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Specialty: Cardiology
Condition: Chronic Kidney Disease
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Total 27 results found since Jan 2013.

Oral Anticoagulant Use in Patients With Atrial Fibrillation and Chronic Kidney Disease: A Review of the Evidence With Recommendations for Australian Clinical Practice
Chronic kidney disease is common in patients with atrial fibrillation (AF) and is associated with heightened risks of stroke/systemic embolisation and bleeding. In this review we outline the evidence for AF stroke prevention in kidney disease, identify current knowledge gaps, and give recommendations for anticoagulation at various stages of chronic kidney disease.Overall, anticoagulation is underused. Warfarin use becomes increasingly difficult with advancing kidney disease, with difficulty maintaining international normalised ratio (INR) in therapeutic range, increased risk of intracranial and fatal bleeding compared to n...
Source: Heart, Lung and Circulation - November 3, 2022 Category: Cardiology Authors: Christopher Hammett, Sunil V. Badve, Peter G. Kerr, Huyen A. Tran, Benjamin K. Dundon, Sidney Lo, Andrew Wong, Joanne E. Joseph, Jenny Deague, Vlado Perkovic Tags: Review Source Type: research

2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment —Authors’ reply
We thank the authors for addressing this important issue.1 Indeed, the assessment of NOAC plasma levels —or potential alternatives—in special situations may represent an important element in the further refinement of non-vitamin K antagonist oral anticoagulant (NOAC) therapy. In their letter, Mbroh and Poli make a case for using point-of-care coagulation tests (POCT) to more rapidly assess the lev el of anticoagulant in patients’ blood samples. In the 2021 EHRA Practical Guide on the use of NOACs, we suggest to consider NOAC plamsa level assessment in two different types of scenarios: emergency situations (e.g. acute...
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research

Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Chronic Kidney Disease Stage G4: A Single-Center Experience
Abstract: Atrial fibrillation (AF) is associated with increased stroke and bleeding risk in patients with chronic kidney disease (CKD). Little is known about the real-life use of non-vitamin K antagonist oral anticoagulants (NOACs) in CKD stage G4. In a retrospective cohort study, we enrolled 182 consecutive AF patients with CKD stage G4 including 90 (49%) subjects on NOAC, ie, 61 on apixaban 2.5 mg bid and 29 on rivaroxaban 15 mg qd, and 92 (51%) subjects on warfarin. Thromboembolic and bleeding events were recorded during a mean follow-up of 26.3 months. There were no differences in demographic, clinical, and laborat...
Source: Journal of Cardiovascular Pharmacology - December 1, 2020 Category: Cardiology Tags: Drugs in the Pipeline – Original Article Source Type: research

Risk of left atrial appendage thrombus in patients with atrial fibrillation and chronic kidney disease.
CONCLUSIONS: Despite OAC, patients with concomitant AF and CKD remain at high risk for LAA thrombus formation. PMID: 32207840 [PubMed - as supplied by publisher]
Source: Cardiology Journal - March 23, 2020 Category: Cardiology Authors: Budnik M, Gawałko M, Gorczyca I, Uziębło-Życzkowska B, Krzesińki P, Kochanowski J, Scisło P, Michalska A, Jelonek O, Starzyk K, Jurek A, Kiliszek M, Wożakowska-Kapłon B, Gielerak G, Filipiak KJ, Opolski G, Kapłon-Cieślicka A Tags: Cardiol J Source Type: research

Anticoagulation in Patients with Advanced Chronic Kidney Disease: Walking the Fine Line between Benefit and Harm
Publication date: Available online 11 July 2019Source: Canadian Journal of CardiologyAuthor(s): Januvi Jegatheswaran, Gregory L. Hundemer, David Massicotte-Azarniouch, Manish M. SoodAbstractChronic kidney disease affects over 3 million Canadians and is highly associated with cardiovascular diseases that require anticoagulation, such as atrial fibrillation and venous thromboembolism. Patients with chronic kidney disease are at a problematic crossroads; they are at high risk of both thrombotic conditions requiring anticoagulation and bleeding complications due to anticoagulation. The limited high-quality clinical evidence to...
Source: Canadian Journal of Cardiology - July 12, 2019 Category: Cardiology Source Type: research

Apixaban for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in France: The PAROS cross-sectional study of routine clinical practice.
CONCLUSIONS: Initiation of apixaban versus NOACs was more common among patients with increased age, higher bleeding risk and decreased renal function, whereas initiation of apixaban versus VKAs was more common among patients with lower bleeding risk and better renal function. PMID: 31014991 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - April 19, 2019 Category: Cardiology Authors: Falissard B, Picard F, Mahe I, Hanon O, Touzé E, Danchin N, Lamy FX, Ricci L, Steg PG Tags: Arch Cardiovasc Dis Source Type: research

