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https://www.readbyqxmd.com/read/28185082/dabigatran-etexilate-a-review-in-nonvalvular-atrial-fibrillation
#1
Hannah A Blair, Gillian M Keating
Dabigatran etexilate (Pradaxa(®)) is approved in the EU for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF) and one or more risk factors. Dabigatran etexilate is a prodrug of dabigatran, a direct inhibitor of thrombin. In patients with NVAF in the phase III RE-LY trial, dabigatran etexilate dosages of 110 and 150 mg twice daily were noninferior to warfarin with regard to the risk of stroke or systemic embolism (primary efficacy endpoint). The higher dosage was associated with a significantly lower risk of stroke or systemic embolism than warfarin, with no significant between-group difference in the risk of major bleeding (primary safety endpoint)...
February 9, 2017: Drugs
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#2
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28179613/left-atrial-appendage-thrombi-formation-in-japanese-non-valvular-atrial-fibrillation-patients-during-anticoagulation-therapy%C3%A3-warfarin-vs-direct-oral-anticoagulants
#3
Mihoko Kawabata, Masahiko Goya, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Takuro Nishimura, Takakatsu Yoshitake, Shinya Shiohira, Mitsuaki Isobe, Kenzo Hirao
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia, associated with increased cardiovascular morbidity and mortality including thromboembolic events. The aims of this study were to assess the prevalence of left atrial appendage (LAA) thrombi in Japanese non-valvular atrial fibrillation (NVAF) patients undergoing preprocedural transesophageal echocardiography (TEE) during anticoagulation therapy, and to compare the efficacy of warfarin and direct oral anticoagulants (DOAC)...
February 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28158211/major-vessel-occlusion-may-predict-subtherapeutic-anticoagulation-intensity-and-feasibility-of-administration-of-intravenous-thrombolytics
#4
Jun Young Chang, Seunguk Jung, Hyun Park, Moon-Ku Han
OBJECTIVE: We investigated the association between the presence of major vessel occlusion (MVO) and the intensity of the International Normalized Ratio (INR) in cardioembolic high-risk patients taking warfarin. We also evaluated whether the presence of MVO could predict the subtherapeutic range of INR ≤1.7 ensuring safe administration of intravenous thrombolytics. METHODS: The medical records of 177 cardioembolic stroke patients who were taking warfarin between April, 2008 and March, 2015 were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28154247/relationship-between-infarct-volume-and-prothrombin-time-international-normalized-ratio-in-ischemic-stroke-patients-with-nonvalvular-atrial-fibrillation
#5
Mari Matsumoto, Manabu Sakaguchi, Shuhei Okazaki, Kazuo Hashikawa, Tsutomu Takahashi, Masayasu Matsumoto, Toshiho Ohtsuki, Takeshi Shimazu, Toshiki Yoshimine, Hideki Mochizuki, Kazuo Kitagawa
BACKGROUND: In Japan, warfarin treatment at prothrombin time-international normalized ratio (PT-INR) of 1.60-2.60 is recommended for elderly patients with nonvalvular atrial fibrillation (NVAF). But it remains unknown whether PT-INR 1.60-1.99 has a similar effect on stroke severity as a value >2.0. The purpose of this study was to clarify the association between infarct volume and PT-INR levels.Methods and Results:The 180 patients (mean age, 76 years [SD, 10 years], 53% male) selected from 429 consecutive ischemic stroke patients admitted within 48 h of onset between 2004 and 2014 with NVAF were included...
January 31, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28151036/the-cost-of-warfarin-treatment-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-in-russia-from-a-collective-perspective
#6
J B Briere, K Bowrin, R Wood, J Roberts, B Tatarsky
AIMS: Vitamin K antagonists (VKAs) are used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) but necessitate regular monitoring of prothrombin time via international normalized ratio (INR) testing. This study explores the economic burden of VKA therapy for Russian patients with NVAF. METHOD: Cardiologists provided clinical characteristics and healthcare resource use data relating to the patient's first year of treatment. Data were used to quantify direct medical costs (INR testing, consultations, drug costs)...
February 2, 2017: Journal of Medical Economics
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
#7
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/28106016/gender-related-differences-in-presentation-and-treatment-of-patients-with-non-valvular-atrial-fibrillation-results-from-ramses-study
#8
Volkan Doğan, Özcan Başaran, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, İsmail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Cevat Kırma, Murat Biteker
OBJECTIVE: Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey. METHODS: As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#9
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28073863/revisiting-sex-differences-in-outcomes-in-non-valvular-atrial-fibrillation-a-population-based-cohort-study
#10
Christel Renoux, Janie Coulombe, Samy Suissa
AIMS: In patients with non-valvular atrial fibrillation (NVAF), it is uncertain whether the higher risk of ischaemic stroke in women reported in some studies is due to residual confounding. We assessed this association using standard time-fixed and more accurate time-dependent adjustment for confounders. METHODS AND RESULTS: Using the computerized databases of the Régie de l'assurance maladie du Québec (RAMQ), we identified a cohort of patients with NVAF during 2000-2009 and RAMQ medication coverage...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28058574/quality-of-life-with-rivaroxaban-in-patients-with-non-valvular-atrial-fibrilation-by-therapeutic-compliance
#11
Emilio Márquez-Contreras, Nieves Martell-Claros, Vicente Gil-Guillén, Mariano De la Figuera-Von Wichmann, Eugenio Sánchez-López, Ines Gil-Gil, Sara Márquez-Rivero
OBJECTIVE: To assess the quality of life (QOL) with rivaroxaban in patients with non-valvular atrial fibrilation (NVAF) related to therapeutic compliance. METHODS: Prospective, longitudinal, multicenter study was developed in 160 Spanish primary or specialized care centers. We included 412 patients treated with rivaroxaban, prescribed for stroke prevention. Three visits were conducted: baseline, 6 and 12 months. Compliance was measured by electronic monitoring systems...
