Dissertations / Theses on the topic 'Atrial fibrillation; stroke; thrombogenesis'
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Kamath, Sridhar. "A study of platelets in atrial fibrillation." Thesis, University of Birmingham, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270055.
Full textKhoo, Chee Wah. "The relationship between left atrial remodelling, atrial fibrillation burden and thrombogenesis." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6847/.
Full textSjälander, Sara. "Stroke prevention in atrial fibrillation." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-124951.
Full textGuttmann, O. P. "Stroke and atrial fibrillation in hypertrophic cardiomyopathy." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1497024/.
Full textWatson, Timothy J. "Circulating progenitor cells in atrial fibrillation : Relationship to endothelial dysfunction, thrombogenesis and inflammation." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1253/.
Full textHendrikx, Tijn. "Catch Atrial Fibrillation, Prevent Stroke : Detection of atrial fibrillation and other arrhythmias with short intermittent ECG." Doctoral thesis, Umeå universitet, Allmänmedicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100497.
Full textSudlow, Christopher Mark. "The prevalence of atrial fibrillation in the UK and of suitability for warfarin treatment amongst those with atrial fibrillation." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301176.
Full textHijazi, Ziad. "New Risk Markers in Atrial Fibrillation." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-198833.
Full textKuo, I. fan. "Physician and patient preferences for stroke prophylaxis in atrial fibrillation." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/46554.
Full textAlbertsson, Kenth. "Contraindications for anticoagulation therapy among patients with atrial fibrillation associated stroke." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-48548.
Full textAbdul-Rahim, Azmil H. "Stroke and the heart : a focus on atrial fibrillation and heart failure." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/7903/.
Full textDing, Eric Y. "Feasibility of Smartwatch-Based Atrial Fibrillation Detection among Older Adults after Stroke." eScholarship@UMMS, 2021. https://escholarship.umassmed.edu/gsbs_diss/1145.
Full textGaerig, Vanesag, Roxana Lang, and Marcella Honkonen. "Post-Stroke Outcomes in Atrial Fibrillation Patients Treated with Various Oral Anticoagulants." The University of Arizona, 2015. http://hdl.handle.net/10150/614122.
Full textObjectives: Warfarin has historically been the anticoagulant used for the primary prevention of stroke in atrial fibrillation (AF), however three target specific oral anticoagulants, dabigatran, rivaroxaban, and apixaban, have recently been approved for use in this setting. Current literature lacks a comparison of these four drugs in relation to post-stroke outcomes, and this study aims to compare their performance in a natural setting. Methods: This retrospective cohort study identified stroke patients admitted to an academic medical center between January 2013 and December 2014 using the Quintiles, Inc.-American Heart Association Get With The Guidelines-Stroke database; pertinent data was collected from the database and patient electronic medical records. Primary endpoints measured were length of stay, 30-day readmission, and discharge disposition; secondary endpoints included rates of admission to the intensive care unit (ICU) and complications. Results: Of 940 stroke admissions, 53 ischemic stroke patients were identified as receiving an oral anticoagulant for stroke prevention in AF. The warfarin (n=40) and non-warfarin (dabigatran, rivaroxaban, and apixaban; n=13) groups were well matched regarding admission demographics, however patients taking warfarin were more likely to have an elevated INR at hospital admission (P=0.0053) and receive tPA (P=0.047). Patients in the warfarin group were also statistically significantly more likely to receive warfarin on discharge (P=0.004). No endpoints achieved statistical significance. Conclusions: No differences in post-stroke outcomes between warfarin and non-warfarin oral anticoagulants used for stroke prevention in AF were found.
Poçi, Dritan. "Atrial fibrillation : on its trigger mechanisms, risks and consequenses /." Göteborg : Dept. of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 2010. http://hdl.handle.net/2077/21927.
Full textGhatnekar, Ola. "The burden of stroke in Sweden : studies on costs and quality of life based on Riks-Stroke, the Swedish stroke register." Doctoral thesis, Umeå universitet, Medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-80917.
Full textYiin, Gabriel Shih Chung. "The prevalence, detection and prognosis of atrial fibrillation in patients with transient ischaemic attack and stroke." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:c317f195-9a7e-4870-9b6a-a7de77e89198.
Full textAlcusky, Matthew. "Anticoagulant Use, Safety and Effectiveness for Ischemic Stroke Prevention in Nursing Home Residents with Atrial Fibrillation." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1034.
Full textHarrington, Amanda Rose. "Cost-Effectiveness of Apixaban, Dabigatran, Rivaroxaban, and Warfarin for the Prevention of Stroke Prophylaxis in Atrial Fibrillation." Thesis, The University of Arizona, 2012. http://hdl.handle.net/10150/268612.
Full textÅsberg, Signild. "Outcome of Stroke Prevention : Analyses Based on Data from Riks-Stroke and Other Swedish National Registers." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-171871.
Full textRose, Adam. "A Decision Analysis of Left Atrial Appendage Closure as an Alternative to Long-Term Anticoagulation in a Health System's Patients with Atrial Fibrillation." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1542723664655377.
Full textMayet, Mohammed. "The prevalence of atrial fibrillation in patients with ischaemic stroke in a district hospital in the Western Cape." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31678.
Full textCupido, Blanche J. "Prevalence, characteristics and additional stroke risk stratification: an analysis of the Atrial Fibrillation cohort within the REMEDY study." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25262.
Full textIshii, Mitsuru. "Relationship of Hypertension and Systolic Blood Pressure With the Risk of Stroke or Bleeding in Patients With Atrial Fibrillation: The Fushimi AF Registry." Kyoto University, 2020. http://hdl.handle.net/2433/258974.
Full textGlader, Eva-Lotta. "Stroke care in Sweden : Hospital care and patient follow-up based on Riks-Stroke, the National Quality Register for Stroke Care." Doctoral thesis, Umeå universitet, Medicin, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-94114.
Full textSjögren, Vilhelm. "Oral anticoagulation and stroke risk." Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-141597.
