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Anticoagulation in valvular heart disease

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https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#1
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29096024/antithrombotic-therapy-in-atrial-fibrillation-associated-with-valvular-heart-disease-a-joint-consensus-document-from-the-european-heart-rhythm-association-ehra-and-european-society-of-cardiology-working-group-on-thrombosis-endorsed-by-the-esc-working-group
#2
Gregory Y H Lip, Jean Philippe Collet, Raffaele de Caterina, Laurent Fauchier, Deirdre A Lane, Torben B Larsen, Francisco Marin, Joao Morais, Calambur Narasimhan, Brian Olshansky, Luc Pierard, Tatjana Potpara, Nizal Sarrafzadegan, Karen Sliwa, Gonzalo Varela, Gemma Vilahur, Thomas Weiss, Giuseppe Boriani, Bianca Rocca
Atrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA2DS2VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including non-vitamin K antagonist oral anticoagulants (NOACs) in patients with VHD other than prosthetic heart valves or haemodynamically significant mitral valve disease, there is a need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD...
November 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29066332/anticoagulation-for-thromboembolic-risk-reduction-in-adults-with-congenital-heart-disease
#3
REVIEW
Darryl Wan, Clara Tsui, Marla Kiess, Jasmine Grewal, Andrew D Krahn, Santabhanu Chakrabarti
Adults with congenital heart disease (ACHD) represent one of the fastest expanding groups of patients in contemporary practice with unique and often complex management pathways. ACHD have a higher risk of thromboembolism not only from their complex physiology and anatomy but also from substrates such as valvular heart disease, atrial arrhythmias, cyanosis, and ventricular dysfunction, resulting in significant morbidity and mortality. Thromboembolic event rates in ACHD have been shown to be related to Congestive Heart Failure, Hypertension, Age (≥75 years), Diabetes, Stroke/Transient Ischemic Attack, Vascular Disease, Age (65-74 years), Sex (Female) (CHA2DS2-VASc) scores (0...
August 19, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29031049/heart-valve-scaffold-fabrication-bioinspired-control-of-macro-scale-morphology-mechanics-and-micro-structure
#4
Antonio D'Amore, Samuel K Luketich, Giuseppe M Raffa, Salim Olia, Giorgio Menallo, Antonino Mazzola, Flavio D'Accardi, Tamir Grunberg, Xinzhu Gu, Michele Pilato, Marina V Kameneva, Vinay Badhwar, William R Wagner
Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial...
October 6, 2017: Biomaterials
https://www.readbyqxmd.com/read/29022745/real-world-adherence-to-oral-anticoagulant-in-non-valvular-atrial-fibrillation-patients-in-china
#5
Xiao Xiang, Yaying Cao, Kexin Sun, Jing Song, Yaohua Tian, Qiongzhou Yin, Juan Juan, Yonghua Hu
BACKGROUND AND OBJECTIVE: Adherence to oral anticoagulants is crucial for the prevention of ischemic stroke in atrial fibrillation patients; however, evidence of oral-anticoagulant adherence from developing countries is still lacking. This study aimed to evaluate the current situation and predictors of oral-anticoagulant adherence in non-valvular atrial fibrillation (NVAF) patients in China. METHODS: Records of NVAF patients were obtained from a regional claims database...
November 8, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29016832/contemporary-stroke-prevention-strategies-in-11%C3%A2-096-european-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-on-atrial-fibrillation-eorp-af-long-term-general-registry
#6
Giuseppe Boriani, Marco Proietti, Cécile Laroche, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Igor Diemberger, Luigi Tavazzi, Aldo P Maggioni, Gregory Y H Lip
Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed. Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84...
September 14, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28990646/-clinical-profile-and-satisfaction-with-anticoagulated-treatment-in-patients-with-non-valvular-atrial-fibrillation-attended-in-internal-medicine-and-neurology-departments-of-spain
#7
(no author information available yet)
AIM: To determine the clinical profile, management of anticoagulant treatment and satisfaction related to anticoagulation in outpatients with nonvalvular atrial fibrillation attended in Neurology or Internal Medicine departments of Spain. PATIENTS AND METHODS: Cross-sectional and multicenter study, in which 1,337 outpatients were included. Patients fulfilled ACTS, SAT-Q and EQ-5D questionnaires. RESULTS: 865 patients (64.7%) were recruited from Neurology department and 472 (35...
