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https://www.readbyqxmd.com/read/28213993/healthcare-resources-and-needs-in-anticoagulant-therapy-for-patients-with-nonvalvular-atrial-fibrillation-samoa-study
#1
V Barrios, M I Egocheaga-Cabello, J Gállego-Culleré, E Ignacio-García, L Manzano-Espinosa, A Martín-Martínez, J Mateo-Arranz, J Polo-García, D Vargas-Ortega
INTRODUCTION AND OBJECTIVES: To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients. METHODS: We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients...
February 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28213368/effects-of-dabigatran-according-to-age-in-atrial-fibrillation
#2
Mandy N Lauw, John W Eikelboom, Michiel Coppens, Lars Wallentin, Salim Yusuf, Michael Ezekowitz, Jonas Oldgren, Juliet Nakamya, Jia Wang, Stuart J Connolly
OBJECTIVE: The prevalence of atrial fibrillation (AF) and the risk of stroke and bleeding vary according to age. To estimate effects of dabigatran, compared with warfarin, on stroke, bleeding and mortality in patients with AF in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial according to age, we analysed treatment effects using age as a continuous variable and using age categories. METHODS: RE-LY included 10 855 (59.9%) patients aged <75 years, 4231 patients (23...
February 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#3
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/28202628/effects-of-upgrade-versus-de-novo-cardiac-resynchronization-therapy-on-clinical-response-and-long-term-survival-results-from-a-multicenter-study
#4
Mate Vamos, Julia W Erath, Zsolt Bari, Denes Vagany, Sven P Linzbach, Tatsiana Burmistrava, Carsten W Israel, Gabor Z Duray, Stefan H Hohnloser
BACKGROUND: Benefits of cardiac resynchronization therapy (CRT) on morbidity and mortality in selected patients are well known. Although the number of upgrade procedures from single- or dual-chamber devices to CRT is increasing, there are only sparse data on the outcomes of upgrade procedures compared with de novo CRT. This study aimed to evaluate clinical response and survival in patients receiving de novo versus upgrade CRT defibrillator therapy. METHODS AND RESULTS: Prospectively collected outcome data were compared in patients undergoing de novo or upgrade CRT defibrillator implantation at 3 implant centers in Germany and Hungary...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28196379/pulmonary-embolism-and-atrial-fibrillation-two-sides-of-the-same-coin-a-systematic-review
#5
Behnood Bikdeli, Maen D Abou Ziki, Gregory Y H Lip
Pulmonary embolism (PE) is a common, potentially fatal thrombotic disease. Atrial fibrillation (AF), the most common arrhythmia, may also lead to thromboembolic complications. Although initially appearing as distinct entities, PE and AF may coexist. The direction and extent of this association has not been well characterized. We performed a search of PubMed, Scopus, and the Cochrane Database of Systematic Reviews for publications that reported coexisting AF in patients with PE, or vice versa, to provide a systematic overview of pathophysiological and epidemiological aspects of this association (last search: October 13, 2016)...
February 14, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#6
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28182279/ranolazine-added-to-amiodarone-facilitates-earlier-conversion-of-atrial-fibrillation-compared-to-amiodarone-only-therapy
#7
Nikos Tsanaxidis, Isaac Aidonidis, Apostolia Hatziefthimiou, Stella S Daskalopoulou, Grigorios Giamouzis, Filippos Triposkiadis, Ioannis Skoularigis
Amiodarone (AMIO) is for many years effectively used to control ventricular rate during atrial fibrillation (AF) and to convert it into sinus rhythm. However, due to its delayed onset of action, ranolazine (RAN), a new antianginal agent with atrial-selective electrophysiologic properties, has recently been attempted as add-on therapy with AMIO to facilitate AF conversion. To establish the role of this combination therapy, we enrolled 173 consecutive patients (68±10 years, 54% male) with recent-onset (< 48 h duration) AF who were eligible for pharmacologic cardioversion...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#8
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/28179613/left-atrial-appendage-thrombi-formation-in-japanese-non-valvular-atrial-fibrillation-patients-during-anticoagulation-therapy%C3%A3-warfarin-vs-direct-oral-anticoagulants
#9
Mihoko Kawabata, Masahiko Goya, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Takuro Nishimura, Takakatsu Yoshitake, Shinya Shiohira, Mitsuaki Isobe, Kenzo Hirao
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia, associated with increased cardiovascular morbidity and mortality including thromboembolic events. The aims of this study were to assess the prevalence of left atrial appendage (LAA) thrombi in Japanese non-valvular atrial fibrillation (NVAF) patients undergoing preprocedural transesophageal echocardiography (TEE) during anticoagulation therapy, and to compare the efficacy of warfarin and direct oral anticoagulants (DOAC)...
