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Efficacy and Safety of Rivaroxaban Versus Warfarin in Patients Taking Nondihydropyridine Calcium Channel Blockers for Atrial Fibrillation (from the ROCKET AF Trial)
Non-dihydropyridine calcium channel blockers (non-DHP CCBs) possess combined P-glycoprotein and moderate CYP3A4 inhibition, which may lead to increased exposure of medications that are substrates for these metabolic pathways, such as rivaroxaban. We evaluated the use and outcomes of non-DHP CCBs in patients with atrial fibrillation (AF) in Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).
Source: The American Journal of Cardiology - May 29, 2017 Category: Cardiology Authors: Jeffrey B. Washam, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Scott D. Berkowitz, Christopher C. Nessel, Richard C. Becker, G ünter Breithardt, Keith A.A. Fox, Jonathan L. Halperin, Graeme J. Hankey, Kenneth W. Mahaffey, Daniel E. Singer, Tags: Arrhythmias and Conduction Disturbances Source Type: research

Anticoagulation Control in Warfarin-Treated Patients Undergoing Cardioversion of Atrial Fibrillation (from the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation Trial)
In the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin–warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open bl inded end-point trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; an...
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 Tags: Arrhythmias and Conduction Disturbances Source Type: research

Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban and Warfarin in Newly Diagnosed Atrial Fibrillation
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran and rivaroxaban in atrial fibrillation (AF). Using 2013-2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with AF who initiated apixaban, dabigatran, rivaroxaban, warfarin or no oral anticoagulation therapy in 2013-2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence.
Source: The American Journal of Cardiology - August 8, 2017 Category: Cardiology Authors: Inmaculada Hernandez, Yuting Zhang, Samir Saba Source Type: research

Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Newly Diagnosed Atrial Fibrillation
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence.
Source: The American Journal of Cardiology - August 8, 2017 Category: Cardiology Authors: Inmaculada Hernandez, Yuting Zhang, Samir Saba Source Type: research

Outcomes with Novel Oral Anticoagulants in Obese Patients Undergoing Electrical Cardioversion for Atrial Tachyarrhythmias
The efficacy of novel oral anticoagulants (NOACs) in severely obese patients is uncertain as volume of distribution is related to weight and few such patients were enrolled in the pivotal trials. As the month following direct-current cardioversion (DCCV) for atrial fibrillation and atrial flutter (AF/AFL) is a high-risk period for stroke, we sought to evaluate the safety of performing DCCV in obese patients on NOAC. All patients who underwent DCCV after ≥ 3 weeks of NOAC or therapeutic warfarin treatment without a prior transesophageal echocardiogram (TEE) over a 3-year period at a single center were included.
Source: The American Journal of Cardiology - July 4, 2018 Category: Cardiology Authors: Rachel M. Kaplan, Celso L. Diaz, Theresa Strzelczyk, Cindy You, Basil Saour, Michelle Fine, Amar Trivedi, Mark J. Shen, Prasongchai Sattayaprasert, Alexandru B. Chicos, Rishi Arora, Susan Kim, Albert Lin, Nishant Verma, Bradley P. Knight, Rod S. Passman Source Type: research

Outcomes With Novel Oral Anticoagulants in Obese Patients who Underwent Electrical Cardioversion for Atrial Tachyarrhythmias
The efficacy of novel oral anticoagulants (NOACs) in severely obese patients is uncertain as volume of distribution is related to weight, and few such patients were enrolled in the pivotal trials. As the month after direct-current cardioversion (DCCV) for atrial fibrillation and atrial flutter is a high-risk period for stroke, we sought to evaluate the safety of performing DCCV in obese patients on NOAC. All patients who underwent DCCV after ≥3 weeks of NOAC or therapeutic warfarin treatment without a previous transesophageal echocardiogram over a 3-year period at a single center were included.
Source: The American Journal of Cardiology - July 4, 2018 Category: Cardiology Authors: Rachel M. Kaplan, Celso L. Diaz, Theresa Strzelczyk, Cindy You, Basil Saour, Michelle Fine, Amar Trivedi, Mark J. Shen, Prasongchai Sattayaprasert, Alexandru B. Chicos, Rishi Arora, Susan Kim, Albert Lin, Nishant Verma, Bradley P. Knight, Rod S. Passman Source Type: research

Impact of Body Mass Index on Outcomes in the Edoxaban Versus Warfarin Therapy Groups in Patients Undergoing Cardioversion of Atrial Fibrillation (From ENSURE-AF)
In the EdoxabaN versus warfarin in subjectS UndeRgoing cardiovErsion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban showed similar efficacy and safety vs enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation. In this ancillary analysis, we compared the primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular [CV] death, overall study period) and safety (composite of major and clinically relevant nonmajor [CRNM] bleeding, on-treatment) endpoints in relation to body mass index (BMI;
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, Maciej Banach, Joris R. de Groot, Lars S. Maier, Sakis Themistoclakis, Giuseppe Boriani, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Safety and Efficacy of Direct Oral Anticoagulants Versus Warfarin in Patients with Chronic Kidney Disease and Atrial Fibrillation
This study evaluated and compared the safety outcomes of DOACs versus warfarin in patients with non-valvular AF and concomitant CKD. Patients in our health system with AF prescribed oral anticoagulants during 2010 to 2017 were identified. All-cause mortality, bleeding, and hemorrhagic and ischemic stroke were evaluated based on degree of renal impairment and method of anticoagulation.
Source: The American Journal of Cardiology - October 30, 2019 Category: Cardiology Authors: Amber Makani, Samir Saba, Sandeep K. Jain, Aditya Bhonsale, Michael S. Sharbaugh, Floyd Thoma, Yisi Wang, Oscar C. Marroquin, Joon S. Lee, N.A. Mark Estes, Suresh R. Mulukutla Source Type: research

Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research

Network Meta-analysis Comparing Apixaban versus Rivaroxaban in Morbidly Obese Patients with Atrial Fibrillation
The efficacy and safety of DOACs in morbidly obese patients have been well investigated over the last few years.1-4 Our recent meta-analysis showed that the DOAC group did not increase stroke or systemic embolism (SE) event rate compared to the warfarin group and the DOAC use was significantly associated with a lower major bleeding event rate compared to the warfarin group.5 However, it is still unknown which DOAC is more appropriate than others. Apixaban and rivaroxaban are the two most common DOACs prescribed in the U.S but there is no guidance on which agent should be selected in morbidly obese patients with AF.
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Kazuhiko Kido, Mikiko Shimizu, Tsuyoshi Shiga, Masayuki Hashiguchi Source Type: research

Meta-Analysis of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Bioprosthetic Valves
Valvular heart disease is frequently complicated by atrial fibrillation, which is associated with an increased risk of mortality. In the presence of a surgical or transcatheter bioprosthetic valve, patients with atrial fibrillation are at increased risks of systemic thromboembolism.1 Although direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin in preventing stroke or thromboembolism associated with nonvalvular atrial fibrillation, the utilization of DOACs in patients with prior bioprosthetic valves has been limited in randomized clinical trials (RCTs).
Source: The American Journal of Cardiology - December 3, 2020 Category: Cardiology Authors: Babikir Kheiri, Ryle Przybylowicz, Timothy F Simpson, Hani Alhamoud, Mohammed Osman, Khidir Dalouk, Babak Nazer, Charles A. Henrikson, Eric Stecker Source Type: research

Comparison of Direct Oral Anticoagulants versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves
The objectives of this study were to evaluate the ambulatory utilization of DOACs and to compare the effectiveness and safety of DOACs versus warfarin in patients with AF and BHVs. We conducted a retrospective cohort study at a large integrated health care delivery system in California. Patients with BHVs and AF treated with warfarin, dabigatran, rivaroxaban or apixaban between September 12, 2011 and June 18, 2020 were identified.
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Lewei Duan, Jason N Doctor, John L Adams, John A Romley, Leigh-Anh Nguyen, Jaejin An, Ming-Sum Lee Source Type: research

Comparison of Low and Full Dose Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Renal Dysfunction (from a National Registry)
The use of direct oral anticoagulants for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) is robust. However, the efficacy and safety of different dosage in patients with renal dysfunction is still a clinical challenge. We aimed to evaluate the clinical characteristics and outcomes of patients treated with apixaban in its different doses. A multicenter prospective cohort study, where consecutive eligible apixaban or warfarin treated patients with NVAF and renal impairment, were registered.
Source: The American Journal of Cardiology - September 7, 2021 Category: Cardiology Authors: Chen Gurevitz, Ela Giladi, Alon Barsheshet, Robert Klempfner, Ilan Goldenberg, Ran Kornowski, Avishay Elis Source Type: research

Effectiveness and Safety of Apixaban Versus Warfarin in Obese Patients with Nonvalvular Atrial Fibrillation Enrolled in Medicare and Veteran Affairs
Real-world studies have evaluated the use of anticoagulants in obese patients with nonvalvular atrial fibrillation (NVAF), but they have been limited by sample size or the use of diagnosis codes on claims to define obesity. This retrospective study used body weight data of ≥100 kg or a body mass index of ≥30 kg/m2 to identify elderly (aged ≥65 years) NVAF patients with obesity in dually enrolled Veterans Affairs and fee-for-service Medicare patients. It evaluated the risk of stroke/systemic embolism (SE) and major bleeding (MB) in patients that initiated apixaba n versus warfarin.
Source: The American Journal of Cardiology - December 18, 2021 Category: Cardiology Authors: Steve Deitelzweig, Janvi Sah, Amiee Kang, Cristina Russ, Madison Preib, Amol D. Dhamane, Anna Ratiu, Matthew Cato, Tamuno Alfred, Edi Levi, Manuela Di Fusco Source Type: research

Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation
Warfarin is the standard anticoagulation therapy for valvular atrial fibrillation (AF); however, new oral anticoagulants have emerged as an alternative. We compared the efficacy and safety of dabigatran with conventional treatment in AF associated with left-sided valvular heart disease (VHD), including mitral stenosis (MS). Patients with AF and left-sided VHD were randomly assigned to receive dabigatran or conventional treatment. The primary end point was the occurrence of clinical stroke or a new brain lesion (silent brain infarct and microbleed) on 1-year follow-up brain magnetic resonance imaging.
Source: The American Journal of Cardiology - May 9, 2022 Category: Cardiology Authors: Min Soo Cho, Minsu Kim, Seung-ah Lee, Sahmin Lee, Dae-Hee Kim, Jun Kim, Jong-Min Song, Gi-Byoung Nam, Sang Joon Kim, Duk-Hyun Kang, Kee-Joon Choi Source Type: research

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