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Maȷor Bleeding Complications and Persistence With Oral Anticoagulation in Non-Valvular Atrial Fibrillation: Contemporary Findings in Real-Life Danish Patients Epidemiology
ConclusionsIn a real‐world cohort of nonvalvular atrial fibrillation patients, apixaban had a lower adjusted major bleeding risk compared with rivaroxaban, dabigatran, and warfarin. Apixaban had a lower risk of nonpersistence compared with dabigatran and warfarin and similar risk compared with rivaroxaban.
Source: JAHA:Journal of the American Heart Association - February 14, 2017 Category: Cardiology Authors: Lamberts, M., Staerk, L., Olesen, J. B., Fosbol, E. L., Hansen, M. L., Harboe, L., Lefevre, C., Evans, D., Gislason, G. H. Tags: Atrial Fibrillation, Epidemiology, Anticoagulants, Complications Original Research Source Type: research

Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation and Peripheral Artery Disease: Insights From the ARISTOTLE Trial Arrhythmia and Electrophysiology
ConclusionsPatients with PAD in ARISTOTLE had a higher crude risk of stroke or systemic embolism compared with patients without PAD that was not present after adjustment. The benefits of apixaban versus warfarin for stroke and systemic embolism were similar in patients with and without PAD. These findings highlight the need to optimize the treatment of patients with atrial fibrillation and PAD.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - January 17, 2017 Category: Cardiology Authors: Hu, P. T., Lopes, R. D., Stevens, S. R., Wallentin, L., Thomas, L., Alexander, J. H., Hanna, M., Lewis, B. S., Verheugt, F. W. A., Granger, C. B., Jones, W. S. Tags: Arrhythmias, Atrial Fibrillation, Anticoagulants, Peripheral Vascular Disease Original Research Source Type: research

Stability of High-Quality Warfarin Anticoagulation in a Community-Based Atrial Fibrillation Cohort: The Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study Epidemiology
Conclusions Nearly 60% of AF patients with high-quality TTR1 on warfarin maintained TTR ≥70% over the next 6 months. A minority deteriorated to very poor TTR. Patient features did not strongly predict TTR in the second 6-month period. Our analyses support watchful waiting for AF patients with initial high-quality warfarin anticoagulation before considering alternative anticoagulants.
Source: JAHA:Journal of the American Heart Association - July 21, 2016 Category: Cardiology Authors: Dallalzadeh, L. O., Go, A. S., Chang, Y., Borowsky, L. H., Fang, M. C., Singer, D. E. Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Anticoagulants Source Type: research

Effectiveness and Safety of Dabigatran, Rivaroxaban, and Apixaban Versus Warfarin in Nonvalvular Atrial Fibrillation Health Services and Outcomes Research
Conclusions In patients with nonvalvular atrial fibrillation, apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin.
Source: JAHA:Journal of the American Heart Association - June 12, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Sangaralingham, L. R., Bellolio, M. F., McBane, R. D., Shah, N. D., Noseworthy, P. A. Tags: Atrial Fibrillation, Secondary Prevention, Anticoagulants, Transplantation, Cerebrovascular Disease/Stroke Health Services and Outcomes Research Source Type: research

Efficacy and Safety of Edoxaban in Elderly Patients With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial Stroke
Conclusions Age has a greater influence on major bleeding than thromboembolic risk in patients with atrial fibrillation. Given the higher rates of bleeding and death with increasing age, treatment of elderly patients with edoxaban provides an even greater absolute reduction in safety events over warfarin, compared to treatment with edoxaban versus warfarin in younger patients. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Kato, E. T., Giugliano, R. P., Ruff, C. T., Koretsune, Y., Yamashita, T., Kiss, R. G., Nordio, F., Murphy, S. A., Kimura, T., Jin, J., Lanz, H., Mercuri, M., Braunwald, E., Antman, E. M. Tags: Atrial Fibrillation, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Source Type: research

Clinical Characteristics, Oral Anticoagulation Patterns, and Outcomes of Medicaid Patients With Atrial Fibrillation: Insights From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF I) Registry Health Services and Outcomes Research
Conclusions In a contemporary AF cohort, use of OAC overall and use of NOACs were not significantly lower among Medicaid patients relative to others. However, among warfarin users, Medicaid patients spent less time in therapeutic range compared with those with other forms of insurance.
Source: JAHA:Journal of the American Heart Association - May 3, 2016 Category: Cardiology Authors: O'Brien, E. C., Kim, S., Thomas, L., Fonarow, G. C., Kowey, P. R., Mahaffey, K. W., Gersh, B. J., Piccini, J. P., Peterson, E. D. Tags: Atrial Fibrillation, Primary Prevention, Health Services, Quality and Outcomes Health Services and Outcomes Research Source Type: research

