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Total 961 results found since Jan 2013.

Stroke Risk Reduction Outweighed Bleeding Risk Increase from Vitamin K Antagonists Treatment among Nonvalvular Atrial Fibrillation Patients with High Stroke risk and Low Bleeding Risk.
CONCLUSION: In NVAF patients at high risk for stroke and low risk for bleeding, our data confirm the effectiveness of anticoagulation for stroke prevention. The decrease in stroke risk of anticoagulation may outweigh the risk of major bleeding events, particularly among elderly patients. Potential risks of warfarin during initiation warrant attention, especially among patients who stop and start therapy repeatedly. PMID: 28008771 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - December 25, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis.
Abstract Large Phase 3 clinical trials for stroke prevention in atrial fibrillation (AF) have compared non-vitamin K antagonist oral anticoagulants (NOACs) against warfarin, with the edoxaban trial only recently reported. In the absence of head to head trials directly comparing these NOACs against each other, we compared the efficacy and safety of edoxaban to other agents by an indirect comparison analysis. We performed an indirect comparison analysis of edoxaban (2 dose strategies) against apixaban (1 dose), dabigatran etexilate (2 doses) and rivaroxaban (1 dose), for their relative efficacy and safety against ea...
Source: Thrombosis and Haemostasis - February 28, 2014 Category: Hematology Authors: Skjøth F, Larsen TB, Rasmussen LH, Lip GY Tags: Thromb Haemost Source Type: research

Acute Management of Stroke Patients Taking Non-vitamin K Antagonist Oral Anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and Rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research

Acute management of stroke patients taking non –vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - September 23, 2016 Category: Cardiology Source Type: research

Insufficient Warfarin Therapy Is Associated With Higher Severity of Stroke Than No Anticoagulation in Patients With Atrial Fibrillation and Acute Anterior-Circulation Stroke.
CONCLUSIONS: Insufficient VKA therapy on admission was associated with higher severity of stroke and higher prevalence of proximal artery occlusion in patients with AF and acute anterior-circulation stroke compared with no anticoagulant medication. PMID: 29269702 [PubMed - as supplied by publisher]
Source: Circulation Journal - December 21, 2017 Category: Cardiology Authors: Sakamoto Y, Okubo S, Nito C, Suda S, Matsumoto N, Nishiyama Y, Aoki J, Shimoyama T, Kanamaru T, Suzuki K, Mishina M, Kimura K Tags: Circ J Source Type: research

Use of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Before Stroke.
CONCLUSIONS: -While experience of using rt-PA in ischemic stroke patients on a NOAC is limited, these preliminary observations suggest that rt-PA appears to be reasonably well tolerated without prohibitive risks for adverse events among selected NOAC treated patients. Future study should evaluate the safety and efficacy of intravenous rt-PA in ischemic stroke patients taking NOACs. PMID: 28119380 [PubMed - as supplied by publisher]
Source: Circulation - January 23, 2017 Category: Cardiology Authors: Xian Y, Federspiel JJ, Hernandez AF, Laskowitz D, Schwamm LH, Bhatt DL, Smith EE, Fonarow GC, Peterson ED Tags: Circulation Source Type: research

Drug treatment strategies for osteoporosis in stroke patients.
Authors: Hsieh CY, Sung SF, Huang HK Abstract Introduction: Osteoporosis and subsequent fractures are well-recognized complications of stroke. However, drug treatment strategies for osteoporosis after stroke have been rarely discussed in the current guidelines for the management of stroke or osteoporosis.Areas covered: The authors review the epidemiology, characteristics, pathophysiology, and risk prediction of post-stroke osteoporosis and fractures. Then they provide an overview of existing evidence regarding drug treatment strategies for osteoporosis in stroke patients. They also review the effects on bone minera...
Source: Expert Opinion on Pharmacotherapy - March 11, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Which drug should we use for stroke prevention in atrial fibrillation?
This article reviews the latest evidence and development of new oral anticoagulants for the prevention of ischaemic stroke, as well as bleeding risk assessment, mitigation and management. Recent findingsDecision-making for stroke prevention has evolved towards the initial identification of ‘low-risk’ patients who do not need any antithrombotic therapy. Subsequent to this step, patients with at least 1 stroke risk factor can be offered effective stroke prevention, which is OAC. There is increased morbidity and mortality amongst warfarin users, if time in therapeutic range is poor. New oral anticoagulants (such as dabiga...
Source: Current Opinion in Cardiology - June 6, 2014 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Harvey D. White Source Type: research

Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation.
Conclusion: Variation in published AF stroke rates for patients not receiving anticoagulant therapy results in multifold variation in the net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty in current thresholds of stroke risk score for recommending anticoagulation. Primary Funding Source: None. PMID: 30264130 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - September 25, 2018 Category: Internal Medicine Authors: Shah SJ, Eckman MH, Aspberg S, Go AS, Singer DE Tags: Ann Intern Med Source Type: research

Healthcare costs of stroke and major bleeding in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants.
CONCLUSIONS: The incremental healthcare costs incurred by patients with versus without stroke/SE was nearly twice as high as those of patients with versus without MB. Moreover, each additional year up to 4 years after the first event was associated with an incremental cost for patients with a stroke/SE or MB event compared to those without an event. PMID: 30939954 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - April 5, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Stroke Prevention in Atrial Fibrillation: Looking Forward.
Abstract Ischemic strokes related to atrial fibrillation are highly prevalent, presenting with severe neurologic syndromes and associated with high risk of recurrence. Although advances have been made in both primary and secondary stroke prevention for patients with atrial fibrillation, the long-term risks for stroke recurrence and bleeding complications from antithrombotic treatment remain substantial. We summarize the major advances in stroke prevention for patients with atrial fibrillation during the past 30 years and focus on novel diagnostic and treatment approaches currently under investigation in ongoing cl...
Source: Circulation - December 15, 2020 Category: Cardiology Authors: Katsanos AH, Kamel H, Healey JS, Hart RG Tags: Circulation Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Percutaneous Left Atrial Appendage Occlusion with a Watchman Device Following Recurrent Stroke on Warfarin and Rivaroxaban in Patient with Paroxysmal Atrial Fibrillation
We present the case of a 66 year-old male with paroxysmal atrial fibrillation who experienced recurrent stroke despite treatment with warfarin initially, and rivaroxaban subsequently. After excluding non-cardioembolic causes of recurrent stroke, we proceeded with percutaneous occlusion of the LAA with a Watchman device. Nine months post-procedure he has not experienced recurrence of neurological symptoms. Our case provides anectodal evidence that catheter-based LAA occlusion can be beneficial in secondary stroke prevention where oral anticoagulation has been problematic.
Source: Heart, Lung and Circulation - September 30, 2013 Category: Cardiology Authors: Roberto Spina, Rajesh Subbiah, Romesh Markus, Brendan Gunalingam Tags: Brief Communications Source Type: research

Medical Costs of Oral Anticoagulants vs Warfarin for Atrial Fibrillation Patients with Different Stroke Risks
Conclusions Medical cost differences associated with OACs vs. warfarin vary according to stroke risk. Of the three OACs, apixaban demonstrated consistent medical cost reductions vs. warfarin for NVAF patients with moderate and high stroke risks.
Source: Cardiology and Therapy - December 1, 2013 Category: Cardiology Source Type: research

Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report
Publication date: Available online 21 September 2017 Source:American Journal of Kidney Diseases Author(s): Vinod K. Bansal, Charles A. Herzog, Mark J. Sarnak, Michael J. Choi, Ravindra Mehta, Bernard G. Jaar, Michael V. Rocco, Holly Kramer Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as...
Source: American Journal of Kidney Diseases - September 21, 2017 Category: Urology & Nephrology Source Type: research