RE-LY: NSAIDs Plus Anticoagulants a Dangerous Combination RE-LY: NSAIDs Plus Anticoagulants a Dangerous Combination

The authors caution against using an NSAID with oral anticoagulants in patients with atrial fibrillation after finding an increased risk for bleeding and stroke.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Cardiology News Source Type: news

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Publication date: Available online 20 September 2018Source: Revista Portuguesa de Cardiologia (English Edition)Author(s): Liliana Reis, Luís Paiva, Marco Costa, Joana Silva, Rogério Teixeira, Ana Botelho, Paulo Dinis, Marta Madeira, Joana Ribeiro, José Nascimento, Lino GonçalvesAbstractIntroductionPercutaneous closure of the left atrial appendage (LAA) is a promising therapy in patients with atrial fibrillation with high risk for stroke and contraindication for oral anticoagulation (OAC). Intracardiac echocardiography (ICE) may make this percutaneous procedure feasible in patients in whom transe...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
This study evaluated outcomes in younger patients, specifically aged 50 years and younger, after mechanical aortic valve replacement (mAVR) and bioprosthetic AVR (bAVR).MethodsFrom 1994 to 2016, 643 patients underwent AVR (411 mAVR and 232 bAVR) at age 50 or younger. Concomitant coronary artery bypass grafting and mitral valve procedures were also included. Propensity score-matching methods resulted in 170 evenly matched patient pairs. Primary end points were operative mortality and long-term survival. Secondary end points were stroke, major bleeding, and redo AVR. Median observation time was 8.1 years (range, 0 to 23.6 ye...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: Clarke A, Ibrahim A, Kiernan TJ Abstract INTRODUCTION: Patients with atrial fibrillation taking oral anticoagulation and undergoing percutaneous coronary intervention with stent insertion are recommended to receive antithrombotic therapy with aspirin and P2Y12 receptor antagonist. This combinatory regime encompasses triple therapy (TT). Although TT reduces the risk of ischaemic events such as stroke and stent thrombosis, it is associated with an increased bleeding risk. Areas covered: The efficacy and safety profile of TT is uncertain with undetermined optimal duration and therapeutic combination. This rev...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
We describe two clinical cases of spontaneous choroidal hemorrhage in patients treated with direct oral anticoagulants (rivaroxaban and dabigatran etexilate) for atrial fibrillation. These cases show that an ocular hemorrhagic risk exists with these drugs. Patients treated with DOAC should have the therapeutic dose adjusted based on creatinine clearance. Special monitoring should be performed in patients with age-related macular degeneration or with hypertension even though meta-analysis shows that the risk of intraocular bleeding is reduced by 22% compared with warfarin. PMID: 30213607 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
Warfarin is very useful to prevent stroke in patients with atrial fibrillation and maintenance of function of a mechanical prosthetic valve. At the same time it has several limitations: Unpredictable response: Same dose produces different responses in terms of elevation of prothrombin time international normalized ratio (PT-INR) in different persons and in same person at different times. Narrow therapeutic window: Difference between toxic dose and ineffective dose is narrow. A mild increase in dose can produce a disproportionate rise in INR. Slow onset and offset of action: On the average it takes about 4 days for a stea...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Uncategorized Source Type: blogs
CONCLUSION: The derived ICER was 13,168.50 € per QALY, consistent with NOACs being cost-effective vs. warfarin when anticoagulation is used with antiplatelet agents. Nevertheless, country-, practice-, and patient-related factors influence the ICER. Our cost-utility calculation should be used a starting point for decision-making. PMID: 30209519 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Abstract Aims: The management of anticoagulation therapy in patients with atrial fibrillation (AF) and cancer is challenging due to increased thrombotic and bleeding risks. We sought to determine the safety and efficacy of rivaroxaban in patients with AF and a history of cancer. Methods and Results: ROCKET AF randomized 14,264 patients with AF to rivaroxaban or warfarin with a median follow-up of 1.9 years. Cox regression models were used to assess the association between cancer history and clinical outcomes, and the relative treatment effect of rivaroxaban versus warfarin in these patients. A total of 640 pa...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: Eur Heart J Qual Care Clin Outcomes Source Type: research
This report describes data from Indian patients recruited in this registry.Methods and resultsA total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P
Source: Indian Heart Journal - Category: Cardiology Source Type: research
ConclusionA high percentage of the elderly AF patients did not receive AT, even at discharge. Patients who did not receive AT at discharge had higher bleeding and frailty scores. In the 1-year follow-up period after hospital discharge, high all-cause mortality and a high number of hospital readmissions were recorded.
Source: Drugs and Aging - Category: Geriatrics Source Type: research
AbstractFrailty is an important prognostic factor in older adults with cardiovascular diseases. We aim to describe the characteristics of elderly hospitalised frail patients with non-valvular atrial fibrillation (NVAF) and to assess the influence of frailty, along with other functional and health status variables on anticoagulation prescription, 1-year all-cause mortality, and the incidence of ischemic and bleeding complications. An observational, prospective multicentre study was carried out on patients with NVAF over the age of 75, who were admitted to the Internal Medicine departments in Spain. A total of 615 patients w...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
More News: Atrial Fibrillation | Bleeding | Cardiology | Health | Heart | Stroke