scholarly journals A Comparative Study of Frequency of Atrial Fibrillation (AF) in Patients Diagnosed With Ischemic Stroke

2021 ◽  
Vol 15 (5) ◽  
pp. 920-923
Author(s):  
Muzammil Khalid ◽  
M. Asif Naseer
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Informed Consent ◽  
Clinical Investigation ◽  
Operational Definition ◽  
Cross Sectional ◽  
Stroke Risk Factors ◽  
Stroke Study ◽  
The Mean ◽  
Obesity Hypertension

Aim: To find frequency of atrial fibrillation (AF) in patients diagnosed with ischemic stroke. Study design: A Cross sectional descriptive study. Place and duration of study: Department of Medicine, PAF Hospital Mushaf, Sargodha from July 4, 2019 to Jan 4, 2020. Methods: In this study a total of 260 patients were taken after taking informed consent meeting inclusion criteria from Department of Medicine, PAF Hospital Mushaf, Sargodha. The informed consent was taken from patients or attendants. Basic information like, age, gender and contact details were taken of all selected subjects. After basic clinical investigation, ECG was done for all patients with 24 hours of Ischemic stroke who presented to the selected setting. Atrial fibrillation was as per operational definition. On pre designed proforma, data was collected from all patients. Results: The mean age of patients was 57.34±12.82 years with minimum and maximum age as 20 and 80 years. There were 150(57.7%) males. According to operational definition 91 (35%) cases had atrial fibrillation while other 169(65%) cases did not have atrial fibrillation. The frequency of atrial fibrillation was statistically same when stratified for age), gender, smoking, obesity, hypertension, diabetes mellitus. Conclusion: The frequency of atrial fibrillation was seen in 35% of the cases having ischemic stroke. Hence if atrial fibrillation is diagnosed early then ischemic stroke can be prevented. Keywords: Stroke, risk factors, complications, echocardiography, atrial fibrillation.

scholarly journals Comparison of Left Atrial Appendage Occlusion versus Non-Vitamin-K Antagonist Oral Anticoagulation in High-Risk Atrial Fibrillation: An Update

2021 ◽  
Vol 8 (6) ◽  
pp. 69
Author(s):  
Shaojie Chen ◽  
K. R. Julian Chun ◽  
Zhiyu Ling ◽  
Shaowen Liu ◽  
Lin Zhu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
High Risk ◽  
Vitamin K ◽  
Major Bleeding ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Vitamin K Antagonists ◽  
Left Atrial Appendage Occlusion ◽  
The Mean

Transcatheter left atrial appendage occlusion (LAAO) is non-inferior to vitamin K antagonists (VKAs) in preventing thromboembolic events in atrial fibrillation (AF). Non-vitamin K antagonists (NOACs) have an improved safety profile over VKAs; however, evidence regarding their effect on cardiovascular and neurological outcomes relative to LAAO is limited. Up-to-date randomized trials or propensity-score-matched data comparing LAAO vs. NOACs in high-risk patients with AF were pooled in our study. A total of 2849 AF patients (LAAO: 1368, NOACs: 1481, mean age: 75 ± 7.5 yrs, 63.5% male) were enrolled. The mean CHA2DS2-VASc score was 4.3 ± 1.7, and the mean HAS-BLED score was 3.4 ± 1.2. The baseline characteristics were comparable between the two groups. In the LAAO group, the success rate of device implantation was 98.8%. During a mean follow-up of 2 years, as compared with NOACs, LAAO was associated with a significant reduction of ISTH major bleeding (p = 0.0002). There were no significant differences in terms of ischemic stroke (p = 0.61), ischemic stroke/thromboembolism (p = 0.63), ISTH major and clinically relevant minor bleeding (p = 0.73), cardiovascular death (p = 0.63), and all-cause mortality (p = 0.71). There was a trend toward reduction of combined major cardiovascular and neurological endpoints in the LAAO group (OR: 0.84, 95% CI: 0.64–1.11, p = 0.12). In conclusion, for high-risk AF patients, LAAO is associated with a significant reduction of ISTH major bleeding without increased ischemic events, as compared to “contemporary NOACs”. The present data show the superior role of LAAO over NOACs among high-risk AF patients in terms of reduction of major bleeding; however, more randomized controlled trials are warranted.

