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Meta-Analysis of Gender Differences in Residual Stroke Risk and Major Bleeding in Patients With Nonvalvular Atrial Fibrillation Treated With Oral Anticoagulants
In conclusion, women with AF treated with warfarin have a greater residual risk of CVA/SE and an equivalent major bleeding risk, whereas those treated with NOAC agents deemed superior to warfarin are at equivalent residual risk of CVA/SE and less major bleeding risk compared with men. These results suggest an increased net clinical benefit of NOAC agents compared with warfarin in treating women with AF.
Source: The American Journal of Cardiology - November 14, 2013 Category: Cardiology Authors: Samir B. Pancholy, Parikshit S. Sharma, Dipti S. Pancholy, Tejas M. Patel, David J. Callans, Francis E. Marchlinski Tags: Arrhythmias and Conduction Disturbances Source Type: research

Assessment of Dabigatran Utilization and Prescribing Patterns for Atrial Fibrillation in a Physician Group Practice Setting
For years, warfarin and aspirin have been standard therapies for prophylaxis of stroke in atrial fibrillation. In late 2010, dabigatran, an oral direct thrombin inhibitor, became available for use in nonvalvular atrial fibrillation. We sought to evaluate utilization and prescribing patterns of dabigatran in a physician group practice setting. We retrospectively collected prescription data from October 2010 to December 2011 including indication of use, dose, renal function, drug interactions, history of warfarin therapy, and risk assessment scores (CHADS2 and HAS-BLED). Off-label use (history of valve disease or no diagnosi...
Source: The American Journal of Cardiology - November 25, 2013 Category: Cardiology Authors: Blake Carley, Sara Griesbach, Tonja Larson, Kori Krueger Tags: Arrhythmias and Conduction Disturbances Source Type: research

Safety of Short-Term Use of Dabigatran or Rivaroxaban for Direct-Current Cardioversion in Patients With Atrial Fibrillation and Atrial Flutter
In conclusion, the use of short-term dabigatran or rivaroxaban therapy for DCCV of AF appears safe.
Source: The American Journal of Cardiology - February 3, 2014 Category: Cardiology Authors: Ajay Yadlapati, Christopher Groh, Rod Passman Tags: Arrhythmias and Conduction Disturbances Source Type: research

Meta-Analysis of Efficacy and Safety of Rivaroxaban Compared With Warfarin or Dabigatran in Patients Undergoing Catheter Ablation for Atrial Fibrillation
In conclusion, our study suggests that patients treated with rivaroxaban during periprocedural catheter ablation have similar rates of thromboembolic events and major hemorrhage. Similar results were seen in direct comparisons between dabigatran and rivaroxaban.
Source: The American Journal of Cardiology - June 9, 2014 Category: Cardiology Authors: Madan Raj Aryal, Anene Ukaigwe, Anil Pandit, Paras Karmacharya, Rajesh Pradhan, Naba Raj Mainali, Ranjan Pathak, Leena Jalota, Yashoda Bhandari, Anthony Donato Tags: Arrhythmias and Conduction Disturbances Source Type: research

Overview of the Food and Drug Administration Circulatory System Devices Panel Meetings on WATCHMAN™ Left Atrial Appendage Closure Therapy
The WATCHMAN (Boston Scientific Corp, Maple Grove, MN) left atrial appendage closure (LAAC) technology is a percutaneously delivered permanent cardiac implant placed in the LAA. This device is designed to reduce the risk of stroke and systemic embolism in warfarin-eligible patients with non-valvular atrial fibrillation. The first circulatory system device panel reviewed the Embolic PROTECTion in Patients With Atrial Fibrillation (PROTECT AF) study in 2009, and a “Not Approvable” letter was issued by the US Food and Drug Administration (FDA) based on safety concerns.
Source: The American Journal of Cardiology - November 11, 2014 Category: Cardiology Authors: Ron Waksman, Lakshmana K. Pendyala Source Type: research