February 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28177198/the-tasmanian-atrial-fibrillation-study-transition-to-direct-oral-anticoagulants-2011-2015
#10
Endalkachew Admassie Alamneh, Leanne Chalmers, Luke R Bereznicki
INTRODUCTION: Contemporary Australian data regarding antithrombotic prescribing patterns following approval of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) are limited. AIM: The aim of the present study was to assess antithrombotic prescribing patterns before, during and after the clinical introduction of DOACs. METHODS: Using digital medical records, this retrospective cohort study included all patients with AF as a primary or secondary diagnosis who were admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
February 8, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28166725/does-a-complex-intervention-increase-patient-knowledge-about-oral-anticoagulation-a-cluster-randomised-controlled-trial
#11
Verena Maikranz, Andrea Siebenhofer, Lisa-R Ulrich, Karola Mergenthal, Sylvia Schulz-Rothe, Birgit Kemperdick, Sandra Rauck, Gudrun Pregartner, Andrea Berghold, Ferdinand M Gerlach, Juliana J Petersen
BACKGROUND: Oral anticoagulation therapy (OAT) is a challenge in general practice, especially for high-risk groups such as the elderly. Insufficient patient knowledge about safety-relevant aspects of OAT is considered to be one of the main reasons for complications. The research question addressed in this manuscript is whether a complex intervention that includes practice-based case management, self-management of OAT and additional patient and practice team education improves patient knowledge about anticoagulation therapy compared to a control group of patients receiving usual care (as a secondary objective of the Primary Care Management for Optimised Antithrombotic Treatment (PICANT) trial)...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28153350/incidence-and-predictors-of-left-atrial-appendage-thrombus-in-patients-treated-with-nonvitamin-k-oral-anticoagulants-versus-warfarin-before-catheter-ablation-for-atrial-fibrillation
#12
Joanne Wyrembak, Kristen B Campbell, Benjamin A Steinberg, Tristram D Bahnson, James P Daubert, Eric J Velazquez, Zainab Samad, Brett D Atwater
The utility of routine transesophageal echocardiography (TEE) to exclude left atrial appendage (LAA) thrombus before atrial fibrillation (AF) ablation in patients treated with nonvitamin K oral anticoagulant (NOAC) therapy is unclear. This single-center retrospective study sought to investigate the incidence of LAA thrombus in patients undergoing routine TEE before AF ablation treated with warfarin or NOAC therapy. We included 937 routine pre-AF ablation TEE procedures performed in patients treated with warfarin (n = 517) or NOAC (n = 420)...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28150348/management-of-acute-ischaemic-stroke-in-patients-with-dementia
#13
REVIEW
A Subic, P Cermakova, B Norrving, B Winblad, M von Euler, M G Kramberger, M Eriksdotter, S Garcia-Ptacek
An estimated 10% of stroke patients have an underlying dementia. As a consequence, health professionals often face the challenge of managing patients with dementia presenting with an acute stroke. Patients with dementia are less likely to receive thrombolysis (0.56-10% vs. 1-16% thrombolysis rates in the general population), be admitted to a stroke unit or receive some types of care. Anticoagulation for secondary stroke prevention is sometimes withheld, despite dementia not being listed as an exclusion criterion in current guidelines...
February 2, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28131706/electrical-treatment-of-atrial-arrhythmias-in-heart-failure-patients-implanted-with-a-dual-defibrillator-crt-device-results-from-the-trade-hf-study
#14
Giovanni Luca Botto, Luigi Padeletti, Gregorio Covino, Paolo Pieragnoli, Mattia Liccardo, Barbara Mariconti, Stefano Favale, Giulio Molon, Paolo De Filippo, Leonardo Bolognese, Maurizio Landolina, Giovanni Raciti, Giuseppe Boriani
BACKGROUND: Ventricular and atrial arrhythmias commonly occur in heart failure patients and are a significant source of symptoms, morbidity and mortality. Some specific generators referred to as dual defibrillators, Dual CRT-Ds, have the ability to treat atrial and ventricular arrhythmias. TRADE-HF is a prospective two-arm randomized study aimed at assessing the benefits of complete automatic management of atrial arrhythmias in patients implanted with a dual CRT-D. METHODS: Primary objective of the TRADE-HF study was to document reduction of unplanned hospital admission for cardiac reasons or death for cardiovascular causes or progression to permanent AF, by comparing fully-automatic device driven therapy for atrial tachycardia or fibrillation (AT/AF) to an in-hospital approach for treatment of symptomatic AT/AF...