Full textFinansiär: Forskning och Utveckling, Region Västernorrland
Masci, Alessandro. "Development of a patient-specific computational fluid dynamics model of the left atrium in atrial fibrillation." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amslaurea.unibo.it/13277/.
Full textPennlert, Johanna. "Recurrent stroke : risk factors, predictors and prognosis." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-127304.
Full textAlhazami, Mai. "COST EFFECTIVENESS OF WARFARIN IN ANTICOAGULANT CLINIC AFTER INTRODUCTION OF DABIGATRAN FOR STROKE PREVENTION IN ATRIAL FIBRILLATION PATIENTS IN THE UNITED STATES." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/3883.
Full textHörnsten, Carl. "Stroke and depression in very old age." Doctoral thesis, Umeå universitet, Geriatrik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120388.
Full textI västvärlden inklusive Sverige så ökar gruppen av människor som uppnår åldern 80 år eller äldre. Människorna som uppnår denna mycket höga ålder har en hög förekomst av kardiovaskulära riskfaktorer, har ofta flera samtidiga sjukdomar och ofta funktionsnedsättningar. Medicinska behandlingsåtgärder är ofta mindre effektiva och förknippade med biverkningar i åldersgruppen. Stroke är en sjukdom som beror på skada av hjärnvävnad till följd av minskad blodtillhörsel till delar av hjärnan. Det är känt att såväl förekomsten av och insjuknandet i stroke ökar med stigande ålder. Den som drabbas av stroke löper risk att få en bestående funktionsnedsättning och att dö i förtid. En vanlig komplikation efter att ha drabbats av stroke är nedstämdhet eller depression. Vetenskapliga studier om stroke har tidigare negligerat mycket gamla människor, vilket i takt med den pågående demografiska utvecklingen framstått som allt mer orimligt. Det är ej helt klarlagt vilka riskfaktorer som leder till att insjukna med stroke i mycket hög ålder. Överdödligheten förknippad med att drabbas av depression efter stroke är också oklar i åldersgruppen. Det är också oklart vad som skiljer depression efter stroke från depression bland den övriga befolkningen av åldrade människor. Den populations-baserade kohortstudien GErontologisk Regional DAtabas (GERDA) inleddes år 2000 för att kartlägga faktorer förknippade med gott åldrande bland mycket gamla människor. Hälften av 85-åringarna, alla 90-åringar och alla ≥95-åringar i utvalda kommuner i Västerbotten erbjöds att delta i studien. Därefter har återbesök hos tidigare deltagare i sina nya åldersgrupper och rekrytering av nya deltagare genomförts vart femte år. Studien utvidgades med utvalda kommuner i Österbotten, Finland vid den första femårsuppföljningen. Datainsamlingen i studien bestod av demografiska frågor, skattningsskalor, blodtrycksmätning och kognitiva test genomförda vid ett hembesök i deltagarens hem, samt genomgång av journalhandlingar. År 2010 skickades även en enkät ut till 65-, 70-, 75- och 80-åringar i alla kommuner i Västerbotten och Österbotten. Enkäten innehöll frågor om demografi, hälsa, sjukdomar och intressen. Bland deltagarna i kohortstudien bestämdes förekomsten av tidigare stroke baserat på genomgång av journaluppgifter och uppgifter från hembesöken. Förekomsten av depression bestämdes baserat på poängsättning från en validerad skattningsskala för depression, samt baserat på en sammanvägning av journaluppgifter och skattningsskalor. En specialist i geriatrik fattade det slutliga beslutet om diagnoser. Insjuknande i stroke bestämdes baserat på journalgenomgång av individer med stroke-relaterade diagnoskoder i sjukhusregistret, i dödsorsaksregistret eller uppgift om stroke vid femårsuppföljningen i studien. Bland deltagarna i enkätstudien bestämdes förekomsten av tidigare stroke baserat på självrapportering, och förekomsten av depression bestämdes baserat på en sammanvägning av självrapportering och en skattningsskala för depression. Förekomsten av stroke i enkätstudien steg med ålder, från 4.7% bland 65-åringar till 11.6% bland 80-åringar. Förekomsten av stroke var omkring 20% bland ≥85-åringar, med minimal variation mellan 85-, 90- och ≥95-åringar. Förekomsten av depression var högre bland dem med stroke jämfört med de övriga deltagarna, både gällande den sammavägda diagnosen och baserat endast på poängsättning. Stroke och sömnproblem var oberoende associerade med depression. Bland ≥65-åringar i enkätstudien var funktionsnedsättning och genomgången livskris associerade med depression hos dem med en tidigare stroke. Bland deltagare utan stroke var ett antal ytterligare externa faktorer, inklusive subjektiv upplevelse av dålig ekonomi och att inte ha någon att anförtro sig till, associerade med depression. Både stroke och depression var associerade med ökad dödlighet bland ≥85-åringar. De med stroke utan depression hade en dödlighet i linje med normalbefolkningen utan stroke eller depression. Förekomsten av samtidig stroke och depression var associerad med högre dödlighet än normalbefolkningen, jämfört med dem med enbart stroke eller enbart depression. Högt systoliskt blodtryck (≥160 mmHg), högt diastoliskt blodtryck (≥90 mmHg) och förmaksflimmer var oberoende riskfaktorer för att insjukna i stroke bland ≥85-åringarna. Sambandet mellan blodtryck och strokerisk försvagades ej hos människor med kognitiv eller funktionell nedsättning. Tidigare stroke, hjärtsvikt, kognitiv nedsättning, näringsbrist, depressiva symtom och låg gånghastighet var också associerade med att insjukna i stroke, men ej oberoende av varandra. Sammanfattningsvis så stiger förekomsten av stroke med åldern och är särskilt hög bland mycket gamla människor. Depression är betydligt vanligare hos mycket gamla människor med stroke, även justerat för störningsfaktorer. Depression är främst associerat med funktions-nedsättning hos människor med stroke, men med ett större antal externa faktorer hos människor utan stroke. Mycket gamla människor med stroke har särskilt hög dödlighet om de samtidigt är deprimerade, men en dödlighet i linje med normalbefolkningen om de inte är deprimerade. Högt systoliskt och diastoliskt blodtryck samt förmaksflimmer är viktiga och behandlingsbara orsaker till att drabbas av stroke i mycket hög ålder.
