Among Older Patients with AF, Stroke Risk Is Higher in Women Than in Men
Cardiology Summary and Comment
In a population-based cohort, the increase was independent of comorbidities, baseline risk score, or warfarin use.
Warfarin Ineffective for HF Without Atrial Fibrillation
Cardiology Summary and Comment
Free
In the WARCEF trial, reduced stroke rates were offset by increased bleeding.
Are Migraine and Arterial Dissection Related?
Neurology Summary and Comment
A case-control study provides more evidence that they are, but causal factors remain speculative.
Thrombolysis for Stroke Is Safe in Younger Patients
Emergency Medicine Summary and Comment
Outcomes were better among patients aged 18 to 50 than among those aged 51 to 80.
Experimental Drug Provides Neuroprotection in Monkeys with Induced Stroke
General Medicine Summary and Comment
Neurological function — not just infarct size — was substantially improved by an agent that may lessen the neurotoxicity caused by ischemia.
Spot Sign Reliably Predicts Intracranial Hematoma Expansion
Neurology Summary and Comment
A prospective multicenter study confirms that active contrast extravasation, seen on computed tomography scans, can identify patients at risk for hematoma expansion and clinical deterioration.
By Hooman Kamel, MD
April 3, 2012
Covering:
Demchuk AM et al., Lancet Neurol 2012 Apr; 11:307
The Hemorrhage Risk of Cerebral Cavernous Malformations
Neurology Summary and Comment
Two studies suggest that the risk is increased in those with prior hemorrhage, especially more-recent hemorrhage.
By Gene Sung, MD, MPH
April 3, 2012
Covering:
Flemming KD et al., Neurology 2012 Feb 28; 78:632
Al-Shahi Salman R et al., Lancet Neurol 2012 Mar; 11:217
Vorapaxar: Are Small Secondary-Prevention Gains Worth the Bleeding Risk?
Cardiology Summary and Comment
Free
Probably not, according to findings from the TRA 2P–TIMI 50 trial.
By Harlan M. Krumholz, MD, SM
March 25, 2012
Covering:
Morrow DA et al. for the TRA 2P–TIMI 50 Steering Committee and Investigators., N Engl J Med 2012 Mar 24
No Apparent Benefit from PFO Closure After Cryptogenic Stroke
Neurology Summary and Comment
Free
In the first published randomized trial of patent foramen ovale closure, recurrent strokes were uncommon and usually unrelated to PFO.
By Hooman Kamel, MD
March 14, 2012
Covering:
Furlan AJ et al., N Engl J Med 2012 Mar 15; 366:991
Apixaban vs. Aspirin for Secondary Stroke Prevention in Atrial Fibrillation
Neurology Summary and Comment
This new oral anticoagulant drug significantly reduced the rate of thromboembolism without increasing the rate of intracranial hemorrhage.
By Hooman Kamel, MD
March 6, 2012
Covering:
Diener H-C et al., Lancet Neurol 2012 Mar; 11:225
A Novel Score to Predict Outcomes of Intravenous Thrombolysis
Neurology Summary and Comment
The DRAGON score shows promise as an easy bedside tool, but further validation is needed before it is used clinically.
By Kevin N. Sheth, MD
March 6, 2012
Covering:
Strbian D et al., Neurology 2012 Feb 7; 78:427
"On" Freezing in Parkinson Disease
Neurology Summary and Comment
What to do when dopamine replacement makes your patients with PD freeze.
The Risks and Benefits of Aspirin in Primary Prevention of CVD
General Medicine Summary and Comment
Risk for nontrivial bleeding roughly equals benefit in preventing nonfatal myocardial infarction.
By Thomas L. Schwenk, MD
March 1, 2012
Covering:
Seshasai SRK et al., Arch Intern Med 2012 Feb 13; 172:209
Mora S., Arch Intern Med 2012 Feb 13; 172:217
Dabigatran Associated with Increased Bleeding During Atrial Fibrillation Ablation
Cardiology Summary and Comment
Until the effects of dabigatran use during ablation are clearer, it should be withheld for at least 24 hours before the procedure.
By Mark S. Link, MD
February 29, 2012
Covering:
Lakkireddy D et al., J Am Coll Cardiol 2012 Feb 1
Knight BP., J Am Coll Cardiol 2012 Feb 1
Who Is at Low Risk for Death After Acute Pulmonary Embolism?
Hospital Medicine Summary and Comment
Free
A simplified risk-assessment tool performed well in predicting 30-day and 90-day mortality in patients with acute pulmonary embolism.
Dabigatran and Acute Coronary Syndromes: Meta-Analysis Confirms RE-LY Findings
Cardiology Summary and Comment
Dabigatran increases risk for acute coronary syndromes but decreases mortality.
By Mark S. Link, MD
February 15, 2012
Covering:
Uchino K and Hernandez AV., Arch Intern Med 2012 Jan 9
Cardiology Statistics 2012: Good News, Bad News
Cardiology Summary and Comment
Cardiovascular mortality in the U.S. continues to decline; however, risk factors for cardiac disease are on the rise, especially in the young.
By JoAnne M. Foody, MD
February 15, 2012
Covering:
Roger VL et al., Circulation 2012 Jan 3/10; 125:188
Stroke Survivors Face a High Burden of Vascular Dementia
Neurology Summary and Comment
Delayed dementia after stroke is common and appears to reflect mostly vascular pathology.
By Hooman Kamel, MD
February 7, 2012
Covering:
Allan LM et al., Brain 2011 Dec; 134:3716
Stroke Hospitalizations Among the Young
Neurology Summary and Comment
The prevalence of ischemic stroke hospitalizations among people younger than 45 may have risen in recent years.
By Christine Fox, MD
February 7, 2012
Covering:
George MG et al., Ann Neurol 2011 Nov; 70:713
Statin Use and Hemorrhage After Ischemic Stroke
Neurology Summary and Comment
No increase in risk for hemorrhagic stroke was seen with statin use after intracerebral hemorrhage in a database study.
By Seemant Chaturvedi, MD
February 7, 2012
Covering:
Hackam DG et al., Arch Neurol 2012 Jan; 69:39
Neurologists Sometimes Disagree with Emergency Physicians' Diagnoses of TIA
Emergency Medicine Summary and Comment
In a retrospective single-center study, features associated with discordant diagnoses were headache, involuntary movement, and dizziness.
What's Really Important in a Woman's Lipid Profile?
Cardiology Summary and Comment
Prospective data from the Women's Health Initiative suggest that HDL level is a significant inverse predictor of coronary events, regardless of LDL level.
By Joel M. Gore, MD
February 1, 2012
Covering:
Mora S et al., Ann Intern Med 2011 Dec 6; 155:742
Lifetime Cardiovascular Risk: The More Things Change . . .
Cardiology Summary and Comment
Risk factors are less prevalent than in the past, but they are just as predictive of outcome.
Intravenous Thrombolysis for Acute Ischemic Stroke with Prior Stroke and Diabetes: Think Different?
Neurology Summary and Comment
Free
Diabetes and prior stroke should not preclude use of IV thrombolysis for stroke.
By Clotilde Balucani, MD, and Steven R. Levine, MD
January 24, 2012
Covering:
Mishra NK et al., Neurology 2011 Nov 22; 77:1866
FDA Approves Hand-Held Device to Spot Intracranial Hematomas
Neurology News in Context
A new bedside device has potential for streamlining the care of patients with suspected intracranial bleeding, but widespread use should await further data.
