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https://www.readbyqxmd.com/read/29772946/safety-and-effectiveness-of-apixaban-in-comparison-to-warfarin-in-patients-with-nonvalvular-atrial-fibrillation-a-propensity-matched-analysis-from-japanese-administrative-claims-data
#1
Shun Kohsaka, Jun Katada, Kumiko Saito, Yasuo Terayama
OBJECTIVE: To investigate the risk of bleeding events and stroke/systemic embolism (SE) among Japanese patients with nonvalvular atrial fibrillation (NVAF), focusing on the initial dosage of apixaban and patient age. METHODS: This retrospective cohort study used de-identified electronic health records-based claims data from 314 acute-care hospitals in Japan. NVAF patients newly initiated on warfarin or apixaban, with no prescription during the 180-day blanking period, were eligible...
May 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29748353/gastrointestinal-bleeding-with-edoxaban-versus-warfarin-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction
#2
James Aisenberg, Prapti Chatterjee-Murphy, Kathryn Friedman Flack, Jeffrey I Weitz, Christian T Ruff, Francesco Nordio, Michele F Mercuri, Youngsook Choi, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail. METHODS AND RESULTS: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29728202/case-based-discussion-regarding-challenges-in-patient-selection-and-procedural-planning-in-left-atrial-appendage-occlusion
#3
REVIEW
Sidakpal S Panaich, Thomas Munger, Paul Friedman, Charanjit S Rihal, David R Holmes
Atrial fibrillation (AF) accounts for most embolic strokes, especially in elderly individuals. Although anticoagulation is known to reduce the risk of embolic stroke, a significant proportion of patients have relative or absolute contraindications to anticoagulation. The left atrial appendage has been implicated as the major source of emboli in more than 90% of ischemic strokes in nonvalvular AF. Left atrial appendage occlusion offers an alternative for stroke prevention in patients with an elevated stroke risk (CHADS2 score ≥2 or CHA2 DS2 -VASc score ≥3) who have a rationale for avoiding long-term oral anticoagulation after a shared decision-making process...
May 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29723328/paroxysmal-atrial-fibrillation-in-females-understanding-gender-diferences
#4
Gabriel Odozynski, Alexander Romeno Janner Dal Forno, Andrei Lewandowski, Hélcio Garcia Nascimento, André d'Avila
BACKGROUND: The catheter ablation of atrial fibrillation (AF) is performed less frequently in women. In addition, there is divergent information in the literature regarding the effectiveness and safety for the ablative procedure to females. OBJECTIVES: The objective of this study was to compare the clinical characteristics and outcomes in men and women undergoing paroxysmal atrial fibrillation (PAF) ablation. METHODS: Cohort study of patients undergoing first-ever PAF catheter ablation procedure refractory to antiarrhythmic drugs...
May 3, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29707297/atrial-fibrillation-is-related-to-lower-incidence-of-deep-venous-thrombosis-in-patients-with-pulmonary-embolism
#5
Khalid Bin Waleed, Xumin Guan, Xintao Li, Yiheng Yang, Zhao Wang, Xiaomeng Yin, Zhengyan Wang, Jianghai Liu, Lianjun Gao, Dong Chang, Xianjie Xiao, Rongfeng Zhang, Gary Tse, Yunlong Xia
Background: Atrial fibrillation (AF) is an established risk factor of left atrial thrombosis and systemic embolism. Traditionally pulmonary embolism (PE) is a recognized complication of deep vein thrombosis (DVT). However, whether AF is responsible for right atrial thrombosis and leads to PE has not been examined. Methods: We retrospectively analyzed medical records of patients with confirmed diagnosis of PE with AF (study group) from 2002-2015. Patients with PE without AF, matched by age and sex, served as controls (control group)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29685573/usefulness-of-a-low-resting-heart-rate-to-predict-recurrence-of-atrial-fibrillation-after-catheter-ablation-in-people-%C3%A2-65-years-of-age
#6
Jintao Wu, Xianwei Fan, Haitao Yang, Lijie Yan, Xianjing Xu, Hongyan Duan, Shanling Wang, Yingjie Chu
A low resting heart rate (RHR) is associated with an increased risk of atrial fibrillation (AF), and this is common in older people. Whether a low RHR in older people can predict recurrence of AF after catheter ablation is unclear. A total of 329 consecutive patients ≥65 years of age with paroxysmal AF who underwent index circumferential pulmonary vein isolation were prospectively enrolled. A 10-second standard resting 12-lead electrocardiogram in sinus rhythm was recorded to measure the RR interval, P-wave duration, and PR interval...