Man-Son-Hing, Malcolm. "The efficacy of warfarin for the prevention of stroke in nonvalvular atrial fibrillation: Measuring its minimal clinically important difference from the patients' perspective." Thesis, University of Ottawa (Canada), 1996. http://hdl.handle.net/10393/10113.
Full textGiner, Soriano Maria. "Effectiveness and safety of thromboembolic prevention in patients with non-valvular atrial fibrillation: ESC-FA study. A cohort from a Primary Healthcare electronic database." Doctoral thesis, Universitat Autònoma de Barcelona, 2016. http://hdl.handle.net/10803/393971.
Full textAtrial fibrillation (AF) is the most common chronic arrhythmia. It is associated with a variety of cardiovascular conditions and the most important clinical consequences are higher risks of stroke and mortality than general population. AF management increasingly takes place in Primary Healthcare settings and it is based in stroke prevention, pharmacological control of heart rate and rhythm and handling of concomitant cardiovascular diseases. This thesis is part of the ESC-FA study (Effectiveness, Safety and Costs in AF), which is a population-based retrospective observational cohort study conducted with data from electronic health records from Primary Healthcare in Catalonia. ESC-FA study received funding through 2011 Grants for Independent Clinical Research from the Ministerio de Sanidad, Política Social e Igualdad from the Spanish Government. ESC-FA consists in four sub-studies; I to IV, and this thesis includes studies I and II. Study I results are reported in one published paper (paper 1) and in another paper which is currently under review (paper 2). Study II results are published in paper 3. The study population includes all individuals ≥18 years-old with a diagnosis of nonvalvular AF registered in SIDIAP (Information System for the Improvement of Research in Primary Care) database during 2007-2012, who started antithrombotic treatment (or remained without it) after AF diagnosis. In study I we describe antithrombotic use in 22 585 patients with non-valvular AF and assess effectiveness and safety of these drugs in real-use conditions before the introduction of direct oral anticoagulants in the management of the disease. Our main results showed: a non-valvular AF population with socio-demographic and clinical features similar to those in other populations, a reduction of stroke risk in patients treated with vitamin K antagonists who have higher risks of stroke (CHADS2 and CHA2DS2-VASc index ≥2), an increased risk of stroke and gastrointestinal haemorrhage with antiplatelets and a reduced risk of all-cause mortality with both vitamin K antagonists and antiplatelets, in comparison with patients who were not treated with any antithrombotics. In study II we describe heart rate and rhythm pharmacological management in nonvalvular AF patients. Mostly prescribed drugs were β-blockers, probably pointing out that rate control strategy is the most frequent alternative used, as widely recommended as first-line therapy for management of chronic AF. Some strengths of our study are the large number of patients included, representativeness for the general population, complete socio-demographic and health records, long follow-up, and real clinical practice data. This study has high relevance in our setting as it assesses the real number of patients treated with traditional antithrombotics and the clinical results of their use in terms of stroke, haemorrhages and mortality rates, before assessing these clinical results including direct oral anticoagulants, which have been authorized for non-valvular AF in the last years. Some weaknesses of observational studies conducted with electronic health records are missing or incomplete information, under-register of some health conditions, nonregistered information of some personal circumstances of patients and possible confounders. These limitations have been minimized using the appropriate statistical techniques described in the papers included.
Pujol, i. Iglesias Elisabet. "Taquicàrdia auricular i altres factors predictors de recurrència d’esdeveniments cerebrovasculars, fibril·lació auricular i mortalitat en pacients amb ictus criptogènic." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/666962.
Full textAlthough the relationship between atrial fibrillation (AF) or atrial flutter and ischemic stroke has been well established and demonstrated, there is few information about the association between supraventricular arrhythmias different from atrial fibrillation or atrial flutter and stroke. The aim of this study was to determine whether atrial tachycardia in patients hospitalized for cryptogenic stroke was associated with atrial fibrillation and recurrence of stroke during a period of follow-up. We retrospectively analysed consecutive patients with cryptogenic stroke who underwent 24-hour holter monitoring. We compared patients with and without atrial tachycardia on atrial fibrillation, recurrence of stroke and cardiovascular mortality during 12 months and after 4 years of follow-up. We repeated all analyses after excluding patients prescribed anticoagulation after discharge under physician criteria. It is worth to mention that subjects in our study underwent only conventional tests that are widely used and available in clinical practice. We included 192 patients (78 with atrial tachycardia and 114 without) non-anticoagulated, and 16 patients who received anticoagulation for suspected but unconfirmed atrial fibrillation after discharge (10 of them with atrial tachycardia). Baseline characteristics between both groups did not differ. Patients with atrial tachycardia had higher incidences of atrial fibrillation, recurrent stroke and cardiovascular mortality at 12 months of follow-up. The higher incidence of stroke and cardiovascular mortality in the group with atrial tachycardia was only seen in the analysis excluding anticoagulated patients. Atrial fibrillation was still more frequent in patients with atrial tachycardia at 4 years follow-up. So, in conclusion, the presence of atrial tachycardia in 24 hour holter monitoring of patients with cryptogenic stroke could identify patients with increased risk of atrial fibrillation, stroke recurrence and cardiovascular mortality, especially in the early follow-up period. Patients suffered from cryptogenic stroke and with highly clinically suspected atrial fibrillation for the presence of atrial tachycardia in holter, might benefit from anticoagulation.
Lahtinen, J. (Jarmo). "Predictors of immediate outcome after coronary artery bypass surgery." Doctoral thesis, University of Oulu, 2007. http://urn.fi/urn:isbn:9789514286339.
Full textMuria, Subirats Eulàlia. "Estratificación del riesgo de fibrilación auricular en pacientes de alto riesgo cardiovascular." Doctoral thesis, Universitat Rovira i Virgili, 2021. http://hdl.handle.net/10803/672187.
