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Source: NeLM - Cardiovascular Medicine
Condition: Stroke
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Total 22 results found since Jan 2013.
Systematic review and meta-analysis looks at risk factors for stroke in patients taking warfarin for AF
Source: Stroke
Area: News
The results of a systematic review and meta-analysis seeking to identify the risk factors that contribute to stroke risk in patients with atrial fibrillation (AF) who are taking an oral anticoagulant (OAC) have been published early online in the journal 'Stroke'.
The authors note that although OACs reduce the risks of stroke and mortality in patients with AF, some patients taking them will still sustain stroke. They performed a systematic review to identify contemporary randomised clinical trials investigating OACs in patients with AF, and then performed a meta-analysis of recent...
Source: NeLM - Cardiovascular Medicine - March 25, 2013 Category: Cardiology Source Type: news
SMC accepts apixaban (Eliquis®) for prevention of stroke and systemic embolism in adults with AF
Source: Scottish Medicines Consortium (SMC)
Area: Evidence > Drug Specific Reviews
The Scottish Medicines Consortium has accepted apixaban (Eliquis®) for use within NHS Scotland for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF), with one or more risk factors, such as prior stroke or transient ischaemic attack (TIA); age ?75 years; hypertension; diabetes mellitus; symptomatic heart failure (NYHA class ?II).
The Detailed Advice accompanying the recommendation (see link below) summarises the evidence on efficacy and safety, the clinical effective...
Source: NeLM - Cardiovascular Medicine - February 11, 2013 Category: Cardiology Source Type: news
Meta-analysis of effects of calcium channel blockers in prevention of stroke in adults with hypertension
Source: PLoS One
Area: News
The specific effects of calcium channel blockers (CCBs) against stroke in patients with hypertension as compared to no treatment and other antihypertensive drug classes are not known.
A systematic review and meta-analysis of data from 273,543 participants in 31 RCTs was conducted to evaluate the efficacy of CCBs on stroke in patients with hypertension in studies of CCBs versus placebo, ACE inhibitors (ACEIs), ?-adrenergic blockers, and diuretics.
A literature search to July 31, 2012 identified 31 RCTs with 273,543 participants (including 130,466 experimental subjects and 1...
Source: NeLM - Cardiovascular Medicine - March 21, 2013 Category: Cardiology Source Type: news
NICE issues final appraisal determination on apixaban for prevention of stroke and systemic embolism in non-valvular atrial fibrillation
Source: NICE
Area: News
In its final appraisal determination (FAD), NICE has supported the use of apixaban as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with one or more risk factors (prior stroke or ischaemic attack, age 75 years or older, hypertension, diabetes mellitus or symptomatic heart failure).
The appeal period for this appraisal will close on 6 February 2013.
Source: NeLM - Cardiovascular Medicine - January 23, 2013 Category: Cardiology Source Type: news
NICE issues final guidance supporting the use of apixaban for prevention of stroke and systemic embolism in non-valvular atrial fibrillation (TA 275)
Source: NICE
Area: Evidence > Guidelines
NICE has issued final guidance (TA 275) supporting the use of apixaban as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with 1 or more risk factors such as:
. prior stroke or transient ischaemic attack
. age 75 years or older
. hypertension
. diabetes mellitus
. symptomatic heart failure.
NICE notes that the decision about whether to start treatment with apixaban should be made after an informed discussion between the clinici...
Source: NeLM - Cardiovascular Medicine - February 27, 2013 Category: Cardiology Source Type: news
RPS assessment of research into effects of lycopene on the risk of heart attack, stroke and cancer
Source: Royal Pharmaceutical Society
Area: News
The Royal Pharmaceutical Society has featured a report on a small study in which scientists claim a single pill which contains a chemical found in tomato skin (lycopene) could cut the risk of heart attacks, stroke and even slow down the development of cancer.
The two-month study looked at 36 patients with pre-existing heart disease, who were already taking cholesterol-lowering statin drugs, and 36 healthy volunteers. Tests showed that the natural remedy boosts the elasticity and efficiency of blood vessels; in turn this reduces the hardening of the arteries which ...
Source: NeLM - Cardiovascular Medicine - January 8, 2013 Category: Cardiology Source Type: news
NICE costing statement for its guidance on apixaban for prevention of stroke and systemic embolism in non-valvular atrial fibrillation (TA 275)
Source: NICE
Area: News
NICE has published a costing statement to accompany its guidance on the use of apixaban for preventing stroke and systemic embolism in nonvalvular atrial fibrillation (TA 275).
The statement notes that "Apixaban provides an alternative treatment option at a comparable cost and therefore it is anticipated that there will not be a significant cost impact as a result of implementing this guidance."
Source: NeLM - Cardiovascular Medicine - February 27, 2013 Category: Cardiology Source Type: news
CADTH review: Antithrombotic therapy for patients with atrial fibrillation
Source: Canadian Agency for Drugs and Technologies in Health (CADTH)
Area: News
The Canadian Agency for Drugs and Technologies in Health (CADTH) has published a review addressing the use of novel oral anticoagulants (NOAC) and antiplatelet agents for the management of patients with atrial fibrillation (AF). Evidence-informed recommendations were developed to address the following policy questions:
. In AF patients with a lower risk of stroke (CHADS2 score < 2), which antithrombotic therapy is optimal?