March 29, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29678338/current-trends-in-anticoagulation-bridging-for-patients-with-chronic-atrial-fibrillation-on-warfarin-undergoing-endoscopy
#7
Jeremy A Slivnick, Raymond Y Yeow, Colin McMahon, David G Paje, Jacob E Kurlander, Geoff D Barnes
For warfarin-treated patients with atrial fibrillation (AF) at low thromboembolic risk, recent studies have shown harm associated with periprocedural bridging using low-molecular-weight heparin. Clinician surveys have indicated a preference toward excessive bridging, especially among noncardiologists; however, little is known about actual practice patterns in these patients. We performed a retrospective evaluation of bridging in the setting of gastrointestinal endoscopy. We identified 938 patients with AF on warfarin who underwent esophagogastroduodenoscopy or colonoscopy between 2012 and 2016 at a tertiary health center...
March 16, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29670341/usefulness-of-the-chads-2-and-r-2-chads-2-scores-for-prognostic-stratification-in-patients-with-coronary-artery-disease
#8
Yuerui Li, Juan Wang, Lyu Lv, Cui Xu, Hongbin Liu
Objective: The current risk model for long-term prediction in coronary artery disease (CAD) is complicated, while a simple useful model is still lacking. We aim to investigate if CHADS2 and R2 CHADS2 scores could predict long-term outcome for patients with CAD. Patients and methods: We enrolled 3,700 patients with CAD between November 2010 and September 2014 at the Department of Cardiology from Chinese PLA General Hospital. The CHADS2 and R2 CHADS2 scores were calculated...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29667016/inflammation-and-the-risk-of-atrial-high-rate-episodes-ahres-in-patients-with-cardiac-implantable-electronic-devices
#9
Daniele Pastori, Kazuo Miyazawa, Yanguang Li, Farhan Shahid, Hussein Hado, Gregory Y H Lip
INTRODUCTION: Atrial high-rate episodes (AHREs) are associated with an increased risk of developing atrial fibrillation and thromboembolism. The characteristics of 'real world' patients developing AHREs are poorly known. METHODS: We included 496 consecutive patients with cardiac implantable electronic devices (CIEDs). Primary endpoint was occurrence of AHREs, defined as > 175 bpm and lasting > 5 min, in a median follow-up of 16.5 (IQR 3.9-38.6) months (1082...
