Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis

AbstractSeveral studies have explored the use of NOACs compared with vitamin K antagonists (VKAs) in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF); and therefore, we aimed to compare the efficacy and safety outcomes of NOACs with VKAs in this population. We systematically searched the PubMed and Embase databases until August 5, 2019 for studies that compared the effect of NOACs with VKAs in patients with HCM and AF. The risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. A total of four observational studies were included in this meta-analysis. Overall, compared with VKAs use, the use of NOACs was associated with reduced risks of ischemic stroke (RR 0.49, 95% CI 0.34 –0.69), all-cause death (RR 0.44, 95% CI 0.35–0.55), and intracranial hemorrhage (RR 0.43, 95% CI 0.24–0.77). There were no differences in the risks of stroke or systemic embolism, major or clinically relevant bleeding, and gastrointestinal bleeding in patients with NOACs versus VKAs. Re-analy ses with a fixed-effects model produced the similar results as the main analyses. For the efficacy and safety outcomes, comparisons of NOACs versus warfarin produced the similar results as those of NOACs versus VKAs. Based on current data from observational studies, compared with VKAs, NOACs had sim ilar or lower risks of thromboembolic and bleeding events in patients with HCM and AF.
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research

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Source: Core Evidence - Category: Drugs & Pharmacology Tags: Core Evidence Source Type: research
In conclusion, our study has established a pathophysiological role for ROS signaling in atrial cardiomyocytes, and it may be that ox-CaMKII and p-CaMKII (Thr-286) are activated by ROS to increase AF susceptibility following ibrutinib treatment. We have also identified the inhibition of NOX as a potential novel AF therapy approach.
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Source: European Polymer Journal - Category: Chemistry Source Type: research
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Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
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