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Anticoagulation in atrial fibrillation

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https://www.readbyqxmd.com/read/29786530/meta-analysis-of-safety-and-efficacy-of-oral-anti-coagulants-in-patients-requiring-catheter-ablation-for-atrial-fibrillation
#1
Hammad Rahman, Safi U Khan, Michael DePersis, Tehseen Hammad, Fahad Nasir, Edo Kaluski
BACKGROUND: The ideal oral anticoagulant agent during catheter ablation (CA) for atrial fibrillation (AF) remained unclear. HYPOTHESIS: Novel oral anticoagulants (NOACs) are safer and effective compared to uninterrupted vitamin K antagonists (U-VKA) among patients requiring CA for AF. METHODS: Four randomized controlled trials (RCTs) and 9 observational studies (OS) were selected using PubMed/Medline, EMBASE and the CENTRAL data bases (Inception-December-2017)...
May 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#2
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29782270/-tactics-of-selection-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-ischemic-heart-disease
#3
Y N Belenkov, G A SHakaryants, N V Khabarova
In the clinical practice a physician quite often is at a loss due to "freedom of choice" granted by availability of direct oral anticoagulants (DOAC). If a patient with nonvalvular atrial fibrillation (AF) has indications for therapy with anticoagulants which DOAC should be preferred? What are benefits for a patient with ischemic heart disease and AF when definite NOAC is chosen and what are risks inherent of this choice? Answers to such questions are given in this paper.
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782263/-nonvalvular-atrial-fibrillation-and-diabetic-nephropathy-epidemiology-prognosis-and-choice-of-anticoagulant-therapy
#4
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782261/-chronic-kidney-disease-as-basis-of-high-thrombotic-and-bleeding-risk-in-patients-with-atrial-fibrillation-place-of-oral-anticoagulants
#5
A G Obrezan, A Y Zemchenkov
Chronic kidney disease (CKD) aggravates course of practically all diseases by worsening outcomes and hindering adequate treatment. Specificities of renal excretion of various drugs, changes of parameters of their pharmacokinetics and pharmacodynamics, nephrotoxic effects of drugs, tactics of drug therapy in conditions of CKD, terminal stage of kidney failure and dialysis are in the focus of attention of internists. To a greatest degree difficulties of drug therapy in CKD and associated clinical states refer to the group of anticoagulants...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782252/-problems-of-anticoagulation-therapy-in-patients-with-chronic-heart-failure-and-atrial-fibrillation-role-of-rivaroxaban
#6
Z D Kobalava, S V Villevalde, E A Troitskaya
Heart failure and atrial fibrillation are the two new epidemics of cardiovascular disease. Their frequent coincidence increases mortality rates mainly because of increased risk of thromboembolic events. The review focuses on epidemiology, mechanisms, prognosis in patients with heart failure and atrial fibrillation, approaches to the administration of direct oral anticoagulants and role of rivaroxaban.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29781069/dual-and-triple-antithrombotic-therapies-current-patterns-of-practice-and-controversies
#7
Mark Crowther, John Eikelboom
Dual antiplatelet therapy (DAPT) has been the cornerstone of antithrombotic management for patients undergoing percutaneous coronary intervention (PCI). Despite low-quality evidence, triple antithrombotic therapy involving acetylsalicylic acid, clopidogrel and warfarin or non-vitamin K antagonist oral anticoagulant (NOAC) has been recommended in patients with concomitant atrial fibrillation undergoing PCI, who require long-term oral anticoagulation, although such strategy is associated with a substantially increased risk of bleeding compared with DAPT...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29778588/increased-burden-of-comorbidities-and-risk-of-cardiovascular-death-in-atrial-fibrillation-patients-in-europe-over-ten-years-a-comparison-between-eorp-af-pilot-and-ehs-af-registries
#8
Marco Proietti, Cécile Laroche, Robby Nieuwlaat, Harry J G M Crijns, Aldo P Maggioni, Deirdre A Lane, Giuseppe Boriani, Gregory Y H Lip
BACKGROUND: In 2002, the European Society of Cardiology conducted the Euro Heart Survey (EHS), while in 2014concluded 1-year follow-up of the EURObservational Research Programme AF (EORP-AF) Pilot Registry. METHODS: We analysed differences in clinical profiles, therapeutic approaches and outcomes between these two cohorts after propensity score matching (PSM). RESULTS: After PSM, 5206 patients were analysed. In EORP-AF there were more elderly patients than EHS (p < ...
