the aging population, are closely related and commonly found together. This article explores the relationship between AF and HF and the thromboembolic effect of these diseases. Morbidity and mortality are increased when the 2 conditions are seen together. Read More

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