April 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29663443/time-trends-in-antithrombotic-management-of-patients-with-atrial-fibrillation-treated-with-coronary-stents-results-from-talent-af-the-international-stent-atrial-fibrillation-study-multicenter-registry
#10
Brian J Potter, Giuseppe Andò, Giovanni Cimmino, Ricardo Ladeiras-Lopes, Zied Frikah, Xin Yue Chen, Vittorio Virga, Joao Goncalves-Almeida, A John Camm, Keith A A Fox
BACKGROUND: Antithrombotic management of patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI) is highly variable; limited evidence-based guidelines exist to influence practice. HYPOTHESIS: Patient characteristics and availability of novel drugs may have contributed to practice variability. METHODS: We undertook an international multicenter retrospective registry of AF patients treated with PCI. The primary measures of interest were antiplatelet and OAC prescriptions at discharge...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29661349/clinical-characteristics-and-efficacy-of-radiofrequency-catheter-ablation-in-the-treatment-of-elderly-patients-with-atrial-fibrillation
#11
Xin-Yong Zhang, Rong-Hui Yu, Jian-Zheng Dong
OBJECTIVE: This study aims to investigate the clinical characteristics and therapeutic effect of radiofrequency catheter ablation (RFCA) in elderly patients with atrial fibrillation (AF). MATERIALS AND METHODS: This retrospective study included 668 patients with AF who underwent RFCA in our hospital from June 2010 to June 2015. Patients were divided into 2 groups according to age: group E (≥60 years old, n = 308) and group N (<60 years old, n = 360). Ablation endpoints included the following 3 points: (1) all preset ablation lines were completed; (2) all pulmonary veins were electrically isolated; and (3) negative evoked results were achieved...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29657252/periprocedural-complications-in-patients-undergoing-catheter-ablation-of-atrial-fibrillation-without-discontinuation-of-a-vitamin-k-antagonist-and-direct-oral-anticoagulants
#12
Toshiya Kojima, Katsuhito Fujiu, Nobuaki Fukuma, Hiroshi Matsunaga, Tsukasa Oshima, Jun Matsuda, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Eriko Hasumi, Hiroyuki Morita, Issei Komuro
BACKGROUND: Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further define the efficacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors...
April 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29650382/therapeutic-decisions-in-atrial-fibrillation-for-stroke-prevention-the-role-of-aversion-to-ambiguity-and-physicians-risk-preferences
#13
Luciano A Sposato, Devin Stirling, Gustavo Saposnik
BACKGROUND: Knowledge-to-action gaps influence therapeutic decisions in atrial fibrillation (AF). Physician-related factors are common, but the least studied. We evaluated the prevalence and determinants of physician-related factors and knowledge-to-action gaps among physicians involved in the management of AF patients. DESIGN: In this cross-sectional study, participants from 6 South American countries recruited during an educational program answered questions regarding 16 case scenarios of patients with AF and completed experiments assessing 3 outcome measures: therapeutic inertia, herding, and errors in risk stratification knowledge translated into action (ERSKTA) based on commonly used stratification tools (Congestive heart failure, Hypertension, Age ≥75 years (double), Diabetes mellitus, previous Stroke/transient ischemic attack/thromboembolism (double), Vascular disease, Age 65-74 years, and female gender (score of 0 for males and 1 for female) (CHA2 DS2 -VASc) and Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and previous Stroke/transient ischemic attack (double) (CHADS2 ))...
April 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29649277/estimated-prevalence-of-undiagnosed-atrial-fibrillation-in-the-united-states
#14
Mintu P Turakhia, Jason Shafrin, Katalin Bognar, Jeffrey Trocio, Younos Abdulsattar, Daniel Wiederkehr, Dana P Goldman
INTRODUCTION: As atrial fibrillation (AF) is often asymptomatic, it may remain undiagnosed until or even after development of complications, such as stroke. Consequently the observed prevalence of AF may underestimate total disease burden. METHODS: To estimate the prevalence of undiagnosed AF in the United States, we performed a retrospective cohort modeling study in working age (18-64) and elderly (≥65) people using commercial and Medicare administrative claims databases...
2018: PloS One
https://www.readbyqxmd.com/read/29597211/associations-between-pre-admission-risk-scores-and-two-year-clinical-outcomes-in-ischemic-stroke-or-transient-ischemic-attack-patients-with-non-valvular-atrial-fibrillation
#15
Keisuke Tokunaga, Hiroshi Yamagami, Masatoshi Koga, Kenichi Todo, Kazumi Kimura, Ryo Itabashi, Tadashi Terasaki, Yoshiaki Shiokawa, Kenji Kamiyama, Shunya Takizawa, Satoshi Okuda, Yasushi Okada, Tomoaki Kameda, Yoshinari Nagakane, Yasuhiro Hasegawa, Satoshi Shibuya, Yasuhiro Ito, Hideki Matsuoka, Kazuhiro Takamatsu, Kazutoshi Nishiyama, Kazuomi Kario, Yoshiki Yagita, Takanari Kitazono, Naoto Kinoshita, Junji Takasugi, Takuya Okata, Sohei Yoshimura, Shoichiro Sato, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: We aimed to clarify associations between pre-admission risk scores (CHADS2, CHA2DS2-VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. METHODS: From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years...
