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Condition: Arrhythmia
Drug: Warfarin

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Total 353 results found since Jan 2013.

Left Atrial Appendage Closure -The WATCHMAN Device.
Authors: Akinapelli A, Bansal O, Chen JP, Pflugfelder A, Gordon N, Stein K, Huibregtse B, Hou D Abstract Atrial fibrillation (AF) is one of the most common arrhythmias seen in clinical cardiology practice. Patients with non-valvular AF have an approximately 5-fold increase in the risk of stroke, with an exponential increase with advancing age. Cardioembolic strokes carry a high mortality risk. Although the potential of warfarin to reduce systemic embolization in AF patients is well established, its use is difficult due to narrow therapeutic windows and additional complications (e.g. increased risk of bleeding), esp...
Source: Current Cardiology Reviews - August 6, 2015 Category: Cardiology Tags: Curr Cardiol Rev Source Type: research

Safety of Left Atrial Appendage Closure in Patients with Low Ejection Fraction
The Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation (PROTECT-AF) trial and subsequent Continued Access registry (CAP) compared left atrial appendage (LAA) closure with the Watchman device to continued warfarin anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Although the device was shown to have a high level of procedural safety across the entire trial population, safety of LAA closure in heart failure patients has not been assessed.
Source: Journal of Cardiac Failure - July 31, 2015 Category: Cardiology Authors: Sameer Gafoor, Vivek Reddy, Jonathan Halperin, Shephal Doshi, Maurice Buchbinder, Petr Neuzil, Kenneth Huber, Brian Whisenant, Saibal Kar, Vijay Swarup, Mathew J. Price, David Holmes, Nicole Gordon, Horst Sievert Tags: Electrophysiology/Arrhythmias II Source Type: research

Comparison of Characteristics and Outcomes of Versus in Hypertensive Patients With Atrial Fibrillation (from the RE-LY Trial)
Hypertension is frequent in patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg (D110) and 150 mg twice daily (D150) noninferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed.
Source: The American Journal of Cardiology - July 28, 2015 Category: Cardiology Authors: Rangadham Nagarakanti, Lars Wallentin, Herbert Noack, Martina Brueckmann, Paul Reilly, Andreas Clemens, Stuart J. Connolly, Salim Yusuf, Michael D. Ezekowitz Tags: Arrhythmias and Conduction Disturbances Source Type: research

Non–Vitamin K Antagonist Oral Anticoagulant Use in Patients With Atrial Fibrillation and Associated Intracranial Hemorrhage: A Focused Review
ABSTRACT Atrial fibrillation (AF) is the most common cardiac arrhythmia and predisposes patients to an increased risk of embolic stroke. After nearly 60 years, warfarin is no longer the only effective therapeutic option for patients with AF. Large randomized trials have consistently shown that non–vitamin K oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban significantly reduce from the risk of intracranial hemorrhage (ICH) compared with warfarin. We provide a focused review regarding the NOACs and ICH in AF patients by summarizing findings of these large clinical trials, mechanisms of ...
Source: Clinical Cardiology - July 14, 2015 Category: Cardiology Authors: Boris Arbit, Jonathan C. Hsu Tags: Review Source Type: research

How to define valvular atrial fibrillation?
Abstract Atrial fibrillation (AF) confers a substantial risk of stroke. Recent trials comparing vitamin K antagonists (VKAs) with non-vitamin K antagonist oral anticoagulants (NOACs) in AF were performed among patients with so-called "non-valvular" AF. The distinction between "valvular" and "non-valvular" AF remains a matter of debate. Currently, "valvular AF" refers to patients with mitral stenosis or artificial heart valves (and valve repair in North American guidelines only), and should be treated with VKAs. Valvular heart diseases, such as mitral regurgitation, aortic stenosis (AS) and aortic insufficiency, do...
Source: Archives of Cardiovascular Diseases - July 13, 2015 Category: Cardiology Authors: Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, Babuty D, Bernard A Tags: Arch Cardiovasc Dis Source Type: research

Novel Anticoagulants in Atrial Fibrillation: A Primer for the Primary Physician
This article provides a review of recent published trials of the use of NOACs in atrial fibrillation. Practical points on indications, contraindications, mechanism of action, interactions, and perioperative management tips are discussed with a view toward the safe and effective use of these new medications. When patients are transitioned between different anticoagulant medications, the risks of thrombosis and bleeding need to be considered. When switching from warfarin to a NOAC, the NOAC can be started once the international normalized ratio is ≤2.0.
Source: Journal of the American Board of Family Medicine - July 7, 2015 Category: Primary Care Authors: Mookadam, M., Shamoun, F. E., Mookadam, F. Tags: Clinical Reviews Source Type: research

