Article
Medicine, General & Internal
Gregory F. Michaud, William G. Stevenson
Summary: A 63-year-old healthy male with atrial fibrillation presents with symptoms of dyspnea and irregular heartbeat. Physical examination reveals high blood pressure, irregular pulse, and ECG confirms atrial fibrillation. Further evaluation and treatment plan are needed.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
Gregory Y. H. Lip, Allison Keshishian, Yan Zhang, Amiee Kang, Amol D. Dhamane, Xuemei Luo, Christian Klem, Mauricio Ferri, Jenny Jiang, Huseyin Yuce, Steven Deitelzweig
Summary: In this study of patients with NVAF and high risk of GI bleed, NOACs were associated with lower rates of stroke and/or SE, but NOACs had varying risks of MB compared with warfarin. These results may help inform treatment options in this patient population.
Article
Multidisciplinary Sciences
Giorgio Ciminata, Claudia Geue, Olivia Wu, Manuela Deidda, Noemi Kreif, Peter Langhorne
Summary: This study aimed to explore the methodological challenges of using real-world evidence (RWE) to estimate comparative effectiveness of anticoagulants in Scotland. The results showed that different methods, such as propensity score (PS) matching, inverse probability weighting (IPW), and covariate adjustment with PS, performed well in different subgroups of the study population.
Article
Cardiac & Cardiovascular Systems
Malik Elharram, Michelle Samuel, Ahmed AlTurki, Michael Quon, Hassan Behlouli, Amal Bessissow, Louise Pilote
Summary: This study aimed to investigate the association between oral anticoagulation (OAC) use and thromboembolic events and major bleeding in patients with new postoperative atrial fibrillation (POAF) after noncardiac surgery. The results showed that OAC was not associated with a reduction in long-term thromboembolic events in these patients, but it did increase the risk for major bleeding. Future prospective clinical studies are needed to better understand the efficacy and safety of anticoagulation therapy in the setting of POAF after noncardiac surgery.
CANADIAN JOURNAL OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Finn Akerstrom, Julie Hutter, Emmanouil Charitakis, Fariborz Tabrizi, Fahd Asaad, Hamid Bastani, Tara Bourke, Frieder Braunschweig, Nikola Drca, Anders Englund, Leif Friberg, Per Insulander, Anders Hassel Jonsson, Goran Kenneback, Astrid Paul-Nordin, Bita Sadigh, Ott Saluveer, Serkan Saygi, Jonas Schwieler, Emma Svennberg, Jari Tapanainen, Yusuf Turkmen, Mats Jensen-Urstad
Summary: Catheter ablation of atrial fibrillation is associated with a lower risk of all-cause mortality or stroke.
Article
Multidisciplinary Sciences
Ji Yun Lee, Il-Young Oh, Ju-Hyeon Lee, Seok Kim, Jihoon Cho, Charg Hyun Park, Sooyoung Yoo, Soo-Mee Bang
Summary: This study examined the impact of potential drug-drug interactions on the risk of ischemic stroke and major bleeding in atrial fibrillation patients treated with DOACs. It was found that an increased number of DDIs significantly raised the risk of both ischemic stroke and hospitalization for major bleeding in these patients.
SCIENTIFIC REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Paul L. Hess, Kensey L. Gosch, Sandeep M. Jani, Paul D. Varosy, Steven M. Bradley, Thomas M. Maddox, P. Michael Ho, Salim S. Virani
Summary: This study analyzed the use of oral anticoagulants among patients with valvular atrial fibrillation from 2013 to 2019 using the PINNACLE Registry. The results showed variations in the use of direct oral anticoagulants and warfarin, but consistent trends in their usage over time.
AMERICAN HEART JOURNAL
(2021)
Review
Cardiac & Cardiovascular Systems
Derek Chew, Jonathan P. Piccini
Summary: Catheter ablation is more effective than antiarrhythmic therapy in reducing symptomatic AF, recurrence, and burden. The debate on rate vs. rhythm control has been reopened, potentially impacting stroke risk. Discontinuation of oral anticoagulation post-ablation may increase stroke risk, highlighting the need for further randomized controlled trials to determine the appropriate management.
