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1. Reperfusion therapies in patients with acute ischaemic stroke and atrial fibrillation: data on safety and effectiveness from a multi-centre cohort study

Author

Cancelloni, Virginia, Buratti, Mariachiara, Tsivgoulis, Georgios, Furie, Karen L., Tadi, Prasanna, Caso, Valeria, Becattini, Cecilia, Agnelli, Giancarlo, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Alberti, Andrea, Venti, Michele, de Magistris, Ilaria Leone, Acciarresi, Monica, D’Amore, Cataldo, Mosconi, Maria G., Cimini, Ludovica A., Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Bandini, Fabio, Marcheselli, Simona, Pezzini, Alessandro, Sohn, Sung-I. I., Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Ntaios, George, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Sagris, Dimitrios, Adamou, Anastasia, Vadikolias, Kostantinos, Palaiodimou, Lina, Chondrogianni, Maria, Mumoli, Nicola, Galati, Franco, Sacco, Simona, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Mancuso, Michelangelo, Orlandi, Giovanni, Pascarella, Rosario, Tassinari, Tiziana, Rueckert, Christina, Baldi, Antonio, Toni, Danilo, Lettieri, Federica, Giuntini, Martina, Lotti, Enrico M., Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Halvatsiotis, Panagiotis, Monaco, Serena, Baronello, Mario M., Csiba, Laszlò, Szabò, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Vanacker, Peter, Barlinn, Kristian, Pallesen, Lars P., Kepplinger, Jessica, Deleu, Dirk, Gourbali, Vanessa, Yaghi, Shadi, and Paciaroni, Maurizio

Published
2024
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2. Statin Therapy in Ischemic Stroke Patients with Atrial Fibrillation: Efficacy and Safety Outcomes

Author

Marvardi, Michele, primary, Ferrante, Mario, additional, Paciaroni, Maurizio, additional, Abdul-Rahim, Azmil H, additional, Tsivgoulis, Georgios, additional, Seiffge, David J, additional, Engelter, Stefan T, additional, Lyrer, Philippe A., additional, Polymeris, Alexandros A, additional, Dittrich, Tolga D, additional, Cancelloni, Virginia, additional, Zietz, Annaelle, additional, De Marchis, Gian Marco, additional, Putaala, Jukka, additional, Strbian, Daniel, additional, Tomppo, Liisa, additional, Michel, Patrik, additional, Strambo, Davide, additional, Salerno, Alexander, additional, Vanacker, Peter, additional, Zuurbier, Susanna M., additional, Yperzeele, Laetitia, additional, Loos, Caroline MJ, additional, Cappellari, Manuel, additional, Emiliani, Andrea, additional, Zedde, Marialuisa, additional, Becattini, Cecilia, additional, Pascarella, Rosario, additional, Dawson, Jesse, additional, Cronshaw, Robert, additional, Schirinzi, Erika, additional, Del Sette, Massimo, additional, Stretz, Christoph, additional, Kala, Narendra Sharma, additional, Schomer, Ashley, additional, Mac Grory, Brian, additional, Jayaraman, Mahesh V, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Masotti, Luca, additional, Grifoni, Elisa, additional, Toni, Danilo, additional, Risitano, Angela, additional, Falcou, Anne A, additional, Petraglia, Luca, additional, Lotti, Enrico Maria, additional, Pavolucci, Lucia, additional, Lochner, Piergiorgio, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Alberti, Andrea, additional, Venti, Michele, additional, Leone De Magistris, Ilaria, additional, Mosconi, Maria Giulia, additional, Giustozzi, Michela, additional, Kargiotis, Odysseas, additional, Rocco, Alessandro, additional, Diomedi, Marina, additional, Marcheselli, Simona, additional, Antonenko, Kateryna, additional, Rota, Eugenia, additional, Tassinari, Tiziana, additional, Saia, Valentina, additional, Palmerini, Francesco, additional, Aridon, Paolo, additional, Arnao, Valentina, additional, Monaco, Serena, additional, Cottone, Salvatore, additional, Baldi, Antonio, additional, D'Amore, Cataldo, additional, Ageno, Walter, additional, Pegoraro, Samuela, additional, Ntaios, George, additional, Adamou, Anastasia, additional, Sagris, Dimitrios, additional, Giannopoulos, Sotirios, additional, Kosmidou, Maria, additional, Ntais, Evangelos, additional, Romoli, Michele, additional, Pantoni, Leonardo, additional, Rosa, Silvia, additional, Bertora, Pierluigi, additional, Chiti, Alberto, additional, Canavero, Isabella, additional, Saggese, Carlo Emanuele, additional, Plocco, Maurizio, additional, Giorli, Elisa, additional, Palaiodimou, Lina, additional, Bakola, Eleni, additional, Bandini, Fabio, additional, Gasparro, Antonio, additional, Terruso, Valeria, additional, Mannino, Marina, additional, Pezzini, Alessandro, additional, Ornello, Raffaele, additional, Sacco, Simona, additional, Popovic, Nemanja, additional, Scoditti, Umberto, additional, Genovese, Antonio, additional, Flomin, Yuriy, additional, Mancuso, Michelangelo, additional, D'agliano, Roberto, additional, Baldini, Marco, additional, Ulivi, Leonardo, additional, Giannini, Nicola, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrysoula, additional, Chondrogianni, Maria, additional, Halvatsiotis, Panagiotis, additional, Karagkiozi, Efstathia, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, lanari, alessia, additional, Tatlisumak, Turgut, additional, Acciarresi, Monica, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Sohn, Sung-Il, additional, Mumoli, Nicola, additional, Cararra, Davide, additional, Maccarrone, Miriam, additional, Galati, Franco, additional, Gourbali, Vanessa, additional, Orlandi, Giovanni, additional, Giuntini, Martina, additional, Corea, Francesco, additional, Bellesini, Marta, additional, Karapanayiotides, Theodore, additional, Csiba, Laszlo, additional, Szabo, Lilla, additional, Imberti, Davide, additional, Pieroni, Alessio, additional, Barlinn, Kristian, additional, Pallesen, Lars-Peder, additional, Barlinn, Jessica, additional, Doronin, Boris, additional, Volodina, Vera Alexandrovna, additional, Agnelli, Giancarlo, additional, Deleu, Dirk, additional, Bonetti, Bruno, additional, Gentile, Luana, additional, Reale, Giuseppe, additional, Caliandro, Pietro, additional, Morotti, Andrea, additional, Vannucchi, Vieri, additional, Padroni, Marina, additional, Letteri, Federica, additional, Magoni, Mauro, additional, Tiseo, Cindy, additional, Rigatelli, Alberto, additional, Zauli, Aurelia, additional, Bossi, Francesco, additional, and Caso, Valeria, additional

Published
2024
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3. Safety of Anticoagulation in Patients Treated With Urgent Reperfusion for Ischemic Stroke Related to Atrial Fibrillation

Author

Giustozzi, Michela, Acciarresi, Monica, Agnelli, Giancarlo, Caso, Valeria, Bandini, Fabio, Tsivgoulis, Georgios, Yaghi, Shadi, Furie, Karen L., Tadi, Prasanna, Becattini, Cecilia, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Lees, Kennedy R., Alberti, Andrea, Venti, Michele, D’Amore, Cataldo, Giulia Mosconi, Maria, Anna Cimini, Ludovica, Bovi, Paolo, Carletti, Monica, Rigatelli, Alberto, Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Athanasakis, George, Makaritsis, Konstantinos, Karagkiozi, Efstathia, Vadikolias, Konstantinos, Liantinioti, Chrissoula, Theodorou, Aikaterini, Halvatsiotis, Panagiotis, Mumoli, Nicola, Galati, Franco, Sacco, Simona, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Lanari, Alessia, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Ferrari, Elena, Ulivi, Leonardo, Orlandi, Giovanni, Giannini, Nicola, Tassinari, Tiziana, Luisa De Lodovici, Maria, Rueckert, Christina, Baldi, Antonio, Toni, Danilo, Letteri, Federica, Giuntini, Martina, Maria Lotti, Enrico, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Maimone Baronello, Mario, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Vanacker, Peter, Barlinn, Kristian, Barlinn, Jessica, Deleu, Dirk, Gourbali, Vanessa, Paciaroni, Maurizio, and Masotti, Luca

Published
2020
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4. Anticoagulation After Stroke in Patients With Atrial Fibrillation: To Bridge or Not With Low-Molecular-Weight Heparin?

