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Anticoagulation in atrial fibrillation

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https://www.readbyqxmd.com/read/28213993/healthcare-resources-and-needs-in-anticoagulant-therapy-for-patients-with-nonvalvular-atrial-fibrillation-samoa-study
#1
V Barrios, M I Egocheaga-Cabello, J Gállego-Culleré, E Ignacio-García, L Manzano-Espinosa, A Martín-Martínez, J Mateo-Arranz, J Polo-García, D Vargas-Ortega
INTRODUCTION AND OBJECTIVES: To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients. METHODS: We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients...
February 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28213368/effects-of-dabigatran-according-to-age-in-atrial-fibrillation
#2
Mandy N Lauw, John W Eikelboom, Michiel Coppens, Lars Wallentin, Salim Yusuf, Michael Ezekowitz, Jonas Oldgren, Juliet Nakamya, Jia Wang, Stuart J Connolly
OBJECTIVE: The prevalence of atrial fibrillation (AF) and the risk of stroke and bleeding vary according to age. To estimate effects of dabigatran, compared with warfarin, on stroke, bleeding and mortality in patients with AF in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial according to age, we analysed treatment effects using age as a continuous variable and using age categories. METHODS: RE-LY included 10 855 (59.9%) patients aged <75 years, 4231 patients (23...
February 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#3
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#4
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28209388/increased-risk-of-thromboembolic-events-in-adult-congenital-heart-disease-patients-with-atrial-tachyarrhythmias
#5
Keita Masuda, Tomoko Ishizu, Koichiro Niwa, Fumie Takechi, Shigeru Tateno, Hitoshi Horigome, Kazutaka Aonuma
BACKGROUND: Atrial tachyarrhythmias are a major morbidity in patients with adult congenital heart disease (ACHD). However, few studies have investigated risk stratification of thromboembolic events in ACHD patients with atrial tachyarrhythmias. METHODS AND RESULTS: This retrospective cohort study reviewed the clinical records of 2314 ACHD patients from 1977 to 2014. We found 242 (10.4%) patients with atrial tachyarrhythmias and excluded 84 patients already being treated with anticoagulant therapy...
February 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28209219/anticoagulation-in-atrial-fibrillation-is-the-paradigm-really-shifting
#6
EDITORIAL
Prakash Deedwania, Tushar Acharya
No abstract text is available yet for this article.
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#7
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28208197/reversal-of-direct-oral-anticoagulants-current-status-and-future-directions
#8
Jeffrey I Weitz
Direct oral anticoagulants (DOACs) are increasingly used for prevention and treatment of venous thromboembolism and for prevention of stroke in patients with nonvalvular atrial fibrillation. In phase III clinical trials that included more than 100,000 patients, the DOACs were at least as effective as vitamin K antagonists (VKAs) and were associated with less serious bleeding, particularly less intracranial bleeding. Real-world evidence supports these outcomes. Despite this, some physicians and patients are concerned about serious bleeding or emergencies unless specific reversal agents for the DOACs are available...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208176/postapproval-observational-studies-of-non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation
#9
Tatjana S Potpara, Gregory Y H Lip
No abstract text is available yet for this article.
February 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#10
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#11
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28203466/idiopathic-renal-infarction-mimicking-appendicitis
#12
Marco Di Serafino, Rosa Severino, Chiara Gullotto, Francesco Lisanti, Enrico Scarano
Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%-0.007%). Usually, it manifests in patients aged 60-70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28198520/twelve-month-follow-up-of-left-atrial-appendage-occlusion-with-amplatzer-amulet
#13
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/28198201/clinical-implications-of-reversal-agents-for-direct-oral-anticoagulants
#14
Sarah Monagle, John W Eikelboom, Kuan H Ng, Vinai C Bhagirath
Direct oral anticoagulants (DOACs) are effective in preventing and treating venous thromboembolism, and preventing stroke in atrial fibrillation. Until recently, there has been no specific reversal agent for DOACs. Now, a specific antidote for the direct thrombin inhibitor, dabigatran has been approved for use, and antidotes for factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are being developed. We review the evidence for currently used and emerging reversal strategies, and discuss possible clinical implications, including increased prescription of DOACs, use of DOACs in clinical situations previously felt to pose too great a risk of bleeding, and use of reversal agents beyond currently approved indications...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28197274/early-changes-in-the-antithrombin-and-thrombin-antithrombin-complex-in-patients-with-paroxysmal-atrial-fibrillation
#15
Mariya Negreva, Svetoslav Georgiev, Krasimira Prodanova, Julia Nikolova
BACKGROUND: Data on coagulation changes in paroxysmal atrial fibrillation (PAF) are scarce. The aim of this study was to examine plasma antithrombin (AT) levels and activity as well as thrombin-antithrombin (TAT) complex levels in the early hours of the clinical manifestation of PAF. METHODS: Fifty-one patients (26 men and 25 women; mean age 59.84 ± 1.60 years) were consecutively selected with PAF duration < 24 hours, and 52 controls (26 men and 26 women; mean age 59...
June 2016: Cardiology Research
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
#16
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/28194578/edoxaban-in-atrial-fibrillation-and-venous-thromboembolism-ten-key-questions-and-answers-a-practical-guide
#17
REVIEW
Raffaele De Caterina, Walter Ageno, Giuseppe Boriani, Paolo Colonna, Angelo Ghirarduzzi, Giuseppe Patti, Roberta Rossini, Andrea Rubboli, Piercarla Schinco, Giancarlo Agnelli
Edoxaban is the fourth non-vitamin K antagonist oral anticoagulant now available for clinical use in the prevention of stroke/systemic embolism in atrial fibrillation (AF) and in the treatment of venous thromboembolism (VTE), after the completion of large-scale randomized comparative clinical trials with the vitamin K antagonist warfarin. Edoxaban has some peculiar pharmacological properties and outcome data. Here a group of experts in AF and VTE answers a set of questions on its practical use, trying to define the profile of patients that would be most appropriate for its use...
February 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28193805/correction-to-restarting-anticoagulant-treatment-after-intracranial-hemorrhage-in-patients-with-atrial-fibrillation-and-the-impact-on-recurrent-stroke-mortality-and-bleeding-a-nationwide-cohort-study
#18
https://www.readbyqxmd.com/read/28193802/direct-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-other-than-significant-mitral-stenosis-and-mechanical-valves-a-meta-analysis
#19
Konstantinos C Siontis, Xiaoxi Yao, Bernard J Gersh, Peter A Noseworthy
No abstract text is available yet for this article.
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28191610/italian-intersociety-consensus-on-doac-use-in-internal-medicine
#20
Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D'Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi
The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events...
February 13, 2017: Internal and Emergency Medicine
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