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https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#1
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28428449/current-status-and-outcomes-of-direct-oral-anticoagulant-use-in-real-world-atrial-fibrillation-patients%C3%A3-fushimi-af-registry
#2
Yugo Yamashita, Ryuji Uozumi, Yasuhiro Hamatani, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Satoshi Morita, Masaharu Akao
BACKGROUND: The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status...
April 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28428444/impact-of-atrial-fibrillation-on-the-clinical-course-of-apical-hypertrophic-cardiomyopathy
#3
Sang-Eun Lee, Jin-Kyu Park, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Apical hypertrophic cardiomyopathy (ApHCM) is considered a 'benign' form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM. METHODS: The occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years). RESULTS: AF occurred in 77 patients with ApHCM (prevalence, 25...
April 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation-in-asia
#4
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review showed great variability on the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiology studies on AF have been increasingly reported. METHODS: We therefore conducted an updated systematic review, to present the current knowledge base of AF epidemiology in Asian countries since our prior review. We also explored AF incidence and the risk of stroke in AF using meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28426737/incidence-and-predictors-of-excessive-warfarin-anticoagulation-in-patients-with-atrial-fibrillation-the-ewa-study
#5
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Melina Issakoff, K E Juhani Airaksinen
Vitamin K antagonist warfarin is widely used in clinical practice and excessive anticoagulation is a well-known complication of this therapy. Little is known about permanent and temporary predictors for severe overanticoagulation. The aim of this study was to investigate the occurrence and predicting factors for episodes with very high (≥9) international normalized ratio (INR) values in warfarin treated patients with atrial fibrillation (AF). Excessive Warfarin Anticoagulation (EWA) study screened all patients (n = 13618) in the Turku University Hospital region with an INR ≥2 between years 2003-2015...
2017: PloS One
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#6
Leon A Simons, Michael Ortiz, S Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28420316/persistence-of-secondary-prevention-medication-and-related-factors-for-acute-ischemic-stroke-and-transient-ischemic-attack-in-china
#7
Yue Jiang, Xiaomeng Yang, Zixiao Li, Yuesong Pan, Yilong Wang, Yongjun Wang, Ruijun Ji, Chen Wang
OBJECTIVE: We recently measured the longitudinal use of secondary prevention medication following hospital discharge and the factors influencing persistence in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA) in China. METHODS: Patients with AIS and TIA who were enrolled in the China National Stroke Registry II from June 2012 to January 2013 were surveyed to determine persistence. The medications included antiplatelet therapies, warfarin, antihypertensive therapies, statins, and diabetes medications...
April 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28416977/trends-in-physiological-coagulation-factors-in-japanese-patients-receiving-novel-oral-anticoagulants
#8
Tomoyuki Nagao, Hiroshi Hunakubo, Mayu Suzuki, Takashi Kataoka, Satoshi Okumura, Norihiro Shinoda, Ken Harada, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Shinichi Sakai, Tetsuya Amano, Toyoaki Murohara
BACKGROUND: Little is known about physiological anticoagulation effects via antithrombin III (AT III) and protein C/S (PC/PS) in patients using new oral anticoagulants (NOACs). METHODS: We evaluated 120 consecutive patients with non-valvular atrial fibrillation (AF) receiving NOACs. Patients were randomly divided into three groups: a dabigatran group (DG, N=40), a rivaroxaban group (RG, N=40) or an apixaban group (AG, N=40). A warfarin group (WG, N=40) was matched with NOAC groups for age, sex and type of AF during the same time period...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#9
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416975/effectiveness-and-safety-of-dabigatran-versus-warfarin-in-real-world-japanese-patients-with-atrial-fibrillation-a-single-center-observational-study
#10
Miyoko Naganuma, Tsuyoshi Shiga, Takehiko Nagao, Atsushi Suzuki, Kagari Murasaki, Nobuhisa Hagiwara
BACKGROUND: In "real-world" practice, anticoagulant therapy is indicated for patients whose clinical profiles are not addressed in randomized clinical trials. We assessed the effectiveness and safety of dabigatran versus warfarin in "real-world" Japanese patients with non-valvular atrial fibrillation (NVAF). METHODS: Among 613 NVAF patients who initiated dabigatran or warfarin therapy during the period between 2011 and 2013, 362 patients were included in the study after propensity score adjustment...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28412319/genetic-and-non-genetic-factors-affecting-the-quality-of-anticoagulation-control-and-vascular-events-in-atrial-fibrillation
#11
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/28411903/left-atrial-appendage-closure-device-in-atrial-fibrillation
#12
REVIEW
Michael C Giudici, Prashant D Bhave
The relationship of stroke and atrial fibrillation seems to become more complex as we gain more knowledge of the issue. Recent studies have questioned the temporal relationship between the two, which also questions causation. Left atrial appendage closure is an attractive, but unproven technology when compared with the 50-year experience with warfarin. In a patient who is on warfarin and having no issues with bleeding, medication intolerance, or lack of efficacy, it is difficult to justify stopping the drug and placing a closure device as sole therapy to prevent a stroke...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28409488/a-joint-model-for-vitamin-k-dependent-clotting-factors-and-anticoagulation-proteins
#13
Qing Xi Ooi, Daniel F B Wright, R Campbell Tait, Geoffrey K Isbister, Stephen B Duffull
BACKGROUND: Warfarin acts by inhibiting the reduction of vitamin K (VK) to its active form, thereby decreasing the production of VK-dependent coagulation proteins. The aim of this research is to develop a joint model for the VK-dependent clotting factors II, VII, IX and X, and the anticoagulation proteins, proteins C and S, during warfarin initiation. METHODS: Data from 18 patients with atrial fibrillation who had warfarin therapy initiated were available for analysis...
