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This article examines the disparities in treatment and outcomes for atrial fibrillation (AF) based on gender and economic status in different countries. The study analyzed data from the Global RE-LY AF Registry, which included 15,400 patients from 47 countries. The results showed that females with AF were less likely to receive certain treatments, but were slightly more likely to receive anticoagulation. The study suggests that there may be gaps in AF treatment and outcomes based on sex, and further research is needed to develop specific treatment recommendations. The article also presents a table showing data on gender disparities in different income levels and Global Gender Gap scores. Another study discussed in the article found that female sex was associated with an increased risk of stroke in AF patients, but there was no difference in other outcomes between males and females. The study also found that females were less likely to receive rhythm control therapy, especially in lower income countries and those with less gender parity. Overall, the findings suggest that there are disparities in the management and outcomes of AF based on sex. [Extracted from the article]

Aims: Dementia is a major health problem. Cardiovascular diseases (CVD) and risk factors are associated with incident dementia. However, whether there is an association among CVD, Alzheimer's disease (AD) and vascular dementia (VD) at the population level remains unclear. Methods: We analysed the association between CVD (heart failure [HF], atrial fibrillation [AF], myocardial infarction [MI], peripheral arterial disease, stroke and transient ischemic attack) and the incidence of dementia using nationwide FinnGen data of 218,192 individuals. The last follow‐up information on dementia was available from October 2021. Results: The age at the end of the follow‐up was 61.7 ± 17.1 years, and 53% were women. Overall, we observed 9701 (4.4%) dementia, 6323 (2.9%) AD and 1918 (0.7%) VD cases. Individuals with CVD had a higher risk of developing dementia than unexposed individuals. In the multivariable‐adjusted Cox models, stroke was most strongly associated with dementia (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.6–1.8). CVD was more strongly associated with VD than with AD. Individuals with HF and MI had an increased risk of AD (HF: HR 1.11, 95% CI 1.04–1.19; MI: HR 1.10, 95% CI 1.02–1.18). AF was associated with VD (HR 1.58, 95% CI 1.42–1.77), but not with AD (HR 1.03, 95% CI 0.97–1.09). Clinical characteristics, such as diabetes, smoking and alcohol abuse, were associated with both types of dementia. Conclusion: All major CVDs were associated with an increased risk of developing dementia, particularly VD. Therefore, CVD onset should prompt an assessment of cognitive decline and possible preventive measures. [ABSTRACT FROM AUTHOR]

Background In this cohort study, the association between periodontal disease (PD) and recurrent vascular events was determined among the subjects with ischemic stroke/transient ischemic attack (TIA), and the extent and severity of periodontal disease were estimated among these subjects. Methods This prospective, longitudinal, hospital-based cohort study included 153 individuals who had a stroke or TIA. They were divided into two groups: high periodontal disease (HPD) (N=55, mean age: 59.40±12.21) and low periodontal disease (LPD) (N=98, mean age: 53.03±12.82). Clinical attachment loss (CAL) and probing pocket depth (PPD) were used to measure the severity of the periodontal disease. TOAST criteria were used to determine the ischemic stroke etiology, and the NIH Stroke Scale (NIHSS) was used to determine the ischemic stroke severity. A follow-up survey found that vascular incidents recurred. Results HPD individuals exhibited a higher median NIHSS (eight) than LPD patients (seven) in a subset of stroke population (N=23). Thirty-eight cardiovascular events occurred in the first three months after enrollment, including 23 strokes and seven TIAs, and five myocardial infarctions(MIs). There were three deaths from vascular causes. There was a non-significant association between PD and composite vascular events (HR 1.06, 95% CI, 1.03 to 1.09, p=0.71). Compound vascular events were not related to severe HPD (HR 1.31, 95 % CI 0.54 to 3.16, p=0.07). Conclusion In stroke/TIA patients, there is no link between high periodontal disease and recurrent vascular episodes. The proportions of stroke subtypes were not substantially different between HPD and LPD., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sharma et al.)

A 43-year-old female presents to the emergency department (ED) after she woke up with the sensation that the room was spinning and vomited three times at home. She continues to have significant vertigo when she presents to the ED 4 hours later. Her symptoms are worsened by head movement. She has noticed some unsteadiness but is able to walk unaided. When you examine her, she has left-beating horizontal nystagmus with a slight rotatory component to the left.

A 67-year-old male presents to the emergency department (ED) with a 10-minute history of right upper extremity and right facial weakness, which came on suddenly. His symptoms spontaneously remitted. He has never experienced symptoms like this before. He has a past medical history of coronary artery disease, type 2 diabetes mellitus, dyslipidemia, and is a lifelong smoker. The patient states that he now feels completely well and back to his baseline. On examination, the patient is afebrile. Blood pressure is 160/87, heart rate is 89 in sinus rhythm, and respiratory rate is 16. His oxygen saturation on room air is 94%. Glucose is 5.6 mmol/L. Cranial nerve and peripheral neurological examination are completely unremarkable. Reflexes, coordination, and gait are all within normal limits. Cardiac and respiratory examination are also unremarkable. His electrocardiogram shows normal sinus rhythm.