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Condition: Heart Failure
Drug: Coumadin

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Total 289 results found since Jan 2013.

Simultaneous onset of myocardial infarction and ischemic stroke in a patient with atrial fibrillation: Multiple territory injury revealed on angiography and magnetic resonance
An 84-year-old man with a history of hypertension and paroxysmal atrial fibrillation (AF) who received no anticoagulant drugs experienced acute chest pain and transient loss of consciousness. He was transferred to our emergency room. His initial electrocardiogram showed sinus rhythm with ST-segment elevation in the I, aVL, and V1–V6 leads. His blood pressure was 158/92mmHg and his pulse was regular at 70beats per minute. A chest radiograph showed increased heart size and pulmonary vascular congestion. His troponin T level was elevated (more than 0.1ng/mL). He was diagnosed with ST-elevation myocardial infarction (MI) and...
Source: International Journal of Cardiology - February 4, 2014 Category: Cardiology Authors: Osamu Hashimoto, Kozo Sato, Yohei Numasawa, Joji Hosokawa, Masahiro Endo Tags: Online Letters to the Editor Source Type: research

Beyond age, the need for useful parameters to identify heart failure patients in sinus rhythm that can benefit from oral anticoagulation
It is still unclear whether oral anticoagulant or aspirin therapy is superior for patients with heart failure (HF) who are in sinus rhythm. The subanalyses of the warfarin vs. aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial, that have been recently published , were aimed to identify subgroups of patients with reduced left ventricular ejection fraction (LVEF≤35%) in sinus rhythm that may benefit from warfarin or aspirin. They showed that patients under 60years have an improved outcome with warfarin over aspirin concerning the composite outcome of ischemic stroke, intracerebral hemorrhage and overall death, wha...
Source: International Journal of Cardiology - January 23, 2014 Category: Cardiology Authors: Enrico Ammirati, Dacia Dalla Libera, Maria Frigerio Tags: Online Letters to the Editor Source Type: research

Warfarin Use and the Risk for Stroke and Bleeding in Patients with Atrial Fibrillation Undergoing Dialysis.
CONCLUSIONS: Our results suggest that warfarin use is not beneficial in reducing stroke risk but is associated with a higher bleeding risk in patients with AF undergoing dialysis. PMID: 24452752 [PubMed - as supplied by publisher]
Source: Circulation - January 22, 2014 Category: Cardiology Authors: Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, Humphries KH, Tu JV, Behlouli H, Guo H, Pilote L Tags: Circulation Source Type: research

Long-term PT-INR levels and the clinical events in the patients with non-valvular atrial fibrillation: A special reference to low-intensity warfarin therapy.
CONCLUSIONS: The event rates were similar between the low- (1.6-1.99) and high- (2.0-2.59) intensity warfarin therapy groups in aged patients: <70 years and ≥70 years. Time in therapeutic range and a transient fall or rise in PT-INR were risks for clinical events. Blunt head trauma and concomitant use of antiplatelets were risks for intracranial hemorrhage. PMID: 24440439 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - January 16, 2014 Category: Cardiology Authors: Takarada K, Sato M, Goto M, Saito A, Ikeda Y, Fujita S, Fuse K, Takahashi M, Oguro T, Matsushita H, Kitazawa H, Okabe M, Abe H, Toba K, Yamashina A, Aizawa Y Tags: J Cardiol Source Type: research

High-Sensitivity Troponin T and Risk Stratification in Patients With Atrial Fibrillation During Treatment With Apixaban or Warfarin
ObjectivesThe aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) risk score in patients with atrial fibrillation (AF).BackgroundThe level of troponin is a powerful predictor of cardiovascular events and mortality.MethodsA total of 14,897 patients with AF were randomized to treatment with apixaban or warfarin in the ARISTOTLE (Apixaban for the P...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - January 7, 2014 Category: Radiology Source Type: research

Early Adoption of Dabigatran and Its Dosing in US Patients With Atrial Fibrillation: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation Health Services and Outcomes Research
Conclusions Patients receiving dabigatran were younger and at a lower risk of stroke and bleeding. Patients appeared to drive switching from warfarin, whereas clinical characteristics influenced de novo start of dabigatran. These data suggest cautious early uptake of dabigatran, and more careful attention to dosing adjustments is warranted. Clinical Trial Registration URL: Clinicaltrials.gov. Unique identifier: NCT01165710.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Steinberg, B. A., Holmes, D. N., Piccini, J. P., Ansell, J., Chang, P., Fonarow, G. C., Gersh, B., Mahaffey, K. W., Kowey, P. R., Ezekowitz, M. D., Singer, D. E., Thomas, L., Peterson, E. D., Hylek, E. M., The Outcomes Registry for Better Informed Treatme Tags: Health Services and Outcomes Research Source Type: research

Update on the management of atrial fibrillation.
Abstract Atrial fibrillation (AF) is a common arrhythmia, with a prevalence that increases markedly with increasing age. Presence of AF has implications for management of future stroke risk. If the patient's pulse is irregular, an electrocardiogram should be ordered. Key management decisions are whether to adopt a rhythm control or a rate control strategy and whether to initiate anticoagulation. The primary aim of a rhythm control strategy is improved symptom control. AF ablation may be considered in younger patients (aged < 65 years) with paroxysmal or early persistent AF. AF increases the risk of stroke, an...
Source: Med J Aust - November 4, 2013 Category: Journals (General) Authors: Amerena JV, Walters TE, Mirzaee S, Kalman JM Tags: Med J Aust Source Type: research