Author

Altavilla, Riccardo, Caso, Valeria, Bandini, Fabio, Agnelli, Giancarlo, Tsivgoulis, Georgios, Yaghi, Shadi, Furie, Karen L., Tadi, Prasanna, Becattini, Cecilia, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Lees, Kennedy R., Alberti, Andrea, Venti, Michele, Acciarresi, Monica, D’Amore, Cataldo, Giulia Mosconi, Maria, Anna Cimini, Ludovica, Fusaro, Jessica, Bovi, Paolo, Carletti, Monica, Rigatelli, Alberto, Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Athanasakis, George, Makaritsis, Konstantinos, Karagkiozi, Efstathia, Vadikolias, Konstantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Mumoli, Nicola, Consoli, Domenico, Galati, Franco, Sacco, Simona, Carolei, Antonio, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Lanari, Alessia, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Maccarrone, Miriam, Ulivi, Leonardo, Orlandi, Giovanni, Giannini, Nicola, Gialdini, Gino, Tassinari, Tiziana, De Lodovici, Maria Luisa, Bono, Giorgio, Rueckert, Christina, Baldi, Antonio, D’Anna, Sebastiano, Toni, Danilo, Letteri, Federica, Giuntini, Martina, Maria Lotti, Enrico, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Maimone Baronello, Mario, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Vanacker, Peter, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Deleu, Dirk, Melikyan, Gayane, Ibrahim, Faisal, Akhtar, Naveed, Gourbali, Vanessa, and Paciaroni, Maurizio

Published
2019
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5. Quality metrics in the management of acute stroke in Greece during the first 5 years of Registry of Stroke Care Quality (RES-Q) implementation

Author

Palaiodimou, Lina, primary, Kargiotis, Odysseas, additional, Katsanos, Aristeidis H, additional, Kiamili, Argyro, additional, Bakola, Eleni, additional, Komnos, Apostolos, additional, Zisimopoulou, Vaso, additional, Natsis, Konstantinos, additional, Papagiannopoulou, Georgia, additional, Theodorou, Aikaterini, additional, Zompola, Christina, additional, Safouris, Apostolos, additional, Psychogios, Klearchos, additional, Ntais, Evangelos, additional, Plomaritis, Panagiotis, additional, Karamatzianni, Georgia, additional, Mavriki, Andriana, additional, Koutsokera, Maria, additional, Lykou, Christina, additional, Koutroulou, Ioanna, additional, Gourbali, Vanessa, additional, Skafida, Anastasia, additional, Roussopoulou, Andromachi, additional, Kourtesi, Georgia, additional, Papamichalis, Panagiotis, additional, Papagiannopoulos, Sotirios, additional, Gryllia, Maria, additional, Tavernarakis, Antonios, additional, Kazis, Dimitrios, additional, Karapanayiotides, Theodoros, additional, Magoufis, Georgios, additional, Giannopoulos, Sotirios, additional, and Tsivgoulis, Georgios, additional

Published
2023
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6. The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Caso, Valeria, Becattini, Cecilia, Mosconi, Maria Giulia, Giustozzi, Michela, Tsivgoulis, Georgios, Seiffge, David Julian, Engelter, Stefan T., Lyrer, Philippe, Polymeris, Alexandros A., Dittrich, Tolga, Zietz, Annaelle, Putaala, Jukka, Strbian, Daniel, Tomppo, Liisa, Michel, Patrik, Strambo, Davide, Salerno, Alexander, Remillard, Suzette, Buehrer, Manuela, Bavaud, Odessa, Vanacker, Peter, Zuurbier, Susanna M., Yperzeele, Laetitia, Loos, Caroline M.J., Cappellari, Manuel, Emiliani, Andrea, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Dawson, Jesse, Cronshaw, Robert, Schirinzi, Erika, Del Sette, Massimo, Stretz, Christoph, Kala, Narendra, Reznik, Michael, Schomer, Ashley, Mac Grory, Brian, Jayaraman, Mahesh, Yaghi, Shadi, Furie, Karen L., Masotti, Luca, Grifoni, Elisa, Toni, Danilo, Risitano, Angela, Falcou, Anne, Petraglia, Luca, Lotti, Enrico Maria, Padroni, Marina, Pavolucci, Lucia, Lochner, Piergiorgio, Silvestrelli, Giorgio, Ciccone, Alfonso, Alberti, Andrea, Venti, Michele, De Magistris, Ilaria Leone, Cancelloni, Virginia, Kargiotis, Odysseas, Rocco, Alessandro, Diomedi, Marina, Marcheselli, Simona, Caliandro, Pietro, Zauli, Aurelia, Reale, Giuseppe, Moci, Marco, Antonenko, Kateryna, Rota, Eugenia, Tassinari, Tiziana, Saia, Valentina, Palmerini, Francesco, Aridon, Paolo, Arnao, Valentina, Monaco, Serena, Cottone, Salvatore, Baldi, Antonio, D’Amore, Cataldo, Ageno, Walter, Pegoraro, Samuela, Ntaios, George, Sagris, Dimitrios, Giannopoulos, Sotirios, Kosmidou, Maria, Ntais, Evangelos, Romoli, Michele, Pantoni, Leonardo, Rosa, Silvia, Bertora, Pierluigi, Chiti, Alberto, Canavero, Isabella, Saggese, Carlo Emanuele, Plocco, Maurizio, Giorli, Elisa, Palaiodimou, Lina, Bakola, Eleni, Bandini, Fabio, Gasparro, Antonio, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Morotti, Andrea, Magoni, Mauro, Ornello, Raffaele, Sacco, Simona, Popovic, Nemanja, Scoditti, Umberto, Genovese, Antonio, Denti, Licia, Flomin, Yuriy, Mancuso, Michelangelo, Ferrari, Elena, Caselli, Maria Chiara, Ulivi, Leonardo, Giannini, Nicola, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Carletti, Monica, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Lanari, Alessia, Tatlisumak, Turgut, Acciarresi, Monica, Vannucchi, Vieri, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Sohn, Sung-Il, Mumoli, Nicola, Tadi, Prasanna, Letteri, Federica, Maccarrone, Miriam, Galati, Franco, Tiseo, Cindy, Gourbali, Vanessa, Halvatsiotis, Panagiotis, Orlandi, Giovanni, Giuntini, Martina, Corea, Francesco, Bellesini, Marta, Baronello, Mario Maimone, Karapanayiotides, Theodore, Rueckert, Christina, Csiba, Laszló, Szabó, Lilla, Rigatelli, Alberto, Imberti, Davide, Zabzuni, Dorjan, Pieroni, Alessio, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Doronin, Boris, Volodina, Vera, Deleu, Dirk, Bonetti, Bruno, Porta, Cesare, Gentile, Luana, Eskandari, Ashraf, and De Marchis, Gian Marco

Abstract

Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF.Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding).Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77).Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.

