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Af and anticoagulation

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https://www.readbyqxmd.com/read/29447781/prediction-of-long-term-net-clinical-outcomes-using-the-timi-af-score-comparison-with-cha-2-ds-2-vasc-and-has-bled
#1
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
The TIMI-AF score was described to predict net clinical outcomes (NCOs) in atrial fibrillation (AF) patients receiving warfarin. However, this score derived from the ENGAGE AF-TIMI 48 trial, and no external validation exists in real world clinical practice. We tested the long-term predictive performance of the TIMI-AF score in comparison with CHA 2 DS 2 -VASc and HAS-BLED in a 'real-world' cohort of anticoagulated AF patients. METHODS: We included 1156 consecutive AF patients stable on vitamin K antagonist (INR 2...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447772/the-optimal-anti-coagulation-for-enhanced-risk-patients-post-catheter-ablation-for-atrial-fibrillation-ocean-trial
#2
Atul Verma, Andrew C T Ha, Paulus Kirchhof, Gerhard Hindricks, Jeff S Healey, Michael D Hill, Mukul Sharma, D George Wyse, Jean Champagne, Vidal Essebag, George Wells, Dhiraj Gupta, Hein Heidbuchel, Prashanthan Sanders, David H Birnie
BACKGROUND: The optimal long-term antithrombotic regimen for patients after successful catheter-based atrial fibrillation (AF) ablation is not well defined. Presently, practice variation exists, and the benefits of oral anticoagulation over antiplatelet therapy across the entire spectrum of stroke risk profile remain undefined in the postablation population. To date, there are no randomized trials to inform clinicians on this therapeutic question. OBJECTIVE: The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447733/stroke-risk-in-patients-with-reduced-ejection-fraction-after-myocardial-infarction-without-atrial-fibrillation
#3
João Pedro Ferreira, Nicolas Girerd, John Gregson, Ichraq Latar, Abhinav Sharma, Marc A Pfeffer, John J V McMurray, Azmil H Abdul-Rahim, Bertram Pitt, Kenneth Dickstein, Patrick Rossignol, Faiez Zannad
BACKGROUND: Stroke can occur after myocardial infarction (MI) in the absence of atrial fibrillation (AF). OBJECTIVES: This study sought to identify risk factors (excluding AF) for the occurrence of stroke and to develop a calibrated and validated stroke risk score in patients with MI and heart failure (HF) and/or systolic dysfunction. METHODS: The datasets included in this pooling initiative were derived from 4 trials: CAPRICORN (Effect of Carvedilol on Outcome After Myocardial Infarction in Patients With Left Ventricular Dysfunction), OPTIMAAL (Optimal Trial in Myocardial Infarction With Angiotensin II Antagonist Losartan), VALIANT (Valsartan in Acute Myocardial Infarction Trial), and EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study); EPHESUS was used for external validation...
February 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29444969/atrial-fibrillation-detected-after-stroke-is-related-to-a-low-risk-of-ischemic-stroke-recurrence
#4
Luciano A Sposato, Joshua O Cerasuolo, Lauren E Cipriano, Jiming Fang, Sebastian Fridman, Maryse Paquet, Gustavo Saposnik
OBJECTIVE: To compare the risk of 1-year ischemic stroke recurrence between atrial fibrillation (AF) diagnosed after stroke (AFDAS) and sinus rhythm (SR) and investigate whether underlying heart disease is as frequent in AFDAS as it is in AF known before stroke (KAF). METHODS: In this retrospective cohort study, we included all ischemic stroke patients admitted to institutions participating in the Ontario Stroke Registry from July 1, 2003, to March 31, 2013. Based on heart rhythm assessed during admission, we classified patients as AFDAS, KAF, or SR...
February 14, 2018: Neurology
https://www.readbyqxmd.com/read/29444357/safety-of-direct-oral-anticoagulants-versus-warfarin-in-patients-with-chronic-liver-disease-and-atrial-fibrillation
#5
Pavel Goriacko, Keith T Veltri
BACKGROUND: A complication of chronic liver disease (CLD) is the abnormality of coagulation. In clinical practice, this increased risk of bleeding has not been identified as a protective factor against stroke or systemic embolism associated with atrial fibrillation (AF). The objective of this study was to assess the safety of direct oral anticoagulant (DOAC) agents versus warfarin in CLD patients with AF. METHODS: This was a retrospective cohort study of patients with CLD and AF initiated on oral anticoagulants...
