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J Vasc Surg 2020 May 20. Epub 2020 May 20.

National Director of Vascular Surgery and Endovascular Therapy, Tenet Healthcare Corporation, Delray Medical Center, Delray Beach, FL, USA; Professor of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA. Electronic address:

Objective: Antiplatelet drug resistance is associated with periprocedural ischemic complications in patients undergoing intravascular stent implantation. Nonresponders are subject to increased risk of stent thrombosis and in-stent stenosis, and high on-treatment platelet reactivity (HTPR) is present in up to 44% of patients taking clopidogrel, a widely-used component of dual antiplatelet therapy (DAPT). Evidence points to ticagrelor as a viable alternative to overcome HTPR on clopidogrel. Read More

Clin J Am Soc Nephrol 2020 May 22. Epub 2020 May 22.

Nephrology Division, New York University Langone Medical Center and Grossman School of Medicine, New York, New York.

Background And Objectives: The relative efficacy and safety of apixaban compared with no anticoagulation have not been studied in patients on maintenance dialysis with atrial fibrillation. We aimed to determine whether apixaban is associated with better clinical outcomes compared with no anticoagulation in this population.

Design, Setting, Participants, & Measurements: This retrospective cohort study used 2012-2015 US Renal Data System data. Read More

J Cardiovasc Med (Hagerstown) 2020 May 20. Epub 2020 May 20.

Unità Operativa di Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.

Background: Left atrial appendage occlusion (LAAO) represents an alternative approach for the prevention of cardioembolic stroke in patients with nonvalvular atrial fibrillation (NVAF) and contraindication for oral anticoagulation (OAC). The aim of our study was to analyse the outcomes in patients treated with LAAO, with a focus on cases with previous intracranial bleeding.

Methods: Sixty patients with NVAF underwent LAAO (75. Read More

J Eur Acad Dermatol Venereol 2020 May 22. Epub 2020 May 22.

Dermatology Department, Hospital Universitario La Paz, Madrid, Spain.

We present a case of an 83-year-old woman with a history of hypertension, transient ischemic attack (TIA), atrial fibrillation, chronic renal impairment presented to our dermatology emergency room on April 9, 2020, for evaluation of purple palpable papules and serohaematic blisters on both her lower legs, feet and toes that had appeared 5 days earlier (Figure 1). Read More

Ann Vasc Surg 2020 May 18. Epub 2020 May 18.

Division of Vascular & Endovascular Surgery, Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA. Electronic address:

Objective: Overtreatment and overutilization of resources are leading causes of rising healthcare costs. Identification and elimination of low value services is important in reducing such costs. At many institutions it is routine to send excised plaque after carotid endarterectomy (CEA) for pathology evaluation. Read More

Ann Vasc Surg 2020 May 18. Epub 2020 May 18.

Department of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, Japan.

Background: Free-floating thrombus (FFT) of the cervical carotid artery is a rare but critical condition leading to stroke. The most common underlying pathology is atherosclerotic plaque; non-atherosclerotic pathologies are much rarer. Here we report a case of FFT associated with cervical carotid artery dissection that was successfully treated by surgical thromboendarterectomy. Read More

Clin Oral Investig 2020 May 21. Epub 2020 May 21.

Graduate Program in Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, 6681 Av. Ipiranga, prédio 6, 90619900, Porto Alegre, RS, Brazil.

Objectives: The purpose of the study was twofold: (1) to test the hypothesis that tooth loss is independently associated with carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA) and (2) to test the association between tooth loss and disability following the occurrence of cerebral ischemia.

Materials And Methods: This observational study included 418 patients with IS or TIA. Tooth loss and the CAB were measured through a head and neck multidetector computed tomography angiography. Read More

Ann Palliat Med 2020 May 11. Epub 2020 May 11.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China.

Background: To find out the real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation (AF) catheter ablation China.