Published
2023
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7. Risk of recurrent stroke in patients with atrial fibrillation treated with oral anticoagulants alone or in combination with anti-platelet therapy

Author

Caliandro, Pietro, Cancelloni, Virginia, Marco, Moci, Reale, Giuseppe, Zauli, Aurelia, Agnelli, Giancarlo, Caso, Valeria, Becattini, Cecilia, Calabresi, Paolo, Giulia Mosconi, Maria, Giustozzi, Michela, Tsivgoulis, Georgios, Julian Seiffge, David, Engelter, Stefan T., Lyrer, Philippe, Polymeris, Alexandros A., Dittrich, Tolga, Zietz, Annaelle, Marco De Marchis, Gian, Putaala, Jukka, Strbian, Daniel, Tomppo, Liisa, Michel, Patrik, Strambo, Davide, Salerno, Alexander, Remillard, Suzette, Buehrer, Manuela, Bavaud, Odessa, Vanacker, Peter, Zuurbier, Susanna, Yperzeele, Laetitia, Loos, Caroline M.J., Cappellari, Manuel, Emiliani, Andrea, Zedde, Marialuisa, Abdul-Rahim, Azmil, Dawson, Jesse, Cronshaw, Robert, Schirinzi, Erika, Del Sette, Massimo, Stretz, Christoph, Kala, Narendra, Reznik, Michael, Schomer, Ashley, Mac Grory, Brian, Jayaraman, Mahesh, McTaggart, Ryan, Yaghi, Shadi, Furie, Karen L., Masotti, Luca, Grifoni, Elisa, Toni, Danilo, Risitano, Angela, Falcou, Anne, Petraglia, Luca, Maria Lotti, Enrico, Padroni, Marina, Pavolucci, Lucia, Lochner, Piergiorgio, Silvestrelli, Giorgio, Ciccone, Alfonso, Alberti, Andrea, Venti, Michele, Leone De Magistris, Ilaria, Kargiotis, Odysseas, Rocco, Alessandro, Diomedi, Marina, Marcheselli, Simona, Antonenko, Kateryna, Rota, Eugenia, Tassinari, Tiziana, Saia, Valentina, Palmerini, Francesco, Aridon, Paolo, Arnao, Valentina, Monaco, Serena, Cottone, Salvatore, Baldi, Antonio, D’Amore, Cataldo, Ageno, Walter, Pegoraro, Samuela, Ntaios, George, Sagris, Dimitrios, Giannopoulos, Sotirios, Kosmidou, Maria, Ntais, Evangelos, Romoli, Michele, Pantoni, Leonardo, Rosa, Silvia, Bertora, Pierluigi, Chiti, Alberto, Canavero, Isabella, Emanuele Saggese, Carlo, Plocco, Maurizio, Giorli, Elisa, Palaiodimou, Lina, Bakola, Eleni, Bandini, Fabio, Gasparro, Antonio, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Ornello, Raffaele, Sacco, Simona, Popovic, Nemanja, Scoditti, Umberto, Genovese, Antonio, Denti, Licia, Flomin, Yuriy, Mancuso, Michelangelo, Ferrari, Elena, Chiara Caselli, Maria, Ulivi, Leonardo, Giannini, Nicola, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Halvatsiotis, Panagiotis, Carletti, Monica, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Lanari, Alessia, Tatlisumak, Turgut, Acciarresi, Monica, Vannucchi, Vieri, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Sohn, Sung-Il, Mumoli, Nicola, Tadi, Prasanna, Letteri, Federica, Maccarrone, Miriam, Poli, Loris, Magoni, Mauro, Galati, Franco, Tiseo, Cindy, Gourbali, Vanessa, Orlandi, Giovanni, Giuntini, Martina, Corea, Francesco, Bellesini, Marta, Girardi, Laura, Maimone Baronello, Mario, Karapanayiotides, Theodore, Rueckert, Christina, Csiba, Laszló, Szabó, Lilla, Rigatelli, Alberto, Imberti, Davide, Zabzuni, Dorjan, Pieroni, Alessio, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Doronin, Boris, Volodina, Vera, Deleu, Dirk, Bonetti, Bruno, Porta, Cesare, Gentile, Luana, Eskandari, Ashraf, and Paciaroni, Maurizio

Abstract

Introduction: Ischaemic stroke patients with atrial fibrillation (AF) are at high risk of stroke recurrence despite oral anticoagulation therapy. Patients with cardiovascular comorbidities may take both antiplatelet and oral anticoagulation therapy (OAC/AP). Our study aims to evaluate the safety and efficacy of OAC/AP therapy as secondary prevention in people with AF and ischaemic stroke.Patients and methods: We performed a post-hoc analysis of pooled individual data from multicenter prospective cohort studies and compared outcomes in the OAC/AP cohort and patients on DOAC/VKA anticoagulation alone (OAC cohort). Primary outcome was a composite of ischaemic stroke, systemic embolism, intracranial bleeding, and major extracranial bleeding, while secondary outcomes were ischaemic and haemorrhagic events considered separately. A multivariable logistic regression analysis was performed to identify independent predictors for outcome events. To compare the risk of outcome events between the two cohorts, the relation between the survival function and the set of explanatory variables were calculated by Cox proportional hazard models and the results were reported as adjusted hazard ratios (HR). Finally another analysis was performed to compare the overall risk of outcome events in both OAC/AP and OAC cohorts after propensity score matching (PSM).Results: During a mean follow-up time of 7.5 ± 9.1 months (median follow-up time 3.5 months, interquartile range ±3), 2284 stroke patients were on oral anticoagulants and 215 were on combined therapy. The multivariable model demonstrated that the composite outcome is associated with age (OR: 1.03, 95% CI: 1.01–1.04 for each year increase) and concomitant antiplatelet therapy (OR: 2.2, 95% CI: 1.48–3.27), the ischaemic outcome with congestive heart failure (OR: 1.55, 95% CI: 1.02–2.36) and concomitant antiplatelet therapy (OR: 1.93, 95% CI: 1.19–3.13) and the haemorrhagic outcome with age (OR: 1.03, 95% CI: 1.01–1.06 for each year increase), alcoholism (OR: 2.15, 95% CI: 1.06–4.39) and concomitant antiplatelet therapy (OR: 2.22, 95% CI: 1.23–4.02). Cox regression demonstrated a higher rate of the composite outcome (hazard ratio of 1.93 [95% CI, 1.35–2.76]), ischaemic events (HR: 2.05 [95% CI: 1.45–2.87]) and bleeding outcomes (HR: 1.90 [95% CI, 1.06–3.40]) in OAC/AP cohort. After PSM analysis, the composite outcome remained more frequent in people treated with OAC + AP (RR: 1.70 [95% CI, 1.05–2.74]).Discussion: Secondary prevention with combination of oral anticoagulant and antiplatelet therapy after ischaemic stroke was associated with worse outcomes in our cohort.Conclusion: Further research is needed to improve secondary prevention by investigating the mechanisms of recurrent ischaemic stroke in patients with atrial fibrillation.

Published
2023
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8. Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients With Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Caso, Valeria, Tsivgoulis, Georgios, Furie, Karen L., Tadi, Prasanna, Becattini, Cecilia, Falocci, Nicola, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Lees, Kennedy R., Alberti, Andrea, Venti, Michele, Acciarresi, Monica, D’Amore, Cataldo, Mosconi, Maria Giulia, Cimini, Ludovica Anna, Procopio, Antonio, Bovi, Paolo, Carletti, Monica, Rigatelli, Alberto, Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Bandini, Fabio, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Mumoli, Nicola, Consoli, Domenico, Galati, Franco, Sacco, Simona, Carolei, Antonio, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Colombo, Giovanna, Silvestrelli, Giorgio, Ciccone, Alfonso, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Maccarrone, Miriam, Orlandi, Giovanni, Giannini, Nicola, Gialdini, Gino, Tassinari, Tiziana, De Lodovici, Maria Luisa, Bono, Giorgio, Rueckert, Christina, Baldi, Antonio, D’Anna, Sebastiano, Toni, Danilo, Letteri, Federica, Giuntini, Martina, Lotti, Enrico Maria, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Baronello, Mario Maimone, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Vanacker, Peter, Barlinn, Kristian, Pallesen, Lars-Peder, Kepplinger, Jessica, Bodechtel, Ulf, Gerber, Johannes, Deleu, Dirk, Melikyan, Gayane, Ibrahim, Faisal, Akhtar, Naveed, Gourbali, Vanessa, and Yaghi, Shadi

