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https://www.readbyqxmd.com/read/29121522/effects-of-vitamin-k-antagonist-on-aortic-valve-degeneration-in-non-valvular-atrial-fibrillation-patients-prospective-4-year-observational-study
#1
Kazuhiro Yamamoto, Yukihiro Koretsune, Takashi Akasaka, Akira Kisanuki, Nobuyuki Ohte, Takashi Takenaka, Masaaki Takeuchi, Kiyoshi Yoshida, Kazunori Iwade, Yuji Okuyama, Yutaka Hirano, Yasuharu Takeda, Yasumasa Tsukamoto, Yoshiharu Kinugasa, Satoshi Nakatani, Takashi Sakamoto, Katsuomi Iwakura, Takashi Sozu, Tohru Masuyama
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. METHODS: Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group)...
November 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29109364/trend-of-prevalence-of-atrial-fibrillation-and-use-of-oral-anticoagulation-therapy-in-patients-with-atrial-fibrillation-in-south-korea-2002-2013
#2
Mi Kyoung Son, Nam-Kyoo Lim, Hyun-Young Park
BACKGROUND: This study examined the annual prevalence of atrial fibrillation (AF) and its associated comorbidities, as well as the prevalence of warfarin therapy in South Korean patients with AF. METHODS: The National Health Insurance Service-National Sample Cohort database was searched for subjects aged ≥30 years diagnosed with AF from 2002-2013. The prevalence of AF was analyzed by sex and age, as was the current status of warfarin therapy in AF patients according to CHA2DS2-VASc score and comorbidities...
November 4, 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/29083968/effect-of-apixaban-versus-warfarin-use-on-health-care-resource-utilization-and-costs-among-elderly-patients-with-nonvalvular-atrial-fibrillation
#3
Steven Deitelzweig, Xuemei Luo, Kiran Gupta, Jeffrey Trocio, Jack Mardekian, Tammy Curtice, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
BACKGROUND: The clinical trial ARISTOTLE showed that apixaban was superior to warfarin in reducing the risks of stroke and bleeding among patients with nonvalvular atrial fibrillation (NVAF). Further study of the effect of apixaban versus warfarin use on health care resource utilization (HCRU) and associated costs in the real-world setting is warranted, especially among elderly patients who are at higher risk of stroke and bleeding. OBJECTIVE: To compare HCRU and costs among elderly NVAF patients treated with apixaban versus warfarin in the United States...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29075507/pilot-parallel-randomised-controlled-trial-of-protective-socks-against-usual-care-to-reduce-skin-tears-in-high-risk-people-stopcuts
#4
Roy J Powell, Christopher J Hayward, Caroline L Snelgrove, Kathleen Polverino, Linda Park, Rohan Chauhan, Philip H Evans, Rachel Byford, Carolyn Charman, Christopher J W Foy, Colin Pritchard, Andrew Kingsley
BACKGROUND: Skin tears are common in older adults and those taking steroids and warfarin. They are traumatic, often blunt injuries caused by oblique knocks to the extremities. The epidermis may separate from the dermis or both layers from underlying tissues leaving a skin flap or total loss of tissue, which is painful and prone to infection. 'Dermatuff™' knee-length socks containing Kevlar fibres (used in stab-proof vests and motorcyclists' clothing) aim to prevent skin tears. The acceptability of the socks and the feasibility of a randomised controlled trial (RCT) had not been explored...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29066874/optimization-of-drug-therapy-in-elderly-individuals-admitted-to-a-geriatric-unit
#5
Antoine Piau, Yoann Huet, Adeline Gallini, Laurine Andre, Bruno Vellas, Fati Nourhashemi
BACKGROUND: A substantial share of adverse drug events involves inappropriate prescribing (IP). Specialized geriatric units are supposed to pay particular attention to prescribing appropriateness and to promoting a higher prescribing quality. OBJECTIVE: The objective of this study was to evaluate the reality of such assessment and optimization in real life (usual care) in a population of elderly individuals admitted to a geriatric unit. METHOD: This is an observational study including all older patients admitted to an acute geriatric unit over a 6-month period...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29016776/atrial-fibrillation-is-associated-with-decreased-total-cerebral-blood-flow-and-brain-perfusion
#6
