scholarly journals Correction:Impact of a single non-sex-related stroke risk factor on atrial fibrillation and oral anticoagulant outcomes: a systematic review and meta-analysis

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 1.5-1
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Risk Factor ◽  
Oral Anticoagulant ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Stroke Risk Factor

scholarly journals Impact of a single non-sex-related stroke risk factor on atrial fibrillation and oral anticoagulant outcomes: a systematic review and meta-analysis

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001465
Author(s):  
Maxim Grymonprez ◽  
Stephane Steurbaut ◽  
An De Sutter ◽  
Lies Lahousse
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Risk Factor ◽  
Vitamin K ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Stroke Risk Factor ◽  
Thromboembolic Risk

AimsOral anticoagulants (OACs) are crucial for treating atrial fibrillation (AF) patients at high thromboembolic risk. However, in AF patients at intermediate thromboembolic risk with a single non-sex-related stroke risk factor (CHA2DS2-VASc score 1 in men, 2 in women), guidelines advise to consider starting anticoagulation, which may result in OAC non-initiation due to underestimation of the thromboembolic risk of a single stroke risk factor and overestimation of the OAC-related bleeding risk. A critical appraisal of the role of OACs and the benefit–risk profile of non-vitamin K antagonist oral anticoagulants (NOACs) compared with vitamin K antagonists (VKAs) in this patient subgroup are needed.Methods and resultsThis systematic review provides an overview of literature on the effectiveness and safety of OACs in AF patients with a single non-sex-related stroke risk factor after searching Medline and Embase. Differences between individual stroke risk factors regarding the ischaemic stroke risk in non-anticoagulated AF patients are identified in a meta-analysis, demonstrating the highest increased risk in patients aged 65–74 years old or with diabetes mellitus, followed by heart failure, hypertension and vascular disease. Furthermore, meta-analysis results favour NOACs over VKAs, given their equal effectiveness and superior safety in AF patients at intermediate thromboembolic risk (HR 0.93, 95% CI 0.65 to 1.34 for stroke or systemic embolism; HR 0.60, 95% CI 0.45 to 0.80 for major bleeding; HR 0.48, 95% CI 0.14 to 1.59 for intracranial bleeding; HR 0.58, 95% CI 0.47 to 0.71 for mortality).ConclusionOur systematic review with meta-analysis favours the use of anticoagulation in AF patients with a single non-sex-related stroke risk factor, especially when age ≥65 years or diabetes mellitus is present, with a preference for NOACs over VKAs.

scholarly journals Mobile health as a viable strategy to enhance stroke risk factor control: A systematic review and meta-analysis

2017 ◽  
Vol 378 ◽  
pp. 140-145 ◽  
Author(s):  
Shimeng Liu ◽  
Wuwei Feng ◽  
Pratik Y. Chhatbar ◽  
Yumei Liu ◽  
Xunming Ji ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Mobile Health ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Risk Factor Control ◽  
Stroke Risk Factor

scholarly journals Restarting oral anticoagulant therapy after major bleeding in atrial fibrillation: A systematic review and meta-analysis

2018 ◽  
Vol 261 ◽  
pp. 84-91 ◽  
Author(s):  
Marco Proietti ◽  
Giulio Francesco Romiti ◽  
Imma Romanazzi ◽  
Alessio Farcomeni ◽  
Laila Staerk ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Meta Analysis

scholarly journals Subclinical device-detected atrial fibrillation and stroke risk: a systematic review and meta-analysis

2018 ◽  
Vol 39 (16) ◽  
pp. 1407-1415 ◽  
Author(s):  
Rajiv Mahajan ◽  
Tharani Perera ◽  
Adrian D Elliott ◽  
Darragh J Twomey ◽  
Sharath Kumar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis

scholarly journals Atrial Fibrillation Following Patent Foramen Ovale Closure

Stroke ◽  
2021 ◽  
Vol 52 (5) ◽  
pp. 1653-1661
Author(s):  
Jessie Ze-Jun Chen ◽  
Vincent N. Thijs
Keyword(s):  
Atrial Fibrillation ◽  
Patent Foramen Ovale ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Percutaneous Closure ◽  
Foramen Ovale ◽  
Stroke Risk Factor ◽  
Increased Risk ◽  
Pfo Closure

