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Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Systematic Review and Meta-analysis of Anticoagulation Strategy
ConclusionsCompared with VKAs, a DOAC-based strategy might represent an effective and safe strategy regarding all-cause mortality, major/life-threatening bleeding complications, and TEs in HCM patients with concomitant AF. However, further prospective studies are necessary to reinforce a DOAC-based anticoagulation strategy in this population.
Source: American Journal of Cardiovascular Drugs - April 15, 2023 Category: Cardiology Source Type: research

Factors influencing left ventricular thrombus resolution and its significance on clinical outcomes
ConclusionsThis study suggests that LVT resolution is an important predictor for favourable clinical outcomes. LVEF improvement failure interfered with LVT resolution and appeared to be a crucial factor for LVT recurrence. After LVT resolution, continuation of anticoagulation did not seem to impact LVT recurrence and the prognosis.
Source: ESC Heart Failure - April 4, 2023 Category: Cardiology Authors: Se ‐Eun Kim, Chan Joo Lee, Jaewon Oh, Seok‐Min Kang Tags: Original Article Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

Anticoagulation in cardiomyopathy: unravelling the hidden threat and challenging the threat individually
AbstractCardiomyopathy comprises a heterogeneous group of myocardial abnormalities, structural or functional in nature, in the absence of coronary artery disease and other abnormal loading conditions. These myocardial pathologies can result in premature death or disability from progressive heart failure, arrhythmia, stroke, or other embolic events. The European Cardiomyopathy Registry reports a high stroke risk in cardiomyopathy patients ranging from 2.1% to 4.5%, as well as high prevalence of atrial fibrillation ranging from 14.0% to 48.5%. There is a growing interest in evaluating the risk of thromboembolism depending on...
Source: ESC Heart Failure - September 9, 2021 Category: Cardiology Authors: Xiaogang Zhu, Zhenhua Wang, Markus W. Ferrari, Katharina Ferrari ‐Kuehne, Javed Bulter, Xiuying Xu, Quanzhong Zhou, Yuhui Zhang, Jian Zhang Tags: Review Source Type: research

Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology
ConclusionsThe study reveals a high prevalence and diverse distribution of AF in patients with cardiomyopathies, inadequate anticoagulation regimen, and high risk of stroke/TIA in this population.
Source: ESC Heart Failure - September 16, 2020 Category: Cardiology Authors: Katarzyna Mizia ‐Stec, Alida L.P. Caforio, Philippe Charron, Juan R. Gimeno, Perry Elliott, Juan Pablo Kaski, Aldo P. Maggioni, Luigi Tavazzi, Angelos G. Rigopoulos, Cecile Laroche, Attila Frigy, Elisabetta Zachara, Maria Luisa Pena‐Pena, Tags: Original Research Article Source Type: research

Direct oral anticoagulants compared to vitamin K antagonist for the management of left ventricular thrombus
ConclusionsOur data suggest that DOACs are likely to be at least as effective and safe as VKA for stroke prevention in patients with LV thrombus and, despite their lack of a licence for this indication, are therefore likely to represent a reasonable and more convenient option for this setting. The optimal timing and type of anticoagulation for LV thrombus, as well as the role of screening for high ‐risk patients, should be tested in prospective, randomized trials.
Source: ESC Heart Failure - June 24, 2020 Category: Cardiology Authors: Hansa Iqbal, Sam Straw, Thomas P. Craven, Katherine Stirling, Stephen B. Wheatcroft, Klaus K. Witte Tags: Original Research Article Source Type: research

Management of Left Ventricular Thrombi with Direct Oral Anticoagulants: Retrospective Comparative Study with Vitamin K Antagonists
ConclusionsThis retrospective observational study found a similar efficacy between DOAC and VKA agents in patients with LV thrombi (70.6% vs. 71.5%); however, when the thrombus remains, VKAs are still the standard of care as it is possible to control INR levels (3 –4) with them.
Source: Clinical Drug Investigation - March 5, 2020 Category: Drugs & Pharmacology Source Type: research

Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis
AbstractSeveral studies have explored the use of NOACs compared with vitamin K antagonists (VKAs) in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF); and therefore, we aimed to compare the efficacy and safety outcomes of NOACs with VKAs in this population. We systematically searched the PubMed and Embase databases until August 5, 2019 for studies that compared the effect of NOACs with VKAs in patients with HCM and AF. The risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. A total of four observational studies were included in this meta-analysis. Over...
Source: Journal of Thrombosis and Thrombolysis - December 1, 2019 Category: Hematology Source Type: research

Efficacy and safety of direct oral anticoagulants (DOACs) versus vitamin K antagonist (VKA) among patients with atrial fibrillation and hypertrophic cardiomyopathy: a systematic review and meta-analysis.
Conclusions: The current study found that the risk of all-cause death was significantly reduced but the risk of ischaemic stroke, major bleeding and intracranial bleeding were not significantly different between patients with AF and HCM who had received DOACs and those who received VKA. PMID: 31558097 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - September 30, 2019 Category: Cardiology Tags: Acta Cardiol Source Type: research

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry
ConclusionsCARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC.
Source: IJC Heart and Vasculature - January 18, 2019 Category: Cardiology Source Type: research

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Hypertrophic Cardiomyopathy: A Nationwide Cohort Study.
CONCLUSIONS: Compared with warfarin, patients with HCM and AF on NOACs had similar stroke and major bleeding risks, but lower all-cause mortality and composite fatal cardiovascular events. Our data suggest that patients with HCM and AF can be safely and effectively treated with NOACs. PMID: 30472021 [PubMed - as supplied by publisher]
Source: Chest - November 22, 2018 Category: Respiratory Medicine Authors: Jung H, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH Tags: Chest Source Type: research

Could direct oral anticoagulants be an alternative to vitamin K antagonists in patients with hypertrophic cardiomyopathy and atrial fibrillation?
We read the article “Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation” by Fernando Dominguez et al. [1] interestingly, which has great clinical significance in guiding the use of oral anticoagulants in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrilla tion (AF). Due to the high risk of stroke and thromboembolic complications in patients with HCM and AF, vitamin K antagonists (VKAs) are recommended for those patients, direct oral anticoagulants (NOACs) may represent another option [2].
Source: International Journal of Cardiology - February 15, 2018 Category: Cardiology Authors: Biao Li, Chao Sun, Fen Qin, Na Liu, Zhihong Wu, Qiming Liu Tags: Letter to the Editor Source Type: research

Dabigatran etexilate in a vitamin ‐K antagonist non responder patient during Heartware HVAD support
We report a case of a patient supported with a HeartWare left ventricular assist device for idiopathic cardiomyopathy who was resistance to vitamin‐K antagonists three months after implantation. The patient initially started low‐molecular‐weight heparin therapy and then, after the onset of an ischemic stroke, switched to dabigatran etexilate (DE). The patient had progressive recovery of cardiac function for which the device was explanted. No thrombotic or bleeding events occurred during DE therapy.
Source: Journal of Cardiac Surgery - December 31, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Andrea Baronetto, Paolo Centofanti, Matteo Attisani, Massimo Boffini, Davide Ricci, Erika Simonato, Mauro Rinaldi Tags: PERIOPERATIVE MANAGEMENT Source Type: research