Marianna Gardarsdottir, Sigurdur Sigurdsson, Thor Aspelund, Hrafnhildur Rokita, Lenore J Launer, Vilmundur Gudnason, David O Arnar
Aims: Atrial fibrillation (AF) has been associated with cognitive impairment. Additionally, brain volume may be reduced in individuals with AF. Potential causes may include cerebral micro-embolism or reduced stroke volume due to the beat-to-beat variation in AF. The aims of this study were to measure cerebral blood flow and estimate whole brain perfusion in elderly individuals with and without AF. Methods and results: Blood flow in the cervical arteries was measured with phase contrast MRI and brain perfusion estimated in a large cohort from the AGES-Reykjavik Study...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28981553/dabigatran-versus-warfarin-for-acute-venous-thromboembolism-in-elderly-or-impaired-renal-function-patients-pooled-analysis-of-re-cover-and-re-cover-ii-pooled-analysis-of-re-cover-and-re-cover-ii
#7
Samuel Z Goldhaber, Sam Schulman, Henry Eriksson, Martin Feuring, Mandy Fraessdorf, Jörg Kreuzer, Elke Schüler, Sebastian Schellong, Ajay K Kakkar
Management of acute venous thromboembolism (VTE) with anticoagulants in elderly patients and those with chronic kidney disease poses special challenges. The RE-COVER and RE-COVER II trials showed that dabigatran 150 mg twice daily was as effective as warfarin over 6 months in preventing recurrent VTE, with a lower bleeding risk. We now assess the effects of old age and renal impairment (RI) on pooled trial outcomes in 5,107 patients: 4,504 aged <75 years and 603 aged ≥75 years. The primary efficacy outcome was symptomatic VTE/VTE-related death...
October 4, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28976388/-atrial-fibrillation-in-the-elderly
#8
Kamil Adalet
The prevalence of atrial fibrillation increases dramatically with advancing age. Elderly adults with atrial fibrillation-even those with high bleeding risk- benefit from anticoagulation. The risk of ischemic stroke or systemic embolism was significantly lower with new direct oral anticoagulants (DOACs) than warfarin as was the risk of major bleeding and intracranial bleeding. Antiplatelet therapy should have a limited role for stroke prevention in elderly adults. Left atrial appendix occlusion may be a suitable alternative for those with contraindications to oral anticoagulants...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#9
RANDOMIZED CONTROLLED TRIAL
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28855778/older-age-comorbid-illnesses-and-injury-severity-affect-immediate-outcome-in-elderly-trauma-patients
#10
Dvora Kirshenbom, Zila Ben-Zaken, Nehama Albilya, Eva Niyibizi, Miklosh Bala
INTRODUCTION: Trauma in elderly population is frequent and is associated with significant mortality, not only due to age but also due to complicated factors such as the severity of injury, preexisting comorbidity, and incomplete general assessment. Our primary aim was to determine whether age, Injury Severity Score (ISS), and preexisting comorbidities had an adverse effect on the outcome in patients aged 65 years and above following blunt trauma. METHODS: We included 1027 patients aged ≥65 years who were admitted to our Level I Trauma Center following blunt trauma...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28844193/dual-antithrombotic-therapy-with-dabigatran-after-pci-in-atrial-fibrillation
#11
RANDOMIZED CONTROLLED TRIAL
Christopher P Cannon, Deepak L Bhatt, Jonas Oldgren, Gregory Y H Lip, Stephen G Ellis, Takeshi Kimura, Michael Maeng, Bela Merkely, Uwe Zeymer, Savion Gropper, Matias Nordaby, Eva Kleine, Ruth Harper, Jenny Manassie, James L Januzzi, Jurrien M Ten Berg, P Gabriel Steg, Stefan H Hohnloser
BACKGROUND: Triple antithrombotic therapy with warfarin plus two antiplatelet agents is the standard of care after percutaneous coronary intervention (PCI) for patients with atrial fibrillation, but this therapy is associated with a high risk of bleeding. METHODS: In this multicenter trial, we randomly assigned 2725 patients with atrial fibrillation who had undergone PCI to triple therapy with warfarin plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and aspirin (for 1 to 3 months) (triple-therapy group) or dual therapy with dabigatran (110 mg or 150 mg twice daily) plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and no aspirin (110-mg and 150-mg dual-therapy groups)...
