Cryptogenic stroke due to undetected atrial fibrillation – longer ECG monitoring may be the key

Up to 40% of ischemic strokes remain unexplained after routine evaluation and thus are considered cryptogenic. However, a number of these strokes may be due to an undetected episode of paroxysmal atrial fibrillation (AF) where anticoagulation can reduce the risk of subsequent ischemic stokes. Although a minimum of 24 hours of ECG monitoring is guideline […]

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PFO and stroke – to close or not to close?

Approximately 40% of strokes are classified as cryptogenic or as having no identifiable cause.  Some of these cryptogenic strokes may be due to an embolus from the venous circulation crossing into the systemic circulation through a patent foramen ovale (PFO).  While PFOs are certainly common in the general population – with a prevalence of around […]

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Subclinical AF significantly increases stroke risk

Approximately 25% of all strokes are of unknown cause, and it has long been hypothesised that short subclinical episodes of atrial fibrillation (AF) may be an important common etiologic factor.  While several studies have attempted to detect episodes of subclinical AF, most have been hampered by the infrequency of such episodes and the unlikelihood of […]

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Fewer strokes complicate CABG

Stroke is a serious complication of coronary artery bypass grafting (CABG), occurring in around 1.3% of patients undergoing coronary surgery in the USA.  In this study, Tarakji et al. aimed to examine the prevalence and timing of perioperative stroke in the modern era, to identify patient and surgical factors associated with stroke and its timing, […]

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Clopidogrel and Asprin ACTIVEly prevent stroke

The ACTIVE Trial (Atrial Fibrillation Clopidogrel Trial with Irbesartan for the Prevention of Vascular Events) was designed to assess the role of clopidogrel and aspirin in the prevention of stroke and other vascular events in patients with atrial fibrillation (AF). ACTIVE W has already reported and compared clopidogrel + aspirin with a vitamin K antagonist. […]

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Higher nonfasting triglycerides associated with ischaemic stroke risk

Two recent studies reported a strong association between elevated levels of nonfasting, but not fasting, triglycerides and increased risk of myocardial infarction, ischemic heart disease, and death and total cardiovascular events.  However, to date the evidence regarding the risk of nonfasting triglyceride levels has been less clear. […]

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Thrombolysis in stroke: minutes mean mind

The current thrombolysis guidelines for acute ischaemic stroke recommend thrombolysis with alteplase initiated within 3 hours of symptom onset.  This was following the landmark findings of the 1995 National Institute of Neurological Disorders and Stroke (NINDS) study group.  The ECAS III trial (European Cooperative Acute Stroke Study), a multi-centre, randomised, placebo controlled phase 3 trial […]

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