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Chronic anticoagulation in non-valvular atrial fibrillation: Where things stand
One in every five strokes is due to atrial fibrillation. Anticoagulation is the evidence-based practice for stroke risk reduction in patients with atrial fibrillation. After decades of using warfarin, the recent years have seen an exponential increase in the available oral anticoagulants. An understanding of where things stand regarding indications, relative safety and efficacy as well as the limitations of each available choice is crucial.
Source: International Journal of Cardiology - August 1, 2016 Category: Cardiology Authors: Kareem Bedeir, Robert P. Giugliano, Basel Ramlawi Tags: Review Source Type: research

Atrial Fibrillation and Chronic Kidney Disease Requiring Hemodialysis – Does Warfarin Therapy Improve the Risks of this Lethal Combination?
Warfarin therapy for stroke prevention is recommended for patients with AF, but its value in patients with chronic kidney disease on HD is unknown.
Source: International Journal of Cardiology - July 7, 2016 Category: Cardiology Authors: Lohit Garg, Charity Chen, David E. Haines Source Type: research

Atrial fibrillation and chronic kidney disease requiring hemodialysis — Does warfarin therapy improve the risks of this lethal combination?
Warfarin therapy for stroke prevention is recommended for patients with AF, but its value in patients with chronic kidney disease on HD is unknown.
Source: International Journal of Cardiology - July 7, 2016 Category: Cardiology Authors: Lohit Garg, Charity Chen, David E. Haines Source Type: research

Inadequate stroke prevention in Korean atrial fibrillation patients in the post-warfarin era
This study aimed to investigate the utilization of anticoagulants since the introduction of DOACs in South Korea.
Source: International Journal of Cardiology - June 24, 2016 Category: Cardiology Authors: Eun Joo Choi, Iyn-Hyang Lee, Nam Kyung Je Source Type: research

Cost-effectiveness Modelling of Novel Oral Anticoagulants Incorporating Real-world Elderly Patients with Atrial Fibrillation
Novel oral anticoagulants (NOACs) expand the treatment options for patients with atrial fibrillation (AF). Their benefits need to be weighed against the risk-benefit ratio in real-world elderly patients, prompting this cost-effectiveness study of NOACs (apixaban, dabigatran, edoxaban and rivaroxaban), warfarin and aspirin for stroke prevention in AF.
Source: International Journal of Cardiology - June 22, 2016 Category: Cardiology Authors: Ying Jiao Zhao, Liang Lin, Hui Jun Zhou, Keng Teng Tan, Aik Phon Chew, Chee Guan Foo, Chia Theng Daniel Oh, Boon Peng Lim, Wee Shiong Lim Source Type: research

Review Article: Prospective Randomized Evaluation of the Watchman Left Atrial Appendage Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy
Assessing the safety and effectiveness of left atrial appendage (LAA) (pouch found in the upper chambers of the heart) occlusion, using the Watchman device compared to long term warfarin therapy (drug that reduces clot formation), in preventing the risk of stroke in patients with atrial fibrillation (most common type of irregular heart beat). 90% of strokes in atrial fibrillation arise from clots forming in this pouch. By mechanically blocking it using the device less clots are suggested to be formed.
Source: International Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Djouhar Roufeida Belgaid, Zara Khan, Mariam Zaidi, Adrian Hobbs Source Type: research

Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy
Assessing the safety and effectiveness of left atrial appendage (LAA) (pouch found in the upper chambers of the heart) occlusion, using the Watchman device compared to long term warfarin therapy (drug that reduces clot formation), in preventing the risk of stroke in patients with atrial fibrillation (most common type of irregular heart beat). 90% of strokes in atrial fibrillation arise from clots forming in this pouch. By mechanically blocking it using the device less clots are suggested to be formed.
Source: International Journal of Cardiology - June 13, 2016 Category: Cardiology Authors: Djouhar Roufeida Belgaid, Zara Khan, Mariam Zaidi, Adrian Hobbs Tags: Review Source Type: research

Dabigatran-induced esophagitis: A frequently overlooked adverse effect
Atrial fibrillation (AF) is known to increase the risk of ischemic stroke and other thromboembolic events in patients with atrial fibrillation. For a long time, warfarin was the only available oral anticoagulant. Conventionally it was considered effective and widely prescribed for the prevention of thromboembolic events in patients with AF. However, routine laboratory monitoring on international normalized ratio (INR) and inevitable dose adjustments, potential interactions with several drugs and food presented significant inconvenience and challenge in managing patients taking warfarin on daily medical practice [1].
Source: International Journal of Cardiology - March 23, 2016 Category: Cardiology Authors: Nixiao Zhang, Xiushi Suzy Liu, Guangping Li, Tong Liu Tags: Correspondence Source Type: research

