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https://www.readbyqxmd.com/read/28412319/genetic-and-non-genetic-factors-affecting-the-quality-of-anticoagulation-control-and-vascular-events-in-atrial-fibrillation
#1
Yun Kyung Park, Mi Ji Lee, Jae Ha Kim, Jin Soo Lee, Rae Woong Park, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, June Soo Kim, Soo-Youn Lee, Oh Young Bang
BACKGROUND: Warfarin has a narrow therapeutic window. We hypothesized that genetic factors related to warfarin metabolism (CYP2C9) and activity (VKORC1) would show stronger associations than modifiable factors with the quality of anticoagulation control and risks for thromboembolism and hemorrhage. METHODS: In this retrospective cohort analysis, clinical and genetic data were collected from 380 patients with atrial fibrillation (AF) who were followed for an average observation period of 4 years...
April 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28394435/real-world-clinical-characteristics-and-treatment-patterns-of-individuals-aged-80-and-older-with-nonvalvular-atrial-fibrillation-results-from-the-real-life-multicenter-survey-evaluating-stroke-study
#2
Murat Biteker, Özcan Başaran, Volkan Doğan, İbrahim Altun, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin Çakıllı, Ceyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel
OBJECTIVES: To compare the clinical characteristics of and use of oral anticoagulant (OAC) therapy in individuals aged 80 and older with atrial fibrillation (AF) with those of individuals younger than 80 with AF in clinical practice. DESIGN: Observational study. SETTING: The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey trial (NCT02344901), a national observational registry. PARTICIPANTS: Turkish adults with nonvalvular AF (NVAF)...
April 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28385080/blood-pressure-control-in-anticoagulated-patients-with-hypertension-and-atrial-fibrillation
#3
Vivencio Barrios, Carlos Escobar, Luis Prieto Valiente, Jose María Lobos, Diego Vargas-Ortega, Jose Polo, Nuria Marin Montañés
OBJECTIVE: To determine the clinical profile and blood pressure (BP) control rates of anticoagulated patients with hypertension and atrial fibrillation (AF). METHODS: The PAULA study was a multicenter cross-sectional/retrospective observational study conducted throughout Spain. The study included patients with nonvalvular AF who were receiving vitamin K antagonist therapy during the past year and were attended at primary care setting. Adequate BP control was defined according to 2013 ESC/ESH guidelines...
April 7, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28360808/ischemic-stroke-in-the-elderly-septuagenarians-versus-octogenarians
#4
Birgül Baştan, Sefer Günaydin, Fatma Belgin Balci, Hürtan Acar, Aytül Mutlu, Feriha Özer, Özlem Çokar
INTRODUCTION: Stroke prevalence is known to increase with age. Approximately 50% of acute ischemic stroke patients are aged between 70 and 89 years. METHODS: In this study, records of 770 ischemic stroke patients who were 70-89 years old were retrospectively examined (407 septuagenarians and 363 octogenarians). The demographics, comorbid conditions, ischemic stroke type, and stroke outcome for the two age groups were analyzed. RESULTS: Comorbid hypertension, diabetes mellitus, and HbA1c levels of ≥6...
December 2016: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/28337024/angiotensin-ii-promotes-the-anticoagulant-effects-of-rivaroxaban-via-angiotensin-type-2-receptor-signaling-in-mice
#5
Dan Yang, Junjie Shao, Ruifeng Hu, Haimei Chen, Ping Xie, Chang Liu
Rivaroxaban is an oral direct factor Xa inhibitor approved for the treatment of stroke and systemic thromboembolism in patients with non-valvular atrial fibrillation. Despite its efficacy, rivaroxaban therapy results in adverse effects and complications, such as bleeding. Angiotensin II (AngII) is implicated in many cardiovascular conditions, such as hypertension and heart failure. In this study, we investigate whether AngII influences anticoagulant effects of rivaroxaban by using an experimental mouse model with type 2 diabetes mellitus and advanced glycation end product (AGE)-exposed human umbilical vein endothelial cells (HUVECs)...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28297123/embolization-of-watchman-device-following-a-hybrid-radiofrequency-ablation-of-atrial-fibrillation-and-watchman-implantation-procedure
#6
James Gabriels, Stuart Beldner, Mohammad Khan, Jonah Zeitlin, Ram Jadonath, Apoor Patel
No abstract text is available yet for this article.
