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https://www.readbyqxmd.com/read/27909541/validation-of-the-has-bled-tool-in-atrial-fibrillation-patients-receiving-rivaroxaban
#1
Gorman Ew, Perkel D, Dennis D, Yates J, Heidel Re, Wortham D
Background: Atrial fibrillation (Afib) patients are at an increased risk of stroke. Patients at moderate to high risk of stroke typically receive antithrombotics, placing them at an increased risk of bleeding. The HAS-BLED tool has been validated in Afib patients receiving warfarin for prediction of major bleeding events. Although HAS-BLED has been researched in patients receiving warfarin, this tool has not been validated with the novel anticoagulant rivaroxaban. Methods: The trial design was retrospective case-control approved by the Institutional Review Board at University of Tennessee Medical Center...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909535/search-for-the-ideal-antithrombotic-drug-utopian-task-likely-is-implemented-already
#2
REVIEW
Petras Stirbys Md PhD
Atrial fibrillation is the most prevalent cardiac arrhythmia with a high risk of ischemic stroke. Thromboprophylaxis plays a key role in prevention of cardioembolic and non-cardioembolic events. Oral antithrombotic drugs are most often used to reduce hypercoagulable state. Patients may suffer from both under- and overtreatment compromising the outcomes. Medication peculiarities at large are well-known and widely debated. Non-adherence to antithrombotic drug regimen poses a significant risk of stroke. There is a pressing need for more detailed delineation of risk factors, namely by incorporation of the letter "N" (meaning "Non-adherence to drug therapy") into the well-known risk score alphanumeric display: CHA2DS2N-VASc...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27903938/post-noac-portuguese-observational-study-of-intracranial-hemorrhage-on-non-vitamin-k-antagonist-oral-anticoagulants
#3
Cláudia Marques-Matos, José Nuno Alves, João Pedro Marto, Joana Afonso Ribeiro, Ana Monteiro, José Araújo, Fernando Silva, Fátima Grenho, Miguel Viana-Baptista, João Sargento-Freitas, João Pinho, Elsa Azevedo
BACKGROUND: There is a lower reported incidence of intracranial hemorrhage with non-vitamin K antagonist oral anticoagulants compared with vitamin K antagonist. However, the functional outcome and mortality of intracranial hemorrhage patients were not assessed. AIMS: To compare the outcome of vitamin K antagonists- and non-vitamin K antagonist oral anticoagulants-related intracranial hemorrhage. METHODS: We included consecutive patients with acute non-traumatic intracranial hemorrhage on oral anticoagulation therapy admitted between January 2013 and June 2015 at four university hospitals...
November 30, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27893153/efficacy-and-safety-of-dabigatran-rivaroxaban-and-warfarin-for-stroke-prevention-in-chinese-patients-with-atrial-fibrillation-the-hong-kong-atrial-fibrillation-project
#4
Wen-Hua Li, Duo Huang, Chern-En Chiang, Chu-Pak Lau, Hung-Fat Tse, Esther W Chan, Ian C K Wong, Gregory Y H Lip, Pak-Hei Chan, Chung-Wah Siu
BACKGROUND: Little is known about the comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOAC) compared to warfarin in Chinese atrial fibrillation (AF) patients. Our aim was to compare the ischemic stroke risk reduction and incidence of intracranial hemorrhage (ICH) of warfarin in relation to quality of anticoagulation control (as reflected by time in therapeutic range [TTR]), and to dabigatran and rivaroxaban in a real-world cohort of Chinese AF patients...
November 28, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27888754/body-mass-index-is-an-independent-predictor-of-major-bleeding-in-non-valvular-atrial-fibrillation-patients-taking-dabigatran
#5
Chen-Hung Lee, Tzu-Yu Lin, Shang-Hung Chang, Chi-Hua Chen, Ying-Jen Hsu, Kuo-Chun Hung, Ming-Shien Wen
BACKGROUND/OBJECTIVES: Adverse bleeding events happened more frequently among individuals with, or at risk of, a low body mass index (BMI) than others. Despite increasing use of dabigatran in atrial fibrillation (AF) patients, the relationship between individual BMI and major bleeding events has not been clearly elucidated. METHODS: This study was an observational study of 842 patients who were enrolled and were followed up for a median of 20months to monitor the occurrence of the bleeding complications...
