3,381 results match your criteria Stroke Anticoagulation and Prophylaxis


European Stroke Organisation (ESO) guidelines for prophylaxis for venous thromboembolism in immobile patients with acute ischaemic stroke.

Eur Stroke J 2016 Mar 1;1(1):6-19. Epub 2016 Mar 1.

Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Background: Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism is a frequent complication in immobile patients with acute ischemic stroke. This guideline document presents the European Stroke Organisation guidelines for the prophylaxis of VTE in immobile patients with acute ischaemic stroke. Guidelines for haemorrhagic stroke have already been published. Read More

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http://dx.doi.org/10.1177/2396987316628384DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301216PMC
March 2016
1 Read

Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage.

J Neurol Neurosurg Psychiatry 2019 Apr 16. Epub 2019 Apr 16.

Neurology, University of Erlangen-Nürnberg, Erlangen, Germany

Objective: To determine the occurrence of intracranial haemorrhagic complications (IHC) on heparin prophylaxis (low-dose subcutaneous heparin, LDSH) in primary spontaneous intracerebral haemorrhage (ICH) (not oral anticoagulation-associated ICH, non-OAC-ICH), vitamin K antagonist (VKA)-associated ICH and non-vitamin K antagonist oral anticoagulant (NOAC)-associated ICH.

Methods: Retrospective cohort study (RETRACE) of 22 participating centres and prospective single-centre study with 1702 patients with VKA-associated or NOAC-associated ICH and 1022 patients with non-OAC-ICH with heparin prophylaxis between 2006 and 2015. Outcomes were defined as rates of IHC during hospital stay among patients with non-OAC-ICH, VKA-ICH and NOAC-ICH, mortality and functional outcome at 3 months between patients with ICH with and without IHC. Read More

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http://jnnp.bmj.com/lookup/doi/10.1136/jnnp-2018-319786
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http://dx.doi.org/10.1136/jnnp-2018-319786DOI Listing
April 2019
2 Reads

Acute Management of Ischemic Stroke During Pregnancy.

Obstet Gynecol 2019 Apr 5. Epub 2019 Apr 5.

Departments of Obstetrics & Gynecology and Anesthesiology, the University of Texas Medical Branch at Galveston, Galveston, Texas.

Acute stroke in pregnancy can be devastating. Although neurologists will at some point be involved in the management, most of these patients are likely to first be evaluated by an obstetric care provider. It is, therefore, important for obstetric care providers to have an understanding of the presentation and management of stroke, particularly in the initial period when the window of opportunity for therapy is critical. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003220DOI Listing
April 2019
1 Read

Stroke prophylaxis in critically-ill patients with new-onset atrial fibrillation.

J Thromb Thrombolysis 2019 Apr 8. Epub 2019 Apr 8.

Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, P.O Box 850, MC H187, Hershey, PA, 17033, USA.

Despite a high incidence of new onset atrial fibrillation (NOAF) in critically ill patients and its association with short and long-term incidence of stroke, there is limited data assessing anticoagulation on hospital discharge in these patients. We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac ICUs at our institution between January 2009 and March 2016. Patients with NOAF were identified and CHADS-VASc score of ICU survivors was calculated. Read More

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http://dx.doi.org/10.1007/s11239-019-01854-5DOI Listing
April 2019
1 Read

An under-recognized high-risk atrial fibrillation population: Analyzing transcatheter mitral valve repair patients for left atrial appendage closure device application.

Catheter Cardiovasc Interv 2019 Apr 5. Epub 2019 Apr 5.

Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.

Objective: Identify patients undergoing transcatheter mitral valve repair (TMVR) who could potentially benefit from alternative ischemic stroke prophylaxis utilizing a left atrial appendage closure (LAAC) device.

Background: Patients undergoing TMVR have a high incidence of atrial fibrillation (AF). The co-morbidities which qualify them to undergo TMVR also increase their risk of stroke and bleeding, making stroke prophylaxis problematic. Read More

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http://dx.doi.org/10.1002/ccd.28220DOI Listing
April 2019
1 Read

Unsolved issues in oral anticoagulation treatment in atrial fibrillation.

Authors:
Stefan Agewall

Eur Heart J Cardiovasc Pharmacother 2019 04;5(2):60-61

Editor-in-Chief, Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Oslo, Norway.

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http://dx.doi.org/10.1093/ehjcvp/pvz008DOI Listing
April 2019
1 Read

Effects of Perioperative Venous Thromboembolism on Outcomes in Soft Tissue Reconstruction of Traumatic Lower Extremity Injuries.

Ann Plast Surg 2019 May;82(5S Suppl 4):S345-S349

From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA.

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, represents a significant perioperative complication. However, the outcomes of lower extremity salvage in the setting of perioperative VTE are not well reported.