Abstract WP226: Short Lasting Runs (<30 sec) of Atrial Fibrillation are More Commonly Observed in Ischemic Stroke Patients in Comparison to Controls

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Ethem Murat Arsava ◽  
Ezgi Yetim ◽  
Ugur Canpolat ◽  
Necla Ozer ◽  
Kudret Aytemir ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Multivariate Analyses ◽  
Holter Monitoring ◽  
Female Gender ◽  
Prior History ◽  
Consecutive Series ◽  
Stroke Patients ◽  
Cross Sectional ◽  
History Of

Background: The role of short-lasting (<30 sec) runs of atrial fibrillation (AF) in ischemic stroke pathophysiology is currently unknown. Although these non-sustained attacks are considered as a risk factor for future development of longer lasting, classical AF episodes, prior research has highlighted that associated clinical stroke features are not entirely similar between these two types of arrhythmias. In this study we determined the prevalence of short-lasting AF in stroke-free controls and compared it to a consecutive series of ischemic stroke patients. Methods: A total 235 controls, without any prior history stroke or AF, were evaluated with ECG and 24-hour Holter monitoring for the presence of <30-sec or ≥30-sec lasting AF episodes. The results were compared to a consecutive series of ischemic stroke patients without prior history of AF (n=456). Univariate and multivariate analyses were performed to determine demographic and cardiovascular factors related to <30-sec lasting AF and its association with ischemic stroke. Results: Expectedly, the frequency of newly diagnosed ≥30-sec lasting AF, detected either on ECG or Holter monitoring, was significantly higher in patients with ischemic stroke (18% vs. 2%; p<0.01). Non-sustained AF was positively related to old age (p<0.01), female gender (p=0.01) and hypertension (p<0.01) in univariate analyses. In multivariate analyses, after adjustment for demographic and cardiovascular risk factors, presence of non-sustained AF was significantly higher among both cryptogenic (OR 1.78; 95% CI 1.02-3.10) and non-cryptogenic (OR 1.84; 95% CI 1.15-2.94) stroke patients with respect to controls. Conclusion: Our study shows a higher prevalence of non-sustained AF episodes in ischemic stroke patients in comparison to controls. Whether this cross-sectional association translates into causality in terms of stroke pathophysiology will be the subject of future studies.

scholarly journals Oral contraceptive among risk factors for women with ischemic stroke

2021 ◽  
Vol 12 (1) ◽  
pp. 548
Author(s):  
Carla S. PALUDO ◽  
Amanda SACHETTI ◽  
Maiara S. PAIXÃO
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Oral Contraceptive ◽  
Oral Contraceptives ◽  
Contraceptive Use ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Northern Region ◽  
Cross Sectional ◽  
The Mean

Objective: To evaluate the frequency of use of oral contraceptives and other risk factors among women with ischemic stroke seen at a hospital in the northern region of the state of Rio Grande do Sul. Methods: Prospective, cross-sectional study. The population was characterized by patients admitted with a diagnosis of ischemic stroke during a period from March to August 2019 and the sample by female patients found in the population. The data were collected through an individual interview using a questionnaire developed by the researchers and tabulated for further analysis. All analyzes were performed using the statistical program Bioestat 5.0, considering p = 0.05. Results: In the characterization of the sample, an average age of 68.2 years was observed. The occurrence of gender was 52.4% for women. The mean hospital stay was 12.2 ± 8.91 days. Outcome of hospital discharge was 89.1%. The mean value of body mass index was 25 ± 4.89 kg / m², with an average of 27.4 kg / m² in patients who used oral contraceptives and 25.23 kg / m² in patients who did not use oral contraceptives. The sample had a 34.5%incidence of oral contraceptive use. The average age of those who used oral contraceptives was 62.4 years and of the patients who did not use it was 70.3 years. Conclusion: The study showed a high use of oral contraceptives in the sample, with percentage values very close to other factors evaluated, thus showing itself as a probable risk factor for the development of ischemic stroke.

