Efficacy and Safety of Edoxaban in Elderly Patients With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial Stroke

Background Elderly patients with atrial fibrillation are at higher risk of both ischemic and bleeding events compared to younger patients. In a prespecified analysis from the ENGAGE AF-TIMI 48 trial, we evaluate clinical outcomes with edoxaban versus warfarin according to age. Methods and Results Twenty-one thousand one-hundred and five patients enrolled in the ENGAGE AF-TIMI 48 trial were stratified into 3 prespecified age groups:
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Atrial Fibrillation, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Source Type: research

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ConclusionsFor patients whose HAS-BLED scores increased to  ≥ 3, the continuation of OACs was associated with better clinical outcomes. An increased HAS-BLED score in anticoagulated AF patients may not be the only reason to withhold OACs, but reminds physicians to correct modifiable bleeding risk factors and follow up patients more closely.Graphical abstractAssociations between Continuation or Discontinuation of Oral Anticoagulants and Risks of Clinical Outcomes after HAS-BLED Scores IncreasedAF atrial fibrillation;aHR adjusted hazard ratio;ICH intra-cranial hemorrhage;OACs oral anticoagulants
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Int J Vasc Med. 2021 Dec 6;2021:4244267. doi: 10.1155/2021/4244267. eCollection 2021.ABSTRACTAcute ischemic strokes (AIS) and hemorrhagic strokes lead to disabling neuropsychiatric and cognitive deficits. A serious and fatal complication of AIS is the occurrence of hemorrhagic transformation (HT). HT is cerebral bleeding that occurs after an ischemic event in the infarcted areas. This review summarises how specific risk factors such as demographic factors like age, gender, and race/ethnicity, comorbidities including essential hypertension, atrial fibrillation, diabetes mellitus, congestive heart failure, and ischemic heart...
Source: International Journal of Vascular Medicine - Category: Cardiology Authors: Source Type: research
AbstractBackgroundLiver disease is associated with increased bleeding risk. The efficacy and safety of direct oral anticoagulants (DOACs) is a subject of contention in atrial fibrillation (AF) patients with liver disease.MethodsElectronic databases (PubMed, Embase, and Cochrane Library) were searched to retrieve studies on the efficacy and safety of DOACs versus warfarin in AF patients with liver disease from January 1980 to April 2020. A meta-analysis was conducted using a random-effects model.ResultsSix studies involving 41,859 patients were included. Compared with warfarin, DOACs demonstrated significant reduction in is...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
We report our single-center experience with percutaneous left atrial appendage closure (LAAC) in patients with non-valvular atrial fibrillation (NVAF) and primary hemostasis disorders (HD).MethodsConsecutive patients with primary HD who underwent a percutaneous LAAC were included. Baseline characteristics, procedural data, and clinical outcomes were prospectively collected and compared with the overall LAAC cohort without HD.ResultsSince 2013, among 229 LAAC, 17 patients (7%) had a primary HD: thrombocytopenia (n = 5), myelodysplastic syndrome (n = 6), von Willebrand syndrome (n = ...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
Background: Hemorrhagic transformation (HT) after reperfusion therapy for acute ischemic stroke (AIS) has been well studied; however, there is scarce research focusing on spontaneous HT (sHT). Spontaneous HT is no less important with a relatively high incidence and could be associated with neurological worsening. We aimed to develop and validate a simple and practical model to predict sHT after AIS (SHAIS) and compared the predictive value of the SHAIS score against the models of post-Reperfusion HT for sHT.Methods: Patients with AIS admitted within 24 h of onset were prospectively screened to develop and validate the SHAI...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Any screening program in the community, while providing useful and previously unknown information, has the potential of uncovering findings of uncertain interpretation, especially regarding their impact on clinical outcomes, and therefore the justification of extending the screening to larger cohorts with substantial health care costs. As Shang and colleagues [1] remind us, the STROKESTOP study [2] detected a modest benefit from screening for atrial fibrillation (AF) on the primary combined endpoint of ischaemic or haemorrhagic stroke, systemic embolism, bleeding leading to hospitalisation and all-cause death (1.1% absolut...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research
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