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Anticoagulation in valvular heart disease

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https://www.readbyqxmd.com/read/27876696/stroke-prevention-strategies-in-patients-with-atrial-fibrillation-and-heart-valve-abnormalities-perceptions-of-valvular-atrial-fibrillation-results-of-the-european-heart-rhythm-association-survey
#1
Tatjana S Potpara, Gregory Y H Lip, Torben B Larsen, Antonio Madrid, Dan Dobreanu, Ewa Jędrzejczyk-Patej, Nikolaos Dagres
The purpose of this European Heart Rhythm Association (EHRA) Survey was to assess the perceptions of 'valvular' atrial fibrillation (AF) and management of AF patients with various heart valve abnormalities in daily clinical practice in European electrophysiology (EP) centres. Questionnaire survey was sent via the Internet to the EHRA-EP Research Network Centres. Of the 52 responding centres, 42 (80.8%) were university hospitals. Choosing the most comprehensive definition of valvular AF, a total of 49 centres (94...
October 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27871223/patients-with-hfpef-and-hfref-have-different-clinical-characteristics-but-similar-prognosis-a-retrospective-cohort-study
#2
Tamrat Befekadu Abebe, Eyob Alemayehu Gebreyohannes, Yonas Getaye Tefera, Tadesse Melaku Abegaz
BACKGROUND: Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF...
November 21, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27866289/echocardiographic-findings-in-asymptomatic-systemic-lupus-erythematosus-patients
#3
Abdel GaffarA Mohammed, Abdulaziz A Alghamdi, Mohammad A ALjahlan, Ibrahim A Al-Homood
The aim of this study is to use transthoracic echocardiographic (TTE) imaging methods to identify cardiac dysfunction in asymptomatic systemic lupus erythematosus (SLE) patients and to determine the association between echocardiographic findings and serology. This is a prospective cross-sectional study where 50 patients with confirmed diagnoses of SLE were recruited from rheumatology outpatient clinics. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. Fifty SLE patients, 46 (92%) females and 4 (8%) males, were recruited...
November 19, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27861189/oral-anticoagulation-for-stroke-prevention-amongst-atrial-fibrillation-patients-with-valvular-heart-disease-an-update
#4
Andrew C T Ha, Atul Verma, Subodh Verma
PURPOSE OF REVIEW: The majority of evidence on the safety and efficacy of oral anticoagulation for stroke prevention amongst patients with atrial fibrillation is derived from those without significant valvular heart disease. This article will review current knowledge, areas of uncertainty and controversy, and ongoing research on oral anticoagulation for stroke prevention amongst patients with valvular heart disease. RECENT FINDINGS: The rates of stroke, systemic embolism, and major bleeding were similar for patients with and without significant native valvular disease when treated with direct oral anticoagulants (DOACs) or vitamin K antagonists...
November 18, 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27848065/impact-of-valvular-heart-disease-on-oral-anticoagulant-therapy-in-non-valvular-atrial-fibrillation-results-from-the-ramses-study
#5
Özcan Başaran, Volkan Dogan, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, Ismail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Mehmet Yaman, Sinan İnci, Bernas Altıntaş, Sedat Kalkan, Cevat Kırma, Murat Biteker
The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded...
November 15, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27766043/doacs-advances-and-limitations-in-real-world
#6
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27723665/real-life-multicenter-survey-evaluating-stroke-prevention-strategies-in-non-valvular-atrial-fibrillation-ramses-study
#7
Özcan Başaran, Osman Beton, Volkan Doğan, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, İsmail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Mehmet Yaman, İbrahim Altun, Mustafa Özcan Soylu, Cevat Kırma, Murat Biteker
OBJECTIVE: Data regarding stroke prevention strategies in non-valvular atrial fibrillation (NVAF) are limited to vitamin K antagonists (VKAs). This study aimed to evaluate real-life stroke prevention strategies for NVAF patients in the era of non-VKA oral anticoagulants (NOACs). METHODS: We established a cross-sectional, multicenter, nationwide registry of NVAF patients. All consecutive atrial fibrillation (AF) patients and without mechanical heart valves or rheumatic mitral stenosis (but including those with any degree of mitral regurgitation) were enrolled in the ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies (RAMSES Study; ClinicalTrials...
October 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27666180/anticoagulation-after-heart-valve-replacement-or-transcatheter-valve-implantation
#8
Anthony P Carnicelli, Patrick T O'Gara, Robert P Giugliano
Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines...
