Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology

Background The goal of this study was to compare the safety and effectiveness of individual antiembolic interventions in nonvalvular atrial fibrillation (AF): novel oral anticoagulants (NOACs) (apixaban, dabigatran, edoxaban, and rivaroxaban); vitamin K antagonists (VKA); aspirin; and the Watchman device. Methods and Results A network meta-analysis of randomized, clinical trials (RCTs) was performed. RCTs that included patients with prosthetic cardiac valves or mitral stenosis, mean or median follow-up
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

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Conclusion Our study highlights how DOACs are a safe and effective option for anticoagulation, even in frail elderly people; the introduction of these drugs is leading to an increased use of anticoagulation therapy in this population. Prospective trials will be needed to reinforce these results and to consider new variables in the thrombotic and hemorrhagic risk scores underlying the prescription of DOACs.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: POINT OF VIEW Source Type: research
AbstractAtrial fibrillation (AF) is the most common arrhythmia in clinical practice and its prevalence increases with age. Few data are available about the clinical performance of direct oral anticoagulant (DOACs) in patients aged  ≥ 80 years with AF. The aim of our propensity score matched cohort study was to compare the safety and efficacy of DOACs versus well-controlled VKA therapy among octogenarians with AF in real life setting. Data for this study were sourced from the multicenter prospectively maintained Atrial Fibrillation Research Database (NCT03760874), which includes all AF patients followe...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence increases with age. Age also increases the risk of thromboembolism related to AF. As a result, elderly patients are at increased risk of AF-related stroke compared to younger patients. Age, however, also increases the risk of bleeding, including that of intracranial haemorrhage, an important cause of death and disability. Elderly patients with AF are, therefore, often undertreated due to the fear of bleeding complications, although recent data suggest an even greater net clinical benefit for anticoagulation in general in the elderly, even the very el...
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
By ANISH KOKA Frances Oldham Kelsey by all accounts was not mean to have a consequential life.  She was born in Canada in 1914, at a time women were meant to be seen and not heard.  Nonetheless, an affinity for science eventually lead to a masters in pharmacology from the prestigious McGill University.  Her first real break came after she was accepted for PhD level work in the pharmacology lab of a professor at the University of Chicago.  An esteemed professor was starting a pharmacology lab and needed assistants, and the man from Canada seemed to have a perfect resume to fit.  That’s right, ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
Conclusions—In anticoagulated patients with atrial fibrillation and risk factors for stroke, echocardiographic findings do not seem to add to the risk of thromboembolic events.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: Stroke - Category: Neurology Authors: Tags: Arrhythmias, Echocardiography, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
ConclusionFor symptomatic patients with nonvalvular AF and a high risk of stroke, the one‐stop intervention is feasible, safe, and efficacious.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: ELECTROPHYSIOLOGY Source Type: research
Atrial fibrillation is the most common arrhythmia in over-midlife patients. In addition to systolic heart failure, cerebral thromboembolism represents the most dramatic complication of this rhythm disorder, contributing to morbidity and mortality. Traditionally, anticoagulation has been considered the main strategy in preventing stroke and systemic embolism in atrial fibrillation patients and vitamin K-dependent antagonists have been widely used in clinical practice. Recently, the development of direct oral anticoagulants has certainly improved the management of this disease, providing, for the first time, the opportunity ...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Reviews Source Type: research
Conclusion This study will provide important information regarding the effectiveness and safety of rivaroxaban treatment in Japanese patients with NVAF among general practitioners.
Source: Journal of Arrhythmia - Category: Cardiology Source Type: research
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