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https://www.readbyqxmd.com/read/29903520/a-meta-analysis-of-randomized-controlled-trials-of-uninterrupted-periprocedural-anticoagulation-strategy-in-patients-undergoing-atrial-fibrillation-catheter-ablation
#1
Yating Zhao, Yao Lu, Yue Qin
BACKGROUND: In patients undergoing atrial fibrillation (AF) ablation, despite uninterrupted oral anticoagulants (OACs) have been recommended, no consensus has emerged regarding to whether uninterrupted novel oral anticoagulants (NOACs) are superior to uninterrupted vitamin K antagonists (VKAs) for the periprocedural antithrombotic management. This meta-analysis aimed to compare the efficacy and safety of uninterrupted NOACs and uninterrupted VKAs in patients undergoing AF ablation. METHODS: Databases were searched for articles published up to March 20, 2018...
June 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29898848/oral-anti-xa-anticoagulation-after-trans-aortic-valve-implantation-for-aortic-stenosis-the-randomized-atlantis-trial
#2
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29897439/prevalence-of-left-atrial-appendage-thrombus-detected-by-transoesophageal-echocardiography-before-catheter-ablation-of-atrial-fibrillation-in-patients-anticoagulated-with-non-vitamin-k-antagonist-oral-anticoagulants
#3
Wael Alqarawi, David H Birnie, Stewart Spence, F Daniel Ramirez, Calum J Redpath, Robert Lemery, Girish M Nair, Pablo B Nery, Darryl R Davis, Martin S Green, Luc Beauchesne, Kwan Chan, Kathryn Ascah, Ian Burwash, Mouhannad M Sadek
Aims: There is ongoing controversy about the need for routine transoesophageal echocardiography (TOE) prior to atrial fibrillation (AF) ablation. Recently, the debate was reignited by the publication of a large series of patients showing a prevalence of left atrial appendage thrombus (LAAT) on TOE of 4.4%. We sought to assess the prevalence of LAAT on TOE before AF ablation at our institution. Methods and results: Consecutive patients scheduled for AF ablation at our institution between January 2009 and December 2016 were included...
June 11, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29888274/difference-between-the-upper-and-the-lower-gastrointestinal-bleeding-in-patients-taking-nonvitamin-k-oral-anticoagulants
#4
Kyohei Maruyama, Takatsugu Yamamoto, Hitoshi Aoyagi, Akari Isono, Koichiro Abe, Shinya Kodashima, Hiroto Kita, Yuji Watari, Ken Kozuma
Nonvitamin K oral anticoagulants (NOACs) sometimes cause hemorrhage, and the gastrointestinal tract is a common site of involvement. However, clinical characteristics of gastrointestinal bleeding (GIB) during NOAC therapy have not been fully elucidated. We studied 658 patients who were prescribed dabigatran, rivaroxaban, or apixaban between April 2011 and November 2015. Medical charts were reviewed to examine whether clinically relevant bleeding (Bleeding Academic Research Consortium criteria type 2 or greater) developed...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29885705/the-risk-of-acute-kidney-injury-in-asians-treated-with-apixaban-rivaroxaban-dabigatran-or-warfarin-for-non-valvular-atrial-fibrillation-a-nationwide-cohort-study-in-taiwan
#5
Yi-Hsin Chan, Yung-Hsin Yeh, Mei-Yun Hsieh, Chia-Yu Chang, Hui-Tzu Tu, Shang-Hung Chang, Lai-Chu See, Chang-Fu Kuo, Chi-Tai Kuo
BACKGROUND: Whether or not non-vitamin K antagonist oral anticoagulants (NOACs) are associated with a lower risk of acute kidney injury (AKI) in patients with non-valvular atrial fibrillation (NVAF) remains unknown in real world practice. METHODS: In this nationwide retrospective cohort study, 1507, 3200, 5765 and 4227 NVAF patients with chronic kidney disease (CKD) and 4368, 16,945, 22,301, and 16,908 NVAF patients without CKD taking apixaban, dabigatran, rivaroxaban, and warfarin, respectively, from June 1, 2012 to December 31, 2016 were enrolled from the Taiwan National Health Insurance Program...
August 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29885678/the-safety-and-efficacy-of-non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-in-the-elderly
#6
Giuseppe Patti, Ilaria Cavallari, Olivier Hanon, Raffaele De Caterina
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence increases with age. Age also increases the risk of thromboembolism related to AF. As a result, elderly patients are at increased risk of AF-related stroke compared to younger patients. Age, however, also increases the risk of bleeding, including that of intracranial haemorrhage, an important cause of death and disability. Elderly patients with AF are, therefore, often undertreated due to the fear of bleeding complications, although recent data suggest an even greater net clinical benefit for anticoagulation in general in the elderly, even the very elderly, compared with younger patients...
