简介：Strokeisthemostcommoncomplicationofatrialfibrillation(AF).GuidelinesrecommendanticoagulanttreatmentinpatientswithCHA2DS2VAScscoresof>2.RegistrydatasuggeststhatalmosthalfofpatientswhoshouldbeontherapeuticanticoagulationforstrokepreventioninAF(SPAF)arenot.Warfarinandmorerecentlydevelopedagents,the"novelanticoagulants"(NOACs)reducetheriskofembolicstrokes.Inaddition,theNOACsalsoreduceintracranialhemorrhage(ICH)byover50%comparedtowarfarin.Anticoagulationandbridgingstrategiesinvolvingcardioversion,catheterablation,andinvasive/surgicalproceduresarereviewed.ThedevelopmentofreversalagentsforNOACsandtheintroductionofleftatrialappendageoccludingdeviceswillevolvetheuseofnewerstrategiesforpreventingstrokeinhighriskAFpatients.

简介：BackgroundTheclinicalcharacteristicsofstrokepatientstreatedwithdoubleanti-platelettherapy(DAPT)afterpercutaneouscoronaryintervention(PCI)isnotclear.MethodsIntotal,2675patientsunderwentPCIandDAPTinGuangdongGeneralHospital,and68outofthemwerehospitalizedduetosuspectedstroke,ofwhom23werediagnosedashavingstroke.Dataofthe23strokepatientswerecollectedandtraditionalriskfactorsassociatedwithstrokewereanalyzedretrospectively.ResultsThemeanageofthesepatientswas75.6±8.7years,and20(87.0%)weremales.Notably,19patientswerecomplicatedwithhypertension,7withdiabetesmellitus,7withprevioushistoryofstroke,nonewithatrialfibrillation(AF)orpatentforamenovale(PFO).Specifically,22patientswerediagnosedwithischemicstroke,and1patientwithhemorrhagicstroke.ConclusionStrokeinpatientstreatedwithDAPTafterPCIwascorrelatedwithadvancedage,gender,hypertension,diabetesmellitus,strokehistory.Longtermelectrocardiography(ECG)maybeneededforthediagnosisofAF,whiletrans-esophagealechocardiography(TEE)maybeneededforPFO.

简介：BackgroundEssentialhypertension(EH)isconsideredtobeoneofthemostimportantriskfactorofischemicstroke.Studiesaboutriskfactorsinthepatientsaremeaningfulinearlyforecastandeffectivepreventionoftheonsetofstroke.Renin-angiotensin-aldosteronesystemplaysanimportantroleintheregulationofbloodpressureandthedevelopmentofstroke,whilerecentstudieshavefoundthattheangiotensin-convertingenzyme2(ACE2)maybeareversalagentforthedevelopmentandprogressionofischemicstroke.MethodsTheACE2genewasmeasuredin139EHpatientswithischemicstrokeusingpolymerasechainreaction(PCR)andrestrictionfragmentlengthpolymorphism(PCR-RFLP)tests.Detailedandcompleteclinicalandbiochemicaldatawerecollected,includingpulsepressure,hsCRP,IMT,HDL-Canduricacidlevels.Studythecorrelationbetweenangiotensin-convertingenzyme2geneandtheriskfactorforonsetofischemicstrokeinEHpatients.ResultsPulsepressure,hsCRP,IMTanduricacidlevelshadapositivecorrelationwithon-setofischemicstrokeinEHpatients.Amongmalepatients,pulsepressure,hsCRP,IMTandHDL-CwerehigherinpatientscarryingAallelethanBallele(P<0.05).Whilethesefactorsweredifferentinfemalepa-tientscarryingdifferentgenotypesinwhichAAallelewerehighest.Patientswithvariousgenotypesshoweddifferenturicacidlevelsbutshowednosignificantdifference.ConclusionAmongEHpatientswithcomplicatedischemicstroke,thosecarryingtheA/AAalleleshowhighlevelofriskfactorsandislikelytohavethesusceptibilityofrecurrenceofstroke.

简介：AspatientsinEastAsiaage,theprevalenceofage-relatedandchronicdisease,includingnonvalvularatrialfibrillation,mayincrease.Althoughwarfarinhasbeentheprimarychoiceofanticoagulantforthepreventionofstrokeandsystemicembolicevents,theuseofdirectoralanticoagulants(DOACs)isincreasing.DOACsdonotrequiremonitoringoftheinternationalnormalizedratiotodeterminetheoptimaldose,andhavealowerpotentialforfoodanddruginteractions,improvedbenefit-riskprofiles,andaquickeronsetandoffsetofactionrelativetowarfarin.Thepivotalphase3trialsforeachoftheDOACs–dabigatran,rivaroxaban,apixaban,andedoxaban–includedatleastsomeEastAsianpatients.Additionally,severalclinicaltrialswereconductedspecificallyforEastAsianpatients.ThisreviewdiscussespatternsandpredictorsofanticoagulantuseinEastAsianpatientswithnonvalvularatrialfibrillation,summarizescurrentguidelinerecommendationsforEastAsianpatients,detailstheprimaryresultsdemonstratingthesafetyandefficacyofDOACsinEastAsianpatientsrelativetonon–EastAsianpatients,providesreal-worlddatasupportingthephase3testingresults,andaddressestheclinicalprofileofDOACsinEastAsianpopulations,includingpatientsathighriskofstroke.