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Risks of new anticoagulants.
Authors: Abstract Atrial fibrillation is a major cause of stroke and anticoagulation, with warfarin known to decrease the risk. New oral anticoagulants provide patients with a convenient, fixed-dose alternative to warfarin. These novel drugs have been shown to be as effective at stroke prevention but trials showed an unexpected increase in gastrointestinal bleeding. This retrospective study aimed to quantify this risk by comparing the new drugs dabigatran and rivaroxaban with warfarin. They found no difference for younger patients but risk of bleeding increased with the new drugs in people over the age of 65 and ...
Source: Nursing Older People - June 25, 2015 Category: Nursing Tags: Nurs Older People Source Type: research

Risk Stratification: An Important Stroke Risk Reduction Strategy in Elderly Patients With Nonvalvular Atrial Fibrillation
No abstract available
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: DEPARTMENTS: Progress in Prevention Source Type: research

Risk Stratification: An Important Stroke Risk Reduction Strategy in Elderly Patients With Nonvalvular Atrial Fibrillation.
PMID: 26057052 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Nursing - June 10, 2015 Category: Nursing Authors: Haber DR, Stuart-Shor E Tags: J Cardiovasc Nurs Source Type: research

CE: Atrial Fibrillation: Updated Management Guidelines and Nursing Implications
This article reviews the recently updated guideline for the management of atrial fibrillation, issued jointly by the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society. It focuses on the prevention of thromboembolism and on symptom control, and stresses the importance of patient adherence to treatment plans in order to ensure better outcomes.
Source: AJN - April 24, 2015 Category: Nursing Tags: Feature Articles Source Type: research

New Anticoagulant Approved
* Edoxaban (Savaysa) is a new oral anticoagulant used in the prevention of stroke and blood clots in patients with nonvalvular atrial fibrillation and in the treatment of deep vein thrombosis or pulmonary embolism. It inhibits the action of clotting factor Xa. * The most common adverse effects of edoxaban are anemia, bleeding, rash, and abnormal liver function. Like all anticoagulants, edoxaban carries a risk of bleeding, including major bleeding. Edoxaban shouldn't be used by those who have a creatinine clearance greater than 95 mL/min, indicating renal disease, because a long creatinine clearance increases the risk of ischemic stroke.
Source: AJN - April 24, 2015 Category: Nursing Tags: Drug Watch Source Type: research

CE: Atrial Fibrillation: Updated Management Guidelines and Nursing Implications.
This article reviews the recently updated guideline for the management of atrial fibrillation, issued jointly by the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society. It focuses on the prevention of thromboembolism and on symptom control, and stresses the importance of patient adherence to treatment plans in order to ensure better outcomes. PMID: 25859746 [PubMed - as supplied by publisher]
Source: The American Journal of Nursing - April 9, 2015 Category: Nursing Authors: Cutugno CL Tags: Am J Nurs Source Type: research

Stroke Prevention in Nonvalvular Atrial Fibrillation: Update on Target-Specific Oral Anticoagulants.
Abstract Atrial fibrillation is the most common arrhythmia in adults, and the risk for stroke is increased five-fold. Efforts should be made to educate health care providers to understand the importance of using risk stratification tools. New oral anticoagulants are available for thromboembolic stroke prevention, and knowledge of their clinical indications and use is essential. J Contin Educ Nurs. 2015;46(4):152-154. PMID: 25856447 [PubMed - as supplied by publisher]
Source: Journal of Continuing Education in Nursing - April 1, 2015 Category: Nursing Authors: Patrick C, Clarke R Tags: J Contin Educ Nurs Source Type: research

The caregiver role in thromboprophylaxis management in atrial fibrillation: A literature review
Conclusions: Caregivers have an essential role to play in advocacy, family centred care and shared decision-making. This may influence thromboprophylaxis treatment choices and potentially adherence. Assessment of caregiver needs and support should be central to patient assessment and care planning. There is a need for clinical intervention studies which more target and address the caregiver role.
Source: European Journal of Cardiovascular Nursing - March 20, 2015 Category: Nursing Authors: Ferguson, C., Inglis, S. C., Newton, P. J., Middleton, S., Macdonald, P. S., Davidson, P. M. Tags: Review Article Source Type: research

