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Anticoagulation Control in Warfarin-Treated Patients Undergoing Cardioversion of Atrial Fibrillation (from the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation Trial)
In the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin–warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open bl inded end-point trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; an...
Source: The American Journal of Cardiology - June 15, 2017 Category: Cardiology Authors: Gregory Y.H. Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M. Winters, Dmitry Zamoryakhin, Andreas Goette Tags: Arrhythmias and Conduction Disturbances Source Type: research

Anticoagulation Control in Warfarin Treated Patients Undergoing Cardioversion for Atrial Fibrillation (From the ENSURE-AF Trial)
In the ENSURE-AF study (NCT 02072434), edoxaban was compared to enoxaparin –warfarin in 2199 patients undergoing electrical cardioversion of non-valvular atrial fibrillation (AF). In this multicenter PROBE trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR), time in therapeutic range (TiTR), their clinic al determinants, relation to SAMe-TT2R2 score, and impact on primary endpoints (composite of stroke, systemic embolic event [SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant non-major [CRNM] bleeding).
Source: The American Journal of Cardiology - June 15, 2017 Category: Cardiology Authors: Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette Source Type: research

Comparison of HAS-BLED and HAS-BED versus CHADS2 and CHA2DS2VASC Stroke and Bleeding Scores in Patients with Atrial Fibrillation
Anticoagulation is recommended in Atrial Fibrillation (AF) patients for stroke prevention, and the bleeding risk associated suggests the need for a bleeding risk stratification. HAS-BLED score includes ‘labile INR’ referred to quality of anticoagulation. However, in naïve patients this item is not available. In addition, stroke and bleeding risk prediction scores shared several risk factors. Aims of our study were: 1) to evaluate if the HAS-BLED score in its refined form excluding ‘labile I NR’ (HAS-BED) is still associated with bleeding risk; and 2) to evaluate the predictive ability for bleeding of both stroke a...
Source: The American Journal of Cardiology - January 24, 2017 Category: Cardiology Authors: Daniela Poli, Emilia Antonucci, Vittorio Pengo, Sophie Testa, Gualtiero Palareti Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding and Mortality in Patients with Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. While randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit dialysis patients. We thus undertook this systematic review and meta-analysis of observational studies. Electronic databases were searched for studies including AF patients on dialysis that reported observational associations of anticoagulation use. Twenty-one studies involving 530,031 individuals and 31,611 AF patients on dialysis were identified.
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding, and Mortality in Patients With Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. Although randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit patients on dialysis. We thus undertook this systematic review and meta-analysis of observational studies including patients with AF on dialysis that reported associations of anticoagulation use. Twenty studies involving 529,741 subjects and 31,321 patients with AF on dialysis were identified. Anticoagulation was associated with a 45% (95% CI 13% to 88%) increased risk of any stroke, reflecting a nonsignificant 13% (95% CI −4% to 34...
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Tags: Arrhythmias and Conduction Disturbances Source Type: research

Drug-coated balloon for in-stent restenosis in high risk patients: Another brick in the wall of the challenging settings for interventionists
Recently Miglionico et al. published in this Journal an interesting prospective observational study regarding 82 high-risk patients with in-stent restenosis of bare metal stent (BMS), n=48 (59%) or drug-eluting stent (DES), n=34 (41%) .1 All patients had at least one of the following high-risk features: history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or non-cardiac surgery or recent surgery, chronic inflammatory disease or neoplasm.
Source: The American Journal of Cardiology - March 21, 2016 Category: Cardiology Authors: Dario Buccheri, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Source Type: research

Drug-Coated Balloon for Instent Restenosis in Patients at High Risk: Another Brick in the Wall of the Challenging Settings for Interventionists
Recently, Miglionico et al1 published in this journal an interesting prospective observational study regarding 82 patients at high-risk with instent restenosis of bare-metal stent, n = 48 (59%) or drug-eluting stent (DES), n = 34 (41%). All patients had at least one of the following high-risk features: a history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or noncardiac surgery or recent surgery, chronic inflammatory disease, or neoplasm.
Source: The American Journal of Cardiology - March 20, 2016 Category: Cardiology Authors: Dario Bucchei, Davide Piraino, Giuseppe Andolina, Bernardo Cortese Tags: Readers' Comments Source Type: research