March 29, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29580119/a-nationwide-cohort-study-of-the-role-of-chads-2-score-in-predicting-lower-extremity-amputation-and-death-among-patients-with-peripheral-arterial-occlusive-disease
#16
Wei-Syun Hu, Cheng-Li Lin
OBJECTIVES: The current study aimed to explore whether the CHADS2 score was predictive of lower extremity amputation (LEA) and death in people with peripheral arterial occlusive disease (PAOD). METHODS: This nationwide cohort came from Taiwan, with 16,888 PAOD patients, from 2000 through 2011, extracted from the Longitudinal Health Insurance Database 2000. Cox proportional hazard regression models were employed to identify the LEA and mortality risk according to CHADS2 score...
March 26, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/29578954/health-care-costs-and-utilization-of-dabigatran-compared-with-warfarin-for-secondary-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-a-retrospective-population-study
#17
Nai-Fang Chi, Ye Wang, Li-Nien Chien, Shu-Chen Chien, Yu Ko
BACKGROUND: It remains unclear whether the use of new oral anticoagulants, compared with warfarin, is economically beneficial in Asian countries. OBJECTIVE: The objective of this study is to compare the health care costs and utilization between dabigatran and warfarin in a real-world nonvalvular atrial fibrillation (NVAF) population. RESEARCH DESIGN: Data were obtained from the Taiwan National Health Insurance Database, and patients with an NVAF diagnosis between June 1, 2012, and May 31, 2014, were identified using the International Classification of Diseases, Ninth Revision code of 427...
March 23, 2018: Medical Care
https://www.readbyqxmd.com/read/29572083/atrial-fibrillation-and-prediction-of-mortality-by-conventional-clinical-score-systems-according-to-the-setting-of-care
#18
Igor Diemberger, Elisa Fantecchi, Maria Letizia Bacchi Reggiani, Cristian Martignani, Andrea Angeletti, Giulia Massaro, Matteo Ziacchi, Mauro Biffi, Gregory Y H Lip, Giuseppe Boriani
BACKGROUND: Atrial fibrillation (AF) is associated with high morbidity and mortality, also among anticoagulated patients. Our aim was to evaluate the predictive role for long-term mortality of a series of risk stratification scores associated with cardiovascular or thromboembolic outcomes (CHADS2 , CHA2 DS2 -VASc, ATRIA, TIMI-AF), and bleeding complications (HAS-BLED) in an unselected population of patients with AF. METHODS: Single center, observational, prospective registry of consecutive patients with AF, undergoing clinical/echocardiographic evaluation in a University Hospital, as either in-patients or out-patients...
March 14, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29571030/prediction-of-new-onset-atrial-fibrillation-after-first-ever-ischemic-stroke-a-comparison-of-chads-2-cha-2-ds-2-vasc-and-hatch-scores-and-the-added-value-of-stroke-severity
#19
Cheng-Yang Hsieh, Cheng-Han Lee, Darren Philbert Wu, Sheng-Feng Sung
BACKGROUND AND AIMS: Early detection of atrial fibrillation after stroke is important for secondary prevention in stroke patients without known atrial fibrillation (AF). We aimed to compare the performance of CHADS2 , CHA2 DS2 -VASc and HATCH scores in predicting AF detected after stroke (AFDAS) and to test whether adding stroke severity to the risk scores improves predictive performance. METHODS: Adult patients with first ischemic stroke event but without a prior history of AF were retrieved from a nationwide population-based database...
March 15, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29528778/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#20
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
April 2018: Therapeutic Advances in Cardiovascular Disease
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