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U Aasa, S Lundell, M Barnekow-Bergkvist, E Jansson, M Westerståhl
The main aim of the Swedish physical activity and fitness cohort study (SPAF-1958) was to describe physical fitness, physical activity, health, and lifestyle across part of the lifespan, and to assess the influences on these factors from the environment, personal factors, and genetics. There is inevitable dropout from longitudinal studies, and it may be systematic. The aim of this first paper of the second follow-up of SPAF-1958 was to provide a dropout analysis to consider to what extent the participants, at 52 years of age, remain a representative sample of the original adolescent study population...
March 1, 2016: Scandinavian Journal of Medicine & Science in Sports
Judith Hecker, Sandra Marten, Loretta Keller, Sindy Helmert, Franziska Michalski, Sebastian Werth, Kurtulus Sahin, Luise Tittl, Jan Beyer-Westendorf
The effectiveness and safety of rivaroxaban for stroke prevention in atrial fibrillation (SPAF) demonstrated in ROCKET AF needs to be confirmed in daily care. To evaluate effectiveness and safety of rivaroxaban therapy in SPAF patients in daily care, we used data from an ongoing, prospective, non-interventional registry of more than 2700 patients on novel oral anticoagulants in daily care. Between October 1, 2011 and February 28, 2013, a total of 1204 SPAF patients receiving rivaroxaban were enrolled. During a mean follow-up of 796...
May 2, 2016: Thrombosis and Haemostasis
Jamshed Dalal, Abhay Bhave, Abraham Oomman, Amit Vora, Anil Saxena, Dhiman Kahali, Fali Poncha, D S Gambhir, Jaydip Ray Chaudhuri, Nakul Sinha, Saumitra Ray, S S Iyengar, Suvro Banerjee, Upendra Kaul
The last ten years have seen rapid strides in the evolution of nonvitamin K oral anticoagulants (NOACs) for stroke prevention in patients with atrial fibrillation (AF). For the preparation of this consensus, a comprehensive literature search was performed and data on available trials, subpopulation analyses, and case reports were analyzed. This Indian consensus document intends to provide guidance on selecting the right NOAC for the right patients by formulating expert opinions based on the available trials and Asian/Indian subpopulation analyses of these trials...
December 2015: Indian Heart Journal
S I Lee, M Sayers, G Y H Lip, D A Lane
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are broadly preferable to vitamin K antagonists (VKAs) for stroke prevention in non-valvular atrial fibrillation (AF) given their overall net clinical benefit. We report an audit of the profile of OAC usage and adverse events in patients attending a specialist AF clinic. METHODS: Patients attending our specialist AF clinic who were commenced on NOACs for SPAF between January 2013 and August 2014 were included and electronic medical records were retrospectively reviewed between August 2014 and November 2014, to collect demographic, clinical and outcome data...
November 2015: International Journal of Clinical Practice
Jan Beyer-Westendorf, Franziska Ebertz, Kait Förster, Vera Gelbricht, Franziska Michalski, Christina Köhler, Sebastian Werth, Heike Endig, Sven Pannach, Luise Tittl, Kurtulus Sahin, Katharina Daschkow, Norbert Weiss
The effectiveness and safety of dabigatran for stroke prevention in atrial fibrillation (SPAF) demonstrated in RE-LY needs to be confirmed in daily care. To evaluate treatment persistence, effectiveness and safety of dabigatran therapy in SPAF patients in daily care, we used data from an ongoing, prospective, non-interventional registry of more than 2,500 patients on novel oral anticoagulants in daily care. Between October 1, 2011 and February 28, 2013, a total of 341 SPAF patients receiving dabigatran were enrolled...
June 2015: Thrombosis and Haemostasis
Fd Richard Hobbs, Clare J Taylor, Geert Jan Geersing, Frans H Rutten, Judith R Brouwer
BACKGROUND: Atrial fibrillation affects 1-2% of the general population and 10% of those over 75, and is responsible for around a quarter of all strokes. These strokes are largely preventable by the use of anticoagulation therapy, although many eligible patients are not treated. Recent large clinical trials have added to the evidence base on stroke prevention and international clinical guidelines have been updated. DESIGN: Consensus practical recommendations from primary care physicians with an interest in vascular disease and vascular specialists...