November 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884245/acute-kidney-injury-in-asians%C3%A2-with%C3%A2-atrial%C3%A2-fibrillation-treated%C3%A2-with%C3%A2-dabigatran%C3%A2-or-warfarin
#6
Yi-Hsin Chan, Yung-Hsin Yeh, Lai-Chu See, Chun-Li Wang, Shang-Hung Chang, Hsin-Fu Lee, Lung-Sheng Wu, Hui-Tzu Tu, Chi-Tai Kuo
BACKGROUND: Whether dabigatran is associated with a lower risk of acute kidney injury (AKI) in patients with nonvalvular atrial fibrillation (NVAF) remains unknown. OBJECTIVES: The authors compared the risk of AKI in Asians with NVAF who were prescribed dabigatran versus warfarin. METHODS: The authors analyzed patients enrolled in the Taiwan nationwide retrospective cohort study from June 1, 2012, to December 31, 2013. Dabigatran and warfarin were taken by 7,702 and 7,885 NVAF patients without a history of chronic kidney disease (CKD) and 2,256 and 2,089 NVAF patients with a history of CKD, respectively...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27867289/amplatzer-cardiac-plug-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-bigger-left-atrial-appendix-size
#7
Yoga Yuniadi, Dicky A Hanafy, Sunu B Raharjo, Ario Soeryo, IIf Yasmina, Amiliana M Soesanto
Left atrial appendage (LAA) dimensions have been shown as an independent predictor of higher risk for stroke in AF patients. Little data exist on the outcomes after LAA closure in patients with nonvalvular atrial fibrillation (NVAF) who have relatively bigger LAA size. This study aims to evaluate the results associated with LAA closure with the Amplatzer cardiac plug (ACP, AGA, St. Jude Medical, Minneapolis, MN) in bigger LAA size. A total of 25 patients with NVAF underwent LAA closure with the ACP device. All patients received short-term (up to 3 months) dual-antiplatelet therapy (clopidogrel and aspirin) after the procedure and aspirin only thereafter...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27860070/cha2-ds2-vasc-score-predicts-unsuccessful-electrical-cardioversion-in-patients-with-persistent-atrial-fibrillation
#8
Elzbieta Mlodawska, Anna Tomaszuk-Kazberuk, Paulina Lopatowska, Marcin Kaminski, Wlodzimierz Jerzy Musial
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia occurring in 2% of the population. It is known that AF increases morbidity and limited quality of life. The CHA2 DS2 VASc score is widely used to assess thrombotic complications. The CHA2 DS2 VAS score was not used till now in predicting effectiveness of electrical cardioversion. AIM: The aim of the study was to assess the value of CHA2 DS2 VASc score in predicting unsuccessful electrical cardioversion...
November 9, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27848065/impact-of-valvular-heart-disease-on-oral-anticoagulant-therapy-in-non-valvular-atrial-fibrillation-results-from-the-ramses-study
#9
Özcan Başaran, Volkan Dogan, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, Ismail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Mehmet Yaman, Sinan İnci, Bernas Altıntaş, Sedat Kalkan, Cevat Kırma, Murat Biteker
The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded...
November 15, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27842949/the-hat-score-a-simple-risk-stratification-score-for-coagulopathic-bleeding-during-adult-extracorporeal-membrane-oxygenation
#10
Terence Lonergan, Daniel Herr, Zachary Kon, Jay Menaker, Raymond Rector, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: The study objective was to create an adult extracorporeal membrane oxygenation (ECMO) coagulopathic bleeding risk score. DESIGN: Secondary analysis was performed on an existing retrospective cohort. Pre-ECMO variables were tested for association with coagulopathic bleeding, and those with the strongest association were included in a multivariable model. Using this model, a risk stratification score was created. The score's utility was validated by comparing bleeding and transfusion rates between score levels...
