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https://www.readbyqxmd.com/read/29132650/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#1
REVIEW
Marin Nishimura, Jonathan C Hsu
Over the past decade, there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the non-vitamin K antagonist oral anticoagulants (NOACs) demonstrated favorable clinical outcomes compared with warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) are a particularly complex issue. CKD and ESRD increase both the risk of stroke and bleeding, and since all of the NOACs undergo various levels of renal clearance, renal dysfunction inevitably affects the pharmacokinetics of the drug in each patient...
October 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29132153/outcomes-of-dabigatran-and-warfarin-for-atrial-fibrillation-in-contemporary-practice-a-retrospective-cohort-study
#2
Alan S Go, Daniel E Singer, Sengwee Toh, T Craig Cheetham, Marsha E Reichman, David J Graham, Mary Ross Southworth, Rongmei Zhang, Rima Izem, Margie R Goulding, Monika Houstoun, Katrina Mott, Sue Hee Sung, Joshua J Gagne
Background: Dabigatran (150 mg twice daily) has been associated with lower rates of stroke than warfarin in trials of atrial fibrillation, but large-scale evaluations in clinical practice are limited. Objective: To compare incidence of stroke, bleeding, and myocardial infarction in patients receiving dabigatran versus warfarin in practice. Design: Retrospective cohort. Setting: National U.S. Food and Drug Administration Sentinel network...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#3
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129251/the-relationship-of-renal-function-to-outcome-a-post-hoc-analysis-from-the-edoxaban-versus-warfarin-in-subjects-undergoing-cardioversion-of-atrial-fibrillation-ensure-af-study
#4
Gregory Y H Lip, Naab Al-Saady, Michael D Ezekowitz, Maciej Banach, Andreas Goette
The ENSURE-AF study (NCT 02072434) of anticoagulation for electrical cardioversion in nonvalvular atrial fibrillation (NVAF) showed comparable low rates of bleeding and thromboembolism between the edoxaban and the enoxaparin-warfarin treatment arms. This post hoc analysis investigated the relationship between renal function and clinical outcomes. METHODS: ENSURE-AF was a multicenter, PROBE evaluation trial of edoxaban 60 mg, or dose reduced to 30 mg/d for weight≤60 kg, creatinine clearance (CrCl; Cockcroft-Gault) ≤50 mL/min, or concomitant P-glycoprotein inhibitors compared with therapeutically monitored enoxaparin-warfarin in 2,199 NVAF patients undergoing electrical cardioversion...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#5
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29122810/bleeding-complications-in-anticoagulated-patients-with-atrial-fibrillation-and-sepsis-a-propensity-weighted-cohort-study
#6
Mette Søgaard, Flemming Skjøth, Jette Nordstrøm Kjældgaard, Gregory Y H Lip, Torben Bjerregaard Larsen
BACKGROUND: Sepsis may adversely affect bleeding risk in anticoagulated patients with atrial fibrillation (AF), but the impact of warfarin treatment in such patients is poorly described. This registry-based nationwide cohort study examined safety of oral anticoagulant treatment (OAC) in patients with preexisting AF who were hospitalized because of incident sepsis in the period 2000-2015. METHODS AND RESULTS: We identified 3030 AF patients who were warfarin users at the time of sepsis diagnosis, and we used inverse probability of treatment weighting to compare the rates of bleeding, thromboembolic events, and death within 90 days after sepsis diagnosis with a comparable cohort of 55721 patients without warfarin treatment and known AF...
November 9, 2017: Journal of the American Heart Association
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
#7
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/29121522/effects-of-vitamin-k-antagonist-on-aortic-valve-degeneration-in-non-valvular-atrial-fibrillation-patients-prospective-4-year-observational-study
#8
Kazuhiro Yamamoto, Yukihiro Koretsune, Takashi Akasaka, Akira Kisanuki, Nobuyuki Ohte, Takashi Takenaka, Masaaki Takeuchi, Kiyoshi Yoshida, Kazunori Iwade, Yuji Okuyama, Yutaka Hirano, Yasuharu Takeda, Yasumasa Tsukamoto, Yoshiharu Kinugasa, Satoshi Nakatani, Takashi Sakamoto, Katsuomi Iwakura, Takashi Sozu, Tohru Masuyama
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. METHODS: Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group)...