Full textINTRODUCCIÓN: La fibrilación auricular (FA) es una de las arritmias más frecuentes a nivel mundial. Es imprescindible detectar FA de forma precoz; se dispone de pocas escalas de riesgo para detectar FA. OBJETIVOS: Desarrollar un score clínico para estratificar el riesgo de FA entre pacientes diabéticos e hipertensos y aplicarlo posteriormente a población general. También, evaluar este score clínico de riesgo y su relación con la incidencia de ictus isquémico y la prevalencia de deterioro cognitivo. MATERIAL Y MÉTODOS: Estudio observacional, comunitario y multicéntrico en las Terres de l'Ebre, el primero de 8.237 pacientes diabéticos e hipertensos y el segundo de 46.706 pacientes ≥ 65 años en la población general. En el primer estudio se realizó una regresión de Cox para identificar predictores de FA y con estos se creó una escala de riesgo de FA por cuartiles. Está fórmula posteriormente se aplicó a la población del segundo estudio. RESULTADOS: Los predictores de riesgo de FA fueron CHA2DS2VASc, edad, peso, frecuencia cardíaca y sexo femenino (p<0,05). Con estos se creó la escala de riesgo de FA. El grupo de mayor riesgo de FA del primer artículo se caracterizó por una mayor edad (85,95±6,03, p<0,001), proporción de mujeres (85,2%, p<0,001), densidad de incidencia (DI) de FA (22,5/1.000 personas/año), DI de ictus (3,5/1.000 personas/año), mortalidad total (22,7%, p<0,001) y por un NNS más bajo (9). El grupo de mayor riesgo de FA del segundo artículo se caracterizó por una mayor edad (87,5±7,4, p<0,001), proporción de mujeres (78,2%, p<0,001), DI de FA (17,0/1.000 personas/año), DI de ictus (3,8/1.000 personas/año), deterioro cognitivo (16,4%, p<0,001) y por un NNS más bajo (19). CONCLUSIONES: Este modelo permite discriminar aquellos pacientes con mayor riesgo de FA en cinco años de seguimiento que están asociados a una mayor incidencia de ictus y prevalencia de deterioro cognitivo.
INTRODUCTION: Atrial fibrillation (AF) is one of the most frequent arrhythmias worldwide. It is essential to detect AF early; few risk scales are available to detect AF. OBJECTIVES: To develop a clinical score to stratify the risk of suffering AF among diabetic and hypertensive patients and subsequently apply it to the general population. Also, evaluate this clinical AF risk score and its relationship with the incidence of ischemic stroke and the prevalence of cognitive impairment. MATERIAL AND METHODS: Observational, community and multicenter study in Terres de l'Ebre, the first study of 8,237 diabetic and hypertensive patients and the second of 46,706 patients ≥ 65 years in the general population. In the first study, a Cox regression was performed to identify predictors of AF and with these a risk scale for AF was created by quartiles. Later, this formula was applied to the population of the second study. RESULTS: Risk predictors for AF were: CHA2DS2VASc, age, weight, heart rate and female sex. With these, the AF risk scale was created. The highest risk group for AF in the first article was characterized by older age (85.95±6.03, p<0.001), proportion of women (85.2%, p<0.001), incidence density (ID) of AF (22.5/1,000 people/year), ID of stroke (3.5/1,000 people/year), total mortality (22.7%, p<0.001) and lower NNS (9). The highest risk group for AF in the second article was characterized by older age (87.5±7.4, p<0.001), proportion of women (78.2%, p<0.001), ID of AF (17.0/1,000 people/year), ID of stroke (3.8/1,000 people/year), cognitive impairment (16.4%, p<0.001) and lower NNS (19). CONCLUSIONS: This risk stratification model makes it possible to discriminate those patients with a higher risk of AF in five years of follow-up who are associated with a higher incidence of stroke and higher prevalence of cognitive impairment
Giralt, Steinhauer Eva. "L’ús d’escales clíniques en els ictus isquèmics secundaris a fibril·lació auricular." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/322088.
Full textAF is the most common cardiac arrhythmia in clinical practice, and is a well-known risk factor for cardiogenic embolism. These cardioembolic strokes are frequent and associated with a substantial increased risk of morbidity and mortality. However the risk of stroke and thromboembolism in AF patients is not homogeneous. Different risk factors such as advancing age, hypertension and diabetes mellitus, among others, contribute to the annual thromboembolic risk. Various stroke risk-stratification schemes have been developed for people with AF. The CHADS2 was probably the most often used because of its simplicity. But in 2010 a new scale was published: CHA2DS2-VASc. The first purpose of this thesis was to evaluate how CHADS2 classifies a cohort of patients previous to its first ischemic stroke and compare this risk stratification if the CHA2DS2-VASc scale would have been used. The results of this study showed that this new scale reclassifies a lot of patients out of the category of low-intermediate risk, into a category in which anticoagulation would have been indicated. Studies like ours changed recommendations of both European and U.S guidelines towards the use of the CHA2DS2-VASc score as the main scheme to assess patientís stroke risk. The second objective of our thesis was to evaluate the use of this new scale, not only for risk stratification, but also as prognosis tool in patients who suffered a stroke. We found that each point increase in the scale is associated with a 36% increase in the risk for poor 90-day outcome, independently of stroke severity. In both works, we found a low use of anticoagulation in primary prevention for high risk patients, despite its well-established protective effect, that we were able to replicate. Our research is also orientated towards the detection of a new paroxysmal atrial fibrillation (pAF) in stroke patients, since undetected pAF would lead to a suboptimal secondary prevention with antiplatelet agents. Therefore in the third work, in our cohort with unselected patients, who were admitted in the stroke unit, we detected 11.2% of pAF until de three-month visit. We analyzed which are the clinical risk factors associated to this new diagnosis in a bivariate and afterwards a multivariate analysis (which were advancing age, female sex, initial stroke severity and previous history of congestive heart failure). From this analysis we obtained a risk for new pAF detection for each vascular risk profile, that we represented into two risk charts for easy and immediately interpretation at patientís arrival.