scholarly journals Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19

Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rizky Sarengat ◽  
Mohammad S. Islam ◽  
Mohammad S. Ardhi
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
National Institutes Of Health ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
The Mean

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.

scholarly journals A clinical study investigation the three months prognosis of patients with ischemic stroke treated with recombinant tissue plasminogen activator (rtPA) and its effective factors

2019 ◽  
Vol 5 (2) ◽  
pp. 47-50
Author(s):  
Vahid Abbasi ◽  
Abolfazl Atalu ◽  
Afshan Sharghi ◽  
Fatemeh Taghvatalab
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Close Monitoring ◽  
Cross Sectional ◽  
Admission Time ◽  
Tissue Plasminogen ◽  
The Mean

Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA). Methods: This cross-sectional prospective study was conducted on 30 patients with cerebral ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) >5. Data such as demographic information, signs and symptoms, medical history, risk factors, focused neurological examination, and the NIHSS were collected for all patients. Then, all patients received 0.9 mg/kg of rt-PA as intravenous bolus doses and intravenous infusion under close monitoring in the emergency department. All patients were checked for necessary outcomes and also disability at the admission time, 7 days later and after three months all patients were checked again. All collected data were analyzed by appropriate tests using SPSS version 22. Results: Of all patients, 63.3% were males and 36.7% were females. The mean age of the patients was 62.37 ± 12.62 years with a range of 40-91 years. The mean of NIHSS was 12.46 ± 4.28 at admission time, in day seven it was 8.06 ± 3.72 and in month three after treatment it was 3.62 ± 2.31. There was a significant relationship between age, place of residence and NIHSS. Thirty percent of patients had NIHSS more than 15 at admission time and after 7 days this rate reached to 10% and three months later it declined to 6.7%. These differences were statistically significant. Conclusion: Intravenous thrombolytic therapy is associated with proper short term results in most patients with ischemic stroke.

Mean Placental Birth Weight Ratio at Term in Primigravidae

2021 ◽  
Vol 15 (11) ◽  
pp. 3496-3498
Author(s):  
Nazia Muneer ◽  
Shamaila Shamaun ◽  
Afshan Shahid ◽  
Riffat Jaleel ◽  
Mehreen Iqbal ◽  
...  
Keyword(s):  
Birth Weight ◽  
Maternal Age ◽  
Weight Ratio ◽  
Operational Definition ◽  
Cross Sectional Study ◽  
Placental Weight ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
The Mean

Objective: To determine the mean placental birth weight ratio at term in primigravidae Study design: Cross-sectional study Place and Duration: Department of Obstetrics and Gynecology, Civil Hospital Karachi, duration was six months after the approval of synopsis from 1st January 2016 to 30th June 2016 Subjects and Methods: A total of pregnant women who fulfill the inclusion criteria were included in this study. After delivery, baby was weighed by using weight machine and weight of baby was also noted (as per operational definition). After expulsion of complete placenta, placental weight was measured by using weight machine. The placental-birth weight ratio (PBWR) were calculated as ratio of placental weight to neonatal weight multiplied by 100. Results: Mean ± SD of maternal age was 24.77±4.04 with C.I (24.11----25.42) years. Mean ± SD of placental weight was 505.84±99.97 with C.I (489.71----521.97) grams. Out of 150 neonatal babies 101 (67.3%) were male and 49 (32.7%) were female. Mean placental birth weight ratio was found to be 16.82±2.63 with C.I (16.39----17.24). Conclusion: It is to be concluded that placental weight increased according to the birth weight. The placental weight to birth weight ratio decreased slightly with advancing gestational age. Keywords: Placental weight, Birth weight ratio, Labour at term, Primigravidae

scholarly journals Premature Atrial Contractions on the Screening Electrocardiogram and Risk of Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study

