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Condition: Bleeding
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Total 143 results found since Jan 2013.
Quality of care in patients with atrial fibrillation in primary care: a cross-sectional study comparing clinical and claims data.
Conclusion: Our results suggest that a high rate of AF patients receive a drug therapy according to guidelines. There is a large difference between crude and adjusted OAC treatment rates. This is due to individual contraindications and comorbidities which cannot be documented using ICD coding. Therefore, quality indicators based on crude EMR data or claims data would lead to a systematic underestimation of the quality of care. A possible overtreatment of low-risk patients cannot be ruled out.
PMID: 27980520 [PubMed - in process]
Source: GMS German Medical Science - December 18, 2016 Category: Journals (General) Tags: Ger Med Sci Source Type: research
Different impact of aspirin on renal progression in patients with predialysis advanced chronic kidney disease with or without previous stroke.
CONCLUSIONS: There was no significant benefit in preventing ischemic stroke in the patients with advanced CKD who received aspirin therapy. Furthermore, the use of aspirin was associated with the risk of renal failure in the patients with advanced CKD without previous stroke.
PMID: 27884500 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - November 20, 2016 Category: Internal Medicine Authors: Hsiao KC, Huang JY, Lee CT, Hung TW, Liaw YP, Chang HR Tags: Eur J Intern Med Source Type: research
Prescribing trends of atrial fibrillation patients who switched from warfarin to a direct oral anticoagulant
AbstractDirect oral anticoagulant (DOAC) agents offer several lifestyle and therapeutic advantages for patients relative to warfarin in the treatment of atrial fibrillation (AF). These alternative agents are increasingly used in the treatment of AF, however the adoption practices, patient profiles, and reasons for switching to a DOAC from warfarin have not been well studied. Through the Michigan Anticoagulation Quality Improvement Initiative, abstracted data from 3873 AF patients, enrolled between 2010 and 2015, were collected on demographics and comorbid conditions, stroke and bleeding risk scores, and reasons for anticoa...
Source: Journal of Thrombosis and Thrombolysis - November 10, 2016 Category: Hematology Source Type: research
Short-Term Risk of Bleeding During Heparin Bridging at Initiation of Vitamin K Antagonist Therapy in More Than 90 000 Patients With Nonvalvular Atrial Fibrillation Managed in Outpatient Care Epidemiology
BackgroundSeveral studies have recently examined the risks of bleeding and of ischemic stroke and systemic embolism associated with perioperative heparin bridging anticoagulation in patients with nonvalvular atrial fibrillation. However, few studies have investigated bridging risks during vitamin K antagonist initiation in outpatient settings.Methods and ResultsA retrospective cohort study was conducted on individuals starting oral anticoagulation between January 2010 and November 2014 for nonvalvular atrial fibrillation managed in outpatient care and identified from French healthcare insurance. Bleeding and ischemic strok...
Source: JAHA:Journal of the American Heart Association - October 30, 2016 Category: Cardiology Authors: Bouillon, K., Bertrand, M., Boudali, L., Ducimetiere, P., Dray-Spira, R., Zureik, M. Tags: Atrial Fibrillation, Epidemiology Original Research Source Type: research
Impact of CHA2DS2VASc Score on Candidacy for Anticoagulation in Patients With Atrial Fibrillation: A Multipayer Analysis.
Abstract
PURPOSE: The purpose of this study is to report on the effect of using CHA2DS2VASc (congestive heart failure, hypertension, age ≥75 years [doubled], type 1 or type 2 diabetes mellitus, stroke or transient ischemic attack or thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) rather than CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke) to determine candidacy for anticoagulant prophylaxis in insured patients with atrial fibrillation (AF).
MET...
Source: Clinical Therapeutics - September 22, 2016 Category: Drugs & Pharmacology Authors: Patel AA, Nelson WW, Schein J Tags: Clin Ther Source Type: research
Thromboembolic, Bleeding, and Mortality Risks of Rivaroxaban and Dabigatran in Asians With Nonvalvular Atrial Fibrillation
BackgroundIt is unclear whether the non –vitamin K antagonist oral anticoagulant agents rivaroxaban and dabigatran are superior to warfarin for efficacy and safety outcomes in Asians with nonvalvular atrial fibrillation (NVAF).ObjectivesThe aim of this study was to compare the risk for thromboembolic events, bleeding, and mortality associated with rivaroxaban and dabigatran versus warfarin in Asians with NVAF.MethodsA nationwide retrospective cohort study was conducted of consecutive patients with NVAF taking rivaroxaban (n = 3,916), dabigatran (n = 5,921), or warfarin (n = 5,251) using data collected from the Taiwan...