Methods: We enrolled in our study 1,508 consecutive paroxysmal AF patients who underwent catheter ablation from five centers. Patients' clinical data and follow-up data were collected. Read More

Stroke 2020 May 20:STROKEAHA120030105. Epub 2020 May 20.

From the Division of Neurology, Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong. (K.-C.T., W.C.Y.L., Y.-K.W., R.K.C.L., A.H.Y.C., K.-K.L., M.-Y.T., R.T.F.C., K.K.L.).

Background And Purpose: The current coronavirus disease 2019 (COVID-19) pandemic represents a global public health crisis, disrupting emergency healthcare services. We determined whether COVID-19 has resulted in delays in stroke presentation and affected the delivery of acute stroke services in a comprehensive stroke center in Hong Kong.

Methods: We retrospectively reviewed all patients with transient ischemic attack and stroke admitted via the acute stroke pathway of Queen Mary Hospital, Hong Kong, during the first 60 days since the first diagnosed COVID-19 case in Hong Kong (COVID-19: January 23, 2020-March 24, 2020). Read More

ESC Heart Fail 2020 May 20. Epub 2020 May 20.

Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, 00168, Italy.

Aims: Right ventricular hypertrophy (RVH) is a common finding in Anderson-Fabry disease (AFD), but the prognostic role of right ventricular (RV) involvement has never been assessed. The aim of our study was to evaluate the prognostic significance of RVH and RV systolic function in AFD.

Methods And Results: Forty-five AFD patients (56% male patients) with extensive baseline evaluation, including assessment of RVH and RV systolic function, were followed-up for an average of 51. Read More

Indian Heart J 2020 Jan - Feb;72(1):20-26. Epub 2020 Mar 24.

Department of Medicine, Christian Medical College, Vellore, India.

Aim: Heart failure is a global problem that is increasing in prevalence. We undertook the initiative to compile the Vellore Heart Failure Registry (VHFR) to assess the clinical profile, mortality, risk factors and economic burden of heart failure by conducting a prospective, observational, hospital-based cohort study in Vellore, Tamil Nadu.

Methods And Results: This study was a prospective observational cohort study conducted at the Christian Medical College and Hospital, Vellore, between January 2014 and December 2016. Read More

J Vasc Surg 2020 May 15. Epub 2020 May 15.

Department of Vascular Surgery, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Objective: Transcervical carotid artery stenting (CAS) has emerged as an alternative to transfemoral CAS. An earlier systematic review from our group (n = 12 studies; 739 transcervical CAS procedures [489/739 with flow reversal]) demonstrated that transcervical CAS is a safe procedure associated with a low incidence of stroke and complications. Since then, new studies have been published adding nearly 1,600 new patients to the literature. Read More

Ann Intern Med 2020 May 12. Epub 2020 May 12.

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (W.D., S.Y., D.M., I.I., S.E., J.H., E.H.L., I.F.P., F.S.B., M.N.).

Background: Residual shunt is observed in up to 25% of patients after patent foramen ovale (PFO) closure, but its long-term influence on stroke recurrence currently is unknown.

Objective: To investigate the association of residual shunt after PFO closure with the incidence of recurrent stroke and transient ischemic attack (TIA).

Design: Prospective cohort study comparing stroke or TIA recurrence in patients with and without residual shunt after PFO closure. Read More

West J Emerg Med 2020 Apr 13;21(3):626-632. Epub 2020 Apr 13.

University of Ottawa, Department of Emergency Medicine, Ontario, Canada.

Introduction: Patients with severe, symptomatic carotid stenosis can have their subsequent stroke risk reduced by surgical intervention if performed soon after a transient ischemic attack (TIA) or stroke. Patients presenting to an emergency department (ED) without computed tomography angiography (CTA) with TIA/stroke, may require transfer to another hospital for imaging to rule out carotid artery stenosis. The objective of this study was to determine the test characteristics of carotid artery point-of-care ultrasound (POCUS) in detecting greater than 50% stenosis in patients presenting with TIA/stroke. Read More

J Neurointerv Surg 2020 May 15. Epub 2020 May 15.

Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA

Background: White matter lesions (WML) are associated with poor outcome after mechanical thrombectomy (MT) for large vessel stroke; the reasons are uncertain. To elucidate this issue we sought to determine the association of WML with multiple early and late outcome measures after MT.

Methods: We retrospectively analyzed 181 MT patients prospectively included in our local stroke registry (January 2012 to November 2016). Read More

J Stroke Cerebrovasc Dis 2020 May 12:104877. Epub 2020 May 12.

St George's University Hospitals NHS Trust, Neurology, London, United Kingdom. Electronic address:

Objectives: To assess the prevalence of high on-clopidogrel platelet reactivity (HCPR) in patients with ischaemic stroke or transient ischaemic attack (IS/TIA), their outcome and genetic basis of on-treatment response variability in IS/TIA patients.

Methods: We conducted a comprehensive search of PubMed and EMBASE from their inceptions to March 9, 2019. Studies that reported absolute numbers/percentages of HCRP at any time point after IS/TIA onset evaluated with any type of platelet function tests, clinical outcomes and genotyping data were included. Read More

Front Neurosci 2020 28;14:392. Epub 2020 Apr 28.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: Internal carotid artery occlusion (ICAO) is a relatively uncommon but important cause of transient ischemic attack and cerebral infarction. The majority of cases of symptomatic ICAO requires surgical treatment. In this study we performed an investigation of the efficacy and safety of hybrid surgery which is a surgical method for symptomatic chronic complete ICAO. Read More

Support Care Cancer 2020 May 14. Epub 2020 May 14.

Department of Hematology/Oncology, Saint Francis Cancer Center, Hartford, CT, 06105, USA.

Introduction: Concomitant cardiovascular comorbidities in patients with cancer are not uncommon. There is limited data on the impact of cardiovascular comorbidities on in-hospital mortality in patients admitted with neutropenic fever.

Methods: This is a retrospective cohort study using the 2016 NIS database of adults (> 18 years old) hospitalized for neutropenic fever as the primary diagnosis. Read More

Vascular 2020 May 14:1708538120924158. Epub 2020 May 14.

Section of Vascular Surgery, School of Medicine, Washington University, St. Louis, MO, USA.

Objective: The primary purpose of this study was to examine any potential difference in clinical outcomes between transcarotid artery revascularization performed under local anesthesia compared with general anesthesia by utilizing a large national database.

Methods: The primary outcome of the study was a composite endpoint of postoperative in-hospital stroke, myocardial infarction and mortality following transcarotid artery revascularization for the index procedure. Secondary outcomes included a composite outcome of postoperative in-hospital stroke, transient ischemic attack, myocardial infarction and mortality along with several subsets of its components and each individual component, flow reversal time (min), radiation dose (GY/cm), contrast volume utilized (mL), total procedure time (min), extended total length of stay (>1 day) and extended postoperative length of stay (>1 day). Read More

Am Heart J 2020 May 13. Epub 2020 May 13.

D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.

Background: Angiotensin-converting enzyme-2 (ACE2) may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). Because renin-angiotensin system blockers increase levels of ACE2, a protein that facilitates coronavirus entry into cells, there is concern that these drugs could increase the risk of developing a severe and fatal form of COVID-19. The impact of discontinuing ACEI and ARBs in patients with COVID-19 remains uncertain. Read More

Chin Med J (Engl) 2020 May 11. Epub 2020 May 11.

Department of Trauma Rescue Center, Peking University People's Hospital, Beijing 100044, China.

Background: We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize EMS.

Methods: We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the Medical Priority Dispatch System (MPDS). Read More

J Neurol Neurosurg Psychiatry 2020 May 13. Epub 2020 May 13.

Department of Neurology, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.