Higher N-Terminal Pro–B-Type Natriuretic Peptide May Be Related to Very Different Conditions
We read the paper by Hijazi et al. (1) with interest. The authors investigated the incremental value of measuring N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels in addition to established risk factors (including the CHA2DS2VASc [heart failure, hypertension, age 75 years and older, diabetes, and previous stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category (female sex, respectively)] score) for the prediction of cardiovascular and bleeding events. They concluded that NT-proBNP levels are often elevated in atrial fibrillation (AF) and independently associated with an increa...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - October 14, 2013 Category: Cardiology Source Type: research

Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Postdischarge International Normalized Ratio Testing and Long‐term Clinical Outcomes of Patients With Heart Failure Receiving Warfarin: Findings From the ADHERE Registry Linked to Medicare Claims
ConclusionsPostdischarge outpatient INR testing in patients with heart failure complicated by atrial fibrillation or valvular heart disease was high. INR testing was associated with improved survival and fewer myocardial infarctions at 1 year but was not independently associated with other adverse clinical events.
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Laura G. Qualls, Melissa A. Greiner, Zubin J. Eapen, Gregg C. Fonarow, Roger M. Mills, Winslow Klaskala, Adrian F. Hernandez, Lesley H. Curtis Tags: Clinical Investigation Source Type: research

High-Sensitivity Troponin T and Risk Stratification in Patients With Atrial Fibrillation During Treatment With Apixaban or Warfarin
Objectives: The aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) risk score in patients with atrial fibrillation (AF).Background: The level of troponin is a powerful predictor of cardiovascular events and mortality.Methods: A total of 14,897 patients with AF were randomized to treatment with apixaban or warfarin in the ARISTOTLE (Apixaban for...
Source: Journal of the American College of Cardiology - September 23, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, John H. Alexander, Dan Atar, Bernard J. Gersh, Michael Hanna, Veli Pekka Harjola, John D. Horowitz, Steen Husted, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Granger, Tags: Heart Rhythm Disorders Source Type: research

Benefit of Warfarin Compared With Aspirin in Patients With Heart Failure in Sinus Rhythm: A Subgroup Analysis of WARCEF, a Randomized Controlled Trial Original Articles
Conclusions— In patients <60 years, warfarin improved outcomes over aspirin with or without inclusion of major hemorrhage. In patients ≥60 years, there was no treatment difference, but the aspirin group had significantly better outcomes when major hemorrhage was included. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00041938.
Source: Circulation: Heart Failure - September 17, 2013 Category: Cardiology Authors: Homma, S., Thompson, J. L. P., Sanford, A. R., Mann, D. L., Sacco, R. L., Levin, B., Pullicino, P. M., Freudenberger, R. S., Teerlink, J. R., Graham, S., Mohr, J. P., Massie, B. M., Labovitz, A. J., Di Tullio, M. R., Gabriel, A. P., Lip, G. Y. H., Estol, Tags: Congestive, Cerebrovascular disease/stroke, Thrombosis risk factors, Anticoagulants, Antiplatelets Original Articles Source Type: research

Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board
Summary Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed (<35%) left ventricular ejection fraction have a 4% rate of embolic events. Several prospective randomized trials of anticoagulation in this group of patients were either underpowered or had a short period of follow‐up. Even though in two studies warfarin had a slight advantage over aspirin (in the WATCH and WARCEF trials), it was at the cost of an increased risk in major hemorrhage. To decrease ...
Source: Cardiovascular Therapeutics - September 12, 2013 Category: Cardiology Authors: Alexandru Nicolae Mischie, Valentin Chioncel, Ionel Droc, Crina Sinescu Tags: Short communication Source Type: research

Causes of Death and Influencing Factors in Patients with Atrial Fibrillation: A Competing Risk Analysis from the Randomized Evaluation of Long-Term Anticoagulant Therapy Study.
CONCLUSIONS: The majority of deaths are not related to stroke in a contemporary anticoagulated AF population. These results emphasize the need to identify interventions beyond effective anticoagulation, in order to further reduce mortality in AF. CLINICAL TRIAL REGISTRATION INFORMATION: http://www.clinicaltrials.gov. Identifier: NCT00262600. PMID: 24016454 [PubMed - as supplied by publisher]
Source: Circulation - September 9, 2013 Category: Cardiology Authors: Marijon E, Le Heuzey JY, Connolly S, Yang S, Pogue J, Brueckmann M, Eikelboom JW, Themeles E, Ezekowitz MD, Wallentin L, Yusuf S Tags: Circulation Source Type: research

Dabigatran compared with warfarin in patients with atrial fibrillation and symptomatic heart failure: a subgroup analysis of the RE-LY trial
Conclusions The overall benefits of dabigatran for stroke/SE prevention, and major and intracranial bleeding, relative to warfarin in the RE-LY trial were consistent in patients with and without HF.
Source: European Journal of Heart Failure - August 19, 2013 Category: Cardiology Authors: Ferreira, J., Ezekowitz, M. D., Connolly, S. J., Brueckmann, M., Fraessdorf, M., Reilly, P. A., Yusuf, S., Wallentin, L., on behalf of the RE-LY Investigators Tags: TREATMENT Source Type: research