Published
2017
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9. Practical “1-2-3-4-Day” Rule for Starting Direct Oral Anticoagulants After Ischemic Stroke With Atrial Fibrillation: Combined Hospital-Based Cohort Study

Author

Kimura, Shunsuke, primary, Toyoda, Kazunori, additional, Yoshimura, Sohei, additional, Minematsu, Kazuo, additional, Yasaka, Masahiro, additional, Paciaroni, Maurizio, additional, Werring, David J., additional, Yamagami, Hiroshi, additional, Nagao, Takehiko, additional, Yoshimura, Shinichi, additional, Polymeris, Alexandros, additional, Zietz, Annaelle, additional, Engelter, Stefan T., additional, Kallmünzer, Bernd, additional, Cappellari, Manuel, additional, Chiba, Tetsuya, additional, Yoshimoto, Takeshi, additional, Shiozawa, Masayuki, additional, Kitazono, Takanari, additional, Koga, Masatoshi, additional, Todo, Kenichi, additional, Kimura, Kazumi, additional, Yagita, Yoshiki, additional, Furui, Eisuke, additional, Itabashi, Ryo, additional, Terasaki, Tadashi, additional, Shiokawa, Yoshiaki, additional, Hirano, Teruyuki, additional, Kamiyama, Kenji, additional, Nakagawara, Jyoji, additional, Takizawa, Shunya, additional, Homma, Kazunari, additional, Okuda, Satoshi, additional, Okada, Yasushi, additional, Tokunaga, Keisuke, additional, Kameda, Tomoaki, additional, Kario, Kazuomi, additional, Nagakane, Yoshinari, additional, Hasegawa, Yasuhiro, additional, Akiyama, Hisanao, additional, Shibuya, Satoshi, additional, Mochizuki, Hiroshi, additional, Ito, Yasuhiro, additional, Nakashima, Takahiro, additional, Matsuoka, Hideki, additional, Takamatsu, Kazuhiro, additional, Nishiyama, Kazutoshi, additional, Sato, Shoichiro, additional, Arihiro, Shoji, additional, Inoue, Manabu, additional, Takagi, Masahito, additional, Tanaka, Kanta, additional, Nagatsuka, Kazuyuki, additional, Yamaguchi, Takenori, additional, Hashimoto, Yoichiro, additional, Houkin, Kiyohiro, additional, Kitagawa, Kazuo, additional, Matsumoto, Masayasu, additional, Tanahashi, Norio, additional, Terayama, Yasuo, additional, Uchiyama, Shinichiro, additional, Mori, Etsuro, additional, Furukawa, Yutaka, additional, Kimura, Takeshi, additional, Kumon, Yoshiaki, additional, Nagata, Ken, additional, Nogawa, Shigeru, additional, Sakamoto, Tomohiro, additional, Hirai, Toshinori, additional, Kudo, Kohsuke, additional, Sasaki, Makoto, additional, Kobayashi, Shotai, additional, Hamasaki, Toshimitsu, additional, Giustozzi, Michela, additional, Acciarresi, Monica, additional, Agnelli, Giancarlo, additional, Caso, Valeria, additional, Bandini, Fabio, additional, Tsivgoulis, Georgios, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Tadi, Prasanna, additional, Becattini, Cecilia, additional, Zedde, Marialuisa, additional, Abdul-Rahim, Azmil H, additional, Lees, Kennedy R, additional, Alberti, Andrea, additional, Venti, Michele, additional, D’Amore, Cataldo, additional, Giulia Mosconi, Maria, additional, Anna Cimini, Ludovica, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Rigatelli, Alberto, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Marcheselli, Simona, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Vannucchi, Vieri, additional, Sohn, Sung-Il, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Ntaios, George, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, Karagkiozi, Efstathia, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrissoula, additional, Chondrogianni, Maria, additional, Mumoli, Nicola, additional, Galati, Franco, additional, Sacco, Simona, additional, Tiseo, Cindy, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Colombo, Giovanna, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Lanari, Alessia, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Ulivi, Leonardo, additional, Orlandi, Giovanni, additional, Giannini, Nicola, additional, Tassinari, Tiziana, additional, De Lodovici, Maria Luisa, additional, Rueckert, Christina, additional, Baldi, Antonio, additional, Toni, Danilo, additional, Letteri, Federica, additional, Giuntini, Martina, additional, Lotti, Enrico Maria, additional, Flomin, Yuriy, additional, Pieroni, Alessio, additional, Kargiotis, Odysseas, additional, Karapanayiotides, Theodore, additional, Monaco, Serena, additional, Baronello, Mario Maimone, additional, Csiba, Laszló, additional, Szabó, Lilla, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Del Sette, Massimo, additional, Imberti, Davide, additional, Zabzuni, Dorjan, additional, Doronin, Boris, additional, Volodina, Vera, additional, Michel, Patrik, additional, Vanacker, Peter, additional, Barlinn, Kristian, additional, Pallesen, Lars-Peder, additional, Barlinn, Jessica, additional, Deleu, Dirk, additional, Melikyan, Gayane, additional, Ibrahim, Faisal, additional, Akhtar, Naveed, additional, Gourbali, Vanessa, additional, Masotti, Luca, additional, Parry-Jones, Adrian, additional, Patterson, Chris, additional, Price, Christopher, additional, Elmarimi, Abduelbaset, additional, Parry, Anthea, additional, Nallasivam, Arumug, additional, Mohd Nor, Azlisham, additional, Esis, Bernard, additional, Bruce, David, additional, Roffe, Christine, additional, Holmes, Clare, additional, Cohen, David, additional, Hargroves, David, additional, Mangion, David, additional, Chadha, Dinesh, additional, Vahidassr, Djamil, additional, Manawadu, Dulka, additional, Giallombardo, Elio, additional, Warburton, Elizabeth, additional, Flossman, Enrico, additional, Gunathilagan, Gunaratam, additional, Proschel, Harald, additional, Emsley, Hedley, additional, Anwar, Ijaz, additional, Okwera, James, additional, Putterill, Janet, additional, O’Connell, Janice, additional, Bamford, John, additional, Corrigan, John, additional, Scott, Jon, additional, Birns, Jonathan, additional, Kee, Karen, additional, Saastamoinen, Kari, additional, Pasco, Kath, additional, Dani, Krishna, additional, Sekaran, Lakshmanan, additional, Choy, Lillian, additional, Iveson, Liz, additional, Mamun, Maam, additional, Sajid, Mahmud, additional, Cooper, Martin, additional, Burn, Matthew, additional, Smith, Matthew, additional, Power, Michael, additional, Davis, Michelle, additional, Smyth, Nigel, additional, Veltkamp, Roland, additional, Sharma, Pankaj, additional, Guyler, Paul, additional, O’Mahony, Paul, additional, Wilkinson, Peter, additional, Datta, Prabel, additional, Aghoram, Prasanna, additional, Marsh, Rachel, additional, Luder, Robert, additional, Meenakishundaram, Sanjeevikumar, additional, Subramonian, Santhosh, additional, Leach, Simon, additional, Ispoglou, Sissi, additional, Andole, Sreeman, additional, England, Timothy, additional, Manoj, Aravindakshan, additional, Harrington, Frances, additional, Rehman, Habib, additional, Sword, Jane, additional, Staals, Julie, additional, Mahawish, Karim, additional, Harkness, Kirsty, additional, Shaw, Louise, additional, McCormich, Michael, additional, Sprigg, Nikola, additional, Mansoor, Syed, additional, Krishnamurthy, Vinodh, additional, Lyrer, Philippe A, additional, Bonati, Leo H, additional, Seiffge, David J, additional, Traenka, Christopher, additional, Peters, Nils, additional, De Marchis, Gian Marco, additional, Thilemann, Sebastian, additional, Avramiotis, Nikolaos S, additional, Gensicke, Henrik, additional, Hert, Lisa, additional, Wagner, Benjamin, additional, Schaub, Fabian, additional, Meya, Louisa, additional, Fladt, Joachim, additional, Dittrich, Tolga, additional, Fisch, Urs, additional, Bonetti, Bruno, additional, Tomelleri, Giampaolo, additional, Micheletti, Nicola, additional, Zivelonghi, Cecilia, additional, Emiliani, Andrea, additional, Macha, Kosmas, additional, Siedler, Gabriela, additional, Stoll, Svenja, additional, Wang, Ruihao, additional, Volbers, Bastian, additional, Schwab, Stefan, additional, Haupenthal, David, additional, and Gaßmann, Luise, additional

