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Persisting stroke risk in patients with atrial fibrillation despite proper anticoagulation – Unmet clinical needs
Oral anticoagulation (OAC) is crucial to prevent cardioembolic stroke in patients with atrial fibrillation (AF). Development of the direct oral anticoagulants (DOAC), which inhibit activities of the coagulant proteases thrombin and activated factor X (FXs), has improved the safety and efficacy of anticoagulation in AF, compared to traditional vitamin K antagonists like warfarin [1,2]. Yet in a small, but numerically relevant proportion of up to 2% of patients, this cornerstone principle fails for unclear reasons.
Source: International Journal of Cardiology - August 6, 2022 Category: Cardiology Authors: Florian Bruns, Dobromir Dobrev, Anke C. Fender Tags: Editorial Source Type: research

Effect of calcium or vitamin D supplementation on vascular outcomes: A meta-analysis of randomized controlled trials
Conclusions: Calcium supplementation might increase the risk of major cardiovascular events, myocardial infarction, and stroke compared to the risk with a placebo.
Source: International Journal of Cardiology - September 12, 2013 Category: Cardiology Authors: Pei-Juan Mao, Chi Zhang, Lan Tang, Yu-Qiong Xian, Yan-Song Li, Wei-Dong Wang, Xiu-Hua Zhu, Hua-Li Qiu, Jia He, Yu-Hao Zhou Tags: Reviews 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

The efficacy and safety of low intensity warfarin therapy in Chinese elderly atrial fibrillation patients with high CHADS2 risk score
Non-valvular atrial fibrillation (NVAF) increases the risk of ischemic stroke by 5 fold and results in higher mortality and disability . Although clinical trials and published guidelines recommend oral vitamin K antagonist therapy in elderly patients with atrial fibrillation, warfarin is still underused due to fear of hemorrhage, inconvenient to monitor international normalized ratio (INR) and interact with other drugs and foods . However, the current status of anticoagulation therapy for China elderly NVAF patients with high risk for stroke, particularly in octogenarians, is not clear. Therefore, the purpose of the presen...
Source: International Journal of Cardiology - November 30, 2012 Category: Cardiology Authors: Jun Wu, Junhong Wang, Surong Jiang, Jian Xu, Qun Di, Chuanwei Zhou, Xiaoyan Min, Sisi Pang, Hui Wang, Di Xu, Yan Guo Tags: Letters to the Editor Source Type: research

Antiplatelet Therapy in Japanese Patients with Atrial Fibrillation without Oral Anticoagulants: Pooled Analysis of Shinken Database, J-RHYTHM Registry and Fushimi AF Registry
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke. Oral anticoagulants (OAC) are effective for stroke prevention in patients with AF, and recent evidences have revealed the efficacy and safety of non-vitamin K antagonist OAC (NOAC) as well as warfarin. Although aspirin was shown to be inferior to warfarin or apixaban in preventing stroke [1,2], it is still prescribed to many AF patients in clinical practice [3–5]. This may be because physicians perceived it to be a safer and more convenient alternative to OAC.
Source: International Journal of Cardiology - April 22, 2015 Category: Cardiology Authors: Hisashi Ogawa, Masaharu Akao, Shinya Suzuki, Takeshi Yamashita, Ken Okumura, Hirotsugu Atarashi, Hiroshi Inoue Tags: Letter to the Editor Source Type: research

Efficacy and safety of novel anticoagulants versus vitamin K antagonists in patients with mild and moderate to severe renal insufficiency: Focus on apixaban
The high risk of both stroke and major bleeding in atrial fibrillation (AF) patients with chronic kidney disease (CKD) defines an important population for whom the assessment of the balance between the risk of ischemic stroke and of bleeding is essential. The use of novel oral anticoagulants (NOACs) may be a viable option in this population due to their greater net clinical benefit than warfarin, as demonstrated by the results of the clinical phase III trials. NOACs have been found to have a greater net clinical benefit than warfarin in patients at high risk of either stroke (CHADS2 ≥1 or CHA2DS2-VASc score≥2) or bleeding (HAS-BLED≥3).
Source: International Journal of Cardiology - September 30, 2016 Category: Cardiology Authors: Francesco Pelliccia, Salvatore Rosanio, Giuseppe Marazzi, Sara Poggi, Alessandra Tanzilli, Cesare Greco, Carlo Gaudio, Giuseppe Rosano Tags: Review Source Type: research

