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Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Newly Diagnosed Atrial Fibrillation
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence.
Source: The American Journal of Cardiology - August 8, 2017 Category: Cardiology Authors: Inmaculada Hernandez, Yuting Zhang, Samir Saba Source Type: research

Meta-analysis of the Impact of Avoiding Balloon Predilation in Transcatheter Aortic Valve Implantation
Balloon predilation (BPD) has been an integral part of transcatheter aortic valve implantation (TAVI) since inception. We sought to investigate the effect of avoiding BPD on outcomes of TAVI across different valve types. Articles were included if outcomes of TAVI without BPD were reported. Pooled meta-analysis used a random effects model and reported Odds Ratios (OR). Twenty-one studies with 10,752 patients were pooled for analysis. Age and gender were well matched between NoBPD and BPD groups. There was no difference in mortality, stroke, bleeding, and acute kidney injury.
Source: The American Journal of Cardiology - April 30, 2018 Category: Cardiology Authors: Kinjal Banerjee, Krishna Kandregula, Kesavan Sankaramangalam, Anil Anumandla, Arnav Kumar, Parth Parikh, Jimmy Kerrigan, Shameer Khubber, Amar Krishnaswamy, Stephanie Mick, Jonathon White, Lars Svensson, Samir Kapadia Source Type: research

Embolic and Other Adverse Outcomes in Symptomatic Versus Asymptomatic Patients with Atrial Fibrillation (from the ORBIT-AF Registry)
We examined the incidence of major adverse outcomes in patients with asymptomatic versus symptomatic AF using ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), a nationwide US registry of AF patients. We compared stroke/non-CNS embolism, MACNE (Major Adverse Cardiovascular and Neurologic Events), bleeding, and death in 9,319 asymptomatic (defined by European Heart Rhythm Association (EHRA) score =1 or “no symptoms”) versus symptomatic patients.
Source: The American Journal of Cardiology - August 20, 2018 Category: Cardiology Authors: Munveer Thind, DaJuanicia N. Holmes, Marwan Badri, Karen S. Pieper, Amitoj Singh, Rosalia G. Blanco, Benjamin A. Steinberg, Gregg C. Fonarow, Bernard J. Gersh, Kenneth W. Mahaffey, Eric D. Peterson, James A. Reiffel, Jonathan P. Piccini, Peter R. Kowey, O Tags: Full Length Article Source Type: research

Impact of Body Mass Index on Outcomes in the Edoxaban Versus Warfarin Therapy Groups in Patients Undergoing Cardioversion of Atrial Fibrillation (From ENSURE-AF)
In the EdoxabaN versus warfarin in subjectS UndeRgoing cardiovErsion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban showed similar efficacy and safety vs enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation. In this ancillary analysis, we compared the primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular [CV] death, overall study period) and safety (composite of major and clinically relevant nonmajor [CRNM] bleeding, on-treatment) endpoints in relation to body mass index (BMI;
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, Maciej Banach, Joris R. de Groot, Lars S. Maier, Sakis Themistoclakis, Giuseppe Boriani, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Safety and Efficacy of Direct Oral Anticoagulants Versus Warfarin in Patients with Chronic Kidney Disease and Atrial Fibrillation
This study evaluated and compared the safety outcomes of DOACs versus warfarin in patients with non-valvular AF and concomitant CKD. Patients in our health system with AF prescribed oral anticoagulants during 2010 to 2017 were identified. All-cause mortality, bleeding, and hemorrhagic and ischemic stroke were evaluated based on degree of renal impairment and method of anticoagulation.
Source: The American Journal of Cardiology - October 30, 2019 Category: Cardiology Authors: Amber Makani, Samir Saba, Sandeep K. Jain, Aditya Bhonsale, Michael S. Sharbaugh, Floyd Thoma, Yisi Wang, Oscar C. Marroquin, Joon S. Lee, N.A. Mark Estes, Suresh R. Mulukutla Source Type: research

Long-term Follow-up of Transcatheter Aortic Valve Implantation with Portico vs. Evolut devices
New-generation devices such as Evolut and Portico have provided favorable results in patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing long-term outcomes, including the major adverse events (i.e. the composite of death, stroke, myocardial infarction, major vascular complication or major bleeding).
Source: The American Journal of Cardiology - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research

Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices
New-generation devices such as Evolut and Portico have provided favorable results in patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing on long-term outcomes, including major adverse events (i.e., the composite of death, stroke, myocardial infarction, major vascular complication, or major bleeding).
Source: The American Journal of Cardiology - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Observed versus Expected Ischemic and Bleeding Events Following Left Atrial Appendage Occlusion
Data on the efficacy of left atrial appendage occlusion (LAAO) in clinical practice are limited. We performed a systematic review and meta-analysis of observational studies that reported observed vs. expected rates of ischemic strokes and/or major bleeding following LAAO. Our primary end points were the pooled relative risk reduction (RRR) in ischemic stroke and major bleeding with corresponding 95% confidence intervals (CI) compared with what was expected by the CHA2DS2-VASc and HASBLED scores, respectively.
Source: The American Journal of Cardiology - March 13, 2020 Category: Cardiology Authors: Tatiana Busu, Safi U Khan, Muhammad Alhajji, Fahad Alqahtani, David R Holmes, Mohamad Alkhouli Source Type: research