Published
2022
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10. Timing of initiation of oral anticoagulants in patients with acute ischemic stroke and atrial\ud fibrillation comparing posterior and anterior circulation strokes

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Giustozzi, Michela, Tsivgoulis, Georgios, Yaghi, Shadi, MacGrory, Brian, Furie, Karen L., Tadi, Prasanna, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Dawson, Jesse, Lees, Kennedy R., Alberti, Andrea, Venti, Michele, Acciarresi, Monica, D'Amore, Cataldo, Mosconi, Maria Guilia, Bognini, Valentina, Cappellari, Manuel, Rigatelli, Alberto, Bonetti, Bruno, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Bandini, Fabio, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Grifoni, Elisa, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Athanasakis, George, Makaritsis, Konstantinos, Karagkiozi, Efstathia, Vadikolias, Konstantinos, Liantinioti, Chrissoula, Palaiodimou, Lina, Mumoli, Nicola, Porta, Cesare, Galati, Franco, Sacco, Simona, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Caselli, Maria Chiara, Maccarrone, Miriam, Ulivi, Leonardo, Orlandi, Giovanni, Giannini, Nicola, Tassinari, Tiziana, De Lodovici, Maria Luisa, Rueckert, Christina, Baldi, Antonio, Toni, Danilo, Gentile, Luana, Letteri, Federica, Giuntini, Martina, Lotti, Enrico Maria, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Mannino, Marina, Maimone Baronello, Mario, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Schirinzi, Erika, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Eskandari, Ashraf, Vanacker, Peter, Barlinn, Kristian, Barlinn, Jessica, Deleu, Dirk, Gourbali, Vanessa, and Caso, Valeria

Abstract

Background: The aim of this study in patients with acute posterior ischemic stroke (PS) and atrial fibrillation (AF) were to evaluate the risks of recurrent ischemic event and severe bleeding and these risks in relation with oral anticoagulant therapy (OAT) and its timing.\ud \ud Methods: Patients with PS were prospectively included; the outcome events of these patients were compared with those of patients with anterior stroke (AS) which were taken from previous registries. The primary outcome was the composite of: stroke recurrence, TIA, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding occurring within 90 days from acute stroke.\ud \ud Results: A total of 2,470 patients were available for the analysis: 473 (19.1%) with PS and 1,997 (80.9%) AS. Over 90 days, 213 (8.6%) primary outcome events were recorded: 175 (8.7%) in patients with AS and 38 (8.0%) in those with PS. In patients who initiated OAT within 2 days, the primary outcome occurred in 5 out of 95 patients (5.3%) with PS compared to 21 out of 373 patients (4.3%) with AS (OR 1.07; 95% CI 0.39-2.94). In patients who initiated OAT between days 3 and 7, the primary outcome occurred in 3 out of 103 patients (2.9%) with PS compared to 26 out of 490 patients (5.3%) with AS (OR 0.54; 95% CI 0.16-1.80).\ud \ud Conclusions: Patients with posterior or anterior stroke and AF appear to have similar risks of\ud ischemic or hemorrhagic events at 90 days with no difference concerning the timing of initiation of OAT.

Published
2020

11. Quality metrics in the management of acute stroke in Greece during the first 5 years of Registry of Stroke Care Quality (RES-Q) implementation

Author

Caso, Valeria, Tsivgoulis, Georgios, Norrving, Bo, Palaiodimou, Lina, Kargiotis, Odysseas, Katsanos, Aristeidis H, Kiamili, Argyro, Bakola, Eleni, Komnos, Apostolos, Zisimopoulou, Vaso, Natsis, Konstantinos, Papagiannopoulou, Georgia, Theodorou, Aikaterini, Zompola, Christina, Safouris, Apostolos, Psychogios, Klearchos, Ntais, Evangelos, Plomaritis, Panagiotis, Karamatzianni, Georgia, Mavriki, Andriana, Koutsokera, Maria, Lykou, Christina, Koutroulou, Ioanna, Gourbali, Vanessa, Skafida, Anastasia, Roussopoulou, Andromachi, Kourtesi, Georgia, Papamichalis, Panagiotis, Papagiannopoulos, Sotirios, Gryllia, Maria, Tavernarakis, Antonios, Kazis, Dimitrios, Karapanayiotides, Theodoros, Magoufis, Georgios, Giannopoulos, Sotirios, and Tsivgoulis, Georgios

Abstract

Introduction: Establishment of a prospective stroke registry may promote the documentation and improvement of acute stroke care. We present the status of stroke management in Greece using the Registry of Stroke Care Quality (RES-Q) dataset.Methods: Consecutive patients with acute stroke were prospectively registered in RES-Q registry by contributing sites in Greece during the years 2017–2021. Demographic and baseline characteristics, acute management, and clinical outcomes at discharge were recorded. Stroke quality metrics, with a specific interest in the association between acute reperfusion therapies and functional recovery in ischemic stroke patients are presented.Results: A total of 3590 acute stroke patients were treated in 20 Greek sites (61% men, median age 64 years; median baseline NIHSS 4; 74% ischemic stroke). Acute reperfusion therapies were administered in almost 20% of acute ischemic stroke patients, with a door to needle and door to groin puncture times of 40 and 64 min, respectively. After adjustment for contributing sites, the rates of acute reperfusion therapies were higher during the time epoch 2020–2021 compared to 2017–2019 (adjusted OR 1.31; 95% CI 1.04–1.64; p< 0.022; Cochran-Mantel-Haenszel test). After propensity-score-matching, acute reperfusion therapies administration was independently associated with higher odds of reduced disability (one point reduction across all mRS scores) at hospital discharge (common OR 1.93; 95% CI 1.45–2.58; p< 0.001).Conclusions: Implementation and maintenance of a nationwide stroke registry in Greece may guide the stroke management planning, so that prompt patient transportation, acute reperfusion therapies, and stroke unit hospitalization become more widely accessible, improving the functional outcomes of stroke patients.

