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Assessing the impact of dabigatran and warfarin on health-related quality of life: Results from an RE-LY sub-study
Conclusions: Over the course of one year, all anticoagulated patients without outcome events (e.g. strokes or major bleedings) had stable HRQoL. Scores between dabigatran and warfarin were comparable, which was unexpected given the known complexities of warfarin treatment.
Source: International Journal of Cardiology - May 10, 2013 Category: Cardiology Authors: B.U. Monz, S.J. Connolly, M. Korhonen, H. Noack, J. Pooley Tags: Original Articles Source Type: research

Efficacy of new oral anticoagulants in patients with atrial fibrillation previously treated with warfarin: A meta-analysis of randomized controlled trials
Vitamin K antagonists (VKAs), together with newer oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, or apixaban, reduce the risk of stroke in patients with atrial fibrillation (AF). However, patients with no prior exposure to anticoagulation (i.e., VKA naive) may be at higher risk for adverse outcomes (thromboembolic events and/or bleeding) than patients who are VKA experienced. When adjusted-dose VKA (INR 2–3) cannot be used in a patient with AF where an oral anticoagulant (OAC) is recommended, due to difficulties in keeping INR within therapeutic range of 2 to 3, experiencing side effects of VKAs, or inabili...
Source: International Journal of Cardiology - March 13, 2014 Category: Cardiology Authors: Laurent Fauchier, Nicolas Clementy, Christophe Saint-Etienne, Edouard Simeon, Denis Angoulvant, Anne Bernard-Brunet Tags: Letters to the Editor Source Type: research

Comparative evaluation of HAS-BLED and ATRIA scores by investigating the full potential of their bleeding prediction schemes in non-valvular atrial fibrillation patients on vitamin-K antagonists
Although vitamin K antagonists (VKAs) greatly reduce the risk of stroke in non-valvular atrial fibrillation (NVAF), the risk of bleeding with this therapy remains challenging [1]. HAS-BLED [2,3] and ATRIA [4] are currently the most popular scoring systems for bleeding risk assessment in NVAF. Until now, the main studies [5–7] compared both scores used “modified” versions of the original scores, whilst the current recommendation [3] is to use HAS-BLED as it was originally conceived. Furthermore, most of these studies came from trial population or hospitalized patients [5,7].
Source: International Journal of Cardiology - August 7, 2014 Category: Cardiology Authors: Rami Riziq-Yousef Abumuaileq, Emad Abu-Assi, Sergio Raposeiras-Roubin, Andrea López-López, Alfredo Redondo-Diéguez, Diego Álvarez-Iglesias, Moisés Rodríguez-Mañero, Carlos Peña-Gil, Jose Ramón González-Juanatey Source Type: research

Thromboembolic risk in the initiation, switch and interruption/re-initiation of oral anticoagulants: Do newcomers improve outcomes? Insights from a meta-analysis of RCTs.
Anticoagulation is the cornerstone treatment in patients with atrial fibrillation for stroke prevention. In the last decades, oral vitamin K antagonists (VKA) have been the most used drug of this class. The clinical management of these patients is not straightforward due to the need of periodical evaluation of the INR, as well as due to the numerous drug-drug and drug-food interactions. In addition, recent studies have provided new insights of potential problems associated to VKA treatment:
Source: International Journal of Cardiology - September 27, 2014 Category: Cardiology Authors: Daniel Caldeira, João Costa, Joaquim J. Ferreira, Fausto J. Pinto Tags: Letter to the Editor Source Type: research

Vitamin D deficiency and atrial fibrillation
Vitamin D deficiency has been linked with hypertension, coronary artery disease, and stroke, but there is no consensus regarding the possible association between vitamin D deficiency and atrial fibrillation (AF). Vitamin D negatively regulates the renin–angiotensin–aldosterone-system (RAAS), mediates calcium homeostasis, binds to vitamin D receptors on cardiac myocytes, and has antioxidant properties that may reduce levels of reactive oxygen species (ROS) in the atria, which contribute to inflammation and proarrhythmic substrate formation.
Source: International Journal of Cardiology - February 10, 2015 Category: Cardiology Authors: Joseph Thompson, Rynda Nitiahpapand, Prashan Bhatti, Antonios Kourliouros Tags: Review Source Type: research

Prothrombotic risk of vitamin K antagonists during the first days of treatment: One more reason to use new oral anticoagulants
In the controlled clinical trials ROCKET AF and ARISTOTLE, which included patients with nonvalvular atrial fibrillation (AF), introduction of warfarin was associated with an excess of ischemic strokes during the first 30days after randomization in vitamin K antagonist (VKA)-naive patients compared with warfarin-experienced patients (4.40/100 patient-years versus 2.86/100 patient-years in ROCKET AF and 5.41/100 patient-years versus 1.42/100 patient-years in ARISTOTLE) [1]. A similar observation was made in the RE-LY trial, in which the risk of ischemic stroke was 0.26% for warfarin versus 0.12% for dabigatran (odds ratio 2....
Source: International Journal of Cardiology - March 19, 2015 Category: Cardiology Authors: Sébastien Gaertner, Elena-Mihaela Cordeanu, Corina Mirea, Dominique Stephan Tags: Letter to the editor Source Type: research

