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Reduced dose direct oral anticoagulants compared with warfarin with high time in therapeutic range in nonvalvular atrial fibrillation
The objective of this study was to compare effectiveness and safety between reduced dose DOACs and high TTR warfarin treatment (TTR  ≥ 70%) in NVAF. A Swedish anticoagulation registry was used in identifying eligible patients from July 2011 to December 2017. The study cohort consisted of 40,564 patients with newly initiated DOAC (apixaban, dabigatran, or rivaroxaban) (11,083 patients) or warfarin treatment (29,481 patients ) after exclusion of 374,135 patients due to not being warfarin or DOAC naïve, not being prescribed reduced dose, having previous mechanical heart valve (MHV), or being under 18 years old. The me...
Source: Journal of Thrombosis and Thrombolysis - January 6, 2023 Category: Hematology Source Type: research

Bleeding risk in patients with venous thromboembolic events treated with new oral anticoagulants
AbstractNew oral anticoagulants (NOACs) is the preferred treatment in secondary prophylaxis of venous thromboembolic events (VTE). The aim of this study was to investigate possible risk factors associated with major bleeding in VTE-patients treated with NOACs. In this retrospective register-based study we screened the Swedish anticoagulation registerAuricula (during 2012.01.01 –2017.12.31) to find patients and used other national registers for outcomes. Primary endpoint was major bleeding defined as bleeding leading to hospital care. Multivariate Cox-regression analysis was used to reveal risk factors. 18 219 patients wi...
Source: Journal of Thrombosis and Thrombolysis - November 2, 2020 Category: Hematology Source Type: research

Risk factors for severe bleeding events during warfarin treatment: the influence of sex, age, comorbidity and co-medication
ConclusionMost of the well-established risk factors were found to be significantly associated with bleeding events in our study. We additionally found that women had a lower incidence of bleeding. Potential biases are selection effects, residual confounding and unmeasured frailty.
Source: European Journal of Clinical Pharmacology - March 27, 2020 Category: Drugs & Pharmacology Source Type: research

Predictors for INR-control in a well-managed warfarin treatment setting
AbstractWarfarin is well studied in patients with non-valvular atrial fibrillation (AF). It has low complication rates for patients achieving individual Time in Therapeutic Range (iTTR)  >  70%. The risk scores SAMe-TT2R2 and PROSPER are designed to predict future TTR, but are derived from a heterogeneous population with generally low iTTR. The aim of this study was to evaluate predictors for high and low iTTR in an AF population in Sweden, where there is a generally good anticoagulation control. A retrospective register study based on Swedish warfarin dosing system AuriculA, including 28,011 AF patients starting tr...
Source: Journal of Thrombosis and Thrombolysis - November 8, 2018 Category: Hematology Source Type: research

Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation.
Conclusion: Variation in published AF stroke rates for patients not receiving anticoagulant therapy results in multifold variation in the net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty in current thresholds of stroke risk score for recommending anticoagulation. Primary Funding Source: None. PMID: 30264130 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - September 25, 2018 Category: Internal Medicine Authors: Shah SJ, Eckman MH, Aspberg S, Go AS, Singer DE Tags: Ann Intern Med Source Type: research

Heart failure: a weak link in CHA2DS2 ‐VASc
ConclusionsA clinical diagnosis of heart failure was not an independent risk factor for stroke in patients with atrial fibrillation, which may have implications for anticoagulation management.
Source: ESC Heart Failure - February 1, 2018 Category: Cardiology Authors: Leif Friberg, Lars H. Lund Tags: Original Research Article Source Type: research

Blood-thinning drugs may reduce dementia risk in people with irregular heartbeats
Conclusion If you’ve been diagnosed with AF and you have been prescribed anticoagulant treatments such as warfarin or clopidogrel, we already know they protect you against having a stroke. This study suggests they may also help to protect you against dementia. Cutting the risk of dementia for people who have a raised risk because of AF would be an exciting step forward. Unfortunately, we can’t tell from this study whether the protection against dementia was down to the anticoagulants, because of the possible effect of unmeasured confounding factors. Usually, we would want to see a randomised controlled trial (RCT) to f...
Source: NHS News Feed - October 25, 2017 Category: Consumer Health News Tags: Neurology Source Type: news

One-Year Incidence, Time Trends, and Predictors of Recurrent Ischemic Stroke in Sweden From 1998 to 2010 Clinical Sciences
Conclusions—The risk of recurrent ischemic stroke decreased from 1998 to 2010. Well-known risk factors for stroke were associated with a higher risk of ischemic stroke recurrence; whereas, secondary preventive medication was associated with a reduced risk, emphasizing the importance of secondary preventive treatment.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Lisa Bergstrom, Anna–Lotta Irewall, Lars Soderstrom, Joachim Ogren, Katarina Laurell, Thomas Mooe Tags: Epidemiology, Risk Factors, Secondary Prevention, Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research

Cost-effectiveness of dabigatran compared with warfarin for patients with atrial fibrillation in Sweden
Conclusion Dabigatran is a cost-effective treatment in Sweden, as its incremental cost-effectiveness ratio is below the normally accepted willingness to pay limit.
Source: European Heart Journal - January 14, 2013 Category: Cardiology Authors: Davidson, T., Husberg, M., Janzon, M., Oldgren, J., Levin, L.-A. Tags: Arrhythmia/electrophysiology Source Type: research