Published
2023
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13. Ischemic Stroke despite Oral Anticoagulant Therapy in Patients with Atrial Fibrillation

Author

David, Seiffge, Gian Marco De Marchis, Masatoshi, Koga, Maurizio, Paciaroni, Duncan, Wilson, Manuel, Cappellari, Kosmas, Macha, Georgios, Tsivgoulis, Gareth, Ambler, Shoji, Arihiro, Leo, H Bonati, Bruno, Bonetti, Bernd, Kallmünzer, Keith, W Muir, Paolo, Bovi, Henrik, Gensicke, Manabu, Inoue, Stefan, Schwab, Shadi, Yaghi, Martin, M Brown, Philippe, Lyrer, Masahito, Takagi, Monica, Acciarrese, Hans Rolf Jager, Alexandros, A Polymeris, Kazunori, Toyoda, Michele, Venti, Christopher, Traenka, Hiroshi, Yamagami, Andrea, Alberti, Sohei, Yoshimura, Valeria, Caso, Stefan, T Engelter, David, J Werring, Kenichi, Todo, Kazumi, Kimura, Kensaku, Shibazaki, Yoshiki, Yagita, Eisuke, Furui, Ryo, Itabashi, Tadashi, Terasaki, Yoshiaki, Shiokawa, Teruyuki, Hirano, Rieko, Suzuki, Kenji, Kamiyama, Jyoji, Nakagawara, Shunya, Takizawa, Kazunari, Homma, Satoshi, Okuda, Yasushi, Okada, Koichiro, Maeda, Tomoaki, Kameda, Kazuomi, Kario, Yoshinari, Nagakane, Yasuhiro, Hasegawa, Hisanao, Akiyama, Satoshi, Shibuya, Hiroshi, Mochizuki, Yasuhiro, Ito, Takahiro, Nakashima, Hideki, Matsuoka, Kazuhiro, Takamatsu, Kazutoshi, Nishiyama, Kanta, Tanaka, Kaoru, Endo, Tetsuya, Miyagi, Masato, Osaki, Junpei, Kobayashi, Takuya, Okata, Eijiro, Tanaka, Yuki, Sakamoto, Keisuke, Tokunaga, Hotake, Takizawa, Junji, Takasugi, Soichiro, Matsubara, Kyoko, Higashida, Takayuki, Matsuki, Naoto, Kinoshita, Masayuki, Shiozawa, Toshihiro, Ide, Takeshi, Yoshimoto, Daisuke, Ando, Kyohei, Fujita, Masaya, Kumamoto, Teppei, Kamimura, Muneaki, Kikuno, Tadataka, Mizoguchi, Takeo, Sato, Karen, L Furie, Prasanna, Tadi, Cecilia, Becattini, Nicola, Falocci, Marialuisa, Zedde, Azmil, H Abdul-Rahim, Kennedy, R Lees, Cataldo, D’Amore, Maria, G Mosconi, Ludovica, A Cimini, Monica, Carletti, Alberto, Rigatelli, Jukka, Putaala, Liisa, Tomppo, Turgut, Tatlisumak, Fabio, Bandini, Simona, Marcheselli, Alessandro, Pezzini, Loris, Poli, Alessandro, Padovani, Luca, Masotti, Vieri, Vannucchi, Sung-Il, Sohn, Gianni, Lorenzini, Rossana, Tassi, Francesca, Guideri, Maurizio, Acampa, Giuseppe, Martini, George, Ntaios, Efstathia, Karagkiozi, George, Athanasakis, Kostantinos, Makaritsis, Kostantinos, Vadikolias, Chrysoula, Liantinioti, Maria, Chondrogianni, Nicola, Mumoli, Domenico, Consoli, Franco, Galati, Simona, Sacco, Antonio, Carolei, Cindy, Tiseo, Francesco, Corea, Walter, Ageno, Marta, Bellesini, Giorgio, Silvestrelli, Alfonso, Ciccone, Umberto, Scoditti, Licia, Denti, Mancuso, Michelangelo, Miriam, Maccarrone, Orlandi, Giovanni, Nicola, Giannini, Gino, Gialdini, Tiziana, Tassinari, Maria Luisa De Lodovici, Giorgio, Bono, Christina, Rueckert, Antonio, Baldi, Danilo, Toni, Federica, Letteri, Martina, Giuntini, Enrico, M Lotti, Yuriy, Flomin, Alessio, Pieroni, Odysseas, Kargiotis, Theodore, Karapanayiotides, Serena, Monaco, Laszló, Csiba, Lilla, Szabó, Alberto, Chiti, Elisa, Giorli, Massimo Del Sette, Davide, Imberti, Dorjan, Zabzuni, Boris, Doronin, Vera, Volodina, Patrik, Michel, Peter, Vanacker, Kristian, Barlinn, Lars, P Pallesen, Ulf, Bodechtel, Leonardo, Ulivi, Dirk, Deleu, Gayane, Melikyan, Jessica, Bourlinn, Naveed, Akhar, Falsal, Ibrahin, Gourbali, Vanessa, Hawone, Baronello, Lisa, Hert, Nils, Peters, Marina, Maurer, and Martina, Wiegert

Subjects
0301 basic medicine, medicine.medical_specialty, Vascular disease, business.industry, Hazard ratio, Ischemia, 610 Medicine & health, Atrial fibrillation, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Neurology, Interquartile range, Internal medicine, Heart failure, medicine, Neurology (clinical), Prospective cohort study, business, Stroke, 030217 neurology & neurosurgery, Research Articles, Research Article
Abstract

Objective:\ud It is not known whether patients with atrial fibrillation (AF) with ischemic stroke despite oral anticoagulant therapy are at increased risk for further recurrent strokes or how ongoing secondary prevention should be managed.\ud \ud Methods:\ud We conducted an individual patient data pooled analysis of 7 prospective cohort studies that recruited patients with AF and recent cerebral ischemia. We compared patients taking oral anticoagulants (vitamin K antagonists [VKA] or direct oral anticoagulants [DOAC]) prior to index event (OACprior ) with those without prior oral anticoagulation (OACnaive ). We further compared those who changed the type (ie, from VKA or DOAC, vice versa, or DOAC to DOAC) of anticoagulation (OACchanged ) with those who continued the same anticoagulation as secondary prevention (OACunchanged ). Time to recurrent acute ischemic stroke (AIS) was analyzed using multivariate competing risk Fine-Gray models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).\ud \ud Results:\ud We included 5,413 patients (median age = 78 years [interquartile range (IQR) = 71-84 years]; 5,136 [96.7%] had ischemic stroke as the index event, median National Institutes of Health Stroke Scale on admission = 6 [IQR = 2-12]). The median CHA2 DS2 -Vasc score (congestive heart failure, hypertension, age≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category) was 5 (IQR = 4-6) and was similar for OACprior (n = 1,195) and OACnaive (n = 4,119, p = 0.103). During 6,128 patient-years of follow-up, 289 patients had AIS (4.7% per year, 95% CI = 4.2-5.3%). OACprior was associated with an increased risk of AIS (HR = 1.6, 95% CI = 1.2-2.3, p = 0.005). OACchanged (n = 307) was not associated with decreased risk of AIS (HR = 1.2, 95% CI = 0.7-2.1, p = 0.415) compared with OACunchanged (n = 585).\ud \ud Interpretation:\ud Patients with AF who have an ischemic stroke despite previous oral anticoagulation are at a higher risk for recurrent ischemic stroke despite a CHA2 DS2 -Vasc score similar to those without prior oral anticoagulation. Better prevention strategies are needed for this high-risk patient group.

Published
2019

15. Hemorrhagic transformation in acute ischemic stroke patients and atrial fibrillation: time to initiation of anticoagulants and outcome

Author

Paciaroni, Maurizio, Bandini, Fabio, Agnelli, Giancarlo, Tsivgoulis, Georgios, Yaghi, Shadi, Furie, Karen L., Tadi, Prasanna, Becattini, Cecilia, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Lees, Kennedy R., Alberti, Andrea, Venti, Michele, Acciarresi, Monia, Volpi, Giacomo, Bovi, Paolo, Carletti, Monica, Rigatelli, Alberto, Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Targut, Marcheselli, Luca, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Guiseppe, Ntaios, George, Athanasakis, George, Makaritsis, Konstantinos, Karagkiozi, Efstathia, Vadikolias, Konstantinos, Liantinioti, Chirissoula, Chondrogianni, Maria, Mumoli, Nicola, Consoli, Domenico, Galati, Franco, Saxxo, Simona, Carolei, Antonio, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Colombo, Giovanna, Silvestrelli, Giorgio, Ciccone, Alfonso, Lanari, Alessia, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Maccarrone, Miriam, Ulivi, Leonardo, Orlandi, Giovanni, Giannini, Nicola, Gialdini, Gino, Tassinari, Tiziana, De Lodovici, Maria Luisa, Bono, Giorgio, Rueckert, Christina, Baldi, Antonio, D'Anna, Sebastiano, Toni, Danilo, Letteri, Federica, Giuntini, Martina, Lotti, Enrico Maria, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Maimone Baronello, Mario, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Vanacker, Peter, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Deleu, Dirk, Melikyan, Gayane, Ibrahim, Faisal, Akhtar, Navveed, Gourbali, Vanessa, and Caso, Valeria