Introduction: Predictors of long-term ischaemic and haemorrhagic complications in atrial fibrillation (AF) have been studied, but there are limited data on predictors of early ischaemic and haemorrhagic complications after AF-associated ischaemic stroke. We sought to determine these predictors.

Methods: The Initiation of Anticoagulation after Cardioembolic stroke study is a multicentre retrospective study across that pooled data from consecutive patients with ischaemic stroke in the setting of AF from stroke registries across eight comprehensive stroke centres in the USA. Read More

Clin Neurophysiol 2020 Apr 23;131(7):1508-1516. Epub 2020 Apr 23.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Objectives: We assessed whether significant intraoperative electroencephalography (EEG) changes have predictive value for perioperative stroke within 30 days after carotid endarterectomy (CEA) procedures for carotid stenosis (CS) patients. We also assessed the diagnostic accuracy of various EEG changes in predicting perioperative stroke.

Methods: We searched databases for reports with outcomes of CS patients who underwent CEA with intraoperative EEG monitoring. Read More

N Engl J Med 2020 05;382(20):1933-1941

From the Department of Neurology and Stroke Center, Assistance Publique-Hôpitaux de Paris, SOS-TIA Clinic, Bichat Hospital, Laboratory for Vascular Translational Science, INSERM Unité 1148, Département Hospitalo Universitaire-Fibrose Inflammation Remodelage, University of Paris, Paris.

Neurol Sci 2020 May 12. Epub 2020 May 12.

Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.

Long-term consequences of cervical artery dissection (CeAD), a major cause of ischemic stroke in young people, have been poorly investigated. The Italian Project on Stroke at Young Age - Cervical Artery Dissection (IPSYS CeAD) project is a multicenter, hospital-based, consecutively recruiting, observational, cohort study aimed to address clinically important questions about long-term outcome of CeAD patients, which are not covered by other large-scale registries. Patients with radiologically diagnosed CeAD were consecutively included in the registry. Read More

Stroke 2020 May 1:STROKEAHA119027960. Epub 2020 May 1.

From the Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada (M.L., E.L., C.P.).

Background and Purpose- Multiple studies have shown the 90-day risk of stroke following an emergency department (ED) diagnosis of transient ischemic attack (TIA) or minor stroke is significant, with the greatest risk of recurrence being within the first 24 to 48 hours following initial symptom onset. This study explored regional differences in ED disposition, neuroimaging, and subsequent 90-day stroke risk of patients diagnosed with TIA or minor stroke in Alberta. Methods- We used administrative databases to identify ED visits, neuroimaging, and 90-day return visits for TIA or minor stroke in Alberta from April 2011 to March 2016 among adults ≥20 years of age and stratified them based on regions of presentation (Edmonton, Calgary, or nonmajor urban). Read More

Postgrad Med 2020 May 20:1-8. Epub 2020 May 20.

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou, China.

Objective: We study whether the carotid artery stenting (CAS) and carotid endarterectomy (CEA) differ from each other in postoperative ventricular arrhythmia, along with neurological complications (perioperative stroke and transient ischemic attack), in-hospital mortality, and estimated medical cost.

Methods: This study used data of patients with carotid artery stenosis from the National Inpatient Sample (NIS) database (2011-2014) from the United States of America. Based on the procedure that patients received, individuals were categorized into groups of CAS and CEA. Read More

Cochrane Database Syst Rev 2020 May 11;5:CD012825. Epub 2020 May 11.

Department of Neurology, Mater Misericordiae University Hospital, Dublin 7, Ireland.

Background: An increasing body of evidence suggests that inflammation plays a key role in stroke, in particular stroke of atherosclerotic origin. Anti-inflammatory medications are a widely heterogeneous group of drugs that are used to suppress the innate inflammatory pathway and thus prevent persistent or recurrent inflammation. Anti-inflammatory agents have the potential to stabilise atherosclerotic plaques by impeding the inflammatory pathway. Read More

Qual Life Res 2020 May 9. Epub 2020 May 9.

Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478, Lørenskog, Norway.

Purpose: To describe the health-related quality of life (HRQoL) of caregivers and survivors of transient ischaemic attack (TIA) and stroke during one year post discharge in comparison to age- and sex-matched population norms; and to analyse the association of initial stroke severity, measured by a routinely used stroke-specific scale, on subsequent HRQoL of caregivers and survivors.

Methods: Cohort of hospitalized patients with TIA and stroke discharged alive from a large university hospital in Norway, and their informal caregivers. Questionnaires at 3 and 12 months post discharge were filled out by caregivers (n = 320 and n = 326, respectively) and survivors (n = 368 and n = 383, respectively). Read More

J Interv Card Electrophysiol 2020 May 8. Epub 2020 May 8.

Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool, L14 3PE, UK.

Purpose: Treatment of typical atrial flutter (AFL) with cavo-tricuspid isthmus (CTI) ablation is associated with a high occurrence rate of new onset atrial fibrillation (AF) during follow-up. There are data to support the addition of pulmonary vein isolation (PVI) to CTI ablation in patients with both AF and AFL, but the role of cryoballoon PVI only, with no CTI ablation, in AFL patients with no prior documentation of AF has not been studied.

Methods: CRAFT is an international, prospective, randomised, open with blinded assessment, multicentre superiority study comparing radiofrequency CTI ablation and cryoballoon PVI in patients with typical AFL. Read More

Neuroradiology 2020 May 9. Epub 2020 May 9.

Comprehensive Stroke Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, 695011, India.

Purpose: Aging and increased burden of cardiovascular risk factors are associated with severity of white matter hyperintensity (WMH). We assessed the burden and risk factor profile of WMHs in South Asian patients with transient ischemic attack (TIA) and minor stroke.

Methods: Patients with acute ischemic stroke with the National Institute of Health stroke scale (NIHSS) score ≤ 5 who underwent MRI were included. Read More

Emerg Med J 2020 May 8. Epub 2020 May 8.

Institute of Neuroscience (Stroke Research Group), Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.

Introduction/background: Accurate prehospital identification of patients who had an acute stroke enables rapid conveyance to specialist units for time-dependent treatments such as thrombolysis and thrombectomy. Misidentification leads to patients who had a 'stroke mimic' (SM) being inappropriately triaged to specialist units. We evaluated the positive predictive value (PPV) of prehospital stroke identification by ambulance clinicians in the North East of England. Read More

BMC Neurol 2020 May 8;20(1):174. Epub 2020 May 8.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Background: Cognitive impairment (CI) with mixed vascular and neurodegenerative pathologies after stroke is common. The role of amyloid pathology in post-stroke CI is unclear. We hypothesize that amyloid deposition, measured with Flutemetamol (F-Flut) positron emission tomography (PET), is common in seven-year stroke survivors diagnosed with CI and, further, that quantitatively assessed F-Flut-PET uptake after 7 years correlates with amyloid-β peptide (Aβ) levels in cerebrospinal fluid (CSF) at 1 year, and with measures of neurodegeneration and cognition at 7 years post-stroke. Read More

Scand J Surg 2020 May 8:1457496920917269. Epub 2020 May 8.

Department of Cardiology, Tampere Heart Hospital, Tampere, Finland.

Background: The prevalence of abdominal aortic aneurysms is higher in population with other vascular comorbidities, especially among men. Utility of screening among patients with cerebrovascular disease is unclear.

Objective: To determine the prevalence of abdominal aortic aneurysm in male patients with diagnosed cerebrovascular disease manifested by transient ischemic attack or stroke. Read More

Sisli Etfal Hastan Tip Bul 2020 25;54(1):83-87. Epub 2020 Mar 25.

Department of Neurology, Bakırköy Mental and Neurological Diseases Training and Research Hospital, Istanbul, Turkey.

