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Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation.
CONCLUSIONS: -In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death, and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with non-valvular AF. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran. PMID: 25359164 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2014 Category: Cardiology Authors: Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, Sheu TC, Mott K, Goulding MR, Houstoun M, MaCurdy TE, Worrall C, Kelman JA Tags: Circulation Source Type: research

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012
Approximately half of patients with atrial fibrillation and with risk factors for stroke are not treated with oral anticoagulation (OAC), whether it be with vitamin K antagonists (VKAs) or novel OACs (NOACs); and of those treated, many discontinue treatment. Leaders from academia, government, industry, and professional societies convened in Washington, DC, on December 3-4, 2012, to identify barriers to optimal OAC use and adherence and to generate potential solutions. Participants identified a broad range of barriers, including knowledge gaps about stroke risk and the relative risks and benefits of anticoagulant therapies;...
Source: American Heart Journal - April 25, 2014 Category: Cardiology Authors: Paul L. Hess, Michael J. Mirro, Hans-Christoph Diener, John W. Eikelboom, Sana M. Al-Khatib, Elaine M. Hylek, Hayden B. Bosworth, Bernard J. Gersh, Daniel E. Singer, Greg Flaker, Jessica L. Mega, Eric D. Peterson, John S. Rumsfeld, Benjamin A. Steinberg, Tags: Results of Expert Meetings Source Type: research

A cluster-randomized controlled trial of a computerized antithrombotic risk assessment tool to optimize stroke prevention in general practice: a study protocol
This study (a prospective, cluster-randomized controlled clinical trial) will be conducted across selected regions in the state of New South Wales, Australia. Fifty GPs will be randomized to either the 'intervention' or 'control' arm, with each GP recruiting 10 patients (aged>=65 with AF); target sample size is 500 patients. GPs in the intervention arm will use CARAT during routine patient consultations to: assess risk factors for stroke, bleeding and medication misadventure; quantify the risk/benefit ratio of antithrombotic treatment, identify the recommended therapy, and decide on the treatment course, for an individual ...
Source: BMC Health Services Research - February 7, 2014 Category: Journals (General) Authors: Beata BajorekParker MaginSarah HilmerInes Krass Source Type: research

Warfarin therapy for atrial fibrillation in general practice - is bleeding risk underestimated?
Abstract BACKGROUND Atrial fibrillation causes a five-fold increase in the risk of thromboembolic stroke. Warfarin therapy reduces the risk by 64 %, but increases the risk of serious bleeding. We aimed to investigate the quality of warfarin therapy in a general practice and determine which patients would be likely to benefit from the treatment.MATERIAL AND METHOD We carried out retrospective registration of patients with atrial fibrillation, and calculated the risk of thromboembolism (CHA2DS2-VASc score) and of bleeding (HAS-BLED score) for each patient. Two alternative methods were used for calculating the absol...
Source: Tidsskrift for den Norske Laegeforening - January 28, 2014 Category: Journals (General) Authors: Bratland B, Hornnes MB Tags: Tidsskr Nor Laegeforen Source Type: research

The UK prevalence of hereditary haemorrhagic telangiectasia and its association with sex, socioeconomic status and region of residence: a population-based study
Conclusions HHT prevalence is more common in the UK population than previously demonstrated, though this updated figure is still likely to be an underestimate. HHT appears to be significantly under-diagnosed in men, which is likely to reflect their lower rates of consultation with primary care services. There is under-diagnosis in patients from lower socioeconomic groups and a marked variation in the prevalence of diagnosis between different geographical regions across the UK that requires further investigation.
Source: Thorax - January 15, 2014 Category: Respiratory Medicine Authors: Donaldson, J. W., McKeever, T. M., Hall, I. P., Hubbard, R. B., Fogarty, A. W. Tags: Epidemiologic studies, General practice / family medicine, Clinical genetics, Ear, nose and throat/otolaryngology Orphan lung disease Source Type: research

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