March 2016: European Journal of Preventive Cardiology
Jan Beyer-Westendorf, Kati Förster, Franziska Ebertz, Vera Gelbricht, Thomas Schreier, Maria Göbelt, Franziska Michalski, Heike Endig, Kurtulus Sahin, Luise Tittl, Norbert Weiss
AIMS: Worldwide, rivaroxaban is increasingly used for stroke prevention in atrial fibrillation (SPAF) but little is known about the rates of or reasons for rivaroxaban discontinuations in daily care. Using data from a prospective, non-interventional oral anticoagulation (NOAC) registry, we analysed rivaroxaban treatment persistence. METHODS AND RESULTS: Persistence with rivaroxaban in SPAF was assessed in an ongoing, prospective, non-interventional registry of >2600 NOAC patients from daily care using the Kaplan-Meier time-to-first-event analysis...
April 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Siriporn Jarungsuccess, Satadon Taerakun
PURPOSE: The genetic polymorphism was one of the major considerations for adjusting doses of warfarin in Thai individuals. As a result, new oral anticoagulants (NOACs) were introduced to achieve therapeutic goals in stroke prevention in atrial fibrillation (SPAF) patients. However, a cost-utility analysis in a population-specific model was lacking in Thailand. This study was performed to determine which NOACs yielded population-specific, cost-effective results for SPAF compared with warfarin from both governmental and societal perspectives in Thailand...
October 1, 2014: Clinical Therapeutics
Kumaresan Ramdas, Vijay Kumar Peddinti, Peter Cariani
The question of how harmonic sounds produce strong, low pitches at their fundamental frequencies, F0s, has been of theoretical and practical interest to scientists and engineers for many decades. Currently the best auditory models for F0 pitch, [e.g., Meddis and Hewitt, J. Acoust. Soc. Am. 89(6), 2866-2894 (1991)] are based on bandpass filtering (cochlear mechanics), half-wave rectification and low-pass filtering (haircell transduction and synaptic transmission), channel autocorrelations (all-order interspike interval statistics) aggregated into a summary autocorrelation, and an analysis that determines the most prevalent interspike intervals...
April 2014: Journal of the Acoustical Society of America
Brendan L Limone, William L Baker, Elizabeth S Mearns, C Michael White, Jeffrey Kluger, Craig I Coleman
OBJECTIVES: Decision makers use models to assist in evaluating the cost-effectiveness of pharmacologic stroke prevention in atrial fibrillation (SPAF). STUDY DESIGN AND SETTING: We performed a search of databases through October 3, 2012 to identify pharmacologic SPAF cost-effectiveness models. RESULTS: Of 30 identified models, 28 included warfarin, but only 60% assessed the impact of warfarin control on conclusions. Aspirin, dual antiplatelet, and newer anticoagulants were included in 41%, 10%, and 63% of models, respectively...
October 2014: Journal of Clinical Epidemiology
Amit Vora
Atrial fibrillation (AF) affects millions worldwide. Stroke is the most devastating complication of AF and is associated with a huge disease burden. As a preventive measure, anticoagulant therapy is recommended for most AF patients based on presence of stroke risk factors. For the past six decades warfarin remained the gold standard for stroke prevention in AF (SPAF). However, it is associated with numerous limitations such as a high risk of drug-drug, drug-food interactions and need for frequent INR (2-3) monitoring...
December 2013: Journal of the Association of Physicians of India
Jan Beyer-Westendorf, Kati Förster, Sven Pannach, Franziska Ebertz, Vera Gelbricht, Christoph Thieme, Franziska Michalski, Christina Köhler, Sebastian Werth, Kurtulus Sahin, Luise Tittl, Ulrike Hänsel, Norbert Weiss
Worldwide, rivaroxaban is increasingly used for stroke prevention in atrial fibrillation and treatment of venous thromboembolism, but little is known about rivaroxaban-related bleeding complications in daily care. Using data from a prospective, noninterventional oral anticoagulation registry of daily care patients (Dresden NOAC registry), we analyzed rates, management, and outcome of rivaroxaban-related bleeding. Between October 1, 2011, and December 31, 2013, 1776 rivaroxaban patients were enrolled. So far, 762 patients (42...
August 7, 2014: Blood
Alissia Valentinis, Noah Ivers, Sacha Bhatia, Nazanin Meshkat, Kori Leblanc, Andrew Ha, Dante Morra
OBJECTIVE: To determine the proportion of patients with atrial fibrillation (AF) in primary care achieving guideline-concordant stroke prevention treatment based on both the previous (2010) and the updated (2012) Canadian guideline recommendations. DESIGN: Retrospective chart review. PARTICIPANTS: Primary care patients (N = 204) with AF. The mean age was 71.3 years and 53.4% were women. SETTING: Large urban community family practice in Toronto, Ont...