Objectives: Transient Ischemic Attack (TIA) is due to a temporary lack of adequate blood and oxygen to the brain. TIAs typically last less than 24 hours. 10-15% of ischemic stroke patients have a history of TIA. Read More

Cerebrovasc Dis Extra 2020 May 6;10(2):44-49. Epub 2020 May 6.

Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy.

Introduction And Objective: Even though the introduction of less cumbersome anticoagulant agents has improved, the rates ofoverall anticoagulant treatment in eligible patients with atrial fibrillation (AF) remain to be defined. We aimed to assess the rates of and determinants for the use of anticoagulation treatment before stroke in patients with known AF since the introduction of direct oral anticoagulants (DOAC) in clinical practice.

Methods: Consecutive patients admitted to an individual stroke unit, from September 2013 through July 2019, for acute ischemic stroke or transient ischemic attack (TIA) with known AF before the event were included in the study. Read More

Front Neurol 2020 16;11:268. Epub 2020 Apr 16.

Department of Neurology and Stroke Center, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.

The association of retinal microvascular abnormalities with the total cerebral small vessel disease (cSVD) burden found on brain MRI has not been determined. In the present study, we examined whether the retinopathy score could predict the total cSVD burden in ischemic stroke/transient ischemic attack (TIA) patients. A simple practical diagnostic tool may help identify candidates for MRI screening. Read More

Front Neurol 2020 21;11:216. Epub 2020 Apr 21.

Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.

Cognitive impairment following a minor stroke or transient ischemic attack (TIA) is common; however, due to diagnostic difficulties, the prevalence and underlying cause of impairment remain poorly defined. We compared cognition in patients after a minor stroke, TIA, or mimic event at three time points in the first year following the event. We examine whether cognitive impairment occurs following these events and whether this impairment differs based on the event type. Read More

Herzschrittmacherther Elektrophysiol 2020 May 5. Epub 2020 May 5.

Herz- & Gefäßzentrum am Krankenhaus Neu Bethlehem, Humboldtallee 6, 37073, Göttingen, Deutschland.

Introduction: Electrophysiology study (EPS) and catheter ablation (abl.), in particular for atrial fibrillation, are increasingly performed in Germany. Therefore, measures and steps to ensure quality assurance are indicated. Read More

J Chin Med Assoc 2020 May 1. Epub 2020 May 1.

Division of General Neurology, Neurological Institute, Taichung Veterans General Hospital, Taiwan, ROC.

Background: A subgroup of patients with acute minor stroke (AMS) or transient ischemic attack (TIA) become disabled due to disease progression (DP) or recurrent stroke within three months. To identify the risk factors for DP in AMS/TIA patients. In the literature, no studies focused on computed tomography perfusion (CTP) in AMS/TIA patients at the acute stage. Read More

Open Heart 2020 May;7(1)

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

Objectives: Prolonged ECG monitoring is clinically useful to detect unknown atrial fibrillation (AF) in stroke survivors. The diagnostic yield of prolonged ECG monitoring in other patient populations is less well characterised. We therefore studied the diagnostic yield of prolonged Holter ECG monitoring for AF in an patient cohort referred from primary care or seen in a teaching hospital. Read More

Zhonghua Xin Xue Guan Bing Za Zhi 2020 Apr;48(4):308-314

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

To determine the predictors of recurrent hospitalizations among atrial fibrillation (AF) patients. We analyzed data from the Chinese Atrial Fibrillation Registry (CAFR), a prospective cohort study involving non-valvular atrial fibrillation (NVAF) patients from Augest 2011 to December 2017. A total of 5 349 NVAF patients with a minimum of 48 months follow-up were included for analysis. Read More

Cerebrovasc Dis 2020 May 5:1-7. Epub 2020 May 5.

Department of Neurology, Cerebrovascular Division, State University of New York Downstate Medical Center, Brooklyn, New York, USA.

