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https://www.readbyqxmd.com/read/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#1
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28906578/ultra-early-hematoma-growth-in-antithrombotic-pretreated-patients-with-intracerebral-hemorrhage
#2
Jaume Roquer, Rosa María Vivanco-Hidalgo, Jaume Capellades, Angel Ois, Elisa Cuadrado-Godia, Eva Giralt-Steinhauer, Carolina Soriano-Tárraga, Marina Mola-Caminal, Maria Serra-Martínez, Carla Avellaneda-Gómez, Jordi Jiménez-Conde, Ana Rodríguez-Campello
BACKGROUND: Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. We analyzed the effect of antiplatelet (AP) and vitamin-K antagonist (VKA) pretreatment on ultra-early hematoma growth (uHG), and its relationship with mortality in patients with acute supratentorial ICH. METHODS: This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken less than 6 hours from ICH symptoms onset...
September 14, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28883793/a-multilevel-analysis-of-real-world-variations-in-oral-anticoagulation-initiation-for-atrial-fibrillation-in-valencia-a-european-region
#3
Aníbal García-Sempere, Daniel Bejarano-Quisoboni, Julián Librero, Clara L Rodríguez-Bernal, Salvador Peiró, Gabriel Sanfélix-Gimeno
Introduction: Beyond clinical trials, clinical practice guidelines, and administrative regulation, treatment decision-making can be influenced by individual and contextual factors. Our goal was to describe variations in the patterns of initiation of anticoagulation therapy in patients with atrial fibrillation by Health Areas (HA) in the region of Valencia in Spain and to quantify the influence of the HAs on variations in treatment choice. Methods: We conducted a population-based retrospective cohort study of all atrial fibrillation patients who started treatment with oral anticoagulants between November 2011 and February 2014 in each of the region's 24 HAs...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28882323/left-atrial-appendage-closure-for-prevention-of-death-stroke-and-bleeding-in-patients-with-nonvalvular-atrial-fibrillation
#4
Steffen Gloekler, Jacqueline Saw, Konstantinos C Koskinas, Caroline Kleinecke, Werner Jung, Fabian Nietlispach, Bernhard Meier
Nonvalvular atrial fibrillation (AF) is the most frequent arrhythmia with a prevalence of 1%-2% in the general population. Its prevalence increases with age and its diagnosis benefits of improvement and simplification of technologies for its detection. Today, AF affects approximately 7% of individuals age>65years and 15%-20% of octogenarians. Due to stasis and activation of coagulation in a fibrillating atrium, patients are at increased risk of thromboembolism, in particular ischemic stroke, with an overall stroke risk of 5% per year...
August 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28867534/-vitamin-k-antagonist-induced-necrotic-leg-ulcer-without-protein-c-and-s-deficiencies
#5
F Kurihara, E Tella, M-L Sigal, E Mahé
INTRODUCTION: Patients treated by vitamin K antagonists (VKA) represent 1% of the population in France. We report a case of atypical necrotic leg ulcers induced by VKA. CASE REPORT: A 84-year-old woman was referred to our dermatology department because of necrotic leg ulcers that developed for the past 5weeks, and appeared spontaneously after the introduction of a VKA, fluindione. The etiological assessment was non contributive, in particular the search for thrombophilic factors...
August 31, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28867369/-oral-anticoagulation-in-atrial-fibrillation-what-is-the-guideline-for-using-new-drugs
#6
J A Ibáñez Pérez de Viñaspre, J Gómez Bitrian, R Royo Hernández, M de Azúa Jiménez, C Marco López, L Urieta González
OBJECTIVE: To assess whether there are differences between atrial fibrillation (AF) patients initiating new direct-acting oral anticoagulants (DOAC) therapy and vitamin K antagonist (VKA) therapy in an emergency service. METHODS: Descriptive, observational, prospective study. We enrolled patients with AF who were visited in a hospital emergency service over one year. RESULTS: This study included 492 patients with AF, and 189 subjects received anticoagulant therapy, 104 with VKA (55%), and 85 with DOAC (45%)...
August 31, 2017: Semergen
https://www.readbyqxmd.com/read/28846806/apixaban-rivaroxaban-and-dabigatran-use-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-using-the-second-generation-cryoballoon
#7
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. HYPOTHESIS: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. METHODS: In 200 consecutive patients (mean age, 64...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28838044/natural-history-of-subclinical-leaflet-thrombosis-affecting-motion-in-bioprosthetic-aortic-valves
#8
Lars Sondergaard, Ole De Backer, Klaus F Kofoed, Hasan Jilaihawi, Andreas Fuchs, Tarun Chakravarty, Mohammad Kashif, Yoshio Kazuno, Hiroyuki Kawamori, Yoshio Maeno, Gintautas Bieliauskas, Hongfei Guo, Gregg W Stone, Raj Makkar
Aims: Four-dimensional volume-rendered computed tomography (4DCT) has demonstrated instances of hypo-attenuating leaflet thickening (HALT) with or without hypo-attenuation affecting motion (HAM) after transcatheter and surgical aortic valve implantation (TAVI, SAVR). The temporal pattern of evolution of these phenomena is uncertain. Methods and results: The SAVORY registry enrolled patients treated by TAVI (n = 75) or SAVR (n = 30) with two 4DCT scans fully interpretable for HALT and HAM as well as unchanged anti-thrombotic medication between the scans...
