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Decision making for oral anticoagulants in atrial fibrillation: The ATA-AF study.
CONCLUSIONS: Oral anticoagulants are more frequently used in CARD than in MED, plausibly due to greater complexity of MED patients. Stratification of thrombotic and hemorrhagic risk significantly drives the choice for VKA. However the fraction of patients in whom prescription or non-prescription is based on other individual characteristics is not negligible. PMID: 23684591 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - May 16, 2013 Category: Internal Medicine Authors: Gussoni G, Di Pasquale G, Vescovo G, Gulizia M, Mathieu G, Scherillo M, Panuccio D, Lucci D, Nozzoli C, Fabbri G, Colombo F, Riva L, Baldo CI, Maggioni AP, Mazzone A, ATA-AF Steering Committee and Investigators Tags: Eur J Intern Med Source Type: research

Potential impact of new oral anticoagulants on the management of atrial fibrillation‐related stroke in primary care
ConclusionThe clinical and economic benefits of the new oral anticoagulants, along with appropriate risk stratification, may enable a higher number of patients with AF to receive effective and convenient prophylaxis for stroke prevention.
Source: International Journal of Clinical Practice - April 28, 2013 Category: Internal Medicine Authors: K. Harris, J. Mant Tags: Review Article Source Type: research

Practical use of dabigatran etexilate for stroke prevention in atrial fibrillation
Summary Atrial fibrillation (AF) is associated with an increased risk of thromboembolism, and is the most prevalent factor for cardioembolic stroke. Vitamin K antagonists (VKAs) have been the standard of care for stroke prevention in patients with AF since the early 1990s. They are very effective for the prevention of cardioembolic stroke, but are limited by factors such as drug–drug interactions, food interactions, slow onset and offset of action, haemorrhage and need for routine anticoagulation monitoring to maintain a therapeutic international normalised ratio (INR). Multiple new oral anticoagulants have been develope...
Source: International Journal of Clinical Practice - April 5, 2013 Category: Internal Medicine Authors: K. Huber, S. J. Connolly, A. Kher, F. Christory, G.‐A. Dan, R. Hatala, R. G. Kiss, B. Meier, B. Merkely, B. Pieske, T. Potpara, J. Stępińska, N. Vene Klun, D. Vinereanu, P. Widimský Tags: Consensus Source Type: research

Daily multivitamin supplements did not reduce risk for major CV events over > 10 years in men.
CONCLUSION Daily multivitamin supplements did not affect risk for major cardiovascular events over > 10 years in male physicians in the USA.Daily multivitamin supplements vs placebo in male physicians in the USA‡OutcomesMultivitaminPlaceboAt a median 11.2 yRRI (95% CI)§NNHMajor CV events12.0%11.7%1% (-8 to 9)NSFatal and nonfatal stroke4.5%4.2%6% (-9 to 22)NSRRR (CI)§NNTFatal and nonfatal MI4.3%4.6%7% (-9 to 20)NSAll-cause mortality18%19%5% (-2 to 11)NS‡CV = cardiovascular; MI = myocardial infarction; NS = not significant; other abbreviations defined in Glossary. RRI, RRR, and CI calculated from adjusted hazar...
Source: Annals of Internal Medicine - February 19, 2013 Category: Internal Medicine Authors: Fairfield KM Tags: Ann Intern Med Source Type: research

Oral treatment of acute pulmonary embolism with a fixed dose of rivaroxaban is non-inferior to standard treatment
Commentary on: EINSTEIN-PE Investigators, Büller HR, Prins MH, Lensin AW, et al.. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012;366:1287–97. Context Pulmonary embolism (PE) is a common disease with potentially life-threatening consequences. Current guidelines1 recommend immediate start of anticoagulation with heparin for at least 5 days. Thereafter, heparin may be replaced by vitamin K antagonists (VKAs). The EINSTEIN-PE study tested rivaroxaban for the treatment of acute PE. Rivaroxaban, an oral anti-Xa antagonist, has the major advantage of oral administration wit...
Source: Evidence-Based Medicine - January 17, 2013 Category: Internal Medicine Authors: Niessner, A. Tags: Drugs: cardiovascular system, Stroke, Hypertension, Venous thromboembolism, Pulmonary embolism, Drugs: musculoskeletal and joint diseases Therapeutics Source Type: research

A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Arnold J. Greenspon, MD DOI: 10.3810/pgm.2012.11.2608 Abstract: There is a high prevalence of atrial fibrillation in the United States, particularly in the elderly population. Patients with atrial fibrillation are at an increased risk of stroke and anticoagulant therapy is recommended. However, many eligible patients are not receiving therapy due to limitations and concerns related to the use of the vitamin K antagonist warfarin, such as slow onset of action, variable drug metabolism, risk of bleeding, and requirement for monitoring. Novel oral anticoagulants (NOACs) have been developed and may be used as an alternat...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

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