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28840739/-rivaroxaban-in-high-risk-patients
#12
Jindřich Špinar, Lenka Špinarová
Blockade of factor Xa becomes a routine part of clinical practice instead of vitamin K blockade with warfarin, providing a more beneficial and safer effect. The main indications are prevention of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, deep vein thrombosis and pulmonary embolism. Rivaroxaban has the largest number of data across high risk patients. Rivaroxaban is an oral selective anti Xa inhibitor with well predictive pharmacokinetics and pharmacodynamics. It inhibits thrombin formation for 24 hours, is well absorbed and biological availability is 80-100 %...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#13
REVIEW
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
September 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28756016/pharmacological-stroke-prevention-in-the-elderly-with-atrial-fibrillation-in-poland-results-of-polsenior-study
#14
Beata Łabuz-Roszak, Michał Skrzypek, Agnieszka Machowska-Majchrzak, Małgorzata Mossakowska, Jerzy Chudek, Andrzej Więcek, Krystyna Pierzchała, Beata Łącka-Gaździk, Tomasz Grodzicki
INTRODUCTION: Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland. OBJECTIVES: The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors...
July 11, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#15
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28726972/consequences-of-warfarin-suspension-after-major-bleeding-in-very-elderly-patients-with-non-valvular-atrial-fibrillation
#16
Giacomo Zoppellaro, Serena Granziera, Giulia Bertozzo, Gentian Denas, Lucia Marigo, Florinda Petruzzellis, Seena Padayattil Jose, Katia Rossi, Giovanni Nante, Vittorio Pengo
No abstract text is available yet for this article.
August 30, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28664360/factors-associated-with-antithrombotic-treatment-decisions-for-stroke-prevention-in-atrial-fibrillation-in-the-stockholm-region-after-the-introduction-of-noacs
#17
Joris Komen, Tomas Forslund, Paul Hjemdahl, Björn Wettermark
PURPOSE: The purpose of this study was to investigate the influence of patient characteristics such as age and stroke and bleeding risks on decisions for antithrombotic treatment in patients with atrial fibrillation (AF). METHODS: This was a retrospective, population-based study including AF patients initiated with either warfarin, dabigatran, rivaroxaban, apixaban, or low-dose aspirin (ASA) between March 2015 and February 2016. Multivariate models were used to calculate adjusted odds ratios (aOR) for factors associated with treatment decisions...
October 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28622547/co-morbidity-and-clinically-significant-interactions-between-antiepileptic-drugs-and-other-drugs-in-elderly-patients-with-newly-diagnosed-epilepsy
#18
Emmi Bruun, Lauri J Virta, Reetta Kälviäinen, Tapani Keränen
PURPOSE: A study was conducted to investigate the frequency of potential pharmacokinetic drug-to-drug interactions in elderly patients with newly diagnosed epilepsy. We also investigated co-morbid conditions associated with epilepsy. METHOD: From the register of Kuopio University Hospital (KUH) we identified community-dwelling patients aged 65 or above with newly diagnosed epilepsy and in whom use of the first individual antiepileptic drug (AED) began in 2000-2013 (n=529)...
June 13, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28573932/efficacy-and-safety-of-uninterrupted-low-intensity-warfarin-for-radiofrequency-catheter-ablation-of-atrial-fibrillation-in-the-elderly-a-pilot-study
#19
Yangbo Xing, Buyun Xu, Chao Xu, Fang Peng, Biao Yang, Yufang Qiu, Yong Sun, Shengkai Wang, Hangyuan Guo
BACKGROUND: No previous studies exist investigating the optimal intensity of uninterrupted anticoagulation with warfarin during radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) in the elderly. OBJECTIVE: Evaluate the efficacy and safety of continuous low-intensity warfarin therapy throughout the periprocedural period of RFCA for AF in the elderly. METHODS: This is a prospective randomized study. We enrolled AF patients (age ≥ 70 years) who underwent first-time RFCA for AF...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28535119/comparison-of-effectiveness-and-safety-of-treatment-with-apixaban-vs-other-oral-anticoagulants-among-elderly-nonvalvular-atrial-fibrillation-patients
#20
Steven Deitelzweig, Xuemei Luo, Kiran Gupta, Jeffrey Trocio, Jack Mardekian, Tammy Curtice, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
OBJECTIVE: To compare the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) of elderly (≥65 years of age) nonvalvular atrial fibrillation (NVAF) patients initiating apixaban vs. rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients with Medicare Advantage coverage in the US initiating oral anticoagulants (OACs, index event) were identified from the Humana database (1/1/2013-9/30/2015) and grouped into cohorts depending on OAC initiated. Propensity score matching (PSM), 1:1, was conducted among patients treated with apixaban vs...
May 23, 2017: Current Medical Research and Opinion
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