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Introduction: Atrial fibrillation (AF), a common heart rhythm abnormality, is linked to a higher risk of stroke. Traditionally, warfarin has been the primary anticoagulation treatment for reducing the stroke risk. The new standard of treatment by direct oral anticoagulants (DOACs) offers greater benefits including improved efficacy and fewer adverse effects with reduced monitoring.

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Since treatment with anticoagulants can prevent recurrent strokes, identification of patients at risk for incident AF after stroke is crucial. We aimed to investigate whether the addition of AF polygenic risk scores (PRS) to existing clinical risk predictors could improve prediction of AF after stroke. Patients diagnosed with ischemic stroke at Massachusetts General Hospital between 2003-2017 were included.

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Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation and Hemodialysis: An International, Multicentric Registry.

JACC Clin Electrophysiol

January 2025

Cardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Frankfurt am Main, Germany.

Background: The net benefit of oral anticoagulation in patients with end-stage renal disease on hemodialysis (HD) is uncertain. In recent years, left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation; however, there is scant evidence of LAAC in patients on HD.

Objectives: This study aimed to assess the feasibility and safety of LAAC in patients on HD.

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This case report describes an otherwise healthy 43-year-old female who presented with severe pain, foot drop, and critical limb ischemia to her left foot caused by thrombosis of a peripheral artery secondary to antiphospholipid syndrome. Antiphospholipid syndrome is an autoimmune disease that frequently manifests as recurrent arterial and/or venous thrombotic events, ischemic strokes, and miscarriages. Antiphospholipid syndrome affecting primarily the arteries is less common as compared to venous thrombosis.

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Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.

Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).

Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.

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