Read by QxMD icon Read

Anticoagulation in valvular heart disease

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
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
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
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
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
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
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
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
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
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
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
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
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
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
Saad Ahmad, Heath Wilt
There is a clinically staggering burden of disease stemming from cerebrovascular events, of which a majority are ischemic in nature and many are precipitated by atrial fibrillation (AF). AF can occur in isolation or in association with myocardial or structural heart disease. In the latter case, and when considering health at an international level, congenital and acquired valve-related diseases are frequent contributors to the current pandemic of AF and its clinical impact. Guidelines crafted by the American Heart Association, American College of Cardiology, European Society of Cardiology and Heart Rhythm Society underscore the use of vitamin K antagonists (VKAs) among patients with valvular heart disease, particularly in the presence of concomitant AF, to reduce the risk of ischemic stroke of cardioembolic origin; however, the non-VKAs, also referred to as direct, target-specific or new oral anticoagulants (NOACs), have not been actively studied in this particular population...
2016: Open Cardiovascular Medicine Journal
Iqbal H Jaffer, Richard P Whitlock
The choice of prosthesis type in patients with valvular heart disease should always be individualised. The treating heart team must weigh the concerns surrounding durability of bioprosthetic valves compared with mechanical valves and the need for lifelong anticoagulation required with mechanical valves. In general, guidelines recommend that patients under the age of 60 would benefit from a mechanical valve, and those over 70 would benefit from a bioprosthetic valve. We would argue, in this context, that the most appropriate choice for this patient would be undertaking a mitral valve replacement with a mechanical prosthesis...
2016: Heart Asia
Hein Heidbuchel, Peter Verhamme, Marco Alings, Matthias Antz, Hans-Christoph Diener, Werner Hacke, Jonas Oldgren, Peter Sinnaeve, A John Camm, Paulus Kirchhof
In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P...
June 9, 2016: European Heart Journal
Ashok Kumar, Aditya Kapoor, Sudeep Kumar
Renal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot...
March 2016: Saudi Journal of Kidney Diseases and Transplantation
Raffaele De Caterina, Steen Husted, Lars Wallentin, Felicita Andreotti, Harald Arnesen, Fedor Bachmann, Colin Baigent, Jean-Philippe Collet, Sigrun Halvorsen, Kurt Huber, Jørgen Jespersen, Steen Dalby Kristensen, Gregory Y H Lip, João Morais, Lars Hvilsted Rasmussen, Fabrizio Ricci, Dirk Sibbing, Agneta Siegbahn, Robert F Storey, Jurriën Ten Berg, Freek W A Verheugt, Jeffrey I Weitz
Until recently, vitamin K antagonists (VKAs) were the only available oral anticoagulants evaluated for long-term treatment of patients with coronary heart disease (CHD), particularly after an acute coronary syndrome (ACS). Despite efficacy in this setting, VKAs are rarely used because they are cumbersome to administer. Instead, the more readily manageable antiplatelet agents are the mainstay of prevention in ACS patients. This situation has the potential to change with the introduction of non-VKA oral anticoagulants (NOACs), which are easier to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring...
April 2016: Thrombosis and Haemostasis
David Hutchings, Afzal Hayat, Arun Karunakaran, Nadim Malik
BACKGROUND: Femoral artery closure device use following percutaneous cannulation allows earlier mobilization, reduced staff burden, and improved comfort for patients compared with manual compression. The Mynx device (Access Closure, Inc), a novel extravascular closure device, uses a water-soluble non-thrombogenic polyethylene glycol plug. METHODS: We report retrospective analysis of success, complication rates, and associated factors in 432 consecutive patients undergoing elective outpatient coronary angiography in a single United Kingdom center...
March 2016: Journal of Invasive Cardiology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"