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Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban Versus Warfarin in Patients With Nonvalvular Atrial Fibrillation and Previous Stroke or Transient Ischemic Attack Clinical Sciences
Conclusions—Results from our study of the 3 NOACs versus warfarin in nonvalvular atrial fibrillation patients with a previous history of stroke/transient ischemic attack are relatively consistent with their respective phase III trials and previous stroke/transient ischemic attack subgroup analyses. All NOACs seemed no worse than warfarin in respect to ischemic stroke, ICH, or major bleeding risk.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Craig I. Coleman, W. Frank Peacock, Thomas J. Bunz, Mark J. Alberts Tags: Arrhythmias, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Real-World Setting Comparison of Nonvitamin-K Antagonist Oral Anticoagulants Versus Vitamin-K Antagonists for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—This meta-analysis confirms the main findings of the randomized controlled trials of dabigatran, rivaroxaban, and apixaban in the real-world setting and, hence, strengthens their validity.
Source: Stroke - August 28, 2017 Category: Neurology Authors: George Ntaios, Vasileios Papavasileiou, Konstantinos Makaritsis, Konstantinos Vemmos, Patrik Michel, Gregory Y.H. Lip Tags: Arrhythmias, Secondary Prevention, Meta Analysis, Mortality/Survival, Ischemic Stroke Original Contributions Source Type: research

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm 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

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke by about five times.1 Oral anticoagulation (OAC) with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) reduces ischemic stroke risk in AF patients. Currently, DOAC (apixaban, dabigatran, edoxaban and rivaroxaban) are recommended as first-line treatment for stroke prevention in AF patients.2 Despite several advantages compared to VKA, DOAC have a short half-life of about 12 h. Missing more than 5% of intakes is associated with a higher occurrence of thromboembolic events in OAC-treated AF patients.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2020 Category: Neurology Authors: Valerie Albert, Alexandros A. Polymeris, Fine Dietrich, Stefan T. Engelter, Kurt E. Hersberger, Sabine Schaedelin, Philippe A. Lyrer, Isabelle Arnet Source Type: research

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

Timing of anticoagulation after recent ischaemic stroke in patients with atrial fibrillation
Publication date: Available online 8 November 2018Source: The Lancet NeurologyAuthor(s): David J Seiffge, David J Werring, Maurizio Paciaroni, Jesse Dawson, Steven Warach, Truman J Milling, Stefan T Engelter, Urs Fischer, Bo NorrvingSummaryBackgroundAbout 13–26% of all acute ischaemic strokes are related to non-valvular atrial fibrillation, the most common cardiac arrhythmia globally. Deciding when to initiate oral anticoagulation in patients with non-valvular atrial fibrillation is a longstanding, common, and unresolved clinical challenge. Although the risk of early recurrent ischaemic stroke is high in this population,...
Source: The Lancet Neurology - November 9, 2018 Category: Neurology Source Type: research

Practical Considerations in the Use of Novel Oral Anticoagulants for Stroke Prevention in Nonvalvular Atrial Fibrillation
This article is protected by copyright. All rights reserved.
Source: Cardiovascular Therapeutics - October 1, 2013 Category: Cardiology Authors: Steven Deitelzweig Tags: Unsolicited Review Source Type: research

Direct Oral Anticoagulants for the Prevention of Stroke in Patients with Nonvalvular Atrial Fibrillation: Understanding Differences and Similarities
Abstract The presence of atrial fibrillation (AF), the most common sustained cardiac arrhythmia, significantly increases the risk for stroke. Current guidelines recommend that the vitamin K antagonist warfarin or direct oral anticoagulants (DOACs), such as the approved direct thrombin inhibitor dabigatran and the approved direct factor Xa inhibitors apixaban, rivaroxaban, and edoxaban, should be used for thromboprophylaxis in patients with nonvalvular AF at risk for stroke or systemic embolic events (SEE). Warfarin, the mainstay of stroke prevention in AF, increases the risk of major bleeding. Furthermore, warfari...
Source: Drugs - September 14, 2015 Category: Drugs & Pharmacology Source Type: research

Oral anticoagulant use for stroke prevention in atrial fibrillation patients with difficult scenarios
Publication date: September 2018Source: IJC Heart & Vasculature, Volume 20Author(s): Ting-Yung Chang, Jo-Nan Liao, Tze-Fan Chao, Jennifer Jeanne Vicera, Chin-Yu Lin, Ta-Chuan Tuan, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Shih-Ann ChenAbstractAtrial fibrillation (AF) has become the most prevalent arrhythmia and it will increase the risk of ischemic stroke, heart failure, mortality, sudden cardiac death, myocardial infarction, and dementia. Stroke prevention with oral anticoagulant is crucial for management of AF patients. Vitamin K antagonist, which inhibits the clotting factors II, VII, IX and X...
Source: IJC Heart and Vasculature - September 1, 2018 Category: Cardiology Source Type: research

Current and new oral antithrombotics in non-valvular atrial fibrillation: a network meta-analysis of 79 808 patients
Conclusions In this network meta-analysis, novel oral anticoagulants were the most promising treatments to reduce stroke, stroke or systemic embolism, and all-cause mortality in patients with AF.
Source: Heart - February 10, 2014 Category: Cardiology Authors: Dogliotti, A., Paolasso, E., Giugliano, R. P. Tags: Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research

Design and rationale of Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation: A global registry program on long-term oral antithrombotic treatment in patients with atrial fibrillation
Conclusions: Novel features of this registry program will add data from clinical practice to those from randomized trials to expand knowledge of antithrombotic treatment in patients with AF.
Source: American Heart Journal - December 23, 2013 Category: Cardiology Authors: Menno V. Huisman, Gregory Y.H. Lip, Hans C. Diener, Sergio J. Dubner, Jonathan L. Halperin, Chang S. Ma, Kenneth J. Rothman, Christine Teutsch, Kristina Zint, Diana Ackermann, Andreas Clemens, Dorothee B. Bartels Tags: Trial Design Source Type: research

Individualised approaches to thrombo-prophylaxis in atrial fibrillation
Publication date: Available online 11 November 2015 Source:American Heart Journal Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in adults over 55 years of age is at least 33.5 million globally and is predicted to more than double in the next half-century. Anticoagulation, heart-rate control, and heart-rhythm control comprise the three main treatment strategies in AF. Anticoagulation is aimed at preventing debilitating stroke, systemic embolism and associated mortality. Historically, anticoagulation in AF was achieved with a vitamin K antag...
Source: American Heart Journal - November 12, 2015 Category: Cardiology Source Type: research

Relative efficacy and safety of non-Vitamin K oral anticoagulants for non-valvular atrial fibrillation: Network meta-analysis comparing apixaban, dabigatran, rivaroxaban and edoxaban in three patient subgroups
Stroke is the most serious clinical consequence of atrial fibrillation, which is the most common cardiac arrhythmia. Non-vitamin K antagonist oral anticoagulants (NOACs) have emerged as efficacious, safe and convenient stroke prevention agents. This updated network meta-analysis focused on the relative efficacy and safety of apixaban compared with dabigatran, rivaroxaban and edoxaban for stroke prevention in (i) patients with CHADS2 score ≥2, (ii) secondary stroke prevention, and (iii) patients with high quality anticoagulation control with warfarin.
Source: International Journal of Cardiology - November 17, 2015 Category: Cardiology Authors: Gregory Y.H. Lip, Stephen A. Mitchell, Xianchen Liu, Larry Z. Liu, Hemant Phatak, Sumesh Kachroo, Sarah Batson Source Type: research

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