Abstract

Background: \ud 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.\ud \ud Methods and Results: \ud HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset. The incidence of ischemic recurrences as well as mortality or disability (modified Rankin Scale scores >2) were evaluated at 90 days. Ischemic recurrences were the composite of ischemic stroke, transient ischemic attack, or systemic embolism. Among the 2183 patients included in the study, 241 (11.0%) had HT. Patients with and without HT initiated anticoagulant therapy after a mean 23.3 and 11.6 days, respectively, from index stroke. At 90 days, 4.6% (95% confidence interval, 2.3–8.0) of the patients with HT had ischemic recurrences compared with 4.9% (95% confidence interval, 4.0–6.0) of those without HT; 53.1% of patients with HT were deceased or disabled compared with 35.8% of those without HT. On multivariable analysis, HT was associated with mortality or disability (odds ratio, 1.71; 95% confidence interval, 1.24–2.35).\ud \ud Conclusions: \ud In patients with HT, anticoagulation was initiated about 12 days later than patients without HT. This delay was not associated with increased detection of ischemic recurrence. HT was associated with increased mortality or disability.

Published
2018

16. Hemorrhagic Transformation in Patients With Acute Ischemic Stroke and Atrial Fibrillation: Time to Initiation of Oral Anticoagulant Therapy and Outcomes

Author

Paciaroni, Maurizio, primary, Bandini, Fabio, additional, Agnelli, Giancarlo, additional, Tsivgoulis, Georgios, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Tadi, Prasanna, additional, Becattini, Cecilia, additional, Zedde, Marialuisa, additional, Abdul‐Rahim, Azmil H., additional, Lees, Kennedy R., additional, Alberti, Andrea, additional, Venti, Michele, additional, Acciarresi, Monica, additional, D'Amore, Cataldo, additional, Mosconi, Maria Giulia, additional, Cimini, Ludovica Anna, additional, Altavilla, Riccardo, additional, Volpi, Giacomo, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Rigatelli, Alberto, additional, Cappellari, Manuel, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Marcheselli, Simona, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Masotti, Luca, additional, Vannucchi, Vieri, additional, Sohn, Sung‐Il, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Ntaios, George, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, Karagkiozi, Efstathia, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrissoula, additional, Chondrogianni, Maria, additional, Mumoli, Nicola, additional, Consoli, Domenico, additional, Galati, Franco, additional, Sacco, Simona, additional, Carolei, Antonio, additional, Tiseo, Cindy, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Colombo, Giovanna, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Lanari, Alessia, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Ulivi, Leonardo, additional, Orlandi, Giovanni, additional, Giannini, Nicola, additional, Gialdini, Gino, additional, Tassinari, Tiziana, additional, De Lodovici, Maria Luisa, additional, Bono, Giorgio, additional, Rueckert, Christina, additional, Baldi, Antonio, additional, D'Anna, Sebastiano, additional, Toni, Danilo, additional, Letteri, Federica, additional, Giuntini, Martina, additional, Lotti, Enrico Maria, additional, Flomin, Yuriy, additional, Pieroni, Alessio, additional, Kargiotis, Odysseas, additional, Karapanayiotides, Theodore, additional, Monaco, Serena, additional, Maimone Baronello, Mario, additional, Csiba, Laszló, additional, Szabó, Lilla, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Del Sette, Massimo, additional, Imberti, Davide, additional, Zabzuni, Dorjan, additional, Doronin, Boris, additional, Volodina, Vera, additional, Michel, Patrik, additional, Vanacker, Peter, additional, Barlinn, Kristian, additional, Pallesen, Lars‐Peder, additional, Barlinn, Jessica, additional, Deleu, Dirk, additional, Melikyan, Gayane, additional, Ibrahim, Faisal, additional, Akhtar, Naveed, additional, Gourbali, Vanessa, additional, and Caso, Valeria, additional

Published
2018
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17. Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke

Author

Paciaroni, Maurizio, primary, Angelini, Filippo, additional, Agnelli, Giancarlo, additional, Tsivgoulis, Georgios, additional, Furie, Karen L, additional, Tadi, Prasanna, additional, Becattini, Cecilia, additional, Falocci, Nicola, additional, Zedde, Marialuisa, additional, Abdul-Rahim, Azmil H, additional, Lees, Kennedy R, additional, Alberti, Andrea, additional, Venti, Michele, additional, Acciarresi, Monica, additional, Altavilla, Riccardo, additional, D’Amore, Cataldo, additional, Mosconi, Maria G, additional, Cimini, Ludovica A, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Rigatelli, Alberto, additional, Cappellari, Manuel, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Bandini, Fabio, additional, Marcheselli, Simona, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Masotti, Luca, additional, Vannucchi, Vieri, additional, Sohn, Sung-Il, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Ntaios, George, additional, Karagkiozi, Efstathia, additional, Athanasakis, George, additional, Makaritsis, Kostantinos, additional, Vadikolias, Kostantinos, additional, Liantinioti, Chrysoula, additional, Chondrogianni, Maria, additional, Mumoli, Nicola, additional, Consoli, Domenico, additional, Galati, Franco, additional, Sacco, Simona, additional, Carolei, Antonio, additional, Tiseo, Cindy, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Orlandi, Giovanni, additional, Giannini, Nicola, additional, Gialdini, Gino, additional, Tassinari, Tiziana, additional, Lodovici, Maria Luisa De, additional, Bono, Giorgio, additional, Rueckert, Christina, additional, Baldi, Antonio, additional, Toni, Danilo, additional, Letteri, Federica, additional, Giuntini, Martina, additional, Lotti, Enrico M, additional, Flomin, Yuriy, additional, Pieroni, Alessio, additional, Kargiotis, Odysseas, additional, Karapanayiotides, Theodore, additional, Monaco, Serena, additional, Baronello, Mario M, additional, Csiba, Laszló, additional, Szabó, Lilla, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Sette, Massimo Del, additional, Imberti, Davide, additional, Zabzuni, Dorjan, additional, Doronin, Boris, additional, Volodina, Vera, additional, Michel Pd-Mer, Patrik, additional, Vanacker, Peter, additional, Barlinn, Kristian, additional, Pallesen, Lars P, additional, Kepplinger, Jessica, additional, Deleu, Dirk, additional, Melikyan, Gayane, additional, Ibrahim, Faisal, additional, Akhtar, Naveed, additional, Gourbali, Vanessa, additional, Yaghi, Shadi, additional, and Caso, Valeria, additional

Published
2018
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18. Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non–Vitamin‐K Oral Anticoagulants (RAF‐NOACs) Study

