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Anticoagulation in atrial fibrillation

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https://www.readbyqxmd.com/read/28735494/trends-in-use-of-warfarin-and-direct-oral-anticoagulants-in-atrial-fibrillation-in-norway-2010-to-2015
#1
Lars J Kjerpeseth, Hanne Ellekjær, Randi Selmer, Inger Ariansen, Kari Furu, Eva Skovlund
PURPOSE: Since 2011, several direct oral anticoagulants (DOACs; dabigatran, rivaroxaban, apixaban) have been introduced as alternatives to warfarin for stroke prophylaxis in atrial fibrillation. We wanted to investigate changes in utilization of oral anticoagulants for atrial fibrillation in Norway following the introduction of DOACs. METHODS: Using nationwide registries, we identified all adults with pharmacy dispensings for warfarin or DOACs between January 2010 and December 2015 in Norway, and used ambulatory reimbursement codes to identify atrial fibrillation as indication...
July 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28735423/the-anticoagulant-effect-of-heparin-during-radiofrequency-ablation-rfa-in-patients-taking-apixaban-or-rivaroxaban
#2
L C Brendel, F Dobler, G Hessling, J Michel, S L Braun, A L Steinsiek, P Groha, R Eckl, I Deisenhofer, A Hyseni, M Roest, I Ott, B Steppich
PURPOSE: Measuring the anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban and rivaroxaban is challenging, since the activated coagulation time (ACT) does not seem to reflect the true anticoagulant activity of these drugs. We therefore evaluated coagulation properties of apixaban and rivaroxaban during RFA by different coagulation assays to better monitor periprocedural hemostasis. METHODS: The study included 90 patients (61 ± 12 years) with atrial fibrillation who underwent RFA procedures...
July 22, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28733435/different-implications-of-heart-failure-ischemic-stroke-and-mortality-between-nonvalvular-atrial-fibrillation-and-atrial-flutter-a-view-from-a-national-cohort-study
#3
Yu-Sheng Lin, Tien-Hsing Chen, Ching-Chi Chi, Ming-Shyan Lin, Tao-Hsin Tung, Chi-Hung Liu, Yung-Lung Chen, Mien-Cheng Chen
BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes between nonvalvular AF and AFL. METHODS AND RESULTS: AF and AFL patients without any prescribed anticoagulation were enrolled from a 13-year national cohort database. Under series exclusion criteria, ischemic stroke, heart failure hospitalization, and all-cause mortality were compared between the groups in real-world conditions and after propensity score matching...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#4
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28730948/nonvitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-previous-stroke-or-transient-ischemic-attack-an-updated-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
George Ntaios, Vasileios Papavasileiou, Hans-Chris Diener, Konstantinos Makaritsis, Patrik Michel
Background In a previous systematic review and meta-analysis, we assessed the efficacy and safety of nonvitamin-K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and stroke or transient ischemic attack. Since then, new information became available. Aim The aim of the present work was to update the results of the previous systematic review and meta-analysis. Methods We searched PubMed until 24 August 2016 for randomized controlled trials using the following search items: "atrial fibrillation" and "anticoagulation" and "warfarin" and "previous stroke or transient ischemic attack...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730619/real-world-adherence-and-persistence-with-direct-oral-anticoagulants-in-adults-with-atrial-fibrillation
#6
Beenish S Manzoor, Todd A Lee, Lisa K Sharp, Surrey M Walton, William L Galanter, Edith A Nutescu
BACKGROUND: Evidence of adherence and persistence patterns in anticoagulation (AC) therapy comparing treatment-naïve and non-naïve patients is lacking. The objective of this study was to evaluate patterns of medication adherence and persistence in a real-world setting among AC-naïve and AC-experienced atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs). METHODS: AF patients newly initiating a DOAC with a minimum of 6 months of continuous health plan enrollment pre and post-index date (first DOAC prescription) were identified from the Truven Health MarketScan(®) Commercial and Medicare Supplemental databases (2009-2013)...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#7
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28727359/-stroke-prevention-in-patients-with-atrial-fibrillation
#8
Gaia Sirimarco, Lorenz Hirt, Roman Sztajzel, Fabienne Perren
Oral anticoagulation with vitamin K antagonists (VKA) was the cornerstone of stroke prevention in atrial fibrillation (AF). This review article presents the state of the art, with regard to the treatment options developed over the past few years, the new oral anticoagulants (NOAC). A search in PubMed for relevant published studies has been performed. Dabigatran and apixaban were superior to warfarin to reduce stroke risk or systemic embolism ; dabigatran, rivaroxaban and edoxaban were non-inferior. All NOAC are globally non-inferior to warfarin for stroke prevention in non-valvular AF and they have a superior safety profile, with a reduced intracranial bleeding risk...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28725983/dabigatran-and-vitamin-k-antagonists-use-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-a-cross-sectional-study-of-primary-care-based-electronic-health-records
#9
Bogdan Vlacho, Maria Giner-Soriano, Edurne Zabaleta-Del-Olmo, Albert Roso-Llorach, Ana García-Sangenís, Rosa Morros-Pedrós
PURPOSE: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). METHODS: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed...
