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warfarin atrial fibrillation

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https://www.readbyqxmd.com/read/28530526/warfarin-management-and-outcomes-in-patients-with-nonvalvular-atrial-fibrillation-within-an-integrated-health-care-system
#1
JaeJin An, Fang Niu, Chengyi Zheng, Nazia Rashid, Robert A Mendes, Diana Dills, Lien Vo, Prianka Singh, Amanda Bruno, Daniel T Lang, Paul T Le, Kristin P Jazdzewski, Gustavus Aranda
BACKGROUND: Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes is important for quality improvement; however, currently little evidence associating outcomes with management patterns exists. OBJECTIVES: To (a) describe warfarin management patterns and (b) evaluate associations between warfarin treatment and clinical outcomes for patients with NVAF in an integrated health care system...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529736/use-of-dabigatran-vs-warfarin-with-low-molecular-weight-heparin-bridging-in-catheter-ablation-for-atrial-fibrillation-patients-with-a-low-chads2-score
#2
Li Hao, Bing Rong, Fei Xie, Ming-Jie Lin, Jing-Quan Zhong
The purpose of the present study was to compare the efficacy and safety of dabigatran and interrupted warfarin with low-molecular-weight heparin bridging in non-valvular atrial fibrillation (AF) catheter ablation. Previously, there has been concerns that bridging therapy increases bleeding events without the benefit of stroke prevention. It has been suggested that bridging therapy should be considered only for patients at high-risk of thrombosis. Nevertheless, bridging therapy in AF patients with a low CHADS2 score may be safe and effective...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28527773/prevalence-management-and-long-term-6-year-outcomes-of-atrial%C3%A2-fibrillation-among-patients-receiving-drug-eluting-coronary-stents
#3
Hyo-In Choi, Jung-Min Ahn, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to investigate the incidence, management, and clinical relevance of atrial fibrillation (AF) during and after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and evaluate outcomes of different antithrombotic strategies. BACKGROUND: Uncertainty exists regarding the optimal antithrombotic strategy in patients with AF who are undergoing PCI with DES. METHODS: Using a consecutive series of 10,027 patients who underwent DES implantation between 2003 and 2011, we evaluated the overall prevalence and clinical impact of AF...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521884/influence-of-direct-oral-anticoagulants-on%C3%A2-rates-of-oral-anticoagulation-for-atrial%C3%A2-fibrillation
#4
Lucas N Marzec, Jingyan Wang, Nilay D Shah, Paul S Chan, Henry H Ting, Kensey L Gosch, Jonathan C Hsu, Thomas M Maddox
BACKGROUND: Oral anticoagulation (OAC) with warfarin is underused for atrial fibrillation (AF). The availability of direct oral anticoagulants (DOACs) may improve overall OAC rates in AF patients, but a large-scale evaluation of their effects has not been conducted. OBJECTIVES: This study assessed the effect of DOAC availability on overall OAC rates for nonvalvular AF. METHODS: Between April 1, 2008 and September 30, 2014, we identified 655,000 patients with nonvalvular AF and a CHA2DS2-VASc score of >1 in the National Cardiovascular Data Registry PINNACLE registry...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28520924/dabigatran-vs-warfarin-in-relation-to-the-presence-of-left-ventricular-hypertrophy-in-patients-with-atrial-fibrillation-the-randomized-evaluation-of-long-term-anticoagulation-therapy-re-ly-study
#5
Paolo Verdecchia, Gianpaolo Reboldi, Fabio Angeli, Giovanni Mazzotta, Gregory Y H Lip, Martina Brueckmann, Eva Kleine, Lars Wallentin, Michael D Ezekowitz, Salim Yusuf, Stuart J Connolly, Giuseppe Di Pasquale
Aim: We tested the hypothesis that left ventricular hypertrophy (LVH) interferes with the antithrombotic effects of dabigatran and warfarin in patients with atrial fibrillation (AF). Methods and results: This is a post-hoc analysis of the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) Study. We defined LVH by electrocardiography (ECG) and included patients with AF on the ECG tracing at entry. Hazard ratios (HR) for each dabigatran dose vs. warfarin were calculated in relation to LVH...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#6
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28516318/effect-of-apixaban-on-all-cause-death-in-patients-with-atrial-fibrillation-a-meta-analysis-based-on-imputed-placebo-effect
#7
Patrícia O Guimarães, Renato D Lopes, Daniel M Wojdyla, Azmil H Abdul-Rahim, Stuart J Connolly, Greg C Flaker, Junyuan Wang, Michael Hanna, Christopher B Granger, Lars Wallentin, Kennedy R Lees, John H Alexander, John J V McMurray
PURPOSE: Vitamin K antagonists (VKAs) are the standard of care for stroke prevention in patients with atrial fibrillation (AF); therefore, there is not equipoise when comparing newer oral anticoagulants with placebo in this setting. METHODS: To explore the effect of apixaban on mortality in patients with AF, we performed a meta-analysis of apixaban versus placebo using a putative placebo analysis based on randomized controlled clinical trials that compared warfarin, aspirin, and no antithrombotic control...