Background: Two recent cerebrovascular studies, Clopidogrel (Clo) in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and minor ischemic stroke (POINT), have purportedly demonstrated the superiority of early dual antiplatelet therapy (DAPT), using aspirin (ASA) plus Clo, in comparison to ASA alone following the occurrence of acute minor cerebral infarction or transient ischemic attack. However, limitations to these trials exist that may not have been adequately explored and presented in the literature, and which may impact the overall efficacy and benefit of DAPT in these situations. Herein we provide a detailed and extensive critique of these 2 trials and of a combined analysis, with particular attention to study data and analyses pertaining to hemorrhagic complications. Read More

Clin Nucl Med 2020 Jun;45(6):427-433

Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.

Purpose: The aim of this study was to evaluate random forests (RFs) to identify ROIs on F-florbetapir and F-FDG PET associated with Montreal Cognitive Assessment (MoCA) score.

Materials And Methods: Fifty-seven subjects with significant white matter disease presenting with either transient ischemic attack/lacunar stroke or mild cognitive impairment from early Alzheimer disease, enrolled in a multicenter prospective observational trial, had MoCA and F-florbetapir PET; 55 had F-FDG PET. Scans were processed using the MINC toolkit to generate SUV ratios, normalized to cerebellar gray matter (F-florbetapir PET), or pons (F-FDG PET). Read More

JAMA Neurol 2020 May 4. Epub 2020 May 4.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

Importance: Over the last decade or so, there have been substantial investments in the development of stroke systems of care to improve access and quality of care in rural communities. Whether these have narrowed rural-urban disparities in care is unclear.

Objective: To describe trends among rural and urban patients with acute ischemic stroke or transient ischemic attack in the type of health care centers to which patients were admitted, what care was provided, and the outcomes patients experienced. Read More

Neuroradiology 2020 May 4. Epub 2020 May 4.

Interventional Radiology Diagnosis and Treatment Center, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Purpose: Silent new ischemic cerebral lesions (sNICL) detected by diffusion-weighted imaging (DWI) are common after carotid artery stenting (CAS). As part of the Revascularization of Extracranial Carotid Artery Stenosis (RECAS) study, this work aimed to determine predictors of sNICL detected by DWI following CAS.

Methods: A total of 694 patients eligible for the RECAS study treated in Xuanwu Hospital, Capital Medical University, with complete imaging data were included in this retrospective study. Read More

J Geriatr Cardiol 2020 Apr;17(4):184-192

Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To compare clinical outcomes between patients with and without history of major bleeding according to types of antithrombotic medications in patients with non-valvular atrial fibrillation (NVAF).

Methods: We conducted a multicenter registry of patients with NVAF during 2014 to 2017 in Thailand. The following data were collected: demographic data, type of NVAF, medical illness, components of CHADS-VASc and HAS-BLED scores, history of bleeding and severity, investigations, and antithrombotic medications. Read More

Ann Vasc Surg 2020 Apr 30. Epub 2020 Apr 30.

Fourth Department of Cardiac Surgery, HYGEIA Hospital, Athens, Greece.

Introduction: KLF4 is known to preserve vascular homeostasis. In the present study, we sought to correlate serum KLF4 levels with arterial aneurysm size and their clinical presentation. We also explored the association between serum KFL4 levels and the severity of extracranial carotid and peripheral arterial disease. Read More

Am J Cardiol 2020 Apr 10. Epub 2020 Apr 10.

Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania.

It remains unknown whether the comparative effectiveness of direct oral anticoagulants (DOACs) and warfarin differs between atrial fibrillation patients with and without a history of stroke or transient ischemic attack (TIA). Using 2012 to 2014 Medicare claims data, we identified patients newly diagnosed with AF in 2013 to 2014 who initiated apixaban, dabigatran, rivaroxaban, or warfarin. We categorized patients based on a history of stroke or TIA. Read More

BMC Neurol 2020 May 1;20(1):168. Epub 2020 May 1.

Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Read More