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https://www.readbyqxmd.com/read/28209388/increased-risk-of-thromboembolic-events-in-adult-congenital-heart-disease-patients-with-atrial-tachyarrhythmias
#1
Keita Masuda, Tomoko Ishizu, Koichiro Niwa, Fumie Takechi, Shigeru Tateno, Hitoshi Horigome, Kazutaka Aonuma
BACKGROUND: Atrial tachyarrhythmias are a major morbidity in patients with adult congenital heart disease (ACHD). However, few studies have investigated risk stratification of thromboembolic events in ACHD patients with atrial tachyarrhythmias. METHODS AND RESULTS: This retrospective cohort study reviewed the clinical records of 2314 ACHD patients from 1977 to 2014. We found 242 (10.4%) patients with atrial tachyarrhythmias and excluded 84 patients already being treated with anticoagulant therapy...
February 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#2
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28161883/chads2-cha2ds2-vasc-and-r2chads2-scores-predict-mortality-in-patients-with-coronary-artery-disease
#3
Fang-Yang Huang, Bao-Tao Huang, Xiao-Bo Pu, Yong Yang, Shi-Jian Chen, Tian-Li Xia, Yi-Yue Gui, Yong Peng, Rui-Shuang Liu, Yuanweixiang Ou, Fei Chen, Ye Zhu, Mao Chen
Few studies to date address the predictive ability of CHA2DS2-VASc and R2CHADS2 in CAD patients. Our aim is to investigate the prognostic performance of CHADS2, CHA2DS2-VASc and R2CHADS2 scores in patients with coronary artery disease (CAD). Angiographically obstructive CAD patients were enrolled. The prognostic performance of the three risk scores was evaluated using Cox hazards models. In addition, we compared their predictive values by calculating C statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI)...
February 4, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28135822/impact-of-warfarin-persistence-on-health-care-utilization-and-costs-among-patients-with-atrial-fibrillation-managed-in-anticoagulation-clinics-in-the-united-states
#4
Steven B Deitelzweig, Michael Evans, Jeffrey Trocio, Kiran Gupta, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
Warfarin is a recommended therapy to reduce the risk of stroke in patients with nonvalvular atrial fibrillation (NVAF). The objectives of this study were to identify potential factors associated with warfarin persistence and evaluate the impact of warfarin persistence on health-care resource utilization and costs among patients with NVAF in the United States. Patients (≥18 years) with ≥1 inpatient or ≥2 outpatient diagnoses of AF without valvular disease were identified from an electronic medical record database (January 1, 2004, to January 31, 2015)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28128883/early-canadian-multi-center-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#5
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There is limited data with WATCHMAN for left atrial appendage (LAA) closure in patients with non-valvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at 4 major Canadian centers. Indications for LAA closure were CHADS2 ≥ 1 or CHA2 DS2 -VASc ≥ 2, and contraindication/intolerance to or failure on anticoagulation...
January 27, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28106147/prediction-of-very-late-arrhythmia-recurrence-after-radiofrequency-catheter-ablation-of-atrial-fibrillation-the-mb-later-clinical-score
#6
Nebojša Mujović, Milan Marinković, Nebojša Marković, Alena Shantsila, Gregory Y H Lip, Tatjana S Potpara
Reliable prediction of very late recurrence of atrial fibrillation (VLRAF) occuring >12 months after catheter ablation (CA) in apparently "cured" patients could optimize long-term follow-up and modify decision-making regarding the discontinuation of oral anticoagulant therapy. In a single-centre cohort of consecutive patients post radiofrequency AFCA, we retrospectively derived a novel score for VLRAF prediction. Of 133 consecutive post AFCA patients (mean age 56.9 ± 11.8 years, 63.9% male, 69.2% with paroxysmal AF) who were arrhythmia-free at 12 months (excluding 3-month "blanking period"), 20 patients expirienced a VLRAF during a 29...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28103532/timing-of-anticoagulant-re-initiation-following-intracerebral-hemorrhage-in-mechanical-heart-valves-survey-of-neurosurgeons-and-thrombosis-experts
#7
Fahad AlKherayf, Yan Xu, Harrison Westwick, Ioana Doina Moldovan, Philip S Wells
BACKGROUND: While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. METHODS: A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis...