2016 ◽  
Vol 47 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Wesley T. O'Neal ◽  
Hooman Kamel ◽  
Dawn Kleindorfer ◽  
Suzanne E. Judd ◽  
George Howard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Stroke Risk ◽  
Cox Regression ◽  
Stroke Risk Factors ◽  
Stroke Study ◽  
Increased Risk ◽  
Study Participants ◽  
The Relationship

Background: It is currently unknown if premature atrial contractions (PACs) detected on the routine screening electrocardiogram are associated with an increased risk of ischemic stroke. Methods: We examined the association between PACs and ischemic stroke in 22,975 (mean age 64 ± 9.2; 56% women; 40% black) participants from the Reasons for Geographic and Racial Differences in Stroke study. Participants who were free of stroke at baseline were included. PACs were detected from centrally read electrocardiograms at baseline. Cox regression was used to examine the association between PACs and ischemic stroke events through March 31, 2014. Results: PACs were present in 1,687 (7.3%) participants at baseline. In a Cox regression model adjusted for stroke risk factors and potential confounders, PACs were associated with an increased risk of ischemic stroke (hazards ratio (HR) 1.34, 95% CI 1.04-1.74). The relationship was limited to non-lacunar infarcts (HR 1.42, 95% CI 1.08-1.87), and not lacunar strokes (HR 1.01, 95% CI 0.51-2.03). An interaction by sex was detected, with the association between PACs and ischemic stroke being stronger among women (HR 1.82, 95% CI 1.29-2.56) than men (HR 1.03, 95% CI 0.69-1.52; p-interaction = 0.0095). Conclusion: PACs detected on the routine electrocardiogram are associated with an increased risk for non-lacunar ischemic strokes, especially in women.

scholarly journals Quality of informed consent documents among US. hospitals: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033299
Author(s):  
Erica S Spatz ◽  
Haikun Bao ◽  
Jeph Herrin ◽  
Vrunda Desai ◽  
Sriram Ramanan ◽  
...  
Keyword(s):  
Informed Consent ◽  
Cross Sectional Study ◽  
Face Validity ◽  
Fee For Service ◽  
Cross Sectional ◽  
Consent Document ◽  
Informed Consent Document ◽  
The Mean ◽  
Quality Threshold

ObjectiveTo determine whether informed consent for surgical procedures performed in US hospitals meet a minimum standard of quality, we developed and tested a quality measure of informed consent documents.DesignRetrospective observational study of informed consent documents.Setting25 US hospitals, diverse in size and geographical region.CohortAmong Medicare fee-for-service patients undergoing elective procedures in participating hospitals, we assessed the informed consent documents associated with these procedures. We aimed to review 100 qualifying procedures per hospital; the selected sample was representative of the procedure types performed at each hospital.Primary outcomeThe outcome was hospital quality of informed consent documents, assessed by two independent raters using an eight-item instrument previously developed for this measure and scored on a scale of 0–20, with 20 representing the highest quality. The outcome was reported as the mean hospital document score and the proportion of documents meeting a quality threshold of 10. Reliability of the hospital score was determined based on subsets of randomly selected documents; face validity was assessed using stakeholder feedback.ResultsAmong 2480 informed consent documents from 25 hospitals, mean hospital scores ranged from 0.6 (95% CI 0.3 to 0.9) to 10.8 (95% CI 10.0 to 11.6). Most hospitals had at least one document score at least 10 out of 20 points, but only two hospitals had >50% of their documents score above a 10-point threshold. The Spearman correlation of the measures score was 0.92. Stakeholders reported that the measure was important, though some felt it did not go far enough to assess informed consent quality.ConclusionAll hospitals performed poorly on a measure of informed consent document quality, though there was some variation across hospitals. Measuring the quality of hospital’s informed consent documents can serve as a first step in driving attention to gaps in quality.

