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Total 91 results found since Jan 2013.

Preserve the Brain: Primary Goal in the Therapy of Atrial Fibrillation∗
Treatment of atrial fibrillation (AF) involves 3 major strategies: prevention of stroke, maintenance of sinus rhythm, and rate control . Stroke is the most dreaded complication of AF, and its prevention is key. Anticoagulation with warfarin and the newer agents dabigatran, rivaroxaban, and apixaban is highly effective in preventing strokes in patients with AF . However, defining the appropriate patient for anticoagulant therapy is not an exact science, and the stroke risk schema CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/transient ischemic attack) and CHA2DS2-VASc (...
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Eric N. Prystowsky, Benzy J. Padanilam Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

An Aspirin a Day: Is the Benefit Worth the Risk?
Studies have shown that aspirin, the age old remedy for pain and fever, also thins the blood. Because of this property, it can also help to lower the chances of a heart attack or a stroke caused by a blood clot in the brain. And, although research has found that it only works in certain people (specifically, those with a history of heart attack or stroke) many Americans are inappropriately taking daily, low doses of aspirin as a preventative measure. In fact, researchers have found that about 12 percent of the of nearly 69,000 U.S. adults taking aspirin on a long-term basis should not have received the prescription in the ...
Source: Healthy Living - The Huffington Post - March 13, 2015 Category: Consumer Health News Source Type: news

Trends in antithrombotic therapy for atrial fibrillation: Data from the Veterans Health Administration Health System
Conclusions Among US veterans with new AF and additional risk factors for stroke, only about half receive OAC, and the proportion is declining.
Source: American Heart Journal - September 3, 2016 Category: Cardiology Source Type: research

Dabigatran and vitamin K antagonists ’ use in naïve patients with non-valvular atrial fibrillation: a cross-sectional study of primary care-based electronic health records
ConclusionsMost patients recently diagnosed with non-valvular atrial fibrillation initiated treatment with VKA. Primary healthcare patients with non-valvular atrial fibrillation initiating dabigatran are younger, had a lower risk of stroke or bleeding, fewer comorbidity and more history of stroke and intracranial haemorrhage compared to those who were initiated on VKA.
Source: European Journal of Clinical Pharmacology - July 19, 2017 Category: Drugs & Pharmacology Source Type: research

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.
Conclusion: The available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF. The DOACs had similar benefits across several patient subgroups and seemed safe and efficacious for a wide range of patients with nonvalvular AF. Primary Funding Source: Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42017069999). PMID: 30383133 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 30, 2018 Category: Internal Medicine Authors: Lowenstern A, Al-Khatib SM, Sharan L, Chatterjee R, LaPointe NMA, Shah B, Borre ED, Raitz G, Goode A, Yapa R, Davis JK, Lallinger K, Schmidt R, Kosinski AS, Sanders GD Tags: Ann Intern Med Source Type: research

Abstract 14: Clinical Characteristics and Treatment Patterns of Medicaid Patients with Atrial Fibrillation: Insights From the ORBIT-AF I Registry Session Title: Concurrent Session IIB: Oral Abstracts - Quality of Care
Conclusions: In a contemporary, community-based AF cohort, Medicaid patients had a greater comorbidity burden and higher stroke risk, yet were less likely to receive OAC compared with those with other forms of insurance.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: O'Brien, E. C., Kim, S., Thomas, L., Fonarow, G. C., Mahaffey, K. W., Kowey, P. R., Gersh, B. J., Burton, P. S., Piccini, J. P., Peterson, E. D. Tags: Session Title: Concurrent Session IIB: Oral Abstracts - Quality of Care Source Type: research

Nonvitamin K Antagonist Oral Anticoagulants Use in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves/Prior Surgical Valve Repair: A Multicenter Clinical Practice Experience
Semin Thromb Hemost DOI: 10.1055/s-0037-1615261This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and...
Source: Seminars in Thrombosis and Hemostasis - January 5, 2018 Category: Hematology Authors: Russo, Vincenzo Attena, Emilio Mazzone, Carmine Esposito, Francesca Parisi, Valentina Bancone, Ciro Rago, Anna Nigro, Gerardo Sangiuolo, Raffaele D' Onofrio, Antonio Tags: Original Article Source Type: research