January 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28096204/atrial-fibrillation-diagnosis-timing-ambulatory-ecg-monitoring-utilization-and-risk-of-recurrent-stroke
#8
Gregory Y H Lip, Tina D Hunter, Maria E Quiroz, Paul D Ziegler, Mintu P Turakhia
BACKGROUND: The risk of recurrence after an initial ischemic stroke or transient ischemic attack (TIA) may be impacted by undiagnosed atrial fibrillation (AF). We therefore assessed the impact of AF diagnosis and timing on stroke/TIA recurrence rates in a large real-world sample of patients. METHODS AND RESULTS: Using commercial claims data (Truven Health Analytics MarketScan), we performed a retrospective cohort study of patients with an index stroke or TIA event recorded in years 2008 through 2011...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28091833/the-gap-between-indicated-and-prescribed-stroke-prevention-therapies-in-a-high-risk-geriatric-population
#9
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28068791/the-utilization-of-antithrombotic-therapy-in-older-patients-in-aged-care-facilities-with-atrial-fibrillation
#10
Bridget Frain, Ronald Castelino, Luke R Bereznicki
Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28064291/anticoagulation-use-and-predictors-of-stroke-bleeding-and-mortality-in-multi-ethnic-asian-patients-with-atrial-fibrillation-a-single-centre-experience
#11
P L Chia, X Teoh, C M Hua, M E Ching, D Foo
INTRODUCTION: Atrial fibrillation (AF) is the most common cardiac arrhythmia in singapore. We describe a cohort of multi-ethnic Asian patients with AF, with the aim to evaluate anticoagulation use and to identify factors predictive of stroke, bleeding and all-cause mortality. MATERIALS AND METHODS: this was a single centre, retrospective cohort study. All patients with an admission diagnosis of AF between 1 January 2000 and 31 December 2010 were identified. Of these patients, those who had follow-up data up to 31 December 2012 were included in the study...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28057218/usefulness-of-the-chads2-score-for-prognostic-stratification-in-patients-with-coronary-artery-disease-having-coronary-artery-bypass-grafting
#12
Dai-Yin Lu, Chin-Chou Huang, Po-Hsun Huang, Jaw-Wen Chen, Tzeng-Ji Chen, Shing-Jong Lin, Wan-Leong Chan, Chiu-Yang Lee, Hsin-Bang Leu
Current risk model for long-term survival prediction in isolated coronary artery bypass graft surgery is complicated, whereas a simple useful model is still lacking. We aim to investigate if CHADS2 score could predict long-term outcome for patients after coronary artery bypass graft surgery. From 2000 to 2007, we identified a study cohort consisting of patients who underwent coronary bypass surgery in the Taiwan National Health Insurance Research Database. After operation, all cases were followed to track the incidence of major adverse cardiovascular events and overall mortality...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#13
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28041702/can-we-predict-new-af-occurrence-in-single-chamber-icd-patients-insights-from-an-observational-investigation
#14
Mauro Biffi, Matteo Ziacchi, Renato Pietro Ricci, Domenico Facchin, Giovanni Morani, Maurizio Landolina, Maurizio Lunati, Saverio Iacopino, Alessandro Capucci, Stefano Bianchi, Tommaso Infusino, Giovanni Luca Botto, Luigi Padeletti, Giuseppe Boriani
BACKGROUND: Atrial tachyarrhythmias (AT/AF) have been associated with an increased risk of mortality, morbidity and ischemic stroke. Up to now, single chamber ICD diagnostics was not able to detect AT/AF, therefore the incidence of new onset AT/AF in patients with single chamber ICD is not known. OBJECTIVE: To evaluate incidence and predictors of AT/AF occurrence in patients with dual-chamber ICD with no pacing indications and no history of AT/AF that strictly mimic single chamber ICD recipient...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039854/continued-use-of-warfarin-in-veterans-with-atrial-fibrillation-after-dementia-diagnosis
#15
Ariela R Orkaby, Al Ozonoff, Joel I Reisman, Donald R Miller, Shibei Zhao, Adam J Rose