August 13, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27642112/temporal-trends-predictors-and-outcomes-of-in-hospital-gastrointestinal-bleeding-associated-with-percutaneous-coronary-intervention
#9
Nileshkumar J Patel, Dhaval Pau, Nikhil Nalluri, Parth Bhatt, Badal Thakkar, Ritesh Kanotra, Kanishk Agnihotri, Nitesh Ainani, Nilay Patel, Nish Patel, Sapna Shah, Sabeeda Kadavath, Shilpkumar Arora, Azfar Sheikh, Apurva O Badheka, James Lafferty, Carlos Alfonso, Mauricio Cohen
Since the introduction of new antiplatelet and anticoagulant agents in the last decade, large-scale data studying gastrointestinal bleeding (GIB) in patients undergoing percutaneous coronary intervention (PCI) are lacking. Using the Nationwide Inpatient Sample, we identified all hospitalizations from 2006 to 2012 that required PCI. Temporal trends in the incidence and multivariate predictors of GIB associated with PCI were analyzed. A total of 4,376,950 patients underwent PCI in the United States during the study period...
October 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27623680/exploring-unmet-needs-in-venous-and-arterial-thromboembolism-with-rivaroxaban
#10
Riccardo Cappato, Robert Welsh
The vast clinical research programme for the direct, oral factor Xa inhibitor rivaroxaban has generated a wealth of data since the first rivaroxaban approval in 2008 for the prevention of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery. While rivaroxaban is widely used across a spectrum of seven indications, there is continuous commitment to investigating its wider benefits in new indications and attempts to refine current evidence. Key data from recently completed randomised controlled trials (RCTs) have shown that rivaroxaban is a feasible anticoagulation option for patients with non-valvular atrial fibrillation (NVAF) undergoing cardioversion or catheter ablation...
September 28, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27620996/risk-factors-for-postoperative-hematoma-after-inguinal-hernia-repair-an-update
#11
Muhammad H Zeb, T K Pandian, Moustafa M El Khatib, Nimesh D Naik, Abhishek Chandra, David S Morris, Rory L Smoot, David R Farley
BACKGROUND: We recently sensed an increase in the frequency of groin hematoma after inguinal hernia repair (IHR) at our institution. The aim of this study was to provide a more updated assessment of the risk factors inherent to this complication. METHODS: We performed a case-control study of all adult patients (age ≥ 18 y) who developed a groin hematoma after IHR at our institution between 2003 and 2015. Univariate and multivariable analyses were performed to assess for independent predictors for groin hematoma...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27612901/use-of-anticoagulant-warfarin-in-patients-presenting-with-atrial-fibrillation-in-a-tertiary-level-hospital
#12
M S Islam, M A Islam, A K Azad, S K Banerjee, C M Ahmed, H Haque, M K Ahmed, R S Rumki, M Mahmood, F B Rashid
Atrial fibrillation (AF) is the most common sustained arrhythmia in the World, occurring in approximately 0.4% of the general population. The purpose of the present study was to see the trend of use of warfarin in hospital admitted patients with atrial fibrillation. It was conducted in the department of cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2008 to January 2009. A total of 150 patients with atrial fibrillation were enrolled in this study...
July 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27595409/practical-considerations-for-the-nonvitamin-k-antagonist-oral-anticoagulants
#13
Rahul Trikha, Peter R Kowey
OBJECTIVES: Dabigatran, rivaroxaban, apixaban, and edoxaban are nonvitamin K antagonist oral anticoagulants (NOACs) approved for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). Phase-3 clinical trials demonstrated NOACs were as effective as warfarin in the prevention of stroke or systemic embolism and associated with decreased incidences of intracranial bleeding. Additionally, NOACs provide quicker onset of action, simpler dosing, more predictable pharmacokinetic profiles, and decreased food and drug interactions compared with warfarin...
September 6, 2016: Cardiology
https://www.readbyqxmd.com/read/27574927/oral-anticoagulation-in-the-elderly-new-oral-anticoagulants-innovative-solution-for-an-old-problem
#14
Mario Barbosa, Luiz Menezes Falcão
Direct oral anticoagulants emerge as the most innovative and promising drug toward preventing and treating cardiovascular disease, raising great interest among the scientific community. Numerous studies and meta-analysis generated much data clarifying clinicians' doubts; however, uncertainties remain regarding their use in particular groups such as patients with prosthetic valves, in valvular atrial fibrillation (defined as atrial fibrillation related to mitral rheumatic heart disease or prosthetic heart valves), among the elderly, in paraneoplastic thromboembolism, in pulmonary embolism with hemodynamic compromise, and scarcity of specific antidotes...
