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Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research

Efficacy and safety of dabigatran, rivaroxaban, and warfarin for stroke prevention in Chinese patients with atrial fibrillation: the Hong Kong Atrial Fibrillation Project
ConclusionsIn Chinese AF patients, the benefits of warfarin therapy for stroke prevention and ICH reduction depend on TTR. Of the treatments compared, dabigatran, as well as rivaroxaban 20 mg daily, was associated with lowest ischemic stroke and ICH rates.
Source: Clinical Cardiology - September 30, 2016 Category: Cardiology Authors: Wen ‐Hua Li, Duo Huang, Chern‐En Chiang, Chu‐Pak Lau, Hung‐Fat Tse, Esther W. Chan, Ian C.K. Wong, Gregory Y. H. Lip, Pak‐Hei Chan, Chung‐Wah Siu Tags: Clinical Investigations Source Type: research

Design and Rationale of the RE ‐DUAL PCI Trial: A Prospective, Randomized, Phase 3b Study Comparing the Safety and Efficacy of Dual Antithrombotic Therapy With Dabigatran Etexilate Versus Warfarin Triple Therapy in Patients With Nonvalvular Atrial Fibrillation Who Have Undergone Percutaneous Coronary Intervention With Stenting
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest‐sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking. The RE‐DUAL PCI trial (NCT...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Christopher P. Cannon, Savion Gropper, Deepak L. Bhatt, Stephen G. Ellis, Takeshi Kimura, Gregory Y.H. Lip, Ph. Gabriel Steg, Jurri ën M. Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M. Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll Tags: Trial Designs 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

Practical Considerations for Using Novel Oral Anticoagulants in Patients With Atrial Fibrillation
Abstract Novel oral anticoagulants, including dabigatran, rivaroxaban, and apixaban, represent new options for preventing stroke in patients with atrial fibrillation, as shown by the results from large, randomized phase III trials. Because of their greater specificity, rapid onset of action, and predictable pharmacokinetics, the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) address several limitations of warfarin or other vitamin K antagonists in day‐to‐day clinical practice. However, a range of practical questions relating to the novel oral anticoagulants has emerged, including topics such as patie...
Source: Clinical Cardiology - November 19, 2013 Category: Cardiology Authors: Irene Savelieva, A. John Camm Tags: Review Source Type: research

Cost‐Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital
ConclusionsThe study favored dabigatran for stroke prophylaxis in patients with nonvalvular AF in Hong Kong under the current hospital's perspective and provided a reference for further comparisons under patient and subsidization perspectives.
Source: Clinical Cardiology - March 14, 2013 Category: Cardiology Authors: Andy M. Chang, Jason C. S. Ho, Bryan P. Yan, Cheuk Man Yu, Yat Yin Lam, Vivian W. Y. Lee Tags: Clinical Investigation Source Type: research