Initial Experience with Minimally Invasive Surgical Exclusion of the Left Atrial Appendage with an Epicardial Clip

2017 ◽  
Vol 12 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Nathan E. Smith ◽  
Jeevan Joseph ◽  
John Morgan ◽  
Saqib Masroor
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Intercostal Space ◽  
Atrial Appendage ◽  
Maze Procedure ◽  
Initial Experience ◽  
The Mean

Objective Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA. An alternate technique is epicardial clipping, which has been approved through sternotomy for permanent exclusion of LAA. We present our initial experience of epicardial clipping of the LAA using a minimally invasive approach. Methods Between May 2012 and December 2015, a total of 24 consecutive patients underwent minimally invasive, echo-guided epicardial clipping. Indications for the procedure were persistent (n = 12) or paroxysmal (n = 12) AF in patients who could not tolerate full anticoagulation because of a combination of gastrointestinal bleeding (n = 7), hemorrhagic stroke (n = 5), ischemic stroke (n = 5), intramuscular bleeding (n = 3), falls (n = 2), urinary tract bleeding (n = 2), subdural hematoma (n = 1), traumatic aortic intramural hematoma (n = 1), and lifestyle and career practices inconsistent with anticoagulation (n = 1). The clipping was performed through three 5-mm ports in the left seventh intercostal space (n = 22) or a 5-cm incision in the fifth intercostal space (n = 2). Echocardiography was performed to exclude the presence of LAA thrombus and to confirm exclusion of LAA before final deployment of the clip. Results The mean age was 73.6 years. The mean CHA2DS2VASC score was 4.7 and the mean HAS-BLED score was 3.8. The mean postoperative length of stay was 6.4 days. One patient died of stroke-related complications 10 days after successful clipping, and two patients required thoracentesis to drain recurrent pleural effusions. All patients had successful exclusion of LAA defined as residual sac of less than 1 cm. Conclusions Isolated epicardial left atrial clipping is a safe treatment option in high-risk patients with AF. Long-term success in preventing stroke is still to be determined, but short-term results are very encouraging.

scholarly journals THE EPIDEMIOLOGICAL PATTERN OF FACTORS ASSOCIATED WITH ISCHEMIC STROKE IN PATIENTS UNDER 50 YEARS OF AGE: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 11 (3) ◽  
pp. 9-13
Author(s):  
Nourollah Ramroodi ◽  
Seyed Mehdi Hashemi ◽  
Mehrdad Ramroudi
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Epidemiological Pattern ◽  
The Mean

Objective: The aim of the present study was to investigate the epidemiological pattern of factors associated with ischemic stroke among patients under 50 years old. Methods: The present cross-sectional study was performed on 197 Stroke patients. Individuals with confirmed ischemic stroke based on of CT scan were included in the study. Demographic information included age, sex, history of smoking, place of residence, season of disease incidence, history of contraceptive use in women, history of hypertension, having high blood pressure at the onset of diabetes, hyperlipidemia, heart disease and patient weight. Finally, the collected data was analyzed using SPSS ver. 22. Results: The mean age of participants was 40.18 years. The mean weight, height, body mass index (BMI) were 79.83, 168.63, and 28.12, respectively. A total of 60.4% of the participants were male and 39.6% were female. Moreover, 66.9% were urban residents, 38.6% had complications in winter, 67% were smokers, and 50% used contraceptives. The history of hypertension, diabetes, hyperlipidemia, and heart disease was seen in 69%, 49.7, 66%, and 73.6% of cases, respectively. Also, 53.8% of patients had high blood pressure upon admission. Conclusion: The present study showed that a history of heart disease and a history of hypertension in the past and nicotine use are very common in people with stroke. Considering the above mentioned epidemiological factors, it is recommended to prioritize the mentioned factors when identifying new cases

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