March 2014: Canadian Family Physician Médecin de Famille Canadien
Mauro Molteni, Claudio Cimminiello
Vitamin K Antagonists (VKAs) are widely used in clinical practice and nearly 1% of the entire population receives oral anticoagulation at least once in life. However, the rate of prescription of anticoagulation is low, compared to what it should be. No more than 50-60% of patients affected by atrial fibrillation (AF) receive anticoagulation. In the setting of AF, VKAs are safe and effective when properly managed, reducing stroke and systemic embolism by more than 60%. VKAs safety and effectiveness are closely related to the quality of anticoagulation (e...
2014: Thrombosis Journal
Hongmou Zhao, Xiaojun Liang, Guangrong Yu, Yi Li, Jun Lu, Dongsheng Zhang
OBJECTIVE: To investigate the effectiveness and biomechanical analysis of 3 fixation methods of screw anterior-posterior fixation (SAPF), screw posterior-anterior fixation (SPAF), and buttress plate fixation (BPF) in treatment of posterior Pilon fractures. METHODS: Fifteen fresh-frozen skeleto-ligamentous lower leg specimens were harvested to establish the models of posterior Pilon fracture, and then fracture was fixed with BPF (n = 5), SAPF (n = 5), and SPAF (n = 5)...
October 2013: Chinese Journal of Reparative and Reconstructive Surgery
S Lahaye, S Regpala, S Lacombe, M Sharma, S Gibbens, D Ball, K Francis
Patient's values and preferences regarding the relative importance of preventing strokes and avoiding bleeding are now recognised to be of great importance in deciding on therapy for the prevention of stroke due to atrial fibrillation (SPAF). We used an iPad questionnaire to determine the minimal clinically important difference (Treatment Threshold) and the maximum number of major bleeding events that a patient would be willing to endure in order to prevent one stroke (Bleeding Ratio) for the initiation of antithrombotic therapy in 172 hospital in-patients with documented non-valvular atrial fibrillation in whom anticoagulant therapy was being considered...
March 3, 2014: Thrombosis and Haemostasis
Christopher A Aakre, Christopher J McLeod, Stephen S Cha, Teresa S M Tsang, Gregory Y H Lip, Bernard J Gersh
BACKGROUND AND PURPOSE: Several accepted algorithms exist to characterize the risk of thromboembolism in atrial fibrillation. We performed a comparative analysis to assess the predictive value of 9 such schemes. METHODS: In a longitudinal community-based cohort study from Olmsted County, Minnesota, 2720 residents with atrial fibrillation were followed up for 4.4±3.6 years±SD from 1990 to 2004. Risk factors were identified using a diagnostic index integrated with the electronic medical record...
February 2014: Stroke; a Journal of Cerebral Circulation
Tawkiful Alam, Christopher A Clyne, C Michael White
Stroke prevention in atrial fibrillation (SPAF) has traditionally been confined to aspirin and warfarin therapy. Based on CHADS2 scoring it was clearly delineated when aspirin and warfarin would be used in individual patients, but many patients had to forgo recommended therapy due to contraindications or adverse events. There has recently been a paradigm shift in SPAF, with new and promising options on the horizon. These emerging strategies include dual antiplatelet therapy, direct thrombin inhibition, factor Xa inhibition and mechanical prophylaxis therapy...
May 2012: Journal of Comparative Effectiveness Research
Motomi Tachibana, Naoki Mukouhara, Ryouichi Hirami, Hideki Fujio, Akihisa Yumoto, Yutaka Watanuki, Aiko Hayashi, Isao Suminoe, Hiroshi Koudani
Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line...
2013: Acta Medica Okayama
Andreas Clemens, Mandy Fraessdorf, Jeffrey Friedman
BACKGROUND: Dabigatran 150 mg twice daily was shown to be superior to warfarin in preventing stroke in subjects with nonvalvular atrial fibrillation (SPAF) in the RE-LY (Randomized Evaluation of Long-term anticoagulation therapY) trial. Numerically, more myocardial infarctions occurred in patients receiving dabigatran compared with well-controlled warfarin. This observation prompted a comprehensive analysis of cardiovascular outcomes, including myocardial infarction, in all completed Phase II and III trials of dabigatran etexilate...
2013: Vascular Health and Risk Management
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