Methods: A retrospective review of lower extremity trauma patients requiring soft tissue reconstruction between July 2007 and December 2015 at an urban trauma center was performed. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001871DOI Listing

Venous thromboembolism and cancer: Current and future role of direct-acting oral anticoagulants.

Thromb Res 2019 May 27;177:33-41. Epub 2019 Feb 27.

Internal and Cardiovascular Medicine - Stroke Unit, University of Perugia, Italy.

Approximately one-fifth of all cases of venous thromboembolism (VTE) are related to cancer and anticoagulant treatment in these patients has remained a challenge. Cancer patients with VTE are at increased risk of developing recurrent VTE compared to patients without cancer, but also have a higher risk of major bleeding. In these patients, low molecular weight heparins (LMWHs) have been shown to be more effective and as safe as vitamin K-antagonists (VKAs) for the treatment of VTE. Read More

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http://dx.doi.org/10.1016/j.thromres.2019.02.031DOI Listing
May 2019
1 Read

Non-vitamin K oral anticoagulant use in the elderly: a prospective real-world study - data from the REGIstry of patients on Non-vitamin K oral Anticoagulants (REGINA).

Vasc Health Risk Manag 2019 14;15:19-25. Epub 2019 Feb 14.

Cardiac Rehabilitation Department, IRCCS Istituti Clinici Scientifici Maugeri, Milano, Italy,

Purpose: Numerous studies on thromboembolic prevention for non-valvular atrial fibrillation (NVAF) have shown either equal or better efficacy and safety of non-vitamin K oral anticoagulants (NOACs) compared to warfarin, even for patients aged ≥75 years. Data on elderly patients, in particular, octogenarians, are lacking. Paradoxically, this population is the one with the highest risk of bleeding and stroke with a worse prognosis. Read More

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http://dx.doi.org/10.2147/VHRM.S191208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378887PMC
April 2019
6 Reads

Cryptogenic stroke - How to make sense of a non-diagnostic entity.

Authors:
Ursula G Schulz

Maturitas 2019 Apr 11;122:44-50. Epub 2019 Jan 11.

Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK. Electronic address:

Secondary preventive strategies in ischaemic stroke depend on the underlying aetiology. However, approximately one-third of ischaemic strokes remain unexplained, or 'cryptogenic'. There is a wide range of possible underlying causes in cryptogenic stroke, and the best approach to secondary prevention of these may differ. Read More

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http://dx.doi.org/10.1016/j.maturitas.2019.01.004DOI Listing

Direct Oral Anticoagulants in Cirrhotic Patients: Current Evidence and Clinical Observations.

Can J Gastroenterol Hepatol 2019 8;2019:4383269. Epub 2019 Jan 8.

The Department of Gastroenterology at Staten Island University Hospital, Northwell Health, USA.

The introduction of Direct Oral Anticoagulants (DOACs) to the pharmaceutical market provided patients and clinicians with novel convenient and safe options of anticoagulation. The use of this class of medications is currently limited to venous thromboembolic therapy and prophylaxis, in addition to stroke prophylaxis in patients with nonvalvular atrial fibrillation. Despite their altered hemostasis, patients with cirrhosis are thought to be in a procoagulant state and thus prone to thrombus formation. Read More

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http://dx.doi.org/10.1155/2019/4383269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354142PMC
January 2019
1 Read

Stroke prevention in patients with acute ischemic stroke and atrial fibrillation in Germany - a cross sectional survey.

BMC Neurol 2019 Feb 12;19(1):25. Epub 2019 Feb 12.

Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.

Background: Atrial fibrillation (AF) is present in 15-20% of patients with acute ischemic stroke. Oral anticoagulation reduces the risk of AF-related recurrent stroke but clinical guideline recommendations are rather vague regarding its use in the acute phase of stroke. We aimed to assess the current clinical practice of medical stroke prevention in AF patients during the acute phase of ischemic stroke. Read More

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http://dx.doi.org/10.1186/s12883-019-1249-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371606PMC
February 2019

Safety of direct oral anticoagulants in real-world clinical practice: translating the trials to everyday clinical management.

Expert Opin Drug Saf 2019 Mar 18;18(3):187-209. Epub 2019 Feb 18.

c Liverpool Centre for Cardiovascular Science , University of Liverpool and Liverpool Heart & Chest Hospital , Liverpool , UK.

Introduction: Direct oral anticoagulants (DOACs) may be regarded as some of the most successful innovations in recent times. These drugs which were specifically developed to overcome the challenges posed by warfarin did just that and in the process, have changed the outlook towards stroke prevention with anticoagulation. The decade of experience with these drugs that has resulted in the availability of large scale data on their safety profile has aided this. Read More

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https://www.tandfonline.com/doi/full/10.1080/14740338.2019.1
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http://dx.doi.org/10.1080/14740338.2019.1578344DOI Listing
March 2019
3 Reads

Adherence to Guideline-Directed Stroke Prevention Therapy for Atrial Fibrillation Is Achievable.

