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https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#1
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29304527/is-there-a-preferred-stroke-prevention-strategy-for-diabetic-patients-with-non-valvular-atrial-fibrillation-comparing-warfarin-dabigatran-and-rivaroxaban
#2
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Yu, Chi-Jung Huang, Hao-Min Cheng
BACKGROUND:  The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. METHODS AND RESULTS:  Diabetic AF patients taking dabigatran (n = 322), rivaroxaban (n = 320) or warfarin (n = 1,899) were identified from the nationwide diabetes pay-for-performance program (n = 814,465) in Taiwan...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#3
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29247109/evaluation-of-anticoagulation-status-for-atrial-fibrillation-on-early-ischaemic-stroke-outcomes-a-registry-based-prospective-cohort-study-of-acute-stroke-care-in-surrey-uk
#4
Thang S Han, Christopher H Fry, David Fluck, Brendan Affley, Giosue Gulli, Christopher Barrett, Puneet Kakar, Tasmin Patel, Sapna Sharma, Pankaj Sharma
OBJECTIVE: The relationship of anticoagulation therapies with stroke severity and outcomes have been well documented in the literature. However, none of the previous research has reported the relationship of atrial fibrillation (AF)/anticoagulation therapies with urinary tract infection (UTI), pneumonia and length of stay in hyperacute stroke units (HASUs). The present study aimed to evaluate AF and anticoagulation status in relation to early outcomes in 1387 men (median age=75 years, IQR=65-83) and 1371 women (median age=83 years, IQR=74-89) admitted with acute ischaemic stroke to HASUs in Surrey between 2014 and 2016...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181519/role-of-antiplatelet-therapy-in-stroke-prevention-in-patients-with-atrial-fibrillation
#5
Rohini Manaktala, Jeffrey Kluger
Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to oral anticoagulation, remains controversial...
December 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29175298/does-type-2-diabetes-affect-the-on-treatment-levels-of-direct-oral-anticoagulants-in-patients-with-atrial-fibrillation
#6
Matej Samoš, Tomáš Bolek, Lucia Stančiaková, Ingrid Škorňová, Jela Ivanková, František Kovář, Peter Galajda, Peter Kubisz, Ján Staško, Marián Mokáň
AIMS: Type 2 diabetes (T2D) is connected with several abnormalities in haemostasis; and with higher risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NV-AF). However, it is recently unknown whether T2D affects the activity of direct oral anticoagulants (DOACs). The aim of this study was to determine the impact of T2D on DOACs activity in patients with NV-AF. METHODS: This pilot prospective study enrolled totally 65 patients with NV-AF (20 dabigatran-treated, 110 mg/twice daily; 28 rivaroxaban-treated, 15 mg/daily; 17 apixaban-treated, 5 mg/twice daily)...
November 23, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29173598/mechanisms-clinical-significance-and-prevention-of-cognitive-impairment-in-patients-with-atrial-fibrillation
#7
REVIEW
Lena Rivard, Paul Khairy
Atrial fibrillation (AF) and dementia are major health issues, with growing evidence suggesting a consistent association between AF and all forms of dementia. Although dementia and AF share several risk factors, the association appears to be independent of a history of clinical stroke and other comorbidities such as hypertension, heart failure, and diabetes. Proposed mechanisms linking AF to cognitive decline include altered hemodynamics resulting in cerebral hypoperfusion, inflammation, genetic factors, and silent cerebral ischemia due to subclinical microemboli...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29171361/canadian-stroke-best-practice-recommendations-secondary-prevention-of-stroke-sixth-edition-practice-guidelines-update-2017
#8
Theodore Wein, M Patrice Lindsay, Robert Côté, Norine Foley, Joseph Berlingieri, Sanjit Bhogal, Aline Bourgoin, Brian H Buck, Jafna Cox, Dion Davidson, Dar Dowlatshahi, Jim Douketis, John Falconer, Thalia Field, Laura Gioia, Gord Gubitz, Jeffrey Habert, Sharon Jaspers, Cheemun Lum, Dana McNamara Morse, Paul Pageau, Mubeen Rafay, Amanda Rodgerson, Bill Semchuk, Mukul Sharma, Ashkan Shoamanesh, Arturo Tamayo, Elisabeth Smitko, David J Gladstone
