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Condition: Heart Failure
Drug: Coumadin

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Total 289 results found since Jan 2013.

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Patients’ Time in Therapeutic Range on Warfarin Among U.S. Atrial Fibrillation Patients: Results from ORBIT-AF Registry
Conclusions Among AF patients in US clinical practices, TTR on warfarin is suboptimal and those at highest predicted risks for stroke and bleeding were least likely to be in therapeutic range.
Source: American Heart Journal - April 3, 2015 Category: Cardiology Source Type: research

Contraindications to Anticoagulation Therapy and Eligibility for Novel Anticoagulants in Older Patients With Atrial Fibrillation
ConclusionsOlder adults with atrial fibrillation rarely have absolute contraindications to oral anticoagulation therapy. Among patients without contraindications, most appeared to be eligible for any anticoagulant, and relatively high‐risk features appeared not to influence warfarin use.This article is protected by copyright. All rights reserved.
Source: Cardiovascular Therapeutics - April 1, 2015 Category: Cardiology Authors: Benjamin A. Steinberg, Melissa A. Greiner, Bradley G. Hammill, Lesley H. Curtis, Emelia J. Benjamin, Susan R. Heckbert, Jonathan P. Piccini Tags: Original Research Article Source Type: research

Left Ventricular Assist Devices vs. the Total Artificial Heart: Which Causes More Cerebrovascular Accidents?
More recently, the continuous flow left ventricular assist devices (LVADs) have been more commonly used in patients (pts) with severe left heart failure. However, these devices also have risk for strokes, both ischemic and hemorrhagic. The Total Artificial Heart (TAH) has also been used in patients with biventricular heart failure at our single institution. Both continuous flow LVADs and TAH patients are systemically anti-coagulated with warfarin and aspirin. We sought to compare stroke rates between the LVAD patients and TAH pts.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: C. Runyan, F. Arabia, L. Czer, M. Kittleson, E. Passano, F. Liou, J. Yabuno, H. Henry, D.H. Chang, J. Kobashigawa, J. Moriguchi Source Type: research

Rates of Ischemic Stroke During Warfarin Treatment for Atrial Fibrillation Brief Reports
Conclusions— In a large cohort of older patients with atrial fibrillation, we observed the highest rate of ischemic stroke in the first 30 days after warfarin initiation. Although causation cannot be established given the observational nature of this study, our findings highlight the need for future research in this population.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Tung, J. M., Mamdani, M. M., Juurlink, D. N., Paterson, J. M., Kapral, M. K., Gomes, T. Tags: Cardiovascular Pharmacology, Anticoagulants, Epidemiology Brief Reports Source Type: research

Comparison of warfarin time in the therapeutic range at a pharmacist-run anticoagulation clinic and the RE-LY trial.
CONCLUSION: TTR values among PAC-managed patients with nonvalvular atrial fibrillation were comparable to those reported in the RE-LY trial. PMID: 25788509 [PubMed - in process]
Source: American Journal of Health-System Pharmacy : AJHP - March 20, 2015 Category: Drugs & Pharmacology Authors: Biszewski M, Nitzki-George D, Zhou Y Tags: Am J Health Syst Pharm Source Type: research

Anticoagulation therapy in 2015: where we are and where we are going
Abstract Oral anticoagulants are a mainstay for the prevention and treatment of venous and arterial thrombosis. In 2015, the non-vitamin K oral anticoagulants (NOACs) are already replacing warfarin for many indications. Ongoing studies are focused on development of antidotes and specific reversal agents for the NOACs, and assessing their utility for prevention of cardiovascular events in patients with heart failure, coronary or peripheral artery disease, or embolic stroke of unknown source. This paper (a) lists the current indications for the NOACs; (b) reviews the current impact of the NOACs in each of these indi...
Source: Journal of Thrombosis and Thrombolysis - February 19, 2015 Category: Hematology Source Type: research

Predictors of Anticoagulant Treatment in Patients With Nonvalvular Atrial Fibrillation: Results From Atrial Fibrillation in Turkey: Epidemiologic Registry
In this study, we demonstrated that stroke history, persistent/permanent AF, hypertension, DM, and left atrial diameter were positive predictors, whereas advanced age and heart failure were negative predictors of oral anticoagulant use in patients with nonvalvular AF.
Source: Clinical and Applied Thrombosis/Hemostasis - February 2, 2015 Category: Hematology Authors: Kaya, H., Ertaş, F., Koroğlu, B., Vatan, B., Cağlıyan, C. E., Gedik, S., Yeter, E., Aydin, M., Akil, M. A., Soydinc, M. S., Ozhan, H., Ulgen, M. S., for the AFTER Investigators Tags: Original Articles Source Type: research

Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naive atrial fibrillation patients: Danish nationwide descriptive data 2011-2013
Conclusion Among oral anticoagulation-naïve AF patients initiated on oral anticoagulation in Denmark, warfarin initiation has declined since the introduction of dabigatran in August 2011. Dabigatran is the most frequently used alternative option to warfarin; however, use of rivaroxaban and apixaban is increasing. Patients initiated with rivaroxaban or apixaban in general have a higher predicted stroke and bleeding risks compared with warfarin or dabigatran initiators.
Source: Europace - January 29, 2015 Category: Cardiology Authors: Olesen, J. B., Sorensen, R., Hansen, M. L., Lamberts, M., Weeke, P., Mikkelsen, A. P., Kober, L., Gislason, G. H., Torp-Pedersen, C., Fosbol, E. L. Tags: Atrial fibrillation Source Type: research

Management of anticoagulation and antiplatelet therapy in patients with left ventricular assist devices
Abstract Left ventricular assist devices (LVADs) have increased the survival of patients with advanced heart failure fourfold. Despite these advances, significant bleeding and thrombotic complications occur. Hemorrhage requiring surgery has been reported in up to 30 % of adults and 50 % of children after LVAD placement. LVAD thrombosis and embolic stroke lead to significant long-term morbidity. Adults are treated with antithrombotic therapy to prevent thrombotic complications, but the amount and intensity of treatment differs between institutions. The goal international normalized ratio for warfarin therapy vari...
Source: Journal of Thrombosis and Thrombolysis - December 31, 2014 Category: Hematology Source Type: research

Net Clinical Benefit of Antithrombotic Therapy in Patients With Atrial Fibrillation and Chronic Kidney Disease A Nationwide Observational Cohort Study
ConclusionsCKD is associated with a higher risk of stroke/thromboembolism across stroke risk strata in AF patients. High-risk CKD patients (CHA2DS2-VASc ≥2) with AF benefit from warfarin treatment for stroke prevention.
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research

Characterizing Major Bleeding in Patients With Nonvalvular Atrial Fibrillation: A Pharmacovigilance Study of 27 467 Patients Taking Rivaroxaban
ConclusionsIn this large observational study, the MB rate was generally consistent with the registration trial results, and fatal bleeds were rare.
Source: Clinical Cardiology - December 1, 2014 Category: Cardiology Authors: Sally Tamayo, W. Frank Peacock, Manesh Patel, Nicholas Sicignano, Kathleen P. Hopf, Larry E. Fields, Troy Sarich, Shujian Wu, Daniel Yannicelli, Zhong Yuan Tags: Quality and Outcomes Source Type: research

Recurrent Stroke in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial
In this study, we explore IIS rates in WARCEF patients with and without baseline stroke to look for risk factors for IIS and determine if a subgroup with an IIS rate high enough to give a clinically relevant stroke risk reduction can be identified. Methods: We compared potential stroke risk factors between patients with baseline stroke and those without using the exact conditional score test for Poisson variables. We looked for risk factors for IIS, by comparing IIS rates between different risk factors. For EF we tried cut-off points of 10, 15 and 20%. The cut-off point 15% was used as it was the highest EF that was associ...
Source: Cerebrovascular Diseases - November 7, 2014 Category: Neurology Source Type: research

Study On Drug Utilization And Assessment Of Stroke Risk Using Chads2 And Cha2ds2-Vasc Scoring In Elderly Patients With Non-Valvular Atrial Fibrillation
Stroke Risk Stratification in AF patients of can be done using CHADS2 (Congestive heart failure, Hypertension, Age ≥75, DM, prior Stroke/TIA [2 points] ); or CHA2DS2VASc2 (Congestive heart failure/left ventricular ejection fraction ≤35%, Hypertension, Age ≥75 [2 points], DM, prior Stroke/TIA/thromboembolism [2 points], Vascular disease, Age 65–74, Sex- female). Treatment options for Prevention of stroke includes Anti-coagulants (Vitamin K Antagonist-Warfarin, Acenocoumarol; and Newer Oral Anticoagulant- Dabigatran) and anti-platelets (Aspirin and Clopidogrel).
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: T. Raj, S. Bonthu, S.R. Mallayasamy Source Type: research

Antithrombotic therapy for atrial fibrillation and coronary artery disease in older patients
Conclusions Among older patients with AF and CAD, overall warfarin use was low. Patients ≥80 years old at highest stroke risk received warfarin in similar proportions to the overall cohort. Further investigation into optimizing antithrombotic strategies in this population is warranted.
Source: American Heart Journal - October 20, 2014 Category: Cardiology Source Type: research