Andersson, Jonas. "Inflammation and lifestyle in cardiovascular medicine." Doctoral thesis, Umeå universitet, Medicin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-36221.
Full textHållmarker, Ulf. "Epidemiological Studies on Long Distance Cross-Country Skiers : Participants in the Vasaloppet 1955-2010." Doctoral thesis, Uppsala universitet, Uppsala kliniska forskningscentrum (UCR), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-260994.
Full textAndersen, Kasper. "Physical Activity and Cardiovascular Disease." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-217309.
Full textLim, Han Sung. "Mechanisms of thrombogenesis in atrial fibrillation." Thesis, 2012. http://hdl.handle.net/2440/95884.
Full textThesis (Ph.D.) -- University of Adelaide, School of Medical Sciences, 2012
Schultz, Carlee Deanne. "Thrombogenesis in substrates of atrial fibrillation." Thesis, 2014. http://hdl.handle.net/2440/97880.
Full textThesis (Ph.D.) -- University of Adelaide, School of Medicine, 2014
Cruz, Diana Vanessa Marques. "GWAS contribution to Atrial Fibrillation and Atrial Fibrillation-related Stroke: pathophysiological implications." Master's thesis, 2019. https://hdl.handle.net/10216/120789.
Full textCruz, Diana Vanessa Marques. "GWAS contribution to Atrial Fibrillation and Atrial Fibrillation-related Stroke: pathophysiological implications." Dissertação, 2019. https://hdl.handle.net/10216/120789.
Full textChuang, Yuan-Hsin, and 莊芫欣. "A Study of Ischemic Stroke Patients with Atrial Fibrillation." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/bjqwcb.
Full text國立虎尾科技大學
工業管理系工業工程與管理碩士班
106
Stroke is a cerebrovascular obstructive or cerebrovascular rupture, resulting in damage to brain cells and neurological symptoms. Cause of stroke is very wide, about 10-15% is directly related to heart disease. The atrial fibrillation is clinically the most common type of arrhythmias. According to the prevalence survey, it is estimated that about 2% of the population have gotten atrial fibrillation. The chance of atrial fibrillation patients get stroke is more than five times the normal. Therefore, in this study, patients with atrial fibrillation in the database of an anonymous medical institution in Taiwan were adopted as research participants. Through the collection of relevant literature and interview with professional physicians to select the factors that affect the ischemic stroke, using particle swarm optimization, cross entropy and genetic algorithms logistic regression combined with back propagation neural network and support vector machines to construct six predictive models of ischemic stroke patients with atrial fibrillation. In addition, using weight of three algorithms combined with case-based reasoning technique to construct evaluation system of ischemic stroke patients with atrial fibrillation. Research results show that there are significant differences among six predictive models. Among these models, the best two models are constructed by particle swarm optimization that the average accuracy rate and the average area under the ROC curve are both over 88% and 0.85. For the evaluation system, there are no significant differences among three algorithms. Thus, three algorithms are all suitable for the weight of the evaluation system. The average accuracy and average area under the ROC curve are both over 85% and 0.80. The prediction models and evaluation system constructed in this study can provide medical institutions and relevant medical personnel as a reference for assisting diagnosis and evaluation. From the perspective of preventive medicine, there will be a help to early detection of diseases to avoid the consumption of medical resources.
Varela, Flávia Alexandra Costa. "Stroke prevention in patients with atrial fibrillation and chronic hepatic disease." Master's thesis, 2018. http://hdl.handle.net/10451/42167.
Full textIntrodução: A fibrilhação auricular é uma arritmia frequente e uma causa major de AVC isquémico. O risco de AVC é avaliado através de scores como CHADS2 ou CHA2DS2VASc, podendo indicar o inicio de terapêutica trombo-profilática. A profilaxia do AVC com anticoagulantes orais tem uma eficácia conhecida, porém associada a um risco de hemorragia que não deve ser ignorado. Considerando que a formação de trombos está maioritariamente associada à aurícula esquerda, outras técnicas não farmacológicas estão a ser desenvolvidas de forma local. No caso do paciente também sofrer de doença hepática crónica, a eficácia e a segurança destas abordagens não está ainda esclarecida, sendo a escolha de como e quando começar terapêutica ainda difícil, considerando a pouca evidencia disponível. Métodos: Realizámos uma pesquisa em bases de dados como Medline Ovid (até janeiro de 2018) e a Cochrane Central Registry. Dos artigos selecionados apresentámos os nossos resultados em tabelas e analisámos o seu conteúdo. Finalmente elaborámos um algoritmo. Resultados: A terapêutica anticoagulante oral tradicional e os novos anticoagulantes orais parecem ser seguros para doentes com doença hepática ligeira e moderada, exceto o rivaroxaban e o edoxaban, cujo uso não está indicado em casos de doença moderada; os doentes devem sujeitar-se a controlos regulares dos níveis dos fármacos e das enzimas hepáticas. As técnicas de encerramento da aurícula esquerda são diversas e uma delas provou, num ensaio controlado e randomizado, ser não inferior à varfarina. Conclusões: Mais estudos devem ser realizados a fim de provar a eficácia e a segurança do uso de anticoagulantes em pacientes com doença hepática crónica com o fim de obter uma norma orientadora para a clínica. A oclusão da aurícula esquerda tem-se revelado promissora, porém nenhum estudo foi realizado especificamente em pacientes com cirrose, permanecendo a terapêutica anticoagulante como primeira linha. A alternativa local fica reservada aos doentes cuja anticoagulação está contraindicada.