Circulation 2019 Mar;139(12):1497-1506

MetroHealth System Campus, Case Western Reserve University, Cleveland, OH (W.R.L.).

Background: Efforts to improve prescription of oral anticoagulation (OAC) drugs in patients with atrial fibrillation have had limited success in improving guideline adherence.

Methods: We evaluated adherence to the American College of Cardiology/American Heart Association performance measures for OAC in eligible patients with a CHADS-VASc score ≥2 and trends in prescription over time in the American Heart Association's Get With The Guidelines-AFIB (atrial fibrillation) registry. Adjusted associations with in-hospital outcomes were also determined. Read More

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https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.0
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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035909DOI Listing
March 2019
22 Reads
14.430 Impact Factor

Stroke Outcomes in the COMPASS Trial.

Circulation 2019 Feb;139(9):1134-1145

McMaster University/Population Health Research Institute, Hamilton, Canada (M.S., R.G.H., S.J.C., J.B., O.S., K.K.H.N., L.C., S.Y., J.W.E.).

Background: Strokes were significantly reduced by the combination of rivaroxaban plus aspirin in comparison with aspirin in the COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies). We present detailed analyses of stroke by type, predictors, and antithrombotic effects in key subgroups.

Methods: Participants had stable coronary artery or peripheral artery disease and were randomly assigned to receive aspirin 100 mg once daily (n=9126), rivaroxaban 5 mg twice daily (n=9117), or rivaroxaban 2. Read More

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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035864DOI Listing
February 2019
7 Reads

Dementia: new vistas and opportunities.

Neurol Sci 2019 Apr 21;40(4):763-767. Epub 2019 Jan 21.

Department of Clinical Neurological Sciences, Western University, 339 Windermere Road, London, Ontario, N6A 5A5, Canada.

Over the past four decades, Alzheimer disease has become near synonymous with dementia and the amyloid/tau hypothesis as its dominant explanation. However, this monorail approach to etiology has failed to yield a single disease-modifying drug. Part of the explanation stems from the fact that most dementias in the elderly result from interactive Alzheimer and cerebrovascular pathologies. Read More

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http://dx.doi.org/10.1007/s10072-019-3714-1DOI Listing
April 2019
4 Reads

Cardiac Sarcoidosis as an Uncommon Etiology for Posterior Circulation Stroke Presenting with Alexia without Agraphia.

Case Rep Neurol Med 2018 17;2018:3418465. Epub 2018 Dec 17.

Department of Neurology, Inova Fairfax Hospital, Falls Church, VA, USA.

Sarcoidosis is a systemic disease with cardiac involvement occurring in 20-50% of cases. Cardiogenic stroke caused by cardiac sarcoidosis, especially PCA infarction, is a rare clinical presentation that necessitates timely diagnosis and may warrant treatment prophylaxis against CVA. In this case report, we describe a 54-year-old Caucasian male presenting with left PCA stroke in the setting of cardiac and pulmonary sarcoidosis, and hypertension. Read More

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https://www.hindawi.com/journals/crinm/2018/3418465/
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http://dx.doi.org/10.1155/2018/3418465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311803PMC
December 2018
16 Reads

The Quality of Anticoagulation Therapy among Warfarin-Treated Patients with Atrial Fibrillation in a Primary Health Care Setting.

Medicina (Kaunas) 2019 Jan 15;55(1). Epub 2019 Jan 15.

Department of Family medicine, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

Long-term therapy with oral anticoagulants is recommended for stroke prevention in patients with atrial fibrillation (AF). This study evaluated the quality of anticoagulation therapy among warfarin-treated AF patients in selected primary health care centres in Lithuania. : This was a retrospective study conducted in nine primary health care centres in Lithuania. Read More

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http://dx.doi.org/10.3390/medicina55010015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359001PMC
January 2019
1 Read

Prestroke and Poststroke Antithrombotic Therapy in Patients With Atrial Fibrillation: Results From a Nationwide Cohort.

JAMA Netw Open 2018 May 18;1(1):e180171. Epub 2018 May 18.

Department of Cardiology, University Hospital of Copenhagen, Copenhagen, Denmark.

Importance: Antithrombotic therapies are effective in both primary and secondary stroke prophylaxis in high-risk patients with atrial fibrillation (AF), but they are often underused in community practice.

Objective: To examine prestroke and poststroke antithrombotic treatment patterns and long-term outcomes in patients with AF presenting with ischemic stroke.

