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https://www.readbyqxmd.com/read/28814457/direct-oral-anticoagulant-vs-vitamin-k-antagonist-related-nontraumatic-intracerebral-hemorrhage
#1
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis Varelas, Aristeidis H Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W Alexandrov, Panayiotis Mitsias, Andrei V Alexandrov
OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH...
August 16, 2017: Neurology
https://www.readbyqxmd.com/read/28812917/predictive-role-of-cha2ds2-vasc-score-for-cardiovascular-events-and-death-in-patients-with-arterial-hypertension-and-stable-sinus-rhythm
#2
Carmine Mazzone, Giovanni Cioffi, Cosimo Carriere, Giulia Barbati, Giorgio Faganello, Giulia Russo, Antonella Cherubini, Gianfranco Sinagra, Nadia Zeriali, Andrea Di Lenarda
Background The CHA2DS2-VASc score well stratifies the risk for thromboembolic events in non-valvular atrial fibrillation (NVAF) patients. This score may also predict thromboembolic events in sinus rhythm populations. Purpose The purpose of this study was to assess the prognostic role of CHA2DS2-VASc in a Caucasian community population of patients with arterial hypertension and sinus rhythm. Methods A total of 12,599 arterial hypertension residents not receiving anticoagulation were selected from a community population in Trieste between November 2009 and October 2014: 11,159 sinus rhythm and 1440 NVAF patients...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28809201/secondary-use-of-ehr-interpreting-clinician-inter-rater-reliability-through-qualitative-assessment
#3
Sarah Mullin, Edwin Anand, Shyamashree Sinha, Buer Song, Jane Zhao, Peter L Elkin
In a retrospective secondary-use EHR study identifying a cohort of Non-Valvular Atrial Fibrillation (NVAF) patients, chart abstraction was done by two sets of clinicians to create a gold standard for risk measures CHA2DS2-VASc and HAS-BLED. Inter-rater reliability between each set of clinicians for NVAF and the outcomes of interest were variable, ranging from extremely low agreement to high agreement. To assess the chart abstraction process, a focus group and a survey was conducted. Survey findings revealed patterns of difficulty in assessing certain items dealing with temporality and social data...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#4
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...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#5
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischemic-stroke-and-non-valvular-atrial-fibrillation
#6
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Yohei Takayama, Kentaro Suzuki, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has a potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aims of the present study were to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF (NVAF)...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28797952/left-atrial-appendage-closure-using-amplatzer%C3%A2-devices-a-large-multicenter-italian-registry
#7
Sergio Berti, Gennaro Santoro, Elvis Brscic, Matteo Montorfano, Luigi Vignali, Paolo Danna, Claudio Tondo, Gianpiero D'Amico, Amerigo Stabile, Salvatore Saccà, Giuseppe Patti, Antonio Rapacciuolo, Arnaldo Poli, Paolo Golino, Paolo Magnavacchi, Alberto De Caterina, Francesco Meucci, Bruno Pezzulich, Marco Rezzaghi, Miroslava Stolcova, Giuseppe Tarantini
BACKGROUND: Left atrial appendage occlusion (LAAO) has been proven to be effective for stroke prophylaxis in patients with non-valvular atrial fibrillation (NVAF). We aim to assess the safety and efficacy of LAAO by AMPLATZER™ devices in a large, multicenter, single-nation cohort of NVAF patients at high-risk of stroke and bleeding. METHODS: From December 2008 to April 2015 613 NVAF patients (75.1±8.0years, 62.5% male) underwent LAAO in 15 Italian centers by AMPLATZER™ devices...
July 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28795348/all-cause-stroke-and-bleed-specific-healthcare-costs-comparison-among-patients-with-non-valvular-atrial-fibrillation-nvaf-newly-treated-with-dabigatran-or-warfarin
#8
Adrienne M Gilligan, Pranav Gandhi, Xue Song, Cheng Wang, Caroline Henriques, Stephen Sander, David M Smith
OBJECTIVE: Our objective was to compare all-cause and stroke- and bleed-specific healthcare costs among patients with non-valvular atrial fibrillation (NVAF) treated with dabigatran or warfarin. METHODS: Administrative claims data from the MarketScan(®) Databases for 2009-2014 were used. Patients with NVAF newly treated with dabigatran were matched 1:1 to those treated with warfarin. All-cause and stroke- and bleed-specific costs per patient per month (PPPM) ($US, year 2015 values) up to a 12-month follow-up period were analyzed...