July 19, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28725332/thyrotoxic-valvulopathy-case-report-and-review-of-the-literature
#10
Keniel Pierre, Sushee Gadde, Bassam Omar, G Mustafa Awan, Christopher Malozzi
We report a 42-year-old female who was admitted for abdominal pain, and also endorsed dyspnea, fatigue and chronic palpitations. Past medical history included asthma, patent ductus arteriosus repaired in childhood and ill-defined thyroid disease. Physical examination revealed blood pressure of 136/88 mm Hg and heart rate of 149 beats per minute. Cardiovascular exam revealed an irregularly irregular rhythm, and pulmonary exam revealed mild expiratory wheezing. Abdomen was tender. Electrocardiogram revealed atrial fibrillation with rapid ventricular response which responded to intravenous diltiazem...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28725275/ash-meeting-2016-developments-in-hemostaseology
#11
REVIEW
Clemens Feistritzer, Birgit Mosheimer
During the annual meeting of the American Society of Hematology (ASH) in San Diego/California, novel developments in the field of hemostaseology were presented. Alternative treatment strategies besides factor replacement were discussed for patients with hemophilia. One of the highlights of the meeting in this year's plenary session was the presentation of successful adeno-associated virus mediated gene transfer in patients with hemophilia B leading to sustained elevation of factor IX:C (FIX:c). Other alternative treatment approaches in patients with hemophilia A may include bispecific antibodies mimicking factor VIIIa (FVIIIa) activity or disrupting anticoagulant proteins...
2017: Memo
https://www.readbyqxmd.com/read/28724879/infectious-complications-in-patients-with-cardiac-implantable-electronic-devices-risk-factors-prevention-and-prognosis
#12
Anna Polewczyk, Wojciech Jacheć, Aneta Maria Polewczyk, Andrzej Tomasik, Marianna Janion, Andrzej Kutarski
INTRODUCTION    Cardiac device infections (CDI) are still a significant problem. The knowledge of risk factors for CDI is crucial both for preventing infections and reducing mortality. OBJECTIVES    The assesment of the risk factors and long term survival of patients with CDI. PATIENTS AND METHODS    The clinical data of 1837 patients (40.9% CDI) undergoing transvenous leads extraction (TLE) at a single institution from 2006 to 2015 was analyzed. We compared the clinical and procedure-related factors for all types of CDI: isolated pocket infection (IPI), isolated lead-related infective endocarditis (ILRIE) and PI+LRIE...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28724655/sex-differences-in-the-use-of-oral-anticoagulants-for-atrial-fibrillation-a-report-from-the-national-cardiovascular-data-registry-ncdr-%C3%A2-pinnacle-registry
#13
Lauren E Thompson, Thomas M Maddox, Lanyu Lei, Gary K Grunwald, Steven M Bradley, Pamela N Peterson, Frederick A Masoudi, Alexander Turchin, Yang Song, Gheorghe Doros, Melinda B Davis, Stacie L Daugherty
BACKGROUND: Despite higher thromboembolism risk, women with atrial fibrillation have lower oral anticoagulation (OAC) use compared to men. The influence of the CHA2DS2-VASc score or the introduction of non-vitamin K OACs on this relationship is not known. METHODS AND RESULTS: Using the PINNACLE National Cardiovascular Data Registry from 2008 to 2014, we compared the association of sex with OAC use (warfarin or non-vitamin K OACs) overall and by CHA2DS2-VASc score and examined temporal trends in OAC use by sex...