The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29169605/relation-of-stroke-and-bleeding-risk-profiles-to-efficacy-and-safety-of-edoxaban-for-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-warfarin-in-subjects-undergoing-cardioversion-of-atrial-fibrillation-ensure-af-study
#9
Gregory Y H Lip, Jose L Merino, G Andrei Dan, Sakis Themistoclakis, Kenneth A Ellenbogen, Raffaele De Caterina, Assen Goudev, James Jin, Michael Melino, Shannon M Winters, Andreas Goette
In the EdoxabaN versus warfarin in subjectS UndeRgoing cardiovErsion of Atrial Fibrillation (ENSURE-AF) study, edoxaban was compared with enoxaparin-warfarin in patients who underwent electrical cardioversion of nonvalvular atrial fibrillation, showing comparable low rates of bleeding and thromboembolism. The present study is an ancillary analysis investigating differences in relation to stroke and bleeding risk profiles. It also determined the relation of patients' clinical risk profiles to the quality of anticoagulation control in the warfarin arm...
November 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29139276/preventing-stroke-and-assessing-risk-in-women
#10
Tracey Keteepe-Arachi, Sanjay Sharma
Ischaemic stroke is rare in premenopausal women but risk increases with advancing age and doubles in the ten years following the menopause. Up to the age of 75 years men have a 25% higher risk of suffering a stroke compared with women. However, the increased life expectancy of women ultimately results in a higher overall incidence. Twice as many women die from stroke compare with breast cancer. Women with cerebrovascular disease are more likely to present with atypical symptoms than men. Altered mental status (including unresponsiveness, confusion and behavioural change) is the most common nonconventional symptom, and is reported by 23% of women compared with 15% of men...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#11
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29122636/clinical-outcomes-and-history-of-fall-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-insights-from-the-aristotle-trial
#12
Meena P Rao, Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Dan Atar, Elaine M Hylek, Michael Hanna, Lars Wallentin, Renato D Lopes, Bernard J Gersh, Christopher B Granger
PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population. METHODS: Of the 18,201 patients in ARISTOTLE, 16,491 had information about history of falling - 753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29109364/trend-of-prevalence-of-atrial-fibrillation-and-use-of-oral-anticoagulation-therapy-in-patients-with-atrial-fibrillation-in-south-korea-2002-2013
#13
Mi Kyoung Son, Nam-Kyoo Lim, Hyun-Young Park
BACKGROUND: This study examined the annual prevalence of atrial fibrillation (AF) and its associated comorbidities, as well as the prevalence of warfarin therapy in South Korean patients with AF. METHODS: The National Health Insurance Service-National Sample Cohort database was searched for subjects aged ≥30 years diagnosed with AF from 2002-2013. The prevalence of AF was analyzed by sex and age, as was the current status of warfarin therapy in AF patients according to CHA2DS2-VASc score and comorbidities...
November 4, 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/29095971/quality-of-oral-anticoagulation-with-vitamin-k-antagonists-in-real-world-patients-with-atrial-fibrillation-a-report-from-the-prospective-multicentre-fantasiia-registry
#14
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Inmaculada Roldán-Rabadán, Vanessa Roldán, Javier Muñiz, Paula Raña-Míguez, Martín Ruiz-Ortiz, Ángel Cequier, Vicente Bertomeu-Martínez, Lina Badimón, Manuel Anguita, Gregory Y H Lip, Francisco Marín
Aims: The efficacy and safety of oral anticoagulation (OAC) using the vitamin K antagonists (VKA) are closely associated with the quality of anticoagulation, reflected by time in therapeutic range (TTR). The SAMe-TT2R2 is a risk score developed to predict the quality of anticoagulation control among VKA users. To analyse the quality of anticoagulation and its clinical determinants based on different methods in a prospective cohort of atrial fibrillation patients on VKA treatment participating in the multicentre Spanish observational registry FANTASIIA...