Effects of Oral Anticoagulant Therapy in Medical In-patients ≥65 Years of Age with Atrial Fibrillation
In this retrospective cohort observational study we investigated mortality, ischemic and hemorrhagic events, in patients ≥65 years of age with atrial fibrillation (AF) consecutively discharged from an Acute Geriatric Ward in the period 2010-2013. Stroke and bleeding risk were evaluated using CHA2DS2-VASC and HAS-BLED scores. Comorbidity, cognitive status and functional autonomy were evaluated using standardized scales. Independent associations between clinical variables, including use of Vitamin K Antagonists (VKAs)-based oral anticoagulant therapy (OAT), and all-cause mortality, fatal and non-fatal ischemic and hemorrha...
Source: The American Journal of Cardiology - December 1, 2015 Category: Cardiology Authors: Mario Bo, Irene Sciarrillo, Federica Li Puma, Marco Badinella Martini, Yolanda Falcone, Marina Iacovino, Enrica Grisoglio, Elena Menditto, Gianfranco Fonte, Enrico Brunetti, Guido Maggiani, Giovanni Carlo Isaia, Fiorenzo Gaita Source Type: research

Effects of Oral Anticoagulant Therapy in Medical Inpatients ≥65 Years With Atrial Fibrillation
In this retrospective cohort observational study, we investigated mortality, ischemic, and hemorrhagic events in patients ≥65 years with atrial fibrillation consecutively discharged from an Acute Geriatric Ward in the period 2010 to 2013. Stroke and bleeding risk were evaluated using CHA2DS2-VASC (congestive heart failure/left ventricular dysfunction, hypertension, aged ≥75 years, diabetes mellitus, stroke/transient ischemic attack/systemic embolism, vascular disease, aged 65 to 74 years, gender category) and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile in...
Source: The American Journal of Cardiology - December 1, 2015 Category: Cardiology Authors: Mario Bo, Irene Sciarrillo, Federica Li Puma, Marco Badinella Martini, Yolanda Falcone, Marina Iacovino, Enrica Grisoglio, Elena Menditto, Gianfranco Fonte, Enrico Brunetti, Guido Maggiani, Giovanni Carlo Isaia, Fiorenzo Gaita Tags: Arrhythmias and Conduction Disturbances Source Type: research

Meta-analysis of Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement in patients with Severe Aortic Valve Stenosis Patients
Transcatheter aortic valve replacement (TAVR) is a viable option in the treatment of severe aortic stenosis in patients at high risk for surgery. We sought to further investigate outcomes in low-to-intermediate-risk patients with aortic stenosis undergoing surgical aortic valve replacement (SAVR) versus TAVR. We systematically searched the electronic databases, MEDLINE, PUBMED, EMBASE and Cochrane for prospective cohort studies of the effects of TAVR vs SAVR on clinical outcomes (30-day mortality, all cause mortality, stroke and myocardial infarction [MI], major vascular complications, paravalvular regurgitation, permanent...
Source: The American Journal of Cardiology - November 5, 2015 Category: Cardiology Authors: Ashok Kondur, Alexandros Briasoulis, Mohan Palla, Anirudh Penumetcha, Sagar Mallikethi-Reddy, Apurva Badheka, Theodore Schreiber Source Type: research

Balancing the Risk of Bleeding and Stroke in Patients with Atrial Fibrillation after Percutaneous Coronary Intervention (from the AVIATOR-registry)
We describe patterns and determinants of antithrombotic prescriptions in this population. The AVIATOR (Antithrombotic strategy Variability In ATrial fibrillation and Obstructive coronary disease Revascularized with PCI) Registry was an international observational study of 859 consecutive patients with AF undergoing PCI between 2009 and 2011.
Source: The American Journal of Cardiology - April 7, 2015 Category: Cardiology Authors: Marco G. Mennuni, Jonathan L. Halperin, Sameer Bansilal, Mikkel M. Schoos, Kleanthis N. Theodoropoulos, Omar A. Meelu, Samantha Sartori, Daniele Giacoppo, Chiara Bernelli, Pedro R. Moreno, Prakash Krishnan, Usman Baber, Carla Lucarelli, George D. Dangas, Source Type: research