October 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28950374/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-systematic-review-and-meta-analysis
#8
Daniel Caldeira, Cláudio David, João Costa, Joaquim J Ferreira, Fausto J Pinto
BACKGROUND: The non-vitamin K antagonist oral anticoagulants (NOACs) were approved for non-valvular atrial fibrillation (AF) but this term may be misnomer. Thus, the term non-mechanical and rheumatic mitral valvular (non-MARM) AF was proposed to exclude patients with valvular heart disease (VHD) without contraindications for NOACs. We aimed to review the efficacy and safety of NOACs in patients with AF and VHD compared to Vitamin K Antagonists (VKA). METHODS: A systematic review with meta-analysis (PROSPERO CRD42015024837) including data from randomized controlled trials (RCTs) retrieved in November 2016...
September 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28944137/pulmonary-hypertension-associated-with-antiphospholipid-antibody-call-for-a-screening-tool
#9
REVIEW
Rukma Parthvi, Rutuja R Sikachi, Abhinav Agrawal, Ajay Adial, Abhinav Vulisha, Sameer Khanijo, Arunabh Talwar
Antiphospholipid (aPL) antibodies are antibodies specific for anionic phospholipids. They are immunoglobulins that attack phospholipids, phospholipid-binding proteins, or phospholipid-protein complexes and are detected in anticardiolipin and lupus anticoagulant assays. aPL antibodies are often associated with antiphospholipid syndrome (APS) which can be idiopathic or from secondary causes such as systemic lupus erythematosus (SLE), infection or drugs. They have also been shown to be associated with Pulmonary Hypertension...
August 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28938962/regional-differences-in-presentation-and-antithrombotic-treatment-of-patients-with-atrial-fibrillation-baseline-characteristics-from-a-clustered-randomized-trial-to-improve-treatment-with-anticoagulants-in-patients-with-atrial-fibrillation-impact-af
#10
RANDOMIZED CONTROLLED TRIAL
Dragos Vinereanu, Hussein R Al-Khalidi, Meena P Rao, Wensheng He, Renato D Lopes, Cecilia M Bahit, Andrea O Ciobanu, Kathleen A Fox, Sean D Pokorney, Ying Xian, Jie Jiang, Deepak Y Kamath, Otavio Berwanger, Carlos Tajer, Yong Huo, Denis Xavier, Christopher B Granger
Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide. However, there are few contemporary comparative data on AF from middle-income countries. METHODS: Baseline characteristics of the IMPACT-AF trial were analyzed to assess regional differences in presentation and antithrombotic treatment of AF from 5 middle-income countries (Argentina, Brazil, China, India, and Romania) and factors associated with antithrombotic treatment prescription. RESULTS: IMPACT-AF enrolled 2281 patients (69 ± 11 years, 47% women) at 48 sites...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28934312/clinical-characteristics-and-12-month-outcomes-of-patients-with-valvular-and-non-valvular-atrial-fibrillation-in-kenya
#11
Tecla M Temu, Kathleen A Lane, Changyu Shen, Loise Ng'ang'a, Constantine O Akwanalo, Peng-Sheng Chen, Wilfred Emonyi, Susan R Heckbert, Myra M Koech, Imran Manji, Matteo Vatta, Eric J Velazquez, Jennifer Wessel, Sylvester Kimaiyo, Thomas S Inui, Gerald S Bloomfield
BACKGROUND: Atrial fibrillation (AF) is a major contributor to the global cardiovascular disease burden. The clinical profile and outcomes of AF patients with valvular heart diseases in sub-Saharan Africa (SSA) have not been adequately described. We assessed clinical features and 12-month outcomes of patients with valvular AF (vAF) in comparison to AF patients without valvular heart disease (nvAF) in western Kenya. METHODS: We performed a cohort study with retrospective data gathering to characterize risk factors and prospective data collection to characterize their hospitalization, stroke and mortality rates...
2017: PloS One
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#12
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28867369/-oral-anticoagulation-in-atrial-fibrillation-what-is-the-guideline-for-using-new-drugs
#13
J A Ibáñez Pérez de Viñaspre, J Gómez Bitrian, R Royo Hernández, M de Azúa Jiménez, C Marco López, L Urieta González
OBJECTIVE: To assess whether there are differences between atrial fibrillation (AF) patients initiating new direct-acting oral anticoagulants (DOAC) therapy and vitamin K antagonist (VKA) therapy in an emergency service. METHODS: Descriptive, observational, prospective study. We enrolled patients with AF who were visited in a hospital emergency service over one year. RESULTS: This study included 492 patients with AF, and 189 subjects received anticoagulant therapy, 104 with VKA (55%), and 85 with DOAC (45%)...
August 31, 2017: Semergen
https://www.readbyqxmd.com/read/28867157/-fine-tuning-of-antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-the-afinva-register
#14
Daniela Dubois Marques, Vicente Mora Llabata, Julián Pacheco Arroyo, Salvador Gasull Insertis, Manuela Vicente Cañizares, Ildefonso Roldán Torres
OBJECTIVE: To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines. DESIGN: Prospective observational study. LOCATION: Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain. PARTICIPANTS: A total of 505 patients with nonvalvular atrial fibrillation were included in the study...