October 31, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#15
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29081978/device-closure-for-patent-foramen-ovale-following-cryptogenic-stroke-a-survey-of-current-practice-in-the-uk
#16
Katherine Von Klemperer, Aleksander Kempny, Christopher William Pavitt, John C Janssen, Anselm Uebing, Edward Nicol
Patent foramen ovale (PFO) closure for cryptogenic stroke remains controversial due to a lack of conclusive randomised controlled data. Many experts feel PFO closure is indicated in selected cases; however, national and international guideline recommendations differ. We surveyed the UK cardiologists, stroke physicians and neurologists, seeking to determine specialist interpretation of the evidence base, and to gain an insight into the current UK practice. The British Cardiac Society and British Society of Stroke physicians distributed our survey which was performed using an online platform...
2017: Open Heart
https://www.readbyqxmd.com/read/29080863/temporal-trends-in-the-use-and-comparative-effectiveness-of-direct-oral-anticoagulant-agents-versus-warfarin-for-nonvalvular-atrial-fibrillation-a-canadian-population-based-study
#17
Amy Y X Yu, Shaun Malo, Lawrence W Svenson, Stephen B Wilton, Michael D Hill
BACKGROUND: Direct oral anticoagulants (DOACs) are noninferior to warfarin for stroke prevention in atrial fibrillation (AF). We aimed to determine the population risk of stroke and death in incident AF, stratified by anticoagulation status and type, and the temporal trends of oral anticoagulation practice in the post-DOAC approval period. METHODS AND RESULTS: We conducted a population-based cohort study of incident nonvalvular AF cases using administrative health data in Alberta, Canada...
October 28, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29058207/stroke-risk-in-patients-with-device-detected-atrial-high-rate-episodes
#18
REVIEW
Ö Erküner, M Rienstra, I C Van Gelder, U Schotten, H J G M Crijns, J G L M Luermans
Cardiovascular implantable electronic devices (CIEDs) can detect atrial arrhythmias, i. e. atrial high-rate episodes (AHRE). The thrombo-embolic risk in patients showing AHRE appears to be lower than in patients with clinical atrial fibrillation (AF) and it is unclear whether the former will benefit from oral anticoagulants. Based on currently available evidence, it seems reasonable to consider antithrombotic therapy in patients without documented AF showing AHRE >24 hours and a CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes mellitus, prior stroke [doubled], vascular disease, age 65-74 years and female sex) ≥1, awaiting definite answers from ongoing randomised clinical trials...
October 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29043146/calciphylaxis-in-a-nondialysis-patient-treated-with-sodium-thiosulfate-and-high-dose-of-oxygen
#19
Anawin Sanguankeo, Natanong Thamcharoen, Sikarin Upala
BACKGROUND: Calciphylaxis in a nondialysis patient is a rare condition and is characterized by calcific deposition in tissue. We present a case of calciphylaxis in a nondialysis patient who was diagnosed by clinical presentation and skin biopsy and was treated with sodium thiosulfate with improvement of skin lesions. CASE: A 43-year-old female with type 2 diabetes and atrial fibrillation taking oral anticoagulation medication presented with reddish drainage from the right buttock...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29022745/real-world-adherence-to-oral-anticoagulant-in-non-valvular-atrial-fibrillation-patients-in-china
#20
Xiao Xiang, Yaying Cao, Kexin Sun, Jing Song, Yaohua Tian, Qiongzhou Yin, Juan Juan, Yonghua Hu
BACKGROUND AND OBJECTIVE: Adherence to oral anticoagulants is crucial for the prevention of ischemic stroke in atrial fibrillation patients; however, evidence of oral-anticoagulant adherence from developing countries is still lacking. This study aimed to evaluate the current situation and predictors of oral-anticoagulant adherence in non-valvular atrial fibrillation (NVAF) patients in China. METHODS: Records of NVAF patients were obtained from a regional claims database...
November 8, 2017: Current Medical Research and Opinion
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