April 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28408716/sex-specific-comparative-effectiveness-of-oral-anticoagulants-in-elderly-patients-with-newly-diagnosed-atrial-fibrillation
#14
Ghanshyam Palamaner Subash Shantha, Prashant D Bhave, Saket Girotra, Denice Hodgson-Zingman, Alexander Mazur, Michael Giudici, Elizabeth Chrischilles, Mary S Vaughan Sarrazin
BACKGROUND: Sex-specific comparative effectiveness of direct oral anticoagulants among patients with nonvalvular atrial fibrillation is not known. Via this retrospective cohort study, we assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. METHODS AND RESULTS: Elderly (aged ≥66 years) Medicare beneficiaries enrolled in Medicare Part D benefit plan from November 2011 to October 2013 with newly diagnosed atrial fibrillation formed the study cohort (65 734 [44...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28407368/association-of-body-weight-with-efficacy-and-safety-outcomes-in-phase-iii-randomized-controlled-trials-of-direct-oral-anticoagulants-a-systematic-review-and-meta-analysis
#15
Kochawan Boonyawat, Francois Caron, Ang Li, Chatree Chai-Adisaksopha, Wendy Lim, Alfonso Iorio, Renato D Lopes, David Garcia, Mark A Crowther
BACKGROUND: Concerns have arisen in direct oral anticoagulant (DOAC)-treated patients about safety and efficacy in extremes of body weight. The aims of this systematic review were to investigate the association of body weight and patient-important outcomes in patients treated with DOACs or warfarin, and to demonstrate the fixed-dose effect of DOACs. METHODS: MEDLINE, EMBASE were searched until November 2016. Phase III randomized controlled trials (RCTs) using DOACs in atrial fibrillation (AF) and acute venous thromboembolism (VTE) were included...
April 13, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28398377/-new-oral-anticoagulants-in-patients-with-atrial-fibrillation-efficacy-and-safety-data-from-the-real-world
#16
Letizia Riva, Giuseppe Di Pasquale
New oral anticoagulants (NOACs: dabigatran, rivaroxaban, apixaban and edoxaban) proved to be at least non-inferior to warfarin in reducing thromboembolic risk in patients with atrial fibrillation. In addition, NOACs have been demonstrated to be safe and associated with a significant reduction in major and intracranial bleeding events. With the exception of apixaban, an increase in gastrointestinal bleedings has been observed, but as a whole NOACs have been shown to reduce mortality with rates similar to those of warfarin...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398376/-efficacy-and-safety-of-oral-anticoagulants-in-frail-elderly-patients-with-atrial-fibrillation-an-unsolved-problem
#17
Paolo Alboni, Nicola Stucci, Elena Cojocaru, Andrea Ungar
At present, the efficacy and safety of anticoagulants, warfarin, or new oral anticoagulants in frail patients remain unknown, as these patients have largely been excluded from both randomized trials and "real-world" studies; as a result, the guidelines do not provide guidance for the management of this population. Frail patients with atrial fibrillation (AF) are significantly less likely to receive oral anticoagulants compared to their nonfrail counterparts; is that an expression of reasonable prudence or malpractice? In this regard, some aspects of physical frailty should be considered: (i) increased vulnerability to stressors, including pharmacological agents with potential severe adverse effects; (ii) frail elderly patients are at high risk of falls and, therefore, of severe traumatic hemorrhages on oral anticoagulation; (iii) frail patients are more likely to have complications during intercurrent affections, potentially responsible for hemorrhages...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398375/-comparability-of-efficacy-and-safety-results-among-phase-iii-trials-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation
#18
Giuseppe Patti, Paolo Colonna, Francesco Pelliccia, Vittorio Pengo, Pasquale Perrone Filardi, Paolo Verdecchia
In this paper we demonstrate that among four phase III trials comparing warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) vs warfarin in patients with non-valvular atrial fibrillation there was heterogeneity in the thromboembolic and bleeding risk of the included populations, variability in the definitions of primary endpoints, especially for safety, and different criteria for reducing NOAC dosage according to renal function. Therefore, findings from these four studies are not directly comparable and it is incorrect to conduct comparative evaluations between various NOACs...
March 2017: Giornale Italiano di Cardiologia
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
#19
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/28393461/bleeding-risk-of-antiplatelet-drugs-compared-with-oral-anticoagulants-in-older-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#20
Marc Melkonian, Witold Jarzebowski, Eric Pautas, Virginie Siguret, Joël Belmin, Carmelo Lafuente-Lafuente
BACKGROUND: The hemorrhagic risk of antiplatelet drugs in old patients could be higher as usually assumed. OBJECTIVE: To compare the bleeding risk of antiplatelet drugs and oral anticoagulants in elderly patients. METHODS: A systematic review and meta-analysis. We searched PubMed, EMBASE and the Cochrane Library up to January 2016 for randomized and non-randomized controlled trials (RCTs) and parallel cohorts comparing antiplatelet drugs and oral anticoagulants in patients 65 years or older...
April 10, 2017: Journal of Thrombosis and Haemostasis: JTH
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