A network meta-analysis of non-vitamin K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and diabetes mellitus.
CONCLUSION: In patients suffering from AF and diabetes, dabigatran 110 mg (bid) was more likely to become the choice for its performance on preventing systemic embolism or stroke and major bleeding, followed by rivaroxaban 20 mg (QD). PMID: 33432890 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - January 13, 2021 Category: Cardiology Tags: Acta Cardiol Source Type: research

Long-term comparative effectiveness and safety of dabigatran, rivaroxaban, apixaban and edoxaban in patients with atrial fibrillation: A nationwide cohort study
Conclusion: NOACs had better long-term risk-benefit profiles than VKAs. While effectiveness was comparable, apixaban was overall associated with a more favorable safety profile followed by dabigatran.
Source: Frontiers in Pharmacology - February 2, 2023 Category: Drugs & Pharmacology 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

Apixaban exerts anti-inflammatory effects in mesangial cells by blocking thrombin/protease-activated receptor-1 system
Atrial fibrillation (AF) is most frequent arrhythmia in patients with chronic kidney disease (CKD) [1,2]. Since diabetes and hypertension are risk components of CHADS2 score and also risk factors for CKD, CKD could affect cardiovascular outcomes in patients with AF [2–5]. Indeed, several papers have shown that renal dysfunction increases the risk of thromboembolic events, stroke and all-cause mortality in AF patients [2–5]. In randomized trials of AF patients with stage III CKD, novel oral anticoagulant, dabigatran 150mg twice daily was superior to warfarin for stroke prevention, while apixaban was superior in regard t...
Source: Thrombosis Research - September 25, 2014 Category: Hematology Authors: Yuji Ishibashi, Takanori Matsui, Sho-ichi Yamagishi Tags: Letter to the Editor-in-Chief Source Type: research

Dabigatran anticoagulation
Atrial fibrillation (AF) is a common heart arrhythmia for which anticoagulant agents such as warfarin are prescribed. A recently licensed anticoagulant, dabigatran (Pradaxa), diminishes the risk of stroke or systemic emboli in patients with AF and those having joint replacement surgery. Adult patients with non-valvular AF with previous stroke, transient ischemic attack or systemic embolism, left ventricular ejection fraction less than 40%, symptomatic heart failure exceeding New York Heart Association class 2, or age over 65 years with diabetes mellitus, coronary artery disease or hypertension are also candidates for dabigatran therapy.
Source: Dental Abstracts - May 1, 2015 Category: Dentistry Tags: Hands On Source Type: research

Improved persistence with non-vitamin K oral anticoagulants compared with warfarin in patients with atrial fibrillation: recent Australian experience.
CONCLUSIONS: Persistence with NOAC drugs in patients with AF appears to be superior to warfarin. If continued long-term, this alone will be of clinical importance in the prevention of stroke and death. PMID: 27463735 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - July 29, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Plasma lipids affect dabigatran etexilate anticoagulation in rats with unbalanced diabetes mellitus
ConclusionsThis study indicates a significantly more intense DE‐induced anticoagulation in diabetic rats that does not seem to be solely related to altered kidney function, and demonstrates that plasma cholesterol can significantly affect DE‐anticoagulation in this setting. These results could explain the similar benefits of DE on stroke prevention in patients with and without DM, despite the significantly higher intrinsic thrombotic risk of the former, as well as the lack of benefit of reducing major bleeding in diabetics.
Source: Journal of Diabetes - July 1, 2017 Category: Endocrinology Authors: Alina Scridon, Marcel Perian, Alina M ărginean, Adina Huțanu, Doina Gherțescu, Adriana Vântu, Paul Ciprian Fișcă, Philippe Chevalier, Răzvan Constantin Șerban, Dan Dobreanu Tags: Original Article Source Type: research