Review
Medicine, General & Internal
K. E. Juhani Airaksinen
Summary: Cardioversion is an important strategy in the treatment of atrial fibrillation, and the timing of the procedure is crucial for its success and safety. Early cardioversion has a higher success rate and lower risk of early recurrences compared to later elective cardioversion. However, cardioversion does increase the risk of thromboembolic complications, which can be reduced with effective anticoagulation. Even with therapeutic anticoagulation, each elective cardioversion still carries a higher risk of stroke compared to acute cardioversion or avoiding cardioversion. For otherwise healthy patients on therapeutic anticoagulation, a short wait-and-see approach may be a reasonable option.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Jien-Jiun Chen, Fu-Chun Chiu, Sheng-Nan Chang, Hsiao-Liang Cheng, Pang-shuo Huang, Cho-Kai Wu, Yi-Chih Wang, Juey-Jen Hwang, Chia-Ti Tsai
Summary: This pioneer study investigated the impact of pre-existing left atrial appendage occluder (LAAO) on atrial fibrillation (AF) substrates and outcomes of pulmonary vein isolation (PVI). Results showed that LAAO may modulate left atrial substrate and induce peridevice fibrosis, peridevice left atrial flutter, and complex fractionate atrial electrogram.
Article
Medicine, General & Internal
Darae Ko, Kueiyu Joshua Lin, Lily G. Bessette, Su Been Lee, Allan J. Walkey, Susan Cheng, Erin Kim, Robert J. Glynn, Dae Hyun Kim
Summary: Undertreatment of anticoagulation therapy in older adults with atrial fibrillation is a significant issue. The introduction of direct oral anticoagulants (DOACs) has improved treatment initiation, but there is still room for improvement. Further research and strategies are needed to enhance stroke prophylaxis in this population.
Article
Medicine, General & Internal
Stephan Willems, Melanie A. Gunawardene, Christian Eickholt, Jens Hartmann, Michael Schmoeckel, Benjamin Schaeffer
Summary: Atrial fibrillation, as the most common type of cardiac arrhythmia, requires a multimodal approach in clinical management, including risk stratification, lifestyle modification, prevention of thromboembolism, and early rhythm control therapy if possible. Early rhythm control strategy has been found beneficial in high-risk patients and those with heart failure.
DEUTSCHES ARZTEBLATT INTERNATIONAL
(2022)
Article
Clinical Neurology
Alexandros A. Polymeris, Kosmas Macha, Maurizio Paciaroni, Duncan Wilson, Masatoshi Koga, Manuel Cappellari, Sabine Schaedelin, Annaelle Zietz, Nils Peters, David J. Seiffge, David Haupenthal, Luise Gassmann, Gian Marco De Marchis, Ruihao Wang, Henrik Gensicke, Svenja Stoll, Sebastian Thilemann, Nikolaos S. Avramiotis, Bruno Bonetti, Georgios Tsivgoulis, Gareth Ambler, Andrea Alberti, Sohei Yoshimura, Martin M. Brown, Masayuki Shiozawa, Gregory Y. H. Lip, Michele Venti, Monica Acciarresi, Kanta Tanaka, Maria Giulia Mosconi, Masahito Takagi, Rolf H. Jager, Keith Muir, Manabu Inoue, Stefan Schwab, Leo H. Bonati, Philippe A. Lyrer, Kazunori Toyoda, Valeria Caso, David J. Werring, Bernd Kallmuenzer, Stefan T. Engelter
Summary: This study investigated the safety and effectiveness of DOAC versus VKA in patients aged >= 85 years with atrial fibrillation after recent stroke. The results showed that there was no significant difference in the composite outcome risk between DOAC and VKA in the oldest old patients.
ANNALS OF NEUROLOGY
(2022)
Article
Multidisciplinary Sciences
Jakub Z. Qazi, Mireille E. Schnitzer, Robert Cote, Marie-Josee Martel, Marc Dorais, Sylvie Perreault
Summary: The study aimed to develop a predictive model for major bleeding in new users of oral anticoagulants with atrial fibrillation, finding similar predictors among different types of anticoagulant users. The final model accurately predicted the risk of bleeding, providing a useful tool for future pharmacoepidemiologic studies.
