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Secondary Prevention of Stroke in Patients with Non-Valvular Atrial Fibrillation and Advanced Chronic Kidney Disease.
J Atheroscler Thromb
January 2025
Department of Cardiology, the First Affiliated Hospital of Dalian Medical University.
Aims: Evidence supporting the prescription of anticoagulant therapy for patients with atrial fibrillation (AF) with advanced chronic kidney disease (CKD) has been limited, and its clinical application in this context remains controversial.
Methods: We identified AF patients with advanced CKD (G4-G5) and a history of stroke who were admitted to the First Affiliated Hospital of Dalian Medical University between January 1, 2011, and June 30, 2023. Patients were classified into warfarin, non-vitamin K antagonist oral anticoagulant (NOAC), antiplatelet therapy, and control (no antithrombotic therapy) groups.
Effect of pocket compression device on pocket hematoma after cardiac implantable electronic device implantation.
Sci Rep
January 2025
Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Pocket hematoma is a common and serious complication following cardiac implantable electronic device (CIED) implantation, contributing to significant morbidity and mortality. This study aimed to evaluate the efficacy of a novel pocket compression device in reducing pocket hematoma occurrence. We enrolled 242 patients undergoing CIED implantation, randomly assigning them to receive either the novel compression vest with a pressure cuff or conventional sandbag compression.
View Article and Find Full Text PDF[Gastric adenocarcinoma complicated by subarachnoid hemorrhage and cerebral infarction: a rare case of Trousseau syndrome and literature review].
Zhonghua Nei Ke Za Zhi
February 2025
Department of Neurology, the Eighth Medical Center of Chinese PLA General Hospital, Beijing100091, China.
Trousseau's syndrome is a thromboembolic disorder associated with malignancies, with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer. This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage. We performed a comprehensive literature review in the Wanfang and PubMed databases, searching for relevant studies on Trousseau's syndrome, cerebral embolism, and subarachnoid hemorrhage.
View Article and Find Full Text PDFApixaban versus aspirin for stroke prevention in people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack: subgroup analysis of the ARTESiA randomised controlled trial.
Lancet Neurol
February 2025
Department of Medicine, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
Background: People with subclinical atrial fibrillation are at increased risk of stroke, albeit to a lesser extent than those with clinical atrial fibrillation, leading to an ongoing debate regarding the benefit of anticoagulation in these individuals. In the ARTESiA trial, the direct-acting oral anticoagulant apixaban reduced stroke or systemic embolism compared with aspirin in people with subclinical atrial fibrillation, but the risk of major bleeding was increased with apixaban. In a prespecified subgroup analysis of ARTESiA, we tested the hypothesis that people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack, who are known to have an increased risk of recurrent stroke, would show a greater benefit from oral anticoagulation for secondary stroke prevention compared with those without a history of stroke or transient ischaemic attack.
View Article and Find Full Text PDFDesign and early progress of the Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial.
Int J Stroke
January 2025
Medical University of South Carolina, Charleston, SC, USA.
Background: The usual antithrombotic treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) consists of dual treatment with clopidogrel and aspirin for 90 days followed by aspirin alone but the risk of recurrent stroke remains high up to 12 months. The Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial was designed to determine whether other combinations of dual antithrombotic therapy are superior to clopidogrel and aspirin.
Methods: CAPTIVA is an ongoing, prospective, double-blinded, three-arm clinical trial at over 100 sites in the United States and Canada that will randomize 1683 high-risk subjects with a symptomatic infarct attributed to 70-99% stenosis of a major intracranial artery to 12 months of treatment with (1) ticagrelor (180 mg loading dose, then 90 mg twice daily), (2) low-dose rivaroxaban (2.
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