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https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#1
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#2
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29761426/predictors-of-self-reported-adherence-to-direct-oral-anticoagulation-in-a-population-of-elderly-men-and-women-with-non-valvular-atrial-fibrillation
#3
Andrea P Rossi, Roberto Facchinetti, Elena Ferrari, Nicole Nori, Selena Sant, Elena Masciocchi, Elena Zoico, Francesco Fantin, Gloria Mazzali, Mauro Zamboni
There is a general lack of studies evaluating medication adherence with self-report scales for elderly patients in treatment with direct oral anticoagulants (DOACs). The aim of the study was to assess the degree of adherence to DOAC therapy in a population of elderly outpatients aged 65 years or older affected by non-valvular atrial fibrillation (NVAF), using the 4-item Morisky Medication Adherence Scale, and to identify potential factors, including the geriatric multidimensional evaluation, which can affect adherence in the study population...
May 14, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29759670/systemic-octreotide-therapy-in-prevention-of-gastrointestinal-bleeds-related-to-arteriovenous-malformations-and-obscure-etiology-in-atrial-fibrillation
#4
Venkat Vuddanda, Mohammad-Ali Jazayeri, Mohit K Turagam, Madhav Lavu, Valay Parikh, Donita Atkins, Sudharani Bommana, Madhu Reddy Yeruva, Luigi Di Biase, Jie Cheng, Vijay Swarup, Rakesh Gopinathannair, Mojtaba Olyaee, Vijay Ivaturi, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The present study describes the use of octreotide (OCT) in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) who have gastrointestinal (GI) bleeding related to arteriovenous malformations (AVMs), as well as its effect on OAC tolerance and subsequent rebleeding. BACKGROUND: AVMs cause significant GI bleeding, especially in patients with AF who are receiving OAC for stroke prevention. OCT has been shown to minimize recurrent GI bleeds related to AVMs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754808/long-term-event-reduction-after-left-atrial-appendage-closure-results-of-the-iberian-registry-ii
#5
José R López-Mínguez, Juan M Nogales-Asensio, Eduardo Infante De Oliveira, Vasco De Gama Ribeiro, Rafael Ruiz-Salmerón, Dabit Arzamendi-Aizpurua, Marco Costa, Hipólito Gutiérrez-García, José Antonio Fernández-Díaz, Victoria Martín-Yuste, Juan Carlos Rama-Merchán, Raúl Moreno-Gómez, Amparo Benedicto-Buendía, Andrés Íñiguez-Romo
INTRODUCTION AND OBJECTIVES: Many patients with nonvalvular atrial fibrillation are still left without protection due to a contraindication for anticoagulants. This study aimed to establish the occurrence of stroke and major bleeding events in patients with nonvalvular atrial fibrillation and left atrial appendage closure with long-term follow-up and to explore the factors associated with higher long-term mortality. METHODS: Analysis of a multicenter single cohort prospectively recruited from 2009 to 2015...
May 10, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29752398/device-related-thrombus-after-left-atrial-appendage-closure-incidence-predictors-and-outcomes
#6
Srinivas R Dukkipati, Saibal Kar, David R Holmes, Shephal K Doshi, Vijendra Swarup, Douglas N Gibson, Brijeshwar Maini, Nicole T Gordon, Michael L Main, Vivek Y Reddy
Background -In patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) with the Watchman device prevents thromboembolism from the LAA; however, thrombus may form on the left atrial face of the device, and then potentially embolize. Herein, we studied the incidence, predictors and clinical outcome of device-related thrombus (DRT) using a large series of clinical trial cohorts of patients undergoing Watchman implantation. Methods -We studied the device arms of 4 prospective FDA trials: PROTECT-AF (n=463); PREVAIL (n=269); CAP (n=566); CAP2 (n=578)...