Design, Setting, And Participants: A retrospective cohort study of Danish patients with AF, with a prestroke CHA2DS2-VASc score of 1 or higher for men and 2 or higher for women, and presenting with ischemic stroke was conducted from January 1, 2004, to January 31, 2017. Read More

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https://jamanetwork.com/article.aspx?doi=10.1001/jamanetwork
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http://dx.doi.org/10.1001/jamanetworkopen.2018.0171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324317PMC
May 2018
11 Reads

Clinical Impact of Oral Anticoagulation in Patients with Atrial High-rate Episodes.

J Stroke Cerebrovasc Dis 2019 Apr 11;28(4):971-979. Epub 2019 Jan 11.

Centro Hospitalar de Setubal, Cardiology Department, Setubal Portugal.

Background: Atrial high-rate episodes (AHREs) are common in pacemaker patients. Our aims were to compare patients with AHREs to those without them and to assess if, in those with AHREs, the initiation of oral anticoagulation (OAC) has any clinical impact on the occurrence of ischemic and hemorrhagic events.

Methods: From 2014-2017 we selected patients with pacemaker in whom AHREs were detected. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.019DOI Listing
April 2019
3 Reads

Antiplatelet Therapy versus Anticoagulation after Surgical Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

Thromb Haemost 2019 Feb 7;119(2):328-339. Epub 2019 Jan 7.

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

Background:  The optimal antithrombotic therapy after surgical bioprosthetic aortic valve replacement (BAVR) is uncertain. We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs) comparing antiplatelet therapy and anticoagulation in patients with surgical BAVR.

Methods:  We searched Cochrane CENTRAL, MEDLINE and EMBASE from inception to 3 November 2017 for studies evaluating antiplatelet therapy versus anticoagulation early after surgical BAVR. Read More

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http://dx.doi.org/10.1055/s-0038-1676816DOI Listing
February 2019
25 Reads

Geographic Disparities in the Incidence of Stroke among Patients with Atrial Fibrillation in the United States.

J Stroke Cerebrovasc Dis 2019 Apr 21;28(4):890-899. Epub 2018 Dec 21.

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Aim: To determine whether regional variation in stroke incidence exists among individuals with AF.

Methods: Using healthcare utilization claims from 2 large US databases, MarketScan (2007-2014) and Optum Clinformatics (2009-2015), and the 2010 US population as the standard, we estimated age-, sex-, race- (only in Optum) standardized stroke incidence rates by the 9 US census divisions. We also used Poisson regression to examine incidence rate ratios (IRR) of stroke and the probability of anticoagulation prescription fills across divisions. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475902PMC
April 2019
2 Reads

[Making balances between the risks and benefits of pharmacological treatment in dementia, chronic pain and anticoagulation in elderly persons].

Aten Primaria 2018 Nov;50 Suppl 2:39-50

Grupo de Trabajo de Neurología, Sección Demencias de la semFYC.

In dementia, specific drugs and psychotropic drugs used for psychotic and behavioral symptoms have limited efficacy. Adverse effects may be important given the age and comorbidity of the patients. It is necessary, frequently, its withdrawal, planned together with the family, monitoring the response and offering non-pharmacological treatment alternatives. Read More

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http://dx.doi.org/10.1016/j.aprim.2018.09.003DOI Listing
November 2018
2 Reads

Design and rationale of the Edoxaban Treatment in routiNe clinical prActice for patients with Atrial Fibrillation in Europe (ETNA-AF-Europe) study.

J Cardiovasc Med (Hagerstown) 2019 Feb;20(2):97-104

Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS Trusts, Birmingham, UK.

Aim: Edoxaban, a nonvitamin K antagonist oral anticoagulant, is an oral factor Xa inhibitor approved for the prevention of stroke and systemic embolism in adult patients with atrial fibrillation and for the treatment and secondary prevention in adult patients with venous thromboembolism (VTE). This study details the design of the Edoxaban Treatment in routiNe clinical prActice for patients with Atrial Fibrillation in Europe (ETNA-AF-Europe) study - a postauthorization observational study, which is part of the postapproval plan for edoxaban agreed with the European Medicines Agency.

Methods: The ETNA-AF-Europe study (Clinicaltrials. Read More

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http://dx.doi.org/10.2459/JCM.0000000000000737DOI Listing
February 2019
22 Reads

[Treatment with oral anticoagulants in older patients: Should warfarin still be prescribed?]

Presse Med 2019 Feb 7;48(2):154-164. Epub 2018 Dec 7.

AP-HP, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, site Charles Foix, service de gériatrie à orientation cardiologique et neurologique, 94205 Ivry-sur-Seine, France; Sorbonne université, faculté de médecine, 75013 Paris, France.