Cholesterol-adjusted vitamin E serum levels are associated with cardiovascular events in patients with non-valvular atrial fibrillation
Abstract: Background: Non-valvular atrial fibrillation is associated with an increase in thromboembolism, i.e. stroke, and atherosclerotic events, i.e. myocardial infarction. Vitamin E possesses anti-coagulant as well as anti-atherosclerotic properties.Our aim was to assess whether vitamin E is associated with cardiovascular events in patients with non-valvular atrial fibrillation.Methods: Serum levels of cholesterol-adjusted vitamin E were measured in 1012 patients with non-valvular atrial fibrillation. Patients were followed for a mean time of 27.0months, and cardiovascular events, such as cardiovascular death and fatal ...
Source: International Journal of Cardiology - May 7, 2013 Category: Cardiology Authors: Roberto Cangemi, Pasquale Pignatelli, Roberto Carnevale, Gino Roberto Corazza, Daniele Pastori, Alessio Farcomeni, Stefania Basili, Giovanni Davì, Domenico Ferro, William R. Hiatt, Giuseppe Licata, Gregory Y.H. Lip, Lorenzo Loffredo, Pier Mannuccio Mannu Tags: Original Articles Source Type: research

There is a need for independent studies about new oral anticoagulants in atrial fibrillation patients
Dabigatran, rivaroxaban, and apixaban are new oral anticoagulants (NOAC) which have been investigated in patients with atrial fibrillation (AF) for primary and secondary prevention of stroke and thromboembolism . In RELY, ROCKET-AF and ARISTOTLE, NOAC had a similar efficacy and safety profile like vitamin-K-antagonists (VKA). Based on these results, NOAC are recommended by national and international societies as an alternative to VKA or even the first choice drug for the prevention of stroke or embolism in AF-patients.
Source: International Journal of Cardiology - January 21, 2014 Category: Cardiology Authors: Claudia Stöllberger, Birke Schneider, Josef Finsterer Tags: Online Letters to the Editor Source Type: research

Antiplatelet Properties of Oral Anticoagulants
Until recently, vitamin K antagonists (VKA) were the only oral anticoagulant drugs used in clinical practice for stroke or systemic embolism prevention in patients with non-valvular atrial fibrillation (AF). New oral anticoagulant drugs such as dabigatran etexilate and rivaroxaban have been developed and are currently available as an alternative in this indication. Both drugs were demonstrated to be non-inferior to warfarin for the prevention of stroke or systemic embolism in patients with non-valvular AF in the RE-LY and ROCKET trials [1,2].
Source: International Journal of Cardiology - December 23, 2014 Category: Cardiology Authors: Corinne Frère, Marc Laine, Franck Paganelli, Françoise Dignat-George, Laurent Bonello Tags: Letter to the Editor Source Type: research

Reply: Health status, geriatric syndromes and prescription of oral anticoagulant therapy in elderly medical in-patients with atrial fibrillation: A prospective observational study
We agree with the content of the letter from Dr Jolobe OMP and, specifically we concur with his conclusion, where he underlines the fragile evidence for aspirin use in the prevention of atrial fibrillation (AF)-related stroke. According to recent European guidelines [1], our study aimed to assess prevalence of and variables associated with under-prescription of currently recommended anticoagulant therapy for AF patients, including vitamin K antagonists (VKAs) and new direct oral anticoagulants (DOAs), but not those associated with use or under-use of aspirin, which is currently not recommended for prevention of AF-related stroke.
Source: International Journal of Cardiology - April 15, 2015 Category: Cardiology Authors: M. Bo, F. Li Puma, M. Badinella Martini, Y. Falcone, M. Iacovino, E. Grisoglio, M. Bonetto, G. Isaia, G. Ciccone, G.C. Isaia, F. Gaita Tags: Letters to the Editor Source Type: research