September 1, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27836133/impact-of-baseline-stroke-risk-and-bleeding-risk-on-warfarin-international-normalized-ratio-control-in-atrial-fibrillation-from-the-treat-af-study
#11
Jessica A Hellyer, Farnaz Azarbal, Claire T Than, Jun Fan, Susan K Schmitt, Felix Yang, Susan M Frayne, Ciaran S Phibbs, Celina Yong, Paul A Heidenreich, Mintu P Turakhia
Warfarin prevents stroke and prolongs survival in patients with atrial fibrillation and flutter (AF, collectively) but can cause hemorrhage. The time in international normalized ratio (INR) therapeutic range (TTR) mediates stroke reduction and bleeding risk. This study sought to determine the relation between baseline stroke, bleeding risk, and TTR. Using data from The Retrospective Evaluation and Assessment of Therapies in Atrial Fibrillation (TREAT-AF) retrospective cohort study, national Veterans Health Administration records were used to identify patients with newly diagnosed AF from 2003 to 2012 and subsequent initiation of warfarin...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27834042/effect-of-oral-anticoagulant-therapy-on-mortality-in-end-stage-renal-disease-patients-with-atrial-fibrillation-a-prospective-study
#12
Simonetta Genovesi, Paola Rebora, Maurizio Gallieni, Andrea Stella, Fabio Badiali, Ferruccio Conte, Sonia Pasquali, Silvio Bertoli, Patrizia Ondei, Giuseppe Bonforte, Claudio Pozzi, Emanuela Rossi, Maria Grazia Valsecchi, Antonio Santoro
BACKGROUND: The aim of this study was to evaluate, in a cohort of haemodialysis patients with atrial fibrillation (AF), the relationship between oral anticoagulant therapy (OAT) and mortality, thromboembolic events and haemorrhage. METHODS: Two hundred and ninety patients with AF were prospectively followed for 4 years. Warfarin and antiplatelet intake, age, dialytic age, comorbidities, CHA2DS2-VASc and HAS-BLED scores were considered as predictors of risk of death, thromboembolism and bleeding events...
November 11, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27824417/-anticoagulation-and-new-therapeutic-options-in-atrial-fibrillation
#13
Karl Mischke
Oral anticoagulation plays an essential role in the treatment of patients with atrial fibrillation as it is indicated for most patients to reduce the risk of stroke. It is prudent to assess the risks of stroke and bleeding using the CHA2DS2-VASc and HAS-BLED scores. Oral anticoagulation is indicated in general for all patients with valvular atrial fibrillation (atrial fibrillation in moderate to severe mitral stenosis or mechanical prosthetic valve) as well as for patients with a CHA2DS2-VASc-Score of 1 - 2 points or higher...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27823686/how-well-does-physician-risk-assessment-predict-stroke-and-bleeding-in-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-orbit-af
#14
Benjamin A Steinberg, Peter Shrader, Sunghee Kim, Laine Thomas, Gregg C Fonarow, Jack Ansell, Peter R Kowey, Daniel E Singer, Bernard J Gersh, Kenneth W Mahaffey, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Assessments of stroke and bleeding risks are essential to selecting oral anticoagulation in patients with atrial fibrillation (AF). We aimed to assess outcomes according to physician assessed risk, with comparison to empirical risk scores. METHODS: This was a prospective, observational study of 9,715 outpatients with AF enrolled in ORBIT-AF, a US national registry. Stroke and bleeding risks were quantified by physician assignment, CHADS2 and CHA2DS2-VASc stroke scores, and ATRIA and HAS-BLED bleeding scores...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27818480/rivaroxaban-for-periprocedural-anticoagulation-therapy-in-japanese-patients-undergoing-catheter-ablation-of-paroxysmal-non-valvular-atrial-fibrillation
#15
Mihoko Kawabata, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Yasuteru Yamauchi, Junichi Nitta, Masahiko Goya, Kenzo Hirao
Direct oral anticoagulants (DOACs) have been shown to be safe and effective for the prevention of stroke in nonvalvular atrial fibrillation (NVAF) patients, however, experience with peri-AF ablation management of DOACs is scarce. This study aimed to investigate the safety and feasibility of periprocedural anticoagulation therapy with rivaroxaban in Japanese patients undergoing paroxysmal non-valvular AF (NVAF) ablation using radiofrequency energy.This study was a multicenter, prospective pilot study. In paroxysmal NVAF patients, rivaroxaban (15 mg or 10 mg once-daily) was started at least 4 weeks prior to AF ablation, discontinued on the day of the procedure, resumed within 24 hours after ablation, and continued at least 3 months afterwards...