Vitamin-K antagonists (VKA) have been the standard for oral anticoagulation. However, they carry several problems in older patients: frequent bleeding complications, complex management, risk of interactions with multiple drugs. Two classes of direct oral anticoagulants (DOA) are currently available in France: (a) direct thrombin inhibitors: dabigatran; and (b) direct factor Xa inhibitors: rivaroxaban, apixaban and others. Read More

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http://dx.doi.org/10.1016/j.lpm.2018.11.010DOI Listing
February 2019
1 Read

Abstract 4: Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants: A Systematic Review and Meta-analysis.

Stroke 2018 Jan;49(Suppl_1):A4

Dept of Neurology, Danville, PA.

Introduction: Direct oral anticoagulants (DOACs) are increasingly being administered for atrial fibrillation and stroke prevention. The risk of symptomatic hemorrhagic transformation (sHT) following intravenous thrombolysis (IVT) among stroke patients who take DOACs is not clear.

Methods: We conducted a systematic review of literature through six different resources-PubMed, Scopus, Embase, Clinicaltrial. Read More

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http://dx.doi.org/10.1161/str.49.suppl_1.4DOI Listing
January 2018
1 Read

Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II.

J Korean Med Sci 2018 Dec 21;33(49):e323. Epub 2018 Nov 21.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction.

Methods: We conducted a multicenter, prospective, non-interventional study. Read More

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http://dx.doi.org/10.3346/jkms.2018.33.e323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262187PMC
December 2018
2 Reads

Bleeding and thrombotic events occur early in children on durable ventricular assist devices.

Thromb Res 2019 01 22;173:65-70. Epub 2018 Nov 22.

Murdoch Children's Research Institute, Hematology Research Group, Parkville, Victoria, Australia; Royal Children's Hospital, Department of Clinical Hematology, Parkville, Victoria, Australia; University of Melbourne, Department of Pediatrics, Parkville, Victoria, Australia.

Introduction: Durable Ventricular Assist Devices (VADs) are increasingly used in children with end-stage heart failure. Major complications are bleeding and thromboembolism (TE). Our objective was to determine the timing, incidence and risk factors for bleeding and TE in children implanted with VADs. Read More

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http://dx.doi.org/10.1016/j.thromres.2018.11.019DOI Listing
January 2019
3 Reads

Electronic Decision support for Improvement of Contemporary Therapy for Stroke Prevention.

J Stroke Cerebrovasc Dis 2019 Mar 22;28(3):569-573. Epub 2018 Nov 22.

Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida.

Background: Despite ample clinical trial data demonstrating that oral anticoagulation (OAC) treatment is highly effective in reducing stroke for patients with atrial fibrillation (AF), OAC treatment remains underutilized in current clinical practice. Targeting hospitalist and emergency department providers with electronic decision support represents a potential quality improvement opportunity in the use of OAC medication in AF patients.

Methods: We conducted a 3-center study in which 2 sites utilized an electronic alert (EA) embedded in the electronic health record and 1 site provided usual care. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.10.041DOI Listing
March 2019
14 Reads
1.993 Impact Factor

Is it safe to stop oral anticoagulation after catheter ablation for atrial fibrillation?

Expert Rev Cardiovasc Ther 2019 Jan 18;17(1):31-41. Epub 2018 Dec 18.

a Department of Cardiology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA.

Introduction: Atrial fibrillation is the most common arrhythmia worldwide. Its increasing prevalence has made the use of oral anticoagulants for stroke prevention routine; however, their use after the blanking period of catheter ablation remains uncertain. Areas covered: This review outlines the pros and cons of stopping oral anticoagulation after catheter ablation. Read More

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http://dx.doi.org/10.1080/14779072.2019.1550718DOI Listing
January 2019
5 Reads

Warfarin and the Risk of Death, Stroke, and Major Bleeding in Patients With Atrial Fibrillation Receiving Hemodialysis: A Systematic Review and Meta-Analysis.

Front Pharmacol 2018 6;9:1218. Epub 2018 Nov 6.

Department of Clinical Pharmacy, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Up to date, the efficacy and safety of warfarin treatment in atrial fibrillation patients receiving hemodialysis remain controversial. So we performed this meta-analysis to try to offer recommendations regarding warfarin management in this population. We searched Pubmed, Embase, and Cochrane library and reviewed relevant reference lists from 1980 to March 2018. Read More

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http://dx.doi.org/10.3389/fphar.2018.01218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232383PMC
November 2018
8 Reads

The Role of Double and Triple Therapy with Direct Oral Anticoagulants in Coronary Artery Disease, Peripheral Artery Disease, and Stroke.