Meta-analysis Comparing Multiple Arterial Grafts versus Single Arterial Graft for Coronary-Artery Bypass Grafting
Observational studies and randomized controlled trials (RCTs) have shown conflicting outcomes for multiple arterial graft (MAG) coronary artery bypass graft surgery (CABG) compared to single arterial grafts (SAGs). The predominant evidence supporting the use of MAGs is observational. The aim of this meta-analysis of RCTs is to compare outcomes following MAG and SAG. We searched multiple databases for RCTs comparing MAG versus SAG. The clinical outcomes studied were all-cause mortality, cardiac mortality, myocardial infarction (MI), revascularization, stroke, sternal wound complications, and major bleeding.
Source: The American Journal of Cardiology - June 14, 2020 Category: Cardiology Authors: Khalid Changal, Saqib Masroor, Ahmed Elzanaty, Mitra Patel, Tanveer Mir, Shayan Khan, Salik Nazir, Ronak Soni, Carson Oostra, Sadik Khuder, Ehab Eltahawy Source Type: research

Effects of Atrial Fibrillation and Chronic Kidney Disease on Major Adverse Cardiovascular Events
Atrial fibrillation (AF) is strongly linked to chronic kidney disease (CKD) and both of these conditions contribute to poor cardiovascular outcomes. We evaluated the impact of renal failure on major adverse cardiovascular events (MACE) in AF, and predictive value of the 2MACE score in this post-hoc analysis of the AMADEUS trial. The primary endpoint was MACE (composite of myocardial infarction, cardiac revascularisation and cardiovascular mortality). Secondary endpoints included the composite of stroke, major bleeding and non-cardiovascular mortality, and each of the specific outcomes separately.
Source: The American Journal of Cardiology - July 10, 2020 Category: Cardiology Authors: Wern Yew Ding, Gregory Y.H. Lip, Daniele Pastori, Alena Shantsila Source Type: research

Network Meta-analysis Comparing Apixaban versus Rivaroxaban in Morbidly Obese Patients with Atrial Fibrillation
The efficacy and safety of DOACs in morbidly obese patients have been well investigated over the last few years.1-4 Our recent meta-analysis showed that the DOAC group did not increase stroke or systemic embolism (SE) event rate compared to the warfarin group and the DOAC use was significantly associated with a lower major bleeding event rate compared to the warfarin group.5 However, it is still unknown which DOAC is more appropriate than others. Apixaban and rivaroxaban are the two most common DOACs prescribed in the U.S but there is no guidance on which agent should be selected in morbidly obese patients with AF.
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Kazuhiko Kido, Mikiko Shimizu, Tsuyoshi Shiga, Masayuki Hashiguchi Source Type: research

Comparison in Patients < 75 Years of Age - vs – Those > 75 Years on One-Year-Events with Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry)
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared to younger patients, they benefit from optimal anticoagulation. The sub-analysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients ( ≥ 75 years) compared to younger (
Source: The American Journal of Cardiology - September 13, 2020 Category: Cardiology Authors: Aref El Nasasra, Johannes Brachmann, Thorsten Lewalter, Ibrahim Akin, Horst Sievert, Christoph A. Nienaber, Christian Wei ß, Sven T. Pleger, Hüseyin Ince, Jens Maier, Stephan Achenbach, Holger H. Sigusch, Matthias Hochadel, Steffen Schneider, Jochen Sen Source Type: research

Outcomes of Transcatheter Aortic Valve Replacement with Percutaneous Coronary Intervention versus Surgical Aortic Valve Replacement with Coronary Artery Bypass Grafting
We aimed to compare the outcomes of combined surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG) to concurrent transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) in a large U.S. population sample. The National Inpatient Sample (NIS) was queried for all patients diagnosed with aortic valve stenosis who underwent SAVR with CABG or TAVR with PCI during the years 2016-2017. Study outcomes included all-cause in-hospital mortality, acute stroke, pacemaker insertion, vascular complications, major bleeding, acute kidney injury, sepsis, non-home discharge, le...
Source: The American Journal of Cardiology - September 25, 2020 Category: Cardiology Authors: Ashraf Abugroun, Mohammed Osman, Saria Awadalla, Lloyd Klein Source Type: research

Comparison in Patients < 75 Years of Age - Versus – Those > 75 Years on One-year-Events With Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry)
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared with younger patients, they benefit from optimal anticoagulation. The subanalysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients ( ≥ 75 years) compared with younger (
Source: The American Journal of Cardiology - September 13, 2020 Category: Cardiology Authors: Aref El Nasasra, Johannes Brachmann, Thorsten Lewalter, Ibrahim Akin, Horst Sievert, Christoph A. Nienaber, Christian Wei ß, Sven T. Pleger, Hüseyin Ince, Jens Maier, Stephan Achenbach, Holger H. Sigusch, Matthias Hochadel, Steffen Schneider, Jochen Sen Source Type: research

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