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Atrial fibrillation stroke prophylaxis

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https://www.readbyqxmd.com/read/28198520/twelve-month-follow-up-of-left-atrial-appendage-occlusion-with-amplatzer-amulet
#1
Caroline Kleinecke, Jai-Wun Park, Martin Gödde, Konstantin Zintl, Steffen Schnupp, Johannes Brachmann
BACKGROUND: The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second generation Amplatzer device for left atrial appendage occlusion for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. METHODS: In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the Amplatzer Amulet device...
February 15, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28196815/major-bleeding-complications-and-persistence-with-oral-anticoagulation-in-non-valvular-atrial-fibrillation-contemporary-findings-in-real-life-danish-patients
#2
Morten Lamberts, Laila Staerk, Jonas Bjerring Olesen, Emil Loldrup Fosbøl, Morten Lock Hansen, Louise Harboe, Cinira Lefevre, David Evans, Gunnar Hilmar Gislason
BACKGROUND: The nonvitamin K antagonist oral anticoagulants have recently become available as an alternative to warfarin as stroke prophylaxis in atrial fibrillation, but data on real-life patient experience, including bleeding risk, are lacking. Our objective was to compare major bleeding events and nonpersistence between the nonvitamin K antagonist oral anticoagulant apixaban and other nonvitamin K antagonist oral anticoagulants (dabigatran and rivaroxaban) and warfarin in a contemporary, nation-wide cohort of patients with nonvalvular atrial fibrillation...
February 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28185918/warfarin-use-and-the-risk-of-mortality-stroke-and-bleeding-in-hemodialysis-patients-with-atrial-fibrillation
#3
Brandon Kai, Yuliya Bogorad, Leigh-Ann N Nguyen, Su-Jau Yang, Wansu Chen, Hillard T Spencer, Albert Y-J Shen, Ming-Sum Lee
BACKGROUND: The optimal management of stroke prophylaxis in hemodialysis patients with atrial fibrillation is controversial. OBJECTIVE: The objectives of this study were to determine the risk of mortality, stroke, and bleeding associated with the use of warfarin in hemodialysis patients with atrial fibrillation. METHODS: This is a retrospective, population-based study of hemodialysis patients with atrial fibrillation between Jan 1, 2006 to Sept 30, 2015...
February 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28110293/increased-use-of-oral-anticoagulants-in-patients-with-atrial-fibrillation-temporal-trends-from-2005-to-2015-in-denmark
#4
Kasper Gadsbøll, Laila Staerk, Emil Loldrup Fosbøl, Caroline Sindet-Pedersen, Anna Gundlund, Gregory Y H Lip, Gunnar Hilmar Gislason, Jonas Bjerring Olesen
AIM: The aim of this study is to examine temporal trends in the use oral anticoagulants (OAC) as stroke prophylaxis in patients with atrial fibrillation (AF) and to examine factors associated with OAC initiation. METHODS AND RESULTS: From Danish nationwide registries, we identified patients diagnosed with AF at Danish hospitals and outpatient clinics between January 2005 and June 2015. OAC initiation was assessed from prescription fills ±180 days from date of AF diagnosis...
January 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28050712/optimizing-the-use-of-oral-anticoagulant-therapy-for-atrial-fibrilation-in-primary-care-a-pharmacist-led-intervention
#5
Mandeep S Virdee, Derek Stewart
Background Updated evidence-based guidelines for the management of atrial fibrillation (AF) necessitate patient review, particularly with respect to oral anticoagulants, to ensure maximum health gain around stroke prophylaxis. Objective To quantify the level of anticoagulation utilisation in patients with a CHA2DS2-VASc ≥1/≥2 (male/female) according to evidence-based guidelines and to assess the impact of a pharmacist-led intervention to optimise therapy. Setting Fifteen general medical practices in Liverpool, North-West England with a practice population of 99,129...
February 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28017326/the-association-of-anticoagulation-ischemic-stroke-and-hemorrhage-in-elderly-adults-with-chronic-kidney-disease-and-atrial-fibrillation
#6
Vaibhav Keskar, Eric McArthur, Ron Wald, Ziv Harel, Deborah Zimmerman, Amber O Molnar, Amit X Garg, Ngan N Lam, Megan K McCallum, Sarah E Bota, Jeffrey Perl, Manish M Sood
The utility of anticoagulants for ischemic stroke prophylaxis in elderly patients with chronic kidney disease (CKD) and atrial fibrillation remains uncertain. In this population-based retrospective cohort study, we determined the association of anticoagulant use with ischemic stroke or hemorrhage in elderly patients (66 years and older) with advanced chronic kidney disease (eGFR under 45 ml/min/1.73m(2)) and atrial fibrillation. We followed 6,544 patients with CKD and new onset atrial fibrillation, of whom 1,475 filled a prescription for an anticoagulant...
