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Source: Canadian Journal of Cardiology
Condition: Bleeding
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Total 60 results found since Jan 2013.
CHA2DS2-VASc Recalibration with an Additional Age Category (50-64 years) Enhances Stroke Risk Stratification in Chinese Atrial Fibrillation Patients
CONCLUSION Chinese patients with AF and low CHA2DS2-VASc score were at a disproportionally high risk of ischemic stroke. Chinese patients between 50-64 are at a high risk for stroke despite a low CHA2DS2-VASc score and have low bleeding risk. Only patients aged <50 years are truly low risk. Teaser Chinese atrial fibrillation (AF) patients with low CHA2DS2-VASc scores had a higher ischemic stroke risk than the Caucasians’ counterparts. In this study, we identified that even for Chinese AF patients aged 50-64 years, stroke risk is still markedly elevated. Only patients aged <50 belong to the truly low risk group.
Source: Canadian Journal of Cardiology - May 13, 2016 Category: Cardiology Source Type: research
The Risk Stratification and Stroke Prevention Therapy Care Gap in Canadian Atrial Fibrillation Patients
Conclusions In a large Canadian AF population, primary care physicians did not provide a stroke or bleeding risk in a substantial proportion of their AF patients. When estimates were provided, they were on the basis of a predictive stroke and bleeding risk index in less than half of the patients. Furthermore, there was under- and overestimation of stroke and bleeding risk in a substantial proportion of patients. As many as 1 in 3 patients receiving warfarin have their TTR < 60%. These findings suggest an opportunity to enhance knowledge translation to primary care physicians.
Source: Canadian Journal of Cardiology - October 23, 2015 Category: Cardiology Source Type: research
Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research
Association Between Patient and Physician Sex and Physician-Estimated Stroke and Bleeding Risks in Atrial Fibrillation
ConclusionsOur study is the first to examine the association between patient and physician sex influences and stroke and bleeding risk estimation in AF. While there were differences in agreement between physician estimated stroke risk and calculated CHADS2 scores, these differences were small and unlikely to impact clinical practice; further, despite any perceived differences in the accuracy of risk assessment by sex, most patients received anticoagulation.
Source: Canadian Journal of Cardiology - December 4, 2018 Category: Cardiology Source Type: research
Resident Physicians Choices of Anticoagulation for Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation
This study revealed that, across a wide sampling of disciplines and centers, resident physician choices of anticoagulation in nonvalvular AF differ significantly from contemporary CCS guidelines. Teaser The mainstay of atrial fibrillation (AF) management is stroke prevention using oral anticoagulants. We surveyed 1014 resident physicians from family medicine, emergency medicine, internal medicine and adult cardiology specialties. We found that resident physicians provide care to large number of AF patients and their choices of anticoagulation for stroke prevention are not congruent with the Canadian Cardiovascular Societyâ...
Source: Canadian Journal of Cardiology - August 15, 2015 Category: Cardiology Source Type: research
Antithrombotic treatments for stroke prevention in elderly patients with non-valvular atrial fibrillation: Drugs and doses
Publication date: Available online 14 June 2016 Source:Canadian Journal of Cardiology Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are prior stroke and age ≥75 years. Canadian guidelines recommend anticoagulant therapy for AF patients over the age of 65 but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagulants appear to be safer, at l...
Source: Canadian Journal of Cardiology - June 14, 2016 Category: Cardiology Source Type: research
Antithrombotic Treatments for Stroke Prevention in Elderly Patients With Nonvalvular Atrial Fibrillation: Drugs and Doses
Publication date: September 2016 Source:Canadian Journal of Cardiology, Volume 32, Issue 9 Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are previous stroke and age ≥ 75 years. Canadian guidelines recommend anticoagulant therapy for patients with AF who are older than the age of 65 years, but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagu...
Source: Canadian Journal of Cardiology - August 25, 2016 Category: Cardiology Source Type: research
Blinded Randomized trial of Anticoagulation to prevent Ischemic stroke and Neurocognitive impairment in AF (BRAIN-AF): Methods and design
ConclusionBRAIN-AF will determine whether oral anticoagulation therapy with rivaroxaban compared with standard of care reduces the risk of stroke, TIA or cognitive decline in patients with non-valvular AF and a low risk of stroke.