November 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29121212/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-in-patients-80-years-of-age-with-nonvalvular-atrial-fibrillation
#9
Craig I Coleman, Erin R Weeda, Elaine Nguyen, Thomas J Bunz, Nitesh A Sood
No abstract text is available yet for this article.
November 7, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29119732/metabolic-benefits-of-rivaroxaban-in-non-valvular-atrial-fibrillation-patients-after-radiofrequency-catheter-ablation
#10
Jun Zhu, Rong-Jun Gao, Qiang Liu, Ru-Hong Jiang, Lu Yu, Ya-Xun Sun, Pei Zhang, Jian-Wei Lin, Yang Ye, Zu-Wen Zhang, Shi-Quan Chen, Hui Cheng, Xia Sheng, Chen-Yang Jiang
BACKGROUND AND OBJECTIVE: Rivaroxaban is a new oral anticoagulant for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), which has less drug-food interaction than warfarin. We conducted this prospective randomized study to evaluate the metabolic benefits as well as the safety and efficacy with rivaroxaban versus warfarin in patients with NVAF following radiofrequency catheter ablation (RFCA). METHODS: From April to July 2014, 60 patients with NVAF undergoing RFCA were prospectively enrolled in our study...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/29114736/association-of-warfarin-use-with-lower-overall-cancer-incidence-among-patients-older-than-50-years
#11
Gry S Haaland, Ragnhild S Falk, Oddbjørn Straume, James B Lorens
Importance: In cancer models, warfarin inhibits AXL receptor tyrosine kinase-dependent tumorigenesis and enhances antitumor immune responses at doses not reaching anticoagulation levels. This study investigates the association between warfarin use and cancer incidence in a large, unselected population-based cohort. Objective: To examine the association between warfarin use and cancer incidence. Design, Setting, and Participants: This population-based cohort study with subgroup analysis used the Norwegian National Registry coupled with the Norwegian Prescription Database and the Cancer Registry of Norway...
November 6, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29110602/pharmacometabonomics-technique-to-identify-warfarin-response-using-nuclear-magnetic-resonance-spectroscopy
#12
Abdulkader Ahmad Bawadikji, Chin-Hoe Teh, Muhamad Ali Bin Sheikh Abdul Kader, Syed Azhar Syed Sulaiman, Baharudin Ibrahim
BACKGROUND: Warfarin, an anticoagulant medication, has prescribed regularly despite of its bleeding tendency for the prevention and/or treatment of various thromboembolic conditions, such as deep vein thrombosis, and complications associated with atrial fibrillation, and myocardial infarction, but because of its narrow therapeutic window have a lot of interactions with drugs and diet. METHOD: Warfarin relies on regular monitoring of International Normalized Ratio which is a standardized test to measure prothrombin time and appropriate dose adjustment...
November 3, 2017: Current Pharmaceutical Biotechnology
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/29107192/renal-function-and-risk-of-stroke-and-bleeding-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-comparison-between-uninterrupted-direct-oral-anticoagulants-and-warfarin-administration
#14
Satoshi Yanagisawa, Yasuya Inden, Aya Fujii, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara
BACKGROUND: The effect of uninterrupted oral anticoagulant use in patients with chronic kidney disease (CKD) during catheter ablation for atrial fibrillation (AF) is not fully understood. OBJECTIVE: The present study aimed to evaluate safety and efficacy of periprocedural uninterrupted direct oral anticoagulant (DOAC) use compared with uninterrupted warfarin in patients undergoing catheter ablation for AF, stratified by various renal function groups. METHODS: A total of 2,091 patients were retrospectively included...
