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Novel anticoagulants, coronary artery disease, diabetes

Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 2018: Progress in Cardiovascular Diseases
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
Wei Xiang, Jingwei Zhang, Meilin Liu, Fang Liu, Xueru Feng, Yuchuan Wang
OBJECTIVE: Non-valvular atrial fibrillation (NVAF) is one common arrhythmia in the elderly. However, use of antithrombotic therapy in this population is not well known in the People's Republic of China. This study aimed at investigating antithrombotic therapy status in elderly patients with NVAF in our hospital. METHODS: A cross-sectional study of consecutive geriatric patients aged ≥60 years with NVAF who discharged from our hospital between January 2012 and December 2013 were collected...
2015: Clinical Interventions in Aging
Corey M Coleman, Shaden Khalaf, Steven Mould, Oussama Wazni, Mohamed Kanj, Walid Saliba, Daniel Cantillon
BACKGROUND: Novel oral anticoagulant (NOAC) agents dabigatran, rivaroxaban, and apixaban are increasingly utilized as thromboembolic prevention for patients with atrial fibrillation undergoing direct current cardioversion (DCCV) with post hoc analyses of clinical trials suggesting satisfactory safety and efficacy. This study characterizes utilization, effectiveness, and complications of NOAC agents for stroke prophylaxis in the setting of DCCV. METHODS: Comparison of warfarin and NOAC agents as periprocedural anticoagulation for DCCV procedures performed at Cleveland Clinic from January 2009 through December 2013...
June 2015: Pacing and Clinical Electrophysiology: PACE
Gregory Y H Lip, Cécile Laroche, Gheorghe-Andrei Dan, Massimo Santini, Zbigniew Kalarus, Lars Hvilsted Rasmussen, Popescu Mircea Ioachim, Otilia Tica, Giuseppe Boriani, Paolo Cimaglia, Igor Diemberger, Camilla Fragtrup Hellum, Bettina Mortensen, Aldo P Maggioni
BACKGROUND: Current guidelines strongly recommend that oral anticoagulation should be offered to patients with atrial fibrillation and ≥1 stroke risk factors. The guidelines also recommend that oral anticoagulation still should be used in the presence of stroke risk factors irrespective of rate or rhythm control. METHODS: In an analysis from the dataset of the EURObservational Research Programme on Atrial Fibrillation Pilot Survey (n = 3119), we examined antithrombotic therapy prescribing, with particular focus on the risk factors determining oral anticoagulation or antiplatelet therapy use...
June 2014: American Journal of Medicine
Masaharu Akao, Yeong-Hwa Chun, Hiromichi Wada, Masahiro Esato, Tetsuo Hashimoto, Mitsuru Abe, Koji Hasegawa, Hikari Tsuji, Keizo Furuke
BACKGROUND: Atrial fibrillation (AF) increases the risks of stroke and death, and the prevalence of AF is increasing significantly. Until recently, warfarin was the only oral anticoagulant for stroke prevention, but novel anticoagulants are now under development. METHODS AND RESULTS: The Fushimi AF Registry is a community-based survey of AF patients. We aimed to enroll all of the AF patients in Fushimi-ku, which is located at the southern end of the city of Kyoto...
April 2013: Journal of Cardiology
Davide Tavano, Gabriella Visconti, Davide D'Andrea, Amelia Focaccio, Bruno Golia, Mariateresa Librera, Mario Caccavale, Bruno Ricciarelli, Carlo Briguori
Bivalirudin demonstrated similar efficacy but resulted in a lower rate of bleeding compared to unfractionated heparin (UFH) plus platelet glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention. It has not been clearly evaluated whether this can also be applied to patients with diabetes mellitus. A total of 335 consecutive patients with diabetes mellitus referred for elective percutaneous coronary intervention were randomized in the Novel Approaches for Preventing or Limiting EventS (NAPLES) trial to receive bivalirudin monotherapy or UFH plus routine tirofiban...
November 1, 2009: American Journal of Cardiology
Günter Breithardt, Dobromir Dobrev, Nicolas Doll, Andreas Goette, Boris Hoffmann, Paulus Kirchhof, Ilka Köster, Karl-Heinz Kuck, Angelika Leute, Thomas Meinertz, Michael Näbauer, Michael Oeff, Ursula Ravens, Andreas Schuchert, Claudia Sprenger, Gerhard Steinbeck, Stephan Willems
The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF) since 2003. The AFNET aims at improving treatment of atrial fibrillation (AF), the most frequent sustained arrhythmia of the heart. The AFNET has established a nationwide patient registry on manifestation, diagnostics, and therapy of AF in Germany. The data analyzed to date demonstrate that patients with AF are likely to have multiple comorbidities (hypertension, valvular heart disease, coronary artery disease, diabetes mellitus) and an advanced age...
December 2008: Herz
D J Schneider, B E Sobel
Cardiovascular morbidity and mortality are increased 4- to 6-fold in patients with type II diabetes. The high prevalence is multifactorial and reflects in part the adverse influence of covariate, cardiac risk factors such as hypertension and hyperlipidemia. Type II diabetes is characterized by insulin resistance, hyperinsulinemia, and altered carbohydrate and lipid metabolism resulting in hyperglycemia, increased concentrations in blood of very low-density and low-density lipoproteins, and decreased blood high-density lipoproteins...
May 1997: Clinical Cardiology
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