Source: Journal of the American College of Cardiology - September 20, 2016 Category: Cardiology 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
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
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
Cardiovascular, Bleeding, and Mortality Risks of Dabigatran in Asians With Nonvalvular Atrial Fibrillation Clinical Sciences
Conclusions—
In real-world practice, dabigatran was associated with a reduced risk of ischemic stroke, intracranial hemorrhage, all hospitalized major bleeding, and all-cause mortality compared with warfarin in Asian patients with nonvalvular atrial fibrillation. Dabigatran did not increase the risk of major gastrointestinal bleeding or myocardial infarction compared with warfarin.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Chan, Y.-H., Yen, K.-C., See, L.-C., Chang, S.-H., Wu, L.-S., Lee, H.-F., Tu, H.-T., Yeh, Y.-H., Kuo, C.-T. Tags: Atrial Fibrillation, Cardiovascular Disease, Race and Ethnicity, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research
Antithrombotic use and bleeding risk in patients with atrial fibrillation: findings from a multipayer analysis.
CONCLUSION: Levels of thromboprophylaxis for high-risk AF patients in real-world data differ significantly from current medical guidelines for stroke prevention.
PMID: 26690040 [PubMed - as supplied by publisher]
Source: Journal of Comparative Effectiveness Research - December 23, 2015 Category: Journals (General) Tags: J Comp Eff Res Source Type: research
Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis - A Nationwide Cohort Study.
CONCLUSIONS: Among AMI patients on dialysis undergoing percutaneous coronary interventions, DES implantation significantly reduced the risk of recurrent MI, CV death and all-cause mortality compared with BMS implantation.
PMID: 26581755 [PubMed - as supplied by publisher]
Source: Circulation Journal - November 19, 2015 Category: Cardiology Authors: Chen DY, Mao CT, Tsai ML, Hsieh MJ, Lin YS, Cherng WJ, Wen MS, Wang CH, Hsieh IC, Hung MJ, Chen CC, Chen TH Tags: Circ J Source Type: research
Safety and effectiveness of dabigatran and warfarin in routine care of patients with atrial fibrillation.
In conclusion, in routine care of patients with non-valvular atrial fibrillation, dabigatran treatment resulted in improved health outcomes compared with warfarin.
PMID: 26446507 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - October 8, 2015 Category: Hematology Authors: Seeger JD, Bykov K, Bartels DB, Huybrechts K, Zint K, Schneeweiss S Tags: Thromb Haemost Source Type: research
Underutilization of warfarin for stroke prophylaxis in patients with atrial fibrillation or atrial flutter in Korea.
CONCLUSIONS: A high portion of AF/AFL patients with CHADS2 score ≥2 were undertreated with warfarin. As ischemic stroke is one of the leading causes of death in Korea, a more aggressive approach to prevent stroke in patients with AF/AFL is required.
PMID: 26242197 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - August 1, 2015 Category: Cardiology Authors: Lee IH, Kim H, Je NK Tags: J Cardiol Source Type: research
Predictors of Gastrointestinal Bleeding Among Patients with Atrial Fibrillation After Initiating Dabigatran Therapy
ConclusionThe risk of GI bleeding in patients receiving dabigatran is highly associated with increased age and cardiovascular, renal, and other comorbidities, even after adjusting for other factors. Fewer than 50% of patients restarted an anticoagulant after experiencing a GI bleed. Clinicians should continue to monitor for these risk factors or consider whether alternative therapies may be appropriate.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - May 1, 2015 Category: Drugs & Pharmacology Authors: Julie C. Lauffenburger, Denise H. Rhoney, Joel F. Farley, Anil K. Gehi, Gang Fang Tags: Original Research Article Source Type: research