March 15, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28266823/cardiovascular-disease-update-atrial-fibrillation
#7
Johnathan D McDivitt, Craig Barstow
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The prevalence increases with age, especially in the seventh and eighth decades of life. AF also is associated with multiple risk factors and conditions that are managed commonly in family medicine settings, such as hypertension and diabetes. Rhythm control and rate control are primarily equivalent for mortality rate, but patients treated for rhythm control have more hospitalizations; however, rhythm control may be a viable option for select patients...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28258654/novel-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-diabetes-good-or-excellent
#8
Aviv A Shaul, Alon Eisen
No abstract text is available yet for this article.
March 4, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28253498/brain-natriuretic-peptide-is-a-powerful-predictor-of-outcome-in-stroke-patients-with-atrial-fibrillation%C3%A2
#9
Kenji Maruyama, Shinichiro Uchiyama, Tsuyoshi Shiga, Mutsumi Iijima, Kentaro Ishizuka, Takao Hoshino, Kazuo Kitagawa
BACKGROUND: Since stroke patients with nonvalvular atrial fibrillation (NVAF) have poor outcomes in general, the prediction of outcomes following discharge is of utmost concern for these patients. We previously reported that brain natriuretic peptide (BNP) levels were significantly higher in NVAF patients with larger infarcts, higher modified Rankin Scale (mRS) score, and higher CHADS2 score. In the present study, we evaluated an array of variables, including BNP, in order to determine significant predictors for functional outcome in patients with NVAF after acute ischemic stroke (AIS)...
March 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28237286/comparison-of-has-bled-and-has-bed-versus-chads2-and-cha2ds2vasc-stroke-and-bleeding-scores-in-patients-with-atrial-fibrillation
#10
Daniela Poli, Emilia Antonucci, Vittorio Pengo, Sophie Testa, Gualtiero Palareti
Anticoagulation is recommended in patients with atrial fibrillation (AF) for stroke prevention, and the bleeding risk associated suggests the need for a bleeding risk stratification. HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio (INR), elderly >65 years, drugs/alcohol concomitantly) score includes "labile INR" referred to quality of anticoagulation. However, in naïve patients, this item is not available. In addition, stroke and bleeding risk prediction scores shared several risk factors...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28228305/clinical-presentation-management-and-outcomes-in-the-indian-heart-rhythm-society-atrial-fibrillation-ihrs-af-registry
#11
A Vora, A Kapoor, M Nair, Y Lokhandwala, C Narsimhan, A G Ravikishore, S K Dwivedi, N Namboodiri, R Hygriv, A Saxena, A Nabar, S Garg, N Bardoloi, R Yadav, A Nambiar, U Pandurangi, D Jhala, A Naik, Nagmallesh, S Rajagopal, R Selvaraj, V Arora, A Thachil, J Thomas, G Panicker
AIM: A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. METHODS: A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28224930/incidence-of-severe-renal-dysfunction-among-individuals-taking-warfarin-and-implications-for-non-vitamin-k-oral-anticoagulants
#12
Christina L Fanola, Deirdre Mooney, Andrew J Cowan, Darae Ko, Emily K Sisson, Lori E Henault, Yorghos Tripodis, Elaine M Hylek
BACKGROUND: The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHODS: Patients on warfarin for atrial fibrillation or venous thromboembolism were consecutively enrolled from January 2007 to December 2010. Baseline kidney function was assessed, and patients were followed to their first decline of kidney function to creatinine clearance<30 mL/min...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#13
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#14
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28151869/effect-of-statin-use-on-clinical-outcomes-in-ischemic-stroke-patients-with-atrial-fibrillation
#15
Yi-Ling Wu, Jeffrey L Saver, Pei-Chun Chen, Jiann-Der Lee, Hui-Hsuan Wang, Neal M Rao, Meng Lee, Bruce Ovbiagele
It remains unclear whether statin therapy should be applied to ischemic stroke patients with atrial fibrillation. The objective of this study was to clarify whether statin therapy can influence the prognosis in recent ischemic stroke patients with atrial fibrillation.We identified ischemic stroke patients with atrial fibrillation between 2001 and 2011 from Taiwan National Health Insurance Database. Patients not treated with statins during the first 90 days after the index stroke were matched to patients treated with statins in the first 90 days in a 2:1 ratio on the basis of age, sex, hypertension, diabetes mellitus, ischemic heart disease, heart failure, estimated National Institutes of Health Stroke Scale, use of anticoagulant, and year of their entry into the cohort...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28126158/insulin-requiring-versus-noninsulin-requiring-diabetes-and-thromboembolic-risk-in-patients%C3%A2-with%C3%A2-atrial-fibrillation-prefer-in-af
#16
Giuseppe Patti, Markus Lucerna, Ilaria Cavallari, Elisabetta Ricottini, Giulia Renda, Ladislav Pecen, Fabio Romeo, Jean-Yves Le Heuzey, Josè Luis Zamorano, Paulus Kirchhof, Raffaele De Caterina
BACKGROUND: Diabetes is a known risk predictor for thromboembolic events in patients with atrial fibrillation (AF), but no study has explored the prognostic weight of insulin in this setting. OBJECTIVES: This study evaluated the differential role of insulin versus no insulin therapy on thromboembolic risk in patients with diabetes and AF. METHODS: We accessed individual patient data from the prospective, real-world, multicenter, PREFER in AF (European Prevention of thromboembolic events-European Registry in Atrial Fibrillation)...