. In AF patients with a higher risk of stroke (CHADS2 score ? 2) who are unable to achieve ade...
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news
Decision on funding of dabigatran in Australia delayed
Source: National Prescribing Service (Australia)
Area: News
In Australia, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended dabigatran for stroke prevention in atrial fibrillation (AF) for public funding in March 2011. Such a positive committee verdict usually ensures smooth passage into the national Pharmaceutical Benefits Scheme (PBS), but the Australian Minister for Health announced in December 2012 that the PBAC decision is being delayed. This follows the release of a report reviewing anticoagulation therapies in AF which identified uncertainties regarding the magnitude of any incremental clinical and ...
Source: NeLM - Cardiovascular Medicine - January 17, 2013 Category: Cardiology Source Type: news
Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors' adherence to warfarin therapy recommendations
Source: European Journal of Clinical Pharmacology
Area: Evidence > Medicines Management > References
Background: Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden.
Objective: The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors' adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e. congestive heart failure, hypertension, age over 75 years, diabetes, previous stroke and transient ischaemic attack.
Methods: Data were obtained from...
Source: NeLM - Cardiovascular Medicine - January 18, 2013 Category: Cardiology Source Type: news
Cohort study: Chlorthalidone vs. hydrochlorothiazide for the treatment of hypertension
Source: Ann Intern Med
Area: News
The Annals of Internal Medicine has featured a study comparing the effectiveness and safety of chlorthalidone and hydrochlorothiazide for the treatment of hypertension in older adults.
The Canadian propensity score-matched observational cohort study with up to 5 years of follow-up, incorporated data from 29,873 identified individuals aged 66 years or older who were newly treated with chlorthalidone or hydrochlorothiazide and who were not hospitalised for heart failure, stroke, or myocardial infarction in the prior year. Each chlorthalidone recipient was matched to up to 2 hydro...
Source: NeLM - Cardiovascular Medicine - March 19, 2013 Category: Cardiology Source Type: news
Concomitant use of antiplatelet therapy with dabigatran or warfarin in the randomised evaluation of long-term anticoagulation therapy (RE-LY®) trial: subgroup analysis
Source: Circulation
Area: News
RE-LY showed that dabigatran etexilate 150 mg bid (DE150) was superior, and 110 mg bid (DE110) non-inferior to warfarin in preventing stroke and systemic embolism (SSE) in patients with atrial fibrillation (AF). A common clinical dilemma regarding treatment of patients with AF is the need to use concomitant antiplatelets for a variety of reasons. While the combination of OAC and antiplatelets carry the potential of additive benefits, they also carry the danger of increased risk of bleeding.
With the emergence of dabigatran, questions on its efficacy and safety in patients receivin...
Source: NeLM - Cardiovascular Medicine - January 4, 2013 Category: Cardiology Source Type: news
NHS Evidence expert commentary: Benefits of drug therapy are unclear for mild hypertension
Source: NHS Evidence
Area: News
The January edition of 'Eyes on Evidence', the free monthly e-bulletin from NHS Evidence covering major new published evidence as it emerges with an explanation about what it means for current practice, includes an expert commentary on new data from a Cochrane review that aimed to quantify the effects of antihypertensive drug therapy versus no treatment on mortality and morbidity in adults with mild hypertension and no evidence of cardiovascular disease. It included four RCTs with 8912 participants. The review concluded that, compared with placebo, antihypertensive treatment does not reduce...
Source: NeLM - Cardiovascular Medicine - January 10, 2013 Category: Cardiology Source Type: news
National utilization patterns of warfarin use in older patients with atrial fibrillation: a population-based study of Medicare Part D beneficiaries
Source: Annals of Pharmacotherapy
Area: Evidence > Medicines Management > References
Background: Although warfarin therapy reduces stroke incidence in patients with atrial fibrillation (AF), the rate of warfarin use in this population remains low. In 2008, the US Medicare Part D programme was expanded to pay for medications for Medicare enrollees.
Objective: To examine rates and predictors of warfarin use in Medicare Part D beneficiaries with AF.
Methods: This population-based retrospective cohort study used claims data from 41,447 Medicare beneficiaries aged 66 and older with at least 2 AF diagnoses in ...
Source: NeLM - Cardiovascular Medicine - January 24, 2013 Category: Cardiology Source Type: news
Epidemiological study: Use of anticoagulants in the management of atrial fibrillation among general practices in England
Source: Heart
Area: News
Despite the fact that anticoagulation is very effective in preventing strokes due to atrial fibrillation (AF), there is extensive evidence that anticoagulants (AC) remain underused. The Guidance on Risk Assessment and Stroke Prevention in Atrial Fibrillation (GRASP-AF) tool is a software suite based on the CHADS2 risk evaluation system, which searches general practice clinical information systems to enable practices to identify patients with a history of AF and review their individual risk profile.
The aggregated uploaded information from GRASP-AF forms the basis of this study which pro...
Source: NeLM - Cardiovascular Medicine - February 7, 2013 Category: Cardiology Source Type: news
