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aspirin use in af

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https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#1
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349596/concomitant-use-of-antiplatelets-and-anticoagulants-in-patients-with-coronary-heart-disease-and-atrial-fibrillation-what-do-recent-clinical-trials-teach-us
#2
REVIEW
David H Lam, Sean M Bell, Ravi S Hira
PURPOSE OF REVIEW: Coronary heart disease (CHD) and atrial fibrillation (AF) are among the most common cardiovascular diseases. A significant proportion of patients have both CHD and AF and are at increased risk for thrombotic complications. Current therapy for CHD and AF includes antiplatelet and anticoagulant medications, respectively. Patients with concurrent CHD and AF may be prescribed dual antiplatelet therapy (DAPT) in addition to anticoagulation, which increases their bleeding risk...
January 19, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#3
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#4
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29335863/integrative-medicine-on-optimizing-clopidogrel-and-aspirin-therapy
#5
REVIEW
Hui Chen
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI)...
January 15, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#6
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#7
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29315961/reduction-of-thromboembolic-events-during-ablation-using-the-laserballoon-the-rethreva-registry
#8
Martin Eichenlaub, Arne Pfeufer, Lars Behrens, Volker Klauss, Michael Roettinger, Turgut Brodherr, Thorsten Lewalter
INTRODUCTION: Cerebral events (CE), including silent (SCE), are a known complication of left atrial catheter ablation (LACA) in patients with atrial fibrillation. The aim of this prospective registry was to gain more information about CE during laserballoon LACA and to reduce the risk of their occurrence. METHODS AND RESULTS: We enrolled 74 patients (age 61 ± 11 years; 74% male; CHA2 DS2 -VASc 1.9 ± 1.4). Cerebral MRI (1.5 Tesla) was performed to detect CE...
January 9, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29296820/cumulative-incidence-risk-factors-and-management-of-atrial-fibrillation-in-patients-receiving-ibrutinib
#9
Tracy E Wiczer, Lauren B Levine, Jessica Brumbaugh, Jessica Coggins, Qiuhong Zhao, Amy S Ruppert, Kerry Rogers, Anli McCoy, Luay Mousa, Avirup Guha, Nyla A Heerema, Kami Maddocks, Beth Christian, Leslie A Andritsos, Samantha Jaglowski, Steven Devine, Robert Baiocchi, Jennifer Woyach, Jeffrey Jones, Michael Grever, Kristie A Blum, John C Byrd, Farrukh T Awan
Atrial fibrillation (AF) has been reported in up to 16% of patients taking ibrutinib. Data regarding the management of AF in this patient population are limited, and stroke prevention poses a challenge because of increased risk of bleeding with ibrutinib treatment. Our study sought to describe the incidence of AF in adult patients treated with ibrutinib for a hematologic malignancy, assess management strategies, evaluate stroke and bleeding outcomes, and identify risk factors for occurrence. Of 582 patients treated with ibrutinib, 76 developed AF...
September 12, 2017: Blood Advances
https://www.readbyqxmd.com/read/29282401/recurrent-vitreous-hemorrhage-from-an-optic-nerve-retinal-arterial-macroaneurysm
#10
Jessica F Yang, Kamal Kishore
Objective: To report a case of recurrent vitreous hemorrhage from an optic nerve retinal arterial macroaneurysm (ONRAM) successfully treated with intraoperative endolaser. Patient and Methods: A 92-year-old woman on oral aspirin and warfarin anticoagulation for atrial fibrillation developed three episodes of dense vitreous hemorrhage from an ONRAM. Due to failure of the vitreous hemorrhage to clear spontaneously, a total of three pars plana vitrectomy (PPV) procedures were performed along with a 1...
September 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29274198/dabigatran-versus-vitamin-k-antagonist-an-observational-across-cohort-comparison-in-acute-coronary-syndrome-patients-with-atrial-fibrillation
#11
Mélanie Gaubert, Noémie Resseguier, Marc Laine, Laurent Bonello, Laurence Camoin-Jau, Franck Paganelli
BACKGROUND: Dual antithrombotic therapy comprising a vitamin K antagonist (VKA) plus clopidogrel reduces the incidence of major bleeding compared with triple therapy (VKA+clopidogrel+aspirin) in acute coronary syndrome (ACS) patients with atrial fibrillation (AF), with a similar thrombotic risk. The oral thrombin inhibitor dabigatran (150 mg twice a day) showed superiority over VKA in non-valvular AF, but data supporting its use in AF patients presenting with ACS are limited. OBJECTIVE: We sought to evaluate the efficacy of dabigatran versus VKA in the management of AF patients undergoing percutaneous coronary intervention for an ACS...