Concomitant Use of Single Antiplatelet Therapy With Edoxaban or Warfarin in Patients With Atrial Fibrillation: Analysis From the ENGAGE AF-TIMI48 Trial Arrhythmia and Electrophysiology
Conclusions Patients with AF who were selected by their physicians to receive SAPT in addition to an anticoagulant had a similar risk of stroke/SEE and higher rates of bleeding than those not receiving SAPT. Edoxaban exhibited similar relative efficacy and reduced bleeding compared to warfarin, with or without concomitant SAPT. Clinical Trial Registration URL: http://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Xu, H., Ruff, C. T., Giugliano, R. P., Murphy, S. A., Nordio, F., Patel, I., Shi, M., Mercuri, M., Antman, E. M., Braunwald, E. Tags: Platelets, Chronic Ischemic Heart Disease, Anticoagulants, Acute Coronary Syndromes Arrhythmia and Electrophysiology Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial Stroke
Conclusions High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. Clinical Trial Registration URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - December 1, 2015 Category: Cardiology Authors: Rao, M. P., Halvorsen, S., Wojdyla, D., Thomas, L., Alexander, J. H., Hylek, E. M., Hanna, M., Bahit, M. C., Lopes, R. D., De Caterina, R., Erol, C., Goto, S., Lanas, F., Lewis, B. S., Husted, S., Gersh, B. J., Wallentin, L., Granger, C. B., the Apixaban Tags: Stroke Source Type: research

Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research

Stroke and Bleeding Risk Associated With Antithrombotic Therapy for Patients With Nonvalvular Atrial Fibrillation in Clinical Practice Health Services and Outcomes Research
Conclusions Continuation of antithrombotic therapy as well as maintaining an adequate level of TTR is beneficial to prevent strokes while minimizing bleeding events.
Source: JAHA:Journal of the American Heart Association - July 17, 2015 Category: Cardiology Authors: An, J., Niu, F., Lang, D. T., Jazdzewski, K. P., Le, P. T., Rashid, N., Meissner, B., Mendes, R., Dills, D. G., Aranda, G., Bruno, A. Tags: Health Services and Outcomes Research Source Type: research

Effectiveness and Safety of Dabigatran and Warfarin in Real-World US Patients With Non-Valvular Atrial Fibrillation: A Retrospective Cohort Study Health Services and Outcomes Research
Conclusions Dabigatran could be a safe and potentially more effective alternative to warfarin in patients with atrial fibrillation managed in routine practice settings.
Source: JAHA:Journal of the American Heart Association - April 10, 2015 Category: Cardiology Authors: Lauffenburger, J. C., Farley, J. F., Gehi, A. K., Rhoney, D. H., Brookhart, M. A., Fang, G. Tags: Health Services and Outcomes Research Source Type: research

Relationship Between Time in Therapeutic Range and Comparative Treatment Effect of Rivaroxaban and Warfarin: Results From the ROCKET AF Trial Arrhythmia and Electrophysiology
Conclusions The treatment effect of rivaroxaban compared with warfarin for the prevention of stroke and systemic embolism is consistent regardless of cTTR.
Source: JAHA:Journal of the American Heart Association - April 22, 2014 Category: Cardiology Authors: Piccini, J. P., Hellkamp, A. S., Lokhnygina, Y., Patel, M. R., Harrell, F. E., Singer, D. E., Becker, R. C., Breithardt, G., Halperin, J. L., Hankey, G. J., Berkowitz, S. D., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., ROCKET AF Investig Tags: Arrhythmia and Electrophysiology Source Type: research

Early Adoption of Dabigatran and Its Dosing in US Patients With Atrial Fibrillation: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation Health Services and Outcomes Research
Conclusions Patients receiving dabigatran were younger and at a lower risk of stroke and bleeding. Patients appeared to drive switching from warfarin, whereas clinical characteristics influenced de novo start of dabigatran. These data suggest cautious early uptake of dabigatran, and more careful attention to dosing adjustments is warranted. Clinical Trial Registration URL: Clinicaltrials.gov. Unique identifier: NCT01165710.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Steinberg, B. A., Holmes, D. N., Piccini, J. P., Ansell, J., Chang, P., Fonarow, G. C., Gersh, B., Mahaffey, K. W., Kowey, P. R., Ezekowitz, M. D., Singer, D. E., Thomas, L., Peterson, E. D., Hylek, E. M., The Outcomes Registry for Better Informed Treatme Tags: Health Services and Outcomes Research Source Type: research