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Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

Comparison of aspirin and Naoxintong Capsule (脑心通胶囊) with adjusted-dose warfarin in elderly patients with high-risk of non-valvular atrial fibrillation and genetic variants of vitamin K epoxide reductase
Conclusions Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596)
Source: Chinese Journal of Integrative Medicine - February 26, 2016 Category: Internal Medicine Source Type: research

Abstract 203: Preventing Stroke in Patients With Atrial Fibrillation: A Review of Published Interventions to Aid Patient Decision Making Session Title: Abstract Poster Session II
Conclusion: Interventions designed to aid patient decision making around stroke prevention in AF improved a selection of patient-centered outcomes. Given the availability of multiple NOACs and an implantable device for stroke prevention in AF, there is a need to develop and evaluate new patient decision support tools.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Elwyn, G., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

The Use of Novel Oral Anticoagulants in Atrial Fibrillation.
Authors: Ansari U, Behnes M, Fastner C, Akin I Abstract Atrial fibrillation is known to be associated with an increased risk of ischaemic stroke and systemic embolism. After stratification using various risk calculation scores, patients were traditionally prescribed anticoagulants in the form of Aspirin or the traditional Vitamin K Antagonists. The use of Warfarin has proven to reduce incidents of ischaemic stroke; however its use has several limitations. The necessity for strict anticoagulation monitoring so as to maintain the narrow therapeutic range as measured by the international normalized ratio (INR) between...
Source: Cardiovascular and Hematological Disorders Drug Targets - December 19, 2015 Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research

Stroke subtypes and interventional studies for transient ischemic attack.
Authors: Lavallée P, Amarenco P Abstract Transient ischemic attack (TIA) is the most important risk factor for ischemic stroke. The risk is the highest in the first hours after symptom onset, and treatment must be initiated in emergency. In the acute phase, antithrombotic agent is probably the most important treatment, but it is not excluded that lipid-lowering agents and/or antihypertensive drugs are also important. For current guidelines, monotherapy of antiplatelet agent remains the gold standard in emergency. However, most recent data and meta-analysis support a combination therapy of clopidogrel and aspirin. ...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Rivaroxaban or Warfarin ROCKET AF Trial
ConclusionsIn the ROCKET AF trial, rivaroxaban increased GI bleeding compared with warfarin. The absolute fatality rate from GI bleeding was low and similar in both treatment arms. Our results further illustrate the need for minimizing modifiable risk factors for GI bleeding in patients on oral anticoagulation.
Source: Journal of the American College of Cardiology - November 23, 2015 Category: Cardiology Source Type: research

Clinical and Economic Implications of Apixaban Versus Aspirin in the Low-Risk Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— Anticoagulant treatment with apixaban versus aspirin in low-risk patients, as identified using CHADS2 or CHA2DS2–VASc, is projected to increase life expectancy and provide clinical benefits that are cost effective.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Lip, G. Y. H., Lanitis, T., Mardekian, J., Kongnakorn, T., Phatak, H., Dorian, P. Tags: Primary prevention, Cerebrovascular disease/stroke, Anticoagulants, Antiplatelets Clinical Sciences Source Type: research

Warfarin and Aspirin Use for Stroke Prevention Among Patients With Atrial Fibrillation: The US National Health and Wellness Survey
This study examined VKA and ASA use and their clinical correlates, including CHADS2 stroke risk scores, among adult patients with AF in the general population. Participants included 1290 (1.72%) adults reporting diagnosis with AF (mean age, 64.9 years; 65% men) from the 2009 US National Health and Wellness Survey, an online, self-administered, nationwide, stratified random sample survey of 75,000 adults. Antithrombotic use patterns, including VKA, ASA, VKA+ASA, and non-VKA/ASA, and their correlates were examined using logistic regressions. Respondents with AF were treated with VKA (26.6%), ASA (34.5%), VKA+ASA (15.4%), or ...
Source: American Journal of Therapeutics - July 1, 2015 Category: Drugs & Pharmacology Tags: Original Articles Source Type: research

Discrepancy between guidelines for stroke prevention in atrial fibrillation and practice patterns in primary care. The nationwide French AFIGP survey.
CONCLUSIONS: In this large French study, approximately 45% of thromboembolic high-risk patients were either not treated or inadequately treated. Better compliance with evidence-based guidelines is needed to reduce the burden of stroke in the AF population. PMID: 26113478 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - June 22, 2015 Category: Cardiology Authors: Sabouret P, Bricard M, Hermann MA, Cotté FE, Deret-Bixio L, Rushton-Smith S Tags: Arch Cardiovasc Dis Source Type: research