November 4, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27783556/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-in-incident-treatment-na%C3%A3-ve-nonvalvular-atrial-fibrillation
#16
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27775592/prokaryotic-expression-purification-and-immunogenicity-in-rabbits-of-the-small-antigen-of-hepatitis-delta-virus
#17
Vera L Tunitskaya, Olesja V Eliseeva, Vladimir T Valuev-Elliston, Daria A Tyurina, Natalia F Zakirova, Olga A Khomich, Martins Kalis, Oleg E Latyshev, Elizaveta S Starodubova, Olga N Ivanova, Sergey N Kochetkov, Maria G Isaguliants, Alexander V Ivanov
Hepatitis delta virus (HDV) is a viroid-like blood-borne human pathogen that accompanies hepatitis B virus infection in 5% patients. HDV has been studied for four decades; however, the knowledge on its life-cycle and pathogenesis is still sparse. The studies are hampered by the absence of the commercially-available HDV-specific antibodies. Here, we describe a set of reproducible methods for the expression in E. coli of His-tagged small antigen of HDV (S-HDAg), its purification, and production of polyclonal anti-S-HDAg antibodies in rabbits...
October 20, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27771008/cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation-at-high-risk-of-bleeding-and-normal-kidney-function
#18
Inmaculada Hernandez, Kenneth J Smith, Yuting Zhang
INTRODUCTION: The comparative cost-effectiveness of all oral anticoagulants approved up to date has not been evaluated from the US perspective. The objective of this study was to compare the cost-effectiveness of edoxaban 60mg, apixaban 5mg, dabigatran 150mg, dabigatran 110mg, rivaroxaban 20mg and warfarin in stroke prevention in atrial fibrillation patients at high-risk of bleeding (defined as HAS-BLED score≥3). MATERIALS AND METHODS: We constructed a Markov state-transition model to evaluate lifetime costs and quality-adjusted life years (QALYs) with each of the six treatments from the perspective of US third-party payers...
October 15, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27754141/os-27-05-frailty-assessment-in-older-atrial-fibrillation-patients
#19
Sun-Wook Kim, Sol-Ji Yoon, Jung-Yeon Choi, Min-Gu Kang, Kwang-Il Kim, Cheol-Ho Kim
OBJECTIVE: Atrial fibrillation is the common arrhythmia in the elderly, and the average age of atrial fibrillation patients is rising. Elderly patients with atrial fibrillation have high incidence of thromboembolic complication and increasing age is associated with stroke severity. Assessing CHADS-VASc score is pivotal to evaluate substantial morbidity and mortality, especially regarding the increased risk of stroke. In addition, considering bleeding risk with HAS-BLED score is important to balance the benefit against the risk of bleeding...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27749772/suboptimal-use-of-non-vitamin-k-antagonist-oral-anticoagulants-results-from-the-ramses-study
#20
Özcan Başaran, Volkan Dogan, Osman Beton, Mehmet Tekinalp, Ahmet Cağri Aykan, Ezgi Kalaycioğlu, Ismail Bolat, Onur Taşar, Özgen Şafak, Macit Kalcik, Mehmet Yaman, Sinan İnci, Bernas Altintaş, Sedat Kalkan, Cevat Kirma, Murat Biteker
This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines...
August 2016: Medicine (Baltimore)
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