Initiation of Oral Anticoagulation after Acute Ischaemic Stroke or Transient Ischaemic Attack: Timing and Complications of Overlapping Heparin or Conventional Treatment

2008 ◽  
Vol 26 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Heinrich J. Audebert ◽  
Berit Schenk ◽  
Viola Tietz ◽  
Johannes Schenkel ◽  
Peter U. Heuschmann
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Oral Anticoagulation ◽  
Transient Ischaemic Attack ◽  
Conventional Treatment ◽  
Ischaemic Attack

scholarly journals Secondary prevention medication persistence and prognosis of acute ischaemic stroke or transient ischaemic attack

2021 ◽  
pp. svn-2020-000471
Author(s):  
Lei Zhang ◽  
Junfeng Shi ◽  
Yuesong Pan ◽  
Zixiao Li ◽  
Hongyi Yan ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Transient Ischaemic Attack ◽  
Recurrent Stroke ◽  
Medication Persistence ◽  
Level Ii ◽  
Composite Events ◽  
Ischaemic Attack ◽  
Level I

IntroductionThe risk of disability and mortality is high among recurrent stroke, which highlights the importance of secondary prevention measures. We aim to evaluate medication persistence for secondary prevention and the prognosis of acute ischaemic stroke or transient ischaemic attack (TIA) in China.MethodsPatients with acute ischaemic stroke or TIA from the China National Stroke Registry II were divided into 3 groups based on the percentage of persistence in secondary prevention medication classes from discharge to 3 months after onset (level I: persistence=0%, level II: 0%<persistence<100%, level III: persistence=100%). The primary outcome was recurrent stroke. The secondary outcomes included composite events (stroke, myocardial infarction or death from cardiovascular cause), all-cause death and disability (modified Rankin Scale score=3–5) from 3 months to 1 year after onset. Recurrent stroke, composite events and all-cause death were performed using Cox regression model, and disability was identified through logistic regression model using the generalised estimating equation method.Results18 344 patients with acute ischaemic stroke or TIA were included, 315 (1.7%) of whom experienced recurrent strokes. Compared with level I, the adjusted HR of recurrent stroke for level II was 0.41 (95% CI 0.31 to 0.54) and level III 0.37 (0.28 to 0.48); composite events for level II 0.41 (0.32 to 0.53) and level III 0.38 (0.30 to 0.49); all-cause death for level II 0.28 (0.23 to 0.35) and level III 0.20 (0.16–0.24). Compared with level I, the adjusted OR of disability for level II was 0.89 (0.77 to 1.03) and level III 0.82 (0.72 to 0.93).ConclusionsPersistence in secondary prevention medications, especially in all classes of medications prescribed by the physician, was associated with lower hazard of recurrent stroke, composite events, all-cause death and lower odds of disability in patients with acute ischaemic stroke or TIA.

scholarly journals Whole genome sequencing of 10K patients with acute ischaemic stroke or transient ischaemic attack: design, methods and baseline patient characteristics

2020 ◽  
pp. svn-2020-000664
Author(s):  
Si Cheng ◽  
Zhe Xu ◽  
Yang Liu ◽  
Jinxi Lin ◽  
Yong Jiang ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Acute Ischaemic Stroke ◽  
Transient Ischaemic Attack ◽  
Clinical Characteristics ◽  
Molecular Mechanisms ◽  
Whole Genome ◽  
Sequencing Data ◽  
Ischaemic Attack

Background and purposeStroke is the second leading cause of death worldwide and the leading cause of mortality and long-term disability in China, but its underlying risk genes and pathways are far from being comprehensively understood. We here describe the design and methods of whole genome sequencing (WGS) for 10 914 patients with acute ischaemic stroke or transient ischaemic attack from the Third China National Stroke Registry (CNSR-III).MethodsBaseline clinical characteristics of the included patients in this study were reported. DNA was extracted from white blood cells of participants. Libraries are constructed using qualified DNA, and WGS is conducted on BGISEQ-500 platform. The average depth is intended to be greater than 30× for each subject. Afterwards, Sentieon software is applied to process the sequencing data under the Genome Analysis Toolkit best practice guidance to call genotypes of single nucleotide variants (SNVs) and insertion-deletions. For each included subject, 21 fingerprint SNVs are genotyped by MassARRAY assays to verify that DNA sample and sequencing data originate from the same individual. The copy number variations and structural variations are also called for each patient. All of the genetic variants are annotated and predicted by bioinformatics software or by reviewing public databases.ResultsThe average age of the included 10 914 patients was 62.2±11.3 years, and 31.4% patients were women. Most of the baseline clinical characteristics of the 10 914 and the excluded patients were balanced.ConclusionsThe WGS data together with abundant clinical and imaging data of CNSR-III could provide opportunity to elucidate the molecular mechanisms and discover novel therapeutic targets for stroke.