July 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28836865/the-cost-effectiveness-and-monetary-benefits-of-dabigatran-in-the-prevention-of-arterial-thromboembolism-for-patients-with-non-valvular-atrial-fibrillation-in-the-netherlands
#9
Marinus van Hulst, Jelena Stevanovic, Maartje S Jacobs, Robert G Tieleman, Bregt Kappelhoff, Maarten J Postma
BACKGROUND: Atrial fibrillation (AF) causes a significant health and economic burden to the Dutch society. Dabigatran was proven to have at least similar efficacy and a similar or better safety profile when compared to vitamin K antagonists (VKAs) in preventing arterial thromboembolism in patients with AF. OBJECTIVE: To evaluate the cost-effectiveness and monetary benefit of dabigatran vs VKAs in Dutch patients with non-valvular AF. Value-based pricing considerations and corresponding negotiations on dabigatran will be explicitly considered...
September 7, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28827248/risks-of-postextraction-bleeding-after-receiving-direct-oral-anticoagulants-or-warfarin-a-retrospective-cohort-study
#10
Takahiro Yagyuu, Mao Kawakami, Yoshihiro Ueyama, Mitsuhiko Imada, Miyako Kurihara, Yumiko Matsusue, Yuichiro Imai, Kazuhiko Yamamoto, Tadaaki Kirita
OBJECTIVE: The effect of direct oral anticoagulants (DOACs) on the risk of bleeding after tooth extraction remains unclear. This study aimed to evaluate the incidence of postextraction bleeding among patients who received DOAC and vitamin K antagonists (VKAs), such as warfarin. DESIGN: This study was a retrospective cohort analysis. Incidence rates and propensity score-matched regression models were used to compare the risks of bleeding after tooth extractions involving DOACs and VKAs...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28816341/clinical-impact-of-major-bleeding-in-patients-with-venous-thromboembolism-treated-with-factor-xa-inhibitors-or-vitamin-k-antagonists-an-individual-patient-data-meta-analysis
#11
Suzanne M Bleker, Marjolein P A Brekelmans, Elise S Eerenberg, Alexander T Cohen, Saskia Middeldorp, Gary Raskob, Harry R Büller
Factor Xa (fXa)-inhibitors are as effective and safer than vitamin-K-antagonists (VKA) in the treatment of venous thromboembolism (VTE). We previously classified the severity of clinical presentation and course of all major bleeding events from the EINSTEIN, AMPLIFY and HOKUSAI-VTE trials separately. The current aim was to combine these findings in order to increase precision, assess a class effect and analyse presentation and course for different types of bleeding, i. e. intracranial, gastro-intestinal, and other...
August 17, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28815410/efficacy-and-safety-of-a-4-factor-prothrombin-complex-concentrate-for-rapid-vitamin-k-antagonist-reversal-in-japanese-patients-presenting-with-major-bleeding-or-requiring-urgent-surgical-or-invasive-procedures-a-prospective-open-label-single-arm-phase-3b-study
#12
Shigeki Kushimoto, Toshio Fukuoka, Akio Kimura, Kazunori Toyoda, Andres Brainsky, Amy Harman, Thomas Chung, Masahiro Yasaka
Rapid vitamin K antagonist (VKA) reversal is required in patients experiencing major bleeding or requiring urgent surgery. Four-factor prothrombin complex concentrate (4F-PCC; Beriplex(®)/Kcentra(®)) was shown in two large randomized controlled, international phase 3b trials to be an effective alternative to plasma for urgent VKA reversal. In the present prospective, open-label, single-arm phase 3b trial, we evaluate the efficacy and safety of 4F-PCC in Japanese patients. Eleven patients [international normalized ratio (INR) ≥2] requiring rapid VKA reversal owing to major bleeding (n = 6) or before urgent surgical/invasive procedures (n = 5) were administered 4F-PCC dosed based on INR and weight...
August 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28814457/direct-oral-anticoagulant-vs-vitamin-k-antagonist-related-nontraumatic-intracerebral-hemorrhage
#13
REVIEW
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis Varelas, Aristeidis H Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W Alexandrov, Panayiotis Mitsias, Andrei V Alexandrov
OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH...