August 31, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28844512/meta-analysis-of-usefulness-of-anticoagulation-after-transcatheter-aortic-valve-implantation
#15
REVIEW
Kinjal Banerjee, Kanhaiya Poddar, Stephanie Mick, Jonathon White, Amar Krishnaswamy, Douglas Johnston, Leonardo Rodriguez, E Murat Tuzcu, Samir Kapadia
Since the advent of bioprosthetic valves, the implications of long-term anticoagulation after valve replacement are unclear. There are very little data on outcomes of long-term anticoagulation after transcatheter aortic valve implantation (TAVI). Our aim was to conduct a systematic review of literature regarding anticoagulation after TAVI. The existing literature on anticoagulation after bioprosthetic valve replacement was thoroughly reviewed, including the most recent American College of Cardiology/American Heart Association 2017 guidelines for management of valvular disease, which is based on sparse, nonrandomized retrospective data...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28795332/the-patterns-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-use-in-patients-with-atrial-fibrillation-in-seven-balkan-countries-a-report-from-the-balkan-af-survey
#16
Tatjana S Potpara, Elina Trendafilova, Gheorghe-Andrei Dan, Artan Goda, Zumreta Kusljugic, Sime Manola, Ljilja Music, Viktor Gjini, Belma Pojskic, Mircea Ioakim Popescu, Catalina Arsenescu Georgescu, Elena S Dimitrova, Delyana Kamenova, Uliks Ekmeciu, Denis Mrsic, Ana Nenezic, Sandro Brusich, Srdjan Milanov, Ivan Zeljkovic, Gregory Y H Lip
INTRODUCTION: Data on management of atrial fibrillation (AF) in the Balkan Region are scarce. To capture the patterns in AF management in contemporary clinical practice in the Balkan countries a prospective survey was conducted between December 2014 and February 2015, and we report results pertinent to the use of non-vitamin K antagonist oral anticoagulants (NOACs). METHODS: A 14-week prospective, multicenter survey of consecutive AF patients seen by cardiologists or internal medicine specialists was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania, and Serbia (a total of about 50 million inhabitants)...
August 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28769114/diagnosing-antiphospholipid-syndrome-extra-criteria-manifestations-and-technical-advances
#17
REVIEW
Savino Sciascia, Mary-Carmen Amigo, Dario Roccatello, Munther Khamashta
First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS...
September 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28724563/management-of-anticoagulant-and-antiplatelet-therapy-in-patients-undergoing-interventional-pulmonary-procedures
#18
REVIEW
Vikas Pathak, J Erin Allender, Mollie W Grant
There has been great progress in antithrombotic therapy over the past several years. Its use has increased with the advent of novel anticoagulants, as these medications do not require frequent blood tests for monitoring. Antithrombotic therapy is aimed at reducing the risk of thromboembolic events in patients with atrial fibrillation, coronary artery disease, deep vein thrombosis, valvular heart disease and pulmonary embolism. These patients are often critically ill and frequently undergo urgent interventions requiring discontinuation of anticoagulant or antiplatelet therapy which can increase the risk of thrombosis; however, continuing these agents can lead to increased risk of haemorrhage...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28720644/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-a-systematic-review-and-meta-analysis
#19
REVIEW
Kuo-Li Pan, Daniel E Singer, Bruce Ovbiagele, Yi-Ling Wu, Mohamed A Ahmed, Meng Lee
BACKGROUND: The original non-vitamin K antagonist oral anticoagulant (NOAC) trials in nonvalvular atrial fibrillation (AF) enrolled patients with native valve pathologies. The object of this study was to quantify the benefit-risk profiles of NOACs versus warfarin in AF patients with native valvular heart disease (VHD). METHODS AND RESULTS: Trials were identified by exhaustive literature search. Trial data were combined using inverse variance weighting to produce a meta-analytic summary hazard ratio (HR) and 95% confidence interval (CI) of efficacy and safety of NOACs versus warfarin...
July 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28671806/valvular-heart-disease-in-adults-management-of-prosthetic-heart-valves
#20
REVIEW
John F Trujillo, Steven M Hollenberg
Patients undergoing cardiac valve replacement may receive mechanical or bioprosthetic valves. Mechanical valves require lifelong anticoagulation but are durable and the need for a second surgery is up to eightfold times less than with bioprosthetic valves. Bioprosthetic valves do not require lifelong anticoagulation and thus are associated with fewer bleeding complications but they are less durable and associated with higher morbidity and mortality rates, particularly in younger patients. Anticoagulation with mechanical valves is achieved using warfarin; use of direct-acting oral anticoagulants is not indicated...
June 2017: FP Essentials
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