January 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28122078/atrial-fibrillation-type-2-diabetes-and-non-vitamin-k-antagonist-oral-anticoagulants-a-review
#17
Anna Plitt, Darren K McGuire, Robert P Giugliano
Importance: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a 5-fold increase in the risk for stroke. Type 2 diabetes is an independent risk factor for both stroke and atrial fibrillation, and in the setting of AF, type 2 diabetes is independently associated with a 2% to 3.5% increase in absolute stroke rate per year. The overlap in the pathophysiologies of AF and type 2 diabetes are not well understood, and current practice guidelines provide few recommendations regarding patients with both conditions...
April 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28029216/safety-and-efficacy-of-nonvitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-diabetic-patients-with-atrial-fibrillation-a-study-level-meta-analysis-of-phase-iii-randomized-trials
#18
REVIEW
Giuseppe Patti, Giuseppe Di Gioia, Ilaria Cavallari, Antonio Nenna
In patients with atrial fibrillation (AF), the safety and efficacy of nonvitamin K antagonist oral anticoagulants (NOACs) vs warfarin according to diabetes mellitus (DM) status are not completely characterized. We performed a meta-analysis to clarify whether in these patients the strategy of oral anticoagulation should be tailored to diabetes status. In this study-level meta-analysis, we included 4 randomized phase III trials comparing NOACs and warfarin in patients with nonvalvular AF; a total of 18 134 patients with DM and 40 454 without DM were overall considered...
March 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/27939441/cardiovascular-risk-factors-nonvalvular-atrial-fibrillation-and-retinal-vein-occlusion
#19
M Lisa Gracia, A Córdoba Alonso, J L Hernández Hernández, R Pérez Montes, J J Napal Lecumberri
OBJECTIVES: To analyse the importance of cardiovascular risk factors, ultrasound findings in the supra-aortic trunk and the presence of anticoagulated nonvalvular atrial fibrillation (NVAF) in patients with retinal vein occlusion (RVO) and in a control group. PATIENTS AND METHODS: A cross-sectional study was conducted of all patients with RVO consecutively referred to the office of internal medicine, comparing them with a control group. We analysed clinical, electrocardiographic and ultrasound variables...
December 7, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27938343/thromboembolic-events-bleeding-and-drug-discontinuation-in-patients-with-atrial-fibrillation-on-anticoagulation-a-prospective-hospital-based-registry
#20
Oliver Königsbrügge, Alexander Simon, Hans Domanovits, Ingrid Pabinger, Cihan Ay
BACKGROUND: The clinical practice of stroke prevention in atrial fibrillation (AF) with direct oral anticoagulants (DOACS) differs from anticoagulation in randomized trial patients. We investigated the risk of thromboembolism, bleeding, and drug discontinuation in a hospital-based real-world setting. METHODS: All-comer patients with non-valvular AF were recruited into a registry at an academic tertiary care center. After informed consent, patients underwent a personal structured interview including medical history, past and current anticoagulation, and returned for follow-up after 6-12 months...
December 9, 2016: BMC Cardiovascular Disorders
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