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Delaying clinical events among patients with non-valvular atrial fibrillation treated with oral anticoagulants: Insights from the ARISTOPHANES study
CONCLUSIONS: Over 12 months after initiation, apixaban and dabigatran conferred progressive increases in event free time for stroke/SE and MB vs warfarin, whereas rivaroxaban conferred an increase in stroke/SE-free time but a loss in MB-free time vs warfarin.PMID:36456387 | DOI:10.1016/j.ejim.2022.10.021
Source: European Journal of Internal Medicine - December 1, 2022 Category: Internal Medicine Authors: Steven Deitelzweig Allison Keshishian Amiee Kang Aaron Jenkins Nipun Atreja Patricia Schuler Jenny Jiang Huseyin Yuce Xiaoxi Sun Gregory Y H Lip Source Type: research

Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation : A Multinational Population-Based Cohort Study
CONCLUSION: Among patients with AF, apixaban use was associated with lower risk for GIB and similar rates of ischemic stroke or systemic embolism, ICH, and all-cause mortality compared with dabigatran, edoxaban, and rivaroxaban. This finding was consistent for patients aged 80 years or older and those with chronic kidney disease, who are often underrepresented in clinical trials.PRIMARY FUNDING SOURCE: None.PMID:36315950 | DOI:10.7326/M22-0511
Source: Annals of Internal Medicine - October 31, 2022 Category: Internal Medicine Authors: Wallis C Y Lau Carmen Olga Torre Kenneth K C Man Henry Morgan Stewart Sarah Seager Mui Van Zandt Christian Reich Jing Li Jack Brewster Gregory Y H Lip Aroon D Hingorani Li Wei Ian C K Wong Source Type: research

Association of Neighborhood Disadvantage and Anticoagulation for Patients with Atrial Fibrillation in the Veterans Health Administration: the REACH-AF Study
ConclusionsAmong Veterans with incident AF, we observed similar initiation of any anticoagulant, though neighborhood deprivation was associated with decreased DOAC use among anticoagulant initiators. Future interventions to improve pharmacoequity in anticoagulant prescribing for AF should consider the role of neighborhood-level determinants of health inequities.
Source: Journal of General Internal Medicine - September 23, 2022 Category: Internal Medicine Source Type: research

Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis
CONCLUSION: Although LAAO could be an alternative to anticoagulants for stroke prevention in patients with AF and high bleeding risk, the overall benefit from LAAO depends on the combination of stroke and bleeding risks in individual patients. These results suggest the need for a sufficiently low stroke risk for LAAO to be beneficial. The authors believe that these results could improve shared decision making when selecting patients for LAAO.PRIMARY FUNDING SOURCE: None.PMID:35969865 | DOI:10.7326/M21-4653
Source: Annals of Internal Medicine - August 15, 2022 Category: Internal Medicine Authors: Derek S Chew Ke Zhou Sean D Pokorney David B Matchar Sreekanth Vemulapalli Larry A Allen Kevin P Jackson Zainab Samad Manesh R Patel James V Freeman Jonathan P Piccini Source Type: research

Effectiveness and Safety of Dabigatran in Atrial Fibrillation Patients with Severe Obesity: a Real-World Retrospective Cohort Study
ConclusionsAmong AF patients with a BMI>40kg/m2 or a weight>120kg in a real-world clinical setting, dabigatran was effective in reducing the risk of thromboembolism and mortality but was associated with an increased risk of bleeding when compared to warfarin. Dabigatran may be a reasonable option for AF patients with severe obesity.
Source: Journal of General Internal Medicine - September 20, 2021 Category: Internal Medicine Source Type: research

Adherence to oral anticoagulation in ischemic stroke patients with atrial fibrillation
CONCLUSIONS: Adherence was poor in half of AF patients who survived an ischaemic stroke. Independent patient-related factors, rather than composite scores, were associated with poor adherence in these patients.KEY MESSAGESAdherence was poor in half of the atrial fibrillation patients who survived an ischaemic stroke.Independent patient-related factors rather than composite scores were associated with poor adherence.The findings support the importance of recognising adherence support as a crucial part of holistic patient care recommended by recent AF guideline.PMID:34498537 | DOI:10.1080/07853890.2021.1968031
Source: Annals of Medicine - September 9, 2021 Category: Internal Medicine Authors: Paula Tiili Ioannis Leventis Janne Kinnunen Ida Svedjeb äck Mika Lehto Efstathia Karagkiozi Dimitrios Sagris George Ntaios Jukka Putaala Source Type: research

Prescribing of direct oral anticoagulants and warfarin to older people with atrial fibrillation in UK general practice: a cohort study
Anticoagulation for stroke prevention in atrial fibrillation (AF) has, historically, been under-used in older people. The aim of this study was to investigate prescribing of oral anticoagulants (OACs) for peop...
Source: BMC Medicine - August 31, 2021 Category: Internal Medicine Authors: Anneka Mitchell, Julia Snowball, Tomas J. Welsh, Margaret C. Watson and Anita McGrogan Tags: Research article Source Type: research

Frailty and Clinical Outcomes of Direct Oral Anticoagulants Versus Warfarin in Older Adults With Atrial Fibrillation : A Cohort Study
CONCLUSION: For older adults with AF, apixaban was associated with lower rates of adverse events across all frailty levels. Dabigatran and rivaroxaban were associated with lower event rates only among nonfrail patients.PRIMARY FUNDING SOURCE: National Institute on Aging.PMID:34280330 | DOI:10.7326/M20-7141
Source: Annals of Internal Medicine - July 19, 2021 Category: Internal Medicine Authors: Dae Hyun Kim Ajinkya Pawar Joshua J Gagne Lily G Bessette Hemin Lee Robert J Glynn Sebastian Schneeweiss Source Type: research

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