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IJERPH, Vol. 19, Pages 11939: Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs? & mdash;Results of the Polish Atrial Fibrillation (POL-AF) Registry
Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
Source: International Journal of Environmental Research and Public Health - September 21, 2022 Category: Environmental Health Authors: Anna Szyszkowska Łukasz Kuźma Beata Wo żakowska-Kapłon Iwona Gorczyca-G łowacka Olga Jelonek Beata Uzi ębło-Życzkowska Pawe ł Krzesiński Maciej W ójcik Robert B łaszczyk Monika Gawa łko Agnieszka Kap łon-Cieślicka Tomasz Tokarek Renata Rajt Tags: Article Source Type: research

Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
ConclusionsIn AF-stroke patients treated with OAC, the presence of CMBs was associated with an unfavorable composite outcome for both VKAs and DOACs, with a higher risk for recurrent IS than for ICH. Strokes were numerically higher under VKAs and increased in the presence of CMBs.Clinical trial registrationhttp://www.clinicaltrials.gov, Unique identifier: NCT03826927.
Source: Frontiers in Neurology - September 20, 2022 Category: Neurology Source Type: research

Efficacy and Safety of Anticoagulants in Patients with Atrial Fibrillation and History of Falls or Risk of Falls: A Systematic Review and Multilevel Meta-Analysis
ConclusionNOACs were associated with less intracranial hemorrhages and ischemic strokes/systemic embolisms than VKAs in AF patients at risk of falls. These findings suggesting preferred use of NOACs over VKAs have clinical implications for physicians, patients and policy makers.
Source: Drug Safety - September 19, 2022 Category: Drugs & Pharmacology Source Type: research

Direct oral anticoagulants for the treatment of left ventricular thrombosis: an updated systematic review and meta-analysis
Conclusion Compared with VKAs, we found DOACs to have similar efficacy on thrombus resolution and favorable effects on stroke reduction and bleedings. DOACs should be considered as an alternative treatment for LVT. Large prospective randomized clinical trials are needed to confirm this exploratory finding.
Source: Journal of Cardiovascular Medicine - September 17, 2022 Category: Cardiology Tags: Research articles: Hear failure Source Type: research

Daily Multivitamins Linked to Improved Cognition in Older People
Taking a daily multivitamin may improve cognitive function in older people, astudy inAlzheimer ’s& Dementia has found. Taking a cocoa supplement, however, does not appear to slow cognitive decline.“There is an urgent need to identify effective strategies to preserve cognitive function to mitigate the heavy societal burden associated with Alzheimer’s disease and related dementia, which affect more than 46 million people worldwide,” wrote Laura D. Baker, Ph.D., of Wake Forest University S chool of Medicine and colleagues. Cocoa extract is rich in compounds called flavanols, and previous small studies suggest that...
Source: Psychiatr News - September 16, 2022 Category: Psychiatry Tags: Alzheimer ' s & Dementia cardiovacsular disease cocoa extract cognitive decline COSMOS-Mind multivitamin Source Type: research

GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide
ConclusionsSimilarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use.Graphical abstract
Source: Clinical Research in Cardiology - September 12, 2022 Category: Cardiology Source Type: research

Dual therapy with oral anticoagulation and single antiplatelet agent versus monotherapy with oral anticoagulation alone in patients with atrial fibrillation and stable ischemic heart disease: a systematic review and meta-analysis
ConclusionsIn patients with AF and stable ischemic heart disease, OAC  + SAPT as compared to OAC monotherapy is associated with a significant increase in bleeding events without a significant reduction in thrombotic events, cardiovascular mortality, and all-cause mortality.
Source: Journal of Interventional Cardiac Electrophysiology - September 9, 2022 Category: Cardiology Source Type: research

Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study
CONCLUSIONS: Early initiation was noninferior to delayed start of NOAC after acute ischemic stroke in patients with atrial fibrillation. Numerically lower rates of ischemic stroke and death and the absence of symptomatic intracerebral hemorrhages implied that the early start of NOAC was safe and should be considered for acute secondary stroke prevention in patients eligible for NOAC treatment.REGISTRATION: URL: http://www.CLINICALTRIALS: gov; Unique identifier: NCT02961348.PMID:36065821 | DOI:10.1161/CIRCULATIONAHA.122.060666
Source: Circulation - September 6, 2022 Category: Cardiology Authors: Jonas Oldgren Signild Åsberg Ziad Hijazi Per Wester Maria Bertilsson Bo Norrving National TIMING Collaborators Source Type: research

Risk of bleeding complications per different perioperative antithrombotic regimes during carotid endarterectomy: a national registry analysis
CONCLUSION: The effectiveness and safety of DAPT did not differ from single antiplatelet therapy (SAPT) in patients undergoing CEA and needs further evaluation in prospective studies. Considering additional data from the literature and guideline recommendations DAPT should be started immediately after stroke until 30 days after CEA followed by SAPT, due to possible reduction in the risk of recurrency.PMID:36031046 | DOI:10.1016/j.ejvs.2022.08.020
Source: PubMed: Eur J Vasc Endovasc ... - August 28, 2022 Category: Surgery Authors: Simone Ja Donners Joost M Mekke Eline S van Hattum Raechel J Toorop Gert J de Borst Dutch Audit for Carotid Interventions (DACI) Collaborators Source Type: research

Appropriateness of Non-vitamin K Antagonist Oral Anticoagulants Dosing According to Different Prescription Guides Used in Belgian Ambulatory Care
ConclusionsInappropriate NOAC dosing is present in almost twenty percent of AF patients according to the SmPC and requires further education of health care professionals and frequent reassessment of NOAC dosing. However, a significant lower prevalence of underdosing was present when judged by the 2018 EHRA criteria, likely reflecting decision making in complex AF patients. Perceived frailty, weight, renal function and type of NOAC are the main determinants of deviated dosing.
Source: Clinical Drug Investigation - August 20, 2022 Category: Drugs & Pharmacology Source Type: research

Bridging intravenous thrombolysis in patients with atrial fibrillation
ConclusionBridging IVT appears to be a reasonable clinical option in selected patients with AF. Given the increased sICH risk in patients with VKA, subgroup analysis of the randomized controlled trials should analyze whether patients with VKA might benefit from withholding bridging IVT.Registrationclinicaltrials.gov; Unique identifier: NCT03496064.
Source: Frontiers in Neurology - August 3, 2022 Category: Neurology Source Type: research

Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research