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Meta-analysis of Stroke and Bleeding Risk in Patients with Various Atrial Fibrillation Patterns Receiving Oral Anticoagulants
Oral anticoagulation therapy (OAT) is a mainstay for stroke prevention in atrial fibrillation (AF) patients. However, whether the risks of stroke/systemic embolic events (SEE) and bleeding events are affected by the type, duration, and frequency of AF in patients receiving OAT has been previously debated. We aimed to determine the risk of stroke/SEE and bleeding events associated with paroxysmal AF compared to persistent or permanent AF among patients who received OAT. Comprehensive literature searches of the Cochrane Library, PubMed/MEDLINE, and EMBASE databases were conducted from inception to July 2018.
Source: The American Journal of Cardiology - December 19, 2018 Category: Cardiology Authors: Weifang Zhang, Youwen Xiong, Lingling Yu, Aizhen Xiong, Huihui Bao, Xiaoshu Cheng 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

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

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

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n  = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients with Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients of nonvalvular atrial fibrillation with LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

Usefulness of the CHA2DS2-VASc and HAS-BLED Scores in Predicting the Risk of Stroke Versus Intracranial Bleeding in Patients With Atrial Fibrillation (from the FibStroke Study)
CHA2DS2-VASc and HAS-BLED scores stratify the risk of thromboembolic and bleeding events respectively in patients with atrial fibrillation. There is only little information on how they differentiate which of the 2 clinically most important complications (ischemic stroke [IS] or an intracranial bleeding [IB]) the patient is more prone to suffer. We evaluated both scores in patients with either of these major complications. The FibStroke Study collected data on all patients with atrial fibrillation with either an IS or an IB event between 2003 and 2012 in 4 Finnish hospital districts.
Source: The American Journal of Cardiology - February 12, 2018 Category: Cardiology Authors: Samuli Jaakkola, Tuomas O. Kiviniemi, Ilpo Nuotio, Juha Hartikainen, Pirjo Mustonen, Antti Palom äki, Jussi Jaakkola, Antti Ylitalo, Päivi Hartikainen, K.E. Juhani Airaksinen Source Type: research

Usefulness of the CHA2DS2-VASc and HAS-BLED Scores in Predicting the Risk of Stroke Versus Intracranial Bleeding in Patients with Atrial Fibrillation (From the FibStroke Study)
CHA2DS2-VASc and HAS-BLED scores stratify the risk of thromboembolic and bleeding events respectively in patients with atrial fibrillation (AF). There is only little information on how they differentiate which of the 2 clinically most important complications (ischemic stroke, IS or an intracranial bleeding, IB) the patient is more prone to suffer. We evaluated both scores in patients suffering either of these major complications. The FibStroke Study collected data on all patients with AF suffering either an ischemic stroke or an intracranial bleeding event between 2003-2012 in 4 Finnish hospital districts.
Source: The American Journal of Cardiology - February 12, 2018 Category: Cardiology Authors: Samuli Jaakkola, Tuomas O. Kiviniemi, Ilpo Nuotio, Juha Hartikainen, Pirjo Mustonen, Antti Palom äki, Jussi Jaakkola, Antti Ylitalo, Päivi Hartikainen, K.E. Juhani Airaksinen Source Type: research

Meta-Analysis Comparing Patent Foramen Ovale Closure Versus Medical Therapy to Prevent Recurrent Cryptogenic Stroke
New evidence suggests that closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials that compared PFO closure plus MT with MT alone in patients with cryptogenic stroke. The efficacy end points were recurrent stroke, transient ischemia attack, and death. The safety end points were major bleeding and newly detected atrial fibrillation.
Source: The American Journal of Cardiology - December 11, 2017 Category: Cardiology Authors: Tomo Ando, Anthony A. Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L. Grines, Sripal Bangalore Source Type: research

Meta-Analysis Comparing Patent Foramen Ovale Closure Versus Medical Therapy to Prevent Recurrent Stroke
It is unknown if closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials (RCT) that compared PFO closure plus MT to MT alone in patients with cryptogenic stroke. The efficacy endpoints were recurrent stroke, transient ischemia attack (TIA), and death. The safety endpoints were major bleeding and newly-detected atrial fibrillation (AF).
Source: The American Journal of Cardiology - December 11, 2017 Category: Cardiology Authors: Tomo Ando, Anthony A. Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L. Grines, Sripal Bangalore Source Type: research

Relation of Stroke and Bleeding Risk Profiles to Efficacy and Safety of Edoxaban for Cardioversion of Atrial Fibrillation (From the Edoxaban Versus Warfarin in Subjects Undergoing Cardioversion of Atrial Fibrillation ENSURE-AF Study)
In the ENSURE-AF study, edoxaban was compared to enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation, showing comparable low rates of bleeding and thromboembolism. This ancillary analysis investigated differences in relation to stroke and bleeding risk profiles. Secondly, we determined clinical risk profi les to quality of anticoagulation control in the warfarin arm. Primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular death) and safety (composite of major and clinically relevant nonmajor bleeding) outcomes and time to...
Source: The American Journal of Cardiology - October 26, 2017 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, G. Andrei Dan, Sakis Themistoclakis, Kenneth A. Ellenbogen, Raffaele De Caterina, Assen Goudev, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and End Stage Renal Disease
Over the last decade there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) demonstrated favorable clinical outcomes compared to warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) is a particularly complex issue. CKD and ESRD increase both the risk of stroke as well as bleeding, and since all of the NOACs undergo various level of renal clearance, rena...
Source: The American Journal of Cardiology - October 13, 2017 Category: Cardiology Authors: Marin Nishimura, Jonathan C. Hsu Source Type: research

Non –Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and End-Stage Renal Disease
Over the past decade, there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the non –vitamin K antagonist oral anticoagulants (NOACs) demonstrated favorable clinical outcomes compared with warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) are a part icularly complex issue. CKD and ESRD increase both the risk of stroke and bleeding, and since all of the NOACs undergo various levels of renal clearance, re...
Source: The American Journal of Cardiology - October 13, 2017 Category: Cardiology Authors: Marin Nishimura, Jonathan C. Hsu Tags: Review Source Type: research

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 in atrial fibrillation (AF). Using 2013-2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with AF who initiated apixaban, dabigatran, rivaroxaban, warfarin or no oral anticoagulation therapy in 2013-2014. 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

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

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