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https://www.readbyqxmd.com/read/28506913/predicting-determinants-of-atrial-fibrillation-or-flutter-for-therapy-elucidation-in-patients-at-risk-for-thromboembolic-events-predate-af-study
#1
Javed M Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater
BACKGROUND: Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown. OBJECTIVES: In this study, we prospectively evaluated the use of the CHA2DS2-VASc score for the prediction of new-onset AF using insertable cardiac monitors (ICMs) and examined whether this screening led to the initiation of OAC therapy...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28493056/non-vitamin-k-oral-anticoagulants-for-stroke-prevention-in-special-populations-with-atrial-fibrillation
#2
REVIEW
Arnaud Bisson, Denis Angoulvant, Raphael Philippart, Nicolas Clementy, Dominique Babuty, Laurent Fauchier
Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke or systemic embolism compared with normal sinus rhythm. These strokes may efficiently be prevented in patients with risk factors using oral anticoagulant therapy, with either vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) (i.e., direct thrombin inhibitors or direct factor Xa inhibitors). Owing to their specific risk profiles, some AF populations may have increased risks of both thromboembolic and bleeding events...
May 10, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28482261/nonvitamin-k-dependent-oral-anticoagulants-noacs-in-chronic-kidney-disease-patients-with-atrial-fibrillation
#3
REVIEW
L Di Lullo, C Ronco, M Cozzolino, D Russo, L Russo, B Di Iorio, A De Pascalis, V Barbera, M Galliani, E Vitaliano, C Campana, F Santoboni, A Bellasi
Atrial fibrillation (AF) represents the most common arrhythmia in patients with chronic kidney disease (CKD). As in the general population, in CKD patients AF is associated with an increased risk of thromboembolism and stroke. However, CKD patients, especially those on renal replacement therapy (RRT), also exhibit an increased risk of bleeding, especially from the gastrointestinal tract. Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF presenting increased risk of stroke...
May 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28480507/initiation-of-anticoagulation-in-atrial-fibrillation-which-factors-are-associated-with-choice-of-anticoagulant
#4
Anna Gundlund, Laila Staerk, Emil Loldrup Fosbøl, Kasper Gadsboel, Caroline Sindet-Pedersen, Anders Nissen Bonde, Gunnar H Gislason, Jonas Bjerring Olesen
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prophylaxis in atrial fibrillation (AF) is increasing rapidly. We compared characteristics of AF patients initiated on NOACs versus vitamin K antagonists (VKAs). METHODS: Using Danish nationwide registry data we identified AF patients initiating either a VKA or a NOAC from 22 August 2011 until 30 September 2016. We compared patient characteristics including age, gender, comorbidities, concomitant pharmacotherapy and CHA2 DS2 -VASc and HAS-BLED scores in patients initiated on a VKA, dabigatran, rivaroxaban or apixaban...
May 8, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28479184/systemic-thrombolysis-in-acute-ischemic-stroke-after-dabigatran-etexilate-reversal-with-idarucizumab-a-case-report
#5
Derya Tireli, Jun He, Mette Maria Nordling, Troels Wienecke
INTRODUCTION: Idarucizumab is a reversal agent for dabigatran etexilate. By reversing the anticoagulating effect of dabigatran etexilate with idarucizumab (Praxbind), patients presenting with an acute ischemic stroke can now be eligible for thrombolysis. PATIENT: We describe our experience with idarucizumab in a 71-year-old male patient pretreated with dabigatran etexilate. The patient arrived with a hemiparesis, central facial palsy, and dysarthria. METHOD: Dabigatran etexilate was antagonized with idarucizumab, approximately 2...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28472251/rivaroxaban-withdrawal-and-rebound-hypercoagulability-leading-to-upper-extremity-deep-vein-thrombosis-a-case-report
#6
Subramaniam Nagasayi, Surendra Varman, Yeo Yan Ting, Wendy Ang
As the newer oral anticoagulants (NOACs) are increasingly used in older patients, clinical scenarios when they may need to be discontinued temporarily or indefinitely, may be encountered. Similarly with increasing use of permanent pacemakers and other intra-cardiac devices, there is an increased risk of upper limb venous thrombosis even few years after their insertion. We report a case of a patient with a permanent pacemaker, on rivaroxaban (NOAC) for atrial fibrillation, who developed an upper extremity deep vein thrombosis after its temporary withdrawal following a traumatic acute subdural haematoma...