The use of anticoagulants in chronic kidney disease: Common point of view of cardiologists and nephrologists.
Abstract In patients diagnosed with chronic kidney disease (CKD), atrial fibrillation (AF) is associated with an increased risk of thromboembolism and stroke. Moreover, patients with CKD - especially those in end-stage renal disease - also present an increased risk of bleeding. Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF and an increased risk of stroke. However, the underuse of these drugs was observed, mainly due to safety reasons and restricted evidence on efficacy. Much evidence suggests that non-vitamin K-dependent oral anticoagulant agents significantly reduce the...
Source: Cardiology Journal - March 25, 2019 Category: Cardiology Authors: Domienik-Karłowicz J, Tronina O, Lisik W, Durlik M, Pruszczyk P Tags: Cardiol J Source Type: research

Anticoagulation for Stroke Prevention in Older Adults with Atrial Fibrillation and Comorbidity: Current Evidence and Treatment Challenges.
Authors: Sabbag A, Yao X, Siontis KC, Noseworthy PA Abstract The burden of atrial fibrillation (AF) is projected to increase substantially over the next decade in parallel with the aging of the population. The increasing age, level of comorbidity, and polypharmacy will complicate the treatment of older adults with AF. For instance, advanced age and chronic kidney disease have been shown to increase the risk of both thromboembolism and bleeding in patients with AF. Frailty, recurrent falls and polypharmacy, while very common among elderly patients with AF, are often overlooked in the clinical decision making despite...
Source: Korean Circulation Journal - September 22, 2018 Category: Cardiology Tags: Korean Circ J Source Type: research

Variability in Non–Vitamin K Antagonist Oral Anticoagulants Dose Adjustment in Atrial Fibrillation Patients With Renal Dysfunction: The Influence of Renal Function Estimation Formulae
ConclusionsMDRD and CKD-EPI eGFR fail to correctly identify a significant proportion of patients who require NOAC dose adjustment, limiting their clinical utility. Cockcroft-Gault eCrCl should be calculated for all patients in whom a NOAC is being prescribed.RésuméContexteL’administration d’un nouvel anticoagulant oral non-antivitamine K (NACO) nécessite un ajustement de la dose en fonction des paramètres rénaux. La mesure de la fonction rénale la plus communément utilisée est le taux de filtration glomérulaire estimé (TFGe) selon la formule « Modified Diet in Renal Disease » (TFGe MDRD) ou « Chronic Kidne...
Source: Canadian Journal of Cardiology - July 24, 2018 Category: Cardiology Source Type: research

Nonvitamin K Oral Anticoagulants in Patients With Atrial Fibrillation and Severe Renal Dysfunction
Publication date: Available online 27 June 2018Source: Revista Española de Cardiología (English Edition)Author(s): Maria Mahmood, Gregory Y.H. LipAbstractBoth atrial fibrillation (AF) and chronic kidney disease (CKD) are highly prevalent, especially with increasing age and associated comorbidities, such as hypertension, diabetes, heart failure, and vascular disease. The relationship between both AF and CKD seems to be bidirectional: CKD predisposes to AF while onset of AF seems to lead to progression of CKD. Stroke prevention is the cornerstone of AF management, and AF patients with CKD are at higher risk of stroke, mort...
Source: Revista Espanola de Cardiologia - July 10, 2018 Category: Cardiology Source Type: research

Variability In NOAC Dose Adjustment In Atrial Fibrillation Patients With Renal Dysfunction: The Influence Of Renal Function Estimation Formulae
Conclusion MDRD and CKD-EPI eGFR fails to correctly identify a significant proportion of patients that require NOAC dose adjustment, limiting their clinical utility. Cockcroft-Gault eCrCl should be calculated for all patients in whom a NOAC is being prescribed. Teaser While glomerular filtration rate is the most common estimates of renal function employed in practice the landmark stroke prevention trials use of the Cockcroft-Gault creatinine clearance equation to determine drug eligibility and dose adjustment. In a large cohort of patients with non-dialysis dependent chronic kidney disease and atrial fibrillation the use o...
Source: Canadian Journal of Cardiology - April 26, 2018 Category: Cardiology Source Type: research

Risk of Cardiovascular Events and Incident Atrial Fibrillation in Patients without Prior Atrial Fibrillation: Implications for Expanding the Indications for Anticoagulation
Conclusions Patients without diagnosed AF but with certain risk factors were at a particularly high cardiovascular risk and may require new prevention approaches. In addition to the ongoing trials, future trials in other high-risk populations, e.g., diabetes and chronic kidney disease may be warranted.
Source: American Heart Journal - February 10, 2018 Category: Cardiology Source Type: research

Real-world Data and Recommended Dosage of Non-vitamin K Oral Anticoagulants for Korean Patients.
Authors: Joung B Abstract Regulatory approvals of non-vitamin K antagonist oral anticoagulants (NOACs) have been based on large randomized phase III trials evaluating dabigatran, rivaroxaban, apixaban, or edoxaban relative to warfarin for atrial fibrillation (AF). The results of the trials showed that all NOACs were at least non-inferior to warfarin in the prevention of stroke/thromboembolism and showed lower rates of intracranial bleeding than those associated with warfarin. However, the trials were designed differently, varied in the inclusion/exclusion criteria, and used either one dose or a low/high dose of the...
Source: Korean Circulation Journal - November 26, 2017 Category: Cardiology Tags: Korean Circ J Source Type: research