May 11, 2018: Circulation
https://www.readbyqxmd.com/read/29748353/gastrointestinal-bleeding-with-edoxaban-versus-warfarin-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction
#7
James Aisenberg, Prapti Chatterjee-Murphy, Kathryn Friedman Flack, Jeffrey I Weitz, Christian T Ruff, Francesco Nordio, Michele F Mercuri, Youngsook Choi, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail. METHODS AND RESULTS: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29739915/cost-effectiveness-of-left-atrial-appendage-closure-with-the-watchman-device-compared-with-warfarin-or-non-vitamin-k-antagonist-oral-anticoagulants-for-secondary-prevention-in-nonvalvular-atrial-fibrillation
#8
Vivek Y Reddy, Ronald L Akehurst, Stacey L Amorosi, Meghan B Gavaghan, Deanna S Hertz, David R Holmes
BACKGROUND AND PURPOSE: Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non-vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29727507/optimal-combination-strategy-of-left-atrial-appendage-closure-plus-catheter-ablation-in-a-single-procedure-in-patients-with-nonvalvular-atrial-fibrillation
#9
Xianfeng Du, Huimin Chu, Bin He, Binhao Wang, Jing Liu, Mingjun Feng, Yibo Yu, Guohua Fu, He Jin, Fang Gao, Jingjing Zhu, Xiaomin Chen
BACKGROUND: The efficacy and safety of combining left atrial appendage closure (LAAC) plus atrial fibrillation (AF) catheter ablation (CA) in a single procedure has been established, but the optimal combination strategy has not been thoroughly elucidated to date. OBJECTIVE: We aimed to investigate the impact of different combination strategies on clinical outcomes. METHODS: Eighty-two consecutive patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
May 4, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29721111/risk-factors-and-prevention-of-dabigatran-related-gastrointestinal-bleeding-in-patients-with-atrial-fibrillation
#10
Teerapat Nantsupawat, Suthipong Soontrapa, Nopakoon Nantsupawat, David Sotello, Saranapoom Klomjit, Selcuk Adabag, Alejandro Perez-Verdia
Introduction: Dabigatran, as compared with warfarin, was associated with lower rates of stroke and systemic embolism with similar rates of major hemorrhage. But it has a significantly higher risk of gastrointestinal bleeding (GIB). There are limited data on how to prevent GIB from dabigatran and what are the risk factors. Methods: We performed a retrospective cohort study of patients with atrial fibrillation who have ever taken dabigatran for thromboprophylaxis from October 2010 to February 2013...
February 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29717155/survey-of-antithrombotic-treatment-in-rural-patients-60-years-with-atrial-fibrillation-in-east-china
#11
Yong Wei, Juan Xu, Haiqing Wu, Genqing Zhou, Songwen Chen, Caihong Wang, Yahong Shen, Shunhong Yang, Bin Wang, Zheng He, Jianping Sun, Weidong Sun, Ping Ouyang, Shaowen Liu
The prevalence and antithrombotic treatment of atrial fibrillation (AF) in Chinese rural population is not well known. The aim of this study was to investigate the extent to which antithrombotic treatment was prescribed for rural AF patients >60 years. We identified 828 AF patients from 36734 rural residents >60 years in Shanghai China. Our data indicated the overall prevalence rate of AF was 2.3% in rural population >60 years in East China and 38.9% of AF patients underwent antithrombotic therapy, including warfarin (5...
May 1, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29703518/the-safira-study-a-reflection-on-the-prevalence-and-treatment-patterns-of-atrial-fibrillation-and-cardiovascular-risk-factors-in-7500-elderly-subjects
#12
Pedro Monteiro
INTRODUCTION AND AIM: Atrial fibrillation (AF) is a common arrhythmia and an important risk factor for ischemic stroke. The current ESC guidelines state that all patients aged 65 and over should be regularly screened for AF. The SAFIRA study aimed to determine the prevalence, epidemiology and clinical and therapeutic characterization of AF in the Portuguese elderly population. METHODS: The study population (7500 subjects) were recruited from all Portuguese administrative regions...
April 24, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29694285/real-world-health-care-costs-based-on-medication-adherence-and-risk-of-stroke-and-bleeding-in-patients-treated-with-novel-anticoagulant-therapy
#13
Chinmay G Deshpande, Stephen Kogut, Cynthia Willey
BACKGROUND: With the lack of real-world evidence, the challenge for drug reimbursement policy decision makers is to understand medication adherence behavior among users of novel oral anticoagulants (NOACs) and its effect on overall cost savings. No study has examined and quantified the burden of cost in high-risk patients taking NOAC therapy. OBJECTIVE: To examine the association of cost with adherence, comorbidity, and risk of stroke and bleeding in patients taking NOACs (rivaroxaban and dabigatran)...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29663443/time-trends-in-antithrombotic-management-of-patients-with-atrial-fibrillation-treated-with-coronary-stents-results-from-talent-af-the-international-stent-atrial-fibrillation-study-multicenter-registry
#14
Brian J Potter, Giuseppe Andò, Giovanni Cimmino, Ricardo Ladeiras-Lopes, Zied Frikah, Xin Yue Chen, Vittorio Virga, Joao Goncalves-Almeida, A John Camm, Keith A A Fox
BACKGROUND: Antithrombotic management of patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI) is highly variable; limited evidence-based guidelines exist to influence practice. HYPOTHESIS: Patient characteristics and availability of novel drugs may have contributed to practice variability. METHODS: We undertook an international multicenter retrospective registry of AF patients treated with PCI. The primary measures of interest were antiplatelet and OAC prescriptions at discharge...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29657252/periprocedural-complications-in-patients-undergoing-catheter-ablation-of-atrial-fibrillation-without-discontinuation-of-a-vitamin-k-antagonist-and-direct-oral-anticoagulants
#15
Toshiya Kojima, Katsuhito Fujiu, Nobuaki Fukuma, Hiroshi Matsunaga, Tsukasa Oshima, Jun Matsuda, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Eriko Hasumi, Hiroyuki Morita, Issei Komuro
BACKGROUND: Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further define the efficacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors...