Balancing the Risk of Bleeding and Stroke in Patients With Atrial Fibrillation After Percutaneous Coronary Intervention (from the AVIATOR Registry)
We describe patterns and determinants of antithrombotic prescriptions in this population. The Antithrombotic Strategy Variability in Atrial Fibrillation and Obstructive Coronary Disease Revascularized with PCI Registry was an international observational study of 859 consecutive patients with AF who underwent PCI from 2009 to 2011.
Source: The American Journal of Cardiology - April 7, 2015 Category: Cardiology Authors: Marco G. Mennuni, Jonathan L. Halperin, Sameer Bansilal, Mikkel M. Schoos, Kleanthis N. Theodoropoulos, Omar A. Meelu, Samantha Sartori, Daniele Giacoppo, Chiara Bernelli, Pedro R. Moreno, Prakash Krishnan, Usman Baber, Carla Lucarelli, George D. Dangas, Tags: Coronary Artery Disease Source Type: research

Meta-analysis Of Randomized Controlled Trials and Adjusted Observational Results Of Use Of Clopidogrel, Aspirin and Oral Anti-coagulants In Patients Undergoing Percutaneous Coronary Intervention
The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulation (OAC) is currently debated. Medline and Cochrane Library were searched for studies reporting outcomes of patients undergoing PCI and who were on triple therapy (TT)or dual antiplatelet therapy (DAPT) with aspirin and clopidogrel or dual therapy(DT) with OAC and clopidogrel. Major bleeding was the primary end point, while all-cause death, myocardial infarction (MI), stent thrombosis and stroke were secondary ones.
Source: The American Journal of Cardiology - February 11, 2015 Category: Cardiology Authors: Fabrizio D’Ascenzo, Salma Taha, Claudio Moretti, Pierluigi Omedè, Walter Grossomarra, Jonas Persson, Morten Lamberts, Willem Dewilde, Andrea Rubboli, Sergio Fernández, Enrico Cerrato, Ilaria Meynet, Flavia Ballocca, Umberto Barbero, Giorgio Quadri, Fr Source Type: research

Meta-analysis of Net Long-term Benefit of Different Therapeutic Strategies in Patients with Cryptogenic Stroke and Patent Foramen Ovale
We pooled available data on follow-up events in patients with patent foramen ovale and cryptogenic stroke to evaluate the net clinical benefit of different therapeutic strategies (percutaneous closure vs antiplatelet vs anticoagulant therapy). MEDLINE/Pubmed and Cochrane databases and reviewed cited references to identify relevant studies were used; 3,311 patients from 21 clinical studies, both observational and randomized, with follow-up ≥12 months were overall included. Net clinical benefit was evaluated considering the cumulative incidence of both stroke/transient ischemic attack and major bleeding events.
Source: The American Journal of Cardiology - January 5, 2015 Category: Cardiology Authors: Giuseppe Patti, Francesco Pelliccia, Carlo Gaudio, Cesare Greco Source Type: research

Effect of an Invasive Strategy on Outcome in Patients ≥75 Years of Age with Non-ST-Elevation Acute Coronary Syndrome
The Italian Elderly ACS study was the first randomized trial (RCT) comparing an early aggressive (EA) with an initially conservative strategy in patients with NSTEACS aged ≥75 years, with the results showing no significant benefit of EA. We evaluated the outcomes of study patients, according to the treatment actually received during hospitalization. The RCT enrolled 313 patients. The primary endpoint was the composite of death, myocardial infarction (MI), disabling stroke, and repeat hospital stay for cardiovascular causes or bleeding within 1 year.
Source: The American Journal of Cardiology - December 17, 2014 Category: Cardiology Authors: Gennaro Galasso, Stefano De Servi, Stefano Savonitto, Teresa Strisciuglio, Raffaele Piccolo, Nuccia Morici, Ernesto Murena, Claudio Cavallini, Anna Sonia Petronio, Federico Piscione Source Type: research

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