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https://www.readbyqxmd.com/read/28324091/association-between-dabigatran-vs-warfarin-and-risk-of-osteoporotic-fractures-among-patients-with-nonvalvular-atrial-fibrillation
#1
Wallis C Y Lau, Esther W Chan, Ching-Lung Cheung, Chor Wing Sing, Kenneth K C Man, Gregory Y H Lip, Chung-Wah Siu, Joanne K Y Lam, Alan C H Lee, Ian C K Wong
Importance: The risk of osteoporotic fracture with dabigatran use in patients with nonvalvular atrial fibrillation (NVAF) is unknown. Objective: To investigate the risk of osteoporotic fracture with dabigatran vs warfarin in patients with NVAF. Design, Setting, and Participants: Retrospective cohort study using a population-wide database managed by the Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through 2014 and prescribed dabigatran or warfarin were matched by propensity score at a 1:2 ratio with follow-up until July 31, 2016...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28320118/prothrombin-complex-concentrate-administration-for-bleeding-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-the-samurai-nvaf-study
#2
Sohei Yoshimura, Shoichiro Sato, Kenichi Todo, Yasushi Okada, Eisuke Furui, Takayuki Matsuki, Hiroshi Yamagami, Masatoshi Koga, Jun C Takahashi, Kazuyuki Nagatsuka, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: Antidotes appropriate for non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are not yet in widespread clinical use. Efficacy of prothrombin complex concentrate (PCC) in NOAC-associated bleeding remains unclarified. METHODS: Ten NOAC users (4 women, median 74years old) who developed major bleeding and received PCC were prospectively enrolled. Eight single-center NOAC users (0 women, median 74years old) with intracerebral hemorrhage, who over the same period did not receive PCC, were studied for comparison...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28306170/impact-of-atrial-fibrillation-on-platelet-gene-expression
#3
Waldemar E Wysokinski, Alfonso Tafur, Naser Ammash, Samuel J Asirvatham, Yanhong Wu, Izabella Gosk-Bierska, Diane E Grill, Joshua P Slusser, Jozef Mruk, Robert D McBane
AIMS: Platelets retain cytoplasmic messenger RNA and are capable of protein biosynthesis. Several diseases are known to impact the platelet transcriptome but the effect of non-valvular atrial fibrillation (NVAF) on platelet RNA transcript is essentially unknown. The aim of this study was to evaluate the impact of NVAF on platelet RNA transcript by measuring platelet genes expression in consecutive NVAF patients before and 3-4 months after pulmonary vein isolation (PVI) and compared to normal sinus rhythm controls (NSR)...
March 17, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28301912/potential-causes-and-implications-of-low-target-therapeutic-ratio-in-warfarin-treated-patients-for-thrombosis-prophylaxis
#4
Halil Atas, Ahmet Anıl Sahin, Dilek Barutçu Atas, Murat Sunbul, Alper Kepez, Mehmet Agirbasli
Time in therapeutic range (TTR) of international normalized ratio is crucial for the safety and efficacy of anticoagulation with warfarin and it is influenced by many factors. There are limited data about the quality of warfarin therapy and its effects on clinical outcomes in Turkey. The aim of this study is to demonstrate the quality of anticoagulant therapy with warfarin and evaluate the parameters that affect the quality of warfarin therapy. A total of 170 patients with atrial fibrillation (AF; mean age: 62...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28301907/drug-adherence-in-patients-with-nonvalvular-atrial-fibrillation-taking-non-vitamin-k-antagonist-oral-anticoagulants-in-turkey
#5
Sadık Volkan Emren, Oktay Şenöz, Murat Bilgin, Osman Beton, Abdullah Aslan, Uğur Taşkin, Gönül Açiksari, Lale Dinç Asarcikli, Hakan Çakir, Lütfü Bekar, İsmail Bolat, Çağrı Yayla, Barış Çelebi, Onur Dalgiç, Oğuzhan Çelik, Özgen Şafak, Serdar Akyel, Hasan Güngör, Barış Düzel, Mehdi Zoghi
Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#6
Xiaoyan Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28283738/anti-inflammatory-effect-of-factor-xa-inhibitors-in-japanese-patients-with-atrial-fibrillation
#7
Hiromasa Katoh, Tsuyoshi Nozue, Ichiro Michishita
Activated factor-X (FXa) plays an important role not only in the coagulation cascade, but also in pro-inflammatory responses. However, few data exist regarding the anti-inflammatory effect of FXa inhibitors in clinical practice. The aim of this study was to evaluate the anti-inflammatory and anti-atherosclerotic effects of FXa inhibitors in Japanese patients with non-valvular atrial fibrillation (NVAF). Eighty-three patients with NVAF were treated with FXa inhibitors from March 2013 to March 2015 at our institution...
March 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28272725/-comparison-of-the-cost-utility-of-direct-oral-anticoagulants-for-the-prevention-of-stroke-in-patients-with-atrial-fibrillation-in-spain
#8
M Monreal-Bosch, S Soulard, C Crespo, S Brand, A Kansal
INTRODUCTION: Apixaban, dabigatran and rivaroxaban are three new direct oral anticoagulants (DOACs) used in the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) in Spain. AIM: To assess the relative cost-utility of the three DOACs compared with vitamin K antagonists. PATIENTS AND METHODS: A Markov model with 3-month cycles was used to simulate NVAF patients starting with treatment and followed up for their lifetime from the perspective of the National Health System...
