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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

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

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

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

Stroke with atrial fibrillation or atrial flutter: a descriptive population-based study from the Brest stroke registry
The objective of the present prospective study, using data from 2008, was to evaluate the prevalence of AA (atrial fibrillation/flutter) in patients with stroke and the impact of implementing AF guidelines. Methods: The prevalence of AA was studied in patients diagnosed with stroke from January 1 to December 31, 2008 in the population-based Stroke Registry of Brest, France (total population, 363,760 according to the 2008 census, with 295,553 aged 15 years or older). Guidelines implementation was assessed in terms of antithrombotic therapy (VKA, antiplatelet agent, none), and the CHADS2 (Congestive heart failure, Hypertens...
Source: BMC Geriatrics - June 11, 2015 Category: Geriatrics Authors: Virginie JannouSerge TimsitEmmanuel NowakFrançois RouhartPhilippe GoasFrançois-Mathias MerrienIrina Viakhireva-DovganyukAnne Tirel-BadetsArmelle Gentric Source Type: research

Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report
Publication date: Available online 21 September 2017 Source:American Journal of Kidney Diseases Author(s): Vinod K. Bansal, Charles A. Herzog, Mark J. Sarnak, Michael J. Choi, Ravindra Mehta, Bernard G. Jaar, Michael V. Rocco, Holly Kramer Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as...
Source: American Journal of Kidney Diseases - September 21, 2017 Category: Urology & Nephrology 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

Abbott Wins Approval for CATALYST Trial for At-Risk Stroke Patients
This study is an extremely important step in assessing the Amplatzer Amulet as an effective non-prescription drug alternative for patients with AFib who are at an increased risk for ischemic stroke." In an email sent to MD+DI, Abbott wrote, “We already have an Amulet IDE trial underway that is intended to support our submission for approval in the U.S. for Amplatzer Amulet. The newly announced CATALYST trial will support our submission for an expanded indication for Amulet as a safe and effective alternative to NOAC drugs for patients with atrial fibrillation and at risk of stroke.” Abbo...
Source: MDDI - February 3, 2020 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Regulatory and Compliance Source Type: news

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation: Data From ROCKET AF Arrhythmia and Electrophysiology
Conclusions In a large population of patients anticoagulated for nonvalvular atrial fibrillation, 7 in 10 deaths were cardiovascular, whereas <1 in 10 deaths were caused by nonhemorrhagic stroke or systemic embolism. Optimal prevention and treatment of heart failure, renal impairment, chronic obstructive pulmonary disease, and diabetes may improve survival. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00403767.
Source: JAHA:Journal of the American Heart Association - March 7, 2016 Category: Cardiology Authors: Pokorney, S. D., Piccini, J. P., Stevens, S. R., Patel, M. R., Pieper, K. S., Halperin, J. L., Breithardt, G., Singer, D. E., Hankey, G. J., Hacke, W., Becker, R. C., Berkowitz, S. D., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., for the Tags: Atrial Fibrillation, Sudden Cardiac Death, Heart Failure, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Rationale, design and methodology of the RAMSES Study: ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies.
CONCLUSION: The RAMSES registry will be the largest study in Turkish NVAF patients. The study will provide insights into real-world problems and anticoagulant treatment in patients with NVAF. PMID: 27138310 [PubMed - in process]
Source: Turk Kardiyoloji Dernegi arsivi - March 31, 2016 Category: Cardiology Authors: Başaran Ö, Doğan V, Memic Sancar K, Altun İ, Mert KU, Mert GÖ, Başaran NF, Çekiç EG, Kırma C, Biteker M, RAMSES investigators Tags: Turk Kardiyol Dern Ars Source Type: research

Pharmacological stroke prevention in the elderly with atrial fibrillation in Poland – Results of PolSenior study
Conclusions The study was unique to determine the frequency of pharmacological stroke prevention among elderly people with AF in Poland. It occurred that oral anticoagulant drugs were applied too rarely in this group of patients. Educational programs should be developed among general practitioners concerning current recommendations for patients with AF.
Source: Polish Journal of Neurology and Neurosurgery - July 12, 2017 Category: Neurosurgery Source Type: research

Apixaban in the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in France: Rationale and design of the PAROS cross-sectional study.
CONCLUSION: The PAROS study will provide real-life data on the characteristics of NVAF patients and their anticoagulant prescription in France. PMID: 29191525 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - November 27, 2017 Category: Cardiology Authors: Picard F, Ducrocq G, Danchin N, Falissard B, Hanon O, Mahe I, Touzé E, Steg PG Tags: Arch Cardiovasc Dis Source Type: research

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