May 3, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28466118/who-should-be-referred-for-left-atrial-appendage-occlusion-therapy
#7
REVIEW
Sidakpal S Panaich, David R Holmes
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 7 million individuals in USA. It is one of the most significant arrhythmias, which accounts for a majority of embolic strokes, especially in elderly individuals. Although oral anti-coagulation is beneficial in lowering the risk of stroke, 1 in 10 patients have a contra-indication to warfarin therapy. Among patients who do tolerate either warfarin or novel oral anticoagulant (NOAC), major or recurrent bleeding, intracranial bleeds, etc...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#8
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28461140/laa-occluder-device-for-stroke-prevention-data-on-watchman-and-other-laa-occluders
#9
REVIEW
Martin W Bergmann
NOAC therapy has become the standard for stroke prevention in patients with atrial fibrillation. Yet some patients suffer extracranial bleeding events or have other reasons to seek non-pharmacologic stroke protection. LAA occlusion with the WATCHMAN device has been proven safe and effective for such patients and is now recommended in current guidelines for this patient group; other devices also seek approval.
March 24, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28460024/non-vitamin-k-dependent-oral-anticoagulants-have-a-positive-impact-on-ischaemic-stroke-severity-in-patients-with-atrial-fibrillation
#10
Simon Hellwig, Ulrike Grittner, Heinrich Audebert, Matthias Endres, Karl Georg Haeusler
Aims: Several studies showed reduced stroke severity in patients with atrial fibrillation (AF) if the international normalized ratio (INR) was ≥ 2 at stroke onset. There are no respective data for non-vitamin K-dependent oral anticoagulants (NOACs). The aim of this study was to compare the impact of NOAC or phenprocoumon intake on stroke severity. Methods and results: In this single-centre observational study, 3669 patients with acute ischaemic stroke were retrospectively analysed regarding AF status and medication immediately before admission...
April 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28458008/risk-of-gastrointestinal-bleeding-in-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-a-systematic-review-and-meta-analysis
#11
Corey S Miller, Alastair Dorreen, Myriam Martel, Thao Huynh, Alan N Barkun
BACKGROUND AND AIMS: Non-vitamin K antagonist oral anticoagulants (NOACs) are convenient and effective in prevention and treatment of venous thromboembolism and prevention of stroke in patients with atrial fibrillation. However, these drugs have been associated with increased risk of gastrointestinal (GI) bleeding. We conducted a systematic review and meta-analysis to determine the risk of GI bleeding in patients receiving these drugs. METHODS: We searched the EMBASE, Medline, Cochrane, and ISI Web of knowledge databases through January 2016 for randomized trials that compared NOACs to conventional anticoagulants for approved indications...
April 27, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28439617/-stroke-prophylaxis-in-atrial-fibrillation-when-how-and-for-whom
#12
T Maurer, C Sohns
In patients suffering from atrial fibrillation (AF), modern antithrombotic therapy and anticoagulation strategies should be individualized based on shared decision making including patient preferences and the absolute and relative risks of stroke and bleeding. Estimation of the individual risk for stroke is still based on the CHA2DS2-VASc score. Based on the most recent guidelines for the management of AF, oral anticoagulation therapy should be considered for men with a CHA2DS2-VASc score ≥1 and women with a score ≥2, balancing the expected stroke reduction, risk of bleeding and patient preference...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#13
Leon A Simons, Michael Ortiz, S Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28416977/trends-in-physiological-coagulation-factors-in-japanese-patients-receiving-novel-oral-anticoagulants
#14
Tomoyuki Nagao, Hiroshi Hunakubo, Mayu Suzuki, Takashi Kataoka, Satoshi Okumura, Norihiro Shinoda, Ken Harada, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Shinichi Sakai, Tetsuya Amano, Toyoaki Murohara
BACKGROUND: Little is known about physiological anticoagulation effects via antithrombin III (AT III) and protein C/S (PC/PS) in patients using new oral anticoagulants (NOACs). METHODS: We evaluated 120 consecutive patients with non-valvular atrial fibrillation (AF) receiving NOACs. Patients were randomly divided into three groups: a dabigatran group (DG, N=40), a rivaroxaban group (RG, N=40) or an apixaban group (AG, N=40). A warfarin group (WG, N=40) was matched with NOAC groups for age, sex and type of AF during the same time period...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#15
