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Af and anticoagulation

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https://www.readbyqxmd.com/read/28822239/ischemic-stroke-rates-decline-in-patients-with-atrial-fibrillation-as-anticoagulants-uptake-improves-a-swedish-cohort-study
#1
Natalia Mochalina, Nazim Isma, Peter J Svensson, Anders Själander, Maj Carlsson, Tord Juhlin, Mattias Wieloch
INTRODUCTION: The impact of the increased anticoagulants uptake on incidence rate of ischemic stroke is largely unknown. We assessed time trends in rates of ischemic stroke in patients with incident atrial fibrillation (AF) diagnosed between 2011 and 2013. MATERIALS AND METHODS: Population-based retrospective registry study of all 11,500 adults diagnosed with incident non-valvular atrial fibrillation in 2011-2013 in primary and secondary care and receiving oral anticoagulants (n=4847), aspirin (n=2850) or no treatment (n=3766) in Skåne County, Sweden...
August 11, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#2
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#3
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28811871/do-all-patients-with-atrial-fibrillation-need-long-term-anticoagulation
#4
Munish Sharma, Rohit Masih, Daniel A N Mascarenhas
Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide with an estimated number of 2.7-6.1 million cases in the United States (US) alone. The incidence of AF is expected to increase 2.5 fold over the next 50 years in the US. The management of AF is complex and includes mainly three aspects; restoration of sinus rhythm, control of ventricular rate and prevention of systemic thromboembolism. AF as a cause of systemic embolization has been well known for many years, and majority of patients are on oral anticoagulants (OACs) to prevent this...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28811092/direct-oral-anticoagulants-in-patients-with-hypertrophic-cardiomyopathy-and-atrial-fibrillation
#5
Fernando Dominguez, Vicente Climent, Esther Zorio, Tomás Ripoll-Vera, Joel Salazar-Mendiguchía, Jose Manuel García-Pinilla, Jose Angel Urbano-Moral, Xusto Fernández-Fernández, David Lopez-Cuenca, Raquel Ajo-Ferrer, Jorge Sanz-Sanchez, Yolanda Gomez-Perez, Miguel A López-Garrido, Roberto Barriales-Villa, Juan Ramón Gimeno, Pablo Garcia-Pavia
BACKGROUND: Chronic anticoagulation with vitamin K antagonists (VKAs) is recommended in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF). Direct oral anticoagulants (NOACs) are an alternative to VKAs but there are limited data to support their use in HCM. We sought to describe the pattern of use, thromboembolic events, bleeding and quality of life in patients with HCM and AF treated with NOACs. METHODS: Data from patients treated with NOACs (n=99) and VKA (n=433) at 9 inherited cardiac diseases units were retrospectively collected...
August 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28805957/stroke-or-left-atrial-thrombus-prediction-using-antithrombin-iii-and-mean-platelet-volume-in-patients-with-nonvalvular-atrial-fibrillation
#6
Seo-Won Choi, Bo-Bae Kim, Dong-Hyun Choi, Geon Park, Byung Chul Shin, Heesang Song, DongHun Kim, Dong-Min Kim
BACKGROUND: CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF). HYPOTHESIS: To determine the association of antithrombin III (AT-III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF...
August 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28803036/relationship-between-atrial-fibrillation-and-cognitive-decline-in-individuals-aged-80-and-older-a-narrative-review
#7
REVIEW
Marco Proietti, Angela Recchia, Emma Riva, Ugo Lucca, Mauro Tettamanti, Pier Mannuccio Mannucci, Alessandro Nobili
BACKGROUND: Atrial fibrillation (AF) and dementia are largely prevalent and incident in progressively older subjects, suggesting a link between the two conditions. While in the general population there are several findings supporting a causal relationship between AF and dementia, it is unclear whether or not this association is still present in individuals aged 80 and older. RESULTS: So far, the few studies that analysed this issue did not provide enough evidence supporting the causative role of AF in increasing the risk of cognitive decline or dementia in patients aged 80 and older...