Review
Economics
Charles Okafor, Joshua Byrnes, Simon Stewart, Paul Scuffham, Clifford Afoakwah
Summary: This study aimed to evaluate the cost effectiveness of treatment strategies to manage atrial fibrillation (AF) in adults living in low-, middle-, and high-income countries. The findings showed that different strategies were cost-effective in different resource settings. In high-income countries, apixaban and left atrial appendage closure were effective for stroke prevention, while propranolol, catheter ablation, and the convergent procedure were options for rate or rhythm control. In middle-income countries, apixaban and high-dose edoxaban were effective for stroke prevention, and radiofrequency catheter ablation was an option for rhythm control.
Article
Clinical Neurology
Andrew Smyth, Martin O'Donnell, Sumathy Rangarajan, Graeme J. Hankey, Shahram Oveisgharan, Michelle Canavan, Clodagh McDermott, Denis Xavier, Hongye Zhang, Albertino Damasceno, Alvaro Avezum, Nana Pogosova, Aytekin Oguz, Danuta Ryglewicz, Helle Klingenberg Iversen, Fernando Lanas, Annika Rosengren, Salim Yusuf, Peter Langhorne
Summary: This study examined the association between alcohol consumption and stroke in a large international population. It found that high and moderate alcohol intake increased the odds of stroke, while low intake was not associated with stroke. However, there were regional variations in the relationship.
Article
Cardiac & Cardiovascular Systems
Josephine Harrington, Anthony P. Carnicelli, Kaiyuan Hua, Lars Wallentin, Manesh R. Patel, Stefan H. Hohnloser, Robert P. Giugliano, Keith A. A. Fox, Ziad Hijazi, Renato D. Lopes, Sean D. Pokorney, Hwanhee Hong, Christopher B. Granger
Summary: Through meta-analysis of multiple research databases, it was found that standard-dose DOACs are safer and more effective than warfarin in patients with kidney dysfunction. While lower-dose DOACs do not significantly lower the incidence of bleeding or intracranial hemorrhage compared to standard-dose DOACs, they are associated with a higher incidence of stroke and systemic embolism as well as death. Therefore, these findings support the use of standard-dose DOACs over warfarin in patients with kidney dysfunction.
Article
Endocrinology & Metabolism
Xiaoying Liu, Kaye E. Brock, Tara C. Brennan-Speranza, Leon Flicker, Jonathan Golledge, Graeme J. Hankey, Christian M. Girgis, Bu B. Yeap
Summary: Older people are more prone to vitamin D deficiency, and individual lifestyle factors have an impact on vitamin D levels. This study focused on older men and found that engaging in multiple healthy lifestyle behaviors, including physical activity, was associated with better vitamin D status. Further research is needed to determine the effects of promoting healthy lifestyle behaviors on vitamin D sufficiency.