August 9, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#9
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#10
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28764897/-clinical-characteristics-of-patients-with-atrial-fibrillation-treated-with-direct-oral-anticoagulants-attended-in-primary-care-setting-the-silver-ap-study
#11
Mariano de la Figuera, Sergio Cinza, Nuria Marín, Isabel Egocheaga, Miguel Angel Prieto
OBJECTIVE: To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC). DESIGN: Observational, cross-sectional and multicentre study. LOCATION: Autonomous Communities in which the general practitioner can prescribe DOAC (n=9). PARTICIPANTS: The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months...
July 29, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28752782/the-feasibility-of-substituting-left-atrial-wall-strain-for-flow-velocity-of-left-atrial-appendage
#12
Akihito Miyoshi, Yoichi Nakamura, Yukio Kazatani, Hiroshi Ito
OBJECTIVE: Non-valvular atrial fibrillation (NVAF) is frequently complicated by thromboembolism. Left atrial appendage (LAA) flow is a predictor of LAA thrombosis. LAA flow is measured by transesophageal echocardiography (TEE), which is a semi-invasive diagnostic tool. Recently, speckle-tracking methods have been adapted for the evaluation of local cardiac function. We hypothesised that if we could determine LAA wall motion utilising a speckle tracking technique, we could non-invasively analyse LAA flow...
July 28, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28748652/bleeding-related-hospital-admissions-and-30-day-re-admissions-in-patients-with-nonvalvular-atrial-fibrillation-treated-with-dabigatran-versus-warfarin
#13
Wallis C Y Lau, Xue Li, Ian C K Wong, Kenneth K C Man, Gregory Y H Lip, Wai K Leung, Chung W Siu, Esther W Chan
BACKGROUND: Reducing 30-day hospital re-admission is a policy priority worldwide. Warfarin-related bleeding is among the most common cause of hospital admissions due to adverse drug events. Compared to warfarin, dabigatran achieve full anticoagulation effect more quickly following its initiation, hence may lead to early-onset bleeds. OBJECTIVES: To compare the incidence of bleeding-related hospital admissions and 30-day re-admissions with dabigatran versus warfarin in patients with nonvalvular atrial fibrillation (NVAF)...
July 27, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28741791/comparison-of-the-safety-and-effectiveness-of-apixaban-versus-warfarin-in-patients-with-severe-renal-impairment-an-alternative-viewpoint
#14
Megan Z Roberts, T Michael Farley, Ryan E Owens
We thank Dr. Stanton and colleagues for their great work evaluating the clinical outcomes of apixaban in patients with severe renal dysfunction, ultimately concluding apixaban is a reasonable alternative to warfarin.(1) One question that clinicians should ask before applying this conclusion to clinical practice is what dose of apixaban should be used? The authors note that patients were primarily receiving apixaban 2.5 mg twice/day but gave no further breakdown based upon indication or level of renal dysfunction...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28738273/factors-influencing-warfarin-control-in-australia-and-singapore
#15
Nijole Bernaitis, Chi Keong Ching, Siew Chong Teo, Liping Chen, Tony Badrick, Andrew K Davey, Julia Crilly, Shailendra Anoopkumar-Dukie
INTRODUCTION: Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore...
