September 2024 Br J Cardiol 2024;31(3) doi:10.5837/bjc.2024.040 Online First
Oscar M P Jolobe with a response from Nimisha Shaji, Robert F Storey and William A E Parker
The latter study enrolled 9,361 participants, of whom 4,683 were randomised to a goal SBP of <140 mmHg, and 4,678 were randomised to a goal SBP of <120 mmHg, the latter defined as intensive blood-pressure lowering. During 5.2 years of follow-up, intensive SBP lowering was associated with a 26% lower risk of developing new-onset AF (hazard ratio 0.74, 95% confidence interval 0.56 to 0.98, p<0.037). This effect was consistent among prespecified subgroups of participants stratified by age and sex.2 It is salutary to note that patients aged 60 years and older who have a life-expectancy of >3 years also benefit from intensive SBP lower
November 2023 Br J Cardiol 2023;30:139–43 doi:10.5837/bjc.2023.040
Nimisha Shaji, Robert F Storey, William A E Parker
Introduction Stroke is defined as an acute neurological deficit of cerebrovascular origin lasting longer than 24 hours. In the UK each year, stroke affects approximately 100,000 people, is a leading cause of mortality, causing over 30,000 deaths in 2020, and is a significant contributor to severe disability.1 Caring for patients with stroke in the UK costs approximately £2.5 million each year and leads to significant production losses. Clearly, preventing stroke has many benefits. Strokes can be ischaemic (85%), where tissue damage is due to occlusion of blood supply, or haemorrhagic (15%), due to a ruptured vessel.2 Ischaemic stroke can be
May 2022 Br J Cardiol 2022;29:46–51 doi:10.5837/bjc.2022.015
David Muggeridge, Kara Callum, Lynsey Macpherson, Nick Howard, Claudia Graune, Ian Megson, Adam Giangreco, Susan Gallacher, Linda Campbell, Gethin Williams, Ashish Macaden, Stephen J Leslie
Introduction Cerebrovascular disease is a major cause of disability and mortality in adults worldwide.1 Patients can present with a stroke or transient ischaemic attack (TIA). Due to the risk of recurrent events, early investigation and treatment of risk factors is advised.2,3 One of the major risk factors for stroke is atrial fibrillation (AF). AF is a common cardiac arrhythmia, which is estimated to affect 2.5% of the adult population in Scotland, with a large proportion undiagnosed and consequently untreated. Cardioembolism accounts for around a quarter of all ischaemic strokes, which is most commonly caused by AF.4 Current evidence shows
July 2019 Br J Cardiol 2019;26(suppl 2):S10–S14 doi:10.5837/bjc.2019.s09
Paul Guyler
Introduction Atrial fibrillation (AF) more than doubles the five-year risk of stroke in middle-aged men and women.1 Prior cerebrovascular disease markedly amplifies the risk of recurrent stroke in patients with or without AF.1,2 Figure 1 shows the influence of AF and prior cerebrovascular disease (stroke or transient ischaemic attack [TIA]) on the estimated five-year risk of a composite of stroke, systemic thromboembolism, or TIA (most events were ischaemic strokes) for a 60-year-old individual, from a large cohort study conducted in the UK.1 These observations demonstrate the need for long-term treatment to reduce the risk of stroke in thes
May 2019 Br J Cardiol 2019;26:52
BJC Staff
Stat tests loaded into the VITROS XT 7600 Moderate alcohol consumption does not protect against stroke Blood pressure and stroke risk increase steadily with increasing alcohol intake, and previous claims that one to two alcoholic drinks a day might protect against stroke are not borne out by new evidence from a genetic study involving 160,000 adults. Studies of East Asian genes, where two common genetic variants strongly affect what people choose to drink, show that alcohol itself directly increases blood pressure and the chances of having a stroke, according to a new study published in The Lancet (doi: 10.1016/S0140-6736(18)31772-0). Researc
February 2019 Br J Cardiol 2019;26:23–6 doi:10.5837/bjc.2019.007
Calum Creaney, Karissa Barkat, Christopher Durey, Susan Gallagher, Linda Campbell, Ashish MacAden, Paul Findlay, Gordon F Rushworth, Stephen J Leslie
Introduction Atrial fibrillation (AF) increases an individual’s risk of stroke fivefold.1 Oral anticoagulation (OAC) with warfarin reduces the risk of stroke by 64%.2 Novel or direct oral anticoagulants are non-inferior to warfarin in preventing stroke in non-valvular AF and have a similar bleeding profile, but with a lower risk of fatal intracranial haemorrhage and several practical advantages.3-7 While several antiplatelet agents have been shown to reduce the risk of recurrent stroke, they are considerably less effective than OAC, with a similar risk of major bleeding, and, therefore, are no longer recommended in national guidelines for
June 2018 Br J Cardiol 2018;25:52
BJC Staff
New practical NOACs guide A new version of EHRA Practical Guide on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) was launched at the congress. ESC guidelines state that NOACs should be preferred over vitamin K antagonists, such as warfarin, for stroke prevention in AF patients, except those with a mechanical heart valve or rheumatic mitral valve stenosis, and their use in clinical practice is increasing. The guide gives concrete, practical advice on how to use NOACs in specific clinical situations. The guide is published in European Heart Journal (doi: 10.1093/eurheartj/ehy136). Anti
March 2018
BJC Staff
Large-scale studies examining these key aspects of work have been carried out in the US, but not within the UK and there is a significant data gap. The survey will take only 15–20 minutes to complete and will provide valuable insight in to the professional life of the UK cardiologist. Visit: https://bbk.onlinesurveys.ac.uk/the-organisation-life-work-balance-and-gender-perceptions CASTLE-AF: AF ablation first-line therapy in HF? Results from CASTLE-AF “indicate heart failure patients with co-existing AF should be treated with catheter ablation as a first-line therapy,” says the study’s co-lead investigator Dr Johannes Brachmann, (Cobur
November 2017 Br J Cardiol 2017;24:135
BJC Staff
Cardiff Metropolitan University has just launched Stroke Hub Wales (SHW) – a resource facility that will support and coordinate research, innovation and education programmes across Wales – part of the Welsh Government’s five-year strategy to tackle stroke in individuals of all ages. The aim of SHW (www.stroke.wales) is to achieve a step-change in high-impact stroke research for the benefit of the health, wellbeing and prosperity of people in Wales. The hub will act as a resource for researchers, clinicians and allied health professionals across our NHS Trusts, University Health Boards and Universities. It will build on established relat
October 2017 Br J Cardiol 2017;24:(4) doi:10.5837/bjc.2017.026 Online First
Ioannis Merinopoulos, Sajid Alam, David Bloore
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