Articles Tagged With: stroke

• Surprising Data on Patient Preference for Informed Consent in Acute Stroke

  When there is a decision to be made regarding whether to treat a stroke patient with tPA, time is limited. Yet, there is no standard approach for informed consent for these high-pressure cases.

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• CABG vs. PCI for Left Main Disease at 5 Years

  Five years after randomizing 1,905 patients with left main disease to coronary artery bypass grafting or percutaneous coronary intervention, researchers found no significant difference in the primary composite outcome of death, stroke, or myocardial infarction.

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• Survey Reveals Gaps in Blood Pressure Measurement Training

  Professional associations develop e-learning tool to help refresh these skills.

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• Vegetarians and Stroke

  A prospective cohort study in the United Kingdom demonstrated that vegetarians have a 22% lower incidence of ischemic heart disease, but a 20% increased incidence of total stroke, mostly related to hemorrhagic stroke, when compared to meat eaters. No difference in ischemic stroke or acute myocardial infarction was found.

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• Dual Antiplatelet Therapy Results in Increase in Serious Hemorrhages Following TIA or Minor Stroke

  The POINT trial showed a 25% reduction in the composite outcome of ischemic stroke, myocardial infarction, or ischemic vascular death in patients treated with clopidogrel plus aspirin for 90 days, immediately following a transient ischemic attack (TIA) or minor acute ischemic stroke. The investigators performed a secondary analysis and found the risk of major hemorrhages was low in both groups, although treatment with clopidogrel and aspirin together increased the risk of major hemorrhages over aspirin alone. Caution should be taken and very close observation of patients maintained when treating with dual antiplatelet therapies.

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• Smartwatches for the Diagnosis of Atrial Fibrillation

  The Apple Heart Study participants were people without atrial fibrillation who purchased a smart phone app and consented to monitoring using a smartwatch-based irregular pulse notification algorithm, which identified possible atrial fibrillation. If notification occurred, the person was mailed an electrocardiography (ECG) patch to be worn for seven days to confirm the findings first identified by the smartwatch. The age distribution of this group is different than the usual cohort at risk for atrial fibrillation: 52% were between the ages of 22 and 39 years of age, and only 5.9% were 65 years or older. A much more useful study would have included an older cohort that carries a higher risk of atrial fibrillation.

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• What Is the Optimal Blood Pressure for Secondary Prevention of Stroke?

  High blood pressure is the most prevalent and important risk factor for stroke, and great efforts have been made to reduce blood pressure for both primary and secondary stroke prevention. However, at this time, we do not have evidence to support a firm recommendation for optimal blood pressure management for secondary stroke prevention.

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• Patients With Stable Coronary Disease and Atrial Fibrillation Are Best Treated With Rivaroxaban, Alone

  Optimal antithrombotic therapy for stroke prevention in patients with atrial fibrillation continues to evolve.Monotherapy with rivaroxiban was noninferior to combination therapy for the primary efficacy endpoint.

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• Blood Pressure and Brain Lesions: Is There a Connection?

  Reducing blood pressure in elderly patients could lower risk for development of lesions.

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• Intravenous Thrombolysis Prior to Mechanical Thrombectomy Improves Outcome

  Bridging therapy with intravenous thrombolysis appears to be associated with improved functional outcome without any additional complications compared to direct mechanical thrombectomy for patients with acute ischemic stroke who have LVOs.

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