Clin Ther 2018 Nov 24;40(11):1907-1917.e3. Epub 2018 Oct 24.

Brigham and Women's Hospital, Boston, MA, USA.

Purpose: Combining antiplatelet and anticoagulant therapy is often necessary in clinical practice. However, there is limited literature on tolerability and efficacy for triple therapy with the newer direct oral anticoagulants (DOACs). The objective of this study is to characterize the discharge prescribing practice of double versus triple antithrombotic therapy with a DOAC at a large, tertiary academic medical center. Read More

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http://dx.doi.org/10.1016/j.clinthera.2018.09.014DOI Listing
November 2018
25 Reads

Advances in Stroke Prevention.

Authors:
J David Spence

J Transl Int Med 2018 Sep 9;6(3):105-114. Epub 2018 Oct 9.

Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Canada.

There have been recent advances in stroke prevention in nutrition, blood pressure control, antiplatelet therapy, anticoagulation, identification of high-risk asymptomatic carotid stenosis, and percutaneous closure of patent foramen ovale. There is evidence that the Mediterranean diet significantly reduces the risk of stroke and that B vitamins lower homocysteine, thus preventing stroke. The benefit of B vitamins to lower homocysteine was masked by harm from cyanocobalamin among study participants with impaired renal function; we should be using methylcobalamin instead of cyanocobalamin. Read More

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http://dx.doi.org/10.2478/jtim-2018-0024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231304PMC
September 2018
3 Reads

[Risk factors for hypertensive and cerebral amyloid angiopathy associated intracerebral hemorrhage: a retrospective comparison].

Fortschr Neurol Psychiatr 2018 12 12;86(12):763-769. Epub 2018 Nov 12.

Klinik für Neurologie, HELIOS Kliniken Schwerin, Schwerin, Deutschland.

Introduction: The aim of this study was to compare possible risk factors for the most common forms of spontaneous intracerebral hemorrhage (ICH), namely hypertensive and cerebral amyloid angiopathy (CAA) associated ICH.

Methods: Retrospectively, different parameters and factors were compared in patients with hypertensive ICH (n = 141) and patients with a CAAassociated ICH (n = 95). These included age, INR value and blood pressure at admission, cardiovascular risk factors as well as pre-medication. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0732-5523
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http://dx.doi.org/10.1055/a-0732-5523DOI Listing
December 2018
16 Reads

Low-dose rivaroxaban plus aspirin for the prevention of cardiovascular events: an evaluation of COMPASS.

Future Cardiol 2018 11 12;14(6):443-453. Epub 2018 Nov 12.

Department of Medicine, McMaster University, Hamilton, ON, L8S 4K1, Canada.

The cardiovascular outcomes for people using anticoagulation strategies (NCT01776424) trial randomized 27,395 patients with stable coronary artery disease or peripheral artery disease (PAD) to receive rivaroxaban 5 mg twice-daily alone, the combination of rivaroxaban 2.5 mg twice-daily and aspirin 100 mg daily, or aspirin 100 mg daily alone. The combination arm resulted in a 24% reduction in the primary end point of cardiovascular death, stroke or myocardial infarction, and an 18% reduction in mortality. Read More

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https://www.futuremedicine.com/doi/10.2217/fca-2018-0059
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http://dx.doi.org/10.2217/fca-2018-0059DOI Listing
November 2018
5 Reads

2018 Korean Guideline of Atrial Fibrillation Management.

Korean Circ J 2018 Dec;48(12):1033-1080

Division of Cardiology, Department of Internal Medicine, Kyung Hee University Medical College, Seoul, Korea.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. This guideline is based on recent data of the Korean population and the recent guidelines of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, American Heart Association, and Asia Pacific Heart Rhythm Society. Read More

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https://synapse.koreamed.org/DOIx.php?id=10.4070/kcj.2018.03
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http://dx.doi.org/10.4070/kcj.2018.0339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221873PMC
December 2018
14 Reads

Delayed presentation of pulmonary artery perforation by an Amulet left atrial appendage closure device.

BMJ Case Rep 2018 Nov 3;2018. Epub 2018 Nov 3.

Department of Cardiothoracic Surgery and Transplantation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

Left atrial appendage occlusion (LAAO) devices offer stroke prevention in atrial fibrillation for patients intolerant of anticoagulation. Device placement leading to bleeding and cardiac tamponade have been reported periprocedurally but delayed presentations have not been reported in the literature. We present the case of an Amulet LAAO device causing erosion and bleeding from the main pulmonary artery that presented with cardiac tamponade 6 months after device placement. Read More

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http://dx.doi.org/10.1136/bcr-2018-227098DOI Listing
November 2018
2 Reads

International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines--Stroke Program.