CLINICAL ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Ross J. Marriott, Kevin Murray, Charley A. Budgeon, Veryan Codd, Jennie Hui, Gillian M. Arscott, John P. Beilby, Graeme J. Hankey, Gary A. Wittert, Frederick C. W. Wu, Bu B. Yeap
Summary: Lower testosterone concentrations in middle-aged and older men are associated with shorter telomeres, suggesting that testosterone may contribute to biological aging in men.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Yongjun Wang, Jiejie Li, S. Claiborne Johnston, Graeme J. Hankey, J. Donald Easton, Xia Meng, Fu-Dong Shi, Yilong Wang, Xingquan Zhao, Zixiao Li, Liping Liu, Hongqiu Gu, Yong Jiang, Anxin Wang, Yuesong Pan, Jing Jing, Siying Niu, Hao Li
Summary: The CHANCE-3 study is a randomized, double-blind, placebo-controlled multicenter trial that aims to investigate the efficacy of colchicine therapy in patients with acute minor-to-moderate ischemic stroke or transient ischemic attack. The study will randomly assign 8,238 patients with high-sensitivity CRP level of >= 2 mg/L to receive colchicine or placebo, in addition to optimal medical therapy. The primary outcome is the occurrence of any stroke within 3 months of randomization, with a goal of detecting a 25% reduction in the colchicine group.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Review
Medicine, General & Internal
Ross J. Marriott, Kevin Murray, Robert J. Adams, Leen Antonio, Christie M. Ballantyne, Douglas C. Bauer, Shalender Bhasin, Mary L. Biggs, Peggy M. Cawthon, David J. Couper, Adrian S. Dobs, Leon Flicker, David J. Handelsman, Graeme J. Hankey, Anke Hannemann, Robin Haring, Benjumin Hsu, Magnus Karlsson, Sean A. Martin, Alvin M. Matsumoto, Dan Mellstroem, Claes Ohlsson, Terence W. O'Neill, Eric S. Orwoll, Matteo Quartagno, Molly M. Shores, Antje Steveling, Asa Tivesten, Thomas G. Travison, Dirk Vanderschueren, Gary A. Wittert, Frederick C. W. Wu, Bu B. Yeap
Summary: The study found that various factors, including age, obesity, marital status, physical activity, smoking, hypertension, cardiovascular disease, cancer, and diabetes, are associated with variations in male testosterone, SHBG, and LH concentrations. Reduced testosterone and increased LH concentrations may indicate impaired testicular function in men older than 70 years.
ANNALS OF INTERNAL MEDICINE
(2023)
Article
Psychiatry
Osvaldo P. Almeida, Graeme J. Hankey, Bu B. Yeap, Jonathan Golledge, Christopher Etherton-Beer, Suzanne Robinson, Leon Flicker
Summary: This study examined the prevalence of common mental disorders among older Australian men and found that the rates of depressive and anxiety disorders increase with age, especially among the older old, which is different from the results of the NSMHW conducted in 2020-2021.
AUSTRALASIAN PSYCHIATRY
(2023)
Article
Clinical Neurology
Karly Zacharia, Emily Ramage, Margaret Galloway, Meredith Burke, Graeme J. Hankey, Elizabeth Lynch, Catherine M. Said, Coralie English, Amanda Patterson, Lesley Macdonald-Wicks
Summary: This study examined the dietary intake and quality of Australian stroke survivors. The findings indicate that the diet quality of stroke survivors is poor, with inadequate intake of nutrients important for reducing recurrent stroke risk. Further research is needed to develop effective interventions to improve diet quality.
CEREBROVASCULAR DISEASES
(2023)
Article
Clinical Neurology
Coralie English, Emily R. Ramage, John Attia, Julie Bernhardt, Billie Bonevski, Meredith Burke, Margaret Galloway, Graeme J. Hankey, Heidi Janssen, Richard Lindley, Elizabeth Lynch, Chris Oldmeadow, Catherine M. Said, Neil J. Spratt, Karly Zacharia, Lesley MacDonald-Wicks, Amanda Patterson
Summary: This study tested the feasibility and safety of a 6-month telehealth intervention to increase physical activity and improve diet quality. The results showed that the intervention was safe and feasible and may have led to significant behavior change.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Clinical Neurology
Valery L. Feigin, Rita Krishnamurthi, Oleg Medvedev, Alexander Merkin, Balakrishnan Nair, Michael Kravchenko, Shabnam Jalili-Moghaddam, Suzanne Barker-Collo, Yogini Ratnasabapathy, Luke Skinner, Mayowa Owolabi, Bo Norrving, Perminder S. Sachdev, Bruce Arroll, Michael Brainin, Amanda Thrift, Graeme J. Hankey
Summary: The PreventS-MD web app showed high usability, feasibility, and satisfaction among healthcare professionals (HCPs) and individuals at risk of stroke/CVD. Patients at risk of stroke/CVD also demonstrated strong confidence and motivation in following and adhering to the preventive recommendations generated by PreventS-MD.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Rehabilitation
J. Kim, G. Sookram, E. Godecke, E. Brogan, E. Armstrong, F. Ellery, T. Rai, M. L. Rose, N. Ciccone, S. Middleton, A. Holland, G. J. Hankey, J. Bernhardt, D. A. Cadilhac
Summary: This study aimed to estimate costs in patients with aphasia after stroke by comparing different therapies. The results showed that there were no significant differences in costs and outcomes among the different treatment options for patients with aphasia after stroke.