Left Atrial Appendage Occlusion For Stroke Prevention
Atrial fibrillation (AF) remains the most common arrhythmia encountered in clinical practice. One of its more common deleterious effects is the development of thromboembolism leading to stroke. The left atrial appendage (LAA) has been shown to the site of the majority of thrombus formation leading to stroke. Anticoagulation with warfarin has been the treatment of choice for prevention of embolic events. Newer anticoagulants have been developed but they still have the potential side effect of causing major bleeding.
Source: Current Problems in Cardiology - June 11, 2015 Category: Cardiology Authors: Oluseun O. Alli, David R. Holmes Source Type: research

Antithrombotic options for atrial fibrillation in 2012.
Authors: Rude J, Quevedo K, Rodriguez de Armas L, Mukherjee D Abstract Atrial fibrillation (AF) is a common arrhythmia in clinical practice. An important component of the management of patients with AF involves prevention of thromboembolism and stroke. Coumarins, such as warfarin had been the only available oral antithrombotic agent for prevention of thromboembolism for many decades. Following intestinal absorption, coumarins inhibit multiple steps of the clotting cascade that leads to inhibition of coagulation factors II, VII, IX and X. In addition to delayed and variable inhibition of coagulation, coumarin therap...
Source: Cardiovascular and Hematological Disorders Drug Targets - June 4, 2015 Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research

Use of Non-Vitamin K Antagonist Oral Anticoagulants in Special Patient Populations with Nonvalvular Atrial Fibrillation: A Review of the Literature and Application to Clinical Practice
The objective of this review is to provide the clinician with an update on the use of NOACs for NVAF, focusing on older adults and patients with renal impairment in light of recently published atrial fibrillation guidelines. Available data on using NOACs in coronary artery stenting, cardioversion, and ablation are also reviewed.
Source: Drugs - May 22, 2015 Category: Drugs & Pharmacology Source Type: research

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention 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

Analysis of anticoagulant prescribing in non-valvular atrial fibrillation and development of a clinical tool for guiding anticoagulant selection
This study demonstrated that patients admitted to our hospital were prescribed appropriate therapy the majority of the time; however, 34 % were prescribed inadequate antithrombotic therapy compared to current practice guidelines given their CHA2DS2VASc score. The development of an institution-specific guideline stratifying appropriate use of anticoagulation in this population may increase adherence to national guideline recommendations.
Source: Journal of Thrombosis and Thrombolysis - May 8, 2015 Category: Hematology Source Type: research

Estimating the cost-effectiveness of left Atrial Appendage closure compared to warfarin for stroke prevention in Atrial Fibrillation
The objective of this study was to evaluate the cost-effectiveness of LAA closure relative to chronic warfarin therapy for stroke prevention in AF patients at elevated stroke risk.
Source: Value in Health - May 1, 2015 Category: Global & Universal Authors: V. Shih, B. Devine Source Type: research

Dabigatran anticoagulation
Atrial fibrillation (AF) is a common heart arrhythmia for which anticoagulant agents such as warfarin are prescribed. A recently licensed anticoagulant, dabigatran (Pradaxa), diminishes the risk of stroke or systemic emboli in patients with AF and those having joint replacement surgery. Adult patients with non-valvular AF with previous stroke, transient ischemic attack or systemic embolism, left ventricular ejection fraction less than 40%, symptomatic heart failure exceeding New York Heart Association class 2, or age over 65 years with diabetes mellitus, coronary artery disease or hypertension are also candidates for dabigatran therapy.
Source: Dental Abstracts - May 1, 2015 Category: Dentistry Tags: Hands On Source Type: research

An evidence-based review of edoxaban and its role in stroke prevention in patients with nonvalvular atrial fibrillation
Tushar Acharya, Prakash Deedwania Division of Cardiology, Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA Abstract: Atrial fibrillation is the most common arrhythmia in the elderly. It is responsible for significant morbidity and mortality from cardioembolic complications like stroke. As a result, atrial fibrillation patients are risk-stratified using the CHADS2 or CHA2DS2-VASc scoring systems. Those at intermediate-to-high risk have traditionally been treated with therapeutic anticoagulation with warfarin for stroke prevention. Although effective, warfarin use is fraught with mult...
Source: Core Evidence - April 27, 2015 Category: Drugs & Pharmacology Tags: Core Evidence Source Type: research