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Source: American Heart Journal
Condition: Bleeding

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Total 167 results found since Jan 2013.

Changes in glomerular filtration rate and outcomes in patients with atrial fibrillation
Conclusions Rates of IS/TE, mortality and bleeding increased with worsening eGFR >4.81 ml/min/1.73 m2. Worsening eGFR was an independent predictor of IS/TE and of bleeding, and a better predictor of IS/TE than renal impairment in AF.
Source: American Heart Journal - December 31, 2017 Category: Cardiology Source Type: research

The Optimal Anti-Coagulation for Enhanced Risk Patients Post-Catheter Ablation for Atrial Fibrillation (OCEAN) trial
Discussion The OCEAN trial is a multicenter randomized controlled trial evaluating two antithrombotic treatment strategies for patients with risk factors for stroke after apparently successful AF ablation. We hypothesize that rivaroxaban will reduce the occurrence of clinically overt stroke, systemic embolism, and covert stroke when compared to ASA alone.
Source: American Heart Journal - December 9, 2017 Category: Cardiology Source Type: research

Efficacy and Safety of Dual Antiplatelet Therapy after Coronary Stenting in Patients with Chronic Kidney Disease
Conclusions The rates of POCO and coronary thrombotic events were significantly higher in patients with CKD compared with those without CKD, which was not affected by short- or long-term DAPT. Higher bleeding incidence by long-term DAPT was only observed in non-CKD patients but not in CKD patients. Further large scales studies are warranted to confirm our findings.
Source: American Heart Journal - December 7, 2017 Category: Cardiology Source Type: research

Prediction of long-term net clinical outcomes using the TIMI-AF score: Comparison with CHA2DS2-VASc and HAS-BLED
Conclusions In VKA-experienced AF patients, the TIMI-AF score has limited usefulness predicting NCOs over a long-term period of follow-up. This novel score was not superior to CHA2DS2-VASc and HAS-BLED identifying ‘low risk’ AF patients.
Source: American Heart Journal - November 10, 2017 Category: Cardiology Source Type: research

Percutaneous Coronary Intervention and Antiplatelet Therapy in Patients with Atrial Fibrillation Receiving Apixaban or Warfarin: Insights from the ARISTOTLE Trial
Conclusions PCI occurred infrequently during follow-up. The majority of patients on study drug at the time of PCI remained on study drug in the peri-PCI period; 19% continued the study drug without interruption. Antiplatelet therapy use post-PCI was variable, though the majority of patients received DAPT. Additional data are needed to guide the use of antithrombotics in patients undergoing PCI.
Source: American Heart Journal - November 10, 2017 Category: Cardiology Source Type: research

Efficacy and safety of potent platelet P2Y12 receptor inhibitors in elderly versus nonelderly patients with acute coronary syndrome: A systematic review and meta-analysis
Conclusions The effect of more potent P2Y12 inhibitors compared with clopidogrel on efficacy and safety end points is consistent in elderly and younger patients. These data imply that potent P2Y12 inhibitors should not be withheld from eligible patients solely because of advanced age.
Source: American Heart Journal - November 9, 2017 Category: Cardiology Source Type: research

Rationale and design of the DEAR-OLD trial: randomized evaluation of routinely Deferred versus EARly invasive strategy in elderly patients of 75years or OLDer with non-ST-elevation myocardial infarction
Conclusions the DEAR-OLD trial is a prospective, nationwide, multi-center, non-inferiority designed, open-label randomized clinical trial evaluating efficacy and safety of routinely deferred invasive strategy compared with early invasive strategy in Chinese elderly patients with NSTEMI.
Source: American Heart Journal - November 9, 2017 Category: Cardiology Source Type: research

