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https://www.readbyqxmd.com/read/28532651/suboptimal-anticoagulant-management-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-warfarin-for-stroke-prevention
#1
Teruyuki Hirano, Hirokazu Kaneko, Sari Mishina, Feng Wang, Satoshi Morita
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with increasing prevalence in Japan. Although prothrombin time-international normalized ratio (PT-INR) targets for monitoring warfarin therapy in patients with nonvalvular AF (NVAF) are well defined, real-world patient characteristics and PT-INR levels remain unknown among Japanese patients with NVAF who initiate and continue warfarin (warfarin maintainers) versus those who switch from warfarin to direct oral anticoagulants (DOACs; warfarin switchers)...
May 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28529736/use-of-dabigatran-vs-warfarin-with-low-molecular-weight-heparin-bridging-in-catheter-ablation-for-atrial-fibrillation-patients-with-a-low-chads2-score
#2
Li Hao, Bing Rong, Fei Xie, Ming-Jie Lin, Jing-Quan Zhong
The purpose of the present study was to compare the efficacy and safety of dabigatran and interrupted warfarin with low-molecular-weight heparin bridging in non-valvular atrial fibrillation (AF) catheter ablation. Previously, there has been concerns that bridging therapy increases bleeding events without the benefit of stroke prevention. It has been suggested that bridging therapy should be considered only for patients at high-risk of thrombosis. Nevertheless, bridging therapy in AF patients with a low CHADS2 score may be safe and effective...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28528288/cancer-atrial-fibrillation-and-stroke
#3
REVIEW
Tess Fitzpatrick, Marc Carrier, Grégoire Le Gal
Cancer patients appear to be at increased risk for atrial fibrillation. Although surgery and chemotherapy exacerbate this risk, this association is observed even in the absence of any cancer-specific treatment. The underlying mechanism of this is likely multifactorial, but systemic inflammation and autonomic dysregulation are hypothesized to play critical roles. Cancer and atrial fibrillation are both independent risk factors for ischemic stroke; however, it is not clear whether this translates to an increased risk of stroke in patients with both comorbidities...
May 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#4
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#5
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
May 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28506981/contemporary-trends-in-oral-anticoagulant-prescription-in-atrial-fibrillation-patients-at-low-to-moderate-risk-of-stroke-after-guideline-recommended-change-in-use-of-the-chads2-to-the-cha2ds2-vasc-score-for-thromboembolic-risk-assessment-analysis-from-the-national
#6
David F Katz, Thomas M Maddox, Mintu Turakhia, Anil Gehi, Emily C O'Brien, Steven A Lubitz, Alexander Turchin, Gheorghe Doros, Lanyu Lei, Paul Varosy, Lucas Marzec, Jonathan C Hsu
BACKGROUND: Use of the CHA2DS2-VASc score instead of the CHADS2 score for thromboembolic risk stratification and initiation of oral anticoagulation (OAC) was recommended in the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines. We sought to define the proportion of patients with AF qualifying for and receiving OAC in contemporary practice by applying the CHA2DS2-VASc score to patients with a low CHADS2 score. METHODS AND RESULTS: Among patients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's outpatient Practice Innovation and Clinical Excellence registry (2008-2014) CHADS2 score of 0 or 1, we calculated the impact of adoption of the CHA2DS2-VASc score on the proportion of patients with an indication for OAC...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28483209/the-population-based-long-term-impact-of-anticoagulant-and-antiplatelet-therapies-in-low-risk-patients-with-atrial-fibrillation
#7
Anjani Golive, Heidi T May, Tami L Bair, Victoria Jacobs, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller, T Jared Bunch
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data, the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoagulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1, or 2 were studied...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28468510/safety-and-efficacy-of-bridging-with-low-molecular-weight-heparin-during-temporary-interruptions-of-warfarin-a-register-based-cohort-study
#8
Vilhelm Sjögren, Bartosz Grzymala-Lubanski, Henrik Renlund, Peter J Svensson, Anders Själander
Low-molecular-weight heparin (LMWH) is often recommended as a bridging therapy during temporary interruptions in warfarin treatment, despite lack of evidence. The aim of this study was to see whether we could find benefit from LMWH bridging. We studied all planned interruptions of warfarin within the Swedish anticoagulation register Auricula during 2006 to 2011. Low-molecular-weight heparin bridging was compared to nonbridging (control) after propensity score matching. Complications were identified in national clinical registers for 30 days following warfarin cessation, and defined as all-cause mortality, bleeding (intracranial, gastrointestinal, or other), or thrombosis (ischemic stroke or systemic embolism, venous thromboembolism, or myocardial infarction) that was fatal or required hospital care...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28466118/who-should-be-referred-for-left-atrial-appendage-occlusion-therapy
