Cardiologia
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Browsing Cardiologia by Subject "Acidente Vascular Cerebral"
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- Ischemic stroke in patients previously anticoagulated for non-valvular atrial fibrillation: Why does it happen?Publication . Fernandes, L; Sargento-Freitas, J; Milner, J; Silva, A; Novo, A; Gonçalves, T; Marinho, AV; Mariano Pego, G; Cunha, L; António, NOral anticoagulants have proved to be highly effective in preventing atrial fibrillation (AF)-related strokes. The occurrence of stroke despite oral anticoagulation is unexpected and little is known about the mechanisms responsible. The aim of this study was to assess possible mechanisms for stroke occurrence, such as poor treatment adherence and inappropriate dosage, in patients chronically anticoagulated for AF.
- Stroke after MitraClip: Systematic Review and Meta-AnalysisPublication . Barros da Silva, P; Sousa, JP; Oliveiros, B; Donato, H; Costa, M; Gonçalves, L; Teixeira, RAIMS: To assess stroke rate after transcatheter mitral valve repair (TMVR) with MitraClip, comparing it with surgical mitral valve repair (SMVR) and optimal medical treatment (OMT). METHODS AND RESULTS: We systematically searched PubMed, Embase and Cochrane Controlled Register of Trials, in December 2018, for studies comparing TMVR with SMVR and/or OMT for the treatment of severe mitral regurgitation. Random-effects and cumulative meta-analysis was performed. Ten studies were included: seven of TMVR versus SMVR and three of TMVR versus OMT, providing a total of 1881 patients and 61 pooled strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no difference in stroke incidence between TMVR and SMVR (pooled OR 0.49 [0.17, 1.42], P=0.19). Cumulative meta-analysis showed a significantly lower stroke rate in TMVR, compared to SMVR (OR 0.4 [0.24, 0.67], P< 0.01). For TMVR versus OMT, no difference in stroke rate was identified (pooled OR 1.09 [0.60, 1.97], P=0.79). Post-procedure de novo atrial fibrillation was more frequent in SMVR when compared with TMVR. CONCLUSIONS: Although with a low number of pooled events, there was a trend for a lower post-procedure stroke in TMVR when compared with SMVR and a similar one between TMVR and OMT alone.