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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lone atrial fibrillation is a major health problem for elderly patients with cardiovascular risk factors as hypertension, congestive heart failure or previous myocardial infarction. The increased stroke rate of these patients is significantly reduced by oral anticoagulation (target: INR 2-3) and less effective by acetylsalicylic acid at a dose of 325 mg/d. As an alternative to the vitamin K-antagonistic anticoagulants currently the SPORTIF trial program is performed investigating the safety and efficacy of the oral direct thrombin inhibitor ximelagatran. Recent data derived from a dose-finding study and its open label continuous follow-up period are very encouraging with regard to the low incidence of bleeding complications and ximelagatran's clinical efficacy for the prevention of thromboembolic events. Large confirmatory trials engaging about 3000 patients each are under way in Europe as an open-label trial and the United Staates as a double blind trial. Results are being expected for the end of year 2002. These data will clarify the role of ximelagatran for the prevention of thromboembolic events in patients with lone atrial fibrillation and may give us an insight into a new standard drug regimen for stroke prevention in high risk patients.
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PMID:[New developments in anticoagulation therapy for Ione atrial fibrillation]. 1221 59

In 66 patients with embolic stroke of cardiac origin (33 with persistent and 33 with paroxysmal atrial fibrillation) transthoracic and transesophageal (21 patients, 31.2%) echocardiography was used for detection of atrial thrombosis. Lone atrial fibrillation was significantly more frequent among patients with paroxysmal atrial fibrillation. Frequency of thrombosis of left atrial appendage was similar in patients with nonrheumatic persistent and paroxysmal atrial fibrillation.
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PMID:[Comparative assessment of persistent and paroxysmal atrial fibrillation as causes of cardiocerebral embolism]. 1249 4

Lone atrial fibrillation (LAF) is generally regarded as a benign disorder that does not significantly increase the risk of thromboembolism and mortality. However, there is growing evidence that "lone" atrial fibrillation (AF) is a "heterogeneous" disorder with varying risk for thromboembolism based on the patient's underlying cardiovascular risk factors. Blood biomarkers, including markers of myocardial strain, inflammation, endothelial injury, platelet activation, and hypercoagulability, have potential to improve our risk stratification and management of LAF. Currently, there is a paucity of data on biomarkers in strictly defined LAF. The majority of studies that aimed to study lone atrial fibrillation excluded patients with structural heart disease, but did not exclude patients with co-existing cardiovascular risk factors such as hypertension or diabetes mellitus. Moreover, many of the studies did not exclude patients based on age, thereby increasing the likelihood of including patients with cardiovascular co-morbidities. There are currently a limited number of studies aimed to investigate the role of biomarkers in true LAF. The results are conflicting as to whether these biomarkers are associated with LAF or stroke risk. Future studies enrolling patients with true LAF using strict definition are needed. Herein, we review our current knowledge of biomarkers in association with atrial fibrillation and LAF and discuss their potential clinical utility.
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PMID:Biomarkers in lone atrial fibrillation - an additional 'fine tuning' of risk? 2517 91