OBJECTIVES: To determine the effectiveness of warfarin in older adults with dementia. DESIGN: Retrospective cohort study. SETTING: Department of Veterans Affairs national healthcare system. PARTICIPANTS: Veterans aged 65 and older (73% aged ≥75, 99% male, 91% white) who had been receiving warfarin for nonvalvular atrial fibrillation for at least 6 months, were newly diagnosed with dementia in fiscal year 2007 or 2008, and were not enrolled in Medicare Advantage (n = 2,572)...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28027833/usefulness-of-a-healthcare-database-for-epidemiological-research-in-atrial-fibrillation
#16
Yukihiro Koretsune, Takeshi Yamashita, Masahiro Yasaka, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: Big data are gaining attention as a valuable resource for providing insights into a range of issues and questions in healthcare. We evaluated the capacity of a Japanese healthcare database to conduct epidemiological research in non-valvular atrial fibrillation (NVAF). METHODS AND RESULTS: We examined data collected between April 2008 and September 2013 in a Japanese healthcare database. Prior to the risk factor analysis, we validated the criteria for defining the occurrence of a stroke, systemic embolic event (SEE), and intracranial bleeding event during the study period...
December 24, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28008771/stroke-risk-reduction-outweighed-bleeding-risk-increase-from-vitamin-k-antagonist-treatment-among-nonvalvular-atrial-fibrillation-patients-with-high-stroke-risk-and-low-bleeding-risk
#17
Winnie W Nelson, François Laliberté, Aarti A Patel, Guillaume Germain, Dominic Pilon, Nora McCormick, Patrick Lefebvre
OBJECTIVE: Warfarin is widely used for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). We compared the rates of stroke and major bleeding in NVAF patients with a high stroke risk and low bleeding risk profile during warfarin treated (W+) and warfarin untreated (W-) periods. METHOD: Insurance claims from six commercial, Medicaid or Medicare databases were analyzed from 2000 to 2014. NVAF patients treated with warfarin, with a CHADS2/CHA2DS2-VASc score ≥2, and an ATRIA score ≤3 at baseline were identified...
January 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27943538/catheter-ablation-for-atrial-fibrillation-in-patients-with-watchman-left-atrial-appendage-occlusion-device-results-from-a-multicenter-registry
#18
Mohit K Turagam, Madhav Lavu, Muhammad R Afzal, Venkat Vuddanda, Mohammad-Ali Jazayeri, Valay Parikh, Donita Atkins, Sudharani Bommana, Luigi DI Biase, Rodney Horton, Rong Bai, Vijay Swarup, Jie Cheng, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: There have been an increasing number of atrial fibrillation (AF) patients with Watchman left atrial appendage occlusion (LAAO) device, requiring catheter ablation (CA) for maintenance of normal sinus rhythm. In this study, we describe our experience with the feasibility and safety of CA in patients with a preexisting Watchman LAAO device. METHODS: This was a retrospective multicenter AF registry of 60 patients with Watchman LAAO device who underwent CA for AF...
February 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27933666/risk-of-stroke-and-recurrence-after-af-ablation-in-patients-with-an-initial-event-free-period-of-12-months
#19
Simon Kochhäuser, Pouria Alipour, Tanjah Haig-Carter, Kathleen Trought, Philip Hache, Yaariv Khaykin, Zaev Wulffhart, Alfredo Pantano, Bernice Tsang, David Birnie, Atul Verma
INTRODUCTION: Because of the unclear prognostic effects of ablation of atrial fibrillation (AF), oral anticoagulation (OAC) is often continued after ablation even in asymptomatic patients. We sought to determine the frequency of stroke and AF recurrence in patients on and off therapeutic OAC one year after a successful AF ablation. METHODS AND RESULTS: Patients that underwent AF ablation and were free of AF 12 months after ablation were selected from our AF database...
December 9, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#20
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
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