ITEMS IN AFP WITH KEYWORD:
Stroke and TIA
Nov 1, 2016 Issue
The Risk of MI and Ischemic Stroke with Combined Oral Contraceptives [Cochrane for Clinicians]
The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are used.
In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm [NNTH] =14), edema (NNTH = 9), and fracture (NNTH = 53).
These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling strokes is comparable.
N.C. is a 65-year-old woman who presents for her yearly checkup. She walks one to two miles daily, is in generally good health, has no significant cardiovascular history, and has no health concerns at today's visit.
May 15, 2015 Issue
Screening for Asymptomatic Carotid Artery Stenosis: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population.
Review the most common stroke symptoms and mimics, how to distinguish between ischemic and hemorrhagic stroke, and which diagnostic tests and imaging techniques to employ. Learn how to evaluate stroke severity to determine the need for thrombolytic therapy, and how to educate patients on the warning signs of stroke.
Mar 1, 2015 Issue
AHA/ASA Release Guideline on Stroke Prevention in Women [Practice Guidelines]
The American Heart Association and American Stroke Association (AHA/ASA) have released a guideline to help physicians identify women with increased risk of stroke and initiate appropriate preventive measures. The guideline includes recommendations on pregnancy and stroke; cerebral venous thrombosis;...
The American Heart Association (AHA) and American Stroke Association (ASA) have updated their guideline on prevention of future stroke in patients with a history of stroke or transient ischemic attack (TIA). Currently, the average annual rate of future stroke in these patients is at a historic low.
In this meta-analysis, newer anticoagulants appear to be slightly more effective than warfarin in the short term (two years) in preventing strokes of all kinds in patients with atrial fibrillation. However, they are no more effective than warfarin in preventing ischemic strokes, and they cause more ...
Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it does not req...