March 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28264833/impact-of-gender-on-event-rates-at-1%C3%A2-year-in-patients-with-newly-diagnosed-non-valvular-atrial-fibrillation-contemporary-perspective-from-the-garfield-af-registry
#9
A John Camm, Gabriele Accetta, Wael Al Mahmeed, Giuseppe Ambrosio, Samuel Z Goldhaber, Sylvia Haas, Petr Jansky, Gloria Kayani, Frank Misselwitz, Seil Oh, Ali Oto, Pekka Raatikainen, Jan Steffel, Martin van Eickels, Ajay K Kakkar
OBJECTIVES: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) explored the impact of gender, risk factors and anticoagulant (AC) treatment on 1-year outcomes in patients with non-valvular atrial fibrillation (NVAF). DESIGN: GARFIELD-AF is a prospective non-interventional registry. SETTING: Investigator sites (n=1048) are representative of the care settings/locations in each of the 35 countries. PARTICIPANTS: Patients ≥18yrs with newly diagnosed (≤6 weeks' duration) NVAF and ≥1 investigator-determined stroke risk factors...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28261098/oral-anticoagulants-initiation-in-patients-with-atrial-fibrillation-real-world-data-from-a-population-based-cohort
#10
Clara L Rodríguez-Bernal, Isabel Hurtado, Aníbal García-Sempere, Salvador Peiró, Gabriel Sanfélix-Gimeno
Objective: Little is known about initial prescription of currently used oral anticoagulants (OAC), and correlated characteristics in real-world practice. We aimed to assess patterns of initiation of Vitamin K antagonists (VKA) and non-VKA oral anticoagulants (NOAC) in naive patients with non-valvular atrial fibrillation and the factors associated with starting treatment with NOAC. Methods: Population-based retrospective cohort study of all patients with NVAF who had a first prescription of OAC from November 2011 to February 2014 in the Valencia region, Spain (n = 21,881)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28255434/efficacy-and-safety-of-the-target-specific-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation-the-real-life-evidence
#11
REVIEW
Vincenzo Russo, Anna Rago, Riccardo Proietti, Federica Di Meo, Andrea Antonio Papa, Paolo Calabrò, Antonio D'Onofrio, Gerardo Nigro, Ahmed AlTurki
The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF)...
February 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28253498/brain-natriuretic-peptide-is-a-powerful-predictor-of-outcome-in-stroke-patients-with-atrial-fibrillation%C3%A2
#12
Kenji Maruyama, Shinichiro Uchiyama, Tsuyoshi Shiga, Mutsumi Iijima, Kentaro Ishizuka, Takao Hoshino, Kazuo Kitagawa
BACKGROUND: Since stroke patients with nonvalvular atrial fibrillation (NVAF) have poor outcomes in general, the prediction of outcomes following discharge is of utmost concern for these patients. We previously reported that brain natriuretic peptide (BNP) levels were significantly higher in NVAF patients with larger infarcts, higher modified Rankin Scale (mRS) score, and higher CHADS2 score. In the present study, we evaluated an array of variables, including BNP, in order to determine significant predictors for functional outcome in patients with NVAF after acute ischemic stroke (AIS)...
March 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#13
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28217549/anticoagulation-control-among-patients-with-nonvalvular-atrial-fibrillation-a-single-tertiary-cardiac-center-experience
#14
Shaban Mohammed, Amer H S Aljundi, Mohamed Kasem, Mohammed Alhashemi, Ayman El-Menyar
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital...
January 2017: Journal of Advanced Pharmaceutical Technology & Research
https://www.readbyqxmd.com/read/28215464/patients-with-intracranial-bleeding-and-atrial-fibrillation-treated-with-left-atrial-appendage-occlusion-results-from-the-amplatzer-cardiac-plug-registry
#15
Apostolos Tzikas, Xavier Freixa, Laura Llull, Sameer Gafoor, Samera Shakir, Heyder Omran, George Giannakoulas, Sergio Berti, Gennaro Santoro, Joelle Kefer, Adel Aminian, Steffen Gloekler, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Ignacio Cruz-Gonzalez, Prapa Kanagaratnam, Fabian Nietlispach, Reda Ibrahim, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Bernhard Meier, Haralampos Karvounis
BACKGROUND: In patients with non-valvular atrial fibrillation (NVAF), intracranial bleeding (ICB) constitutes a very challenging situation in which the rate of both ischemic and hemorrhagic events is increased. In these patients, left atrial appendage occlusion (LAAO) might represent a very valid alternative. OBJECTIVES: To investigate the procedural safety and long-term outcome of patients undergoing LAAO therapy due to previous ICB. METHODS: Data from the Amplatzer Cardiac Plug multicenter registry on 1047 consecutive patients were analyzed...
February 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185082/dabigatran-etexilate-a-review-in-nonvalvular-atrial-fibrillation
#16
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
#17
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
#18
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
#19
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
#20
MULTICENTER STUDY
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...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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