August 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29877665/net-clinical-benefit-of-anticoagulation-therapy-in-the-elderly-patients-with-atrial-fibrillation
#7
Lorenzo Palleschi, Eleonora Nunziata
Old age remains one of the strongest risk factors for stroke in patients with atrial fibrillation (AF). Oral anticoagulation (OAC) is the most effective way to prevent thromboembolic disease in patients with atrial fibrillation (AF). Until few years ago, aspirin and vitamin-K antagonists (VKAs) were the primary agents used to prevent thromboembolic disease in patients with AF. The approval of non-vitamin K oral anticoagulants (NOACs) has now expanded the range of therapeutic agents available to providers. The authors highlight practical considerations regarding the selection and use of OAC in older adults to aid clinical decision making...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877660/efficacy-and-safety-of-oral-anticoagulant-therapy-in-frail-patients-with-atrial-fibrillation
#8
Giuseppe Patti, Ludmilla Mantione, Edoardo Bressi, Antonio Bisignani
Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29876713/non-vitamin-k-antagonist-oral-anticoagulants-for-the-treatment-of-intracardiac-thrombosis
#9
REVIEW
Eiman Ghaffarpasand, Maneli D Tehrani, Jolanta Marszalek, Gerald Chi
Intracardiac thrombus most commonly develops in the left atrial appendage (LAA) and left ventricle (LV) in the setting of atrial fibrillation (AF) and post-myocardial fibrillation (MI), respectively. Current guidelines recommend that patients with post-MI LV or LAA thrombus should be treated with vitamin K antagonist (VKA). However, the use of VKA may be limited by bleeding complications, interactions with various food and drugs, and a narrow therapeutic window requiring frequent monitoring. Thus, non-VKA oral anticoagulants (NOACs) have been attempted as an off-label use for the treatment of intracardiac thrombosis in light of their favorable pharmacologic profile...
June 6, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29873002/impact-of-cost-on-use-of-non-vitamin-k-antagonists-in-atrial-fibrillation-patients-in-ontario-canada
#10
Sarah R Monagle, Jack Hirsh, Vinai C Bhagirath, Jeffrey S Ginsberg, Jackie Bosch, Paul Kruger, John W Eikelboom
Canadian guidelines recommend non vitamin K antagonists (NOACs) in preference to vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation (AF), but NOACs are more expensive than VKAs. Canada has a universal healthcare system that covers the cost of NOACs for select patient groups. Ability to pay for NOACs may influence their use. We reviewed medical charts of Hamilton General Hospital outpatients under the age of 65 with a new diagnosis of AF who were referred for initiation of OAC therapy...
June 5, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29864777/new-anticoagulant-agents-incidence-of-adverse-drug-reactions-and-new-signals-thereof
#11
Carlos Treceño-Lobato, María-Isabel Jiménez-Serranía, Raquel Martínez-García, Francisco Corzo-Delibes, Luis H Martín Arias
The aim of this study was to evaluate the adverse drug reaction (ADR) incidence rate and new signals thereof for classic compared with new anticoagulants in real-life ambulatory settings. The authors performed an observational cross-sectional study in two cohorts of surveyed patients treated with vitamin K antagonists (VKAs; acenocoumarol or warfarin) or nonvitamin K antagonist oral anticoagulants (NOACs; apixaban, edoxaban, rivaroxaban, dabigatran etexilate). Descriptive, clinical, and ADRs data were reported and analyzed through a bivariate analysis (odds ratio [OR]) to compare the ADRs incidence rate and an adaptation of Bayesian methodology (false discovery rate [FDR] < 0...
June 4, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29861320/noacs-now-mainstream-for-the-use-of-anticoagulation-in-non-valvular-atrial-fibrillation-in-australia
#12
Derk Pol, Claire Curtis, Satish Ramukumar, Logan Bittinger
The management of stroke risk in patients with non-valvular atrial fibrillation has changed over the past few years. This change has occurred due to the introduction of novel oral anticoagulants (NOACs) such as apixaban, rivaroxaban and dabigatran for the management of non-valvular atrial fibrillation. These agents have shown comparable stroke risk reduction to warfarin in large international multicentre trials [1-3]. This has changed the clinical practice of many treating physicians since their introduction from 2011 to 2013...