February 14, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29443369/relation-of-renal-dysfunction-to-quality-of-anticoagulation-control-in-patients-with-atrial-fibrillation-the-fantasiia-registry
#6
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Inmaculada Roldán-Rabadán, Vanessa Roldán, Javier Muñiz, Paula Raña-Míguez, Martín Ruiz-Ortiz, Ángel Cequier, Vicente Bertomeu-Martínez, Lina Badimón, Manuel Anguita, Gregory Y H Lip, Francisco Marín
BACKGROUND: One-third of atrial fibrillation (AF) patients have chronic kidney disease (CKD), a condition that itself increases thromboembolic and major bleeding risks, especially in patients with severe CKD. Bleeding would be accentuated by suboptimal anticoagulation control with vitamin K antagonists (VKA). PURPOSE: This article aimed to investigate the incidence of cardiovascular events, mortality and quality of anticoagulation in relation to CKD in a 'real-world' prospective cohort of AF patients included in the FANTASIIA registry...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29441513/evaluation-of-indications-for-reduced-dose-noacs-in-hospitalized-atrial-fibrillation-patients
#7
Olga Jelonek, Iwona Gorczyca, Michał Bączek, Paweł Kośmider, Beata Wożakowska-Kapłon
BACKGROUND: Prevention of thromboembolic complications is a priority in patients with atrial fibrillation (AF). The use of non-vitamin K antagonist oral anticoagulants (novel oral anticoagulants, NOAC) is more common, and some patients have indications for a reduced dose of NOAC. AIM: The aim of the study was to evaluate the frequency of NOACs being prescribed to AF patients and to compare the groups of AF patients receiving standard and reduced doses of NOACs. METHODS: The study was conducted in a population of 1,327 patients diagnosed with AF and hospitalized at an institution of the highest referral level in cardiology in years 2015-2016...
February 14, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29440949/the-prevalence-of-long-term-oral-anticoagulation-therapy-in-a-cardiology-center-in-bucharest-romania
#8
Adelina-Mihaela Sorescu, Tudor Enache, Suzana Guberna
Background and aims: Few studies discuss the prevalence of oral anticoagulation therapy (OAT) in clinical practice, despite their increasing use worldwide. In America, studies established that 20% to 80% of the patients with indication benefit from OAT. In Romania, there is no data regarding the utilization of oral anticoagulants. Thus, this study aims to determine the trends of OAT. Methods: We designed a cross-sectional study of the patients admitted to the Cardiology Department of the "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, from the 1st of November 2016 until the 31st of January 2017...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29439477/a-practical-review-of-the-emerging-direct-anticoagulants-laboratory-monitoring-and-reversal-agents
#9
REVIEW
Stephanie A Joppa, Justin Salciccioli, Jill Adamski, Salma Patel, Waldemar Wysokinski, Robert McBane, Farah Al-Saffar, Heidi Esser, Fadi Shamoun
Millions of patients in the United States use anticoagulation for a variety of indications, such as the prevention of stroke in those with atrial fibrillation (AF) and the treatment and prevention of venous thrombosis. For over six decades warfarin was the only available oral anticoagulant, but now several DOACs are available and their use has become more prevalent in recent years. In spite of this increased use, many physicians remain reluctant to prescribe DOACs due to concerns about bleeding and reversibility...