J Am Heart Assoc 2018 Oct;7(20):e010623

1 Department of Neurology Duke University Medical Center Durham NC.

Background Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results We analyzed 19 604 patients with acute ischemic stroke in the China National Stroke Registry and 194 876 patients in the Get With The Guidelines--Stroke registry in the United States from June 2012 to January 2013. Compared with their US counterparts, Chinese patients were younger, had a lower prevalence of comorbidities, and had similar median, lower mean, and less variability in National Institutes of Health Stroke Scale (median 4 [25th percentile-75th percentile, 2-7], mean 5. Read More

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https://www.ahajournals.org/doi/10.1161/JAHA.118.010623
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http://dx.doi.org/10.1161/JAHA.118.010623DOI Listing
October 2018
22 Reads
2.882 Impact Factor

Pharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT-AF.

J Am Heart Assoc 2018 Sep;7(18):e008928

2 Duke Clinical Research Institute Durham NC.

Background Chronic kidney disease ( CKD ) is a common comorbidity in patients with atrial fibrillation. The presence of CKD complicates drug selection for stroke prevention and rhythm control. Methods and Results Patients enrolled in ORBIT AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) with baseline renal function and follow-up data were included (N=9019). Read More

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https://www.ahajournals.org/doi/10.1161/JAHA.118.008928
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http://dx.doi.org/10.1161/JAHA.118.008928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222961PMC
September 2018
16 Reads
2.882 Impact Factor

Patient Satisfaction with Direct Oral Anticoagulants and Warfarin.

Int Heart J 2018 Nov 25;59(6):1266-1274. Epub 2018 Oct 25.

Division of Cardiology, Nihon University Itabashi Hospital.

The burden of anticoagulation treatment affects patient satisfaction, which in turn affects adherence to treatment. Thus, we must thoroughly understand the advantages of direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs)/warfarin given for stroke prevention in patients with atrial fibrillation (AF). We compared satisfaction with anticoagulation therapy between 654 DOAC and 821 warfarin users enrolled in the SAKURA AF Registry. Read More

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http://dx.doi.org/10.1536/ihj.17-649DOI Listing
November 2018
16 Reads

Current and emerging pharmacotherapy for ischemic stroke prevention in patients with atrial fibrillation.

Expert Opin Pharmacother 2018 10 25:1-11. Epub 2018 Oct 25.

a Institute of Cardiovascular Sciences , University of Birmingham , Birmingham , UK.

Introduction: Atrial fibrillation (AF) is associated with high morbidity and mortality rates due to thromboembolic complications, and anticoagulation is central to the management of this common arrhythmia to prevent acute thromboembolic events. The traditional anticoagulants: heparin, fondaparinux, and vitamin K antagonists (VKA, e.g. Read More

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https://www.tandfonline.com/doi/full/10.1080/14656566.2018.1
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http://dx.doi.org/10.1080/14656566.2018.1537368DOI Listing
October 2018
8 Reads

Use of Oral Anticoagulation in Eligible Patients Discharged With Heart Failure and Atrial Fibrillation.

Circ Heart Fail 2018 Oct;11(10):e005356

Division of Cardiovascular Medicine, University of California (Davis) Medical Center, Sacramento (N.L.).

Background: Stroke prophylaxis in patients with atrial fibrillation (AF) and heart failure (HF) in the era of direct oral anticoagulants is not well characterized. Using data from American Heart Association Get With The Guidelines-AFIB, we sought to evaluate oral anticoagulation (OAC) use at discharge among AF patients with concomitant HF.

Methods And Results: AF patients with a diagnosis of HF hospitalized from January 2013 to March 2017 were included. Read More

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https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118
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http://dx.doi.org/10.1161/CIRCHEARTFAILURE.118.005356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319668PMC
October 2018
7 Reads
5.891 Impact Factor

[Oral anticoagulants in elderly patients with coronary artery disease and atrial fibrillation].

Authors:
R Gallet E Teiger

Ann Cardiol Angeiol (Paris) 2018 Dec 17;67(6):404-410. Epub 2018 Oct 17.

Unité de cardiologie interventionnelle, CHU de Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.

Anti-thrombotic management of percutaneous coronary intervention and atrial fibrillation relies on dual antiplatelet therapy and anticoagulation respectively. Because of people ageing, the coexistence of coronary artery disease and atrial fibrillation is increasing. This coexistence raises concerns about the anti-thrombotic strategy, particularly about the association of dual antiplatelet therapy and anticoagulation, known as triple therapy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00033928183016
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http://dx.doi.org/10.1016/j.ancard.2018.09.013DOI Listing
December 2018
17 Reads

Risk of Thromboembolism Associated With Atrial Fibrillation Following Noncardiac Surgery.

