Tag Archives: stroke

New AF guidelines The first collaborative European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on Atrial Fibrillation (AF) were published at the start of the congress.1 These multidisciplinary guidelines focus on early detection of asymptomatic AF, recommending both opportunistic and targeted screening for all patients aged ≥65 years, or with stroke or transient ischaemic attack (TIA). In addition, the guidelines deal with long-term challenges in the management of AF patients, with recommendations on what to do when patients develop complications on anticoagulation, re-initiation of an

Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with a reported worldwide prevalence of 0.6% in men and 0.4% in women.1 AF is independently associated with a five-fold increased rate of stroke, which is comparable with the risk seen in patients with three or more other stroke risk factors.2,3 Furthermore, strokes related to AF are associated with higher rates of disability and mortality than other strokes.4-6 The cost of AF-related strokes in the UK is estimated to be around £750 million per year.7 AF-related stroke is thought to be secondary to thromboembolism from the left atrium to the cerebral circulation. Ora

BSH Parliament day Professor Andrew Clark (President of the British Society for Heart Failure) is pictured here (centre) carrying out an echocardiogram in the House of Commons. He was at a BSH event to help raise awareness that a person diagnosed with heart failure is likely to have a worse prognosis than if they were diagnosed with most cancers. This is despite the availability of specialist heart failure services that can have a remarkable impact on a patient’s chance of survival, but for which there is inconsistent access over the UK leading to wide variations in care and outcomes. Over 60 MPs, Peers, and professional and patient groups

Dear Sirs, Research on sex difference in mortality after myocardial infarction (MI) since the 1990s has been debated and increased. Several observational studies have shown that younger women, in particular, seemed to have higher mortality rates than men of similar age during the two-year or longer follow-up, although these studies were mainly from the USA.1-3 Recent American studies have also found that, even after full adjustment for potential risk factors, excess risk for in-hospital mortality for women was still noted, particularly among those <50 years old with acute ST-segment elevation MI, leading to 98% (odds ratio [OR] 1.98, 95% c

Yet, not all today’s physicians are keeping step with this new world. All too often adopting new ways of talking to patients or prescribing new technologies and medicines is left by the wayside in favour of keeping to tried and tested habits. Treating a common heart disorder Take the case with atrial fibrillation (AF), which affects around 800,000 people in the UK. Anticoagulation to reduce the risk of stroke is an essential part of AF management but according to the Department of Health many patients are not always appropriately anticoagulated.1 Since 2012, the National Institute for Health and Care Excellence (NICE) has approved a number

With the number of patients with atrial fibrillation (AF) set to double by 2050, appropriate anticoagulation for this growing condition was highlighted in a special session at the meeting – a ‘State of The Art Lecture’. Professor Stefan H Hohnloser (JW Goethe University, Frankfurt, Germany) described how stroke in Europe costs an estimated €38 billion per year, with 20% attributable to AF. Yet a decade ago, around 40% of AF patients did not receive appropriate anticoagulation. Of those receiving therapy, only around 50% of time in therapeutic range (TTR) is seen. With this in mind, novel oral anticoagulants (NOACs) are non-inferior to

Introduction Atrial fibrillation (AF) is the most common cardiac dysrrhythmia, whose sequelae include stroke, heart failure and poor quality of life.1 In parallel with an ageing population, the prevalence of AF is increasing, with persistent or permanent forms affecting 10–15% of the population over the age of 75 years.2-6 The effective management of AF has been a source of recurring debate, leading to the publication of combined American College of Cardiology/American Heart Association/European Society of Cardiology (ACC/AHA/ESC), and National Institute for Health and Clinical Excellence (NICE) guidelines in 2006.7,8 In addition to evidenc

to ensure that primary healthcare professionals (predominantly GPs and practice nurses) are screening, diagnosing and treating AF to optimum levels to raise awareness of AF as a risk factor for stroke amongst the public to lobby national policy makers for improvement in and better implementation of guidance around AF detection/treatment. To raise public awareness, The Stroke Association will be organising advertising campaigns on the dangers of AF. A parliamentary reception is planned to spread awareness amongst and gain support from policymakers. It has also carried out a survey of 1,000 GPs to gauge clinical awareness levels of the link b

We audited management of AF at the Royal Surrey County Hospital against standards derived from the NICE guidelines. Fifty-nine of the 663 patients (8.9%) presenting to the acute medical take during the month of May 2008 had a documented diagnosis of AF, 10% of whom presented with a new diagnosis of AF and 90% of whom had a pre-existing diagnosis. The case notes of these 59 patients were reviewed. All patients with a new diagnosis of AF were managed consistently with the NICE guidelines. Compliance for patients with pre-existing AF was much lower. Eighteen out of 31 patients (58%) with pre-existing AF were found to be on digoxin monotherapy on

Dual antiplatelet therapy for all CVD patients? Table 1. Currently used antiplatelet drugs Currently used antiplatelet drugs are summarised in table 1 and pivotal clinical trials of dual antiplatelet therapy in table 2. The Clopidogrel for High Atherothrombotic Risk and Ischaemia Stabilisation, Management and Avoidance (CHARISMA) trial2 is the only prospective randomised clinical trial to evaluate the efficacy and safety of dual antiplatelet therapy in all CVD patients. Initiated after the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE) trial had shown a 9% relative risk reduction with clopidogrel compared w