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https://www.readbyqxmd.com/read/29352007/outcomes-in-anticoagulated-patients-with-atrial-fibrillation-and-with-mitral-or-aortic-valve-disease
#1
Dragos Vinereanu, Alice Wang, Hillary Mulder, Renato D Lopes, Petr Jansky, Basil S Lewis, Bernard J Gersh, Alvaro Avezum, Michael Hanna, Claes Held, Lars Wallentin, Christopher B Granger, John H Alexander
OBJECTIVE: To assess stroke/systemic embolism, major bleeding and other outcomes, and treatment effect of apixaban versus warfarin, in patients with atrial fibrillation (AF) and different types of valvular heart disease (VHD), using data from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS: There were 14 793 patients with known VHD status, categorised as having moderate or severe mitral regurgitation (MR) (n=3382), aortic regurgitation (AR) (n=842) or aortic stenosis (AS) (n=324); patients with moderate or severe mitral stenosis were excluded from the trial...
January 19, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29351137/early-response-to-warfarin-initiation-and-the-risk-of-venous-thromboembolism-after-total-joint-arthroplasty
#2
Adam I Edelstein, Clara Terzaghi, Brandon Nudelman, Charles Qin, Mary Kwasny, David W Manning
BACKGROUND: Venous thromboembolism chemoprophylaxis with warfarin is common after total joint arthroplasty. Early response to warfarin initiation has been theorized to engender a transient increase in the risk of venous thromboembolism. We hypothesized that a rapid rise in the international normalized ratio is a risk factor for venous thromboembolism after total joint arthroplasty. METHODS: This study was a retrospective analysis of Medicare patients undergoing elective total joint arthroplasty who were given nomogram-dosed warfarin for venous thromboembolism prophylaxis...
January 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#3
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350386/comparison-of-clinical-characteristics-of-real-life-atrial-fibrillation-patients-treated-with-vitamin-k-antagonists-dabigatran-and-rivaroxaban-results-from-the-craft-study
#4
Paweł Balsam, Krzysztof Ozierański, Agata Tymińska, Katarzyna Żukowska, Martyna Zaleska, Katarzyna Szepietowska, Kacper Maciejewski, Michał Peller, Marcin Grabowski, Piotr Lodziński, Anna Praska-Ogińska, Inna Zaboyska, Łukasz Kołtowski, Anna Kowalczuk, Janusz Bednarski, Krzysztof J Filipiak, Grzegorz Opolski
BACKGROUND: The first line drugs for treatment of non-valvular atrial fibrillation (AF) are non-vitamin K oral anticoagulants (NOACs), which are preferred over vitamin K antagonists (VKAs). There is some evidence that an everyday clinical practice is distant from the guidelines. AIM: The study aimed to compare characteristics of patients on VKAs, dabigatran and rivaroxaban met in everyday practice (i.e. baseline characteristics, drugs' doses, risk factors of bleeding and thromboembolic events)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349091/coexistent-ipsilateral-internal-carotid-artery-occlusion-and-cerebral-venous-thrombosis-in-hepatitis-c
#5
Karan Seegobin, Somphanh Khousakhoun, Ryan Crooks, Satish Maharaj, Cherisse Baldeo
A 58-year-old male, known to have hepatitis C virus (HCV), presented with intermittent headaches and left-sided sensorimotor symptoms. There were no focal neurological deficits on examination. Electrocardiogram was unremarkable. Computed tomography angiography head and neck displayed extracranial right internal carotid artery occlusion. Magnetic resonance imaging showed right cortical vein thrombosis, with hemorrhagic infarction. Echocardiography with bubble study was unremarkable. Hypercoagulable workup was significant for protein S deficiency...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29348255/hypertension-and-atrial-fibrillation-doubts-and-certainties-from-basic-and-clinical-studies
#6
REVIEW
Paolo Verdecchia, Fabio Angeli, Gianpaolo Reboldi
Hypertension and atrial fibrillation (AF) are 2 important public health priorities. Their prevalence is increasing worldwide, and the 2 conditions often coexist in the same patient. Hypertension and AF are strikingly related to an excess risk of cardiovascular disease and death. Hypertension ultimately increases the risk of AF, and because of its high prevalence in the population, it accounts for more cases of AF than other risk factors. Among patients with established AF, hypertension is present in about 60% to 80% of individuals...