Meta-analysis of Risk of Stroke and Thrombo-Embolism with Rivaroxaban versus Vitamin K antagonists in ablation and cardioversion of atrial fibrillation
: Anticoagulation in cardioversion and ablation of atrial fibrillation is imperative for reducing thrombo-embolic events. Ample information is available about use of warfarin and vitamin K antagonists (VKA) but few trials examine safety and efficacy of rivaroxaban in these procedures. We aim to explore the hypothesis that rivaroxaban causes equal thrombo-embolic and bleeding events when used in atrial fibrillation patients undergoing ablation or cardioversion compared to VKA.
Source: International Journal of Cardiology - March 25, 2015 Category: Cardiology Authors: Ramez Nairooz, Partha Sardar, Maria Pino, Wilbert S. Aronow, Asif Sewani, Debabrata Mukherjee, Hakan Paydak, Waddah Maskoun Source Type: research

Usefulness of the SAME-TTR score to predict anticoagulation control on VKA in patients with atrial fibrillation and obstructive sleep apnea
The objective of this study was to establish if presence of OSA is associated with poor expected benefit from Vitamin K Antagonist (VKA) therapy as assessed using the SAMe-TT2R2 score.
Source: International Journal of Cardiology - November 23, 2015 Category: Cardiology Authors: Filip M. Szymanski, Gregory Y.H. Lip, Krzysztof J. Filipiak, Anna E. Platek, Grzegorz Karpinski Source Type: research

Bleeding risk in patients treated with dabigatran or vitamin K antagonist for atrial fibrillation: A meta analysis of adjusted analysis in routine practice settings
Large randomized controlled trials have found that in non-valvular atrial fibrillation (AF), non-vitamin K antagonist oral anticoagulants (NOACs) had a favorable risk–benefit profile, with significant reductions in stroke, mortality and intracranial hemorrhage, but possibly increased gastrointestinal bleeding [1]. After the approval of dabigatran, many agencies in different countries received reports of severe dabigatran related bleeding reports through their adverse event reporting system. Concurrently, several case reports of dabigatran induced bleeding were published in medical journals and discussed in the mainstream media.
Source: International Journal of Cardiology - January 6, 2016 Category: Cardiology Authors: Walid Darwiche, Theodora Bejan-Angoulvant, François Dievart, Dominique Babuty, Denis Angoulvant, Laurent Fauchier 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

Dabigatran in clinical practice: Contemporary overview of the evidence
Oral anticoagulation is the cornerstone of stroke prevention in non-valvular atrial fibrillation (AF) and management of venous thromboembolism (VTE), resulting in a reduction in thrombotic complications and mortality. Benefit of vitamin K antagonists (VKAs) in such patients has been unambiguously confirmed, but VKA use is complicated by need for regular monitoring of the international normalized ratio and multiple drug and food interactions.Dabigatran is an oral direct thrombin inhibitor that can be used with fixed doses, without the need for routine anticoagulation laboratory monitoring and the advantage of few drug or diet interactions.
Source: International Journal of Cardiology - June 22, 2016 Category: Cardiology Authors: Walter Ageno, John Eikelboom, Gregory Y.H. Lip Source Type: research

Non-vitamin K oral anticoagulant treatment in elderly patients with atrial fibrillation and coronary heart disease
Atrial fibrillation (AF) is the most frequent sustained arrhythmia. Overall prevalence is estimated to 5.5% and the incidence increases with age. As the population ages, the prevalence and costs of AF are expected to increase. AF is the most important cause of stroke in patients>75years. Until recently, Vitamin K antagonists (VKAs) were the only available oral anticoagulants (OACs) evaluated for long-term treatment of patients with AF with or without coronary heart disease (CHD). This situation was challenged by introduction of non-VKA oral anticoagulants (NOACs).
Source: International Journal of Cardiology - August 3, 2016 Category: Cardiology Authors: Xavier Humbert, Vincent Roule, Mathieu Chequel, Sophie Fedrizzi, Marie Brionne, V éronique Lelong-Boulouard, Paul Milliez, Joachim Alexandre Tags: Review Source Type: research

Reduced dose and reduced exposure to non-vitamin K-antagonist oral anticoagulants: Some considerations on this relationship
For the prevention of stroke and/or systemic embolism (SSE) in non-valvular atrial fibrillation (NVAF), the four available non-vitamin K-antagonist oral anticoagulants (NOACs) are each marketed in a higher and a lower dose: 150 and 110mg for dabigatran, 20 and 15mg for rivaroxaban, 5 and 2.5mg for apixaban and 60 and 30mg for edoxaban. The lower dose is commonly used with the aim to reduce the patient's exposure to the drug (and its anticoagulant effect), thereby reducing the risk of bleeding. This however, may not always be true, depending on the NOAC used and the characteristics of the patients to whom the NOAC is given.
Source: International Journal of Cardiology - August 10, 2016 Category: Cardiology Authors: Andrea Rubboli, Freek W.A. Verheugt Tags: Correspondence Source Type: research

Reversal agents for direct oral anticoagulants: A focused review
For several decades the vitamin K antagonist oral anticoagulants were the only outpatient therapy that existed to reduce the risk of stroke and thromboembolism. When the new direct oral anticoagulants were approved for use and addressed many of the issues associated with oral vitamin K antagonists, a new concern arose —the lack of rapid ability to reverse these agents. Physicians and patients were concerned that in cases of life-threatening bleeding or need for emergent surgery, an antidote to reverse the anticoagulation effect of these agents did not exist.
Source: International Journal of Cardiology - August 11, 2016 Category: Cardiology Authors: Boris Arbit, Marin Nishimura, Jonathan C. Hsu Tags: Review Source Type: research

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