May 16, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#9
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29776576/safety-of-apixaban-in-combination-with-dronedarone-in-patients-with-atrial-fibrillation
#10
Leif Friberg
BACKGROUND: There have been concerns about bleeding risks for patients with atrial fibrillation treated with dronedarone in combination with new oral anticoagulants (NOACs). The aim of the study was to compare the bleeding risks with the apixaban + dronedarone and warfarin + dronedarone combinations. METHOD: Retrospective study of Swedish nationwide health registers. All patients with atrial fibrillation who used dronedarone in combination with apixaban or warfarin during 2013-2016 were identified...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#11
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776574/incidence-of-bleeding-in-patients-with-atrial-fibrillation-and-advanced-liver-fibrosis-on-treatment-with-vitamin-k-or-non-vitamin-k-antagonist-oral-anticoagulants
#12
Daniele Pastori, Gregory Y H Lip, Alessio Farcomeni, Francesco Del Sole, Angela Sciacqua, Francesco Perticone, Rossella Marcucci, Elisa Grifoni, Pasquale Pignatelli, Francesco Violi
OBJECTIVES: To investigate the incidence of bleeding events in atrial fibrillation (AF) patients treated with vitamin K (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) screened for the presence of liver fibrosis (LF). BACKGROUND: Previous studies provided conflicting results on bleeding risk in AF patients with liver disease on VKAs, and no data on NOACs in this setting are available. METHODS: Post-hoc analysis of a prospective, observational multicentre study including 2330 AF outpatients treated with VKAs (n = 1297) or NOACs (n = 1033)...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776386/impact-of-vkorc1-cyp4f2-and-nqo1-gene-variants-on-warfarin-dose-requirement-in-han-chinese-patients-with-catheter-ablation-for-atrial-fibrillation
#13
Jiao Li, Wenlong Yang, Zhonghui Xie, Kun Yu, Yuhua Chen, Kaijun Cui
BACKGROUND: The anticoagulation of atrial fibrillation catheter ablation during the perioperative stage does matter and should be treated with discretion. We aimed to assess impact of three important genes participating in vitamin K cycle (i.e. VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566) on the daily stable warfarin dose requirement in Sichuan Han Chinese patients with catheter ablation of atrial fibrillation. METHODS: A total of 222 atrial fibrillation patients taking stable warfarin therapy after catheter ablation operation were enrolled in this study...
May 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29775967/bilateral-breast-calciphylaxis-in-a-patient-who-survived-earlier-extensive-tissue-necrosis-5-years-previously-a-case-report
#14
E M J Verstappen, A J G Maaskant-Braat, M R Scheltinga
INTRODUCTION: Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. PRESENTATION OF CASE: A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29773500/an-analysis-on-distribution-and-inter-relationships-of-biomarkers-under-rivaroxaban-in-japanese-patients-with-non-valvular-atrial-fibrillation-cvi-aro-1
#15
Shinya Suzuki, Takeshi Yamashita, Hidefumi Kasai, Takayuki Otsuka, Koichi Sagara
Prothrombin time (PT) has been widely used for measuring anticoagulation intensity under rivaroxaban therapy, but precise information has not been well established yet. Consecutive 96 non-valvular atrial fibrillation (NVAF) under rivaroxaban between Jan/June, 2015 were recruited. Serum concentration (SC) and PT with 5 representative reagents available in Japan (Neoplastin Plus®, Thromborel S®, Thrombocheck PT®, Thrombocheck PT Plus®, and Recombiplastin®) at 2-4 hours after (peak) and before intake of rivaroxaban (trough) were measured at outpatient clinic in the cardiovascular institute (CVI ARO study 1)...
March 15, 2018: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29772570/undertreatment-of-vascular-risk-factors-in-patients-with-monocular-ischaemic-visual-loss
#16
Angeliki Zarkali, Suk Fun Cheng, Agnes Dados, Robert Simister, Arvind Chandratheva
BACKGROUND AND PURPOSE: Ischaemic visual loss is often considered a lower risk factor than other transient ischaemic attacks (TIA). We aimed to determine the recurrence risk, prevalence and management of vascular risk factors in these patients. METHODS: The study took place in the University College Hospital London daily TIA clinic, main referral centre for North-Central London and Moorfields Eye Hospital. Consecutive records for patients with transient (< 24 h) or permanent (> 24 h) ischaemic visual loss were reviewed during the period January 2014-October 2016...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#17
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#18
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29768158/-issues-of-antithrombotic-therapy-in-acs-patients-with-atrial-fibrillation
#19
N A Kaydalova, L Y Koroleva, G V Kovaleva, N N Paykova, V P Nosov, A T Volkova, A M Koryazina
The review analyzed current ideas on prevalence and clinical significance of atrial fibrillation following acute coronary syndrome; described modern approaches to administration of antithrombotic therapy; and addressed available clinical studies on the treatment with warfarin and new oral anticoagulants as a part of combination antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29764874/resuming-anticoagulants-after-anticoagulation-associated-intracranial-haemorrhage-systematic-review-and-meta-analysis
#20
Zien Zhou, Jie Yu, Cheryl Carcel, Candice Delcourt, Jiehui Shan, Richard I Lindley, Bruce Neal, Craig S Anderson, Maree L Hackett
OBJECTIVE: To determine the adverse outcomes following resumption of anticoagulation in patients with anticoagulation-associated intracranial haemorrhage (ICH). DESIGN: We performed a systematic review and meta-analysis in this clinical population. The Preferred Reporting Items for Systemic Reviews and Meta-Analyses statement was followed, and two authors independently assessed eligibility of all retrieved studies and extracted data. DATA SOURCES: Medline, Embase and the Cochrane Central Register of Controlled Trials, from inception to February 2017...
May 14, 2018: BMJ Open
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