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- Giustozzi, M., et al.
(författare)
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Safety of Anticoagulation in Patients Treated with Urgent Reperfusion for Ischemic Stroke Related to Atrial Fibrillation
- 2020
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Ingår i: Stroke. - 0039-2499. ; 51:8, s. 2347-2354
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: The optimal timing for starting oral anticoagulant after an ischemic stroke related to atrial fibrillation remains a challenge, mainly in patients treated with systemic thrombolysis or mechanical thrombectomy. We aimed at assessing the incidence of early recurrence and major bleeding in patients with acute ischemic stroke and atrial fibrillation treated with thrombolytic therapy and/or thrombectomy, who then received oral anticoagulants for secondary prevention. Methods: We combined the dataset of the RAF and the RAF-NOACs (Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin K Oral Anticoagulants) studies, which were prospective observational studies carried out from January 2012 to March 2014 and April 2014 to June 2016, respectively. We included consecutive patients with acute ischemic stroke and atrial fibrillation treated with either vitamin K antagonists or nonvitamin K oral anticoagulants. Primary outcome was the composite of stroke, transient ischemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding within 90 days from the inclusion. Treated-patients were propensity matched to untreated-patients in a 1:1 ratio after stratification by baseline clinical features. Results: A total of 2159 patients were included, 564 (26%) patients received acute reperfusion therapies. After the index event, 505 (90%) patients treated with acute reperfusion therapies and 1287 of 1595 (81%) patients untreated started oral anticoagulation. Timing of starting oral anticoagulant was similar in reperfusion-treated and untreated patients (median 7.5 versus 7.0 days, respectively). At 90 days, the primary study outcome occurred in 37 (7%) patients treated with reperfusion and in 146 (9%) untreated patients (odds ratio, 0.74 [95% CI, 0.50-1.07]). After propensity score matching, risk of primary outcome was comparable between the 2 groups (odds ratio, 1.06 [95% CI, 0.53-2.02]). Conclusions: Acute reperfusion treatment did not influence the risk of early recurrence and major bleeding in patients with atrial fibrillation-related acute ischemic stroke, who started on oral anticoagulant. © 2020 Georg Thieme Verlag. All rights reserved.
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| 3. |
- Fumes, R. A., et al.
(författare)
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Petrochronology of high-pressure granulite facies rocks from Southern Brasilia Orogen, SE Brazil: Combining quantitative compositional mapping, single-element thermometry and geochronology
- 2022
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Ingår i: Journal of Metamorphic Geology. - : Wiley. - 0263-4929 .- 1525-1314. ; 40:3, s. 517-552
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Tidskriftsartikel (refereegranskat)abstract
- We use a combination of several in situ techniques to assess the P-T-t path of high-pressure granulites from the Passos Nappe in the Southern Brasilia Orogen (SE Brazil). Quantitative element mapping and single-element thermometers (Zr-in-rutile and Ti-in-quartz) are coupled with P-T pseudosections and monazite and rutile dating. Compositional and temperature maps, based on cathodoluminescence mapping and in situ analyses of Ti-in-quartz, are presented as a novel approach to evaluate crystallization temperature. The studied rocks have a pelitic protolith and record a peak pressure assemblage of garnet + kyanite + rutile + K-feldspar + quartz + melt +/- plagioclase that formed at similar to 830 degrees C and 1.2 GPa. Retrograde conditions of similar to 560 degrees C and 0.6 GPa are determined based on the grossular content of garnet and the crystallization of biotite and ilmenite. Metamorphic peak conditions occurred ca. 635 Ma, according to monazite dating, with a younger date of ca. 615 Ma associated with later kyanite crystallization. Rutile ages of ca. 590 Ma are linked to the late retrograde stage (at similar to 600 degrees C). Results show that the distribution of Ti-in-quartz is heterogeneous, decreasing in abundance towards the rim of crystals, though the higher temperatures constrained with Ti-in-quartz thermometry are broadly consistent with peak conditions. The peak pressure conditions are consistent with continental collision setting in the Southern Brasilia Orogen and were followed by an early cooling/decompression stage and then by a slow cooling during exhumation and transport to shallower crustal levels.
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