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28398381/-prevalence-of-atrial-fibrillation-treatment-eligibility-and-consumption-of-oral-anticoagulants-in-italian-local-health-authorities-impact-of-non-vitamin-k-antagonist-oral-anticoagulants
#16
Felicita Andreotti, Daniela D'Angela, R Letizia Mancusi, Federico Spandonaro
BACKGROUND: Atrial fibrillation (AF) increases significantly the risk of comorbidities and premature death. This paper aims to estimate: 1) the current prevalence of AF in Italy as a whole and within individual local health authorities (LHA); 2) the proportion of strongly eligible patients receiving oral anticoagulants; 3) the impact of non-vitamin K antagonist oral anticoagulants (NOACs). METHODS: The prevalence of AF and the proportion of patients strongly eligible for anticoagulant treatment (defined by a CHADS2 score ≥2) were obtained by applying the results of a systematic literature search to the Italian population stratified by gender, age and LHA...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398379/-the-slow-acceptance-of-new-oral-anticoagulants-in-italy-a-critical-analysis-of-a-problem
#17
Giovanni Luca Botto, Claudio Cuccia, Edoardo Gronda, Federico Lombardi, Maurizio Lunati, Antonio Maggi, Ferdinando Maria Massari, Giuseppe Musumeci, Fabrizio Oliva, Luigi Oltrona Visconti, Cesare Proto, Enrico Pusineri, Walter Ageno
The introduction of non-vitamin K antagonist oral anticoagulants (NOACs) into clinical practice has revolutionized the prevention and the therapeutic approaches to thromboembolic events in patients with nonvalvular atrial fibrillation and represents with no doubts one of the most remarkable advances in the history of cardiovascular medicine over the last years. NOACs beyond a comparable efficacy with vitamin K antagonists allow to overcome the limitations of this last category of drugs owing to their less drug to drug interactions and a predictable anticoagulant effect that allows a fixed dose administration without the need for continuous monitoring...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398377/-new-oral-anticoagulants-in-patients-with-atrial-fibrillation-efficacy-and-safety-data-from-the-real-world
#18
Letizia Riva, Giuseppe Di Pasquale
New oral anticoagulants (NOACs: dabigatran, rivaroxaban, apixaban and edoxaban) proved to be at least non-inferior to warfarin in reducing thromboembolic risk in patients with atrial fibrillation. In addition, NOACs have been demonstrated to be safe and associated with a significant reduction in major and intracranial bleeding events. With the exception of apixaban, an increase in gastrointestinal bleedings has been observed, but as a whole NOACs have been shown to reduce mortality with rates similar to those of warfarin...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398375/-comparability-of-efficacy-and-safety-results-among-phase-iii-trials-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation
#19
Giuseppe Patti, Paolo Colonna, Francesco Pelliccia, Vittorio Pengo, Pasquale Perrone Filardi, Paolo Verdecchia
In this paper we demonstrate that among four phase III trials comparing warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) vs warfarin in patients with non-valvular atrial fibrillation there was heterogeneity in the thromboembolic and bleeding risk of the included populations, variability in the definitions of primary endpoints, especially for safety, and different criteria for reducing NOAC dosage according to renal function. Therefore, findings from these four studies are not directly comparable and it is incorrect to conduct comparative evaluations between various NOACs...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28396988/the-non-vitamin-k-antagonist-oral-anticoagulants-noacs-and-extremes-of-body-weight-a-systematic-literature-review
#20
REVIEW
Raffaele De Caterina, Gregory Y H Lip
The non-vitamin K antagonist oral anticoagulants (NOACs) exert their anticoagulant effect closely related to their plasma concentrations. Since their distribution volume is related to body weight (and its correlates, i.e., surface area and body mass index, BMI), extremes in body weight may affect their efficacy or safety. Four NOACs are currently available for long-term use, with few exceptions, in atrial fibrillation and venous thromboembolism: the direct thrombin inhibitor dabigatran etexilate, and the factor (F) Xa inhibitors rivaroxaban, apixaban, and edoxaban...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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