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https://www.readbyqxmd.com/read/27903938/post-noac-portuguese-observational-study-of-intracranial-hemorrhage-on-non-vitamin-k-antagonist-oral-anticoagulants
#1
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/27888754/body-mass-index-is-an-independent-predictor-of-major-bleeding-in-non-valvular-atrial-fibrillation-patients-taking-dabigatran
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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/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
#14
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
#15
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
#16
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)
https://www.readbyqxmd.com/read/27723665/real-life-multicenter-survey-evaluating-stroke-prevention-strategies-in-non-valvular-atrial-fibrillation-ramses-study
#17
Özcan Başaran, Osman Beton, Volkan Doğan, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, İsmail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Mehmet Yaman, İbrahim Altun, Mustafa Özcan Soylu, Cevat Kırma, Murat Biteker
OBJECTIVE: Data regarding stroke prevention strategies in non-valvular atrial fibrillation (NVAF) are limited to vitamin K antagonists (VKAs). This study aimed to evaluate real-life stroke prevention strategies for NVAF patients in the era of non-VKA oral anticoagulants (NOACs). METHODS: We established a cross-sectional, multicenter, nationwide registry of NVAF patients. All consecutive atrial fibrillation (AF) patients and without mechanical heart valves or rheumatic mitral stenosis (but including those with any degree of mitral regurgitation) were enrolled in the ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies (RAMSES Study; ClinicalTrials...
October 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27718518/has-bled-predicts-warfarin-control-in-australian-patients-treated-for-deep-vein-thrombosis
#18
Kylie Mueller, Nijole Bernaitis, Tony Badrick, Shailendra Anoopkumar-Dukie
The HAS-BLED model is widely utilised to assess patients' bleed risk prior to anticoagulant therapy including warfarin. Some of the variables assessed in the model are also known to influence warfarin control, commonly measured by time in therapeutic range (TTR). The aim of the study was to determine if the HAS-BLED risk tool is a good predictor of bleed risk and warfarin control in deep vein thrombosis (DVT) patients. Retrospective data were collected for DVT warfarin care patients at Sullivan Nicolaides Pathology...
October 8, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27716554/efficacy-and-safety-of-novel-anticoagulants-versus-vitamin-k-antagonists-in-patients-with-mild-and-moderate-to-severe-renal-insufficiency-focus-on-apixaban
#19
REVIEW
Francesco Pelliccia, Salvatore Rosanio, Giuseppe Marazzi, Sara Poggi, Alessandra Tanzilli, Cesare Greco, Carlo Gaudio, Giuseppe Rosano
The high risk of both stroke and major bleeding in atrial fibrillation (AF) patients with chronic kidney disease (CKD) defines an important population for whom the assessment of the balance between the risk of ischemic stroke and of bleeding is essential. The use of novel oral anticoagulants (NOACs) may be a viable option in this population due to their greater net clinical benefit than warfarin, as demonstrated by the results of the clinical phase III trials. NOACs have been found to have a greater net clinical benefit than warfarin in patients at high risk of either stroke (CHADS2≥1 or CHA2DS2-VASc score≥2) or bleeding (HAS-BLED≥3)...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27651124/percutaneous-left-atrial-appendage-occlusion-using-different-technologies-in-the-united-kingdom-a-multicenter-registry
#20
Timothy R Betts, Milena Leo, Sandeep Panikker, Prapa Kanagaratnam, Michael Koa-Wing, David Wyn Davies, David Hildick-Smith, Dylan G Wynne, Oliver Ormerod, Oliver R Segal, Anthony W Chow, Derick Todd, Sandra Cabrera Gomez, Graeme J Kirkwood, David Fox, Chris Pepper, John Foran, Tom Wong
OBJECTIVES: This study aimed at assessing the feasibility and long-term efficacy of left atrial appendage occlusion (LAAO) in a "real world" setting. BACKGROUND: Although LAAO has recently emerged as an alternative to oral anticoagulants in patients with atrial fibrillation for the prevention of thromboembolic stroke, "real world" data about the procedure with different devices are lacking. METHODS: Eight centers in the United Kingdom contributed to a retrospective registry for LAAO procedures undertaken between July 2009 and November 2014...
September 21, 2016: Catheterization and Cardiovascular Interventions
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