September 12, 2017: Neurology
https://www.readbyqxmd.com/read/28811092/direct-oral-anticoagulants-in-patients-with-hypertrophic-cardiomyopathy-and-atrial-fibrillation
#14
Fernando Dominguez, Vicente Climent, Esther Zorio, Tomás Ripoll-Vera, Joel Salazar-Mendiguchía, Jose Manuel García-Pinilla, Jose Angel Urbano-Moral, Xusto Fernández-Fernández, David Lopez-Cuenca, Raquel Ajo-Ferrer, Jorge Sanz-Sanchez, Yolanda Gomez-Perez, Miguel A López-Garrido, Roberto Barriales-Villa, Juan Ramón Gimeno, Pablo Garcia-Pavia
BACKGROUND: Chronic anticoagulation with vitamin K antagonists (VKAs) is recommended in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF). Direct oral anticoagulants (NOACs) are an alternative to VKAs but there are limited data to support their use in HCM. We sought to describe the pattern of use, thromboembolic events, bleeding and quality of life in patients with HCM and AF treated with NOACs. METHODS: Data from patients treated with NOACs (n=99) and VKA (n=433) at 9 inherited cardiac diseases units were retrospectively collected...
August 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischaemic-stroke-and-non-valvular-atrial-fibrillation
#15
Y Sakamoto, S Okubo, C Nito, S Suda, N Matsumoto, A Abe, J Aoki, T Shimoyama, Y Takayama, K Suzuki, M Mishina, K Kimura
BACKGROUND AND PURPOSE: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischaemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has the potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aim of the present study was to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28792914/reply-pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#16
Petros Ioannou
In their recent work published in the Romanian Journal of Internal Medicine, Balahura et al. reviewed the cases of pulmonary embolism (PE) diagnosed in an emergency hospital in Bucharest during a 3 year period from January 2014 to December 2016 [1]. Among their observations was that novel oral anticoagulants (NOACs) were administered in 26.3% of patients diagnosed with PE, while vitamin K antagonists (VKA) were administered in 71.7% of them [1]. The authors state that their study was performed at a time when NOACs were just becoming available in the hospitals of Romania, and they imply that more patients with PE could be treated nowadays with NOACs...
August 5, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28780697/persistence-with-vka-treatment-in-newly-treated-atrial-fibrillation-patients-an-analysis-based-on-a-large-sample-of-38-076-german-patients
#17
Thomas Wilke, Antje Groth, Andreas Fuchs, Matthias Pfannkuche, Ulf Maywald
PURPOSE: The aim of this study was to describe persistence with vitamin K antagonist (VKA) treatment in German atrial fibrillation (AF) patients and to identify factors which may be associated with early discontinuation of VKA therapy. METHODS: We did a retrospective cohort study based on an anonymized German claims dataset with VKA treatment-naïve AF patients, who received at least one VKA prescription. VKA therapy discontinuation was defined as a gap >180 days...
August 5, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28780343/the-role-of-heparin-lead-in-in-the-real-world-management-of-acute-venous-thromboembolism-the-prefer-in-vte-registry
#18
Rupert Bauersachs, Giancarlo Agnelli, Anselm K Gitt, Manuel Monreal, Patrick Mismetti, Stefan N Willich, Petra Laeis, Eva-Maria Fronk, Peter Bramlage, Alexander T Cohen
INTRODUCTION: The appropriate strategy for initiating oral anticoagulant (OAC) therapy after an acute venous thromboembolism (VTE) depends on the intermediate-term anticoagulant to be used. While heparin bridging to vitamin K antagonists (VKA) is required, the direct oral anticoagulants (DOAC) rivaroxaban (30mg/day) and apixaban (10mg/day) can be initiated directly without parenteral anticoagulation. The objective was to evaluate OAC initiation patterns in clinical practice. MATERIALS AND METHODS: PREFER in VTE was an international, non-interventional registry conducted between January 2013 and August 2015...
July 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28762665/external-validation-of-the-dash-prediction-rule-a-retrospective-cohort-study
#19
A Tosetto, S Testa, I Martinelli, D Poli, B Cosmi, C Lodigiani, W Ageno, V De Stefano, A Falanga, I Nichele, O Paoletti, P Bucciarelli, E Antonucci, C Legnani, E Banfi, F Dentali, F Bartolomei, L Barcella, G Palareti
Essentials Predicting recurrences may guide therapy after unprovoked venous thromboembolism (VTE). We evaluated the DASH score in 827 patients with unprovoked VTE to verify prediction accuracy. A DASH score ≤ 1 had a cumulative recurrence risk at 1 year of 3.6%, as predicted by the model. The DASH score performed better in younger (< 65 years old) subjects. SUMMARY: Background The DASH prediction model has been proposed as a guide to identify patients at low risk of recurrence of venous thromboembolism (VTE), but has never been validated in an independent cohort...
August 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28756016/pharmacological-stroke-prevention-in-the-elderly-with-atrial-fibrillation-in-poland-results-of-polsenior-study
#20
Beata Łabuz-Roszak, Michał Skrzypek, Agnieszka Machowska-Majchrzak, Małgorzata Mossakowska, Jerzy Chudek, Andrzej Więcek, Krystyna Pierzchała, Beata Łącka-Gaździk, Tomasz Grodzicki
INTRODUCTION: Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland. OBJECTIVES: The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors...
July 11, 2017: Neurologia i Neurochirurgia Polska
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