Reply: Health status, geriatric syndromes and prescription of oral anticoagulant therapy in elderly medical in-patients with atrial fibrillation: A prospective observational study
We agree with the content of the letter from Dr Jolobe OMP and, specifically we concur with his conclusion, where he underlines the fragile evidence for aspirin use in the prevention of atrial fibrillation (AF)-related stroke. According to recent European guidelines [1], our study aimed to assess prevalence of and variables associated with under-prescription of currently recommended anticoagulant therapy for AF patients, including vitamin K antagonists (VKAs) and new direct oral anticoagulants (DOAs), but not those associated with use or under-use of aspirin, which is currently not recommended for prevention of AF-related stroke.
Source: International Journal of Cardiology - April 15, 2015 Category: Cardiology Authors: M. Bo, F. Li Puma, M. Badinella Martini, Y. Falcone, M. Iacovino, E. Grisoglio, M. Bonetto, G. Isaia, G. Ciccone, G.C. Isaia, F. Gaita Tags: Letters to the Editor Source Type: research

Antithrombotic Therapy for Left Ventricular Assist Devices in Adults: a Systematic Review
ConclusionsOf 977 manuscripts, 24 articles met the inclusion criteria of adults with implanted LVADs where clinical outcomes were defined based on anticoagulant and/or antiplatelet regimen. Most studies reported treatment with unfractionated heparin post‐operatively which was transitioned to a vitamin K antagonist (VKA). Goal INR varied between 1.5‐3.5. Antiplatelet regimens ranged from no treatment to dual therapy. Definition of major bleeding differed between trials and incidence varied between 0% and 58%. The available evidence could not demonstrate a clear benefit of aspirin compared with VKA therapy alone [stroke...
Source: Journal of Thrombosis and Haemostasis - April 6, 2015 Category: Hematology Authors: Lisa Baumann Kreuziger, Benjamin Kim, Georg M. Wieselthaler Tags: Review Article Source Type: research

Antithrombotic Therapy for Left Ventricular Assist Devices in Adults: a Systematic Review.
CONCLUSIONS: Of 977 manuscripts, 24 articles met the inclusion criteria of adults with implanted LVADs where clinical outcomes were defined based on anticoagulant and/or antiplatelet regimen. Most studies reported treatment with unfractionated heparin post-operatively which was transitioned to a vitamin K antagonist (VKA). Goal INR varied between 1.5-3.5. Antiplatelet regimens ranged from no treatment to dual therapy. Definition of major bleeding differed between trials and incidence varied between 0% and 58%. The available evidence could not demonstrate a clear benefit of aspirin compared with VKA therapy alone [stroke R...
Source: Thrombosis and Haemostasis - April 6, 2015 Category: Hematology Authors: Kreuziger LB, Kim B, Wieselthaler GM Tags: J Thromb Haemost Source Type: research

Comparison of Medical Costs of Patients With Atrial Fibrillation Unsuitable for Warfarin Treatment With Apixaban or Aspirin Based on AVERROES Trial
Conclusions: Based on AVERROES trial results, among patients with AF unsuitable for warfarin therapy, apixaban use was estimated to be associated with a mean medical cost avoidance of US$735 in a patient-year relative to aspirin. The primary driver was the significant reduction in ischemic stroke rate. The medical cost reduction associated with apixaban use was consistent in sensitivity analyses.
Source: Clinical and Applied Thrombosis/Hemostasis - February 27, 2015 Category: Hematology Authors: Amin, A., Deitelzweig, S., Jing, Y., Makenbaeva, D., Wiederkehr, D., Lin, J., Graham, J. Tags: Original Articles Source Type: research

Study On Drug Utilization And Assessment Of Stroke Risk Using Chads2 And Cha2ds2-Vasc Scoring In Elderly Patients With Non-Valvular Atrial Fibrillation
Stroke Risk Stratification in AF patients of can be done using CHADS2 (Congestive heart failure, Hypertension, Age ≥75, DM, prior Stroke/TIA [2 points] ); or CHA2DS2VASc2 (Congestive heart failure/left ventricular ejection fraction ≤35%, Hypertension, Age ≥75 [2 points], DM, prior Stroke/TIA/thromboembolism [2 points], Vascular disease, Age 65–74, Sex- female). Treatment options for Prevention of stroke includes Anti-coagulants (Vitamin K Antagonist-Warfarin, Acenocoumarol; and Newer Oral Anticoagulant- Dabigatran) and anti-platelets (Aspirin and Clopidogrel).
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: T. Raj, S. Bonthu, S.R. Mallayasamy Source Type: research

Sex differences in stroke prevention in atrial fibrillation in French primary care. Results of the AFIGP (Atrial Fibrillation In General Practice) Database
Conclusions Most AF patients followed by French GPs required stroke prevention according to European guidelines, but many of them did not receive the recommended antithrombotic treatment. Women over 75 were a third less likely to be treated with recommended anticoagulants than men of similar age.
Source: Clinical Research in Cardiology - October 22, 2014 Category: Cardiology Source Type: research

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