{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T11:19:33Z","timestamp":1769944773737,"version":"3.49.0"},"reference-count":66,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2008,8,12]],"date-time":"2008-08-12T00:00:00Z","timestamp":1218499200000},"content-version":"vor","delay-in-days":42,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Stroke remains an increasing worldwide cause of disability and mortality, and it is the second leading cause of death in industrialized countries. Patients with atrial fibrillation form a unique group with increased risk of cardioembolic stroke. Despite the widespread application of the National Institutes of Health stroke scale and guidelines,,  patients with atrial fibrillation represent a clinically challenging group that deserves a special approach during the acute stroke phase.<\/jats:p><jats:p>The mechanism of stroke in these patients is either cardioembolic [especially with an international normalized ratio (INR) &lt; 2.0] or hemorrhagic (especially with INR &gt; 5.0),  (Figure ). Atrial fibrillation with valvular heart disease significantly increases the risk for ischemic stroke. Specifically, patients with mitral stenosis who develop atrial fibrillation increase their risk of cardioembolism by 3 to 7 times. Many patients with atrial fibrillation still develop ischemic or hemorrhagic stroke despite appropriate use of anticoagulation. Prior stroke, transient ischemic attacks, congestive heart failure, hypertension, age &gt; 75, and diabetes mellitus are all well\u2010established risk factors for the development of stroke in patients with atrial fibrillation.,  The CHADS\u20102 score is the most widely studied and clinically used method for stratifying patients with nonrheumatic atrial fibrillation. In our review, we present the most recent clinical guidelines and trends for the approach to and management of this patient group. Journal of Hospital Medicine 2008;3:326\u2013332. \u00a9 2008 Society of Hospital Medicine.<\/jats:p>","DOI":"10.1002\/jhm.343","type":"journal-article","created":{"date-parts":[[2008,8,13]],"date-time":"2008-08-13T01:16:05Z","timestamp":1218590165000},"page":"326-332","source":"Crossref","is-referenced-by-count":3,"title":["Approach to and management of the acute stroke patient with atrial fibrillation: A literature review"],"prefix":"10.1002","volume":"3","author":[{"given":"Konstantinos","family":"Marmagkiolis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis G.","family":"Nikolaidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Themos","family":"Politis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,8,12]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"The Atlas of Heart Disease and Stroke","author":"Mackay J","year":"2004"},{"key":"e_1_2_6_3_2","unstructured":"National Institute of Neurological Disorders and Stroke. NIH Stroke Scale. Available at:http:\/\/www.ninds.nih.gov\/doctors\/NIH_stroke_scale_booklet.pdf. Accessed January2008."},{"key":"e_1_2_6_4_2","volume-title":"Prepared by the Intercollegiate Stroke Working Party","author":"Royal College of Physicians","year":"2004"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507063330102"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-10-200411160-00005"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.099911"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000145172.55640.93"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2007.tb00862.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.181486"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002340100601"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0150-9861(04)97011-3"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.183689"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21130"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.3_suppl.483S"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.670885"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000071228.56362.36"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-3057(99)80035-4"},{"issue":"7","key":"e_1_2_6_19_2","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1080\/02841850701408228","article-title":"Treatment of acute ischemic brain infarction with the assistance of local intraarterial thrombolysis with recombinant tissue\u2010type plasminogen activator","volume":"48","author":"Poncyljusz W","year":"2007","journal-title":"Acta Radiol."},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-007-0306-1"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000101752.23813.C3"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.6.862"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000257304.21967.ba"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000213"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15692-4"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-3057(98)80025-6"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02085-7"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)04011-7"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs0302.104628"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000254600.92975.1f"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(98)00102-9"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.8.1557"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022913"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.06.077"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.19.1830"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000035735.49388.4A"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.4065\/79.12.1495"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050565"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.1.1"},{"key":"e_1_2_6_40_2","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1001\/archinte.1993.00410130073007","article-title":"Bleeding complications in oral anticoagulant therapy: an analysis of risk factors","volume":"153","author":"Van der Meer FJM","year":"1993","journal-title":"Arch Intern Med."},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.7.947"},{"issue":"1","key":"e_1_2_6_42_2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0025-6196(11)60970-1","article-title":"Treatment of warfarin\u2010associated intracerebral hemorrhage: literature review and expert opinion","volume":"82","author":"Hart RG","year":"2007","journal-title":"Mayo Clinic Proc."},{"key":"e_1_2_6_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01815.x"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0765-1"},{"key":"e_1_2_6_45_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000195047.21562.23"},{"key":"e_1_2_6_46_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000238104.75563.2f"},{"key":"e_1_2_6_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0b013e3282010d7a"},{"key":"e_1_2_6_48_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04972.x"},{"key":"e_1_2_6_49_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.3_suppl.204S"},{"key":"e_1_2_6_50_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000221786.81354.d6"},{"key":"e_1_2_6_51_2","doi-asserted-by":"publisher","DOI":"10.2165\/00063030-199912010-00008"},{"key":"e_1_2_6_52_2","doi-asserted-by":"publisher","DOI":"10.1159\/000104481"},{"key":"e_1_2_6_53_2","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:4:3:206"},{"key":"e_1_2_6_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)70233-6"},{"key":"e_1_2_6_55_2","doi-asserted-by":"publisher","DOI":"10.4065\/82.8.987"},{"key":"e_1_2_6_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-004-0207-6"},{"key":"e_1_2_6_57_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-007-0325-6"},{"key":"e_1_2_6_58_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2007.00842.x"},{"issue":"6","key":"e_1_2_6_59_2","first-page":"1177","article-title":"Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I","volume":"27","author":"Smith WS","year":"2006","journal-title":"AJNR Am J Neuroradiol."},{"key":"e_1_2_6_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00887-X"},{"key":"e_1_2_6_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2007.01.005"},{"key":"e_1_2_6_62_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e3180533bfb"},{"key":"e_1_2_6_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.035"},{"key":"e_1_2_6_64_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000250166.06949.95"},{"key":"e_1_2_6_65_2","unstructured":"FDA News. FDA clears genetic lab test for warfarin sensitivity. Available at:http:\/\/www.fda.gov\/bbs\/topics\/news\/2007\/new01701.html. Accessed January2008."},{"issue":"104","key":"e_1_2_6_66_2","first-page":"1","article-title":"Pharmacogenomics and warfarin therapy","author":"Ndegwa S","year":"2007","journal-title":"Issues Emerg Health Technol."},{"key":"e_1_2_6_67_2","doi-asserted-by":"publisher","DOI":"10.2174\/138945007781077355"}],"container-title":["Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjhm.343","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.343","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhm.343","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T14:09:02Z","timestamp":1760623742000},"score":1,"resource":{"primary":{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/10.1002\/jhm.343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7]]},"references-count":66,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.1002\/jhm.343"],"URL":"https:\/\/doi.org\/10.1002\/jhm.343","archive":["Portico"],"relation":{},"ISSN":["1553-5592","1553-5606"],"issn-type":[{"value":"1553-5592","type":"print"},{"value":"1553-5606","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7]]}}}