May 18, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28509761/dabigatran-in-nonvalvular-atrial-fibrillation-from-clinical-trials-to-real-life-experience
#8
Nicola Mumoli, Daniela Mastroiacovo, Eleonora Tamborini-Permunian, Josè Vitale, Matteo Giorgi-Pierfranceschi, Marco Cei, Francesco Dentali
: Atrial fibrillation is the most common arrhythmia in over-midlife patients. In addition to systolic heart failure, cerebral thromboembolism represents the most dramatic complication of this rhythm disorder, contributing to morbidity and mortality. Traditionally, anticoagulation has been considered the main strategy in preventing stroke and systemic embolism in atrial fibrillation patients and vitamin K-dependent antagonists have been widely used in clinical practice. Recently, the development of direct oral anticoagulants has certainly improved the management of this disease, providing, for the first time, the opportunity to go beyond vitamin K-dependent antagonists limits...
July 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#9
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28506913/predicting-determinants-of-atrial-fibrillation-or-flutter-for-therapy-elucidation-in-patients-at-risk-for-thromboembolic-events-predate-af-study
#10
Javed M Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater
BACKGROUND: Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown. OBJECTIVES: In this study, we prospectively evaluated the use of the CHA2DS2-VASc score for the prediction of new-onset AF using insertable cardiac monitors (ICMs) and examined whether this screening led to the initiation of OAC therapy...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28503837/efficacy-of-protocol-based-pharmacotherapy-management-on-anticoagulation-with-warfarin-for-patients-with-cardiovascular-surgery
#11
Y Katada, S Nakagawa, K Minakata, M Odaka, H Taue, Y Sato, A Yonezawa, Y Kayano, I Yano, T Nakatsu, K Sakamoto, K Uehara, H Sakaguchi, K Yamazaki, K Minatoya, R Sakata, K Matsubara
WHAT IS KNOWN AND OBJECTIVE: Anticoagulation therapy with warfarin requires periodic monitoring of prothrombin time-international normalized ratio (PT-INR) and adequate dose adjustments based on the data to minimize the risk of bleeding and thromboembolic events. In our hospital, we have developed protocol-based pharmaceutical care, which we called protocol-based pharmacotherapy management (PBPM), for warfarin therapy. The protocol requires pharmacists to manage timing of blood sampling for measuring PT-INR and warfarin dosage determination based on an algorithm...
May 15, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28502818/renal-function-considerations-for-stroke-prevention-in-atrial-fibrillation
#12
REVIEW
John Fanikos, Allison E Burnett, Charles E Mahan, Paul P Dobesh
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in nonvalvular atrial fibrillation patients with mild or moderate renal impairment...
May 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28497899/replacing-warfarin-with-a-novel-oral-anticoagulant-risk-of-recurrent-bleeding-and-stroke-in-patients-with-warfarin-ineligible-or-failure-in-patients-with-atrial-fibrillation-the-roar-study
#13
Mohit K Turagam, Valay Parikh, Muhammad R Afzal, Rakesh Gopinnathanair, Madhav Lavu, Arun Kanmanthareddy, Jayasree Pillarisetti, Madhu Reddy, Donita Atkins, Sudharani Bommana, Melissa Jaeger, Courtney Jeffery, Sanghamitra Mohanty, Pasquale Santangeli, Jie Cheng, Luigi Dibiase, Calambur Narasimhan, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: A significant proportion of patients treated with warfarin for atrial fibrillation (AF) become warfarin ineligible (WI) due to major bleeding events (MBE) or systemic thromboembolism (STE). We report a large multicenter real-world experience of the use of DOACs in these WI patients. METHODS: We report the outcomes of 263 WI patients treated with DOACs. The primary objective was to evaluate clinical outcomes of STE and MBE with DOACs. Secondary objective was to assess clinical predictors of repeat MBE and STE on DOACs...
May 12, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28493216/appropriateness-of-oral-anticoagulants-for-the-long-term-treatment-of-atrial-fibrillation-in-older-people-results-of-an-evidence-based-review-and-international-consensus-validation-process-oac-forta-2016
#14
REVIEW
Martin Wehling, Ronan Collins, Victor M Gil, Olivier Hanon, Roland Hardt, Martin Hoffmeister, Pedro Monteiro, Terence J Quinn, Dieter Ropers, Giuseppe Sergi, Freek W A Verheugt
BACKGROUND: Age appropriateness of anticoagulants for stroke prevention in atrial fibrillation is uncertain. OBJECTIVE: To review oral anticoagulants for the treatment of atrial fibrillation in older (age >65 years) people and to classify appropriate and inappropriate drugs based on efficacy, safety and tolerability using the Fit-fOR-The-Aged (FORTA) classification. METHODS: We performed a structured comprehensive review of controlled clinical trials and summaries of individual product characteristics to assess study and total patient numbers, quality of major outcome data and data of geriatric relevance...