Fatal stroke following treatment with apixaban in a patient with atrial fibrillation and left atrial appendage thrombus
Atrial fibrillation increases the risk of ischemic stroke 4–5 fold [1] and doubles the mortality independently of other vascular risk factors [2]. The vast majority (>90%) of thrombi associated with atrial fibrillation originate from the left atrial appendage [3]. The direct factor Xa inhibitor apixaban is superior to warfarin in terms of stroke prevention with a lower risk of bleeding and mortality [4].
Source: International Journal of Cardiology - March 23, 2016 Category: Cardiology Authors: Ashkan Eftekhari, Dorte Damgaard, Erik L. Grove Tags: Correspondence Source Type: research

Comparative effectiveness and safety of non-vitamin K Antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and valvular heart disease
Non-vitamin K antagonist oral anticoagulants (NOACs) are approved for prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF). These agents are as effective as warfarin and are associated with less intracranial bleeding and may be preferable for many patients with NVAF [1]. However, the term non-valvular AF remains a source of confusion because clinical trials and guidelines have adopted variable definitions.
Source: International Journal of Cardiology - February 2, 2016 Category: Cardiology Authors: Peter A. Noseworthy, Xiaoxi Yao, Nilay D. Shah, Bernard J. Gersh Source Type: research

Comparison of watchman device with new oral anti-coagulants in patients with atrial fibrillation: A network meta-analysis
New oral anticoagulants (NOAC) and the Watchman device represent an alternative to warfarin for stroke prophylaxis in atrial fibrillation (AF) patients. However, there are no studies comparing these new treatments. Thus, we performed a network meta-analysis to indirectly compare Watchman and NOACs among AF patients.
Source: International Journal of Cardiology - November 28, 2015 Category: Cardiology Authors: Edward Koifman, Michael J. Lipinski, Ricardo O. Escarcega, Romain Didier, Sarkis Kiramijyan, Rebecca Torguson, Ron Waksman Source Type: research

Relative efficacy and safety of non-Vitamin K oral anticoagulants for non-valvular atrial fibrillation: Network meta-analysis comparing apixaban, dabigatran, rivaroxaban and edoxaban in three patient subgroups
Stroke is the most serious clinical consequence of atrial fibrillation, which is the most common cardiac arrhythmia. Non-vitamin K antagonist oral anticoagulants (NOACs) have emerged as efficacious, safe and convenient stroke prevention agents. This updated network meta-analysis focused on the relative efficacy and safety of apixaban compared with dabigatran, rivaroxaban and edoxaban for stroke prevention in (i) patients with CHADS2 score ≥2, (ii) secondary stroke prevention, and (iii) patients with high quality anticoagulation control with warfarin.
Source: International Journal of Cardiology - November 17, 2015 Category: Cardiology Authors: Gregory Y.H. Lip, Stephen A. Mitchell, Xianchen Liu, Larry Z. Liu, Hemant Phatak, Sumesh Kachroo, Sarah Batson Source Type: research

‘Real-world’ haemorrhagic rates for warfarin and dabigatran using population-level data in New Zealand
Anticoagulants such as warfarin and dabigatran can significantly reduce the risk of stroke in individuals with atrial fibrillation that may lead to increased risk of bleeding, especially in older people. Evidence for bleeding risks with anticoagulants within the context of doses, multimorbidity and impaired renal function in real world setting is lacking.
Source: International Journal of Cardiology - November 9, 2015 Category: Cardiology Authors: Prasad S. Nishtala, Danijela Gnjidic, Hamish Jamieson, H. Carl Hanger, Chanaka Kaluarachchi, Sarah N. Hilmer Source Type: research

Time to use mobile health devices to diagnose paroxysmal atrial fibrillation
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice. It is a global healthcare problem with evidence suggesting an increasing prevalence and incidence worldwide. All AF patients whose risk of embolization exceeds the risk of bleeding are candidates for long-term oral anticoagulation (OAC) therapy. In recently published manuscript Konstantinos et al. reported significant underuse of OAC in AF patients presented with stroke; only 37% of high risk AF patients were taking warfarin at the time of stroke.
Source: International Journal of Cardiology - October 21, 2015 Category: Cardiology Authors: Hilal Olgun Kucuk, Ugur Kucuk, Murat Yalcin, Zafer Isilak Tags: Correspondence Source Type: research

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