Overview of the Food and Drug Administration Circulatory System Devices Panel Meetings on WATCHMAN Left Atrial Appendage Closure Therapy
The WATCHMAN left atrial appendage closure (LAAC) technology is a percutaneously delivered permanent cardiac implant placed in the LAA. This device is designed to reduce the risk of stroke and systemic embolism in warfarin-eligible patients with nonvalvular atrial fibrillation. The first circulatory system device panel reviewed the Embolic Protection in Patients With Atrial Fibrillation (PROTECT AF) study in 2009, and a “not approvable” letter was issued by the US Food and Drug Administration (FDA) based on safety concerns.
Source: The American Journal of Cardiology - November 11, 2014 Category: Cardiology Authors: Ron Waksman, Lakshmana K. Pendyala Tags: Review Source Type: research

Reply
We appreciate the interest in our article, “Overview of the Food and Drug Administration Circulatory System Devices Panel Meetings on WATCHMAN Left Atrial Appendage Closure Therapy,” and that it stimulated provocative discussion in a letter to the editor. First, the WATCHMAN device was approved with the indication to reduce the risk of thromboembolism from the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation, who are at an increased risk for stroke and systemic embolism based on CHADS2 or CHA2DS2-VASc scores; are deemed by their physicians to be suitable for warfarin; and have an appropriat...
Source: The American Journal of Cardiology - April 23, 2015 Category: Cardiology Authors: Ron Waksman Source Type: research

Bleeding Risk and Antithrombotic Strategy in Patients With Sinus Rhythm and Heart Failure With Reduced Ejection Fraction Treated With Warfarin or Aspirin
We sought to assess the performance of existing bleeding risk scores, such as the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (HAS-BLED) score or the Outpatient Bleeding Risk Index (OBRI), in patients with heart failure with reduced ejection fraction (HFrEF) in sinus rhythm (SR) treated with warfarin or aspirin. We calculated HAS-BLED and OBRI risk scores for 2,305 patients with HFrEF in SR enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial.
Source: The American Journal of Cardiology - June 24, 2015 Category: Cardiology Authors: Siqin Ye, Bin Cheng, Gregory Y.H. Lip, Richard Buchsbaum, Ralph L. Sacco, Bruce Levin, Marco R. Di Tullio, Min Qian, Douglas L. Mann, Patrick M. Pullicino, Ronald S. Freudenberger, John R. Teerlink, J.P. Mohr, Susan Graham, Arthur J. Labovitz, Conrado J. Tags: Heart Failure Source Type: research

Cost-Effectiveness of Dabigatran (150 mg Twice Daily) and Warfarin in Patients ≥ 65 Years with Non-Valvular Atrial Fibrillation
Dabigatran has been shown to be superior to warfarin for stroke prevention in non-valvular atrial fibrillation (NVAF) but with higher out-of-pocket costs for patients. Although dabigatran has been shown to be cost-effective from a societal perspective, cost implications for individual patients and insurers are not well-described. We aimed to assess cost perspectives of each payer (Medicare and patient) in relation to administration, monitoring and adverse outcomes for dabigatran and warfarin in patients with and without prescription drug coverage.
Source: The American Journal of Cardiology - October 16, 2015 Category: Cardiology Authors: Brian M. Salata, David W. Hutton, Deborah A. Levine, James B. Froehlich, Geoffrey D. Barnes Source Type: research

Meta-Analysis of Renal Function on the Safety and Efficacy of Novel Oral Anticoagulants for Atrial Fibrillation
Novel oral anticoagulants (NOACs) are safe and effective for the prevention of stroke or systemic embolism (S/SE) in atrial fibrillation (AF). The efficacy and safety of NOACs compared to warfarin has not been systematically assessed in subjects with mild or moderate renal dysfunction. We performed a meta-analysis of the randomized clinical trials that compared efficacy and safety (major bleeding) outcomes of NOACs compared to warfarin for the treatment of nonvalvular AF and had available data on renal function.
Source: The American Journal of Cardiology - October 16, 2015 Category: Cardiology Authors: Freddy Del-Carpio Munoz, S. Michael Gharacholou, Thomas M. Munger, Paul A. Friedman, Samuel J. Asirvatham, Douglas L. Packer, Peter A. Noseworthy Source Type: research