March 22, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29860595/is-the-prescription-right-a-review-of-non-vitamin-k-antagonist-anticoagulant-noac-prescriptions-in-patients-with-non-valvular-atrial-fibrillation-safe-prescribing-in-atrial-fibrillation-and-evaluation-of-non-vitamin-k-oral-anticoagulants-in-stroke-prevention
#13
Rebabonye B Pharithi, Deepti Ranganathan, Jim O'Brien, Emmanuel E Egom, Cathie Burke, Daniel Ryan, Christine McAuliffe, Marguerite Vaughan, Tara Coughlan, Edwina Morrissey, John McHugh, David Moore, Ronan Collins
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are a major advance for stroke prevention in atrial fibrillation (AF). Use of the vitamin K antagonist (VKA), warfarin, has dropped 40% since 2010 in our institution. There is limited Irish hospital data on NOAC prescribing for stroke prevention. METHOD: Single centre, retrospective observational cohort study of consecutive AF patients at increased risk of stroke and/or awaiting electrical cardioversion...
June 2, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29851905/the-novel-oral-anticoagulants-noacs-have-worse-outcomes-compared-to-warfarin-in-patients-with-intracranial-hemorrhage-after-tbi
#14
Muhammad Zeeshan, Faisal Jehan, Terence O'Keeffe, Muhammad Khan, El Rasheid Zakaria, Mohammad Hamidi, Lynn Gries, Narong Kulvatunyou, Bellal Joseph
INTRODUCTION: Novel-oral-anticoagulants(NOACs) use is increasing in trauma patients. The reversal of these agents after hemorrhage is still evolving. The aim of our study was to evaluate outcomes after traumatic brain injury in patients on NOACs. METHODS: 3-year (2014-2016) analysis of our prospectively maintained TBI database. We included all TBI patients with intracranial-hemorrhage (ICH) on anticoagulants. Patients were stratified into two groups; those on NOACs and on Warfarin, and were matched in a 1:2 ratio using propensity score matching for demographics, injury and vital parameters, type, and size of ICH...
May 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29803981/dabigatran-rivaroxaban-and-apixaban-vs-high-ttr-warfarin-in-atrial-fibrillation
#15
Sara Själander, Vilhelm Sjögren, Henrik Renlund, Bo Norrving, Anders Själander
INTRODUCTION: New oral anticoagulants are non-inferior compared with warfarin regarding stroke prevention in atrial fibrillation, with similar or decreased risk of bleeding. However, it is unclear whether high TTR warfarin is as effective and safe as NOACs. Our objective was to investigate efficacy and safety of apixaban, dabigatran or rivaroxaban compared with warfarin in clinical practice. MATERIALS AND METHODS: Nationwide retrospective cohort study based on Swedish quality registries...
May 17, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29790596/rivaroxaban-for-stroke-prevention-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#16
Y-G Li, Daniele Pastori, G Y H Lip
Atrial fibrillation (AF) is associated with various cardiovascular comorbidities, such as hypertension, heart failure and diabetes mellitus, which increases not only the risk of ischaemic stroke but also of myocardial infarction and mortality. Oral anticoagulation for stroke prevention is the cornerstone of management for people with AF, both with vitamin K antagonists, or with non-vitamin K antagonist oral anticoagulants (NOACs), which show efficacy, safety and convenience compared with vitamin K antagonists [1]...
May 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29790365/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-bioprosthetic-valves
#17
Jason G Andrade, Elena Meseguer, Romain Didier, Charles Dussault, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillation patients with bioprosthetic valves differs from that in patients without such valves...
May 23, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29789105/oral-anticoagulation-in-chronic-kidney-disease-and-atrial-fibrillation
#18
Gunnar H Heine, Vincent Brandenburg, Stephan H Schirmer
BACKGROUND: Cardiological societies recommend, in their guidelines, that patients with atrial fibrillation and an intermediate (or higher) risk of stroke and systemic embolization should be treated with oral anticoagulant drugs. For patients who do not have mitral valve stenosis or a mechanical valve prosthesis, non-vitamin-K dependent oral anticoagulants (NOAC) are preferred over vitamin K antagonists (VKA) for this purpose. It is unclear, however, whether patients with chronic kidney disease and atrial fibrillation benefit from oral anticoagulation to the same extent as those with normal kidney function...
April 27, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29786530/meta-analysis-of-safety-and-efficacy-of-oral-anti-coagulants-in-patients-requiring-catheter-ablation-for-atrial-fibrillation
#19
Hammad Rahman, Safi U Khan, Michael DePersis, Tehseen Hammad, Fahad Nasir, Edo Kaluski
BACKGROUND: The ideal oral anticoagulant agent during catheter ablation (CA) for atrial fibrillation (AF) remained unclear. HYPOTHESIS: Novel oral anticoagulants (NOACs) are safer and effective compared to uninterrupted vitamin K antagonists (U-VKA) among patients requiring CA for AF. METHODS: Four randomized controlled trials (RCTs) and 9 observational studies (OS) were selected using PubMed/Medline, EMBASE and the CENTRAL data bases (Inception-December-2017)...
May 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#20
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
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