Evaluation of the Safety and Efficacy of an Edoxaban-based Antithrombotic Regimen in Patients with Atrial Fibrillation Following Successful Percutaneous Coronary Intervention (PCI) with Stent Placement: Rationale and Design of the ENTRUST-AF PCI Trial
Publication date: Available online 23 October 2017 Source:American Heart Journal Author(s): Pascal Vranckx, Thorsten Lewalter, Marco Valgimigli, Jan G. Tijssen, Paul-Egbert Reimitz, Lars Eckardt, Hans-Joachim Lanz, Wolfgang Zierhut, Rüdiger Smolnik, Andreas Goette Background The optimal antithrombotic treatment after percutaneous coronary intervention (PCI) with stenting in patients with atrial fibrillation (AF) is unknown. In the ENGAGE AF-TIMI 48 trial, edoxaban was non-inferior to a vitamin-K antagonist (VKA) with respect to the prevention of stroke or systemic embolism and was associated with significantly lower rate...
Source: American Heart Journal - October 23, 2017 Category: Cardiology Source Type: research

Primary percutaneous coronary intervention at centers with and without on-site surgical support: Insights from the blue cross blue shield of Michigan cardiovascular consortium (BMC2)
Conclusions Primary PCI performed at centers with and without cardiac surgery have comparable outcomes and complication rates, when performed with close monitoring of quality and outcomes.
Source: American Heart Journal - October 17, 2017 Category: Cardiology Source Type: research

Is There A Role For Pharmacokinetic/Pharmacodynamic Guided Dosing For Novel Oral Anticoagulants?
Publication date: Available online 10 October 2017 Source:American Heart Journal Author(s): Noel Chan, Philip T. Sager, Jack Lawrence, Thomas's Ortel, Paul Reilly, Scott Berkowitz, Dagmar Kubitza, John Eikelboom, Jeffry Florian, Norman Stockbridge, Martin Rose, Robert Temple, Jonathan H. Seltzer The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy, and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke ...
Source: American Heart Journal - October 10, 2017 Category: Cardiology Source Type: research

Efficacy and Safety of Potent Platelet P2Y12 Receptor Inhibitors in Elderly vs. Non-elderly Patients with Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
Conclusions The effect of more potent P2Y12 inhibitors compared to clopidogrel on efficacy and safety endpoints is consistent in elderly and younger patients. These data imply that potent P2Y12 inhibitors should not be withheld from eligible patients solely because of advanced age.
Source: American Heart Journal - September 22, 2017 Category: Cardiology Source Type: research

Two-year follow-up of patients treated with dabigatran for stroke prevention in atrial fibrillation: GLORIA-AF Registry
Conclusions These global data confirm the sustained safety and effectiveness of dabigatran over 2years of follow-up, consistent with the results from clinical trials as well as contemporary real-world studies. WHAT IS KNOWN • Non- vitamin K antagonist (VKA) anticoagulants (NOACs) are the preferred therapy for prevention of ischemic stroke based on phase 3 trials, but there is insufficient information on their efficacy and safety in daily practice, based on prospectively collected data WHAT IS NEW • This study shows that in non-valvular AF patient population, with up to 2years of follow-up, the use of dabigatran led to ...
Source: American Heart Journal - September 1, 2017 Category: Cardiology Source Type: research

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD, ORBIT-AF I, and ORBIT-AF II Registries
Conclusions Among new-onset AF patients, NOAC use has increased and antiplatelet monotherapy has decreased. However, anticoagulation is used frequently in low-risk patients and inconsistently in those at high-risk of stroke. Significant geographic variability in anticoagulation persists and represents an opportunity for improvement.
Source: American Heart Journal - August 24, 2017 Category: Cardiology Source Type: research

Edoxaban for the Management of Elderly Japanese Patients with Atrial Fibrillation Ineligible for Standard Oral Anticoagulant Therapies: Rationale and Design of the ELDERCARE-AF Study
Publication date: Available online 24 August 2017 Source:American Heart Journal Author(s): Ken Okumura, Gregory Y.H. Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita Edoxaban—a nonvitamin K antagonist oral anticoagulant (NOAC)— 60-mg and 30-mg once-daily dose regimens are noninferior vs well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF ...
Source: American Heart Journal - August 24, 2017 Category: Cardiology Source Type: research

Atrial Fibrillation Decision Support Tool: Population Perspective
Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Source: American Heart Journal - August 23, 2017 Category: Cardiology Source Type: research