February 11, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29439352/linking-atrial-fibrillation-with-alzheimer-s-disease-epidemiological-pathological-and-mechanistic-evidence
#10
Masafumi Ihara, Kazuo Washida
Many studies have shown a relationship between atrial fibrillation (AF) and vascular dementia. AF is a major risk factor for stroke, and stroke is the greatest risk factor for vascular dementia. However, the relationship between Alzheimer's disease (AD), the leading cause of dementia, and AF remains unclear. At least four epidemiological studies have reported AF significantly raises the risk of AD 1.5- to 2.5-fold. Chronic cerebral hypoperfusion, resulting from persistent AF, could explain the link as hypoperfusion may mechanistically exacerbate amyloid-β (Aβ) neuropathology, such as senile plaques and amyloid angiopathy, by upregulating Aβ-producing enzymes and lowering Aβ clearance efficiency...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29438571/use-of-non-vitamin-k-oral-anticoagulants-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#11
REVIEW
O Itzhaki, B Zadok, A Eisen
AIMS: To examine the efficacy and safety of non-vitamin K oral anticoagulants in people with both atrial fibrillation and diabetes mellitus. METHODS: We reviewed efficacy and safety data from the warfarin-controlled phase III non-vitamin K oral anticoagulants trials (ARISTOTLE, RE-LY, ROCKET-AF, ENGAGE and AF-TIMI 48) and their post hoc analyses with regard to diabetes status. We also reviewed the updated literature regarding this population. RESULTS: At baseline 20-40% of the participants in the phase III non-vitamin K oral anticoagulants trials had diabetes mellitus at baseline...
February 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29437577/mir-146a-regulates-neutrophil-extracellular-trap-formation-that-predicts-adverse-cardiovascular-events-in-patients-with-atrial-fibrillation
#12
Ana B Arroyo, Asunción M de Los Reyes-García, José Miguel Rivera-Caravaca, Patricia Valledor, Nuria García-Barberá, Vanessa Roldán, Vicente Vicente, Constantino Martínez, Rocio González-Conejero
OBJECTIVE: Atrial fibrillation (AF) patients experience adverse cardiovascular events (ACEs) despite anticoagulant therapy. We reported that rs2431697 of miR-146a, a negative regulator of inflammation, predicts ACEs in patients with AF. The relationship between neutrophil extracellular traps and thrombogenesis is known. Thus, our aim was to evaluate the role of neutrophil extracellular trap compounds as prognostic markers of ACEs in AF and to study whether miR-146a affects NETosis. APPROACH AND RESULTS: We included 336 steadily anticoagulated AF patients with a median follow-up of 7...
February 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29436194/comparison-of-rhythm-and-rate-control-strategies-for-stroke-occurrence-in-a-prospective-cohort-of-atrial-fibrillation-patients
#13
Yu Jeong Choi, Ki Woon Kang, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung
PURPOSE: Comparisons of rhythm and rate control strategies for stroke prevention in patients with atrial fibrillation (AF) are still inconclusive. We compared differences in clinical outcomes between the rhythm and rate control strategies. MATERIALS AND METHODS: The COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry prospectively enrolled 6000 patients who were treated for AF using real-world guideline adherence at multiple referral centers...
March 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29431527/role-of-cardiac-electronic-implantable-device-in-the-stratification-and-management-of-embolic-risk-of-silent-atrial-fibrillation-are-all-atrial-fibrillations-created-equal
#14
Andrea Di Cori, Alessio Lilli, Giulio Zucchelli, Valerio Zaca
Ischemic strokes may be associated with atrial fibrillation (AF). AF detection is critical in ischemic stroke survivors, often recommending a switch from antiplatelet therapy to oral anticoagulants for secondary prevention. Areas covered: Cardiac implantable electronic devices (CIED) with their long-term recording capability allows to document AF and to quantify the arrhythmia burden. Recent series in pacemaker and implantable cardioverter-defibrillator (ICD) recipients with no prior stroke showed that short episodes of AF increased stroke risk compared with those without AF recorded...