January 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28131705/permanent-discontinuation-of-non-vitamin-k-oral-anticoagulants-in-real-life-patients-with-non-valvular-atrial-fibrillation
#15
Maria Cristina Vedovati, Paolo Verdecchia, Michela Giustozzi, Gabriella Molini, Serenella Conti, Lucia Pierpaoli, Francesca Valecchi, Adolfo Aita, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: Persistence to treatment affects clinical outcomes in patients with chronic disease such as atrial fibrillation (AF). METHODS: This prospective cohort study included consecutive non-valvular AF patients prescribed with non-vitamin K oral anticoagulants (NOACs) and investigated for any permanent discontinuation at 1-year of this therapy, as well as any reasons for discontinuation. RESULTS: Overall, 1305 patients were prescribed with dabigatran (N=473), rivaroxaban (N=425) or apixaban (N=407)...
January 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28130378/rationale-and-design-of-axafa-afnet-5-an-investigator-initiated-randomized-open-blinded-outcome-assessment-multi-centre-trial-to-comparing-continuous-apixaban-to-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation
#16
REVIEW
Luigi Di Biase, David Callans, Karl Georg Hæusler, Gerhard Hindricks, Hussein Al-Khalidi, Lluis Mont, Jens Cosedis Nielsen, Jonathan P Piccini, Ulrich Schotten, Paulus Kirchhof
AIMS: Catheter ablation is the most efficacious rhythm control therapy in atrial fibrillation (AF) patients. There is growing evidence that catheter ablation procedures are best performed during continuous oral anticoagulation, but outcomes are variable depending on the anticoagulation strategy or agent chosen. Specifically, there is a need to evaluate the peri-procedural use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients undergoing catheter ablation of AF. The AXAFA-AFNET 5 trial will test whether peri-procedural anticoagulation therapy using apixaban is a safe alternative to vitamin K antagonist (VKA) therapy for patients undergoing catheter ablation of AF...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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
#17
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/28118749/warfarin-interaction-with-hepatic-cytochrome-p-450-enzyme-inducing-anticonvulsants
#18
Nathan P Clark, Kim Hoang, Thomas Delate, John R Horn, Daniel M Witt
BACKGROUND: Initiation of cytochrome P-450 (CYP)-inducing anticonvulsant medications during warfarin therapy may decrease anticoagulant effect and necessitate frequent warfarin dose adjustments to maintain therapeutic response measured by the international normalized ratio (INR). Clinical information regarding interactions between warfarin and these medications is limited. This study investigated warfarin dose and INR response following CYP-inducing anticonvulsant initiation among chronic warfarin users...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28107569/use-of-higher-maximum-doses-and-infusion-rates-compared-with-those-used-in-standard-unfractionated-heparin-therapy-is-associated-with-adequate-anticoagulation-without-increased-bleeding-in-both-obese-and-nonobese-patients-with-cardiovascular-indications
#19
Catherine K Floroff, Nicole M Palm, Daniel H Steinberg, Eric R Powers, Barbara S Wiggins
STUDY OBJECTIVE: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-Segment Elevation Myocardial Infarction or unstable angina (NSTEMI/UA) or atrial fibrillation. DESIGN: Retrospective cohort study...
January 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28106485/management-strategies-for-atrial-fibrillation
#20
Peysh A Patel, Noman Ali, Andrew Hogarth, Muzahir H Tayebjee
Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80 years. Despite multiple treatment options, it remains an independent prognostic marker of mortality due to its association with clinical sequelae, particularly cerebrovascular events. Management can be broadly divided into treatment of the arrhythmia, via rhythm or rate control, and stroke thromboprophylaxis via anticoagulation. Traditional options for pharmacotherapy include negatively chronotropic drugs such as β-blockers, and/or arrhythmia-modifying drugs such as amiodarone...
January 2017: Journal of the Royal Society of Medicine
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