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Oral Anticoagulants and Antiplatelet Agents in Atrial Fibrillation Patients with Concomitant Critical Limb Ischemia: A nationwide cohort study
ConclusionsDOAC was associated with a significantly lower risk of composite net-clinical-benefit outcome than either warfarin or APT in AF patients with concomitant CLI. Further prospective study is necessary to validate the findings in the future.
Source: Canadian Journal of Cardiology - February 19, 2020 Category: Cardiology Source Type: research

Dual-Antithrombotic Therapy With DOACs After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials
ConclusionsIn patients with AF and recent ACS or PCI, the use of dual-antithrombotic therapy with DOACs was associated with less major bleeding and less major bleeding or clinically relevant nonmajor bleeding compared with triple therapy. The use of dual therapy also showed nonsignificantly higher composite of death and ischemic events but no difference in mortality.RésuméContexteIl est difficile de choisir un traitement antithrombotique en cas de fibrillation auriculaire (FA) chez les patients ayant subi un syndrome coronarien aigu (SCA) ou une intervention coronarienne percutanée (ICP). Nous avons comparé les résult...
Source: Canadian Journal of Cardiology - December 24, 2019 Category: Cardiology Source Type: research

Dual antithrombotic therapy with DOACs after ACS or PCI in Atrial Fibrillation: A meta-analysis of Randomized Controlled Trials
ConclusionsIn patients with AF and recent ACS or PCI, the use of dual antithrombotic therapy with DOACs was associated with less major bleeding, and major bleeding or clinically relevant non-major bleeding, compared to triple therapy. The use of dual therapy also shows non-significantly higher composite of death/ischemic events but no difference in mortality.
Source: Canadian Journal of Cardiology - November 14, 2019 Category: Cardiology Source Type: research

Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research

Net Clinical Benefit of Dabigatran over Warfarin in Patients with Atrial Fibrillation Stratified by CHA2DS2-VASc Score and Time in Therapeutic Range
Conclusion The combination of CHA2DS2-VASc score and TTR facilitates patient prioritization for dabigatran. The best net clinical benefit for switching warfarin to dabigatran was found in those with both high CHA2DS2-VASc score and poor TTR. Teaser Non-vitamin K antagonist oral anticoagulants (NOAC) are now preferred to warfarin for stroke prevention in atrial fibrillation. In this study, we have shown that combination of CHA2DS2-VASc score and time in therapeutic range (TTR) facilitates patient prioritization for Dabigatran – one of the NOACs. The best net clinical benefit for switching from Dabigatran to warfarin was o...
Source: Canadian Journal of Cardiology - January 26, 2016 Category: Cardiology Source Type: research

Time in Therapeutic Range and Percentage of INRs in Therapeutic Range as measure of quality of anticoagulation control in atrial fibrillation patients
Conclusions Amongst AF patients on warfarin, the PINRR is a user-friendly alternative to TTR, having a high sensitivity and positive predictive value in predicting TTR. As with TTRs, PINRR is associated with clinical adverse events, i.e. ischemic stroke and intracranial hemorrhage.
Source: Canadian Journal of Cardiology - November 6, 2015 Category: Cardiology Source Type: research

Resident Physicians Choices of Anticoagulation for Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation
This study revealed that, across a wide sampling of disciplines and centers, resident physician choices of anticoagulation in nonvalvular AF differ significantly from contemporary CCS guidelines. Teaser The mainstay of atrial fibrillation (AF) management is stroke prevention using oral anticoagulants. We surveyed 1014 resident physicians from family medicine, emergency medicine, internal medicine and adult cardiology specialties. We found that resident physicians provide care to large number of AF patients and their choices of anticoagulation for stroke prevention are not congruent with the Canadian Cardiovascular Societyâ...
Source: Canadian Journal of Cardiology - August 15, 2015 Category: Cardiology Source Type: research