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Use of DOACs in real-world challenging settings: a Delphi Consensus from Italian cardiologists.
CONCLUSIONS: DOACs should represent the first-line anticoagulation therapy in non-valvular AF patients in the majority of challenging settings, underexplored by literature. Caution in their prescription is needed in case of severe renal impairment. Dose choice should follow the SmPC, although this is matter of debate in borderline patients. PMID: 31343145 [PubMed - as supplied by publisher]
Source: Minerva Cardioangiologica - July 27, 2019 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Edoxaban for the prevention of stroke in patients with atrial fibrillation.
Authors: Cervantes CE, Merino JL, Barrios V Abstract INTRODUCTION: Edoxaban is the last direct oral anticoagulant marketed for the prevention of stroke among patients with nonvalvular atrial fibrillation (AF). Areas covered: ENGAGE AF-TIMI 48 was the pivotal clinical trial that led to the approval of edoxaban 60 mg once daily. After the publication of this study, a great number of substudies and post hoc analyses have been published, together with some observational studies. The aim of this review was to update the current evidence about the use of edoxaban in AF patients. Expert commentary: In the ENGAGE AF-TIMI 4...
Source: Expert Review of Cardiovascular Therapy - March 24, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Sex Differences in Atrial Fibrillation —Update on Risk Assessment, Treatment, and Long-Term Risk
AbstractPurpose of reviewAtrial fibrillation (AF) is a growing health problem worldwide. While the disease plagues both men and women, this arrhythmia does not affect both sexes equally. Women are more likely to have major adverse outcomes such as stroke and its sequela; however, recent data on stroke prevention show improving outcomes. The purpose of this review of the recent literature is to summarize important updates on risk scores and management of patients with AF.Recent findingsIt has been well known that women have a higher risk of strokes than men when untreated or when treated with warfarin. Current risk scores e...
Source: Current Treatment Options in Cardiovascular Medicine - August 27, 2018 Category: Cardiology Source Type: research

Effect of Non-vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Newly Diagnosed Cancer.
CONCLUSIONS: In AF patients with newly diagnosed cancer, NOACs showed lower incidences of ischemic stroke/SE, major bleeding, and all-cause death than warfarin, especially within 1 year after cancer diagnosis. PMID: 29671285 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - April 21, 2018 Category: Cardiology Tags: Korean Circ J Source Type: research

Abstract 14: The Influence of Provider Specialty on Anticoagulation Prescription Fills and Stroke Risk in Atrial Fibrillation Patients With History of Cancer Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists
Conclusion: AF patients with cancer were less likely to see a cardiologist, and less likely to fill an anticoagulant prescription than AF patients without cancer. However, cardiology involvement was associated with increased anticoagulant prescription fills and reduced risk of stroke, suggesting a beneficial role for cardiology providers to improve outcomes in AF patients with history of cancer.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: ONeal, W. T., Claxton, J., MacLehose, R., Chen, L., Bengtson, L. G., Chamberlain, A. M., Norby, F., Lutsey, P., Alonso, A. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research

Atrial Fibrillation, Clinical Profile and Adherence to Guidelines
Conclusion: Discordance between guidelines and practice was found regarding prescription of OACs and maintenance of optimal anticoagulation for stroke prevention in our population. Optimal anticoagulation needs to be emphasized on both patients as well as physicians to prevent strokes and achieve better outcomes.Keywords:CHADS2 score,International normalized ratio,Oral Anticoagulants,Valvular heart disease.View:PDF (138.96 KB)Click here to download the PDF file.‹ Breast Cancer and the Heart: Burden on the ChestAssociation between Myocardial Infarction and Dermatoglyphics: A Cross-Sectional Study ›
Source: Journal of Cardiovascular Disease Research - March 8, 2018 Category: Cardiology Authors: yunus Source Type: research

Frailty syndrome: an emerging clinical problem in the everyday management of clinical arrhythmias. The results of the European Heart Rhythm Association survey
In conclusion, the complex clinical condition in frail patients presenting with arrhythmias warrants an integrated multidisciplinary approach both for the management of rhythm disturbances and for the decision on using CIEDs.
Source: Europace - October 10, 2017 Category: Cardiology Source Type: research

