Robert G Hart

..Until recently, the value of antithrombotic therapies for acute stroke management has been based on empiric evidence...

..These trials, together involving 39,742 participants, have influenced 2008 European and North American guidelines for secondary prevention of noncardioembolic stroke, and these guideline recommendations are reviewed...

..Future trials should include participants with wider ranges of disease stages and assess broader neurological outcomes...

..Aspirin offers modest reduction in stroke in patients with atrial fibrillation. Whether combination of aspirin with clopidogrel offers additional protection is unclear...

..To compare methods and key management recommendations from recent stroke prevention guidelines...

..A wide range of acute treatments to urgently reverse anticoagulation have been recommended by experts, but prevention is a far better option than treatment of this devastating problem...

..Atrial fibrillation is a strong independent risk factor for stroke...

..We review the incidence, risk factors, and predictors of ICH in patients receiving long-term anticoagulation or antiplatelet therapy...

..For patients at moderate risk for stroke, patient preferences and access to reliable anticoagulation monitoring are particularly relevant...

..These recent studies add important pieces to the complex puzzle of optimal stroke prevention and treatment...

..For younger patients, periprocedural risks were comparable with stenting or endarterectomy, but long-term outcomes are required to assess the relative merits of the two procedures...

..We explore factors associated with ischemic stroke in AF patients taking aspirin...

..Transient ischemic attacks (TIAs) are infrequent in patients with atrial fibrillation, and little is known about the long-term prognosis and response to antithrombotic therapy...

..Oral anticoagulation with vitamin K antagonists increases the risk of intracranial hemorrhage; whether addition of aspirin to oral anticoagulation augments this risk is unclear...

..Making the most of this promise calls for appreciation of the epidemiology of atrial fibrillation and the concept of risk specificity in the face of diverse therapeutic options...

..This study was performed to characterize the risk of stroke in elderly patients with recurrent intermittent atrial fibrillation (AF)...

..Aspirin therapy reduces stroke by about 25% for persons with atherosclerotic vascular disease, but the effect in those without clinically apparent vascular disease is distinctly different...

..For those with moderate stroke risk, individual bleeding risks during anticoagulation and patient preferences should guide antithrombotic therapy...

..The efficacy of adjusted-dose warfarin for prevention of stroke in atrial fibrillation patients with stage 3 chronic kidney disease (CKD) is unknown...

..The practical management implications of these studies refine and improve care of geriatric patients with cerebrovascular disease...

..We assessed the effect of the addition of clopidogrel to aspirin on mortality in a meta-analysis of published randomized trials...

..Reasonable management based on expert opinion includes a wide range of additional measures to reverse anticoagulation in the absence of solid evidence...

..The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Study was a multicenter comparison of high-risk patients with AF who were randomized to either a sinus rhythm control or a rate control strategy...

..4 ng/mmol creatinine. CONCLUSION: Different aspirin dosages significantly affect serum and urinary markers of thromboxane synthesis...

..Reliable and unbiased blood pressure measurement is critical to successful completion of the trial...

..722). These results suggest appliance and self-management therapies can be beneficial for many severe headache patients, irrespective of the headache type (tension-type, migraine without aura, and migraine with aura)...

..To characterize the rates of recurrent intracranial hemorrhage (ICH), ischemic stroke, and death in survivors of primary ICH...

..To analyze the frequency, clinical characteristics, and predictors of symptomatic intracerebral hemorrhage (ICH) after intraarterial (IA) thrombolysis with recombinant pro-urokinase (r-proUK) in acute ischemic stroke...

..This study explored the mechanisms linking clinical and precordial echocardiographic predictors to thromboembolism in atrial fibrillation (AF) by assessing transesophageal echocardiographic (TEE) correlations...

....

..The objective of this study was for stroke experts to define the range of management concerning thrombolytic treatment of acute stroke in hemodialysis...

..Management varies widely, and most published guidelines have not been updated in several years. We sought to create comprehensive, unbiased, evidence-based guidelines for the management of patients with transient ischemic attacks...

..7% per year (95% CI 0.6, 3.8). Many people with AF in this population-derived cohort had relatively low rates of stroke. Further studies to reliably stratify stroke risk in patients with AF are needed...

..Their role as independent risk factors for stroke and management implications based on recent evidence, along with characterization of schemes for antithrombotic management of patients with atrial fibrillation are reviewed...

..The arterial lesions stabilized, and the patient remained asymptomatic. CONCLUSION: Progressive intracranial arterial stenosis can evolve months after meningitis and should be added to the list of recognized vascular complications...

..Since high-risk AF patients appear to benefit most from OAC, determining stroke risk in AF patients is very important...

..Further longitudinal studies are now needed to confirm relationships between endothelial damage/dysfunction, platelet activation, and stroke in AF...

..However, because OAC carries important bleeding complications, risk stratification schemes have been devised to identify patients for whom the absolute benefits of OAC exceed its risks...

....

..Patients with nonvalvular atrial fibrillation (AF) have an increased risk of stroke and other vascular events...

....

....

..4). CONCLUSIONS: For most patients with atrial fibrillation, routine blood pressure-lowering is likely to provide protection against major vascular events additional to that conferred by anticoagulation...

..To study how stroke and mortality rates vary with different degrees of anticoagulation reflected by the international normalised ratio (INR) we critically assess information from different sources...

..This prospective cohort study tested the predictive accuracy of 5 stroke risk stratification schemes...

..This study was an analysis of factors associated with stroke in a population of patients paced for sinus node dysfunction in a large prospective clinical trial (Mode Selection Trial [MOST])...

..This study determined the additive role of plasma vWf levels to clinical factors for risk stratification in patients with AF...

..We review National Institute of Neurologic Disorders and Stroke principles of data and safety monitoring and provide examples to illustrate key concepts...

..The scientific or logistic barriers to stroke primary prevention trials are challenging, but are not insurmountable...

..CONCLUSIONS: Extensive evidence is available identifying a variety of specific factors that increase the risk of a first stroke and providing strategies for reducing that risk...

..CONCLUSIONS: Extensive evidence is available identifying a variety of specific factors that increase the risk of a first stroke and providing strategies for reducing that risk...

..Additional research to identify an optimum scheme for primary prevention and subsequent standardization of recommendations may lead to more uniform selection of patients for anticoagulant prophylaxsis...