Stroke

Detect, protect, perfect: AHSNs going further, faster to reduce AF-related stroke

Since 2014 the 15 Academic Health Science Networks (AHSNs) across England have been working on a collaborative atrial fibrillation (AF) programme focused on reducing AF-related stroke. The national programme has three elements: Detect: finding more people with AF to allow early intervention to prevent stroke; Protect: treating more at-risk patients with anticoagulants to reduce the rate of AF-related stroke; and Perfect: improving the quality of anticoagulation to ensure maximal patient outcomes.

Examining the migraine-CVD link

There appears to be an association between migraine and cardiovascular disease and especially ischaemic stroke. How real is the absolute risk, what may be the cause, and what, if anything should we tell our patients?

Back to Basics: Understanding the DOACs

This month’s Back to Basics summarizes the main features of the key direct oral anticoagulants (DOACs or NOACS). These drugs are becoming a standard therapy in many settings including stroke prevention, management of deep vein thrombosis and pulmonary embolism, and prevention of venous thromboembolism following hip and knee replacement.

Back to Basics: NOAC patient information card

This month’s Back to Basics feature is a patient information card that is included in the 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. The card can be folded into pocket size and is crucial both for the patient and for healthcare providers.

Back to Basics: The direct oral anticoagulants (DOACs)

Back to Basics: What goes wrong in atrial fibrillation?

Atrial fibrillation (AF) is the commonest sustained cardiac dysrhythmia, and an important risk factor for stroke and systemic thromboembolic events. This wall chart outlines AF risk factors, and compares AF with normal heart rhythm.

AF and stroke prevention: Case finding in primary care

Atrial fibrillation (AF) is the commonest sustained cardiac dysrhythmia, but is asymptomatic in about one quarter of patients. Case finding with subsequent assessment of the risk of stroke and bleeding are essential to ensure that the right patients receive appropriate intervention with oral anticoagulation.

Stroke prevention in atrial fibrillation

The prevalence of atrial fibrillation (AF), together with the condition’s associated stroke and systemic thromboembolic risk, is increasing significantly. Fortunately, there are clear, evidence-based clinical guidelines and risk stratification tools, to ensure that patients can make informed choices about optimising their treatment and care.

A review of stroke prevention in 8 primary care practices

GP practices have a central role in the prevention of stroke. This review assessed the adequacy of primary and secondary preventive interventions that were provided for patients who were on the stroke register between January 2009 to December 2012, in the six months before and after a stroke. Eight GP practices in a deprived locality of North London participated in the review.

Using the novel oral anticoagulants in primary care

Stroke related to atrial fibrillation can be prevented effectively through the use of anticoagulants. This article reviews recent guidelines, clinical trials and real-world evidence with non-vitamin K antagonist oral anticoagulants (NOACs) in patients with AF and provides practical guidance on the use of these newer agents in primary care.

Improving anticoagulation in patients with atrial fibrillation

A new case study shows the significant reduction in atrial fibrillation-related stroke incidence achieved using the GRASP-AF audit tool. The case study, highlights improvements in key measures including a 4% reduction in the number of patients treated inappropriately, a 5% increase in the use of oral anticoagulation therapy and a 10% reduction in AF-related strokes.

How to improve AF-related stroke prevention

Recent guidelines recommend two key steps to reduce ischaemic stroke in people with atrial fibrillation: 1. Improving the assessment of stroke risk and 2. Increasing the use of evidence-based anticoagulant therapy. In this article, leading specialists explain how to apply current guidelines to improve current practice in stroke prevention.

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