#9
REVIEW
Sidakpal S Panaich, David R Holmes
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 7 million individuals in USA. It is one of the most significant arrhythmias, which accounts for a majority of embolic strokes, especially in elderly individuals. Although oral anti-coagulation is beneficial in lowering the risk of stroke, 1 in 10 patients have a contra-indication to warfarin therapy. Among patients who do tolerate either warfarin or novel oral anticoagulant (NOAC), major or recurrent bleeding, intracranial bleeds, etc...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28459661/predictors-of-direct-oral-anticoagulants-utilization-for-thromboembolism-prevention-in-atrial-fibrillation
#10
Caroline Brais, Josiane Larochelle, Marie-Hélène Turgeon, Lucie Blais, Paul Farand, Sylvie Perreault, Geneviève Letemplier, Marie-France Beauchesne
PURPOSE: Several factors have been associated with the prescription of direct oral anticoagulants (DOAC) over warfarin such as younger age, fewer concomitant medications, and lower CHADS2 or bleeding scores. The primary objective of this study was to identify predictors of DOAC choice compared with warfarin for patients who are starting a new oral anticoagulant (OAC) for atrial fibrillation (AF). The secondary objective was to describe the proportion of DOAC prescriptions in new users of OAC for AF...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28446621/ischemic-stroke-in-nonvalvular-atrial-fibrillation-at-warfarin-initiation-assessment-via-a-large-insurance-database
#11
Ping G Tepper, Xianchen Liu, Melissa Hamilton, Jack Mardekian, William Petkun, Wilson Tan, Daniel E Singer
BACKGROUND AND PURPOSE: Stroke risk may increase shortly after warfarin initiation in nonvalvular atrial fibrillation patients. Because of the brief period and limited number of events, large samples are needed to study this effect. We compared 30-day rates of ischemic stroke between nonvalvular atrial fibrillation patients initiating warfarin to nonwarfarin comparators using an insurance claims database. METHODS: We identified nonvalvular atrial fibrillation patients via 1 inpatient/2 outpatient diagnosis claims from the MarketScan database, January 1, 2009, to December 31, 2012...
April 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28442233/the-chads2-and-cha2ds2-vasc-scores-predict-atrial-fibrillation-in-dyslipidemic-individuals-role-of-incorporating-low-high-density-lipoprotein-cholesterol-levels
#12
Fotios Barkas, Moses Elisaf, Panagiotis Korantzopoulos, Stavroula Tsiara, Evangelos Liberopoulos
AIM: To investigate the value of CHADS2 and CHA2DS2-VASc scores in predicting atrial fibrillation (AF) among dyslipidemic individuals and assess the additional value of incorporating low levels of high-density lipoprotein cholesterol (HDL-C). METHODS: This observational study included 1241 individuals attending a lipid clinic. Models including clinical and laboratory parameters were constructed to test the predictive value of CHADS2 and CHA2DS2-VASc scores as well as low HDL-C levels for incident AF...
April 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28431065/cha2ds2-vasc-score-and-blood-biomarkers-to-identify-patients-with-atrial-high-rate-episodes-and-paroxysmal-atrial-fibrillation
#13
Paulina Wakula, Benjamin Neumann, Jens Kienemund, Eva Thon-Gutschi, Tatjana Stojakovic, Martin Manninger, Daniel Scherr, Hubert Scharnagl, Martin Kapl, Burkert Pieske, Frank R Heinzel
Aims: Paroxysmal atrial fibrillation (PAF) is often asymptomatic but nonetheless harmful. We evaluated the performance of disease-related blood biomarkers and CHA2DS2-VASc score to discriminate for PAF in patients with continuous rhythm monitoring. Methods and Results: Clinical data and blood samples were obtained from patients with dual-chamber pacemakers selected according to the absence (no_AHRE) or presence of Atrial High-Rate Episodes (AHRE) >6 min in recent device history (case-control approach)...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28427735/comparison-of-frequency-and-characteristics-of-patients-with-atrial-fibrillation-having-ablation-with-versus-without-coronary-narrowing-%C3%A2-50-by-angiography
#14
Toshiro Tomomatsu, Itsuro Morishima, Kenji Okumura, Hideyuki Tsuboi, Yasuhiro Morita, Kensuke Takagi, Ruka Yoshida, Hiroaki Nagai, Yoshihiro Ikai, Naoki Shibata, Kazuhito Tsuzuki, Takahito Sone, Toyoaki Murohara