January 19, 2018: Circulation Research
https://www.readbyqxmd.com/read/29344822/novel-oral-anticoagulants-in-the-preoperative-period-a-meta-analysis
#7
Hua He, Bingbing Ke, Yan Li, Fuheng Han, Xiaodong Li, Yujie Zeng
The purpose of this study is to evaluate the efficacy and safety of novel oral anticoagulant (NOAC) versus warfarin therapy in patients undergoing different operations. We performed a systematic review of MEDLINE, EMBASE, Cochrane Controlled Trials Register, and reports presented at scientific meetings. The efficacy and safety of NOACs during the perioperative period was compared to that using warfarin. Of the 2652 studies initially reviewed, we identified 9 that included 15,880 patients for the meta-analysis...
January 17, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29339702/efficacy-and-safety-of-oral-anticoagulation-in-elderly-patients-with-atrial-fibrillation
#8
Ilaria Cavallari, Giuseppe Patti
Elderly patients with atrial fibrillation are at a higher risk of both ischemic and bleeding events compared with younger patients; therefore, balancing risks and benefits of antithrombotic strategies in this population is crucial. Recent studies have shown that because the risk of stroke increases with age more than the risk of bleeding, the absolute benefit of oral anticoagulation is the highest in elderly patients in whom it outweighs the risk of bleeding. Direct oral anticoagulants (DOACs) have been developed as a treatment for the prevention of cardioembolic stroke to overcome some limitations of warfarin, such as the need for frequent monitoring, labile INR values requiring frequent dose adjustment, dietary and drugs interactions, and increased risk of intracranial bleeding...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#9
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29339165/safety-and-efficacy-of-transcatheter-left-atrial-appendage-closure-for-stroke-prevention-in-patients-with-atrial-fibrillation
#10
REVIEW
Matthew J Price
Atrial fibrillation (AF) is associated with a substantial risk of thromboembolic stroke. Although long-term treatment with warfarin or the non-vitamin K oral anticoagulants can reduce this risk, such therapy is underutilized, and safe and consistent long-term treatment can be challenging. Transcatheter left atrial appendage (LAA) closure is an emerging alternative to long-term oral anticoagulation. Long-term follow-up of randomized clinical trials demonstrate that Watchman LAA closure provides significant reductions in hemorrhagic stroke, cardiovascular death, and all-cause mortality compared with continued warfarin therapy...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29338845/protocolized-warfarin-reversal-with-4-factor-prothrombin-complex-concentrate-versus-3-factor-prothrombin-complex-concentrate-with-recombinant-factor-viia
#11
Cassie A Barton, Marissa Hom, Nathan B Johnson, Jon Case, Ran Ran, Martin Schreiber
INTRODUCTION: Life-threatening bleeding can complicate warfarin therapy. Rapid anticoagulant reversal via replacement of vitamin-K dependent clotting factors is essential for hemostasis. We compare two methods of rapid factor replacement for warfarin reversal. METHODS: A retrospective cohort study of warfarin-treated patients experiencing life-threatening bleeding who received a reversal protocol comprised of 4F PCC or 3F PCC and rFVIIa was performed. Demographic, clinical and anticoagulant reversal information, and all adverse events attributed to warfarin reversal were recorded...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#12
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29336027/evaluating-the-validity-of-subclassifying-warfarin-associated-nonuremic-calciphylaxis-a-retrospective-cohort-study
#13
Julia S Lehman, Tiffany Y Chen, Christine M Lohse, Rokea A El-Azhary
BACKGROUND: Calciphylaxis is a devastating multifactorial disorder of the subcutaneous fat that is known to be associated with hypercoagulability. Recent literature has proposed subclassifying patients with calciphylaxis as having warfarin-associated or warfarin-unassociated disease. AIM: We aimed to determine whether patients with warfarin-associated calciphylaxis differ clinically from patients with warfarin-unassociated calciphylaxis. MATERIALS AND METHODS: We performed a subgroup analysis of patients with nonuremic calciphylaxis from a previously studied cohort and compared clinical and outcomes features of patients who were taking warfarin at the time of disease onset to those of patients who were not...
January 16, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29335863/integrative-medicine-on-optimizing-clopidogrel-and-aspirin-therapy
#14
REVIEW
Hui Chen
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI)...