Antiplatelet therapy, vitamin K antagonist and low time in therapeutic range in patients with atrial fibrillation: Highway to bleed
Use of oral anticoagulant (OAC) therapy for stroke prevention is a main aspect of management for patients with atrial fibrillation (AF). Guidelines for the management of AF indicate that OAC is usually needed in patients with at least one stroke risk factor [1]. This has been possibly achieved for a long time using a vitamin K antagonist (VKA). This may also be done for a few years using one of the non-vitamin K oral anticoagulant (NOACs) in case the patient has neither a EHRA (Evaluated Heartvalves, Rheumatic or Artificial) Type 1 valvular AF nor a contraindication to NOAC [2].
Source: International Journal of Cardiology - December 15, 2017 Category: Cardiology Authors: Laurent Fauchier, Arnaud Bisson, Thibaud Genet Tags: Editorial Source Type: research

Different safety profiles of oral anticoagulants in very elderly non-valvular atrial fibrillation patients: A retrospective propensity score matched cohort study
Vitamin K antagonists (VKAs) have been shown to decrease the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). [1] The non-VKA oral anticoagulants (NOACs) are now increasingly used as an alternative to VKAs thanks to their convenient, fixed dose and no requirement for monitoring. NOACs have shown non-inferiority to warfarin for the prevention of stroke and systemic embolism, with marked reduction in the risk of intracerebral haemorrhage [2].
Source: International Journal of Cardiology - April 25, 2018 Category: Cardiology Authors: Giacomo Zoppellaro, Luca Zanella, Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo Source Type: research

No antiarrhythmic effect of direct oral anticoagulants versus vitamin K antagonists in paroxysmal atrial fibrillation patients undergoing catheter ablation
Direct oral anticoagulants (DOACs) are superior to vitamin K antagonists (VKAs) for the prevention of stroke in atrial fibrillation (AF) patients with elevated stroke risk. Possible antiarrhythmic effects of DOACs have been discussed. We analyzed impact of DOAC treatment on recurrence-free survival after AF catheter ablation.
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: David Zweiker, Martin Manninger, Raphael Sieghartsleitner, Jakob Ebner, Bernadette Pratl, Egbert Bisping, Peter Lercher, Dirk von Lewinski, Rita Riedlbauer, Ursula Rohrer, Henri M.H. Spronk, Andreas Zirlik, Ulrich Schotten, Daniel Scherr Tags: Short communication Source Type: research

Percutaneous left atrial appendage closure vs oral anticoagulation: The scariest might be the cheepest
Left Atrial Appendage Closure (LAAC) in patients with atrial fibrillation (AF) and consequent elevated risk of thromboembolic events has an excellent safety profile, with an equal efficacy in preventing stroke, compared with vitamin K antagonists in patients without contraindications to oral anticoagulants [1]. It is also noninferior to direct oral anticoagulants (DOACs) in preventing major AF-related ischemic and haemorrhagic events [2]. Nevertheless, according to the current practice guidelines, percutaneous LAAC is still recommended only in patients with AF at increased risk of stroke and with contraindications to long-term OAC [3,4].
Source: International Journal of Cardiology - January 29, 2022 Category: Cardiology Authors: Patrizio Mazzone, Paolo Della Bella, Francesca Baratto Tags: Editorial Source Type: research

Eligibility of patients with atrial fibrillation for new oral anticoagulants
Vitamin K antagonists (VKA) have been the mainstay of antithrombotic therapy in atrial fibrillation (AF) for decades but have major limitations such as multiple food and drug interactions, a metabolism affected by genetic polymorphisms, a narrow therapeutic window, and a need for regular monitoring of the international normalized ratio. Many patients with AF at moderate or high risk of stroke are not prescribed VKAs . Novel oral anticoagulants (OACs), thrombin inhibitors (dabigatran) or factor Xa inhibitors (rivaroxaban and apixaban), have proven their efficacy in the prevention of strokes and systemic embolism in large ra...
Source: International Journal of Cardiology - October 2, 2012 Category: Cardiology Authors: Ghassan Moubarak, Nicolas Badenco, Julien Dreyfus, Constantin Simion, Aurélie Delos Paquet, Serge Cazeau, Romain Cador Tags: Letters to the Editor Source Type: research

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