Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Monday, May 14, 2018

PTSD may raise risk for AF

And since you have a 23% chance of stroke survivors getting PTSD, you do expect your doctor to be testing for atrial fibrillation?  And have a treatment plan for preventing PTSD?
https://www.healio.com/cardiology/arrhythmia-disorders/news/online/%7Bcc55aa3f-fca0-47dd-8fbc-262bf54cdf06%7D/ptsd-may-raise-risk-for-af?

BOSTON — Veterans with PTSD were more likely to have atrial fibrillation than veterans without it, according to a study presented at the Heart Rhythm Society Annual Scientific Sessions.
“These data suggest that PTSD is a potentially modifiable risk factor for AF,” Lindsey Rosman, PhD, postdoctoral research fellow in cardiovascular medicine at Yale School of Medicine, said in a press release. “Our results also raise the possibility that early detection and treatment of PTSD may reduce a patient’s risk for developing AF.”

Rosman and colleagues analyzed 1,063,973 veterans (mean age, 30 years; 87% men) who first received care from the Veterans Health Administration between October 2011 and November 2014 and did not have AF or atrial flutter at baseline.
Using multivariate Cox regression models, the researchers estimated the association between PTSD diagnosis with incident AF after adjustment for demographics and time-dependent CV risk factors.
During a mean 4.8 years of follow-up, 2,491 patients were diagnosed with AF.
After adjustment for age, sex, race, smoking status, BMI, hypertension, diabetes, CAD, MI, drug and alcohol use/abuse disorders, major depressive disorder and obstructive sleep apnea, those diagnosed with PTSD had increased risk for a diagnosis of AF compared with those without PTSD (HR = 1.11; 95% CI, 1-1.22), Rosman and colleagues found.
Other predictors of AF included age (HR = 1.05; 95% CI, 1.04-1.06), BMI greater than 30 kg/m2 (HR = 1.86; 95% CI, 1.49-2.33), history of hypertension (HR = 2.35; 95% CI, 2.13-2.6), history of CAD (HR = 4.54; 95% CI, 3.69-5.59), history of MI (HR = 4.15; 95% CI, 2.79-6.17), alcohol abuse (HR = 1.79; 95% CI, 1.56-2.04) and obstructive sleep apnea (HR = 1.67; 95% CI, 1.5-1.86), according to the researchers.
Among the cohort, incidence of AF was lower in women than in men and in racial minorities than in white participants, Rosman and colleagues found.
“It’s important to note that our patient population was much younger than the average patient diagnosed with AF and less than half had pre-existing structural cardiovascular disease prior to developing AF,” Rosman said in the release. “These results point to a potential opportunity to prevent young people who are exposed to trauma from developing a dangerous heart arrhythmia like AF that greatly impacts their long-term health and quality of life.” – by Erik Swain
Reference:
Rosman LA, et al. Abstract B-PO01-019. Presented at: Heart Rhythm Society Annual Scientific Sessions; May 9-12, 2018; Boston.

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