February 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29428144/when-is-device-detected-atrial-fibrillation-actionable
#15
REVIEW
Jeremiah Wasserlauf, Rod S Passman
Device-detected atrial high-rate episodes (AHREs) are frequently encountered in patients with no history of atrial fibrillation (AF) and represent a challenge for clinicians because patients with device-only documented AF have not been included in clinical trials of anticoagulants and other AF therapies. For patients with known history of AF, wireless continuous rhythm monitoring and rapidly acting oral anticoagulants offer the possibility of tailored anticoagulation in response to AHREs, with studies ongoing to evaluate the safety of this approach...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29428132/implantable-loop-recorders-for-cryptogenic-stroke-plus-real-world-atrial-fibrillation-detection-rate-with-implantable-loop-recorders
#16
REVIEW
Dan L Musat, Nicolle Milstein, Suneet Mittal
Cryptogenic stroke (CS) represents 10%-40% of ischemic strokes and is associated with significant morbidity and mortality and high risk of recurrence. Undetected atrial fibrillation is an important consideration in these patients. Tools for electrocardiographic monitoring range from 12-lead electrocardiogram to implantable loop recorders (ILRs). ILRs have become an important tool for long-term electrocardiogram monitoring in CS patients. Advancements in ILR technology are needed to ensure more robust connectivity and to help triage incoming data...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29426785/long-term-prognostic-impact-of-anticoagulation-on-patients-with-atrial-fibrillation-undergoing-hemodialysis
#17
Ruth María Sánchez Soriano, María Dolores Albero Molina, Carlos Israel Chamorro Fernández, Rocío Juliá-Sanchís, Ramón López Menchero, Carlos Del Pozo Fernández, Guillermo Grau Jornet, Julio Núñez Villota
INTRODUCTION AND OBJECTIVES: Evidence for the efficacy and safety of oral anticoagulation with dicumarines in patients with atrial fibrillation (AF) on hemodialysis is controversial. The aim of our study is to evaluate the long-term prognostic implications of anticoagulation with dicumarines in a cohort of patients with non-valvular AF on a hemodialysis program due to end-stage renal disease. METHODS: Retrospective, observational study with consecutive inclusion of 74 patients with AF on hemodialysis...
February 6, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29424018/relation-of-quality-of-anticoagulation-control-with-different-management-systems-amongst-patients-with-atrial-fibrillation-data-from-fantasiia-registry
#18
Inmaculada Roldán Rabadán, María Asunción Esteve-Pastor, Manuel Anguita Sánchez, Javier Muñiz, José Camacho Siles, María Angustias Quesada, Martín Ruiz Ortiz, Francisco Marín, Manuel Martínez Sellés, Vicente Bertomeu, Gregory Y H Lip, Angel Cequier Fillat, Lina Badimón
BACKGROUND: Anticoagulation control in patients with atrial fibrillation (AF) has a multidisciplinary approach although is usually managed by general practitioners (GP) or hematologists. The aim of our study was to assess the quality of anticoagulation control with vitamin K antagonists (VKAs) in relation to the responsible specialist in a "real-world" AF population. METHODS: We consecutively enrolled VKA anticoagulated patients included in the FANTASIIA Registry from 2013 to 2015...
February 9, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29421002/evaluation-of-the-safety-and-efficacy-of-an-edoxaban-based-antithrombotic-regimen-in-patients-with-atrial-fibrillation-following-successful-percutaneous-coronary-intervention-pci-with-stent-placement-rationale-and-design-of-the-entrust-af-pci-trial
#19
Pascal Vranckx, Thorsten Lewalter, Marco Valgimigli, Jan G Tijssen, Paul-Egbert Reimitz, Lars Eckardt, Hans-Joachim Lanz, Wolfgang Zierhut, Rüdiger Smolnik, Andreas Goette
BACKGROUND: The optimal antithrombotic treatment after percutaneous coronary intervention (PCI) with stenting in patients with atrial fibrillation (AF) is unknown. In the ENGAGE AF-TIMI 48 trial, edoxaban was noninferior to a vitamin K antagonist (VKA) with respect to the prevention of stroke or systemic embolism and was associated with significantly lower rates of bleeding and cardiovascular death in patients with nonvalvular AF. The effects of edoxaban in combination with single- or dual-antiplatelet therapy in the setting of PCI are unexplored...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29414920/interventional-left-atrial-appendage-closure-affects-the-metabolism-of-acylcarnitines
#20
Christian Fastner, Michael Behnes, Benjamin Sartorius, Annika Wenke, Siegfried Lang, Gökhan Yücel, Katherine Sattler, Jonas Rusnak, Ahmad Saleh, Christian Barth, Kambis Mashayekhi, Ursula Hoffmann, Martin Borggrefe, Ibrahim Akin
BACKGROUND: Left atrial appendage closure (LAAC) represents the interventional alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF). The metabolism of acylcarnitines was shown to affect cardiovascular diseases. This study evaluates the influence of successful LAAC on the metabolism of acylcarnitines. METHODS: Patients undergoing successful LAAC were enrolled prospectively. Peripheral blood samples for metabolomics measurements were collected immediately before (i...
February 7, 2018: International Journal of Molecular Sciences
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