October 26, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29106523/combining-watchman-left-atrial-appendage-closure-and-catheter-ablation-for-atrial-fibrillation-multicentre-registry-results-of-feasibility-and-safety-during-implant-and-30-days-follow-up
#15
Karen P Phillips, Evgeny Pokushalov, Aleksandr Romanov, Sergey Artemenko, Richard J Folkeringa, Tamas Szili-Torok, Gaetano Senatore, Kenneth M Stein, Omar Razali, Nicole Gordon, Lucas V A Boersma
Aims: Long-term results from catheter ablation therapy for atrial fibrillation (AF) remain uncertain and clinical practice guidelines recommend continuation of long-term oral anticoagulation in patients with a high stroke risk. Left atrial appendage closure (LAAC) with Watchman has emerged as an alternative to long-term anticoagulation for patients accepting of the procedural risks. We report on the initial results of combining catheter ablation procedures for AF and LAAC in a multicentre registry...
July 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29105666/-low-or-reduced-semantics-of-the-doses-of-new-oral-anticoagulants
#16
Andrea Rubboli
The four new oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban and edoxaban are marketed in two doses each for the prevention of stroke and/or systemic thromboembolism in non-valvular atrial fibrillation (NVAF). The meaning and indications for use of the lower dose compared with the higher dose are, however, different between the thrombin-inhibitor dabigatran on the one hand and the activated factor X (Xa) inhibitors on the other. These differences stem from the different design of the registration studies where NOACs were compared with warfarin for the prevention of stroke and/or systemic thromboembolism in patients with NVAF...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29105079/direct-oral-anticoagulants-versus-warfarin-for-preventing-stroke-and-systemic-embolic-events-among-atrial-fibrillation-patients-with-chronic-kidney-disease
#17
REVIEW
Miho Kimachi, Toshi A Furukawa, Kimihiko Kimachi, Yoshihito Goto, Shingo Fukuma, Shunichi Fukuhara
BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for atrial fibrillation (AF), which is more prevalent among CKD patients than the general population. AF causes stroke or systemic embolism, leading to increased mortality. The conventional antithrombotic prophylaxis agent warfarin is often prescribed for the prevention of stroke, but risk of bleeding necessitates regular therapeutic monitoring. Recently developed direct oral anticoagulants (DOAC) are expected to be useful as alternatives to warfarin...
November 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29103847/5-year-outcomes-after-left%C3%A2-atrial%C3%A2-appendage-closure-from-the-prevail-and-protect-af-trials
#18
Vivek Y Reddy, Shephal K Doshi, Saibal Kar, Douglas N Gibson, Matthew J Price, Kenneth Huber, Rodney P Horton, Maurice Buchbinder, Petr Neuzil, Nicole T Gordon, David R Holmes
BACKGROUND: The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, St. Paul, Minnesota) was equivalent to warfarin for preventing stroke in atrial fibrillation, but had a high rate of complications. In a second randomized trial, PREVAIL (Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy), the complication rate was low...
November 4, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29096154/meta-analysis-of-safety-and-efficacy-for-direct-oral-anticoagulation-treatment-of-non-valvular-atrial-fibrillation-in-relation-to-renal-function
#19
Rongjun Zou, Jun Tao, Wanting Shi, Minglei Yang, Hongmu Li, Xifeng Lin, Songran Yang, Ping Hua
INTRODUCTION: We performed a meta-analysis of the safety and efficacy of anticoagulation treatment for atrial fibrillation (AF) in relation to renal function. We also examined the change in estimated glomerular filtration rate (eGFR) from baseline and compared the outcomes for patients with stable and worsening renal function. MATERIALS AND METHODS: We selected studies that used randomized controlled trials in which outcomes for direct oral anticoagulants (DOACs) (dabigatran, rivaroxaban, apixaban, or edoxaban) were compared with those for warfarin in AF patients with normal, mild or moderate renal function, except the severe one (creatinine clearance<30)...
October 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29093823/warfarin-use-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-of-stroke-and-bleeding-outcomes
#20
Chieh Tsai, Laura Quinn Marcus, Priya Patel, Marisa Battistella
Background: Given the lack of clear indications for the use of warfarin in the treatment of atrial fibrillation (AF) in patients on hemodialysis and the potential risks that accompany warfarin use in these patients, we systematically reviewed stroke and bleeding outcomes in hemodialysis patients treated with warfarin for AF. Objective: To systematically review the stroke and bleeding outcomes associated with warfarin use in the hemodialysis population to treat AF...
2017: Canadian Journal of Kidney Health and Disease
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