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Rationale, design and preliminary results of the Quebec Warfarin Cohort Study
ConclusionsThe QWC represents a good research opportunity to investigate clinical and genetic factors in a warfarin anticoagulated population.
Source: Clinical Cardiology - March 15, 2018 Category: Cardiology Authors: Sylvie Perreault, Payman Shahabi, Robert C ôté, Stéphanie Dumas, Étienne Rouleau‐Mailloux, Yassamin Feroz Zada, Sylvie Provost, Ian Mongrain, Marc Dorais, Thao Huynh, Simon Kouz, Ariel Diaz, Mark Blostein, Simon de Denus, Jacques Turgeon, Jeffrey Gi Tags: TRIAL DESIGNS Source Type: research

Efficacy and safety of rivaroxaban compared with warfarin in patients with carotid artery disease and nonvalvular atrial fibrillation: Insights from the ROCKET AF trial
ConclusionsPatients with CD in ROCKET AF had similar risk of stroke/SE compared with patients without CD. Additionally, there was no interaction between CD and the treatment effect of rivaroxaban or warfarin for stroke prevention or safety endpoints.
Source: Clinical Cardiology - December 1, 2017 Category: Cardiology Authors: Ajar Kochar, Anne S. Hellkamp, Yuliya Lokhnygina, W. Schuyler Jones, Richard C. Becker, Scott D. Berkowitz, G ünter Breithardt, Keith A.A. Fox, Jonathan L. Halperin, Graeme J. Hankey, Kenneth W. Mahaffey, Christopher C. Nessel, Daniel E. Singer, Jonathan Tags: CLINICAL INVESTIGATIONS Source Type: research

Incidence of thromboembolic and bleeding events in patients with newly diagnosed nonvalvular atrial fibrillation: An Asian multicenter retrospective cohort study in Singapore
ConclusionsSAPT and DAPT are less effective than warfarin in NVAF patients. DOACs may be considered in view of lower risk of overall bleed.
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Xue Ting Wee, Lih Maan Ho, Han Kiat Ho, Joyce Yu ‐Chia Lee, Chun Wei Yap, Henry William, Linus Chong En Chan, Hooi Ching Tay, Cynthia Eei Mei Goh, Doreen Su‐Yin Tan Tags: CLINICAL INVESTIGATIONS Source Type: research

Oral anticoagulation management in patients with atrial fibrillation undergoing cardiac implantable electronic device implantation
ConclusionsManagement of anticoagulation among AF patients undergoing CIED implantation is highly variable, with OAC being interrupted in more than half of both warfarin‐ and NOAC‐treated patients. Bleeding and stroke events were infrequent in both warfarin and NOAC‐treated patients.
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Eric Black ‐Maier, Sunghee Kim, Benjamin A. Steinberg, Gregg C. Fonarow, James V. Freeman, Peter R. Kowey, Jack Ansell, Bernard J. Gersh, Kenneth W. Mahaffey, Gerald Naccarelli, Elaine M. Hylek, Alan S. Go, Eric D. Peterson, Jonathan P. Piccini, Tags: CLINICAL INVESTIGATIONS Source Type: research

Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research

Design and Rationale of the RE ‐DUAL PCI Trial: A Prospective, Randomized, Phase 3b Study Comparing the Safety and Efficacy of Dual Antithrombotic Therapy With Dabigatran Etexilate Versus Warfarin Triple Therapy in Patients With Nonvalvular Atrial Fibrillation Who Have Undergone Percutaneous Coronary Intervention With Stenting
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest‐sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking. The RE‐DUAL PCI trial (NCT...
Source: Clinical Cardiology - July 31, 2016 Category: Cardiology Authors: Christopher P. Cannon, Savion Gropper, Deepak L. Bhatt, Stephen G. Ellis, Takeshi Kimura, Gregory Y.H. Lip, Ph. Gabriel Steg, Jurri ën M. Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M. Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll Tags: Trial Designs Source Type: research

Characterizing Major Bleeding in Patients With Nonvalvular Atrial Fibrillation: A Pharmacovigilance Study of 27 467 Patients Taking Rivaroxaban
ConclusionsIn this large observational study, the MB rate was generally consistent with the registration trial results, and fatal bleeds were rare.
Source: Clinical Cardiology - December 1, 2014 Category: Cardiology Authors: Sally Tamayo, W. Frank Peacock, Manesh Patel, Nicholas Sicignano, Kathleen P. Hopf, Larry E. Fields, Troy Sarich, Shujian Wu, Daniel Yannicelli, Zhong Yuan Tags: Quality and Outcomes Source Type: research

Practical Considerations for Using Novel Oral Anticoagulants in Patients With Atrial Fibrillation
Abstract Novel oral anticoagulants, including dabigatran, rivaroxaban, and apixaban, represent new options for preventing stroke in patients with atrial fibrillation, as shown by the results from large, randomized phase III trials. Because of their greater specificity, rapid onset of action, and predictable pharmacokinetics, the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) address several limitations of warfarin or other vitamin K antagonists in day‐to‐day clinical practice. However, a range of practical questions relating to the novel oral anticoagulants has emerged, including topics such as patie...
Source: Clinical Cardiology - November 19, 2013 Category: Cardiology Authors: Irene Savelieva, A. John Camm Tags: Review Source Type: research

Postdischarge International Normalized Ratio Testing and Long‐term Clinical Outcomes of Patients With Heart Failure Receiving Warfarin: Findings From the ADHERE Registry Linked to Medicare Claims
ConclusionsPostdischarge outpatient INR testing in patients with heart failure complicated by atrial fibrillation or valvular heart disease was high. INR testing was associated with improved survival and fewer myocardial infarctions at 1 year but was not independently associated with other adverse clinical events.
Source: Clinical Cardiology - October 1, 2013 Category: Cardiology Authors: Laura G. Qualls, Melissa A. Greiner, Zubin J. Eapen, Gregg C. Fonarow, Roger M. Mills, Winslow Klaskala, Adrian F. Hernandez, Lesley H. Curtis Tags: Clinical Investigation Source Type: research

Cost‐Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital
ConclusionsThe study favored dabigatran for stroke prophylaxis in patients with nonvalvular AF in Hong Kong under the current hospital's perspective and provided a reference for further comparisons under patient and subsidization perspectives.
Source: Clinical Cardiology - March 14, 2013 Category: Cardiology Authors: Andy M. Chang, Jason C. S. Ho, Bryan P. Yan, Cheuk Man Yu, Yat Yin Lam, Vivian W. Y. Lee Tags: Clinical Investigation Source Type: research

Novel Oral Anticoagulants in Atrial Fibrillation: A Meta‐analysis of Large, Randomized, Controlled Trials vs Warfarin
Conclusions:Novel oral anticoagulants may be superior to warfarin in patients with atrial fibrillation, reducing the composite of stroke or systemic embolism and lowering all‐cause mortality. The benefit is largely due to fewer hemorrhagic strokes.Ernesto Paolasso, MD, is a national lead investigator for a clinical trial sponsored by Daiichi‐Sankyo investigating a novel oral anticoagulant. Robert Giugliano, MD, SM, is a member of the TIMI Study Group, which has received research grant support from Johnson & Johnson and from Daiichi‐Sankyo related to clinical trials of anticoagulants. Dr. Giugliano has received ho...
Source: Clinical Cardiology - January 1, 2013 Category: Cardiology Authors: Ariel Dogliotti, Ernesto Paolasso, Robert P. Giugliano Tags: Review Source Type: research