May 10, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28483209/the-population-based-long-term-impact-of-anticoagulant-and-antiplatelet-therapies-in-low-risk-patients-with-atrial-fibrillation
#15
Anjani Golive, Heidi T May, Tami L Bair, Victoria Jacobs, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller, T Jared Bunch
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data, the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoagulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1, or 2 were studied...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28482261/nonvitamin-k-dependent-oral-anticoagulants-noacs-in-chronic-kidney-disease-patients-with-atrial-fibrillation
#16
REVIEW
L Di Lullo, C Ronco, M Cozzolino, D Russo, L Russo, B Di Iorio, A De Pascalis, V Barbera, M Galliani, E Vitaliano, C Campana, F Santoboni, A Bellasi
Atrial fibrillation (AF) represents the most common arrhythmia in patients with chronic kidney disease (CKD). As in the general population, in CKD patients AF is associated with an increased risk of thromboembolism and stroke. However, CKD patients, especially those on renal replacement therapy (RRT), also exhibit an increased risk of bleeding, especially from the gastrointestinal tract. Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF presenting increased risk of stroke...
May 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28480651/the-perioperative-management-of-antithrombotic-therapies-using-enoxaparin
#17
Hun Gyu Hwang, So My Koo, Soo Taek Uh, Yang Ki Kim
Oral anticoagulant therapy is frequently and increasingly prescribed for patients at risk of arterial or venous thromboembolism (VTE). Although elective surgical or invasive procedures have necessitated temporary interruption of anticoagulants, managing these patients has been performed empirically and been poorly investigated. This study was designed to evaluate the adequacy of perioperative anticoagulation using enoxaparin. This was a retrospective, single-center study that evaluated the efficacy and safety of therapeutic-dose enoxaparin for bridging therapy in patients on long-term warfarin at Soonchunhyang University Hospital in Korea between August 2009 and July 2011...
June 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28479094/integrating-genotypes-in-the-same-tt2r2-score-for-the-prediction-of-anticoagulation-control-in-chinese-patients-with-atrial-fibrillation-on-warfarin
#18
Jia Liu, Nina Wang, Liuan Qin, Jun Liu, Shaozhi Xi, Xuyun Wang, Xiaoqi Li, Yuxiao Zhang, Tong Yin
INTRODUCTION: The SAMe-TT2R2 score has been proposed to predict whether patients with atrial fibrillation (AF) would be well anti-coagulated with warfarin or not. However, it might over-estimate the number of patients under suboptimal warfarin treatment in non-Caucasians. This study was designed to modify the SAMe-TT2R2 score with genotypes and validate it in Chinese AF patients treated with warfarin. MATERIAL AND METHODS: Consented Chinese-Han patients (n=510) with AF under the treatment of warfarin for at least 3months were randomly divided into a derivation (n=310) and a validation cohort (n=200)...
April 29, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28476700/comparison-of-triple-antithrombotic-therapy-and-dual-antiplatelet-therapy-for-patients-with-atrial-fibrillation-after-percutaneous-coronary-stenting
#19
Xiaoying Fan, Yao Zhang
The aim of this study was to evaluate the safety and efficacy of triple antithrombotic therapy with warfarin, aspirin and clopidogrel in patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI). We retrospectively reviewed clinical and follow-up data of 156 consecutive patients with atrial fibrillation after percutaneous coronary stenting. Patients were followed up at 2 and 12 months. A total of 156 consecutive patients were identified. There were 70 patients (dual antiplatelet therapy group, DAPT), warfarin was not used and 86 patients (triple antithrombotic therapy group, TT), both dual antiplatelet therapy and warfarin therapy were prescribed...
September 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28472091/patients-with-atrial-fibrillation-and-outcomes-of-cerebral-infarction-in-those-with-treatment-of-warfarin-versus-no-warfarin-with-references-to-cha2ds2-vasc-score-age-and-sex-a-swedish-nationwide-observational-study-with-48-433-patients
#20
Tommy Andersson, Anders Magnuson, Ing-Liss Bryngelsson, Ole Frøbert, Karin M Henriksson, Nils Edvardsson, Dritan Poçi
AIMS: There is controversy in the guidelines as to whether patients with atrial fibrillation and a low risk of stroke should be treated with anticoagulation, especially those with a CHA2DS2-VASc score of 1 point. METHODS: In a retrospective, nationwide cohort study, we used the Swedish National Patient Registry, the National Prescribed Drugs Registry, the Swedish Registry of Education and the Population and Housing Census Registry. 48 433 patients were identified between 1 January 2006 and 31 December 2008 with incident atrial fibrillation who were divided in age categories, sex and a CHA2DS2-VASc score of 0, 1, 2 and ≥3 and they were included in a time-varying analysis of warfarin treatment versus no treatment...
2017: PloS One
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