Oral anticoagulation in patients with atrial fibrillation and acute ischaemic stroke: design and baseline data of the prospective multicentre Berlin Atrial Fibrillation Registry

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1621-1632 ◽  
Author(s):  
Karl Georg Haeusler ◽  
Serdar Tütüncü ◽  
Claudia Kunze ◽  
Johannes Schurig ◽  
Carolin Malsch ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Hospital Discharge ◽  
Vitamin K ◽  
Acute Ischaemic Stroke ◽  
Oral Anticoagulation ◽  
Endovascular Thrombectomy ◽  
Stroke Units ◽  
Ischaemic Attack

Abstract Aims The Berlin Atrial Fibrillation Registry was designed to analyse oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) and acute ischaemic stroke. Methods and results This investigator-initiated prospective multicentre registry enrolled patients at all 16 stroke units located in Berlin, Germany. The ongoing telephone follow-up is conducted centrally and will cover 5 years per patient. Within 2014 and 2016, 1080 patients gave written informed consent and 1048 patients were available for analysis. Median age was 77 years [interquartile range (IQR) 72–83], 503 (48%) patients were female, and 254 (24%) had a transient ischaemic attack (TIA). Overall, 470 (62%) out of 757 patients with known AF and a (pre-stroke) CHA2DS2-VASc ≥ 1 were anticoagulated at the time of stroke. At hospital discharge, 847 (81.3%) of 1042 patients were anticoagulated. Thereof 710 (68.1%) received a non-vitamin K-dependent oral anticoagulant (NOAC) and 137 (13.1%) a vitamin K antagonist (VKA). Pre-stroke intake of a NOAC [odds ratio (OR) 15.6 (95% confidence interval, 95% CI 1.97–122)] or VKA [OR 0.04 (95% CI 0.02–0.09)], an index TIA [OR 0.56 (95% CI 0.34–0.94)] rather than stroke, heart failure [OR 0.49 (95% CI 0.26–0.93)], and endovascular thrombectomy at hospital admission [OR 12.9 (95% CI 1.59–104)] were associated with NOAC prescription at discharge. Patients’ age or AF type had no impact on OAC or NOAC use, respectively. Conclusion About 60% of all registry patients with known AF received OAC at the time of stroke or TIA. At hospital discharge, more than 80% of AF patients were anticoagulated and about 80% of those were prescribed a NOAC.

scholarly journals Impairment of cognition and sleep after acute ischaemic stroke or transient ischaemic attack in Chinese patients: design, rationale and baseline patient characteristics of a nationwide multicentre prospective registry

2020 ◽  
pp. svn-2020-000359
Author(s):  
Yongjun Wang ◽  
Xiaoling Liao ◽  
Chunxue Wang ◽  
Ning Zhang ◽  
Lijun Zuo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Ischaemic Stroke ◽  
Sleep Disorder ◽  
Acute Ischaemic Stroke ◽  
Transient Ischaemic Attack ◽  
Associated Factors ◽  
Large Scale ◽  
Chinese Patients ◽  
Imaging Data ◽  
Ischaemic Attack

Background and aimCognitive impairment and sleep disorder are both common poststroke conditions and are closely related to the prognosis of patients who had a stroke. The Impairment of CognitiON and Sleep after acute ischemic stroke or transient ischemic attack in Chinese patients (ICONS) study is a nationwide multicentre prospective registry to investigate the occurrence and associated factors of cognitive impairment and sleep disorder after acute ischaemic stroke (AIS) or transient ischaemic attack (TIA).MethodsConsecutive AIS or TIA in-hospital patients within 7 days after onset were enrolled from 40 participating sites in China. Comprehensive baseline clinical and imaging data were collected prospectively. Blood and urine samples were also collected on admission and follow-up visits. Patients were interviewed face to face for cognition and sleep related outcomes at 2 weeks, 3, 6 and 12 months after AIS/TIA and followed up for clinical outcomes by telephone annually over 5 years.ResultsBetween August 2015 and January 2018, a total of 2625 patients were enrolled. 92.65% patients had AIS and 7.35% patients had TIA. Overall, the average age was 61.04 years, and 72.38% patients were male. Median National Institutes of Health Stroke Scale score was 3 in AIS patients.ConclusionsThe ICONS study is a large-scale nationwide prospective registry to investigate occurrence and the longitudinal changes of cognitive impairment and sleep disorder after AIS or TIA. Data from this registry may also provide opportunity to evaluate associated factors of cognitive impairment or sleep disorder after AIS or TIA and their impact on clinical outcome.

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