December 22, 2016: Kidney International
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
#7
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/27932513/improving-incidence-of-postoperative-atrial-fibrillation-after-cardiac-surgery-using-simplified-clinical-practice-guidelines
#8
Amr S Omar, Hesham Ewila, Mahmoud Allam, Sameh Aboulnagah, Samy Hanoura, Praveen C Sivadasan, Ousama Bilal, Abdul Rasheed A Pattath, Abdulaziz AlKhulaifi
OBJECTIVES: Postoperative atrial fibrillation (POAF) remains a major risk after cardiac surgery. Twelve percent patients admitted to this unit postcardiac surgery experienced POAF, which led to hemodynamic instability, increased risk of stroke, and increased length of postoperative intensive care unit stay. Our aim was to decrease the incidence of POAF in the cardiothoracic intensive care unit by the end of April 2014. METHODS: Design-Retrospective data analysis...
December 8, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#9
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27909475/ablation-of-atrial-fibrillation-in-combination-with-left-atrial-appendage-occlusion-in-a-single-procedure-rationale-and-technique
#10
REVIEW
Ignacio García-Bolao, Naiara Calvo, Alfonso Macias, Joaquin Barba, Nahikari Salterain, Pablo Ramos, Gabriel Ballesteros, Renzo Neglia
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and is associated with a fivefold increase in the risk of ischemic stroke and systemic embolism. Left atrial appendage (LAA) is the source of thrombi in up to 90% of patients with nonvalvular atrial fibrillation (AF). Although thromboembolic prophylaxis by means of oral anticoagulants (OAC) has been shown to be very effective (OAC), they also confer an inevitably risk of serious bleeding. Catheter ablation (CA) is an effective treatment for symptomatic AF but its role in stroke prevention remains unproved...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27846983/gender-specific-differences-for-risk-of-disability-and-death-in-atrial-fibrillation-related-stroke
#11
Ryan C Martin, W Scott Burgin, Matthew B Schabath, Bonnie Kirby, Sanders H Chae, Michael G Fradley, David Z Rose, Arthur J Labovitz
In the latest American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines, CHA2DS2-VASc replaced the CHADS2 stroke risk assessment to determine prophylactic anticoagulation, reflecting female gender's association with stroke incidence in AF. However, little investigation has been pursued of potential risk factors associated with worsened stroke severity. In this study, we examined patients with AF with ischemic stroke patient characteristics associated with increased stroke severity...
January 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27811198/the-efficacy-and-safety-of-edoxaban-for-vte-prophylaxis-post-orthopedic-surgery-a-systematic-review
#12
Lamia AlHajri, Sima Jabbari, Hind AlEmad, Khawla AlMahri, Maryam AlMahri, Noora AlKitbi
BACKGROUND: Venous thromboembolism (VTE) is a common complication that manifests during and/or after hospitalization, as well as postsurgeries including orthopedic surgeries. Edoxaban is a new oral direct factor Xa inhibitor that has been recently approved for treating VTE in patients who have already been treated with a parenteral anticoagulant and for the prevention of stroke and non-central nervous system systemic embolism in patients with nonvalvular atrial fibrillation. OBJECTIVES: The purpose of this systematic review was to evaluate the safety and efficacy of edoxaban for VTE prophylaxis after lower limb orthopedic surgery...
November 2, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27797891/use-of-oral-anticoagulation-in-the-management-of-atrial-fibrillation-in-patients-with-esrd-con
#13
Vaibhav Keskar, Manish M Sood
Among patients with atrial fibrillation, prophylaxis for stroke prevention with the use of anticoagulation is well established in the general population. A number of randomized controlled trials and evidence-based risk prediction tools clearly delineate the benefit and risks of therapy. Despite the high incidence of atrial fibrillation in the late stage CKD and ESRD populations, little high quality evidence exists in these populations. Is it appropriate then to extrapolate findings from the general population to those with CKD/ESRD? In our view, too much uncertainty exists regarding proof of efficacy with clear signals of harm...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27789043/comparison-of-adherence-to-rivaroxaban-versus-apixaban-among-patients-with-atrial-fibrillation
#14
Colleen A McHorney, Eric D Peterson, François Laliberté, Guillaume Germain, Winnie W Nelson, Concetta Crivera, Jeffrey Schein, Patrick Lefebvre
PURPOSE: Non-vitamin K antagonist oral anticoagulant medications are increasingly used for stroke prophylaxis in patients with nonvalvular atrial fibrillation (NVAF). This study aimed to compare adherence with rivaroxaban and apixaban among patients with NVAF in routine clinical practice. METHODS: Using pharmacy and medical claims from Truven Health Analytics MarketScan databases, we identified NVAF patients aged ≥18 years treated with rivaroxaban or apixaban...