April 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29628941/early-outcome-after-intracranial-hemorrhage-related-to-non-vitamin-k-oral-anticoagulants
#16
Senta Frol, Janja Pretnar Oblak
Background: Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of non-vitamin K oral anticoagulant (NOAC) therapy. There are limited data on NOAC-related ICH prognosis. Methods: All consecutive patients admitted to a single center due to acute NOAC-related ICH from September 2012 until the beginning of 2017 were included. Risk factors, type of NOAC, and location of ICH were evaluated. Risk for ischemic and bleeding events and clinical status upon admission and at discharge were evaluated using standard scales...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29616523/short-term-outcome-of-cardiac-surgery-under-cardiopulmonary-bypass-in-patients-who-refuse-transfusion-a-controlled-study
#17
Antonio Reyes Garcia, Gema Vega González, Ricardo Andino Ruiz
BACKGROUND: Although bloodless cardiac surgery has been successfully performed for many years, studies with controls permitting transfusion are few and their results inconclusive. This study compares the outcome of cardiac surgery on Jehovah's Witnesses (JW) refusing transfusion, with that of controls permitting transfusion if required. METHODS: Data from 172 operations in 162 JW were compared with 172 matched controls. Risk factors, preoperative, operative, 48 hour postoperative variables, outcome data and transfusions were recorded...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29607737/dual-antiplatelet-therapy-after-percutaneous-left-atrial-appendage-occlusion-single-center-experience-with-the-amplatzer-cardiac-plug
#18
Philippe B Bertrand, Melanie Habran, Karlijn Kenis, Julie Lecomte, Linde Moonen, Didier Stroobants, Edouard Benit
BACKGROUND: Percutaneous left atrial appendage occlusion (LAAO) is an alternative to anticoagulation in atrial fibrillation patients at high bleeding risk. Dual antiplatelet therapy (DAPT) is generally recommended in the months following the procedure to prevent thrombotic complications. The aim of this study was to evaluate the safety and efficacy of DAPT after LAAO in a single-centre population of high bleeding risk patients. METHODS: All patients who received DAPT after LAAO using the Amplatzer Cardiac Plug at Jessa Hospital (Hasselt, BE) between February 2011 and October 2016 were included...
April 1, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29602206/impact-of-has-bled-score-to-predict-trans-femoral-transcatheter-aortic-valve-replacement-outcomes
#19
Yohsuke Honda, Masahiro Yamawaki, Motoharu Araki, Norio Tada, Toru Naganuma, Futoshi Yamanaka, Yusuke Watanabe, Masanori Yamamoto, Shinichi Shirai, Kentaro Hayashida
BACKGROUND: Predictors of bleeding and mortality after trans femoral transcatheter aortic valve replacement (TF-TAVR) has not been thoroughly investigated. OBJECTIVE: The aim of this study was to assess whether Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly (HAS-BLED) score has predictive value for bleeding and mortality in patients after TAVR. METHODS: Between October 2013 and April 2016, 969 patients underwent TF-TAVI were prospectively included in the OCEAN-TAVI registry from Japan...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29597211/associations-between-pre-admission-risk-scores-and-two-year-clinical-outcomes-in-ischemic-stroke-or-transient-ischemic-attack-patients-with-non-valvular-atrial-fibrillation
#20
Keisuke Tokunaga, Hiroshi Yamagami, Masatoshi Koga, Kenichi Todo, Kazumi Kimura, Ryo Itabashi, Tadashi Terasaki, Yoshiaki Shiokawa, Kenji Kamiyama, Shunya Takizawa, Satoshi Okuda, Yasushi Okada, Tomoaki Kameda, Yoshinari Nagakane, Yasuhiro Hasegawa, Satoshi Shibuya, Yasuhiro Ito, Hideki Matsuoka, Kazuhiro Takamatsu, Kazutoshi Nishiyama, Kazuomi Kario, Yoshiki Yagita, Takanari Kitazono, Naoto Kinoshita, Junji Takasugi, Takuya Okata, Sohei Yoshimura, Shoichiro Sato, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: We aimed to clarify associations between pre-admission risk scores (CHADS2, CHA2DS2-VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. METHODS: From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years...
March 29, 2018: Cerebrovascular Diseases
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