Author

Paciaroni, Maurizio, primary, Agnelli, Giancarlo, additional, Falocci, Nicola, additional, Tsivgoulis, Georgios, additional, Vadikolias, Kostantinos, additional, Liantinioti, Chrysoula, additional, Chondrogianni, Maria, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Cappellari, Manuel, additional, Zedde, Marialuisa, additional, Ntaios, George, additional, Karagkiozi, Efstathia, additional, Athanasakis, George, additional, Makaritsis, Kostantinos, additional, Silvestrelli, Giorgio, additional, Lanari, Alessia, additional, Ciccone, Alfonso, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Abdul‐Rahim, Azmil H., additional, Lees, Kennedy R., additional, Alberti, Andrea, additional, Venti, Michele, additional, Acciarresi, Monica, additional, D'Amore, Cataldo, additional, Becattini, Cecilia, additional, Mosconi, Maria Giulia, additional, Cimini, Ludovica Anna, additional, Soloperto, Rossana, additional, Masotti, Luca, additional, Vannucchi, Vieri, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Sohn, Sung‐Il, additional, Marcheselli, Simona, additional, Mumoli, Nicola, additional, De Lodovici, Maria Luisa, additional, Bono, Giorgio, additional, Furie, Karen L., additional, Tadi, Prasanna, additional, Yaghi, Shadi, additional, Toni, Danilo, additional, Letteri, Federica, additional, Tassinari, Tiziana, additional, Kargiotis, Odysseas, additional, Lotti, Enrico Maria, additional, Flomin, Yuriy, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Giannini, Nicola, additional, Bandini, Fabio, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Consoli, Domenico, additional, Galati, Franco, additional, Sacco, Simona, additional, Carolei, Antonio, additional, Tiseo, Cindy, additional, Gourbali, Vanessa, additional, Orlandi, Giovanni, additional, Giuntini, Martina, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Gialdini, Gino, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Colombo, Giovanna, additional, Monaco, Serena, additional, Maimone Baronello, Mario, additional, Karapanayiotides, Theodore, additional, and Caso, Valeria, additional

Published
2017
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19. Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke

Author

Paciaroni, Maurizio, Angelini, Filippo, Agnelli, Giancarlo, Tsivgoulis, Georgios, Furie, Karen L, Tadi, Prasanna, Becattini, Cecilia, Falocci, Nicola, Zedde, Marialuisa, Abdul-Rahim, Azmil H, Lees, Kennedy R, Alberti, Andrea, Venti, Michele, Acciarresi, Monica, Altavilla, Riccardo, D’Amore, Cataldo, Mosconi, Maria G, Cimini, Ludovica A, Bovi, Paolo, Carletti, Monica, Rigatelli, Alberto, Cappellari, Manuel, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Bandini, Fabio, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Mumoli, Nicola, Consoli, Domenico, Galati, Franco, Sacco, Simona, Carolei, Antonio, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Maccarrone, Miriam, Orlandi, Giovanni, Giannini, Nicola, Gialdini, Gino, Tassinari, Tiziana, Lodovici, Maria Luisa De, Bono, Giorgio, Rueckert, Christina, Baldi, Antonio, Toni, Danilo, Letteri, Federica, Giuntini, Martina, Lotti, Enrico M, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Baronello, Mario M, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Sette, Massimo Del, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel Pd-Mer, Patrik, Vanacker, Peter, Barlinn, Kristian, Pallesen, Lars P, Kepplinger, Jessica, Deleu, Dirk, Melikyan, Gayane, Ibrahim, Faisal, Akhtar, Naveed, Gourbali, Vanessa, Yaghi, Shadi, and Caso, Valeria

Abstract

Background The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear.Purpose In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation.Methods In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke.Results A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24–2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74–2.04)).Conclusions After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence.

Published
2019
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22. Timing of initiation of oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation comparing posterior and anterior circulation strokes.

Author

Paciaroni M, Agnelli G, Giustozzi M, Tsivgoulis G, Yaghi S, Grory BM, Furie KL, Tadi P, Zedde M, Abdul-Rahim AH, Dawson J, Lees KR, Alberti A, Venti M, Acciarresi M, D'Amore C, Mosconi MG, Bogini V, Cappellari M, Rigatelli A, Bonetti B, Putaala J, Tomppo L, Tatlisumak T, Bandini F, Marcheselli S, Pezzini A, Poli L, Padovani A, Masotti L, Grifoni E, Vannucchi V, Sohn SI, Lorenzini G, Tassi R, Guideri F, Acampa M, Martini G, Ntaios G, Athanasakis G, Makaritsis K, Karagkiozi E, Vadikolias K, Liantinioti C, Palaiodimou L, Mumoli N, Porta C, Galati F, Sacco S, Tiseo C, Corea F, Ageno W, Bellesini M, Silvestrelli G, Ciccone A, Scoditti U, Denti L, Mancuso M, Caselli MC, Maccarrone M, Ulivi L, Orlandi G, Giannini N, Tassinari T, Lodovici ML, Rueckert C, Baldi A, Toni D, Gentile L, Letteri F, Giuntini M, Lotti EM, Flomin Y, Pieroni A, Kargiotis O, Karapanayiotides T, Monaco S, Mannino M, Baronello MM, Csiba L, Szabó L, Chiti A, Giorli E, Sette MD, Schirinzi E, Imberti D, Zabzuni D, Doronin B, Volodina V, Michel P, Eskandari A, Vanacker P, Barlinn K, Barlinn J, Deleu D, Gourbali V, and Caso V

Abstract

Introduction: The aim of this study in patients with acute posterior ischaemic stroke (PS) and atrial fibrillation (AF) was to evaluate (1) the risks of recurrent ischaemic event and severe bleeding and (2) these risks in relation with oral anticoagulant therapy (OAT) and its timing., Materials and Methods: Patients with PS were prospectively included; the outcome events of these patients were compared with those of patients with anterior stroke (AS) which were taken from previous registries. The primary outcome was the composite of stroke recurrence, transient ischaemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding occurring within 90 days from acute stroke., Results: A total of 2470 patients were available for the analysis: 473 (19.1%) with PS and 1997 (80.9%) with AS. Over 90 days, 213 (8.6%) primary outcome events were recorded: 175 (8.7%) in patients with AS and 38 (8.0%) in those with PS. In patients who initiated OAT within 2 days, the primary outcome occurred in 5 out of 95 patients (5.3%) with PS compared to 21 out of 373 patients (4.3%) with AS (OR 1.07; 95% CI 0.39-2.94). In patients who initiated OAT between days 3 and 7, the primary outcome occurred in 3 out of 103 patients (2.9%) with PS compared to 26 out of 490 patients (5.3%) with AS (OR 0.54; 95% CI 0.16-1.80)., Discussion: our findings suggest that, when deciding the time to initiate oral anticoagulation, the location of stroke, either anterior or posterior, does not predict the risk of outcome events., Conclusions: Patients with PS or AS and AF appear to have similar risks of ischaemic or haemorrhagic events at 90 days with no difference concerning the timing of initiation of OAT., (© European Stroke Organisation 2020.)

Published
2020
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23. Association of alpha-synuclein Rep1 polymorphism and Parkinson's disease: influence of Rep1 on age at onset.

Author

Hadjigeorgiou GM, Xiromerisiou G, Gourbali V, Aggelakis K, Scarmeas N, Papadimitriou A, and Singleton A

Subjects
Adult, Aged, Aged, 80 and over, Analysis of Variance, Case-Control Studies, Chi-Square Distribution, Confidence Intervals, Female, Gene Frequency, Genotype, Greece ethnology, Humans, Male, Middle Aged, Odds Ratio, Parkinson Disease mortality, Promoter Regions, Genetic, Survival Analysis, Age of Onset, Genetic Predisposition to Disease, Microsatellite Repeats genetics, Parkinson Disease genetics, Polymorphism, Genetic, alpha-Synuclein genetics
Abstract

The alpha-synuclein Rep1 polymorphism was studied in patients and controls in an ethnic Greek population. There was an association of allele 2 with risk of Parkinson's disease (PD; adjusted odd ratio = 3.25; 95% CI = 1.80-5.87). Survival analyses (Cox proportional hazards models) were employed to explore the influence of genotypes on age at onset of PD. Age at onset of carriers of at least one Rep1 allele 2 was earlier (3.6 years) compared to noncarriers (adjusted hazard ratio = 2.21; 95% CI = 1.58-3.10). Kaplan-Meier analysis also supported a dosage effect of Rep1 allele 2 on age at onset. For Rep1 allele 1, there was neither association with risk of PD nor influence on age at onset. This is the first study showing an influence of Rep1 polymorphism on age at onset of PD., (Copyright 2005 Movement Disorder Society.)

Published
2006
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