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Spontaneous calcific cerebral embolization revealing a calcified rheumatic mitral stenosis: a case report
ConclusionSpontaneous calcified cerebral emboli secondary to mitral valve leaflet calcifications is an extremely rare condition. Replacement of the valve is the only option to prevent recurrent emboli and outcomes are still to be determined.
Source: Journal of Medical Case Reports - June 18, 2023 Category: General Medicine Source Type: research

Is There a Role for Vitamin K Antagonist in the Management of Atrial Fibrillation in 2023?
AbstractPurpose of ReviewTo address the following question: Are vitamin K antagonists (VKA) obsolete as stroke prevention therapy for patients with atrial fibrillation (AF) and thromboembolic risk factors?Recent FindingsA patient-level meta-analysis of the pivotal phase III randomized trials confirmed the favorable treatment effect of direct oral anticoagulants (DOAC) over VKA in multiple key patient subgroups. Among patients with AF and rheumatic heart disease (85% of whom had mitral stenosis), a randomized trial showed that rivaroxaban was not superior to VKA for stroke prevention. Caution should be exercised when prescr...
Source: Current Cardiology Reports - March 30, 2023 Category: Cardiology Source Type: research

Non-Vitamin K Antagonists versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Valves: a Systematic Review and Meta-Analysis
Patients with bioprosthetic heart valves and valve repair with concomitant atrial fibrillation are at an increased risk of thromboembolic events.1-5 Until recently, there was a paucity of randomized data to guide the optimal anticoagulation strategy in this patient population. In a prior meta-analysis of 4 randomized studies in patients with atrial fibrillation and valvular heart disease, excluding significant mitral stenosis and mechanical valves, there was a significant reduction in the risk of stroke or systemic embolism with non-vitamin K antagonist oral anticoagulants (NOACs) vs.
Source: The American Journal of Medicine - October 7, 2021 Category: General Medicine Authors: Rhanderson Cardoso, Caique M.P. Ternes, Gustavo B. Justino, Amanda Fernandes, Ana Vitoria Rocha, Leonardo Knijnik, Andre d'Avila, Renato D. Lopes Tags: Clinical Research Study Source Type: research

Oral Anticoagulation.
CONCLUSION: The evidence base for anticoagulation over a time frame of several years is inadequate at present, and direct comparative data for the different types of NOAC are not yet available. PMID: 30602410 [PubMed - in process]
Source: Deutsches Arzteblatt International - January 5, 2019 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research