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Screening over 100 000 patients in 39 general practices in the Netherlands for anticoagulation underprescription in atrial fibrillation: a descriptive, cross-sectional study
Conclusions In this large Dutch study among GPs, we observed 9.8% underprescription of OAC in AF patients. In 76% of the AF patients lacking a prescription for OAC, no documentation for deviating from the guidelines was found. Only in a minority of cases detection of OAC underprescription lead to OAC initiation.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Voorhout, L., Pisters, R., Geurts, C. H. P. H., Oostindjer, A., van Doorn, S., Rila, H., Fuijkschot, W. W., Verheugt, F., Hemels, M. E. W. Tags: Open access, Cardiovascular medicine Source Type: research

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review
Conclusions OAC switching is common in patients with AF and patients often switch back to an OAC they have previously been on. There are aspects of OAC switching that have received little study, especially in switches from DOACs.
Source: BMJ Open - April 25, 2023 Category: General Medicine Authors: Adelakun, A. R., Turgeon, R. D., De Vera, M. A., McGrail, K., Loewen, P. S. Tags: Open access, Cardiovascular medicine Source Type: research

Vitamin-K-antagonist phenprocoumon versus direct oral anticoagulants in patients with atrial fibrillation: a real-world analysis of German claims data
Conclusions The small superiority or non-inferiority of DOACs over warfarin seen in the RCTs might not translate into relevant advantages of DOACs over phenprocoumon. To confirm the hypothesis, an RCT with phenprocoumon is needed. Next to the safety and effectiveness assessments other factors might also play a substantial role in the decision on the right OAC for stroke prevention.
Source: BMJ Open - January 2, 2023 Category: General Medicine Authors: Warkentin, L., Klohn, F., Deiters, B., Kühlein, T., Hueber, S. Tags: Open access, Pharmacology and therapeutics Source Type: research

Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Anticoagulants for people hospitalised with COVID-19
CONCLUSIONS: When compared to a lower-dose regimen, higher-dose anticoagulants result in little to no difference in all-cause mortality and increase minor bleeding in people hospitalised with COVID-19 up to 30 days. Higher-dose anticoagulants possibly reduce pulmonary embolism, slightly increase major bleeding, may result in little to no difference in hospitalisation time, and may result in little to no difference in deep vein thrombosis, stroke, major adverse limb events, myocardial infarction, atrial fibrillation, or thrombocytopenia. Compared with no treatment, anticoagulants may reduce all-cause mortality but the evide...
Source: Cochrane Database of Systematic Reviews - March 4, 2022 Category: General Medicine Authors: Ronald Lg Flumignan Vinicius T Civile J éssica Dantas de Sá Tinôco Patricia If Pascoal Libnah L Areias Charbel F Matar Britta Tendal Virginia Fm Trevisani Álvaro N Atallah Luis Cu Nakano Source Type: research

Informing the Choice of Direct Oral Anticoagulant Therapy in Patients With Atrial Fibrillation
Anticoagulation is the fundamental priority for the prevention of stroke in patients with atrial fibrillation, yet enthusiasm for use among patients at highest thromboembolic risk is often tempered by concern for increased bleeding. In one of the earliest studies evaluating vitamin K antagonists (VKA) in atrial fibrillation, Askey and Cherry noted in 1950 that anticoagulant use for thromboembolic prophylaxis requires “a reasonable assurance that the benefit will justify the bother and expense of control and the dangers of the drug,” and predicted that “safer anticoagulant drugs will be available eventually.” It wou...
Source: JAMA - December 21, 2021 Category: General Medicine Source Type: research

Gender differences in antithrombotic treatment in patients with atrial fibrillation from Spain versus the rest of Western Europe. GLORIA-AF Program
CONCLUSIONS: OAC rates were higher in Spain as compared to rWE. More women received OACs in Spain, while in rWE no difference by gender was observed. DOACs in rWE are the most prescribed OAC while in Spain, due to prescription barriers, its use remains low for both genders and VKAs are preferred. Spanish women received more DOACs compared to men. (NCT01468701).PMID:34895750 | DOI:10.1016/j.medcli.2021.09.016
Source: Medicina Clinica - December 13, 2021 Category: General Medicine Authors: Jos é L López-Sendón David Alonso-Rodr íguez Gonzalo Bar ón-Esquivias Juan Cosin-Sales Francisco Mar ín Jordi Galera-Llorca Natalia Jim énez Sabrina Marler Menno V Huisman Gregory Y H Lip Spanish GLORIA-AF investigators Source Type: research

Safety and efficacy of low-dose non-vitamin K antagonist oral anticoagulants versus warfarin after left atrial appendage closure with the Watchman device
CONCLUSION: The safety and efficacy of low-dose dabigatran and rivaroxaban were comparable to those of warfarin within 45 days after Watchman device implantation in a Chinese population.PMID:34740490 | DOI:10.1016/j.jfma.2021.10.015
Source: J Formos Med Assoc - November 6, 2021 Category: General Medicine Authors: Guohua Fu Binhao Wang Bin He Yibo Yu Zhao Wang Mingjun Feng Jing Liu Xianfeng Du Weidong Zhuo Huimin Chu Source Type: research

Prospective randomised trial examining the impact of an educational intervention versus usual care on anticoagulation therapy control based on an SAMe-TT2R2 score-guided strategy in anticoagulant-naïve Thai patients with atrial fibrillation (TREATS-AF): a study protocol
Introduction The burden of atrial fibrillation (AF) in Thailand is high and associated with increased morbidity, mortality and healthcare costs. Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention in patients with AF in Thailand, are effective but are often suboptimally controlled. We aim to evaluate the impact of an SAMe-TT2R2 score-guided strategy and educational intervention compared to usual care on anticoagulation control expressed by the time in therapeutic range (TTR) at 12 months, in anticoagulant-naïve Thai patients with AF. Methods and analysis Multicentre, open-label, parallel-grou...
Source: BMJ Open - October 11, 2021 Category: General Medicine Authors: Phrommintikul, A., Nathisuwan, S., Gunaparn, S., Krittayaphong, R., Wongcharoen, W., Sehmi, S., Mehta, S., Winkles, N., Brocklehurst, P., Mathers, J., Jowett, S., Jolly, K., Lane, D., Thomas, G. N., Lip, G. Y. H., TREATS-AF Study Group, Prasertwitayakij, Tags: Open access, Medical management Source Type: research

A Real-world Experience of the Safety and Efficacy of Non-vitamin K Oral Anticoagulants Versus Warfarin in Patients with Non-valvular Atrial Fibrillation-A Single-centre Retrospective Cohort Study in Singapore
CONCLUSION: NOACs were associated with similar stroke and major bleeding rates as warfarin for NVAF.PMID:33381777 | DOI:10.47102/annals-acadmedsg.2020184
Source: Ann Acad Med Singapo... - December 31, 2020 Category: General Medicine Authors: Wen Jun Tiew Vivien Lx Wong Vern Hsen Tan Yong Chuan Tan Elena Ms Lee Source Type: research

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