January 15, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29334746/-the-current-role-of-warfarin
#15
Jana Michalcová, Alena Buliková, Jiřina Zavřelová, Marie Prudková, Miroslav Penka
Well-managed warfarin therapy remains an important method of anticoagulation in the 21st century, despite the introduction of new antithrombotics into the clinical practice. The main advantages of warfarin are decades of treatment experience, the possibility to monitor its anticoagulant effect using the INR and the last, but not least, the low cost. Currently, approximately 75 % of anticoagulated patients in the Czech Republic are treated with warfarin and warfarin remains the only option for oral anticoagulant therapy in certain clinical conditions (particularly in patients with valvular atrial fibrillation or mechanical heart valves)...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29330739/patterns-and-outcomes-of-prescribing-venous-thromboembolism-prophylaxis-in-hospitalized-older-adults-a-retrospective-cohort-study
#16
Mark Goldin, Jessica Cohen, Alex Makhnevich, Colm Mulvany, Meredith Akerman, Liron Sinvani
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. Hospitalized, medically ill older adults have increased risk; despite guidelines, data suggest suboptimal pharmacologic prophylaxis rates. Factors influencing provider prescribing non-compliance are unclear. We aimed to describe VTE prophylaxis practices and identify risk factors for, and outcomes of, prescribing non-compliance. A retrospective study was conducted of hospitalized adults aged ≥ 75 years, admitted to the medicine service of a large academic tertiary center from May 1, 2014 to June 30, 2015...
January 12, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29330715/case-series-analysis-of-new-zealand-reports-of-rapid-intense-potentiation-of-warfarin-by-roxithromycin
#17
Ruth L Savage, Michael V Tatley
INTRODUCTION: We undertook an analysis of all the reports to the New Zealand Centre for Adverse Reactions Monitoring of a roxithromycin/warfarin interaction after two recent reports described intense rapid warfarin potentiation. The interaction was first published in 1995. Cytochrome P450 3A4 inhibition has been the proposed mechanism but has limited biologic plausibility. There are suggestions that the clinical significance of the interaction may be increased by severe illness, polypharmacy, renal dysfunction, older age and increased warfarin sensitivity...
January 12, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29330651/3d-computed-tomography-to-compare-the-dimensions-of-the-left-atrial-appendage-in-patients-with-normal-sinus-rhythm-and-those-with-paroxysmal-atrial-fibrillation
#18
Maiko Hozawa, Yoshihiro Morino, Yuki Matsumoto, Ryoichi Tanaka, Kyohei Nagata, Akiko Kumagai, Atsushi Tashiro, Akio Doi, Kunihiro Yoshioka
Although paroxysmal atrial fibrillation (PAF) is an important cause of cardioembolic stroke, in contrast to chronic AF patients, the anatomical features of the left atrial appendage (LAA) in PAF patients remain unknown. Here, we investigated differences in LAA structures in patients with PAF and those with normal sinus rhythms (NSR) using 3D-computed tomography (3D-CT), which allows us to visualize complicated LAA structures at high spatial resolution. Study subjects were 30 consecutive PAF and 30 NSR patients with complete enhanced cardiac 3D-CT images available...
January 12, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29329798/efficacy-of-warfarin-anticoagulation-and-incident-dementia-in-a-community-based-cohort-of-atrial-fibrillation
#19
Malini Madhavan, Tiffany Y Hu, Bernard J Gersh, Veronique L Roger, Jill Killian, Susan A Weston, Jonathan Graff-Radford, Samuel J Asirvatham, Alanna M Chamberlain
OBJECTIVE: To study the association between time in therapeutic range (TTR) during warfarin therapy and risk of dementia in a population-based cohort of incident atrial fibrillation (AF). PATIENTS AND METHODS: We conducted an observational population-based study of 2800 nondemented patients with incident AF from January 1, 2000, through December 31, 2010. The association of incident dementia with warfarin therapy and TTR was examined using Cox proportional hazards regression models...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29327158/comparison-of-warfarin-requirements-in-post-cardiac-surgery-patients-valve-replacement-versus-non-valve-replacement
#20
Logan M Olson, Andrea M Nei, David L Joyce, Narith N Ou, Ross A Dierkhising, Scott D Nei
INTRODUCTION: Anticoagulation with warfarin affects approximately 140,000 post-cardiac surgery patients every year, yet there remains limited published data in this patient population. Dosing remains highly variable due to intrinsic risk factors that plague cardiac surgery candidates and a lack of diverse literature that can be applied to those who have undergone a cardiac surgery alternative to heart valve replacement (HVR). In the present study, our aim was to compare the warfarin requirements between HVR and non-HVR patients...
January 11, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
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