Cost-Effectiveness of Dabigatran (150 mg Twice Daily) and Warfarin in Patients ≥65 Years With Nonvalvular Atrial Fibrillation
Dabigatran has been shown to be superior to warfarin for stroke prevention in nonvalvular atrial fibrillation (NVAF) but with higher out-of-pocket costs for patients. Although dabigatran has been shown to be cost effective from a societal perspective, cost implications for individual patients and insurers are not well described. We aimed to assess cost perspectives of each payer (Medicare and patient) in relation to administration, monitoring, and adverse outcomes for dabigatran and warfarin in patients with and without prescription drug coverage.
Source: The American Journal of Cardiology - October 16, 2015 Category: Cardiology Authors: Brian M. Salata, David W. Hutton, Deborah A. Levine, James B. Froehlich, Geoffrey D. Barnes Tags: Arrhythmias and Conduction Disturbances Source Type: research

Relation of Non-Valvular Atrial Fibrillation to Body Mass Index (From the SPORTIF Trials)
Obesity is well-established as a major cardiovascular (CV) risk factor. Obesity confers a higher risk for developing atrial fibrillation (AF), but the relation between obesity and established non-valvular AF (NVAF) for stroke and all-cause death is still unclear. To ascertain the prevalence of overweight and obesity in NVAF patients, their influence on adverse events and the relation with anticoagulation control we performed this post-hoc analysis of the pooled SPORTIF III and V datasets. For this study, we analysed all patients assigned to the warfarin arm with data on body mass index(BMI).
Source: The American Journal of Cardiology - April 19, 2016 Category: Cardiology Authors: Marco Proietti, Deirdre A. Lane, Gregory Y.H. Lip Source Type: research

Long-Term Population-Based Cerebral Ischemic Event and Cognitive Outcomes of Direct Oral Anticoagulants Compared to Warfarin among Long-Term Anticoagulated Patients for Atrial Fibrillation
Direct oral anticoagulants (DOACs) have been used in clinical practice in the US for the last 4-6 years. While DOACs may be an attractive alternative to warfarin among many patients, long-term outcomes of use of these medications are unknown. We performed a propensity-matched analysis to report patient important outcomes of death, stroke/TIA, bleeding, major bleeding and dementia among patients taking a DOAC or warfarin. Patients receiving long-term anticoagulation between June 2010-December 2014 for thromboembolism prevention with either warfarin or a DOAC were matched 1:1 by index date and propensity score.
Source: The American Journal of Cardiology - May 4, 2016 Category: Cardiology Authors: Victoria Jacobs, Heidi T. May, Tami L. Bair, Brian G. Crandall, Michael J. Cutler, John D. Day, Charles Mallender, Jeffrey S. Osborn, Scott M. Stevens, J. Peter Weiss, Scott C. Woller, T. Jared Bunch Source Type: research

Management of Major Bleeding in Patients With Atrial Fibrillation Treated With Non –Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice (from Phase II of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation ORBIT-AF II)
Non –vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed to assess the frequency, management, and outcomes of major blee ding in the setting of community use of NOACs. Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry, we analyzed rates of International Society on Thrombosis and Haemostasis major bleeding and subsequent outcomes in patients treated with NOACs versus warfarin.
Source: The American Journal of Cardiology - February 28, 2017 Category: Cardiology Authors: Benjamin A. Steinberg, DaJuanicia N. Simon, Laine Thomas, Jack Ansell, Gregg C. Fonarow, Bernard J. Gersh, Peter R. Kowey, Kenneth W. Mahaffey, Eric D. Peterson, Jonathan P. Piccini, Outcomes Registry for Better Informed Treatment of Atrial Fibrillation ( Tags: Arrhythmias and Conduction Disturbances Source Type: research

Anticoagulation Control in Warfarin Treated Patients Undergoing Cardioversion for Atrial Fibrillation (From the ENSURE-AF Trial)
In the ENSURE-AF study (NCT 02072434), edoxaban was compared to enoxaparin –warfarin in 2199 patients undergoing electrical cardioversion of non-valvular atrial fibrillation (AF). In this multicenter PROBE trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR), time in therapeutic range (TiTR), their clinic al determinants, relation to SAMe-TT2R2 score, and impact on primary endpoints (composite of stroke, systemic embolic event [SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant non-major [CRNM] bleeding).
Source: The American Journal of Cardiology - June 15, 2017 Category: Cardiology Authors: Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette Source Type: research

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