Source: Canadian Journal of Cardiology - May 8, 2019 Category: Cardiology Source Type: research
Cost-Effectiveness of Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation Patients with Contraindications to Anticoagulation
Conclusions LAAC is a novel stroke preventative therapy for non-valvular AF and is a cost-effective alternative to aspirin in patients with contraindications to OAC. Teaser We sought to evaluate the cost-effectiveness of left atrial appendage closure (LAAC) compared to aspirin in atrial fibrillation patients with contraindications to oral anticoagulation (OAC). A probabilistic patient-level Markov microsimulation model with lifetime horizon was performed. Aspirin was less effective than LAAC, with average discounted lifetime cost of $38,974±18,783 for aspirin and $30,748±11,600 for LAAC. LAAC was dominant, being more eff...
Source: Canadian Journal of Cardiology - February 25, 2016 Category: Cardiology Source Type: research
Clot lysis time predicts stroke during anticoagulant therapy in patients with atrial fibrillation
ConclusionsImpaired fibrinolysis may predict thromboembolic events in AF patients receiving VKA.
Source: Canadian Journal of Cardiology - August 8, 2019 Category: Cardiology Source Type: research
Importance of risk reassessment in patients with atrial fibrillation in guidelines: Assessing risk as a dynamic process
Publication date: Available online 2 February 2019Source: Canadian Journal of CardiologyAuthor(s): Ting-Yung Chang, Gregory Y.H. Lip, Shih-Ann Chen, Tze-Fan ChaoAbstractThe appropriate use of oral anticoagulants (OACs) for stroke prevention in atrial fibrillation (AF) relies on the convenient and accurate stroke risk prediction scheme, namely the CHA2DS2-VASc score. Since AF patients would become older and accumulate more comorbidities, their risk (for example, as reflected by the CHA2DS2-VASc scores) are not static and could increase over time. The available data demonstrated that follow-up and delta CHA2DS2-VASc scores p...
Source: Canadian Journal of Cardiology - February 2, 2019 Category: Cardiology Source Type: research
Left Atrial Appendage Closure for Atrial Fibrillation Is Safe and Effective After Intracranial or Intraocular Hemorrhage
Conclusions In our consecutive series, LAA closure was found to be safe and effective in patients with AF and a history of ICH or IOH.
Source: Canadian Journal of Cardiology - February 25, 2016 Category: Cardiology Source Type: research
The Effect of Bleeding Risk and Frailty Status on Anticoagulation Patterns in Octogenarians with Atrial Fibrillation: the FRAIL-AF study
Conclusion Our study suggests a higher prevalence of appropriate anticoagulation among octogenarians with atrial fibrillation than reported in previous studies. Further work is needed to develop and disseminate tools to optimize the use of anticoagulants in this high-risk population. Teaser Despite evidence-based recommendations, anticoagulation is not ubiquitous among octogenarians with atrial fibrillation. The objective of this study was to investigate the effect of thromboembolic risk, bleeding risk and frailty on the prevalence of anticoagulation for atrial fibrillation among hospitalized older adults in Montreal, Queb...
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
Uninterrupted new oral anticoagulants compared to uninterrupted Vitamin K antagonists in ablation of atrial fibrillation. A Meta-analysis
Conclusion Use of uninterrupted NOAC in ablation appears to be as safe and efficacious as uninterrupted VKA. Teaser This meta-analysis compares uninterrupted non vitamin K antagonists (NOAC) with uninterrupted vitamin K antagonists (VKA) in ablation of atrial fibrillation. A total of 3544 patients undergoing ablation with uninterrupted anticoagulation. Overall incidence of stroke/TIA was very low 0.16%, major bleeding was 0.5% and only once case of death reported in the uninterrupted VKA arm. Uninterrupted NOAC appears as safe as uninterrupted VKA with no difference in stroke/TIA, major bleeding, minor bleeding or cardiac tamponade.
Source: Canadian Journal of Cardiology - September 26, 2015 Category: Cardiology Source Type: research
Antithrombotic Therapy for Atrial Fibrillation and Coronary Disease de-Mystified
Publication date: Available online 20 August 2018Source: Canadian Journal of CardiologyAuthor(s): Jason G. Andrade, Marc W. Deyell, Graham C. Wong, Laurent MacleABSTRACTAtrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20-30% of those with AF also have coronary artery disease (CAD), and 5-15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on ischemic out...
Source: Canadian Journal of Cardiology - August 21, 2018 Category: Cardiology Source Type: research