Background and Purpose: Multiple studies evaluated whether patent foramen ovale (PFO) closure reduces the risk of ischemic stroke. One commonly reported complication of PFO closure is the development of atrial fibrillation (AF), which is itself a powerful stroke risk factor that requires specific management. This study aims to evaluate the frequency of AF in patients post-percutaneous closure of PFO and the clinical factors that predict AF detection. Methods: Studies were identified by systematically searching EMBASE and MEDLINE databases on July 11, 2019. Meta-analysis of proportions was performed, assuming a random-effects model. Results: A total of 6 randomized controlled trials and 26 observational studies were included, comprising 3737 and 9126 patients, respectively. After PFO closure, the rate of AF development was 3.7 patients per 100 patient-years of follow-up (95% CI, 2.6–4.9). The risk of AF development is concentrated in the first 45 days post-procedure (27.2 patients per 100 patient-years [95% CI, 20.1–34.81], compared with 1.3 patients per 100 patient-years [95% CI, 0.3–2.7]) after 45 days. Meta-regression by age suggested that studies with older patients reported higher rate of AF ( P =0.001). In medically treated patients, the rate of AF development was 0.1 per 100 patient-years of follow-up (95% CI, 0.0–0.4). Closure of PFO is associated with increased risk of AF compared with medical management (odds ratio, 5.3 [95% CI, 2.5–11.41]; P <0.001). Conclusions: AF is more common in PFO patients who had percutaneous closure compared with those who were medically treated. The risk of AF was higher in the first 45 days post-closure and in studies that included patients with increased age.

Female sex as a risk factor for ischaemic stroke varies with age in patients with atrial fibrillation

Heart ◽  
2019 ◽  
Vol 106 (7) ◽  
pp. 534-540 ◽  
Author(s):  
Victor Chien-Chia Wu ◽  
Michael Wu ◽  
Victor Aboyans ◽  
Shang-Hung Chang ◽  
Shao-Wei Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Heart Disease ◽  
Ischaemic Stroke ◽  
Stroke Risk ◽  
Research Database ◽  
Stroke Risk Factor ◽  
Female Sex ◽  
Included Patient ◽  
History Of

ObjectivesFemale sex is an inconsistent ischaemic stroke risk factor in patients with atrial fibrillation (AF). We hypothesised that the ischaemic stroke risk varies with age among women compared with men.MethodsWe retrieved the patients with newly diagnosed AF during 2001–2013 from Taiwan’s National Health Insurance Research Database. Patients with missing information, age <20 years, history of valvular heart disease and surgery, rheumatic heart disease, hyperthyroidism or anticoagulation and/or antiplatelet use were excluded. Propensity score matching (PSM) included patient comorbidities, medications and index date stratified by age and sex groups. Primary outcome was defined as ischaemic stroke at follow-up.ResultsAfter exclusion criteria, 87 369 men and 71 853 women remained for analysis (aged 73.1±14.4 years). After 1:1 PSM, we included 59 583 men (aged 73.5±13.7 years) and 59 583 women (aged 73.4±13.8 years) for analysis. We also stratified patients by age. The ischaemic stroke risk varied with age in women compared with men: lower in the ≤55 years (subdistribution HR (SHR)=0.75, 95% CI 0.62 to 0.90) and 56–65 years (SHR=0.87, 95% CI 0.78 to 0.98) groups, neutral in the 66–75 years group (SHR=1.01, 95% CI 0.94 to 1.08) and adverse in the >75 years group (SHR=1.14, 95% CI 1.09 to 1.19).ConclusionsThe female/male ischaemic stroke risk ratio varied with age. Only women aged >75 years had a higher risk, whereas women aged <65 years had a lower risk compared with men. These findings challenge the ‘sex category’ component of the CHA2DS2-VASc score, used to make decision regarding anticoagulation treatment in AF patients.

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