July 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28724590/long-term-antithrombotic-treatment-in-intracranial-hemorrhage-survivors-with-atrial-fibrillation
#14
Eleni Korompoki, Filippos T Filippidis, Peter B Nielsen, Angela Del Giudice, Gregory Y H Lip, Joji B Kuramatsu, Hagen B Huttner, Jiming Fang, Sam Schulman, Joan Martí-Fàbregas, Celine S Gathier, Anand Viswanathan, Alessandro Biffi, Daniela Poli, Christian Weimar, Uwe Malzahn, Peter Heuschmann, Roland Veltkamp
OBJECTIVE: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM)...
July 19, 2017: Neurology
https://www.readbyqxmd.com/read/28724563/management-of-anticoagulant-and-antiplatelet-therapy-in-patients-undergoing-interventional-pulmonary-procedures
#15
REVIEW
Vikas Pathak, J Erin Allender, Mollie W Grant
There has been great progress in antithrombotic therapy over the past several years. Its use has increased with the advent of novel anticoagulants, as these medications do not require frequent blood tests for monitoring. Antithrombotic therapy is aimed at reducing the risk of thromboembolic events in patients with atrial fibrillation, coronary artery disease, deep vein thrombosis, valvular heart disease and pulmonary embolism. These patients are often critically ill and frequently undergo urgent interventions requiring discontinuation of anticoagulant or antiplatelet therapy which can increase the risk of thrombosis; however, continuing these agents can lead to increased risk of haemorrhage...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28724512/the-health-buddies-app-as-a-novel-tool-to-improve-adherence-and-knowledge-in-atrial-fibrillation-patients-a-pilot-study
#16
Lien Desteghe, Kiki Kluts, Johan Vijgen, Pieter Koopman, Dagmara Dilling-Boer, Joris Schurmans, Paul Dendale, Hein Heidbuchel
BACKGROUND: Atrial fibrillation (AF) constitutes an important risk for stroke, especially in an ageing population. A new app (Health Buddies) was developed as a tool to improve adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in an elderly AF population by providing a virtual contract with their grandchildren, spelling out daily challenges for both. OBJECTIVE: The aim of this pilot study was to assess the feasibility and usability of the Health Buddies app in AF patients...
July 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28722795/influence-of-renal-function-on-anticoagulation-control-in-patients-with-non-valvular-atrial-fibrillation-taking-vitamin-k-antagonists
#17
José M Lobos-Bejarano, Angel Castellanos Rodríguez, Vivencio Barrios, Carlos Escobar, José Polo-García, José Carlos Del Castillo-Rodríguez, Diego Vargas-Ortega, Adriana Lopez-Pineda, Luis Prieto-Valiente, Gregory Y H Lip
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD...
July 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28721832/biomarkers-associated-with-bleeding-risk-in-the-setting-of-atrial-fibrillation
#18
Skevos Sideris, Stefanos Archontakis, George Latsios, George Lazaros, Konstantinos Toutouzas, Eleftherios Tsiamis, Manolis Vavuranakis, Charalampos Vlachopoulos, Konstantinos Gatzoulis, Konstantinos Tsioufis, Dimitris Tousoulis
Background Prevention of thromboembolic disease, mainly stroke, with oral anticoagulants remains a major therapeutic goal in patients with atrial fibrillation. Unfortunately, despite the high efficacy, anticoagulant therapy is associated with a significant risk of, frequently catastrophic, hemorrhagic complications. Among different clinical and laboratory parameters related to an increased risk of bleeding, several biological markers have been recognized and various risk scores for bleeding have been developed...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28721825/biomarkers-associated-with-stroke-risk-in-atrial-fibrillation
#19
Adam Ioannou, Nikolaos Papageorgiou, Debbie Falconer, Onkar Rehal, Emma Sewart, Effimia Zacharia, Konstantinos Toutouzas, Charalampos Vlachopoulos, Gerasimos Siasos, Constantinos Tsioufis, Dimitris Tousoulis
Atrial fibrillation is associated with increased risk for cardioembolic stroke. The risk of cardioembolism is not adequately reduced with the administration of oral anticoagulants, since a number of patients continue to experience thromboembolic events despite receiving anti-thrombotic treatment. Several biomarkers have been proposed to predict cardioembolic stroke in patients with atrial fibrillation. Some of them are already used in the clinical practice, such as D-Dimers, Troponin and brain natriuretic peptide...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28721209/recent-advances-in-preventing-stroke-recurrence
#20
REVIEW
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
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