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Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial Stroke
Conclusions High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. Clinical Trial Registration URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - December 1, 2015 Category: Cardiology Authors: Rao, M. P., Halvorsen, S., Wojdyla, D., Thomas, L., Alexander, J. H., Hylek, E. M., Hanna, M., Bahit, M. C., Lopes, R. D., De Caterina, R., Erol, C., Goto, S., Lanas, F., Lewis, B. S., Husted, S., Gersh, B. J., Wallentin, L., Granger, C. B., the Apixaban Tags: Stroke Source Type: research

Atrial Fibrillation, Stroke, and Anticoagulation in Medicare Beneficiaries: Trends by Age, Sex, and Race, 1992-2010 Stroke
Conclusions Ischemic stroke rates among Medicare AF patients decreased significantly in all demographic subpopulations from 1992–2010, coincident with increasing warfarin use. Ischemic stroke rates remained higher and warfarin use rates remained lower for women and blacks with AF, groups whose baseline CHADS scores were higher.
Source: JAHA:Journal of the American Heart Association - June 3, 2014 Category: Cardiology Authors: Shroff, G. R., Solid, C. A., Herzog, C. A. Tags: Stroke Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Efficacy and Safety of Edoxaban in Elderly Patients With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial Stroke
Conclusions Age has a greater influence on major bleeding than thromboembolic risk in patients with atrial fibrillation. Given the higher rates of bleeding and death with increasing age, treatment of elderly patients with edoxaban provides an even greater absolute reduction in safety events over warfarin, compared to treatment with edoxaban versus warfarin in younger patients. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Kato, E. T., Giugliano, R. P., Ruff, C. T., Koretsune, Y., Yamashita, T., Kiss, R. G., Nordio, F., Murphy, S. A., Kimura, T., Jin, J., Lanz, H., Mercuri, M., Braunwald, E., Antman, E. M. Tags: Atrial Fibrillation, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Source Type: research

A New Risk Scheme to Predict Ischemic Stroke and Other Thromboembolism in Atrial Fibrillation: The ATRIA Study Stroke Risk Score Arrhythmia and Electrophysiology
Conclusions The ATRIA stroke risk score performed better than existing risk scores, was validated successfully, and showed improvement in predicting severe events, which is of greatest concern. The ATRIA score should improve the antithrombotic decision for patients with AF and should provide a secure foundation for the addition of biomarkers in future prognostic models.
Source: JAHA:Journal of the American Heart Association - June 19, 2013 Category: Cardiology Authors: Singer, D. E., Chang, Y., Borowsky, L. H., Fang, M. C., Pomernacki, N. K., Udaltsova, N., Reynolds, K., Go, A. S. Tags: Arrhythmia and Electrophysiology Source Type: research

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation: Data From ROCKET AF Arrhythmia and Electrophysiology
Conclusions In a large population of patients anticoagulated for nonvalvular atrial fibrillation, 7 in 10 deaths were cardiovascular, whereas <1 in 10 deaths were caused by nonhemorrhagic stroke or systemic embolism. Optimal prevention and treatment of heart failure, renal impairment, chronic obstructive pulmonary disease, and diabetes may improve survival. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00403767.
Source: JAHA:Journal of the American Heart Association - March 7, 2016 Category: Cardiology Authors: Pokorney, S. D., Piccini, J. P., Stevens, S. R., Patel, M. R., Pieper, K. S., Halperin, J. L., Breithardt, G., Singer, D. E., Hankey, G. J., Hacke, W., Becker, R. C., Berkowitz, S. D., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., for the Tags: Atrial Fibrillation, Sudden Cardiac Death, Heart Failure, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Time in Therapeutic Range and Outcomes After Warfarin Initiation in Newly Diagnosed Atrial Fibrillation Patients With Renal Dysfunction Kidney in Cardiovascular Disease
BackgroundIt is unknown whether renal dysfunction conveys poor anticoagulation control in warfarin‐treated patients with atrial fibrillation and whether poor anticoagulation control associates with the risk of adverse outcomes in these patients.Methods and ResultsThis was an observational study from the Stockholm CREatinine Measurements (SCREAM) cohort including all newly diagnosed atrial fibrillation patients initiating treatment with warfarin (n=7738) in Stockholm, Sweden, between 2006 and 2011. Estimated glomerular filtration rate (eGFR; mL/min per 1.73 m2) was calculated from serum creatinine. Time‐in‐therapeuti...
Source: JAHA:Journal of the American Heart Association - March 1, 2017 Category: Cardiology Authors: Szummer, K., Gasparini, A., Eliasson, S., Arnlov, J., Qureshi, A. R., Barany, P., Evans, M., Friberg, L., Carrero, J. J. Tags: Catheter Ablation and Implantable Cardioverter-Defibrillator, Cardiovascular Disease, Anticoagulants, Intracranial Hemorrhage, Ischemic Stroke Original Research Source Type: research

