Publications by authors named "Gianni Lorenzini"
Article Synopsis
- Intravenous thrombolysis (IVT) and endovascular therapy (EVT) are effective treatments for acute stroke, but their safety and efficacy in patients with atrial fibrillation (AF) are debated.
- A study analyzed data from two multicenter studies to compare outcomes of AF patients with acute ischemic stroke treated with reperfusion therapies versus those who weren't.
- Results showed that AF patients treated with reperfusion therapies had better functional outcomes and lower mortality rates compared to those who received conservative treatment.
Article Synopsis
- The study aimed to evaluate the risks of recurrent ischemic events and severe bleeding in patients with acute posterior ischemic stroke (PS) and atrial fibrillation (AF) in relation to oral anticoagulant therapy (OAT) and timing of initiation.
- Researchers compared outcomes in 473 patients with PS to 1997 patients with anterior stroke (AS), focusing on events within 90 days of the initial stroke.
- Findings indicated that both PS and AS patients had similar risks of ischemic or hemorrhagic events at 90 days, regardless of when OAT was initiated.
Article Synopsis
- The study investigates when it's best to start oral anticoagulants after an ischemic stroke caused by atrial fibrillation, particularly focusing on patients who received thrombolysis or thrombectomy.
- It combines data from two studies conducted between 2012 and 2016, analyzing patients treated with either Vitamin K antagonists or non-vitamin K oral anticoagulants for secondary stroke prevention.
- Among 2159 patients included, the timing for starting anticoagulants was similar for those treated with reperfusion therapies and those not treated, with low rates of stroke or bleeding complications observed within 90 days.
Article Synopsis
- * Researchers analyzed data from 1,810 patients, discovering that 20% underwent this bridging therapy, and found that bridged patients had worse outcomes, with a higher rate of ischemic events and major bleeding.
- * The results indicate that bridging therapy significantly raises the risk of early complications compared to patients who did not receive it, prompting a reevaluation of its common use in clinical practice.
Article Synopsis
- The study examined the link between types of atrial fibrillation (paroxysmal vs. sustained) and the occurrence of early ischaemic recurrences after an acute stroke in patients.
- Out of 2150 patients, those with sustained atrial fibrillation experienced a higher percentage of early ischaemic recurrences (6.2%) compared to those with paroxysmal atrial fibrillation (3.3%).
- However, after considering other health risks, sustained atrial fibrillation did not show a significantly increased risk for early recurrence, suggesting that other factors may be more influential.
Background In patients with acute ischemic stroke and atrial fibrillation, early anticoagulation prevents ischemic recurrence but with the risk of hemorrhagic transformation ( HT ). The aims of this study were to evaluate in consecutive patients with acute stroke and atrial fibrillation (1) the incidence of early HT, (2) the time to initiation of anticoagulation in patients with HT , (3) the association of HT with ischemic recurrences, and (4) the association of HT with clinical outcome at 90 days. Methods and Results HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset.
View Article and Find Full Text PDFEarly Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin-K Oral Anticoagulants (RAF-NOACs) Study.
J Am Heart Assoc
November 2017
Article Synopsis
- The study investigates the optimal timing for administering non-vitamin K oral anticoagulants (NOACs) in patients with acute ischemic stroke and atrial fibrillation, focusing on early recurrence of stroke and major bleeding within 90 days post-treatment.
- A total of 1,127 patients participated, with diverse treatment groups receiving dabigatran, rivaroxaban, or apixaban; results revealed a low incidence of early recurrence (2.8%) and major bleeding (2.4%).
- Patients starting NOACs within 2 days of stroke had higher rates of complications (12.4% composite rate), compared to delayed initiation (3-14 days had 2.1%, and >14 days
Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation).
Eur Stroke J
March 2017
Article Synopsis
- Atrial fibrillation increases stroke risk, especially in women, who tend to have worse outcomes than men; this study assesses sex differences in stroke patients with atrial fibrillation regarding risk factors, treatments, and outcomes.
- Data from the RAF-study, involving 1029 patients, revealed women were younger and less likely to receive anticoagulant therapy both before and after stroke compared to men, despite similar timing for starting treatment.
- At 90 days post-stroke, more women were disabled or deceased (57.7%) compared to men (41.1%), highlighting a significant disparity in outcomes related to treatment patterns.
Article Synopsis
- - The study aimed to explore how the prestroke CHADS-VASc score, which assesses stroke risk in patients with atrial fibrillation (AF), relates to the severity of strokes and outcomes like disability and mortality after 90 days.
- - Researchers analyzed data from 1,020 patients with acute ischemic strokes and found that a higher prestroke CHADS-VASc score correlated with more severe strokes at admission and worse functional outcomes 90 days later.
- - The findings suggest that, for patients with AF, a high CHADS-VASc score not only indicates a greater stroke risk but is also linked to increased stroke severity and higher rates of disability and death after three months.
Background And Purposes: This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation.
Methods: The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.
Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence.
View Article and Find Full Text PDFAims: We assessed whether acute intra-arterial infusion of exogenous ghrelin can improve endothelial dysfunction by restoring nitric oxide (NO) availability in the forearm microcirculation of essential hypertensive patients. The effect of ghrelin on endothelial dysfunction (pressurized myograph), vascular oxidative stress generation (fluorescent dihydroethidium), and phosphorylation of p47phox (western blot), an index of NAD(P)H oxidase activation, in isolated small arteries taken from essential hypertensive patients (subcutaneous biopsy) were also investigated.
Methods And Results: In 18 normotensive control subjects and 18 essential hypertensive patients, we studied the forearm blood flow (strain-gauge plethysmography) response to intra-arterial acetylcholine, repeated under NO synthase inhibitor N(G)-monomethyl-l-arginine (l-NMMA) or the antioxidant ascorbic acid.
Article Synopsis
- The study investigates the timing of anticoagulation therapy in patients with acute cardioembolic stroke and atrial fibrillation, focusing on risks for recurrent ischemic events and severe bleeding.
- Out of 1029 patients, 12.6% experienced adverse events within 90 days, with factors like CHA2DS2-VASc score and type of anticoagulant affecting outcomes.
- Starting anticoagulants 4 to 14 days after stroke onset is linked to a significant reduction in complications compared to starting before 4 days or after 14 days.
Although new oral anticoagulants (NOAs) have been marketed in many countries, concern exists about the management of bleedings related to these drugs due to the lack of specific antidotes. The aim of our study was to report on real life management of NOAs-related life-threatening or major bleedings. We report data from consecutive cases of NOAs related major bleedings admitted to 4 hospitals since NOAs became marketed in Italy.
View Article and Find Full Text PDFAims: Aliskiren is a new oral non-peptide renin inhibitor. Its effects on vascular function in human hypertension are unknown. We assessed whether aliskiren may improve peripheral endothelial function and arterial stiffness in essential hypertensive patients (EH), when compared with the angiotensin-converting enzyme-inhibitor ramipril.
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