Introduction: Atrial fibrillation is a common cardiac arrhythmia and a major cause of ischaemic stroke. Stroke risk can be accessed using scores like CHA2DS2VASc and thromboprophylatic therapy with oral anticoagulants might be indicated, whose efficacy is well proven. However it’s also linked to a risk of haemorrhage that cannot be neglected. Considering that thrombus formation is mainly linked to left atrial appendage, other nonpharmacological alternatives are being developed, as local therapies. However, evidence and experience about these approaches are lacking from patients with concomitant hepatic disease, making the decision on how and when to start therapy very delicate and stressful. Methodology: we conducted a research using data sources like Medline Ovid (until January 2018) and the Cochrane Central Registry. We presented our results from the selected articles in tables. Then we analysed our information and built an algorithm. Results: Traditional anticoagulant therapy and NOACs seem to be safe in patients with mild or moderate hepatic impairment, except for rivaroxaban and edoxaban, whose use is not advised for patients with moderate impairment. Nonetheless, patients should undergo regular monitoring of drug levels and hepatic enzymes. The LAAC techniques are several and one proved to be at least non-inferior to warfarin in a large randomized controlled trial. Conclusions: More studies are required to proof OAC’s efficacy and safety in patients with chronic hepatic disease (CHD), in order to build a guideline for clinicians. The left atrial appendage occlusion has revealed promising results but no study was yet conducted in patients with CHD. Anticoagulant therapy remains the first line for thromboprophylaxis, being LAAC reserved for patients with declared contraindications to OAC.
Chao, Tze-Fan, and 趙子凡. "Risk of ischemic stroke in patients with atrial fibrillation in Taiwan." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/23780931606800720863.
Full text國立陽明大學
臨床醫學研究所
104
Background and Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia which increases the risk of ischemic stroke by 4- to 5-fold. AF-related stroke has a worse prognosis and higher recurrence rate compared to non-AF related stroke. The risk of AF-associated stroke is not homogeneous and depends on patients’ age and comorbidities, which have resulted in clinical scores to aid risk stratification for AF patients. Oral anticoagulants (OACs) with warfarin or non-vitamin K antagonist OACs (NOACs) could reduce the risk of AF-related stroke by around 64%. The decision to prescribe OACs for AF patients should be based on individual risk of ischemic stroke which is estimated according to the clinical scores. However, data regarding the risk of ischemic stroke in Taiwan AF patients were lacking. We performed a serial studies to investigate the risk of ischemic stroke in Taiwan AF patients and determine which scoring system should be used. We also compared the risk of ischemic stroke of Taiwanese AF patients to that of Caucasians. Method: We used the “National Health Insurance Research Database” released by the Taiwan National Health Research Institutes. From year 1996-2011, a total of 354,649 AF patients aged ≥ 20 years were identified as study population. Among the study population, we excluded patients who received treatments with warfarin or any antiplatelet agents, including aspirin, clopidogrel, dipyridamole and ticlopidine. Finally, a total of 186,570 patients were enrolled into the study cohort. The study endpoint was the occurrence of ischemic stroke. Main Findings: 1. The annual risk of ischemic stroke for Taiwanese AF patients was around 3.71%. 2. CHA2DS2-VASc performed better than CHADS2 and ATRIA scores for stroke risk stratification, and should be the preferred scoring system for Taiwanese AF patients. 3. The CHA2DS2-VASc score could further refine stroke risk stratification among patients with a low CHADS2 or ATRIA score. 4. The risk of ischemic stroke for Taiwanese AF patients with a low CHA2DS2-VASc score was higher than that of Caucasians. 5. Not all risk factors in CHA2DS2-VASc score carried an equal risk, and age 65-74 was associated with the highest stroke rate. 6. AF males with only 1 risk factor having a CHA2DS2-VASc score of 1 had an annual stroke rate ranging between 1.96%-3.50% depending on the specific covariates composing the score. For AF females with one additional stroke risk factor (ie. CHA2DS2-VASc score of 2), the annual stroke rate ranged from 1.91% to 3.34%. For these patients, OACs should be considered for stroke prevention, and NOACs may be the preferred choices based on their better safety profiles. 7. Hyperuricemia/gout was a novel risk factor of ischemic stroke for AF patients, and may potentially refine the risk stratification system. 8. For Taiwanese patients aged 50 to 64 years, the annual stroke risk was 1.78%, which may exceed the threshold for OAC use for stroke prevention. The annual risk of ischemic stroke for AF patients age <50 years was 0.53%, which was truly low-risk, and OACs could be omitted. The age threshold for an increased risk of ischemic stroke in Taiwanese AF patients may be different from that of Caucasians. Conclusions: The risk of ischemic stroke of Taiwanese AF patients could be accurately estimated using the CHA2DS2-VASc score. OACs should be considered for stroke prevention for AF patients with 1 additional risk factor beyond gender. Whether the consideration of hyperuricemia/gout or resetting the age threshold at 50 years could refine current clinical risk stratification for Taiwanese AF patients deserves further study.
Tsai, Jui-Yao, and 蔡瑞窈. "Factors associated with anticoagulant therapy and disability in stroke patients with atrial fibrillation." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/m55342.
Full text國立臺北護理健康大學
長期照護研究所
105
The study aimed to evaluate the relationship between prescribed medication and functional outcomes in patients with ischemic stroke and atrial fibrillation.We retrospectively recruited patient with from a medical center database in North Taiwan. Research tools was were: (1) National Institutes of Health Stroke Scale (NIHSS); (2) Modified Rankin scale (mRS); (3)Barthel Index( BI). The data was analyzed with IBM SPSS Statistical 23. This was a retrospective cross-sectional study. Patients to medical center database in North Taiwan from 2012 to 2015 were recruited and the study variable included: Demographic characteristics (age, sex, etc.)、the presence of Acute ischemic stroke with atrial fibrillation and the presence of vascular risk factors including coronary artery disease、 diabetes、 hypertension or dyslipidemia. The functional outcomes were represented by NIHSS,mRS and Barthel. The results showed that age、educational、low albumin, NIHSS in emergency were significantly.In addition, the study also found the dependency rates after 1 year were in groups taking oral vitamin k antagonists and new oral anticoagulants lower than the groups taking antiplatelet.
Ferreira, João Maria Guimarães e. Matos Ribeiro. "Early anticoagulation in atrial fibrillation-related acute ischemic stroke: efficacy and safety profile." Master's thesis, 2021. https://hdl.handle.net/10216/134439.