October 24, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27742807/ischaemic-and-haemorrhagic-stroke-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-and-warfarin-use-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#15
Laila Staerk, Emil Loldrup Fosbøl, Gregory Y H Lip, Morten Lamberts, Anders Nissen Bonde, Christian Torp-Pedersen, Brice Ozenne, Thomas Alexander Gerds, Gunnar Hilmar Gislason, Jonas Bjerring Olesen
BACKGROUND: Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are widely used as stroke prophylaxis in non-valvular atrial fibrillation (AF), but comparative data are sparse. PURPOSE: To compare dabigatran, rivaroxaban, and apixaban vs. VKA and the risk of stroke/thromboembolism (TE) and intracranial bleeding in AF. METHODS: Using Danish nationwide registries (2011-15), anticoagulant-naïve AF patients were identified when initiating VKA or an NOAC...
October 14, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27734642/current-perspective-on-use-of-noac-in-clinical-practice-in-india
#16
REVIEW
Jamshed J Dalal, Anil Dhall, Abhay Bhave
Oral vitamin K antagonists (VKA) such as warfarin have been the mainstay of therapy for stroke prevention in patients with non valvular atrial fibrillation (NVAF) while low-molecular-weight heparin, fondaparinux and adjusted-dose warfarin or aspirin have been routinely used for thromboembolism (VTE) prophylaxis in patients undergoing total hip or knee replacement. However, VKAs are associated with considerable limitations, including increased risk of bleeding and narrow therapeutic window. Novel oral anticoagulants (NOACs, now referred as Non Vit K dependent oral anticoagulants), including the direct thrombin inhibitor dabigatran and direct Factor Xa inhibitors such as rivaroxaban and apixaban are now approved alternatives to warfarin for prophylaxis of stroke and systemic embolic events (SEE) in patients with NVAF and treatment and prophylaxis of VTE...
April 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27706224/comparison-of-approaches-for-stroke-prophylaxis-in-patients-with-non-valvular-atrial-fibrillation-network-meta-analyses-of-randomized-controlled-trials
#17
Navkaranbir S Bajaj, Rajat Kalra, Nirav Patel, Taimoor Hashim, Hemant Godara, Sameer Ather, Garima Arora, Tilak Pasala, Thomas T Whitfield, David C McGiffin, Mustafa I Ahmed, Steven G Lloyd, Nita A Limdi, Pankaj Arora
BACKGROUND: Multiple novel oral anticoagulants and left atrial appendage closure devices (WATCHMAN) have been tested against dose-adjusted vitamin K antagonists in randomized controlled trials for stroke prophylaxis in non-valvular atrial fibrillation. No direct comparisons of these strategies are available from randomized controlled trials. We conducted the current analyses by combining efficacy and safety characteristics of all FDA approved stroke prophylaxis treatment strategies for patients with non-valvular atrial fibrillation...
2016: PloS One
https://www.readbyqxmd.com/read/27703066/overcoming-global-challenges-in-stroke-prophylaxis-in-atrial-fibrillation-the-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#18
Ayrton Massaro, Robert P Giugliano, Bo Norrving, Ali Oto, Roland Veltkamp
Atrial fibrillation is the world's most common sustained cardiac arrhythmia and is associated with a significantly increased risk of stroke. The global burden of atrial fibrillation is rising, commensurate with the ageing population. Well-controlled vitamin K antagonist-based anticoagulation has been shown to reduce the risk of stroke secondary to atrial fibrillation by two-thirds. However, patients with atrial fibrillation have frequently been denied anticoagulation because of a variety of perceived risks related to bleeding, falls, chronological age, and poor compliance...
October 4, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27694266/early-start-of-doac-after-ischemic-stroke-risk-of-intracranial-hemorrhage-and-recurrent-events
#19
David J Seiffge, Christopher Traenka, Alexandros Polymeris, Lisa Hert, Nils Peters, Philippe Lyrer, Stefan T Engelter, Leo H Bonati, Gian Marco De Marchis
OBJECTIVE: In patients with recent acute ischemic stroke (AIS) and atrial fibrillation, we assessed the starting time of direct, non-vitamin K antagonist oral anticoagulants (DOACs) for secondary prevention, the rate of intracranial hemorrhage (ICH), and recurrent ischemic events during follow-up. METHODS: We included consecutive patients with nonvalvular atrial fibrillation admitted to our hospital for AIS or TIA (index event) who received secondary prophylaxis with DOAC or vitamin K antagonists (VKAs)...
November 1, 2016: Neurology
https://www.readbyqxmd.com/read/27681577/update-on-hypertrophic-cardiomyopathy-and-a-guide-to-the-guidelines
#20
REVIEW
Srijita Sen-Chowdhry, Daniel Jacoby, James C Moon, William J McKenna
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment...
November 2016: Nature Reviews. Cardiology
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