July 14, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28714523/echocardiographic-parameters-versus-cha2ds2-vasc-score-in-prediction-of-overall-cardiac-events-heart-failure-and-stroke-in-non-valvular-atrial-fibrillation
#16
Li-Tan Yang, Wei-Chuan Tsai, Ho-Ming Su
BACKGROUND: Apart from stroke, atrial fibrillation (AF) is associated with higher mortality and heart failure (HF), in which risk stratification scheme is lacking. Therefore this investigation examined the prognostic value of echocardiographic predictors against CHA₂DS₂-VASc score in permanent non-valvular AF (NVAF). METHOD: In 252 asymptomatic or mildly symptomatic consecutive patients with NVAF, comprehensive echocardiography was performed. Left atrial deformation parameters were also obtained by two-dimensional speckle tracking echocardiography...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28713598/development-of-new-deep-venous-thrombosis-while-on-apixaban
#17
Munish Sharma, Sabarina Ramanathan, Koroush Khalighi
The efficacy of novel oral anticoagulants (NOACs) in preventing deep venous thrombosis (DVT) has been established in large multicenter trials. Predictable pharmacokinetics, avoidance of routine laboratory monitoring, and lesser drug interactions have made NOACs safer and more tolerable treatment option in comparison to warfarin. However, cases of treatment failure mainly due to interindividual variation in plasma drug levels can be seen rarely. In this report we describe a case of acute DVT of right lower extremity in a patient who was on apixaban for prevention of venous thromboembolism (VTE) due to underlying nonvalvular atrial fibrillation (NVAF)...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28701668/effects-of-smoking-on-ischemic-stroke-intracranial-hemorrhage-and-coronary-artery-events-in-japanese-patients-with-non-valvular-atrial-fibrillation
#18
MULTICENTER STUDY
Shinya Suzuki, Takayuki Otsuka, Koichi Sagara, Hiroaki Semba, Hiroto Kano, Shunsuke Matsuno, Hideaki Takai, Yuko Kato, Tokuhisa Uejima, Yuji Oikawa, Kazuyuki Nagashima, Hajime Kirigaya, Junji Yajima, Takashi Kunihara, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
The effects of smoking on the prognosis of non-valvular atrial fibrillation (NVAF) patients are unclear.The Shinken Database 2004-11 (n = 17,517) includes all new patients visiting the Cardiovascular Institute between June 2004 and March 2012. Among these cases, 2,102 NVAF patients were identified. The effects of smoking on ischemic stroke (IS), intracranial hemorrhage (ICH), and coronary artery events including percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS) were analyzed. Smokers were younger and had lower risk profiles compared with non-smokers...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28682153/real-life-cost-of-vitamin-k-antagonist-treatment-in-patients-with-non-valvular-atrial-fibrillation-in-france-in-2013
#19
Jean Dallongeville, Xavier Ansolabehere, Noëlla Karusisi, Frédérique Maurel, Eric Van Ganse, Jean-Yves Le Heuzey
AIMS: Data highlighting the cost drivers for non-valvular atrial fibrillation (NVAF) patients in terms of vitamin K antagonist (VKA) treatment and monitoring are lacking in France. This study aimed to evaluate the real-life daily cost of VKA treatment in 2013, in French patients suffering from NVAF. METHODS: This longitudinal observational study was performed using the EGB (Echantillon Généraliste des Bénéficiaires) database, a random sample of the French national insurance (NHI) database, which covers 80% of the population...
July 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28666358/shifting-to-a-non-vitamin-k-antagonist-oral-anticoagulation-agent-from-vitamin-k-antagonist-in-atrial-fibrillation
#20
Emil L Fosbøl, Naja Emborg Vinding, Morten Lamberts, Laila Staerk, Anna Gundlund, Kasper Gadsbøll, Lars Køber, Gunnar H Gislason, Jonas Bjerring Olesen
Aims: After non-vitamin K antagonist (VKA) oral anticoagulation agents (NOAC) have been approved for thrombo-embolic prophylaxis in non-valvular atrial fibrillation (NVAF), utilization of oral anticoagulants (OAC) in NVAF has changed. Contemporary shifting from a VKA to a NOAC (dabigatran, rivaroxaban, or apixaban) has not been quantified, and could help assess whether these drugs are used according to recommendations. Methods and results: Using Danish nationwide registries, we identified all VKA-experienced NVAF patients initiating a NOAC from 22 August 2011 to 31 December 2015 (shifters) and all VKA-experienced NVAF patients who were not switched to NOACs (non-shifters)...
June 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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