Full textFerreira, João Maria Guimarães e. Matos Ribeiro. "Early anticoagulation in atrial fibrillation-related acute ischemic stroke: efficacy and safety profile." Dissertação, 2021. https://hdl.handle.net/10216/134439.
Full textSilva, Maria Miguel Pinto da. "Anticoagulation management for postoperative atrial fibrillation after cardiothoracic surgery." Master's thesis, 2017. http://hdl.handle.net/10451/35998.
Full textBackground: Oral anticoagulation is essential following post-operative atrial fibrillation. Although warfarin is commonly used, its efficacy is dependent on the achievement of a time in therapeutic range above 65%. Non-vitamin K oral anticoagulants are an alternative option, however the optimal time to initiate post-operatively is unknown, due to 'recent surgery' often being cited as an exclusion criteria within phase III clinical trials. Purpose: To compare the management of oral anticoagulation for stroke prevention in postoperative atrial fibrillation after cardiothoracic surgery. Methods: An ambispective study was conducted at large tertiary centre analysing patients that developed postoperative atrial fibrillation after cardiothoracic surgery from January 2016 to January 2017 reviewing both patient and surgical data. Results: Sixty-four patients developed postoperative atrial fibrillation, of which 39 (60.9%) and 25 (39.1%) were prescribed warfarin and non-vitamin K oral anticoagulants (NOACs), respectively. 14 (51.9%) patients had a confirmed time in therapeutic range below 65%, reflecting poor anticoagulant control with warfarin. NOACs were initiated on an average of 8.36 ± 3.74 days post-operatively. 22 (62.9%) patients in the warfarin group and 13 (65.9%) patients in the NOAC group were confirmed to be in sinus rhythm six weeks after discharge. Among these patients, 14 (40.0%) stopped the anticoagulation after restoration of sinus rhythm, of which were more likely to continue if were receiving a NOAC. Conclusion: Whilst warfarin is commonly initiated for post-operative atrial fibrillation, a time in therapeutic range below 65% for warfarin shows that acute optimal anticoagulation management is difficult to achieve, especially for the short term patients that revert back in to sinus rhythm. NOACs may possibly be a more effective alternative, initiating eight days post operatively. However further studies need to be conducted to ensure optimal dose of these agents as well as the ideal timeframe to initiate anticoagulation in the acute post-operative phase.
Introdução: A fibrilhação auricular (FA) é a arritmia sustentada mais comum na prática clínica e está associada ao aumento da mortalidade e morbilidade, assim como a hospitalizações frequentes e à redução da qualidade de vida. A fibrilhação auricular pós-operatória (FAPO) é uma variante da FA clássica que se caracteriza pelo diagnóstico de um novo caso de FA, habitualmente auto-limitada, após realização de cirurgia-major (tipicamente cardíaca) em doentes que se encontravam em ritmo sinusal previamente ao procedimento cirurgico e sem historial clínico prévio desta arritmia. Estima-se que a FAPO ocorra em cerca de 30% das cirurgias-major. Neste sentido, a terapêutica anticoagulante é essencial como profilaxia para o acidente vascular cerebral, sendo que tanto os anticoagulantes orais não antagonistas da vitamina K (NACOs) (apixabano; dabigatrano; edoxabano; rivaroxabano) como os antagonistas da vitamina K (AVK) (varfarina; acenocumarol) se revelam eficazes na prevenção do acidente vascular cerebral na fibrilhação auricular. Embora a varfarina seja amplamente usada na prática clínica, a sua eficácia está dependente da manutenção da percentagem de tempo no intervalo terapêutico a um nível superior a 65%. Por sua vez, os NACOs revelam-se como uma alternativa à varfarina, sendo referidos como opção preferencial nos normativos das mais reconhecidas sociedades de cardiologia. No entanto, o tempo ideal para iniciar a terapêutica com estes agentes no perído pós-operatório carece de investigação, devido à exclusão desta população dos ensaios clínicos randomisados de fase III. Desta forma, no âmbito do programa Erasmus, este projeto foi desenvolvido durante os três meses em que tive a oportunidade de integrar o Departamento de Farmácia do Hospital St. Bartholomew sediado em Londres, Reino Unido. Tendo sido proposto pelo responsável deste departamento, este estudo teve como objetivo aprofundar o conhecimento relativamente ao tratamento ótimo e efetivo com anticoagulantes orais e, em última análise, permitir a otimização, eficácia e segurança destes agentes. Além disso, refletindo o importante papel do farmacêutico enquanto membro integrado numa equipa multidisciplinar de profissionais de saúde, este projeto permitiu de igual forma, a promoção da discussão com cirurgiões, médicos e enfermeiros acerca do potencial de possíveis mudanças a adotar futuramente na prática clínica de modo a garantir uma melhor gestão da FAPO, e consequentemente proporcionar os melhores cuidados em saúde a estes utentes. Objetivos: Este estudo teve como propósito comparar a gestão da terapêutica anticoagulante oral na fibrilhação auricular pós-cirurgia cardiotorácica. Deste modo, foram formuladas quatro questões de investigação: 1. Qual percentagem de pacientes prescritos com varfarina que demonstrou um tempo no intervalo terapêutico superior a 65%, seis semanas após a alta hospitalar? 2. Qual é a dosagem adequada de NACOs no período pós-operatório? 3. Qual é o momento ideal para iniciar terapêutica com NACOs no período pós-operatório? 