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Oral Anticoagulant Use in Patients With Atrial Fibrillation and Chronic Kidney Disease: A Review of the Evidence With Recommendations for Australian Clinical Practice
Chronic kidney disease is common in patients with atrial fibrillation (AF) and is associated with heightened risks of stroke/systemic embolisation and bleeding. In this review we outline the evidence for AF stroke prevention in kidney disease, identify current knowledge gaps, and give recommendations for anticoagulation at various stages of chronic kidney disease.Overall, anticoagulation is underused. Warfarin use becomes increasingly difficult with advancing kidney disease, with difficulty maintaining international normalised ratio (INR) in therapeutic range, increased risk of intracranial and fatal bleeding compared to n...
Source: Heart, Lung and Circulation - November 3, 2022 Category: Cardiology Authors: Christopher Hammett, Sunil V. Badve, Peter G. Kerr, Huyen A. Tran, Benjamin K. Dundon, Sidney Lo, Andrew Wong, Joanne E. Joseph, Jenny Deague, Vlado Perkovic Tags: Review Source Type: research

708 Stroke Prevention by Non-vitamin K Oral Anticoagulant (NOAC) Agents in the Absence of Atrial Fibrillation: Meta-analysis of Randomized Controlled Trials
Anticoagulation to prevent stroke is a mainstay of atrial fibrillation (AF) management. Use of warfarin in sinus rhythm reduces stroke rates, but with an increase in bleeding. The efficacy and safety of NOACs has not been studied.
Source: Heart, Lung and Circulation - November 8, 2020 Category: Cardiology Authors: K. Lander, P. Thakeria, A. Ha, S. Nayyar Source Type: research

Cardiac Surgery in Indigenous Australians: Early Onset Cardiac Disease with follow-up Challenges
Conclusions: The mean age of 52 years at which Indigenous patients have cardiac surgery is significantly low compared to non-Indigenous patients. Indigenous patients have multiple risk factors for cardiac disease and with a large number requiring emergency surgery. Although surgical outcome in the short term is favourable, a large number of patients are lost to follow-up. The use of mechanical valve and warfarin should be individualised. Strategic post-operative follow-up mechanisms are needed to address these issues.
Source: Heart, Lung and Circulation - February 24, 2014 Category: Cardiology Authors: M.P. Matebele, S. Rohde, A. Clarke, J.F. Fraser Tags: Original Articles Source Type: research

Percutaneous Transcatheter Left Atrial Appendage Closure Devices: Role in the Long-Term Management of Atrial Fibrillation
Conclusions: Percutaneous left atrial appendage occlusion is an exciting and novel therapy of stroke prevention in atrial fibrillation. Whilst further trials and long-term data are required prior to widespread implementation of this procedure, trials so far have highlighted the clinical efficacy of the procedure.
Source: Heart, Lung and Circulation - February 13, 2014 Category: Cardiology Authors: Chieh Howe (Gary) Gan, Aditya Bhat, Lloyd Davis, A. Robert Denniss Tags: Reviews Source Type: research

Does Local Data Support RE-LY?—A One Year Case Series Looking at Major Bleeds on Vitamin K Antagonists Prescribed for Non-valvular AF
Introduction: The RE-LY trial showed that Dabigatran was non-inferior in stroke or systemic embolism prevention to Warfarin . Life threatening bleeding was less for the 110mg dose and similar for the 150mg dose to Warfarin .
Source: Heart, Lung and Circulation - June 24, 2013 Category: Cardiology Authors: V. Mathavan, C. Nunn Tags: Abstracts Source Type: research

Bleeding Events Associated with Novel Anticoagulants: A Case Series
Until lately warfarin was the only valuable oral anticoagulant in stroke reduction in high risk cases with non valvular atrial fibrillation (NVAF). Although with warfarin the rate of stroke reduced notably, the major concern is the risk of serious bleeding and difficulty of establishing and maintaining the international normalised ratio (INR) within the therapeutic range. With the development of the novel anticoagulants we now have for the first time since the innovation of Warfarin feasible alternatives to it to decrease stroke rates in high risk patients with NVAF. To diminish adverse bleeding events with the novel antic...
Source: Heart, Lung and Circulation - May 30, 2013 Category: Cardiology Authors: Sam Mirzaee, Tara Thi Thien Tran, John Amerena Tags: Clinical Spotlights Source Type: research

Dabigatran for Anticoagulation in Atrial Fibrillation – Early Clinical Experience in a Hospital Population and Comparison to Trial Data
Conclusion: In this population our study demonstrates a discontinuation rate of 10% due to side effects of dabigatran, similar to the rate reported in RE-LY. The majority of patients are satisfied with their treatment and preferred dabigatran to warfarin, mainly due to the reduced requirement for blood testing.
Source: Heart, Lung and Circulation - October 10, 2012 Category: Cardiology Authors: Jonathan Michel, David Mundell, Tau Boga, Alexander Sasse Tags: Original Articles Source Type: research