Atrial fibrillation (AF) shares background comorbidities with coronary artery disease (CAD), including hypertension and diabetes mellitus. The aim of the study is to evaluate the prevalence, risk factors, and prognostic significance of CAD among patients who underwent catheter ablation for AF. In 544 consecutive registered patients who underwent catheter ablation for AF (CHADS2 score 1.2 ± 1.1, paroxysmal AF 57%), quantitative coronary angiography was used to detect CAD, defined as luminal narrowing of ≥50% in diameter...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#15
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416974/major-determinants-for-the-selecting-antithrombotic-therapies-in-patients-with-nonvalvular-atrial-fibrillation-in-japan-japaf-study
#16
Koichi Kusakawa, Kouji H Harada, Tatsuo Kagimura, Akio Koizumi
BACKGROUND: Oral anticoagulants (OACs) can help prevent stroke in patients with nonvalvular atrial fibrillation (NVAF). The aim of this study was to characterize the use of OACs other than direct thrombin inhibitors (DTIs) for NVAF. METHODS: Patients with NVAF taking antithrombotics other than DTIs were enrolled in this cross-sectional study. Patient demographics and medication history were collected, and the patients were classified as taking antiplatelet monotherapy (AP), anticoagulant monotherapy (AC), or combination therapy (AP+AC)...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28410424/trends-in-the-prevalence-and-management-of-pre-stroke-atrial-fibrillation-the-south-london-stroke-register-1995-2014
#17
Vageesh Jain, Iain J Marshall, Siobhan L Crichton, Christopher McKevitt, Anthony G Rudd, Charles D A Wolfe
BACKGROUND: Previous studies have found low use of anticoagulation prior to stroke, in people with atrial fibrillation (AF). This study examined data on patients with AF-related stroke from a population-based stroke register, and sought to examine changes in management of AF prior to stroke, and reasons for suboptimal treatment, in those who were known to be at a high risk of stroke. METHODS: The South London Stroke Register (SLSR) is an ongoing population-based register recording first-in-a-lifetime stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28402476/silent-atrial-fibrillation-in-pacemaker-early-post-implantation-period-an-unintentionally-provoked-situation
#18
Juan Benezet-Mazuecos, José Antonio Iglesias, Marcelino Cortés, José Manuel Rubio, Juan José de la Vieja, Ana Del Río, Pepa Sanchez-Borque, Ángel Miracle, Jerónimo Farré
Aims: Atrial high-rate episodes (AHREs) compatible with silent AF detected in pacemakers (PM) are related to an increased risk of stroke and silent ischaemic brain lesions (IBL) on CT scan. AHREs soon after PM implantation could be related with the procedure itself and the prognosis might be different. Methods and results: We analysed the incidence of AHREs >5 min and the presence of silent IBL in 110 patients (56% men, aged 75 ± 9 year-old) with PM and no history of AF, in relation to time from implantation (≤3 months vs...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28398381/-prevalence-of-atrial-fibrillation-treatment-eligibility-and-consumption-of-oral-anticoagulants-in-italian-local-health-authorities-impact-of-non-vitamin-k-antagonist-oral-anticoagulants
#19
Felicita Andreotti, Daniela D'Angela, R Letizia Mancusi, Federico Spandonaro
BACKGROUND: Atrial fibrillation (AF) increases significantly the risk of comorbidities and premature death. This paper aims to estimate: 1) the current prevalence of AF in Italy as a whole and within individual local health authorities (LHA); 2) the proportion of strongly eligible patients receiving oral anticoagulants; 3) the impact of non-vitamin K antagonist oral anticoagulants (NOACs). METHODS: The prevalence of AF and the proportion of patients strongly eligible for anticoagulant treatment (defined by a CHADS2 score ≥2) were obtained by applying the results of a systematic literature search to the Italian population stratified by gender, age and LHA...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28392100/risk-prediction-for-ischemic-stroke-and-transient-ischemic-attack-in-patients-without-atrial-fibrillation-a-retrospective-cohort-study
#20
Zhong Yuan, Erica A Voss, Frank J DeFalco, Guohua Pan, Patrick B Ryan, Daniel Yannicelli, Christopher Nessel
BACKGROUND: Stroke mainly occurs in patients without atrial fibrillation (AF). This study explored risk prediction models for ischemic stroke and transient ischemic attack (TIA) in patients without AF. METHODS: Three US-based healthcare databases (Truven MarketScan Commercial Claims and Encounters [CCAE], Medicare Supplemental [MDCR], and Optum Clinformatics [Optum]) were used to establish patient cohorts without AF during the index period of 2008-2012. The performance of 2 existing models (CHADS2 and CHA2DS2-VASc) for predicting stroke and TIA was examined by fitting a logistic regression to a training dataset and evaluating predictive accuracy in a validation dataset (area under the curve, AUC) using patients with complete follow-up of 1 or 3 years, separately...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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