January 6, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28038818/clinical-characteristics-of-complex-aortic-plaque-in-patients-with-non-valvular-atrial-fibrillation
#12
Pil-Sung Yang, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
BACKGROUND: Although complex aortic plaque (CxAoP) is a component of the CHA2DS2-VASc score in patients with atrial fibrillation (AF), it is underestimated without detection by trans-esophageal echocardiogram (TEE). We have evaluated the incidence and significance of CxAoP among patients with non-valvular AF (NVAF). METHODS: We included 981 patients with NVAF who underwent catheter ablation (59.1±11.1years old, 73.7% male, 70.2% paroxysmal AF). All of the patients underwent pre-procedural TEE evaluation...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28032482/population-pharmacokinetics-of-edoxaban-in-japanese-atrial-fibrillation-patients-with-severe-renal-impairment
#13
Takako Shimizu, Masaya Tachibana, Tetsuya Kimura, Tomohiko Kumakura, Kazutaka Yoshihara
This is a population pharmacokinetic (PopPK) analysis to predict PK of edoxaban, a direct-acting oral anticoagulant, in nonvalvular atrial fibrillation (NVAF) patients with severe renal impairment (SRI; creatinine clearance [CLcr ] <30 mL/min). Data from a phase 3 study recently conducted in Japanese NVAF patients (n = 90), including patients with SRI, were used to update the ENGAGE PopPK model that had been developed based on pooled data from the phase 3 ENGAGE AF-TIMI 48 study and 13 phase 1 PK studies, which included few patients with SRI...
December 29, 2016: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28029563/-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-primary-care-actua-study
#14
V Barrios, C Escobar, J M Lobos, J Polo, D Vargas
OBJECTIVES: Approximately 40% of patients with non-valvular auricular fibrillation (NVAF) who receive vitamin K antagonists (VKA) in Primary Care in Spain have poor anticoagulation control. The objective of the study Actuación en antiCoagulación, Tratamiento y Uso de anticoagulantes orales de acción directa (ACOD) en Atención primaria (ACTUA) (Action in Coagulation, Treatment and Use of direct oral anticoagulants [DOACs]) in Primary Care) was to analyse the current situation regarding the use of VKA and non-vitamin K antagonist oral anticoagulants (NOACs) in patients with NVAF in Primary Care in Spain and the possible issues arising from it...
October 28, 2016: Semergen
https://www.readbyqxmd.com/read/28027833/usefulness-of-a-healthcare-database-for-epidemiological-research-in-atrial-fibrillation
#15
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/28017463/monitoring-of-anti-xa-activity-and-factors-related-to-bleeding-events-a-study-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-rivaroxaban
#16
Teruhiro Sakaguchi, Hiroyuki Osanai, Yosuke Murase, Hideki Ishii, Yoshihito Nakashima, Hiroshi Asano, Susumu Suzuki, Mikito Takefuji, Yasuya Inden, Kazuyoshi Sakai, Toyoaki Murohara, Masayoshi Ajioka
BACKGROUND: Anti-Xa activity (AXA) in patients with nonvalvular atrial fibrillation (NVAF) and relationship to bleeding events remains unclear. METHODS: We evaluated AXA in 94 patients at both trough and peak rivaroxaban concentrations. Rivaroxaban dosage was determined according to creatinine clearance (CrCl): 10 and 15mg once daily for patients with CrCl 15-49 and CrCl ≥50mL/min, respectively. AXA value distribution and its association with bleeding events were examined in enrolled subjects...
December 22, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28012051/assessment-of-the-left-atrial-appendage-structure-and-morphology-comparison-of-real-time-three-dimensional-transesophageal-echocardiography-and-computed-tomography
#17
Wenjuan Bai, Zhongxiu Chen, Hong Tang, Hui Wang, Wei Cheng, Li Rao
In this study, the left atrial appendage (LAA) structure and morphology were assessed using real-time three-dimensional transesophageal echocardiography (RT3D-TEE) and enhanced cardiac computed tomography (CT) scanning, and the two measurements obtained using these different techniques were compared. Two hundred nonvalvular atrial fibrillation (NVAF) patients who were prepared to undergo radiofrequency ablation were enrolled, and 62 controls were enrolled prospectively. RT3D-TEE and CT were performed, and the following parameters were measured: LAA orifice diameter, area, depth, maximum volume, and emptying velocity...
December 23, 2016: International Journal of Cardiovascular Imaging
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
#18
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/28007412/adherence-to-medication-and-characteristics-of-japanese-patients-with-non-valvular-atrial-fibrillation
#19
Tsuyoshi Suzuki, Tsuyoshi Shiga, Hisako Omori, Fujio Tatsumi, Katsuji Nishimura, Nobuhisa Hagiwara
BACKGROUND: Adherence to medication plays an important role in the prevention of morbidity and mortality in non-valvular atrial fibrillation (NVAF) patients. The aim of this study is to assess adherence to medication and risk factors for non-adherence in Japanese NVAF patients who are prescribed anticoagulants. METHODS: A total of 378 outpatients with NVAF who completed self-reported questionnaires were analyzed in this prospective study (mean age 69±12 years; 26% female)...
December 19, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#20
REVIEW
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
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