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Prescriptive behavior of non-vitamin K oral anticoagulants in patients affected by atrial fibrillation in general practice
Biomed Pharmacother. 2023 Jun 21;165:115020. doi: 10.1016/j.biopha.2023.115020. Online ahead of print.ABSTRACTAtrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and in recent years the pharmacological approach has been strongly implemented; in Italy, the prescription of the non-vitamin K oral anticoagulants (NOAC) was also extended to General Practitioners (GPs) since 2020. The aim of the present study was to investigate the GPs prescribing behaviour of NOACs. An observational study was performed by using the computerized medical record of 14 GPs in Sicily: patients affected by AF were selected and st...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - June 23, 2023 Category: Drugs & Pharmacology Authors: M Rottura S F A Drago A Molonia N Irrera S Marino R Scoglio L Orlando M Gigliotti De Fazio F Squadrito V Arcoraci E Imbalzano on the behalf of Audit & Research Messina Primary Care Group Source Type: research

Comparison of Dabigatran Versus Warfarin Treatment for the Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation
Atrial fibrillation is one of the most common arrhythmias in the United States and is associated with an increased risk of thromboembolic events.1 The American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines recommend oral anticoagulation with either warfarin or oral non-vitamin K antagonists for patients diagnosed with atrial fibrillation with a high risk for ischemic stroke based on the CHA2DS2-VASc score.2 The recently published article “Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation” discussed the efficacy of...
Source: The American Journal of Cardiology - October 7, 2022 Category: Cardiology Authors: Marwa S.H. Abrahim, Olufemi Sofola-James, Zeina Bani Hani Source Type: research

Effectiveness and safety of oral anticoagulants in elderly patients with atrial fibrillation
Conclusion In this nationwide cohort study of patients ≥75 years initiating oral anticoagulation for AF, standard and reduced dose NOACs were associated with similar risks of stroke/SE as warfarin and lower or similar risks of bleeding. The NOACs seem to be a safe option also in elderly patients.
Source: Heart - February 16, 2022 Category: Cardiology Authors: Rutherford, O.-C. W., Jonasson, C., Ghanima, W., Söderdahl, F., Halvorsen, S. Tags: Open access Arrhythmias and sudden death Source Type: research

Novel bleeding prediction model in atrial fibrillation patients on new oral anticoagulants
Conclusions We present a novel and simple risk score for prediction of major bleeding in patients with non-valvular AF treated with NOACs. Validation in additional cohorts is warranted.
Source: Heart - January 28, 2022 Category: Cardiology Authors: Barnett-Griness, O., Stein, N., Kotler, A., Saliba, W., Gronich, N. Tags: Editor's choice Arrhythmias and sudden death Source Type: research

Direct-Acting Oral Anticoagulants in Atrial Fibrillation: What’s New in the Literature
Atrial fibrillation (AF) is considered the most common sustained cardiac arrhythmia, and it is associated with a significant risk of adverse events, especially ischemic stroke. Oral anticoagulation is the cornerstone for stroke prevention in AF; for many years, only vitamin K antagonists were used for this purpose, with an absolute risk reduction>60%. However, these agents have limitations, such as narrow therapeutic margins and drug–food and drug–drug interactions. More recently, 4 direct-acting oral anticoagulants (DOACs)—non–vitamin K antagonists—have become available for patients with AF: dabigatran, rivaroxa...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles 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 Antagonist Oral Anticoagulant for Atrial Fibrillation in Obese Patients
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It affects 1 in 4 adults aged>40 years,1 and is associated with a 5-fold increased risk of stroke.1 Hence, anticoagulants are universally recommended to prevent stroke and systemic embolism in patients with AF.1 The non-vitamin K antagonist oral anticoagulants (NOACs) are important alternatives to warfarin for prevention of arterial thromboembolism in patients with AF. Currently, the FDA has approved four NOACs for use in patients with AF: dabigatran is a thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors.
Source: The American Journal of Cardiology - April 22, 2020 Category: Cardiology Authors: Stephen Y Wang, Robert P Giugliano Tags: Review Article Source Type: research

Non-vitamin K antagonist oral anticoagulation agents in patients with atrial fibrillation: Insights from Italian monitoring registries
ConclusionsThis study is the largest European real-world study ever published on NOACs. It includes all Italian patients treated with NOACs since 2013 accounting for about 1/3 of subjects with AF. The enrolled population consisted of very elderly patients, at high risk of ischemic adverse events. The AIFA registries are consolidated tools that guarantee the appropriateness of prescription and provide important information for the governance of National Health System by collecting real-world data.
Source: IJC Heart and Vasculature - January 24, 2020 Category: Cardiology 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

A rapid evidence assessment of bleed-related healthcare resource utilization in publications reporting the use of direct oral anticoagulants for non-valvular atrial fibrillation.
CONCLUSIONS: The limited available evidence for HRU burden among patients receiving oral anticoagulation for NVAF suggests that DOACs (particularly apixaban and dabigatran) offer some degree of benefit in terms of HRU outcomes, compared with warfarin. Further work is required to understand HRU outcomes in patients receiving DOACs. PMID: 30380959 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - November 2, 2018 Category: Research Tags: Curr Med Res Opin 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

Fitting the right non-vitamin K antagonist oral anticoagulant to the right patient with non-valvular atrial fibrillation: An evidence-based choice.
Authors: Li Y, Pastori D, Lip GY Abstract Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing IS/SE with a lower rate of major bleeding. Various analyses from the large Phase III randomised trials demonstrated different efficacy and safety of NOACs in specific subgroups of patient...
Source: Annals of Medicine - April 4, 2018 Category: Internal Medicine Tags: Ann Med Source Type: research

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