Rivaroxaban for Periprocedural Anticoagulation Therapy in Japanese Patients Undergoing Catheter Ablation of Paroxysmal Non-Valvular Atrial Fibrillation.
This study aimed to investigate the safety and feasibility of periprocedural anticoagulation therapy with rivaroxaban in Japanese patients undergoing paroxysmal non-valvular AF (NVAF) ablation using radiofrequency energy.This study was a multicenter, prospective pilot study. In paroxysmal NVAF patients, rivaroxaban (15 mg or 10 mg once-daily) was started at least 4 weeks prior to AF ablation, discontinued on the day of the procedure, resumed within 24 hours after ablation, and continued at least 3 months afterwards. During the interruption of rivaroxaban, bridging anticoagulation therapy with unfractionated heparin was giv...
Source: International Heart Journal - November 9, 2016 Category: Cardiology Tags: Int Heart J Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism
Learning objectives Understand the importance of venous thrombosis in cardiovascular medicine. Appreciate the mode of action of different oral anticoagulants. Recall the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulants. Introduction Thrombosis is the common pathophysiology responsible for ischaemic heart disease, ischaemic stroke and venous thromboembolism (VTE), and a major contributor to the global disease burden.1 This effect is markedly more pronounced by considering the view that cancer is also a thrombotic disease.2 3 Cardiovascular disease (CVD, manifesting as acute coronary syndromes, m...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Blann, A. D., Lip, G. Y. H. Tags: Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Source Type: research

Evolving Treatments for Arterial and Venous Thrombosis: Role of the Direct Oral Anticoagulants.
Abstract The direct oral anticoagulants (DOACs) represent a major advance in oral anticoagulant therapy and have replaced the vitamin K antagonists as the preferred treatment for many indications. By simplifying long-term anticoagulant therapy and improving its safety, the DOACs have the potential to reduce the global burden of thrombosis. Postmarketing studies suggest that the favorable results achieved with DOACs in the randomized controlled trials can be readily translated into practice, but highlight the need for appropriate patient, drug and dose selection, and careful follow-up. Leveraging on their success t...
Source: Circulation Research - April 28, 2016 Category: Cardiology Authors: Chan NC, Eikelboom JW, Weitz JI Tags: Circ Res Source Type: research

0484: The LEADERS FREE Trial: a double blind randomized comparison of a BMS and a polymer-free Drug Coated Stent (DCS) in 2,466 patients at high bleeding risk and treated with one month DAPT only
Conclusion The trial focuses on a never previously studied high bleeding risk population characterized by advanced age and more comorbid conditions. It is the 1st evaluation of a DCS with clinical endpoints and comprises the shortest ever DAPT course with an active stent to be evaluated for both safety and efficacy.
Source: Archives of Cardiovascular Diseases Supplements - March 7, 2016 Category: Cardiology Source Type: research

Abstract 20: Dying With a Left Ventricular Assist Device as Destination Therapy Session Title: Abstract Oral Session
Conclusions: In contrast to the general heart failure population, most patients with DT-LVAD die in the hospital and very few enroll in hospice. A significant body of research has demonstrated that patients who die in the intensive care unit and the hospital, as opposed to home or with hospice assistance, experience worse quality of life, quality of death and caregiver outcomes. Potential reasons that patients with DT-LVAD may experience different end-of-life care than other patients with heart failure exist, including that they often experience sudden changes in health status prior to death from acute events such as hemor...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Dunlay, S. M., Strand, J. J., Wordingham, S. E., Stulak, J. M., Kushwaha, S. S., Luckhardt, A., Swetz, K. M. Tags: Session Title: Abstract Oral Session Source Type: research

Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation: FANTASIIA Study
Conclusion: Medical and social variables were associated with prescription of NOAC. Major bleeding, hemorrhagic stroke, university education, and higher glomerular filtration rate were more frequent among patients under NOAC. On the contrary, patients with history of cancer or bradyarrhythmias more frequently received VKA.
Source: Journal of Cardiovascular Pharmacology and Therapeutics - February 24, 2016 Category: Cardiology Authors: Moreno-Arribas, J., Bertomeu-Gonzalez, V., Anguita-Sanchez, M., Cequier, A., Muniz, J., Castillo, J., Sanchis, J., Roldan, I., Marin, F., Bertomeu-Martinez, V., on behalf of the investigators of the FANTASIIA study Tags: Clinical Studies Source Type: research

Aspirin Therapy in Primary Cardiovascular Disease Prevention A Position Paper of the European Society of Cardiology Working Group on Thrombosis
Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a source of major debate, with major international guidelines providing conflicting recommendations. Here, we review the evidence in favor and against aspirin therapy in primary prevention based on the evidence accumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, we argue for a pragmatic approach to using low-do...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - July 14, 2014 Category: Cardiology Source Type: research

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