August 29, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27496855/comparison-of-dabigatran-and-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-the-re-ly-trial-randomized-evaluation-of-long-term-anticoagulant-therapy
#15
Michael D Ezekowitz, Rangadham Nagarakanti, Herbert Noack, Martina Brueckmann, Claire Litherland, Mark Jacobs, Andreas Clemens, Paul A Reilly, Stuart J Connolly, Salim Yusuf, Lars Wallentin
BACKGROUND: The RE-LY trial (Randomized Evaluation of Long-Term Anticoagulant Therapy) compared dabigatran 150 and 110 mg twice daily with warfarin in 18 113 patients with atrial fibrillation. Those with prosthetic heart valves, significant mitral stenosis, and valvular heart disease (VHD) requiring intervention were excluded. Others with VHD were included. METHODS: This is a post hoc analysis of the RE-LY trial. RESULTS: There were 3950 patients with any VHD: 3101 had mitral regurgitation, 1179 with tricuspid regurgitation, 817 had aortic regurgitation, 471 with aortic stenosis, and 193 with mild mitral stenosis...
August 23, 2016: Circulation
https://www.readbyqxmd.com/read/27476223/cardiac-surgery-for-valvular-heart-disease-at-a-referral-hospital-in-ethiopia-a-review-of-cases-operated-in-the-last-30-years
#16
Senbeta Guteta, Dejuma Yadeta, Aklilu Azazh, Dufera Mekonnen
BACKGROUND: Valvular heart disease has been a significant cause of heart disease worldwide. In Ethiopia, it particularly affects young individuals and constitutes the major cause of cardiovascular disease. Factors associated with choice of treatment for advanced valvular heart disease are variable. The objective of this study is to review surgery done for Ethiopian patients with valvular heart disease. METHODS: We analyzed data on patients who had valve surgery and follow-up at the Tikur Anbessa Specialized Hospital cardiology unit...
April 2016: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/27469320/risk-factors-associated-with-bleeding-after-multi-antithrombotic-therapy-during-implantation-of-cardiac-implantable-electronic-devices
#17
Kohei Ishibashi, Koji Miyamoto, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Yuko Inoue, Hideo Okamura, Takashi Noda, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Satoshi Yasuda, Takashi Akasaka, Kengo Kusano
Previous studies showed that continuous anticoagulation or single antiplatelet therapy during implantations of cardiac implantable electronic devices (CIED) was relatively safe. However, the safety of continuous multi antithrombotic therapy (AT) in patients undergoing CIED interventions has not been clearly defined. We sought to evaluate the safety of this therapy during CIED implantations. A total of 300 consecutive patients (mean 69 years old, 171 males) with CIED implantations were enrolled in this study...
July 28, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27401780/safety-and-feasibility-of-treatment-with-rivaroxaban-for-non-canonical-indications-a-case-series-analysis
#18
Domenico Acanfora, Chiara Acanfora, Pietro Scicchitano, Marialaura Longobardi, Giuseppe Furgi, Gerardo Casucci, Bernardo Lanzillo, Ilaria Dentamaro, Annapaola Zito, Raffaele Antonelli Incalzi, Marco Matteo Ciccone
BACKGROUND AND OBJECTIVES: The new oral anticoagulants (NOACs) are used for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF) and those at risk of deep venous thrombosis. Their rapid onset of action and predictable pharmacokinetic and pharmacodynamic profiles make them the optimal alternative to warfarin in the treatment of these two categories of patients. Unfortunately, however, NOACs cannot be used in patients with valvular AF or valvular cardiac prostheses...
October 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27398295/use-of-chronic-medications-among-patients-with-non-valvular-atrial-fibrillation
#19
Paul T Kocis, Guodong Liu, Dinara Makenbaeva, Jeffrey Trocio, Diana Velott, JoAnn B Trainer, Younos Abdulsattar, Marta I Molina, Douglas L Leslie
BACKGROUND: Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice. OBJECTIVE: The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily. METHODS: Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day...
June 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27394924/vitamin-k-and-non-vitamin-k-antagonist-oral-anticoagulants-for-non-valvular-atrial-fibrillation-in-real-life
#20
Michela Giustozzi, Maria Cristina Vedovati, Paolo Verdecchia, Lucia Pierpaoli, Melina Verso, Serenella Conti, Federica Cianella, Emanuela Marchesini, Esmeralda Filippucci, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: Current guidelines recommend vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with non-valvular atrial fibrillation (AF). METHODS: We compared the clinical features of consecutive in- and out-patients with non-valvular AF newly-treated with NOACs or on treatment with VKAs. RESULTS: Overall, 1314 patients newly-treated with NOACs and 1024 on treatment with VKAs were included in the study...
September 2016: European Journal of Internal Medicine
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