4. Os anticoagulantes orais foram descontinuados nos doentes que revelaram reversão para ritmo sinusal seis semanas após a alta hospitalar? Assim, tendo como ponto de partida as questões supracitadas, foram definidos os seguintes objetivos específicos para este estudo: i) Avaliar a eficácia da varfarina no período pós-operatório; ii) Investigar as tendências e padrões na prática clínica em relação à NACOs (i.e., escolha do NACO prescrito, dosagem, período pós-operatório de iniciação terapêutica); iii) Esclarecer as características envolvidas na hipótese de considerar a redução da dose de NACOs, bem como o prazo ideal para iniciar a terapêutica com estes fármacos no período pós-operatório; iv) Identificar o número de doentes que revertem para ritmo sinusal (RS) seis semanas após a cirurgia cardiotorácica; v) Analisar as taxas de descontinuação de anticoagulantes orais, quando é verificada a reversão para RS. Métodos: Foi conduzido um estudo ambiespectivo em doentes que desenvolveram fibrilhação auricular pós operatória entre janeiro de 2016 e janeiro de 2017. O estudo compreendeu duas fases distintas; Uma retrospetiva e uma prospectiva (desenho ambiespectivo). As informações presentes nos registos médicos dos utentes submetidos a cirurgia entre os dias 1 de janeiro de 2016 e 31 de janeiro de 2017 foram avaliadas retrospectivamente para determinar a amostra de interesse para estudo com base nos critérios de eligibilidade definidos. Foram igualmente consultados retrospectivamente os registos de distribuição da farmácia e os relatórios de controlo de stocks para identificar todos os doentes com prescrições de varfarina ou novos anticoagulantes orais nas alas cardiotorácicas durante o período de coleção de dados. Foram assim constituídos dois coortes de exposição, de acordo com o subgrupo farmacoterapêutico adotado (AVK vs NACO). Foram analisados os registos de prescrição de fármacos e notas médicas eletrónicas, a fim de selecionar de entre os pacientes prescritos com estes anticoagulantes orais, os que foram dispensados do hospital com um diagnóstico confirmado de fibrilhação auricular pós-operatória. Dados demográficos, historial médico e estudos laboratoriais foram analisados. Foram definidas como variáveis de interesse, os valores de tempo no intervalo terapêutico especificamente para o grupo-varfarina; o NACO prescrito, respetiva dose e dia de inicio da terapêutica no período pós-operatório para o grupo-NACO; CHA2DS2‐VASc score, tendo sido realizada a estratificação de risco para tromboembolismo e acidente vascular cerebral para ambas as coortes através da análise dos fatores de risco individuais. A fase prospetiva decorreu desde 31 de Janeiro até 28 de abril de 2017 e serviu para recolher os dados das consultas de follow-up, realizadas em média cerca de seis semanas após cirurgia no Hospital St. Bartolomew. Através da consulta deste dados obteve-se assim informação sobre a reversão para ritmo sinusal (ou não), a consequente descontinuição dos anticoagulantes orais. Os valores de International Normalized Ratio (INR) que estão na origem do cálculo do tempo no intervalo terapêutico foram obtidos através de contactos estabelecidos com as clínicas de anticoagulação onde estes utentes realizavam as mediações do INR. Estes valores foram obtidos prospetivamente para os doentes que continuaram a terapia com varfarina e consequente monitorização de INR coincidente com a fase prospetiva do estudo. Os dados recolhidos foram analisados recorrendo a estatística descritiva univariada e bivariada. Os dados discretos são apresentados como frequências absolutas e relativas, enquanto que os dados contínuos são apresentados através da tendência central e medidas de dispersão, incluindo média, mediana e desvio padrão. A análise bivariada serviu para comparar as características dos utentes das duas coortes de doentes expostas aos dois diferentes tratamentos e verificar se as características dos doentes, nomeadamente o seu perfil de risco de AVC ou risco hemorrágico, poderiam justificar a sua inclusão num ou noutro grupo farmacoterapêutico. Dado o tamanho amostral e a distribuição não-normal dos dados, foram selecionados testes não-paramétricos; o chi-quadrado e a sua extensão peloo teste Exacto de Fisher foram utilizados para analisar dados categóricos e o teste Wilcoxon Mann-Whitney para analisar dados contínuos. O intervalo de confiança considerado foi de 95%. Todos os dados foram analisados usando o IBM Statistical Software Package for Social Sciences (SPSS, versão 24). O protocolo deste estudo foi aprovado pela Comissão de Ética do Hospital St. Bartolomew, sob o número 8021. Resultados: Sessenta e quatro utentes desenvolveram fibrilhação pós-operatória, dos quais 39 (60.9%) e 25 (39.1%) foram medicados com varfarina e NACOs, respetivamente. Foram obtidos 27 dados de valores de tempo no intervalo terapêutico (69% dos medicados com varfarina), sendo que 14 doentes (52%) demonstraram valores de tempo no intervalo terapêutico inferiores a 65%, refletindo fraco controlo e pouca eficácia da terapêutica anticoagulante com varfarina. No que concerne à iniciação de NACOs no período pós-operatório, foi revelado que a terapêutica com estes anticoagulantes teve inicio, em média, 8.36 ± 3.74 dias após realização do procedimento cirurgico. Relativamente à reversão para RS, 22 doentes (62.9%) do grupo da varfarina e 13 doentes (65.0%) do grupo dos NACOs tinham revertido para RS seis semanas após a alta hospitalar. De entre estes doentes, um total de 14 (40.0)% discontinuou os anticoagulantes orais após confirmação de ritmo sinusal. Conclusões: Alcançar um tempo no intervalo terapêutico superior a 65% revela-se desafiante e díficil de alcançar no que diz respeito à terapêutica com varfarina, sendo tal facto demonstrado pela proporção de pacientes que demonstraram valores que expressam a baixa eficácia deste agente, ainda que eventualmente resultante da sua utilização em contexto real onde questões associadas ao estilo de vida, inclusivamente alimentares e de adesão à terapêutica, poderão influenciar profundamente a capacidade de autogestão do doente. Deste modo, os anticoagulantes orais não antagonistas da vitamina K, iniciados oito dias após cirurgia cardiotorácica, podem constituir uma alternativa mais efetiva na tromboprofilaxia associada à fibrilhação auricular. No entanto, será prudente confirmar estes dados em amostras de maior dimensão dadas as limitações deste exercício académico. Estudos adicionais devem igualmente ser realizados de modo a estabelecer a dose ideal, bem como o período apropriado para iniciar a terapêutica anticoagulante com estes agentes na fase aguda do pós-operatório.
Hulvershorn, Sarah Elizabeth. "Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation." Thesis, 2014. http://hdl.handle.net/2152/26481.
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