TOPICS IN STROKE REHABILITATION
(2023)
Review
Endocrinology & Metabolism
Yanning Xu, Arash Derakhshan, Ola Hysaj, Lea Wildisen, Till Ittermann, Alessandro Pingitore, Nazanin Abolhassani, Marco Medici, Lambertus A. L. M. Kiemeney, Niels P. Riksen, Robin P. F. Dullaart, Stella Trompet, Marcus Doerr, Suzanne J. Brown, Boerge Schmidt, Dagmar Fuehrer-Sakel, Mark P. J. Vanderpump, Axel Muendlein, Heinz Drexel, Howard A. Fink, M. Kamran Ikram, Maryam Kavousi, Connie M. Rhee, Isabela M. Bensenor, Fereidoun Azizi, Graeme J. Hankey, Massimo Iacoviello, Misa Imaizumi, Graziano Ceresini, Luigi Ferrucci, Jose A. Sgarbi, Douglas C. Bauer, Nick Wareham, Kristien Boelaert, Stephan J. L. Bakker, J. Wouter Jukema, Bert Vaes, Giorgio Iervasi, Bu B. Yeap, Rudi G. J. Westendorp, Tim I. M. Korevaar, Henry Voelzke, Salman Razvi, Jacobijn Gussekloo, John P. Walsh, Anne R. Cappola, Nicolas Rodondi, Robin P. Peeters, Layal Chaker
Summary: This study aimed to define the optimal healthy ranges of TSH and FT4 based on the risk of cardiovascular disease and mortality. The study found that the 20-40th percentiles of FT4 and the 60-80th percentiles of TSH could represent the optimal healthy ranges of thyroid function.
LANCET DIABETES & ENDOCRINOLOGY
(2023)
Article
Environmental Sciences
Joshua S. Jones, Lee Nedkoff, Jane S. Heyworth, Osvaldo P. Almeida, Leon Flicker, Jonathan Golledge, Graeme J. Hankey, Elizabeth H. Lim, Mark Nieuwenhuijsen, Bu B. Yeap, Michelle L. Trevenen
Summary: This study aimed to determine the dose-response relationship between long-term exposure to low-concentration PM2.5 air pollution and incident ischemic heart disease (IHD), heart failure (HF), and atrial fibrillation (AF) in older men. The results showed a trend of increased incidence of IHD, HF, and AF, but none were statistically significant under low-concentration PM2.5 air pollution exposure.
ENVIRONMENTAL EPIDEMIOLOGY
(2023)
Review
Medicine, General & Internal
A. Cochrane, C. Chen, J. Stephen, O. M. Ronning, C. S. Anderson, G. J. Hankey, Al-Shahi R. Salman
Summary: This study aimed to determine the overall effectiveness and safety of antithrombotic drugs in reducing major adverse cardiovascular events (MACE) for stroke survivors with intracerebral hemorrhage (ICH). The results showed that long-term therapeutic dose oral anticoagulation may reduce MACE and major occlusive vascular events, while short-term prophylactic dose anticoagulation and long-term antiplatelet therapy did not show significant effects. However, the certainty of the evidence was moderate, and further large-scale randomized controlled trials are needed to address the ongoing dilemmas of antithrombotic treatment after ICH.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2023)
Review
Clinical Neurology
Arosha S. Dissanayake, Kwok M. Ho, Timothy J. Phillips, Stephen Honeybul, Graeme J. Hankey
Summary: This study systematically reviews models that aim to provide patient-specific predictions of pre-treatment rebleeding risk in patients with aneurysmal subarachnoid hemorrhage. The reported discriminative performance of the models varied, and no model showed consistently low bias risk and clinical applicability in all domains. Only one model was formulated using a patient cohort that underwent contemporary, evidence-based aneurysm treatment practices, but this model lacked calibration or clinical utility.
JOURNAL OF CLINICAL NEUROSCIENCE
(2024)