December 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29261716/temporal-trends-of-antithrombotic-therapy-for-stroke-prevention-in-korean-patients-with-non-valvular-atrial-fibrillation-in-the-era-of-non-vitamin-k-antagonist-oral-anticoagulants-a-nationwide-population-based-study
#12
So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Myung-Jin Cha, Seil Oh, Gregory Y H Lip
BACKGROUND: Following their introduction, the non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly prescribed in Asia for stroke prevention in patients with non-valvular atrial fibrillation (AF). Few contemporary data are available on temporal trends in antithrombotic therapy use in Asian countries, in the era of NOACs. METHODS AND RESULTS: Using the National Health Insurance Service database of the entire Korean adult AF population, the use of aspirin, vitamin K antagonist, and NOACs between 2008 and 2015 were analyzed (n = 276,246 in 2015)...
2017: PloS One
https://www.readbyqxmd.com/read/29249444/impact-of-quality-of-anticoagulation-control-on-outcomes-in-patients-with-atrial-fibrillation-taking-aspirin-an-analysis-from-the-sportif-trials
#13
Marco Proietti, Gregory Y H Lip
BACKGROUND: Concomitant aspirin (ASA) is often prescribed in anticoagulated patients with atrial fibrillation (AF). We aimed to investigate the relationship between ASA use and quality of anticoagulation control determining major adverse outcomes. METHODS: An ancillary analysis of patients in the warfarin arm of the SPORTIF III and V trials was performed. Quality of anticoagulation control was defined using time in therapeutic range (TTR). RESULTS: 3624 AF patients on warfarin were available for analysis: 1712 (47...
February 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29228736/bleeding-risk-with-dabigatran-rivaroxaban-warfarin-and-antiplatelet-agent-in-asians-with-non-valvular-atrial-fibrillation
#14
Yi-Hsin Chan, Yung-Hsin Yeh, Hui-Tzu Tu, Chi-Tai Kuo, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Lai-Chu See
It is not understood if dabigatran or rivaroxaban are superior to antiplatelet agents (AA) for safety outcomes in Asians with non-valvular atrial fibrillation (NVAF). In this study we evaluated the bleeding risk of dabigatran, rivaroxaban, warfarin and AA in Asians with NVAF. This national retrospective cohort study analyzed 6,600, 3,167, 5,338 and 8,238 consecutive NVAF patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29224638/predictors-of-perioperative-major-bleeding-in-patients-who-interrupt-warfarin-for-an-elective-surgery-or-procedure-analysis-of-the-bridge-trial
#15
RANDOMIZED CONTROLLED TRIAL
Nathan P Clark, James D Douketis, Vic Hasselblad, Sam Schulman, Andrei L Kindzelski, Thomas L Ortel
BACKGROUND: The use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described. METHODS: BRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29224408/oral-anticoagulation-therapy-upon-discharge-in-hospitalized-patients-with-nonvalvular-atrial-fibrillation-a-retrospective-cohort-study
#16
Devada Singh-Franco, Genevieve Hale, Robin J Jacobs
OBJECTIVES: Availability of direct oral anticoagulants and CHA2DS2VASc/HAS-BLED scoring tools underscore the importance of appropriate and safe use of oral anticoagulation therapy (OACT). The purpose of this study was to evaluate stroke prevention pharmacotherapy in adult patients with nonvalvular atrial fibrillation (NVAF) discharged from a large, community-based hospital. METHODS: A retrospective cohort study was conducted using a de-identified data collection sheet for data extraction (demographics, admitting diagnosis, OACT prior to admission and at discharge, concomitant medications that could increase bleed risk and/or acid-suppressive therapies)...
December 11, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29223435/atrial-fibrillation-decision-support-tool-population-perspective
#17
Mark H Eckman, Alexandru Costea, Mehran Attari, Jitender Munjal, Ruth E Wise, Carol Knochelmann, Matthew L Flaherty, Pete Baker, Robert Ireton, Brett M Harnett, Anthony C Leonard, Dylan Steen, Adam Rose, John Kues
BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#18
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29181519/role-of-antiplatelet-therapy-in-stroke-prevention-in-patients-with-atrial-fibrillation
#19
Rohini Manaktala, Jeffrey Kluger
Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to oral anticoagulation, remains controversial...
December 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29179605/anticoagulant-use-in-atrial-fibrillation-and-risk-of-dementia-review-of-contemporary-knowledge
#20
Victoria Jacobs, Kevin G Graves, Thomas J Bunch
Atrial fibrillation (AF) is strongly associated with dementia, including idiopathic dementias such as Alzheimer's disease. The relative risk of dementia is highest in AF patients 70 years and younger, and the burden of exposure to arrhythmia appears to underlie part of the risk. Areas covered: Anticoagulation choices and approach influence dementia risk. In warfarin patients, inadequate time spent in therapeutic range is highly associated with the increased dementia risk long-term. This risk is further accentuated with frequent over anticoagulation in patients also receiving aspirin...
November 28, 2017: Expert Review of Cardiovascular Therapy
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