Perianesthesia Implications of Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a complex medical condition that affects not only the airway but also the cardiopulmonary, endocrine, and central nervous systems. Obstructive sleep apnea can usually be identified with a focused history and physical examination and is commonly associated with obese, middle-aged men with hypertension and glucose intolerance. A high index of suspicion for OSA should arise when reports of loud snoring, nighttime arousal, and acid reflux accompanied by a history of stroke, atrial fibrillation, or congestive heart failure are elicited during a perianesthesia evaluation. Perianesthesia risk in O...
Source: Critical Care Nursing Quarterly - December 11, 2014 Category: Nursing Tags: Original Articles Source Type: research

Patients’ experiences from symptom onset to initial treatment for atrial fibrillation
ConclusionsProviders played a critical role in helping patients to develop an accurate understanding of atrial fibrillation, to cope with the new diagnosis, and motivated them to engage in effective self‐management. Relevance to clinical practiceInsight into participant experiences from symptom onset to initial treatment for atrial fibrillation may inform development of interventions to promote effective atrial fibrillation self‐management.
Source: Journal of Clinical Nursing - November 25, 2014 Category: Nursing Authors: Pamela J McCabe, Lori M Rhudy, Holli A DeVon Tags: Original Article Source Type: research

Is Health-Related Quality of Life a Predictor of Hospitalization or Mortality Among Women or Men With Atrial Fibrillation?
Background: Little is known about predictors of mortality or hospitalization in women compared with men in patients with atrial fibrillation (AF). Although there are established gender differences in patients with coronary artery disease (CAD), differences have not been established in AF. Objectives: The aim of this study was to examine clinical and health-related quality of life (HRQOL) predictors of mortality and 1-year hospitalization in women compared with men with AF. Methods: Limited-use data from the National Institutes of Health/National Heart, Lung, and Blood Institute Atrial Fibrillation Follow-up Investigation o...
Source: Journal of Cardiovascular Nursing - October 9, 2014 Category: Nursing Tags: Articles Source Type: research

Recognising and managing atrial fibrillation in the community.
This article outlines methods for detecting AF in the community and provides an overview of current treatment options, including the newer anti-coagulant agents. The importance of assessing stroke risk and conveying this risk to those with AF is essential. Community health professionals play an important role in monitoring, treating and managing AF within the community setting and supporting and educating the patient in minimising the risk of serious thromboembolic complications such as stroke. PMID: 25184894 [PubMed - as supplied by publisher]
Source: British Journal of Community Nursing - September 2, 2014 Category: Nursing Authors: Lee G, Campbell-Cole C Tags: Br J Community Nurs Source Type: research

Dabigatran etexilate: An alternative to warfarin for patients with nonvalvular atrial fibrillation
ConclusionsSignificant evidence from the PETRO and RE‐LY trials and postmarketing analyses of dabigatran etexilate indicate that this direct thrombin inhibitor is as efficacious as warfarin in ischemic stroke prevention. In fact, the studies found that patients taking dabigatran etexilate had fewer incidences of ischemic stroke and intracranial hemorrhage than those taking warfarin. Risk for major gastrointestinal bleeding appears to be higher than that for warfarin. Implications for practicePatients taking dabigatran etexilate do not require blood work to assess international normalized ratio (INR) levels. Because this ...
Source: Journal of the American Academy of Nurse Practitioners - July 25, 2014 Category: Nursing Authors: Katie A. Scott, Karen A. Amirehsani Tags: CLINICAL PRACTICE Source Type: research

Update on implantable loop recorders for secondary stroke prevention.
Abstract Implantable loop recorders are used to detect abnormal arrhythmias in patients with unexplained syncope. These devices capture paradoxical episodes of atrial fibrillation and may be helpful for patients with unexplained stroke. Nurses should be familiar with safety and care instructions and take precautions surrounding diagnostic testing in patients with these devices. J Contin Educ Nurs. 2014;45(7):290-291. PMID: 24999972 [PubMed - in process]
Source: Journal of Continuing Education in Nursing - July 1, 2014 Category: Nursing Authors: Barry E Tags: J Contin Educ Nurs Source Type: research

NICE advises against aspirin for cutting stroke risk in AF patients
The National Institute for Health and Care Excellence has recommended that people with atrial fibrillation are prescribed an anticoagulant instead of aspirin to reduce their risk of stroke.
Source: Nursing Times Breaking News - June 20, 2014 Category: Nursing Source Type: news

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