Is an Oral Anticoagulant Necessary for Young Atrial Fibrillation Patients With a CHA2DS2-VASc Score of 1 (Men) or 2 (Women)? Arrhythmia and Electrophysiology
ConclusionsFor atrial fibrillation patients aged 20 to 49 years with 1 risk factor in addition to sex, non–vitamin K antagonist OACs should be considered for stroke prevention to minimize the risk of a potentially fatal or disabling event.
Source: JAHA:Journal of the American Heart Association - October 3, 2016 Category: Cardiology Authors: Hung, Y., Chao, T.-F., Liu, C.-J., Tuan, T.-C., Lin, Y.-J., Chang, S.-L., Lo, L.-W., Hu, Y.-F., Liao, J.-N., Chung, F.-P., Lin, W.-Y., Lin, W.-S., Cheng, S.-M., Chen, T.-J., Lip, G. Y. H., Chen, S.-A. Tags: Atrial Fibrillation Original Research Source Type: research

Prospective National Study of the Prevalence, Incidence, Management and Outcome of a Large Contemporary Cohort of Patients With Incident Non-Valvular Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions In the present study the prevalence and incidence of AF, stroke, and death were comparable to those reported in Europe and North America. The low use of anticoagulation calls for measures to increase adherence to current treatment recommendations in order to improve outcomes.
Source: JAHA:Journal of the American Heart Association - January 21, 2015 Category: Cardiology Authors: Haim, M., Hoshen, M., Reges, O., Rabi, Y., Balicer, R., Leibowitz, M. Tags: Arrhythmia and Electrophysiology Source Type: research

Relationship Between Time in Therapeutic Range and Comparative Treatment Effect of Rivaroxaban and Warfarin: Results From the ROCKET AF Trial Arrhythmia and Electrophysiology
Conclusions The treatment effect of rivaroxaban compared with warfarin for the prevention of stroke and systemic embolism is consistent regardless of cTTR.
Source: JAHA:Journal of the American Heart Association - April 22, 2014 Category: Cardiology Authors: Piccini, J. P., Hellkamp, A. S., Lokhnygina, Y., Patel, M. R., Harrell, F. E., Singer, D. E., Becker, R. C., Breithardt, G., Halperin, J. L., Hankey, G. J., Berkowitz, S. D., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., ROCKET AF Investig Tags: Arrhythmia and Electrophysiology Source Type: research

Effectiveness and Safety of Dabigatran and Warfarin in Real-World US Patients With Non-Valvular Atrial Fibrillation: A Retrospective Cohort Study Health Services and Outcomes Research
Conclusions Dabigatran could be a safe and potentially more effective alternative to warfarin in patients with atrial fibrillation managed in routine practice settings.
Source: JAHA:Journal of the American Heart Association - April 10, 2015 Category: Cardiology Authors: Lauffenburger, J. C., Farley, J. F., Gehi, A. K., Rhoney, D. H., Brookhart, M. A., Fang, G. Tags: Health Services and Outcomes Research 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

Concomitant Use of Single Antiplatelet Therapy With Edoxaban or Warfarin in Patients With Atrial Fibrillation: Analysis From the ENGAGE AF-TIMI48 Trial Arrhythmia and Electrophysiology
Conclusions Patients with AF who were selected by their physicians to receive SAPT in addition to an anticoagulant had a similar risk of stroke/SEE and higher rates of bleeding than those not receiving SAPT. Edoxaban exhibited similar relative efficacy and reduced bleeding compared to warfarin, with or without concomitant SAPT. Clinical Trial Registration URL: http://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Xu, H., Ruff, C. T., Giugliano, R. P., Murphy, S. A., Nordio, F., Patel, I., Shi, M., Mercuri, M., Antman, E. M., Braunwald, E. Tags: Platelets, Chronic Ischemic Heart Disease, Anticoagulants, Acute Coronary Syndromes Arrhythmia and Electrophysiology Source Type: research

Stability of High-Quality Warfarin Anticoagulation in a Community-Based Atrial Fibrillation Cohort: The Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study Epidemiology
Conclusions Nearly 60% of AF patients with high-quality TTR1 on warfarin maintained TTR ≥70% over the next 6 months. A minority deteriorated to very poor TTR. Patient features did not strongly predict TTR in the second 6-month period. Our analyses support watchful waiting for AF patients with initial high-quality warfarin anticoagulation before considering alternative anticoagulants.
Source: JAHA:Journal of the American Heart Association - July 21, 2016 Category: Cardiology Authors: Dallalzadeh, L. O., Go, A. S., Chang, Y., Borowsky, L. H., Fang, M. C., Singer, D. E. Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Anticoagulants Source Type: research

Impact of Blood Pressure Control on Thromboembolism and Major Hemorrhage in Patients With Nonvalvular Atrial Fibrillation: A Subanalysis of the J-RHYTHM Registry Arrhythmia and Electrophysiology
Conclusions BP control appears to be more important than a history of hypertension and baseline BP values at preventing thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation. Clinical Trial Registration URL: http://www.umin.ac.jp/ctr. Unique identifier: UMIN000001569.
Source: JAHA:Journal of the American Heart Association - September 11, 2016 Category: Cardiology Authors: Kodani, E., Atarashi, H., Inoue, H., Okumura, K., Yamashita, T., Otsuka, T., Tomita, H., Origasa, H., the J-RHYTHM Registry Investigators Tags: Atrial Fibrillation, High Blood Pressure, Hypertension, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

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