J Am Coll Cardiol 2018 Oct;72(17):2027-2036

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Background: The long-term risk of thromboembolism in patients developing new-onset post-operative atrial fibrillation (POAF) following noncardiac surgery is unknown, and data on stroke prophylaxis in this setting are lacking.

Objectives: The purpose of this study was to assess the long-term risk of thromboembolism in patients developing new-onset POAF following noncardiac surgery relative to patients with nonsurgical, nonvalvular atrial fibrillation (NVAF).

Methods: Using Danish nationwide registries, the authors identified all patients who developed POAF following noncardiac surgery from 1996 to 2015. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07351097183707
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http://dx.doi.org/10.1016/j.jacc.2018.07.088DOI Listing
October 2018
17 Reads

Management of atrial fibrillation: easy as ABC.

Minerva Med 2019 Feb 11;110(1):27-34. Epub 2018 Oct 11.

Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK -

Atrial fibrillation (AF) is the commonest sustained arrhythmia with increasing incidence worldwide. AF is a major cause of morbidity (resulting from heart failure, stroke and hospitalization) and mortality. The aim of primary and specialist care is to improve patient outcome through early detection of AF and optimal clinical management. Read More

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https://www.minervamedica.it/index2.php?show=R10Y9999N00A181
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http://dx.doi.org/10.23736/S0026-4806.18.05824-XDOI Listing
February 2019
18 Reads

Stroke prevention within primary care: management of atrial fibrillation using oral anticoagulation.

Sao Paulo Med J 2018 Jul-Aug;136(4):273-275

MD, DrPH. Full Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.

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http://www.scielo.br/scielo.php?script=sci_arttext&pid=S
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http://dx.doi.org/10.1590/1516-3180.2018.1364110718DOI Listing
December 2018
3 Reads

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure.

ESC Heart Fail 2019 02 9;6(1):10-15. Epub 2018 Oct 9.

Department of Pharmacy Practice, University of Connecticut School of Pharmacy, 69 North Eagleville Road, Unit 3092, Storrs, CT, USA.

Aims: Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.

Methods And Results: Using US Truven MarketScan Commercial and Medicare supplemental database claims data from 11/2011 to 12/2016, we identified oral anticoagulant (OAC)-naïve NVAF patients with HF (International Classification of Diseases, 10th Revision codes of I50 or I09. Read More

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http://doi.wiley.com/10.1002/ehf2.12365
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http://dx.doi.org/10.1002/ehf2.12365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352884PMC
February 2019
4 Reads

Atrial fibrillation and medication treatment among centenarians: Are all very old patients treated the same?

Geriatr Gerontol Int 2018 Dec 26;18(12):1634-1640. Epub 2018 Sep 26.

Institute of Medical Sociology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Aim: Evidence on antithrombotic therapy use in centenarians diagnosed with atrial fibrillation (AF) is sparse. Our objective was to investigate a possible underprescribing in centenarians relative to younger cohorts of the oldest-old. We assumed lower AF rates; and, within AF patients, lower use of anticoagulants in those who died as centenarians (aged ≥100 years) than in those who died aged in their 80s (≥80 years) or 90s (≥90 years). Read More

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http://dx.doi.org/10.1111/ggi.13531DOI Listing
December 2018

Atrial fibrillation and chronic kidney disease: A review of options for therapeutic anticoagulation to reduce thromboembolism risk.

Clin Cardiol 2018 Oct 25;41(10):1395-1402. Epub 2018 Oct 25.

Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, New York.

Atrial fibrillation and chronic kidney disease (CKD) commonly occur together, which poses a therapeutic dilemma due to increased risk of both systemic thromboembolism and bleeding. Chronic kidney disease also has implications for medication selection. The objective of this review is to evaluate the options for anticoagulation for thromboembolism prevention in patients with atrial fibrillation and chronic kidney disease. Read More

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http://doi.wiley.com/10.1002/clc.23085
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http://dx.doi.org/10.1002/clc.23085DOI Listing
October 2018
15 Reads

Stroke prevention in atrial fibrillation: State of the art.

Int J Cardiol 2018 Sep 19. Epub 2018 Sep 19.

Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom; Liverpool Centre for Cardiovascular Science, University of Liverpool, United Kingdom; Department of Cardiology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, China; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address:

Stroke prevention is the cornerstone of the management of patients with atrial fibrillation (AF). Individual stroke risk stratification is generally the first step of deciding whether oral anticoagulation (OAC) will benefit patients with AF. Given that existing approaches to the prediction of 'high-risk' subjects are of limited value, the initial focus should be the identification of 'low-risk' patients who do not need antithrombotic therapy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01675273183217
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http://dx.doi.org/10.1016/j.ijcard.2018.09.057DOI Listing
September 2018
13 Reads