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Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis
Conclusions Our analysis suggests that off-label underdosing of NOACs does not reduce bleeding outcomes. Patients prescribed off-label NOAC doses are at an increased risk of all-cause mortality. These data underscore the importance of prescriber adherence to NOAC dosing guidelines to achieve optimal clinical outcomes for patients with AF. PROSPERO registration number CRD42020219844.
Source: Heart - January 11, 2023 Category: Cardiology Authors: Caso, V., de Groot, J. R., Sanmartin Fernandez, M., Segura, T., Blomström-Lundqvist, C., Hargroves, D., Antoniou, S., Williams, H., Worsley, A., Harris, J., Caleyachetty, A., Vardar, B., Field, P., Ruff, C. T. Tags: Open access Systematic review Source Type: research

Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018
Conclusions There has been an increase in the proportion of patients with AF appropriately prescribed anticoagulants following National Institute for Health and Care Excellence and European Society of Cardiology guidelines, which correlates with improvements in mortality and stroke outcomes. Beta-blockers appear increasingly favoured over digoxin for rate control. There has been a steady decline in GP prescribing rates for rhythm control drugs, possibly related to concerns over efficacy and safety and increased availability of AF ablation.
Source: Heart - March 10, 2022 Category: Cardiology Authors: Phillips, K., Subramanian, A., Thomas, G. N., Khan, N., Chandan, J. S., Brady, P., Marshall, T., Nirantharakumar, K., Fabritz, L., Adderley, N. J. Tags: Arrhythmias and sudden death Source Type: research

Effectiveness and safety of oral anticoagulants in elderly patients with atrial fibrillation
Conclusion In this nationwide cohort study of patients ≥75 years initiating oral anticoagulation for AF, standard and reduced dose NOACs were associated with similar risks of stroke/SE as warfarin and lower or similar risks of bleeding. The NOACs seem to be a safe option also in elderly patients.
Source: Heart - February 16, 2022 Category: Cardiology Authors: Rutherford, O.-C. W., Jonasson, C., Ghanima, W., Söderdahl, F., Halvorsen, S. Tags: Open access Arrhythmias and sudden death Source Type: research

Novel bleeding prediction model in atrial fibrillation patients on new oral anticoagulants
Conclusions We present a novel and simple risk score for prediction of major bleeding in patients with non-valvular AF treated with NOACs. Validation in additional cohorts is warranted.
Source: Heart - January 28, 2022 Category: Cardiology Authors: Barnett-Griness, O., Stein, N., Kotler, A., Saliba, W., Gronich, N. Tags: Editor's choice Arrhythmias and sudden death Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism
Learning objectives Understand the importance of venous thrombosis in cardiovascular medicine. Appreciate the mode of action of different oral anticoagulants. Recall the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulants. Introduction Thrombosis is the common pathophysiology responsible for ischaemic heart disease, ischaemic stroke and venous thromboembolism (VTE), and a major contributor to the global disease burden.1 This effect is markedly more pronounced by considering the view that cancer is also a thrombotic disease.2 3 Cardiovascular disease (CVD, manifesting as acute coronary syndromes, m...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Blann, A. D., Lip, G. Y. H. Tags: Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Source Type: research

Aspirin versus vitamin K antagonist treatment guided by transoesophageal echocardiography in patients with atrial fibrillation: a pilot study
Conclusions This hypothesis-generating pilot trial has found that TEE may be used for refinement of stroke risk in paroxysmal atrial fibrillation patients. A larger trial is needed to confirm these data. (ClinicalTrials.gov number NTC00224757).
Source: Heart - March 5, 2014 Category: Cardiology Authors: Dinh, T., Baur, L. H. B., Pisters, R., Kamp, O., Verheugt, F. W. A., Smeets, J. L. R. M., Cheriex, E. C., Lindeboom, J.-E., Heesen, W. F., Tieleman, R. G., Prins, M. H., Crijns, H. J. G. M., for the TIARA investigators, Dinh, Pisters, Tieleman, Prins, Cri Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests, Epidemiology Cardiac risk factors and prevention Source Type: research