August 9, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28800833/bleeding-risk-scores-in-atrial-fibrillation-and-venous-thromboembolism
#8
REVIEW
Hanis Zulkifly, Gregory Y H Lip, Deirdre A Lane
Patients receiving oral anticoagulant (OAC) therapy for stroke prevention in atrial fibrillation (AF) and prevention of venous thromboembolism (VTE) face an increased risk of bleeding with OAC treatment. Clinicians need to weigh the benefits of OAC treatment against the risk of bleeding. To help formalize bleeding risk assessment, various bleeding risk scores have been developed to help predict the risk of bleeding in AF and VTE patients receiving OAC therapy. This review summarizes the literature involving original studies deriving bleeding risk scores and validation studies of these scores for stroke prevention in AF and treatment/prevention of VTE...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28800176/catheter-ablation-of-left-atrial-arrhythmias-on-uninterrupted-oral-anticoagulation-with-vitamin-k-antagonists-how-is-the-relationship-between-international-normalized-ratio-activated-clotting-time-and-procedure-related-complications
#9
Marc Kottmaier, Felix Bourier, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Carsten Lennerz, Sarah Lengauer, Marielouise Kornmayer, Elena Rousseva, Stephanie Brooks, Amir Brkic, Christian Grebmer, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
BACKGROUND: Ablation of atrial fibrillation (AF) on uninterrupted phenprocoumon reduces periprocedural thromboembolic and bleeding complications. Heparin is administered intraprocedurally to achieve activated clotting times (ACT) of 300-400 seconds. We investigated the effect of international normalized ratio (INR) on ACT and intraprocedural heparin requirements. Moreover, safety of a target ACT of 250-300 seconds was investigated. METHODS AND RESULTS: We studied 949 patients referred for AF or left atrial tachycardia ablation...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28799620/long-term-bleeding-risk-prediction-in-real-world-patients-with-atrial-fibrillation-comparison-of-the-has-bled-and-abc-bleeding-risk-scores-the-murcia-atrial-fibrillation-project
#10
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Vanessa Roldan, Vicente Vicente, Mariano Valdés, Francisco Marín, Gregory Y H Lip
Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABC-Bleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. It was the aim of this study to compare the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up...
August 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28799449/the-impact-of-the-latest-echocardiographic-chamber-quantification-recommendations-on-the-prediction-of-left-atrial-appendage-thrombus-presence-by-transthoracic-echocardiography
#11
Karolina Kupczynska, Jaroslaw D Kasprzak, Blazej W Michalski, Dawid L Miskowiec, Piotr Lipiec
INTRODUCTION: The latest recommendations for echocardiographic chamber quantification have implemented updated normal values for all cardiac chambers. PURPOSE: To evaluate the incidence of normal and abnormal values of routine echocardiographic parameters such as left ventricular ejection fraction (LVEF) and left atrial volume indexed to body surface area (LAVi) in patients with non-valvular atrial fibrillation (AF) and to determine the influence of LVEF and LAVi reclassification on the prediction of LAAT by transthoracic echocardiography...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischemic-stroke-and-non-valvular-atrial-fibrillation
#12
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Yohei Takayama, Kentaro Suzuki, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has a potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aims of the present study were to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF (NVAF)...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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
#13
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 9, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#14
Brystana G Kaufman, Sunghee Kim, Karen Pieper, Larry A Allen, Bernard J Gersh, Gerald V Naccarelli, Michael D Ezekowitz, Gregg C Fonarow, Kenneth W Mahaffey, Daniel E Singer, Paul S Chan, James V Freeman, Jack Ansell, Peter R Kowey, James A Rieffel, Jonathan Piccini, Eric Peterson, Emily C O'Brien
OBJECTIVE: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. METHODS: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites...
August 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28789760/-antithrombotic-treatment-of-patients-with-valvular-atrial-fibrillation
#15
Ann Bovin, Thomas Decker Christensen, Erik Lerkevang Grove
Atrial fibrillation (AF) is associated with a markedly increased risk of thromboembolic events, particularly in patients with valvular AF. Recent trials comparing vitamin K antagonists with non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in AF excluded most patients with valvular AF. Although the definition of valvular AF is disputed, the lack of evidence regarding the use of NOACs for these patients is not. We discuss the definition of valvular AF, the risk of thromboembolism, and the antithrombotic treatment for stroke prevention in these patients...
July 17, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#16
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28768967/dabigatran-therapy-resulting-in-the-resolution-of-rivaroxaban-resistant-left-atrial-appendage-thrombi-in-patients-with-atrial-fibrillation
#17
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Shiro Hoshida
Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to exclude any left atrial appendage (LAA) thrombi. We herein report two cases of persistent AF, both of which were treated with rivaroxaban for more than two years. Since TEE identified mobile LAA thrombi with this treatment, we switched from rivaroxaban to the direct thrombin inhibitor dabigatran...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28766370/predictors-for-total-hospital-and-cardiology-cost-claims-among-patients-with-atrial-fibrillation-initiating-dabigatran-or-acenocoumarol-in-the-netherlands
#18
M S Jacobs, M W J van Leent, R G Tieleman, F G A Jansman, Q Cao, M J Postma, M van Hulst
AIMS: The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and health care costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in patients that recently initiated anticoagulation with acenocoumarol or dabigatran. METHODS: Predictors for claimed total hospital care costs and cardiology costs in AF patients were explored by using hospital financial claims data from propensity score matched patient groups in a large Dutch community hospital...
August 2, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28765771/2017-consensus-of-the-asia-pacific-heart-rhythm-society-on-stroke-prevention-in-atrial-fibrillation
#19
Chern-En Chiang, Ken Okumura, Shu Zhang, Tze-Fan Chao, Chung-Wah Siu, Toon Wei Lim, Anil Saxena, Yoshihide Takahashi, Wee Siong Teo
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#20
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
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